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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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Hassan MM, Ameeq M, Tahir MH, Naz S, Fatima L, Kargbo A. Investigating socioeconomic disparities of Kangaroo mother care on preterm infant health outcomes. J Psychosom Obstet Gynaecol 2024; 45:2299982. [PMID: 38189314 DOI: 10.1080/0167482x.2023.2299982] [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: 10/31/2023] [Accepted: 12/22/2023] [Indexed: 01/09/2024] Open
Abstract
Several studies have been conducted to examine the complicated relationships between various factors that influence Kangaroo mother care (KMC) for preterm infants. However, the extended socio-economic model has not been seen in any of the previous studies that looked into the factors related to KMC and how it affects the health outcomes of babies born before in our study population. This study examines the various dimensions of KMC implementation and its influence on the health outcomes of premature infants. The current cross-sectional study was carried out in South Punjab, Pakistan, covering both private and public KMC units in obstetrics and gynecology departments. The study included a sample size of 719 patients and was conducted during a period covering 21 September 2022 to 14 October 2023. Multinomial logistic regression analysis is employed to ascertain the factors by using SPSS-26 (SPSS Inc., Chicago, IL). The use of folic acid (OR: 1.44; 95% CI: 0.87-3.11) and factor anemia (OR: 8.82; 95% CI: 1.69-14.59) no significantly correlated with better health outcomes, while environmental toxin exposure had a negative impact (OR: 0.90). The findings underscore the need for comprehensive interventions and policies to bridge socioeconomic gaps, ensuring all preterm infants benefit from KMC.
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Affiliation(s)
| | - Muhammad Ameeq
- Department of Statistics, The Islamia University, Bahawalpur, Pakistan
| | - M H Tahir
- Department of Statistics, The Islamia University, Bahawalpur, Pakistan
| | - Sidra Naz
- Department of Statistics, The Islamia University, Bahawalpur, Pakistan
| | - Laraib Fatima
- National College of Business Administration and Economics, Lahore, Pakistan
| | - Alpha Kargbo
- Department of Physical and Natural Sciences, University of The Gambia, Serrekunda, The Gambia
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Andreassen M, Borgestig M, Hemmingsson H. The psychosocial impact of eye-gaze assistive technology on everyday life of children and adults. Ann Med 2024; 56:2318397. [PMID: 38442288 PMCID: PMC10916903 DOI: 10.1080/07853890.2024.2318397] [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: 12/07/2023] [Accepted: 02/08/2024] [Indexed: 03/07/2024] Open
Abstract
PURPOSE This study investigates the psychosocial impact of eye-gaze assistive technology (EGAT) in both children and adults with long-term experience using eye-gaze assistive technology in everyday life, as well as the psychosocial impact as related to duration of use. METHODS In this descriptive comparative study, 34 adult and 27 child EGAT users participated in a structured individual interview using the Psychosocial Impact of Assistive Devices Scale (PIADS). RESULTS The participants' age ranged from 5-74 years, 50% were female and 52% had been diagnosed with cerebral palsy. The EGAT had a positive psychosocial impact on competence, adaptability, and self-esteem among adult and child users. Competence was the only subscale with a higher value for adults (p = 0.038), compared to children. The items with the highest impact for the psychosocial aspects were quality of life, ability to participate, and self-esteem. The adults had longer duration of use than children, but for high-, medium-, and low-duration users, the device showed a positive psychosocial impact. CONCLUSIONS Participants considered EGAT to have high positive impacts for participation and quality of life. The study adds new knowledge in that high positive psychosocial impact may be found even among low-duration users of EGAT, which is important to consider for service providers.
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Affiliation(s)
- Maria Andreassen
- Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, Sweden
| | - Maria Borgestig
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Helena Hemmingsson
- Department of Special Education, Stockholm University, Stockholm, Sweden
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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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Dostie R, Dunn H, Marks WN, Camden C, Lovo S. Use of telehealth for paediatric rehabilitation needs of Indigenous children - a scoping review. Int J Circumpolar Health 2024; 83:2308944. [PMID: 38320112 PMCID: PMC10848996 DOI: 10.1080/22423982.2024.2308944] [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: 12/04/2023] [Accepted: 01/18/2024] [Indexed: 02/08/2024] Open
Abstract
Telerehabilitation is proposed as a promising avenue to enhance service accessibility for Indigenous communities, yet its application for Indigenous children remains relatively unexplored. This scoping review followed the PRISMA-ScR framework to explore current knowledge on the use of telerehabilitation for Indigenous children. Ten scholarly databases, seven grey literature databases, reference searches, and expert consultations were utilised to identify relevant studies. Included articles discussed the use of telerehabilitation provided by rehabilitation professionals (e.g. occupational therapist (OT), physical therapist (PT), speech and language pathologist (SLP) to Indigenous children and/or caregivers. Seven studies were included. Telerehabilitation was explored in different ways, the most common being real-time videoconferencing by SLPs. While some studies explicitly acknowledged cultural responsiveness within both the research process and the intervention, most were not designed for Indigenous children and their caregivers; rather, these participants were included with non-Indigenous participants. Successful implementation and sustainability of telerehabilitation services requires addressing technological limitations, understanding, and respecting diverse worldviews, and co-developing services to meet the unique needs of Indigenous families. Telerehabilitation has been rarely used with Indigenous children and when it was, little attention was given to cultural considerations. These findings emphasise that future telerehabilitation interventions should be truly community-led to ensure cultural relevance.
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Affiliation(s)
- Rosalie Dostie
- School of rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Qc, Canada
| | - Hailey Dunn
- School of rehabilitation sciences, College of Medicine, Saskatchewan University, Saskatoon, SK, Canada
| | | | - Chantal Camden
- School of rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Qc, Canada
| | - Stacey Lovo
- School of rehabilitation sciences, College of Medicine, Saskatchewan University, Saskatoon, SK, Canada
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Biswakarma R, Maslowski K, Reiss MJ, Harper JC. Parenthood intentions of 16-18-year-olds in England: a survey of school students. HUM FERTIL 2024; 27:2310639. [PMID: 38346450 DOI: 10.1080/14647273.2024.2310639] [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: 02/15/2024]
Abstract
There is a need to understand teenagers' views towards having children to better tailor sexuality and reproductive health education. We conducted a survey of parenthood intentions for 16-18-year-old students. The survey was anonymous, contained open-ended and multiple-choice questions and was live from 10 May 2021 to 18 July 2022. The sample size was n = 931. Quantitative data were analysed descriptively and using chi-squared tests; qualitative data were analysed thematically. The majority of students (64%) indicated they wanted to have children in the future, with 49% desiring to have two children. Students who opted against having children cited the turbulent state of the world, concerns about parenthood, and, for many females, negative associations to pregnancy and childbirth. Many students felt concern about the possibility of having children in the future (45%), expressing concerns about their ability to have healthy children and worries about the lives their children might lead. Six themes were identified in their responses to the question 'What are your concerns about the possibility of having children in the future?': Fears; Self-doubt; Health and wellbeing; Big investment; Hinderance to personal aspirations; and Non-inclusive LGBTQ+ education. We conclude by making recommendations as to how school reproductive health and sex education might be improved.
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Affiliation(s)
- Rina Biswakarma
- IOE, UCL's Faculty of Education and Society, University College London, London, UK
| | | | - Michael J Reiss
- IOE, UCL's Faculty of Education and Society, University College London, London, UK
| | - Joyce C Harper
- EGA Institute for Women's Health, University College London, London, UK
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Li H, Duan J, Zhang T, Fu Y, Xu Y, Miao H, Ge X. miR-16-5p aggravates sepsis-associated acute kidney injury by inducing apoptosis. Ren Fail 2024; 46:2322688. [PMID: 38445373 PMCID: PMC10919310 DOI: 10.1080/0886022x.2024.2322688] [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: 10/12/2023] [Accepted: 02/19/2024] [Indexed: 03/07/2024] Open
Abstract
Sepsis-associated acute kidney injury (S-AKI) is a common disease in pediatric intensive care units (ICU) with high morbidity and mortality. The newly discovered results indicate that microRNAs (miRNAs) play an important role in the diagnosis and treatment of S-AKI and can be used as markers for early diagnosis. In this study, the expression level of miR-16-5p was found to be significantly upregulated about 20-fold in S-AKI patients, and it also increased by 1.9 times in the renal tissue of S-AKI mice. Receiver operating characteristic (ROC) curve analysis showed that miR-16-5p had the highest predictive accuracy in the diagnosis of S-AKI (AUC = 0.9188). In vitro, the expression level of miR-16-5p in HK-2 cells treated with 10 μg/mL lipopolysaccharide (LPS) increased by more than 2 times. In addition, LPS-exposed renal tissue and HK-2 cells lead to upregulation of inflammatory cytokines IL-6, IL-1β, TNF-a, and kidney damage molecules kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL). However, inhibition of miR-16-5p significantly mitigated LPS expose-mediated kidney injury and inflammation. Furthermore, LPS-exposed HK-2 cells increased more than 1.7-fold the expression levels of Bax and caspase-3, decreased 3.2-fold the expression level of B-cell lymphoma-2 (Bcl-2), and significantly promoted the occurrence of apoptosis. MiR-16-5p mimic further increased LPS-induced apoptosis in HK-2 cells. Nevertheless, inhibition of miR-16-5p significantly attenuated this effect. In summary, up-regulation of miR-16-5p expression can significantly aggravate renal injury and apoptosis in S-AKI, which also proves that miR-16-5p can be used as a potential biomarker to promote early identification of S-AKI.
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Affiliation(s)
- Han Li
- Department of Emergency/Critical Medicine, Children’s Hospital of Nanjing Medical University, Nanjing, PR China
- Jiangsu Key Laboratory of Children’s Major Disease Research, Jiangsu, PR China
| | - Junyan Duan
- Department of Pediatrics, Changzhou Second Peoples Hospital Affiliated to Nanjing Medical University, Changzhou, PR China
| | - Tongtong Zhang
- Department of Emergency/Critical Medicine, Children’s Hospital of Nanjing Medical University, Nanjing, PR China
| | - Yingjie Fu
- Department of Emergency/Critical Medicine, Children’s Hospital of Nanjing Medical University, Nanjing, PR China
| | - Yue Xu
- Department of Emergency/Critical Medicine, Children’s Hospital of Nanjing Medical University, Nanjing, PR China
| | - Hongjun Miao
- Department of Emergency/Critical Medicine, Children’s Hospital of Nanjing Medical University, Nanjing, PR China
| | - Xuhua Ge
- Department of Emergency/Critical Medicine, Children’s Hospital of Nanjing Medical University, Nanjing, PR China
- Jiangsu Key Laboratory of Children’s Major Disease Research, Jiangsu, PR China
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Kittelsen TB, Castor C, Lee A, Kvarme LG, Winger A. "What about me?": lived experiences of siblings living with a brother or sister with a life-threatening or life-limiting condition. Int J Qual Stud Health Well-being 2024; 19:2321645. [PMID: 38404038 PMCID: PMC10898268 DOI: 10.1080/17482631.2024.2321645] [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: 11/30/2023] [Accepted: 02/18/2024] [Indexed: 02/27/2024] Open
Abstract
BACKGROUND There is a lack of knowledge regarding siblings' experiences of being a brother or sister of a child with a life-threatening or life-limiting condition. Siblings' perspectives are often expressed through their parents and not by siblings themselves. METHOD This study has a qualitative design within hermeneutic phenomenology. Thirteen siblings (ages 3-29) of children with cancer or genetic conditions participated in semi-structured interviews. Analyses followed a thematic analysis guided by van Manen's lifeexistentials. RESULTS One overall theme, "What about me?", illustrates that siblings of children with LT/LL conditions are dealing with their own challenges and needs in the situation while also struggling to receive attention from their parents. The overall theme derives from three subthemes: living with heavy strains, feeling disregarded, and having needs of one's own. CONCLUSION The study revealed that siblings' own needs compete with the needs of the ill child, resulting in the risk of siblings taking a step back rather than expressing what they might actually need themselves. These findings can inform healthcare professionals on the importance of educating and supporting parents and the surrounding community close to the sibling, for example, by helping schoolteachers understand how to meet siblings' needs.
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Affiliation(s)
- Trine Brun Kittelsen
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | | | - Anja Lee
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital HF, Oslo, Norway
| | - Lisbeth Gravdal Kvarme
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Anette Winger
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
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Ganeshan G, Sekar H, Reilly S, Kuo C, Singh S, Michaels J, Yoong W. The effect of the COVID-19 pandemic on the mental health of obstetrics and gynaecology trainees: a world-wide literature review. J OBSTET GYNAECOL 2024; 44:2319791. [PMID: 38419407 DOI: 10.1080/01443615.2024.2319791] [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: 07/26/2023] [Accepted: 12/10/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Coronavirus (COVID-19) pandemic has affected the training and wellbeing of obstetrics and gynaecology (O&G) trainees. The aim of this review is to offer a worldwide overview on its' impact on the mental health of O&G trainees, so that measures can be put into place to better support trainees during the transition back to the 'new normal'. METHODS Key search terms used on PubMed and Google Scholar databases include: mental health, COVID-19, O&G, trainees, residents. RESULTS Fifteen articles (cumulative number of respondents = 3230) were identified, of which eight employed validated questionnaires (n = 1807 respondents), while non-validated questionnaires were used in seven (n = 1423 respondents). Studies showed that COVID-19 appeared to exert more of a negative impact on females and on senior trainees' mental health, while protective factors included marriage/partner and having had children. Validated and non-validated questionnaires suggested that trainees were exposed to high levels of anxiety and depression. Their mental health was also affected by insomnia, stress, burnout and fear of passing on the virus. DISCUSSION This review analyses the global impact of COVID-19 on O&G trainees' mental health, showing a pervasive negative effect linked to fear of the virus. Limited psychological support has led to prolonged issues, hindering patient safety and increasing sick leave. The study underscores the urgency of comprehensive support, particularly in female-dominated fields. Addressing these challenges is crucial for future pandemics, highlighting the need to learn from past mistakes and prioritise mental health resources for trainee well-being during and beyond pandemics.
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Affiliation(s)
- G Ganeshan
- St George's International School of Medicine, Grenada, Caribbean
| | - H Sekar
- Department of Obstetrics and Gynaecology, North Middlesex University Hospital, London, UK
| | - S Reilly
- Department of Obstetrics and Gynaecology, North Middlesex University Hospital, London, UK
| | - C Kuo
- St George's International School of Medicine, Grenada, Caribbean
| | - S Singh
- St George's International School of Medicine, Grenada, Caribbean
| | - J Michaels
- St George's International School of Medicine, Grenada, Caribbean
| | - W Yoong
- Department of Obstetrics and Gynaecology, North Middlesex University Hospital, London, UK
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Al-Kuran O, Jaber DZ, Ahmad A, Abdulfattah S, Mansour S, Abushqeer R, Al Muhaisen N, AlKuran L, AlKhalili M, Al-Mehaisen L. Understanding perspectives on neural tube defect management: insights from Jordanian parents. J Matern Fetal Neonatal Med 2024; 37:2334846. [PMID: 38584146 DOI: 10.1080/14767058.2024.2334846] [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: 02/12/2024] [Accepted: 03/20/2024] [Indexed: 04/09/2024]
Abstract
INTRODUCTION Neural tube defects (NTDs) represent a spectrum of heterogeneous birth anomalies characterized by the incomplete closure of the neural tube. In Jordan, NTDs are estimated to occur in approximately one out of every 1000 live births. Timely identification of NTDs during the 18-22 weeks of gestation period offers parents various management options, including intrauterine NTD repair and termination of pregnancy (TOP). This study aims to assess and compare parental knowledge and perceptions of these management modalities between parents of affected children and those with healthy offspring. MATERIALS AND METHODS This retrospective case-control study was conducted at Jordan University Hospital (JUH) using telephone-administered questionnaires. Categorical variables were summarized using counts and percentages, while continuous variables were analyzed using mean and standard deviation. The association between exposure variables and outcomes was explored using binary logistic regression. Data analysis was performed using SPSS for Windows version 26 (SPSS Inc., Chicago, IL). RESULTS The study sample comprised 143 participants, with 49.7% being parents of children with NTDs. The majority of NTD cases were associated with unplanned pregnancies, lack of folic acid supplementation, and postnatal diagnosis. Concerning parental knowledge of TOP in Jordan, 86% believed it to be legally permissible in certain situations. However, there was no statistically significant difference between cases and controls regarding attitudes toward TOP. While the majority of parents with NTD-affected children (88.7%) expressed a willingness to consider intrauterine surgery, this percentage decreased significantly (to 77.6%) after receiving detailed information about the procedure's risks and benefits (p = .013). CONCLUSIONS This study represents the first case-control investigational study in Jordan focusing on parental perspectives regarding TOP versus intrauterine repair of myelomeningocele following a diagnosis of an NTD-affected fetus. Based on our findings, we urge the implementation of a national and international surveillance program for NTDs, assessing the disease burden, facilitating resource allocation toward prevention strategies, and promoting early diagnosis initiatives either by using newly suggested diagnostic biomarkers or early Antenatal ultrasonography.
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Affiliation(s)
- Oqba Al-Kuran
- Fetomaternal Medicine, The University of Jordan, Amman, Jordan
| | - Dunia Z Jaber
- Medical School, The University of Jordan, Amman, Jordan
| | - Ahmad Ahmad
- Medical School, The University of Jordan, Amman, Jordan
| | | | - Sara Mansour
- Medical School, The University of Jordan, Amman, Jordan
| | | | | | - Lena AlKuran
- Medical School, The University of Jordan, Amman, Jordan
| | - Mais AlKhalili
- Medical School, Al-Balqa Applied University, Salt, Jordan
| | - Lama Al-Mehaisen
- Obstetrics and Gynecology Department, Al-Balqa Applied University, Salt, Jordan
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Pilkay S, Riffer A, Carroll A. Trauma context exerts intergenerational effects on child mental health via DNA methylation. Epigenetics 2024; 19:2333654. [PMID: 38577817 PMCID: PMC11000619 DOI: 10.1080/15592294.2024.2333654] [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: 09/15/2023] [Accepted: 03/18/2024] [Indexed: 04/06/2024] Open
Abstract
Many people experience traumatic or negative events, but few develop mental health issues as a result. This study investigated whether newborn DNA methylation (DNAm) previously associated with maternal childhood physical abuse by her father affected the child's mental health and physical growth, as well as whether it mediated or moderated developmental outcomes. METHODS Study sample (N = 903) and data came from Bristol University's Avon Longitudinal Study of Parents and Children. DNAm was measured in cord blood at birth. DNAm data was preprocessed, normalized, and quality controlled before subsetting to 60 CpG sites of interest from previous research. Linear regression analysis examined newborn DNAm and child development outcome associations. Sobel test examined the mediating relationship between mother's history of childhood abuse by father, newborn targeted gene DNAm of significant CpG sites, and child's mental health and physical growth. Moderation analyses examined the interaction effects between the significant CpG sites and mothers' physical abuse by their fathers on child's mental health and physical growth. RESULTS Full cohort analyses showed that newborn DNAm of several different CpG sites associates with separation anxiety, fear, and unhappy/tearful presentations in children aged 6-7 y. Sex-specific associations emerged with boys showing associations with anxiety and fear, and girls showing associations with fear and unhappiness. In boys only, cord blood DNAm mediates the effect of maternal childhood trauma on offspring mental health. No moderation effects emerged. CONCLUSION Intergenerational effects of mother's relationship to her abuser present in newborn DNAm associate with 7-year-old child's mental health, show sex-specific effects, and newborn DNAm does mediate maternal childhood trauma effects on offspring mental health in early-life.
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Affiliation(s)
- Stefanie Pilkay
- Falk College of Sport and Human Dynamics, School of Social Work, Syracuse University, Syracuse, NYUSA
| | - Andie Riffer
- Jane Addams College of Social Work, University of Illinois at Chicago, Chicago, IL, USA
| | - Andrew Carroll
- Falk College of Sport and Human Dynamics, School of Social Work, Syracuse University, Syracuse, NYUSA
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Wimalachandra M, Dissanayake R, Raj R, Kulasekeraraj A, Samarasinghe S, Gooneratne L. Donor-type bone marrow aplasia following hematopoietic stem cell transplantation in a child with a novel SAMD9L variant. Hematology 2024; 29:2337160. [PMID: 38597819 DOI: 10.1080/16078454.2024.2337160] [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: 10/16/2023] [Accepted: 03/26/2024] [Indexed: 04/11/2024] Open
Abstract
Pathogenic variants in the genes SAMD9 (sterile a-motif domain containing protein - 9) and SAMD9L (SAMD9-like) cause bone marrow failure with characteristic syndromic features. We report a case of a previously healthy, 3-year-old boy with no dysmorphology, who presented with severe aplastic anemia and a novel variant in the SAMD9L gene. His father, elder brother and sister who harbored the same variant were completely healthy. In the absence of a matched unrelated donor, he underwent a stem cell transplant from his sister, a 10/10 match. Almost 2 years later he developed donor type aplasia and succumbed to an invasive fungal infection after a failed haplograft from his mother. This case highlights the pathogenicity of this previously undescribed germline variation of uncertain significance in the SAMD9L gene and the value of comprehensive genetic testing for inherited bone marrow failures even in the absence of a positive family history or characteristic congenital abnormalities.
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Affiliation(s)
| | - Ruwangi Dissanayake
- Department of Paediatrics, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Revathi Raj
- Department of Paediatric Hematology, Oncology and Blood and Marrow Transplantation, Apollo Cancer Institutes, Chennai, India
| | | | | | - Lallindra Gooneratne
- Department of Pathology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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Hatcherson J. Nose of dog, eye of elk, and wolf's liver: exploring the interconnectedness of Indigenous health and foraging among the Dukha reindeer herders of Mongolia. Int J Circumpolar Health 2024; 83:2343454. [PMID: 38634711 PMCID: PMC11028006 DOI: 10.1080/22423982.2024.2343454] [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: 12/11/2023] [Accepted: 04/11/2024] [Indexed: 04/19/2024] Open
Abstract
Recent studies show that Traditional Ecological Knowledge (TEK) of Indigenous Peoples' food systems and the transfer of that knowledge to their children are critical to physical and mental health, promote the transfer of language and culture, and further resilience. The aim of this exploratory, medical ecological study was to document TEK about foraging and plant use among the Dukha, a small, semi-nomadic reindeer herding community in Northern Mongolia. Field research was conducted at multiple remote camps in 2019 and 2023. Methods included semi-structured, open-ended interviews (N = 16), photo identification, and participant observation (N = 34 families). Study Informants identified 27 foraged plants. Results placed Dukha foraging practices within a framework illustrating the interconnectedness of their worldview and cultural norms, including the physical and spiritual aspects of the landscape, with health, illness, and curing. Dukha curative knowledge of the flora aligns with both Traditional Mongolian Medicine (TMM) and scientific studies on healing and preventative care. Through foraging and plant use, the Dukha balance relationships with the land and spirits, benefit from better nutrition and physical activity, utilise healing qualities of indigenous flora, and foster the intergenerational transfer of language and traditional knowledge.
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Ning X, Li L, Liu J, Wang F, Tan K, Li W, Zhou K, Jing S, Lin A, Bi J, Zhao S, Deng H, Zhu C, Lv S, Li J, Liang J, Zhao Q, Wang Y, Chen B, Zhu L, Shen G, Liu J, Li Z, Deng J, Zhao X, Shan M, Wang Y, Liu S, Jiang T, Chen X, Zhang Y, Cai S, Wang L, Lu X, Jiang J, Dong F, Ye L, Sun J, Yao K, Yang Y, Liu G. Invasive pneumococcal diseases in Chinese children: a multicentre hospital-based active surveillance from 2019 to 2021. Emerg Microbes Infect 2024; 13:2332670. [PMID: 38646911 PMCID: PMC11047219 DOI: 10.1080/22221751.2024.2332670] [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: 01/14/2024] [Accepted: 03/15/2024] [Indexed: 04/23/2024]
Abstract
This study aimed to provide data for the clinical features of invasive pneumococcal disease (IPD) and the molecular characteristics of Streptococcus pneumoniae isolates from paediatric patients in China. We conducted a multi-centre prospective study for IPD in 19 hospitals across China from January 2019 to December 2021. Data of demographic characteristics, risk factors for IPD, death, and disability was collected and analysed. Serotypes, antibiotic susceptibility, and multi-locus sequence typing (MLST) of pneumococcal isolates were also detected. A total of 478 IPD cases and 355 pneumococcal isolates were enrolled. Among the patients, 260 were male, and the median age was 35 months (interquartile range, 12-46 months). Septicaemia (37.7%), meningitis (32.4%), and pneumonia (27.8%) were common disease types, and 46 (9.6%) patients died from IPD. Thirty-four serotypes were detected, 19F (24.2%), 14 (17.7%), 23F (14.9%), 6B (10.4%) and 19A (9.6%) were common serotypes. Pneumococcal isolates were highly resistant to macrolides (98.3%), tetracycline (94.1%), and trimethoprim/sulfamethoxazole (70.7%). Non-sensitive rates of penicillin were 6.2% and 83.3% in non-meningitis and meningitis isolates. 19F-ST271, 19A-ST320 and 14-ST876 showed high resistance to antibiotics. This multi-centre study reports the clinical features of IPD and demonstrates serotype distribution and antibiotic resistance of pneumococcal isolates in Chinese children. There exists the potential to reduce IPD by improved uptake of pneumococcal vaccination, and continued surveillance is warranted.
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Affiliation(s)
- Xue Ning
- Key Laboratory of Major Diseases in Children, Ministry of Education, Department of Infectious Diseases, National Center for Children’s Health, Beijing Children’s Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Lianmei Li
- Department of Infectious and Digestive Diseases, Qinghai Province Women and Children's Hospital, Xining, People’s Republic of China
| | - Jing Liu
- Department of Infectious Diseases, Hunan Children’s Hospital, Changsha, People’s Republic of China
| | - Fang Wang
- Department of Infectious Diseases, Henan Children’s Hospital, (Children's Hospital Affiliated of Zhengzhou University, Zhengzhou Children's Hospital), Zhengzhou, People’s Republic of China
| | - Kun Tan
- Department of Infectious Diseases, Shenzhen Children’s Hospital, Shenzhen, People’s Republic of China
| | - Wenhui Li
- Department of Infectious and Digestive Diseases, Children’s Hospital of Hebei Province, Shijiazhuang, People’s Republic of China
| | - Kai Zhou
- Department of Infectious Diseases, Children’s Hospital of Nanjing Medical University, Nanjing, People’s Republic of China
| | - Shujun Jing
- Department of Infectious Diseases, Dalian Children’s Hospital, Dalian, People’s Republic of China
| | - Aiwei Lin
- Department of Infectious Diseases, Children’s Hospital Affiliated to Shandong University, Jinan, People’s Republic of China
- Jinan Children’s Hospital, Shandong University, Jinan, People’s Republic of China
| | - Jing Bi
- Department of Infectious Diseases, Baoding Children’s Hospital, Baoding, People’s Republic of China
| | - Shiyong Zhao
- Department of Infectious Diseases, Hangzhou Children’s Hospital, Hangzhou, People’s Republic of China
| | - Huiling Deng
- Department of Infectious Diseases, Xian Children’s Hospital, Xian, People’s Republic of China
| | - Chunhui Zhu
- Department of Infectious Diseases, Children’s Hospital of Jiangxi Province, Nanchang, People’s Republic of China
| | - Shanshan Lv
- Department of Infectious Diseases, Changchun Children’s Hospital, Changchun, People’s Republic of China
| | - Juan Li
- Department of Infectious Diseases, Urumqi Children’s Hospital, Urumqi, People’s Republic of China
| | - Jun Liang
- Department of Pediatric Intensive Care Unit, People’s Hospital of Liaocheng, Liaocheng, People’s Republic of China
| | - Qing Zhao
- Department of Infectious Diseases, Children’s Hospital of Shanxi Province, Taiyuan, People’s Republic of China
| | - Yumin Wang
- Department of Infectious Diseases, Maternal and Child Health Care Hospital of the Inner Mongolia autonomous region, Huhehaote, People’s Republic of China
| | - Biquan Chen
- Department of Infectious Diseases, Anhui Provincial Children’s Hospital, Hefei, People’s Republic of China
| | - Liang Zhu
- Key Laboratory of Major Diseases in Children, Ministry of Education, Department of Infectious Diseases, National Center for Children’s Health, Beijing Children’s Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Guowu Shen
- Department of clinical laboratory, Qinghai Province Women and Children's Hospital, Xining, People’s Republic of China
| | - Jianlong Liu
- Department of clinic laboratory, Hunan Children’s Hospital, Changsha, People’s Republic of China
| | - Zhi Li
- Department of Infectious Diseases, Henan Children’s Hospital, (Children's Hospital Affiliated of Zhengzhou University, Zhengzhou Children's Hospital), Zhengzhou, People’s Republic of China
| | - Jikui Deng
- Department of Infectious Diseases, Shenzhen Children’s Hospital, Shenzhen, People’s Republic of China
| | - Xin Zhao
- Department of Infectious and Digestive Diseases, Children’s Hospital of Hebei Province, Shijiazhuang, People’s Republic of China
| | - Mingfeng Shan
- Department of Infectious Diseases, Children’s Hospital of Nanjing Medical University, Nanjing, People’s Republic of China
| | - Yi Wang
- Department of Infectious Diseases, Dalian Children’s Hospital, Dalian, People’s Republic of China
| | - Shihua Liu
- Department of Infectious Diseases, Children’s Hospital Affiliated to Shandong University, Jinan, People’s Republic of China
- Jinan Children’s Hospital, Shandong University, Jinan, People’s Republic of China
| | - Tingting Jiang
- Department of Infectious Diseases, Baoding Children’s Hospital, Baoding, People’s Republic of China
| | - Xuexia Chen
- Department of Infectious Diseases, Hangzhou Children’s Hospital, Hangzhou, People’s Republic of China
| | - Yufeng Zhang
- Department of Infectious Diseases, Xian Children’s Hospital, Xian, People’s Republic of China
| | - Sha Cai
- Department of Infectious Diseases, Children’s Hospital of Jiangxi Province, Nanchang, People’s Republic of China
| | - Lixue Wang
- Department of Infectious Diseases, Changchun Children’s Hospital, Changchun, People’s Republic of China
| | - Xudong Lu
- Department of Infectious Diseases, Urumqi Children’s Hospital, Urumqi, People’s Republic of China
| | - Jinghui Jiang
- Department of Pediatric Intensive Care Unit, People’s Hospital of Liaocheng, Liaocheng, People’s Republic of China
| | - Fang Dong
- Department of Infectious Diseases, Children’s Hospital of Shanxi Province, Taiyuan, People’s Republic of China
| | - Lan Ye
- Department of Infectious Diseases, Maternal and Child Health Care Hospital of the Inner Mongolia autonomous region, Huhehaote, People’s Republic of China
| | - Jing Sun
- Department of Infectious Diseases, Anhui Provincial Children’s Hospital, Hefei, People’s Republic of China
| | - Kaihu Yao
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing, People’s Republic of China
| | - Yonghong Yang
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing, People’s Republic of China
| | - Gang Liu
- Key Laboratory of Major Diseases in Children, Ministry of Education, Department of Infectious Diseases, National Center for Children’s Health, Beijing Children’s Hospital, Capital Medical University, Beijing, People’s Republic of China
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Ayele A, Abera S, Edin A, Jara D, Amaje E. Does neonatal resuscitation associated with neonatal death in low-resource settings? A follow-up study. J Matern Fetal Neonatal Med 2024; 37:2285234. [PMID: 38105523 DOI: 10.1080/14767058.2023.2285234] [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: 06/28/2023] [Accepted: 11/14/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND The newborn period is the most vulnerable phase for a child's survival, with around half of all under-five deaths worldwide occurring during this time. Despite existing policies and measures, Ethiopia ranks among the top 10 African countries in terms of newborn mortality. In spite of many studies being carried out in the country, the incidence and predictors of neonatal mortality in the Pastoralist and agro-pastoralist parts of the country's southern still remain unidentified. Therefore, this study aimed to identify the predictors of neonatal mortality in selected public Hospitals in southern Ethiopia. MATERIALS AND METHODS An institution-based retrospective cohort study was conducted among 568 neonates admitted to the neonatal intensive care unit at Bule Hora University teaching Hospital and Yabelo General Hospital, Southern Ethiopia from 1 January 2020-31 December 2021. A simple random sampling technique was used to select records of neonates. Data entry was performed using Epidata version 3.1 and the analysis was performed using STATA version 14.1 Kaplan Meir curve and Log-rank test were used to estimate the survival time and compare survival curves between variables. Hazard Ratios with 95% CI were computed and all the predictors associated with the outcome variable at p-value 0.05 in the multivariable cox proportional hazards analysis were declared as a significant predictor of neonatal death. RESULTS Out of 565 neonates enrolled, 54(9.56%) neonates died at the end of the follow-up period. The overall incidence rate of death was 17.29 (95% CI: 13.24, 22.57) per 1000 neonatal days with a restricted mean follow-up period of 20 days. Of all deaths, 64.15% of neonates died within the first week of life. In the multivariable cox-proportional hazard model, neonatal age < 7 days (AHR: 9.17, 95% CI: (4.17, 20.13), place of delivery (AHR: 2.48, 95% CI: (1.38, 4.47), Initiation of breastfeeding after 1 h of birth (AHR: 6.46, 95% CI: (2.24, 18.59), neonates' body temperature <36.5 °C (AHR: 2.14, 95% CI: (1.19, 3.83), and resuscitated neonates (AHR: 2.15, 95% CI: (1.20, 3.82) were independent predictors of neonatal death. CONCLUSION In the research setting, the incidence of neonatal death was high, especially during the first week of life. The study found that neonatal age < 7 days, place of delivery, Initiation of breastfeeding after 1 h of birth, neonates' body temperature <36.5 °C, and resuscitated neonates were predictors of neonatal death. To improve newborn survival, significant neonatal problems, improved resuscitation, and other relevant factors should be addressed.
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Affiliation(s)
- Angefa Ayele
- Department of Epidemiology, School of public Health, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
| | - Sewunet Abera
- Department of Epidemiology, School of public Health, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
| | - Alo Edin
- Department of Epidemiology, School of public Health, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
| | - Dube Jara
- Department of Epidemiology, School of public Health, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
- Department of Public Health, College of Health sciences, Salale University, Fiche, Ethiopia
| | - Elias Amaje
- Department of Epidemiology, School of public Health, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
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Zhang L, Piao J, Zhang W, Liu N, Zhang X, Shen Y, Jin Y, Wang F, Feng S. Physical activity changes and influencing factors among Chinese pregnant women: a longitudinal study. J Matern Fetal Neonatal Med 2024; 37:2306190. [PMID: 38262926 DOI: 10.1080/14767058.2024.2306190] [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: 08/30/2023] [Accepted: 01/11/2024] [Indexed: 01/25/2024]
Abstract
OBJECTIVE Participating in physical activity during pregnancy has benefited a lot from maternal and child health. However, there are few longitudinal studies describing activity patterns and related factors during pregnancy. The aim of this study is to investigate longitudinal physical activity changes and the influencing factors of Chinese pregnant women. METHODS From January to August 2020, 240 pregnant women were recruited in Hangzhou, China. Physical activity during pregnancy was assessed in the first, second, and third trimesters of pregnancy by using the Pregnancy Physical Activity Questionnaire. RESULTS The daily energy consumption during first, second, and third trimesters was 20.55, 20.76, 17.19 METs-h/d. The results of repeated-measure analysis of variance and pairwise comparison showed that the total daily energy consumption of physical activity in the third trimester was significantly lower than that in the first and second trimesters, with statistical significance (p < 0.001). The generalized estimation equation showed that education level, pre-pregnancy BMI, gravidity, unnaturally conceived and pre-pregnancy exercise habits were the influencing factors of physical activity during pregnancy (p < 0.05). CONCLUSION Physical activity levels of pregnant women during different trimester were not optimistic. In order to improve physical activity during pregnancy and promote the health status of both mother and the developing baby, more attention should be paid on pregnant women with low education level, high BMI before pregnancy, primipara, unnaturally conceived and no good exercise habits before pregnancy.
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Affiliation(s)
- Le Zhang
- Department of Nursing, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jinlan Piao
- Department of Nursing, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Wei Zhang
- Department of Nursing, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ningning Liu
- Department of Nursing, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xuesong Zhang
- Department of Nursing, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yu Shen
- Department of Nursing, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ying Jin
- Department of Nursing, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Fangfang Wang
- Department of Obstetric, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Suwen Feng
- Department of Nursing, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Brown A, Tornberg ÅB, Kristensson Hallström I. Parents' lived experience of early risk assessment for cerebral palsy in their young child using a mobile application after discharge from hospital in the newborn period. Ann Med 2024; 56:2309606. [PMID: 38300887 PMCID: PMC10836479 DOI: 10.1080/07853890.2024.2309606] [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: 02/28/2022] [Accepted: 01/15/2024] [Indexed: 02/03/2024] Open
Abstract
INTRODUCTION General Movement assessment (GMA) is considered the golden standard for early identification of infants with a high risk of developing cerebral palsy (CP). The aim of this study was to explore parents' lived experience of early risk assessment for CP using a mobile application for home video recording after discharge from hospital stay in the newborn period. METHODS An inductive qualitative design using a hermeneutical phenomenological approach was chosen, and fourteen parents with children at risk of CP were interviewed at home. The hermeneutical phenomenological approach describes humans' lived experiences of a specific phenomenon with a possibility of deeper understanding of the expressed statements. The interviews were analyzed using the fundamental lifeworld existential dimensions as guidelines for describing the parents' lived experience. RESULTS The overall understanding of the parents' experience was 'Finding control in an uncontrolled life situation'. During the often-long hospitalizations, the parents struggled with loss of control and difficulty in understanding what was going on. The use of the mobile application followed by a swift result made them feel in control and have a brighter view of the future. CONCLUSIONS The findings suggest that the mobile application did not seem to worry the parents. Instead, it provided the parents with a sense of active participation in the care and treatment of their child. The mobile application should be accompanied with clear instructions and guidelines for the parents and details about how and when the result is given.
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Affiliation(s)
- Annemette Brown
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
- Department of Pediatrics and Adolescence Medicine, Nordsjælland University Hospital, Capital Region of Denmark, Denmark
- Department of Neurology and Physiotherapy, Nordsjællands Hospital, Capital Region of Denmark, Denmark
| | - Åsa B. Tornberg
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
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Lan X, Ao WL, Li J. Preimplantation genetic testing as a preventive strategy for the transmission of mitochondrial DNA disorders. Syst Biol Reprod Med 2024; 70:38-51. [PMID: 38323618 DOI: 10.1080/19396368.2024.2306389] [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: 08/30/2023] [Accepted: 01/07/2024] [Indexed: 02/08/2024]
Abstract
Mitochondrial diseases are distinct types of metabolic and/or neurologic abnormalities that occur as a consequence of dysfunction in oxidative phosphorylation, affecting several systems in the body. There is no effective treatment modality for mitochondrial disorders so far, emphasizing the clinical significance of preventing the inheritance of these disorders. Various reproductive options are available to reduce the probability of inheriting mitochondrial disorders, including in vitro fertilization (IVF) using donated oocytes, preimplantation genetic testing (PGT), and prenatal diagnosis (PND), among which PGT not only makes it possible for families to have genetically-owned children but also PGT has the advantage that couples do not have to decide to terminate the pregnancy if a mutation is detected in the fetus. PGT for mitochondrial diseases originating from nuclear DNA includes analyzing the nuclear genome for the presence or absence of corresponding mutations. However, PGT for mitochondrial disorders arising from mutations in mitochondrial DNA (mtDNA) is more intricate, due to the specific characteristics of mtDNA such as multicopy nature, heteroplasmy phenomenon, and exclusive maternal inheritance. Therefore, the present review aims to discuss the utility and challenges of PGT as a preventive approach to inherited mitochondrial diseases caused by mtDNA mutations.
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Affiliation(s)
- Xinpeng Lan
- College of Basic Medical Sciences, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, China
| | - Wu Liji Ao
- College of Mongolian Medicine and Pharmacy, Inner Mongolia University for Nationalities, Tongliao, Inner Mongolia, China
| | - Ji Li
- College of Basic Medical Sciences, Heilongjiang University of Chinese Medicine, Harbin, China
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Wang T, Wang C, Pang L, Zhang Y, Wang S, Liang X, Huang Z. Immunogenicity and protective efficacy of inactivated coxsackievirus B4 viral particles. Emerg Microbes Infect 2024; 13:2337665. [PMID: 38551145 PMCID: PMC11000607 DOI: 10.1080/22221751.2024.2337665] [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: 12/11/2023] [Accepted: 03/27/2024] [Indexed: 04/06/2024]
Abstract
Coxsackievirus B4 (CVB4) is associated with a range of acute and chronic diseases such as hand, foot, and mouth disease, myocarditis, meningitis, pancreatitis, and type 1 diabetes, affecting millions of young children annually around the world. However, no vaccine is currently available for preventing CVB4 infection. Here, we report the development of inactivated viral particle vaccines for CVB4. Two types of inactivated CVB4 particles were prepared from CVB4-infected cell cultures as vaccine antigens, including F-particle (also called mature virion) consisting of VP1, VP3, VP2, and VP4 subunit proteins, and E-particle (also called empty capsid) which is made of VP1, VP3, and uncleaved VP0. Both the inactivated CVB4 F-particle and E-particle were able to potently elicit neutralizing antibodies in mice, despite slightly lower neutralizing antibody titres seen with the E-particle vaccine after the third immunization. Importantly, we demonstrated that passive transfer of either anti-F-particle or anti-E-particle sera could completely protect the recipient mice from lethal CVB4 challenge. Our study not only defines the immunogenicity and protective efficacy of inactivated CVB4 F-particle and E-particle but also reveals the central role of neutralizing antibodies in anti-CVB4 protective immunity, thus providing important information that may accelerate the development of inactivated CVB4 vaccines.
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Affiliation(s)
- Tingfeng Wang
- Shanghai Institute of Immunity and Infection, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Shanghai, People’s Republic of China
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, People’s Republic of China
| | - Chiyuan Wang
- Shanghai Institute of Immunity and Infection, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Shanghai, People’s Republic of China
| | - Lili Pang
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, People’s Republic of China
| | - Yujie Zhang
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, People’s Republic of China
| | - Shuxia Wang
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, People’s Republic of China
| | - Xiaozhen Liang
- Shanghai Institute of Immunity and Infection, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Shanghai, People’s Republic of China
| | - Zhong Huang
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, People’s Republic of China
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Puig Llobet M, Roca Roger M, Nicolàs Silva T, Pérez Gimenez G, Agüera Z, Lluch Canut MT, Roldan Merino JF, Moreno Arroyo C, Prats Arimon M, Sánchez Ortega MA, Domènech Mascaró X, Hidalgo Blanco MA, Moreno Poyato A. The experiences of family members of persons with intellectual disabilities who used residential care homes during the COVID-19 pandemic. Int J Qual Stud Health Well-being 2024; 19:2288100. [PMID: 38055791 DOI: 10.1080/17482631.2023.2288100] [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: 08/01/2023] [Accepted: 11/22/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND The global COVID-19 pandemic has shown the vulnerability of some population groups, including persons with intellectual and developmental disabilities (IDD). AIM The present paper will provide more clarity and understanding of the experiences of family members of persons with IDD housed in residential facilities in Catalonia within the period of maximum restrictions during the COVID-19 pandemic. METHODS AND PROCEDURES Semi-structured interviews were conducted using an interpretive phenomenological qualitative approach. Study participants consisted of 14 relatives of IDD individuals who were institutionalized in residence facilities or homes. The guiding questions emerged from group discussions with relatives of those with IDD who did not participate in the subsequent interviews. Drawing from this group, the factors that were identified to have had the greatest impact on their lives were later used to guide the interviews. Data collection was carried out in face-to-face individual interviews that were recorded together with the observations of two researchers between February and October 2022. RESULTS Our analysis identified 4 main themes that developed into additional factors: the decision to stay at home or in the residence, fear, illness, and protocol. Individuals with IDD lost their daily routines, suffered from social isolation, and did not understand the situation. CONCLUSION The results of this study allow for a better understanding of the experiences of families of persons with IDD in residential centres during the lockdown by identifying their needs and how to better support them in the future. OUTCOMES AND RESULTS Knowledge and understanding of these events should allow for better management of similar situations in the future.
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Affiliation(s)
- Montserrat Puig Llobet
- Department of Public Health, Mental Health and Maternal-Child Nursing, School of Nursing, University of Barcelona, Health Sciences Campus Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Montserrat Roca Roger
- Department of Public Health, Mental Health and Maternal-Child Nursing, School of Nursing, University of Barcelona, Health Sciences Campus Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - Gemma Pérez Gimenez
- Head of Sick Medical Nursing Area and alternatives to hospitalization, Granollers General Hospital, Granollers, Barcelona, Spain
| | - Zaida Agüera
- Department of Public Health, Mental Health and Maternal-Child Nursing, School of Nursing, University of Barcelona, Health Sciences Campus Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Maria-Teresa Lluch Canut
- Department of Public Health, Mental Health and Maternal-Child Nursing, School of Nursing, University of Barcelona, Health Sciences Campus Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Juan Francisco Roldan Merino
- Department of Mental Health, Campus Docent Sant Joan de Déu-Fundació Privada, University of Barcelona, Barcelona, Spain
| | - Carmen Moreno Arroyo
- Department of Fundamental and Medical-Surgical Nursing, School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona (UB), L'Hospitalet de Llobregat, Spain
| | - Marta Prats Arimon
- Department of Fundamental and Medical-Surgical Nursing, School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona (UB), L'Hospitalet de Llobregat, Spain
| | | | - Xavier Domènech Mascaró
- Personal attention to citizens. Upper Penedès Territorial Pediatric Care Team Upper Penedès-Garraf-Baix Llobregat Nord Primary Care Service. Vilafranca del Penedès, Barcelona, Spain
| | - Miguel Angel Hidalgo Blanco
- Department of Fundamental and Medical-Surgical Nursing, School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona (UB), L'Hospitalet de Llobregat, Spain
| | - Antonio Moreno Poyato
- Department of Public Health, Mental Health and Maternal-Child Nursing, School of Nursing, University of Barcelona, Health Sciences Campus Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
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Mu J, Zhong H, Jiang M, Wang J, Zhang S. Development of a nomogram for predicting myopia risk among school-age children: a case-control study. Ann Med 2024; 56:2331056. [PMID: 38507901 PMCID: PMC10956924 DOI: 10.1080/07853890.2024.2331056] [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: 10/15/2023] [Accepted: 02/23/2024] [Indexed: 03/22/2024] Open
Abstract
OBJECTIVES To analyze the factors influencing myopia and construct a nomogram to forecast the risk of myopia among school-age children, providing a reference for identifying high-risk groups to aid prevention and control. METHODS This case-control study enrolled 3512 students from three primary schools in Shenzhen using random cluster sampling for a questionnaire survey, myopia screening and ocular biometric parameter measurement. Logistic regression was used to analyze the influencing factors of myopia, and a nomogram was constructed to forecast myopia risk. Bootstrap resampling was used to verify the practicability of the nomogram. RESULTS Older age (odds ratio[OR] = 1.164; 95% confidence interval [CI]: 1.111-1.219), female sex (OR = 2.405; 95% CI: 2.003-2.887), maternal myopia (OR = 1.331; 95% CI: 1.114-1.589), incorrect posture during reading and writing (OR = 1.283; 95% CI: 1.078-1.528) and axial length (OR = 7.708; 95% CI: 6.044-8.288) are risk factors for myopia, whereas an increase in corneal radius (OR = 0.036; 95% CI: 0.025-0.052) is a protective factor against myopia. The area under the receiver operating characteristic (ROC) curve of the nomogram was 0.857, and the net benefit was high when the risk threshold of the decision curve analyses (DCA) ranged from 0.20 to 1.00. The measured values were consistent with the prediction. CONCLUSION The nomogram was accurate in predicting the risk of myopia among schoolchildren. This study provides a reference for screening high-risk students and for individualized myopia prevention and control.
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Affiliation(s)
- Jingfeng Mu
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
| | - Haoxi Zhong
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
| | - Mingjie Jiang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
| | - Jiantao Wang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
| | - Shaochong Zhang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
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Wang H, Zhang Y, Zhao C, Peng Y, Song W, Xu W, Wen X, Liu J, Yang H, Shi R, Zhao S. Serum IL-17A and IL-6 in paediatric Mycoplasma pneumoniae pneumonia: implications for different endotypes. Emerg Microbes Infect 2024; 13:2324078. [PMID: 38407218 PMCID: PMC10997354 DOI: 10.1080/22221751.2024.2324078] [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: 11/29/2023] [Accepted: 02/22/2024] [Indexed: 02/27/2024]
Abstract
Paediatric Mycoplasma pneumoniae pneumonia (MPP) is a heterogeneous disease with a diverse spectrum of clinical phenotypes. No studies have demonstrated the relationship between underlying endotypes and clinical phenotypes as well as prognosis about this disease. Thus, we conducted a multicentre prospective longitudinal study on children hospitalized for MPP between June 2021 and March 2023, with the end of follow-up in August 2023. Blood samples were collected and processed at multiple time points. Multiplex cytokine assay was performed to characterize serum cytokine profiles and their dynamic changes after admission. Cluster analysis based on different clinical phenotypes was conducted. Among the included 196 patients, the levels of serum IL-17A and IL-6 showed remarkable variabilities. Four cytokine clusters based on the two cytokines and four clinical groups were identified. Significant elevation of IL-17A mainly correlated with diffuse bronchiolitis and lobar lesion by airway mucus hypersecretions, while that of IL-6 was largely associated with lobar lesion which later developed into lung necrosis. Besides, glucocorticoid therapy failed to inhibit IL-17A, and markedly elevated IL-17A and IL-6 levels may correlate with lower airway obliterans. Our study provides critical relationship between molecular signatures (endotypes) and clustered clinical phenotypes in paediatric patients with MPP.
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Affiliation(s)
- Heng Wang
- Department II of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China
| | - Yanli Zhang
- Division of Pulmonology, Department of Pediatrics, Third Affiliated Hospital of Zhengzhou University, Henan, People’s Republic of China
| | - Chengsong Zhao
- Department of Infectious Diseases, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China
| | - Yun Peng
- Department of Radiology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China
| | - Wenqi Song
- Department of Clinical Laboratory, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China
| | - Weihan Xu
- Department II of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China
| | - Xiaohui Wen
- Department II of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China
| | - Jinrong Liu
- Department II of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China
| | - Haiming Yang
- Department II of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China
| | - Ruihe Shi
- Division of Pulmonology, Department of Pediatrics, Third Affiliated Hospital of Zhengzhou University, Henan, People’s Republic of China
| | - Shunying Zhao
- Department II of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China
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Howley L, Eyerly-Webb S, Killen SAS, Paul E, Krishnan A, Gropler MRF, Drewes B, Dion E, Lund A, Buyon JP, Cuneo BF. Variation in prenatal surveillance and management of anti-SSA/Ro autoantibody positive pregnancies. J Matern Fetal Neonatal Med 2024; 37:2323623. [PMID: 38443062 PMCID: PMC11005667 DOI: 10.1080/14767058.2024.2323623] [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: 10/18/2023] [Accepted: 02/21/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVE To describe international surveillance and treatment strategies for managing anti-SSA/Ro autoantibody positive pregnancies. STUDY DESIGN An electronic REDCap questionnaire was distributed to Fetal Heart Society and North American Fetal Therapy Network members which queried institution-based risk stratification, surveillance methods/frequency, conduction abnormality treatments, and postnatal anti-SSA/Ro pregnancy assessment. RESULTS 101 responses from 59 centers (59% US, 17% international) were collected. Most (79%) do not risk stratify pregnancies by anti-SSA/Ro titer; those that do use varied cutoff values. Many pregnant rheumatology patients are monitored for cardiac abnormalities regardless of maternal anti-SSA/Ro status. Surveillance strategies were based on maternal factors (anti-SSA/Ro status 85%, titer 25%, prior affected child 79%) and monitoring durations varied. Most respondents treat 2° and 3° fetal atrioventricular block, commonly with dexamethasone and/or IVIG. CONCLUSIONS Wide variation exists in current fetal cardiac surveillance and treatment for anti-SSA/Ro autoantibody positive pregnancies, highlighting the need for evidence-based protocols to optimize care.
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Affiliation(s)
- Lisa Howley
- Midwest Fetal Care Center, Children’s Minnesota, Minneapolis, MN, USA
- The Children’s Heart Clinic, Children’s Minnesota, Minneapolis, MN USA
| | | | - Stacy A. S. Killen
- Vanderbilt University Medical Center, Monroe Carell Jr. Children’s Hospital, Nashville, TN, USA
| | - Erin Paul
- Icahn School of Medicine, Mount Sinai Children’s Heart Center, New York, NY, USA
| | | | | | - Bailey Drewes
- University of Colorado School of Medicine, Aurora, CO, USA
| | - Eric Dion
- Midwest Fetal Care Center, Children’s Minnesota, Minneapolis, MN, USA
| | - Amy Lund
- Midwest Fetal Care Center, Children’s Minnesota, Minneapolis, MN, USA
- The Children’s Heart Clinic, Children’s Minnesota, Minneapolis, MN USA
| | - Jill P. Buyon
- New York University Grossman School of Medicine, NYU Langone Medical Center, New York, NY, USA
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Reynolds SR, Salas LA, Chen JQ, Christensen BC. Detailed immune profiling in pediatric Crohn's disease using methylation cytometry. Epigenetics 2024; 19:2289786. [PMID: 38090774 PMCID: PMC10761011 DOI: 10.1080/15592294.2023.2289786] [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: 06/21/2023] [Accepted: 11/24/2023] [Indexed: 12/18/2023] Open
Abstract
DNA methylation has been extensively utilized to study epigenetic patterns across many diseases as well as to deconvolve blood cell type proportions. This study builds upon previous studies examining methylation patterns in paediatric patients with varying stages of Crohn's disease to extend the immune profiling of these patients using a novel deconvolution approach. Compared with control subjects, we observed significantly decreased levels of CD4 memory and naive, CD8 naive, and natural killer cells and elevated neutrophil levels in Crohn's disease. In addition, Crohn's patients had a significantly elevated neutrophil-to-lymphocyte ratio. Using an epigenome-wide association approach and adjusting for potential confounders, including cell type, we observed 397 differentially methylated CpG (DMC) sites associated with Crohn's disease. The top genetic pathway associated with the DMCs was the regulation of arginine metabolic processes which are involved in the regulation of T cells.
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Affiliation(s)
- Samuel R. Reynolds
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, NH, Lebanon, USA
| | - Lucas A. Salas
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, NH, Lebanon, USA
| | - Ji-Qing Chen
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, NH, Lebanon, USA
| | - Brock C. Christensen
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, NH, Lebanon, USA
- Department of Molecular and Systems Biology, Geisel School of Medicine, Dartmouth College, NH, Lebanon, USA
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Yuan W, Yu M, Zhang Z, Miao Q, Liu J, Zhang H, Zhou Q, Chen J, Zhai Y, Fang X, Xu H, Shen Q. The value of bioimpedance analysis in the assessment of hydration and nutritional status in children on chronic peritoneal dialysis. Ren Fail 2024; 46:2301531. [PMID: 38189097 PMCID: PMC10776048 DOI: 10.1080/0886022x.2023.2301531] [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: 08/28/2023] [Accepted: 12/29/2023] [Indexed: 01/09/2024] Open
Abstract
Bioimpedance analysis (BIA)-body composition monitoring (BCM) has been used to evaluate the hydration and nutritional status of adults and children on dialysis. However, its clinical application still has challenges, so further exploration is valuable. We used BIA-BCM to evaluate the hydration and nutritional status of children undergoing chronic peritoneal dialysis from 1 July 2021 to 31 December 2022 in the Children's Hospital of Fudan University to explore the clinical value of this method. A total of 84 children on chronic peritoneal dialysis (PD) were included. In the PD group, 16 (19.05%) and 31 (36.90%) had mild and severe overhydration (OH), respectively; 41.27% (26/63) had a low lean tissue index (LTI). In the PD group, patients with relative OH (Re-OH) > 5.6% had significantly higher systolic blood pressure (SBP) and SBP z score (SBPz). Patients with LTI > 12% had significantly higher body mass index (BMI) and BMI z score (BMIz). Canonical correlation analysis indicated a linear relationship (ρ = 0.708) between BIA-BCM hydration and the clinical hydration indicator and a linear relationship (ρ = 0.995) between the BIA-BCM nutritional indicator and the clinical nutritional indicator. A total of 56% of children on chronic peritoneal dialysis had OH, and 41% had a low LTI. In PD patients, SBP and SBPz were correlated with BIA-BCM Re-OH, and BMI and BMIz were correlated with BIA-BCM LTI. BIA-BCM indicators have good clinical value in evaluating hydration and nutrition.
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Affiliation(s)
- Wei Yuan
- Department of Nephrology, Children’s Hospital -of Fudan University, National Children’s Medical Center, Shanghai, China
- Shanghai Kidney Development & Pediatric Kidney Disease Research Center, Shanghai, China
| | - Minghui Yu
- Department of Nephrology, Children’s Hospital -of Fudan University, National Children’s Medical Center, Shanghai, China
- Shanghai Kidney Development & Pediatric Kidney Disease Research Center, Shanghai, China
| | - Zhiqing Zhang
- Department of Nephrology, Children’s Hospital -of Fudan University, National Children’s Medical Center, Shanghai, China
- Shanghai Kidney Development & Pediatric Kidney Disease Research Center, Shanghai, China
| | - Qianfan Miao
- Department of Nephrology, Children’s Hospital -of Fudan University, National Children’s Medical Center, Shanghai, China
- Shanghai Kidney Development & Pediatric Kidney Disease Research Center, Shanghai, China
| | - Jiaojiao Liu
- Department of Nephrology, Children’s Hospital -of Fudan University, National Children’s Medical Center, Shanghai, China
- Shanghai Kidney Development & Pediatric Kidney Disease Research Center, Shanghai, China
| | - Hui Zhang
- Department of Nephrology, Children’s Hospital -of Fudan University, National Children’s Medical Center, Shanghai, China
- Shanghai Kidney Development & Pediatric Kidney Disease Research Center, Shanghai, China
| | - Qing Zhou
- Department of Nephrology, Children’s Hospital -of Fudan University, National Children’s Medical Center, Shanghai, China
- Shanghai Kidney Development & Pediatric Kidney Disease Research Center, Shanghai, China
| | - Jing Chen
- Department of Nephrology, Children’s Hospital -of Fudan University, National Children’s Medical Center, Shanghai, China
- Shanghai Kidney Development & Pediatric Kidney Disease Research Center, Shanghai, China
| | - Yihui Zhai
- Department of Nephrology, Children’s Hospital -of Fudan University, National Children’s Medical Center, Shanghai, China
- Shanghai Kidney Development & Pediatric Kidney Disease Research Center, Shanghai, China
| | - Xiaoyan Fang
- Department of Nephrology, Children’s Hospital -of Fudan University, National Children’s Medical Center, Shanghai, China
- Shanghai Kidney Development & Pediatric Kidney Disease Research Center, Shanghai, China
| | - Hong Xu
- Department of Nephrology, Children’s Hospital -of Fudan University, National Children’s Medical Center, Shanghai, China
- Shanghai Kidney Development & Pediatric Kidney Disease Research Center, Shanghai, China
- National Key Laboratory of Kidney Diseases, Shanghai, China
| | - Qian Shen
- Department of Nephrology, Children’s Hospital -of Fudan University, National Children’s Medical Center, Shanghai, China
- Shanghai Kidney Development & Pediatric Kidney Disease Research Center, Shanghai, China
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Sha Y, Liu W, Hong J, Yang Y, Yu J, Fu X. A noninvasive method for the detection of foetal DNA in early pregnancy based on differential methylation pattern of Ras association domain family member 1A. J OBSTET GYNAECOL 2024; 44:2292611. [PMID: 38197583 DOI: 10.1080/01443615.2023.2292611] [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: 07/21/2023] [Accepted: 12/04/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND The detection of foetal DNA and extravillus trophoblasts (EVTs) in early pregnancy in cervical and uterine samples offers a potential pathway for non-invasive prenatal diagnostics. However, the challenge lies in effectively quantifying these samples. This study introduces a novel approach using the Ras association domain family 1 A (RASSF1A), which exhibits hypermethylation in foetal cells and hypomethylation in maternal cells. The differential methylation pattern of RASSF1A provides a unique biomarker for quantifying foetal cells in cervical and intrauterine samples. METHODS This study was conducted between September 2022 and May 2023. In total, 23 samples (12 cervical cell samples and 11 intrauterine samples) were collected from women in the Sichuan Jinxin Women & Children Hospital, Jingxiu District, Chengdu, China. The cervical cell samples were collected via lavage and brush techniques, and the intrauterine cell samples were obtained via uterine lavage. These samples were collected as part of a broader effort to advance our understanding of foetal cell dynamics during early pregnancy. The sampling methods were chosen for their minimally invasive nature and their potential in capturing a representative cell population from the respective sites. After digestion of the cell samples using a methylation-sensitive restriction enzyme cocktail, a critical step to differentiate between maternal and foetal DNA, the quantitative polymerase chain reaction (qPCR) of RASSF1A and β-actin (ACTB) were employed to measure foetal DNA and cell concentrations. Immunofluorescence techniques targeting histocompatibility complex, class I G (HLA-G) and GATA binding protein 3 (GATA-3) were employed to detect EVTs in the cell samples and in decidual tissue, with the latter providing an additional layer of confirmation for the presence of foetal cells. RESULTS The results showed no hypermethylated RASSF1A was detected in any of the cervical samples, irrespective of whether the samples were obtained by brush or lavage. However, an average of 17,236 ± 7490 foetal cells per sample were detected in the uterine lavage samples. Foetal cells accounted for approximately 0.14% ± 0.10% of the total cell population in these samples. The presence of EVTs in these samples was confirmed by their expression of both HLA-G and GATA-3. CONCLUSION The detection of foetal cells in uterine cavity samples based on hypermethylation of RASSF1A and quantification of foetal cells can be used to prenatal screening. GATA-3 can be used to label EVTs.
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Affiliation(s)
- Yulin Sha
- Department of Obstetrics, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Sichuan Jinxin Xinan Women & Children Hospital (Jingxiu District), Chengdu, Sichuan, China
| | - Wei Liu
- Department of Obstetrics, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Sichuan Jinxin Xinan Women & Children Hospital (Jingxiu District), Chengdu, Sichuan, China
| | - Jiongzhi Hong
- Triplex International Biosciences (China) Co., LTD, Xiamen, Fujian, China
| | - Yan Yang
- Sichuan Jinxin Xinan Women & Children Hospital (Jingxiu District), Chengdu, Sichuan, China
| | - Jian Yu
- Sichuan Jinxin Xinan Women & Children Hospital (Jingxiu District), Chengdu, Sichuan, China
| | - Xiaodong Fu
- Department of Obstetrics, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
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J-P NA, Watanabe T, Eitoku M, Yamasaki K, Mitsuda N, Maeda N, Fujieda M, Suganuma N. Association of a low chest-to-head circumference ratio with breech or transverse lie: the Japan Environment and Children's Study. J Matern Fetal Neonatal Med 2024; 37:2305678. [PMID: 38290835 DOI: 10.1080/14767058.2024.2305678] [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: 02/01/2024]
Abstract
OBJECTIVE We examined whether the chest-to-head circumference ratio at birth was associated with breech presentation and transverse lie. We also described the obstetric management of such pregnancies in the Japan Environment and Children's Study (JECS). METHODS We performed a cross-sectional evaluation of data collected between January 2011 and March 2014 in a nationwide prospective birth cohort study, the JECS. We analyzed 83,822 non-anomalous singletons born at 34-41 weeks' gestation to mothers with no history of previous cesareans or uterine surgery. We defined low, normal (reference group), and high chest-to-head circumference ratios as <10th percentile, 10th to 90th percentiles, and >90th percentile, respectively. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) for breech presentation and transverse lie. The timing and mode of delivery of such pregnancies were examined. RESULTS Breech presentation was recorded in 2.6% and transverse lie in 0.2%. A low chest-to-head circumference ratio was associated with increased rate of breech presentation (5.2%; adjusted OR 2.36, 95% CI: 2.10-2.65) and transverse lie (0.3%; adjusted OR 2.33, 95% CI: 1.50-3.60), whereas a high ratio was linked to reduced breech presentation (1.1%; adjusted OR 0.51, 95% CI: 0.39-0.66). Subgroup analysis of children delivered by cesarean (n = 7971) showed a similar association, albeit with slightly reduced strength for breech presentation. Eighty-three percent of breech births and 46.3% of transverse lie births occurred at 37-38 weeks' gestation. Cesarean section was performed in 96.8% of breech presentations and 63.4% of transverse-lie ones. CONCLUSIONS These findings imply that the fetal chest-to-head circumference ratio may influence presentation at birth.
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Affiliation(s)
- Naw Awn J-P
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kochi, Japan
| | - Takafumi Watanabe
- Department of Obstetrics, Kochi Health Sciences Center, Kochi, Japan
| | - Masamitsu Eitoku
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kochi, Japan
| | - Keiko Yamasaki
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kochi, Japan
| | - Naomi Mitsuda
- Department of Pediatrics, Kochi Medical School, Kochi University, Kochi, Japan
| | - Nagamasa Maeda
- Department of Obstetrics and Gynecology, Kochi Medical School, Kochi University, Kochi, Japan
| | - Mikiya Fujieda
- Department of Pediatrics, Kochi Medical School, Kochi University, Kochi, Japan
| | - Narufumi Suganuma
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kochi, Japan
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Caron AGM, Bloem M, El Khattabi H, de Waal AC, van Huizen AM, Denswil NP, Gerbens LAA, Spuls PI. The wide variety of methotrexate dosing regimens for the treatment of atopic dermatitis: a systematic review. J DERMATOL TREAT 2024; 35:2292962. [PMID: 38124505 DOI: 10.1080/09546634.2023.2292962] [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: 09/13/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023]
Abstract
Background:Methotrexate is an off-label therapy for atopic dermatitis. A lack of consensus on dosing regimens poses a risk of underdosing and ineffective treatment or overdosing and increased risk of side effects. This systematic review summarizes the available evidence on dosing regimens.Materials and methods:A literature search was conducted, screening all randomized controlled trials (RCTs) and guidelines published up to 6 July 2023, in the MEDLINE, Embase, and Cochrane Library databases.Results:Five RCTs and 21 guidelines were included. RCTs compared methotrexate with other treatments rather than different methotrexate dosing regimens. The start and maintenance doses in RCTs varied between 7.5-15 mg/week and 14.5-25 mg/week, respectively. Despite varied dosing, all RCTs demonstrated efficacy in improving atopic dermatitis signs and symptoms. Guidelines exhibited substantial heterogeneity but predominantly proposed starting doses of 5-15 mg/week for adults and 10-15 mg/m2/week for children. Maintenance doses suggested were 7.5-25 mg/week for adults and 0.2-0.7 mg/kg/week for children. One guideline suggested a test dose and nearly half advised folic acid supplementation.Conclusion:This systematic review highlights the lack of methotrexate dosing guidelines for atopic dermatitis. It identifies commonly recommended and utilized dosing regimens, serving as a valuable resource for clinicians prescribing methotrexate off-label and providing input for an upcoming consensus study.
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Affiliation(s)
- Anouk G M Caron
- Dermatology, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health, Infection and Immunity, University of Amsterdam, Amsterdam, the Netherlands
| | - Manja Bloem
- Surgical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Hajar El Khattabi
- Dermatology, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
| | - Ayla C de Waal
- Dermatology, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
| | - Astrid M van Huizen
- Dermatology, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health, Infection and Immunity, University of Amsterdam, Amsterdam, the Netherlands
| | - Nerissa P Denswil
- Medical Library, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
| | - Louise A A Gerbens
- Dermatology, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health, Infection and Immunity, University of Amsterdam, Amsterdam, the Netherlands
| | - Phyllis I Spuls
- Dermatology, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health, Infection and Immunity, University of Amsterdam, Amsterdam, the Netherlands
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Wang L, Duan H, Zuo H, Wang Z, Jiao S, Liu Y, Li H, Chen J. Cognitive-behavioral stress management relieves anxiety, depression, and post-traumatic stress disorder in parents of pediatric acute myeloid leukemia patients: a randomized, controlled study. Hematology 2024; 29:2293498. [PMID: 38095309 DOI: 10.1080/16078454.2023.2293498] [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: 08/21/2023] [Accepted: 12/02/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVES Cognitive-behavioral stress management (CBSM) is an effective psychological intervention to relieve psychological and symptomatic distress. This study aimed to investigate the effect of CBSM in anxiety, depression, and post-traumatic stress disorder (PTSD) in parents of pediatric acute myeloid leukemia (AML) patients. METHODS Totally, 56 pediatric AML patients and 100 parents were randomized into the CBSM group (28 patients and 49 parents) and the normal control (NC) group (28 patients and 51 parents) to receive corresponding interventions for 10 weeks. The questionnaire scores were assessed at month M0, M1, M3, and M6. RESULTS In parents of pediatric AML patients, self-rating anxiety scale score at M1 (p = 0.034), M3 (p = 0.010), and M6 (p = 0.003), as well as anxiety at M3 (p = 0.036) and M6 (p = 0.012) were decreased in the CBSM group versus the NC group. Self-rating depression scale score at M3 (p = 0.022) and M6 (p = 0.002), as well as depression at M6 (p = 0.019) were declined in the CBSM group versus the NC group. Symptom checklist-90 (a psychotic status questionnaire) score at M3 (p = 0.031) and M6 (p = 0.019) were declined in the CBSM group versus the NC group. Regarding PTSD, the impact of the events scale-revised score at M3 (p = 0.044) and M6 (p = 0.010) were decreased in the CBSM group versus the NC group. By subgroup analyses CBSM (versus NC) improved all outcomes in parents with anxiety at M0 and depression at M0 (all p < 0.050), but could not affect the outcomes in parents without anxiety or depression at M0 (all p > 0.050). CONCLUSION CBSM reduces anxiety, depression, and PTSD in parents of pediatric AML patients.
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Affiliation(s)
- Li Wang
- Department of Pediatrics, Affiliated Hospital of Hebei Engineering University, Handan, People's Republic of China
| | - Hui Duan
- Department of Pediatrics, Affiliated Hospital of Hebei Engineering University, Handan, People's Republic of China
| | - Hongmei Zuo
- Department of Pediatrics, Affiliated Hospital of Hebei Engineering University, Handan, People's Republic of China
| | - Zhongyu Wang
- Department of Oncology, Handan Central Hospital, Handan, People's Republic of China
| | - Shuili Jiao
- Department of Pediatrics Ward 2, Handan Central Hospital, Handan, People's Republic of China
| | - Yanli Liu
- Department of Neonatology Ward 1, Handan Central Hospital, Handan, People's Republic of China
| | - Huihui Li
- Department of Neonatology Ward 1, Handan Central Hospital, Handan, People's Republic of China
| | - Jie Chen
- Department of Nephrology 2, Handan Central Hospital, Handan, People's Republic of China
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Buttazzoni A, Pham J, Nelson Ferguson K, Fabri E, Clark A, Tobin D, Frisbee N, Gilliland J. Supporting children's participation in active travel: developing an online road safety intervention through a collaborative integrated knowledge translation approach. Int J Qual Stud Health Well-being 2024; 19:2320183. [PMID: 38431847 PMCID: PMC10911243 DOI: 10.1080/17482631.2024.2320183] [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: 09/18/2023] [Accepted: 02/14/2024] [Indexed: 03/05/2024] Open
Abstract
Even though regular engagement in physical activity (PA) among children can support their development and encourage the adoption of healthy lifelong habits, most do not achieve their recommended guidelines. Active travel (AT), or any form of human-powered travel (e.g., walking), can be a relatively accessible, manageable, and sustainable way to promote children's PA. One common barrier to children's engagement in AT, however, is a reported lack of education and training. To support children's participation in AT, this paper presents the development of a comprehensive 4-module online road safety education intervention designed to improve children's knowledge and confidence regarding AT. Using a qualitative integrated knowledge translation (iKT) approach undertaken with community collaborators (n = 50) containing expertise in health promotion, public safety, school administration, and transportation planning, our inductive thematic analysis generated fourth themes which constituted the foundation of the intervention modules: Active Travel Knowledge: Awareness of Benefits and Participation; Pedestrian Safety and Skills: Roles, Responsibilities, and Rules; Signs and Infrastructure: Identification, Literacy, and Behaviour; Wheeling Safety and Skills: Technical Training and Personal Maneuvers. Each theme/module was then linked to an explicit learning objective and connected to complementary knowledge activities, resources, and skill development exercises. Implications for research and practice are discussed.
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Affiliation(s)
- Adrian Buttazzoni
- School of Planning, University of Waterloo, Waterloo, ON, Canada
- Human Environments Analysis Laboratory, Department of Geography, Faculty of Social Sciences, University of Western Ontario, London, Ontario, Canada
| | - Julia Pham
- Human Environments Analysis Laboratory, Department of Geography, Faculty of Social Sciences, University of Western Ontario, London, Ontario, Canada
- Department of Geography and Environment, University of Western Ontario, London, Ontario, Canada
| | - Kendra Nelson Ferguson
- Human Environments Analysis Laboratory, Department of Geography, Faculty of Social Sciences, University of Western Ontario, London, Ontario, Canada
- Department of Geography and Environment, University of Western Ontario, London, Ontario, Canada
- Children’s Health Research Institute, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
| | - Emma Fabri
- Human Environments Analysis Laboratory, Department of Geography, Faculty of Social Sciences, University of Western Ontario, London, Ontario, Canada
- Department of Geography and Environment, University of Western Ontario, London, Ontario, Canada
| | - Andrew Clark
- Human Environments Analysis Laboratory, Department of Geography, Faculty of Social Sciences, University of Western Ontario, London, Ontario, Canada
- Department of Geography and Environment, University of Western Ontario, London, Ontario, Canada
| | - Danielle Tobin
- Human Environments Analysis Laboratory, Department of Geography, Faculty of Social Sciences, University of Western Ontario, London, Ontario, Canada
- Department of Geography and Environment, University of Western Ontario, London, Ontario, Canada
| | - Nathaniel Frisbee
- Human Environments Analysis Laboratory, Department of Geography, Faculty of Social Sciences, University of Western Ontario, London, Ontario, Canada
- Department of Geography and Environment, University of Western Ontario, London, Ontario, Canada
| | - Jason Gilliland
- Human Environments Analysis Laboratory, Department of Geography, Faculty of Social Sciences, University of Western Ontario, London, Ontario, Canada
- Department of Geography and Environment, University of Western Ontario, London, Ontario, Canada
- Children’s Health Research Institute, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
- Department of Paediatrics, University of Western Ontario, London, Ontario, Canada
- Department of Epidemiology & Biostatistics, University of Western Ontario, London, Ontario, Canada
- School of Health Studies, University of Western Ontario, London, Ontario, Canada
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Jiménez-Antolinez V, Colunga-Pedraza J, Gómez-De León A, González-Lopez E, Gómez-Almaguer D, González-Llano O. Lesson learned in pediatric haploidentical transplantation in a low-resource environment: delivering melphalan IV and using low dose radiation reduce graft failure. Hematology 2024; 29:2335417. [PMID: 38568018 DOI: 10.1080/16078454.2024.2335417] [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: 01/02/2024] [Accepted: 03/21/2024] [Indexed: 04/05/2024] Open
Abstract
Objectives: Primary graft failure (pGF) after hematopoietic stem-cell transplant is associated with considerable morbidity and mortality. The incidence in haplo-HSCT has been reported to be between 0% and 30%. In 2018, we identified a pGF incidence of 35% in our pediatric haplo-HSCT recipients with hematologic malignancies, which motivated us to enact changes to the conditioning regimen.Methods: We performed a single-center prospective, pre-post study of consecutive patients under 16 years with hematologic malignancies, from January 2015 to December 2022 who received a haplo-HSCT. Twenty-six pediatric patients received a haplo-HSCT before September 2018 (G1) and 36 patients after (G2). The main conditioning regimen for G1 was myeloablative with Flu/Cy/Bu, and for G2 the main regimen was reduced intensity Flu/Cy/Mel/TBI2.Results: Nine patients (35%) in G1 had primary graft failure, while in G2 there were no patients with pGF. The median follow-up for G1 was 15.9 months, and for G2 was 24.8 months, with an estimated overall survival at 12 months of 63% (95% CI 47-76) versus 85% (95% CI 73-93), and at 24 months of 47% (95% CI 31-64) versus 70% (95% CI 54-82) respectively (p = .007).Conclusion: After September 2018 conditioning regimen modifications were implemented with the objective of reducing primary failure, consisting mainly of switching from busulfan to melphalan as the alkylating agent of choice, and adding, when clinically possible TBI. Primary failure has been significantly reduced in our institution since then.
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Affiliation(s)
- Valentine Jiménez-Antolinez
- Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Julia Colunga-Pedraza
- Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Andrés Gómez-De León
- Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | | | - David Gómez-Almaguer
- Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Oscar González-Llano
- Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Mexico
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Liu S, Hu B, Zhang J. Epidemiological characteristics and influencing factors of acute leukemia in children and adolescents and adults: a large population-based study. Hematology 2024; 29:2327916. [PMID: 38578123 DOI: 10.1080/16078454.2024.2327916] [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: 07/30/2023] [Accepted: 03/04/2024] [Indexed: 04/06/2024] Open
Abstract
OBJECTIVE To assess the epidemiological characteristics and prognostic factors of acute leukemia (AL) in children and adolescents, and make comparisons between pediatric and adult patients. METHODS This retrospective cohort study enrolled AL patients from the Surveillance, Epidemiology, and End Results (SEER) 1975-2016. OS in children and adolescents and adults with AL was compared and analyzed separately by age and AL subtype. RESULTS Totally 61,694 AL patients were identified, with 45,411 (73.6%) adults and 16,283 (26.4%) children and adolescents. From 2000 to 2016, the incidence rates of AL [annual percent changes (APC) = 1.2, 95%CI = 0.9-1.6, P < 0.05] and acute lymphoblastic leukemia (ALL) (APC = 1.5, 95%CI = 1.1-1.8, P < 0.05) in children and adolescents were significantly increasing. For adults, AL (APC = 0.9, 95%CI = 0.3-1.5, P < 0.05), ALL (APC = 2.5, 95%CI = 2.0-3.1, P < 0.05) and acute myeloid leukemia (AML) (APC = 0.9, 95%CI = 0.4-1.5, P < 0.05) had significantly elevated incidence rates. Overall survival (OS) in children and adolescents with AL was significantly higher than that in adults with AL (log-rank P < 0.0001). OS in children and adolescents and adults with ALL, AML and AUL decreased with age (all log-rank P < 0.0001). Older age, male sex and black race were risk factors for the survival of children and adolescents and adults with ALL, AML and AUL. CONCLUSION From 2000 to 2016, the incidence rates of AL in children and adolescents and adults were increasing. Children and adolescents with AL had significantly better OS than adults with AL, and OS declined with age in both children and adolescents and adults with ALL, AML and AUL.
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Affiliation(s)
- Shuojie Liu
- Department of Clinical Laboratory, The First Affiliated Hospital of Xiamen University, Xiamen, People's Republic of China
- Xiamen Key Laboratory of Gene Detection, Xiamen, People's Republic of China
| | - Bin Hu
- Cancer Center, The First Affiliated Hospital of Xiamen University, Xiamen, People's Republic of China
| | - Jiaqin Zhang
- Department of Clinical Laboratory, The First Affiliated Hospital of Xiamen University, Xiamen, People's Republic of China
- Xiamen Key Laboratory of Gene Detection, Xiamen, People's Republic of China
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Ko A, O’Brien D, Rivera P, Mancl L, Hopkins S, Randall C, Nguyen DP, Chi DL. Identifying sources of variation in added sugar intake for Alaska Native children using a hair biomarker. Int J Circumpolar Health 2024; 83:2336286. [PMID: 38560896 PMCID: PMC10986438 DOI: 10.1080/22423982.2024.2336286] [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: 09/16/2023] [Accepted: 03/25/2024] [Indexed: 04/04/2024] Open
Abstract
Sugars from sugar-sweetened beverages (SSBs) are an important risk factor for tooth decay. The study goal was to determine if there was variation in added sugar intake across communities and between and within households. In this cross-sectional study, intakes of total sugar, added sugar, and sugar-sweetened beverages (SSBs) were estimated for 282 Alaska Native children ages 0-10 years from 131 households in three Yukon-Kuskokwim (YK) Delta communities using biomarker equations based on hair carbon and nitrogen isotope ratios previously developed for the Yup'ik population. ANOVA was used to assess associations between each predictor (community and household) and outcome (estimated total sugars, added sugars, and SSB intake). Between- and within-household variation was estimated using a linear mixed-effects model with a random intercept for households with three or more children. There was no significant difference in mean estimated total sugar (p = 0.29), added sugar (p = 0.24), or SSB intake (p = 0.40) across communities. Significant variations were observed between and within households, with within-household variation amounting to 59% of the between-household variation. Added sugar intake in Alaska Native children from the three study communities is higher than the recommended maximum, and the variation is greater within households than between households.
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Affiliation(s)
- Alice Ko
- Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, WA, USA
| | - Diane O’Brien
- Center for Alaska Native Health Research, Institute of Arctic Biology, Department of Biology and Wildlife, University of Alaska, Fairbanks, AK, USA
| | - Patricia Rivera
- Center for Alaska Native Health Research, Institute of Arctic Biology, Department of Biology and Wildlife, University of Alaska, Fairbanks, AK, USA
| | - Lloyd Mancl
- Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, WA, USA
| | - Scarlett Hopkins
- Departments of Medicine and Obstetrics & Gynecology, Oregon Health & Science University, Portland, OR, USA
| | - Cameron Randall
- Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, WA, USA
| | - Daisy Patiño Nguyen
- Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, WA, USA
| | - Donald L. Chi
- Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, WA, USA
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Urbieta AD, Barbeito Castiñeiras G, Rivero Calle I, Pardo Seco J, Rodríguez Tenreiro C, Suárez Camacho R, Pérez del Molino Bernal ML, Martinón Torres F. Mycoplasma pneumoniae at the rise not only in China: rapid increase of Mycoplasma pneumoniae cases also in Spain. Emerg Microbes Infect 2024; 13:2332680. [PMID: 38497329 PMCID: PMC10993738 DOI: 10.1080/22221751.2024.2332680] [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: 12/20/2023] [Accepted: 03/15/2024] [Indexed: 03/19/2024]
Abstract
After the use of facemasks, other isolation measures enacted during the SARS-CoV-2 pandemic were lifted, respiratory pathogens, such as RSV, reappeared, but until the November 2023 WHO alert for China, M. pneumoniae had virtually disappeared. After observing a similar reappearance in our hospital, a retrospective analysis of the number of positive M. pneumoniae tests. Between 2018 and December 2023, 1619 PCR tests were ordered and 43 (2.6%) of them were positive. Two outbreaks, one in 2018 and one in 2023, accounted for the majority of cases. Tests were usually ordered in an outpatient setting (53.54%, n = 23) and most of them were paediatric patients with a mean age (sd) of 10.2 (6.2) years. As for the severity of the cases, in the 2018 outbreak, of 15 children who tested positive, 53.3% (n = 8) were admitted to the ward and 6.7% (n = 1) at the intensive care unit. Whereas in 2023, 2 patients were tested in the ward (10.5%) and one in the intensive care unit (5.2%) from a total of 19 patients. The positive rate in 2023 was significantly higher in comparison with years 2020, 2021 and 2022 and significantly lower in comparison with 2018 (P-value=0.003). The outbreak in late 2023 can be explained by the seasonality of Mycoplasma pneumonia alone, which has shown outbreaks every 3-5 years, and it does not appear to be more severe than the previous one.
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Affiliation(s)
- Ana Dacosta Urbieta
- Department of Pediatrics, Hospital Clínico Universitario de Santiago de Compostela, Galicia, Spain
- Genetics, Vaccines and Infections Research Group (GenViP), Instituto de Investigación Sanitaria de Santiago, Universidade de Santiago de Compostela, Santiago de Compostela, Galicia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBER-ES), Madrid, Spain
| | | | - Irene Rivero Calle
- Department of Pediatrics, Hospital Clínico Universitario de Santiago de Compostela, Galicia, Spain
- Genetics, Vaccines and Infections Research Group (GenViP), Instituto de Investigación Sanitaria de Santiago, Universidade de Santiago de Compostela, Santiago de Compostela, Galicia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBER-ES), Madrid, Spain
| | - Jacobo Pardo Seco
- Genetics, Vaccines and Infections Research Group (GenViP), Instituto de Investigación Sanitaria de Santiago, Universidade de Santiago de Compostela, Santiago de Compostela, Galicia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBER-ES), Madrid, Spain
| | - Carmen Rodríguez Tenreiro
- Genetics, Vaccines and Infections Research Group (GenViP), Instituto de Investigación Sanitaria de Santiago, Universidade de Santiago de Compostela, Santiago de Compostela, Galicia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBER-ES), Madrid, Spain
| | - Ricardo Suárez Camacho
- Department of Pediatrics, Hospital Clínico Universitario de Santiago de Compostela, Galicia, Spain
- Genetics, Vaccines and Infections Research Group (GenViP), Instituto de Investigación Sanitaria de Santiago, Universidade de Santiago de Compostela, Santiago de Compostela, Galicia, Spain
| | | | - Federico Martinón Torres
- Department of Pediatrics, Hospital Clínico Universitario de Santiago de Compostela, Galicia, Spain
- Genetics, Vaccines and Infections Research Group (GenViP), Instituto de Investigación Sanitaria de Santiago, Universidade de Santiago de Compostela, Santiago de Compostela, Galicia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBER-ES), Madrid, Spain
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El Sharkawy M, Felix JF, Grote V, Voortman T, Jaddoe VWV, Koletzko B, Küpers LK. Animal and plant protein intake during infancy and childhood DNA methylation: a meta-analysis in the NutriPROGRAM consortium. Epigenetics 2024; 19:2299045. [PMID: 38198623 PMCID: PMC10793674 DOI: 10.1080/15592294.2023.2299045] [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: 03/14/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Higher early-life animal protein intake is associated with a higher childhood obesity risk compared to plant protein intake. Differential DNA methylation may represent an underlying mechanism. METHODS We analysed associations of infant animal and plant protein intakes with DNA methylation in early (2-6 years, N = 579) and late (7̄-12 years, N = 604) childhood in two studies. Study-specific robust linear regression models adjusted for relevant confounders were run, and then meta-analysed using a fixed-effects model. We also performed sex-stratified meta-analyses. Follow-up analyses included pathway analysis and eQTM look-up. RESULTS Infant animal protein intake was not associated with DNA methylation in early childhood, but was associated with late-childhood DNA methylation at cg21300373 (P = 4.27 × 10¯8, MARCHF1) and cg10633363 (P = 1.09 × 10¯7, HOXB9) after FDR correction. Infant plant protein intake was associated with early-childhood DNA methylation at cg25973293 (P = 2.26 × 10-7, C1orf159) and cg15407373 (P = 2.13 × 10-7, MBP) after FDR correction. There was no overlap between the findings from the animal and plant protein analyses. We did not find enriched functional pathways at either time point using CpGs associated with animal and plant protein. These CpGs were not previously associated with childhood gene expression. Sex-stratified meta-analyses showed sex-specific DNA methylation associations for both animal and plant protein intake. CONCLUSION Infant animal protein intake was associated with DNA methylation at two CpGs in late childhood. Infant plant protein intake was associated with DNA methylation in early childhood at two CpGs. A potential mediating role of DNA methylation at these CpGs between infant protein intake and health outcomes requires further investigation.
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Affiliation(s)
- Mohammed El Sharkawy
- Division of Metabolic and Nutritional Medicine, Department of Pediatrics, Dr. Von Hauner Children’s Hospital, LMU University Hospital Munich, Munich, Germany
- Munich Medical Research School, Faculty of Medicine, LMU - Ludwig-Maximilians Universität Munich, Munich, Germany
| | - Janine F. Felix
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Veit Grote
- Division of Metabolic and Nutritional Medicine, Department of Pediatrics, Dr. Von Hauner Children’s Hospital, LMU University Hospital Munich, Munich, Germany
| | - Trudy Voortman
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Vincent W. V. Jaddoe
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Berthold Koletzko
- Division of Metabolic and Nutritional Medicine, Department of Pediatrics, Dr. Von Hauner Children’s Hospital, LMU University Hospital Munich, Munich, Germany
| | - Leanne K. Küpers
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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86
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Nygaard HS, Øen KG. Public health nurses' experiences following up children with overweight and obesity according to national guidelines. A qualitative study. Int J Qual Stud Health Well-being 2024; 19:2306658. [PMID: 38262000 PMCID: PMC10810652 DOI: 10.1080/17482631.2024.2306658] [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: 02/24/2023] [Accepted: 01/14/2024] [Indexed: 01/25/2024] Open
Abstract
PURPOSE This study aimed to develop knowledge of how the follow-up regarding overweight and obesity among children in primary school is experienced by the PHN and how the guidelines may be used to improve health services in this follow-up. METHODS We analysed semi-structured interviews of 9 PHNs using qualitative content analysis. RESULTS Two themes emerged: Following up with children with overweight and obesity is an important but challenging duty; The PHNs call for clearer guidelines. Following five sub-themes: PHNs strive to adhere to the guidelines, show compassion in the follow-up, have difficulty handling parents' feelings and reactions, feel alone with the responsibility, and have suggestions for clearer guidelines. CONCLUSIONS PHNs call for enough resources to communicate the results of the child's weight in a sufficient form. PHNs and families should establish common goals. The PHN should avoid one-way communication but meet the parents' concerns and needs. This requires the PHN to focus on building a secure relation to the child and the families, as described by Peplau. Guidelines must include instructions and tools on how to communicate and meet the family's concerns. Political action and increased funding could strengthen the follow-up and thereby prevent more obesity among children, which can be a predictor of poorer health outcomes later in life.
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Affiliation(s)
- Hanna Skjelbred Nygaard
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Kirsten Gudbjørg Øen
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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Wang H, Li K, Cui B, Yan H, Wu S, Wang K, Yang G, Jiang J, Li Y. Tribbles pseudokinase 3 promotes enterovirus A71 infection via dual mechanisms. Emerg Microbes Infect 2024; 13:2307514. [PMID: 38240287 PMCID: PMC10829831 DOI: 10.1080/22221751.2024.2307514] [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: 12/07/2023] [Accepted: 01/16/2024] [Indexed: 02/01/2024]
Abstract
Enterovirus A71 (EV-A71) is the main pathogen causing hand, foot and mouth disease (HFMD) in children and occasionally associated with neurological diseases such as aseptic meningitis, brainstem encephalitis (BE) and acute flaccid paralysis. We report here that cellular pseudokinase tribbles 3 (TRIB3) facilitates the infection of EV-A71 via dual mechanisms. In one hand, TRIB3 maintains the metabolic stability of scavenger receptor class B member 2 (SCARB2), the bona fide receptor of EV-A71, to enhance the infectious entry and spreading of the virus. On the other hand, TRIB3 facilitates the replication of EV-A71 RNA in a SCARB2-independent manner. The critical role of TRIB3 in EV-A71 infection and pathogenesis was further demonstrated in vivo in mice. In comparison to wild-type C57BL/6 mice, EV-A71 infection in TRIB3 knockdown mice (Trib3+/-) resulted in significantly lower viral loads in muscular tissues and reduced lethality and severity of clinical scores and tissue pathology. In addition, TRIB3 also promoted the replication of coxsackievirus B3 (CVB3) and coxsackievirus A16 (CVA16) in vitro. In conclusion, our results suggest that TRIB3 is one of key host cellular proteins required for the infection and pathogenesis of EV-A71 and some other human enteroviruses and may thus be a potential therapeutic target for combating the infection of those viruses.
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Affiliation(s)
- Huiqiang Wang
- CAMS Key Laboratory of Antiviral Drug Research, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
- Beijing Key Laboratory of Antimicrobial Agents, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
- NHC Key Laboratory of Biotechnology for Microbial Drugs, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Ke Li
- NHC Key Laboratory of Biotechnology for Microbial Drugs, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Boming Cui
- CAMS Key Laboratory of Antiviral Drug Research, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
- NHC Key Laboratory of Biotechnology for Microbial Drugs, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Haiyan Yan
- CAMS Key Laboratory of Antiviral Drug Research, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
- Beijing Key Laboratory of Antimicrobial Agents, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
- NHC Key Laboratory of Biotechnology for Microbial Drugs, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Shuo Wu
- CAMS Key Laboratory of Antiviral Drug Research, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
- Beijing Key Laboratory of Antimicrobial Agents, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
- NHC Key Laboratory of Biotechnology for Microbial Drugs, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Kun Wang
- CAMS Key Laboratory of Antiviral Drug Research, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
- NHC Key Laboratory of Biotechnology for Microbial Drugs, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Ge Yang
- CAMS Key Laboratory of Antiviral Drug Research, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
- NHC Key Laboratory of Biotechnology for Microbial Drugs, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Jiandong Jiang
- Beijing Key Laboratory of Antimicrobial Agents, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
- NHC Key Laboratory of Biotechnology for Microbial Drugs, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Yuhuan Li
- CAMS Key Laboratory of Antiviral Drug Research, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
- Beijing Key Laboratory of Antimicrobial Agents, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
- NHC Key Laboratory of Biotechnology for Microbial Drugs, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
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88
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Zeng Y, He G. Association of blood parameters in early pregnancy with anemia during late pregnancy: a multicenter cohort study in China. J Matern Fetal Neonatal Med 2024; 37:2299110. [PMID: 38185625 DOI: 10.1080/14767058.2023.2299110] [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: 08/07/2023] [Accepted: 12/20/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND Low-hemoglobin concentration and anemia are important risk factors for the health and development of women and children. The aim of this study was to investigate the correlation between blood indicators in early pregnancy among non-anemia women and anemia in the third trimester among pregnant women in China with uncomplicated pregnancies >36 weeks. METHODS This was a multicenter, prospective cohort study. Pregnant women registered at the survey hospitals from May 2019 to December 2020 were included and followed up until delivery and discharge. The predictive value of serum ferritin (SF) and routine blood indexes (platelet count, red blood cell count, hemoglobin level, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration) were analyzed using a receiver operating characteristic (ROC) curve for the occurrence of anemia in the third trimester. RESULTS The area under the ROC curve of the first trimester hemoglobin for predicting anemia during late pregnancy (cutoff value 128 g/L, sensitivity 82.3%, specificity 49.6%) and iron deficiency anemia (cutoff value 124 g/L, sensitivity 66.3%, specificity 66.4%) in the third trimester was larger than those of other blood variables. CONCLUSIONS Hemoglobin levels in the first trimester were significantly better predictors of anemia during the third trimester than the other indices. Our study contributes to the clinical practice of early intervention for anemia, thus taking effective measures to improve maternal and infant outcomes.
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Affiliation(s)
- Yue Zeng
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- Ministry of Education, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Chengdu, China
| | - Guolin He
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- Ministry of Education, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Chengdu, China
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89
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Adrizain R, Nagari MV, Setiabudi D, Berbudi A, Setiabudiawan B. The association of 25(OH)D, interleukin-4, interleukin-5, and interleukin-13 levels with the burden of soil-transmitted helminth infection in stunted children aged 24-59 months. Autoimmunity 2024; 57:2330394. [PMID: 38497343 DOI: 10.1080/08916934.2024.2330394] [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: 12/06/2023] [Accepted: 03/10/2024] [Indexed: 03/19/2024]
Abstract
Soil-transmitted helminth (STH) among children aged 24-59 months is one cause of chronic infection that could lead to stunting. The association of 25(OH)D and immune responses during chronic infection in stunted populations has not yet been well established. An association study of case-control data was conducted in Bandung district from October 2019 to January 2023. Sociodemographic factors, stool samples, and serum levels of 25(OH)D, interleukin-4 (IL-4), interleukin-5 (IL-5), and interleukin-13 (IL-13) were assessed. Statistical analysis was performed to evaluate the prevalence and association of 25(OH)D, IL-4, IL-5, and IL-13 with the burden of STH infection in stunted children. In total, 401 stunted children were recruited. A higher burden of STH infection was found for lower levels of IL-5 (r = -0.477; p = 0.004) and IL-13 (r = -0.433; p = 0.028). Thus, 25(OH)D, IL-4, IL-5, and IL-13 play a role in the burden of STH infection.
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Affiliation(s)
- Riyadi Adrizain
- Department of Child Health, Faculty of Medicine, Universitas Padjadjaran Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
| | | | - Djatnika Setiabudi
- Department of Child Health, Faculty of Medicine, Universitas Padjadjaran Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Afiat Berbudi
- Department of Biomedical Science, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Budi Setiabudiawan
- Department of Child Health, Faculty of Medicine, Universitas Padjadjaran Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
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90
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Fu B, Xu J, Yin D, Sun C, Liu D, Zhai W, Bai R, Cao Y, Zhang Q, Ma S, Walsh TR, Hu F, Wang Y, Wu C, Shen J. Transmission of blaNDM in Enterobacteriaceae among animals, food and human. Emerg Microbes Infect 2024; 13:2337678. [PMID: 38629492 PMCID: PMC11034458 DOI: 10.1080/22221751.2024.2337678] [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: 01/24/2024] [Accepted: 03/27/2024] [Indexed: 04/22/2024]
Abstract
Despite carbapenems not being used in animals, carbapenem-resistant Enterobacterales (CRE), particularly New Delhi metallo-β-lactamase-producing CRE (NDM-CRE), are prevalent in livestock. Concurrently, the incidence of human infections caused by NDM-CRE is rising, particularly in children. Although a positive association between livestock production and human NDM-CRE infections at the national level was identified, the evidence of direct transmission of NDM originating from livestock to humans remains largely unknown. Here, we conducted a cross-sectional study in Chengdu, Sichuan Province, to examine the prevalence of NDM-CRE in chickens and pigs along the breeding-slaughtering-retail chains, in pork in cafeterias of schools, and in colonizations and infections from children's hospital and examined the correlation of NDM-CRE among animals, foods and humans. Overall, the blaNDM increases gradually along the chicken and pig breeding (4.70%/2.0%) -slaughtering (7.60%/22.40%) -retail (65.56%/34.26%) chains. The slaughterhouse has become a hotspot for cross-contamination and amplifier of blaNDM. Notably, 63.11% of pork from the school cafeteria was positive for blaNDM. The prevalence of blaNDM in intestinal and infection samples from children's hospitals was 21.68% and 19.80%, respectively. whole genome sequencing (WGS) analysis revealed the sporadic, not large-scale, clonal spread of NDM-CRE along the chicken and pig breeding-slaughtering-retail chain, with further spreading via IncX3-blaNDM plasmid within each stage of whole chains. Clonal transmission of NDM-CRE is predominant in children's hospitals. The IncX3-blaNDM plasmid was highly prevalent among animals and humans and accounted for 57.7% of Escherichia coli and 91.3% of Klebsiella pneumoniae. Attention should be directed towards the IncX3 plasmid to control the transmission of blaNDM between animals and humans.
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Affiliation(s)
- Bo Fu
- National Key Laboratory of Veterinary Public Health and Safety, College of Veterinary Medicine, China Agricultural University, Beijing, People’s Republic of China
| | - Jian Xu
- Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, People’s Republic of China
| | - Dandan Yin
- Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
- Key Laboratory of Clinical Pharmacology of Antibiotics (MoH), Shanghai, People’s Republic of China
| | - Chengtao Sun
- National Key Laboratory of Veterinary Public Health and Safety, College of Veterinary Medicine, China Agricultural University, Beijing, People’s Republic of China
| | - Dejun Liu
- National Key Laboratory of Veterinary Public Health and Safety, College of Veterinary Medicine, China Agricultural University, Beijing, People’s Republic of China
| | - Weishuai Zhai
- National Key Laboratory of Veterinary Public Health and Safety, College of Veterinary Medicine, China Agricultural University, Beijing, People’s Republic of China
| | - Rina Bai
- National Key Laboratory of Veterinary Public Health and Safety, College of Veterinary Medicine, China Agricultural University, Beijing, People’s Republic of China
| | - Yue Cao
- National Key Laboratory of Veterinary Public Health and Safety, College of Veterinary Medicine, China Agricultural University, Beijing, People’s Republic of China
| | - Qin Zhang
- Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, People’s Republic of China
| | - Shizhen Ma
- National Key Laboratory of Veterinary Public Health and Safety, College of Veterinary Medicine, China Agricultural University, Beijing, People’s Republic of China
| | - Timothy R. Walsh
- National Key Laboratory of Veterinary Public Health and Safety, College of Veterinary Medicine, China Agricultural University, Beijing, People’s Republic of China
- Department of Zoology, Ineos-Oxford Institute of Antimicrobial Research, University of Oxford, Oxford, UK
| | - Fupin Hu
- Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
- Key Laboratory of Clinical Pharmacology of Antibiotics (MoH), Shanghai, People’s Republic of China
| | - Yang Wang
- National Key Laboratory of Veterinary Public Health and Safety, College of Veterinary Medicine, China Agricultural University, Beijing, People’s Republic of China
| | - Congming Wu
- National Key Laboratory of Veterinary Public Health and Safety, College of Veterinary Medicine, China Agricultural University, Beijing, People’s Republic of China
| | - Jianzhong Shen
- National Key Laboratory of Veterinary Public Health and Safety, College of Veterinary Medicine, China Agricultural University, Beijing, People’s Republic of China
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91
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Jia W, Zhang X, Sun R, Li P, Wang D, Gu X, Song C. Value of modified qSOFA, glucose and lactate in predicting prognosis in children with sepsis in the PICU. Ann Med 2024; 56:2337714. [PMID: 38590177 PMCID: PMC11005878 DOI: 10.1080/07853890.2024.2337714] [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: 11/24/2023] [Accepted: 02/29/2024] [Indexed: 04/10/2024] Open
Abstract
The purpose was to investigate how well age-adjusted modified quick Sequential Organ Failure Assessment (qSOFA) scores paired with blood glucose and lactate levels predict the outcomes of septicemic children in the pediatric intensive care unit (PICU). One hundred children who were diagnosed with sepsis and septic shock in the PICU of Henan Children's Hospital were eligible, and other 20 patients in the same hospital at different times were selected as a validation set. Respiratory rate (RR), heart rate (HR), capillary refill time (CRT), and Alert, Voice, Pain, Unresponsive (AVPU) scale were included in the age-adjusted modified qSOFA scoring criteria for scoring. The primary outcome was 28-day all-cause mortality. The predictive values were evaluated by the ROC curve. In the sepsis group, 50 patients were male, and 50 patients were female. The 28-day all-cause mortality rate was 52%. Fifty-one patients with age-adjusted modified qSOFA scores >1. The serum lactate level was 2.4 mmol/L, and the blood glucose level was 9.3 mmol/L. The AUCs for the age-adjusted modified qSOFA score, serum lactate and blood glucose levels for the prediction of 28-day all-cause mortality in children with sepsis were 0.719, 0.719 and 0.737, respectively. The cut-off values were one point, 3.8 mmol/L and 10 mmol/L, respectively. The AUC of the age-adjusted modified qSOFA score for the validation set of was 0.925. When the three indices were combined, the AUC was 0.817, the Hosmer-Lemeshow goodness-of-fit test showed χ2 = 2.428 and p = .965. When children with sepsis are admitted to the ICU, we recommend performing rapid scoring and rapid bedside lactate and glucose testing to determine the early prognosis.
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Affiliation(s)
- Wanyu Jia
- Department of Emergency Medicine, Henan Province Engineering Research Center of Diagnosis and Treatment of Pediatric Infection and Critical Care, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou Children’s Hospital, Zhengzhou, China
| | - Xue Zhang
- Department of Emergency Medicine, Henan Province Engineering Research Center of Diagnosis and Treatment of Pediatric Infection and Critical Care, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou Children’s Hospital, Zhengzhou, China
| | - Ruiyang Sun
- Department of Emergency Medicine, Henan Province Engineering Research Center of Diagnosis and Treatment of Pediatric Infection and Critical Care, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou Children’s Hospital, Zhengzhou, China
| | - Peng Li
- Department of Emergency Medicine, Henan Province Engineering Research Center of Diagnosis and Treatment of Pediatric Infection and Critical Care, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou Children’s Hospital, Zhengzhou, China
| | - Daobin Wang
- Department of Pediatrics, Zhecheng County People’s Hospital, Shangqiu, China
| | - Xue Gu
- Department of Emergency Medicine, Henan Province Engineering Research Center of Diagnosis and Treatment of Pediatric Infection and Critical Care, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou Children’s Hospital, Zhengzhou, China
| | - Chunlan Song
- Department of Emergency Medicine, Henan Province Engineering Research Center of Diagnosis and Treatment of Pediatric Infection and Critical Care, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou Children’s Hospital, Zhengzhou, China
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92
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Leibring I, Kihlgren A, Anderzén Carlsson A. Fear, coping and support- from the perspective of children aged 10-17-year old having acute lymphoblastic leukemia. Int J Qual Stud Health Well-being 2024; 19:2310147. [PMID: 38324664 PMCID: PMC10851796 DOI: 10.1080/17482631.2024.2310147] [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: 07/25/2023] [Accepted: 01/22/2024] [Indexed: 02/09/2024] Open
Abstract
PURPOSE To describe experiences of fear, coping, and support in 10-17-year-old children under treatment for acute lymphoblastic leukaemia (ALL). METHODS A longitudinal descriptive qualitative design was adopted. Ten children participated in one to three interviews each (24 interviews in all). Interviews were analysed using a matrix-based qualitative method. RESULTS The variety of fears described related to uncertainty, pain and medical procedures, bodily changes and loss of control, complications, professionals' attitudes, affected school results, and social isolation. Children used various strategies to deal with fear: some more general, to cope with the whole situation, and others more related to specific events such as treatment and tests. The most reported strategies we labelled Accepting the situation, Positive thinking, and Being an active agent. Less favourable strategies were also reported. Health care professionals, families, and friends offered valuable, but different kinds of, support. CONCLUSIONS Children aged 10 to 17 undergoing treatment for ALL experience various fears. Each experience is individual and changes over time, but there are common patterns. Most children used problem-solving or emotional-regulation strategies, but withdrawal was also reported. Even children who can deal with fear need support from their health care professionals, families, and friends.
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Affiliation(s)
- Ingela Leibring
- Faculty of Health, Science and Technology, Institution for Health, Karlstad University, Karlstad, Sweden
| | - Annica Kihlgren
- Faculty of Health and Medicine, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Agneta Anderzén Carlsson
- Faculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden
- Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
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93
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Wang J, Yang X, Zhang Y, Jiang X, Li Y, Cui J, Liao Y. Single-cell analysis with childhood and adult systemic lupus erythematosus. Autoimmunity 2024; 57:2281228. [PMID: 38347676 DOI: 10.1080/08916934.2023.2281228] [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: 05/04/2023] [Accepted: 11/05/2023] [Indexed: 02/15/2024]
Abstract
Patients with systemic lupus erythematosus (SLE), a heterogeneous and chronic autoimmune disease, exhibit unique changes in the complex composition and transcriptional signatures of peripheral blood mononuclear cells (PBMCs). While the mechanism of pathogenesis for both childhood-onset SLE (cSLE) and adult-onset SLE (aSLE) remains unclear, cSLE patients are considered more unpredictable and dangerous than aSLE patients. In this study, we analysed single-cell RNA sequencing data (scRNA-seq) to profile the PBMC clusters of cSLE/aSLE patients and matched healthy donors and compared the PBMC composition and transcriptional variations between the two groups. Our analysis revealed that the PBMC composition and transcriptional variations in cSLE patients were similar to those in aSLE patients. Comparative single-cell transcriptome analysis between healthy donors and SLE patients revealed IFITM3, ISG15, IFI16 and LY6E as potential therapeutic targets for both aSLE and cSLE patients. Additionally, we observed that the percentage of pre-B cells (CD34-) was increased in cSLE patients, while the percentage of neutrophil cells was upregulated in aSLE patients. Notably, we found decreased expression of TPM2 in cSLE patients, and similarly, TMEM150B, IQSEC2, CHN2, LRP8 and USP46 were significantly downregulated in neutrophil cells from aSLE patients. Overall, our study highlights the differences in complex PBMC composition and transcriptional profiles between cSLE and aSLE patients, providing potential biomarkers that could aid in diagnosing SLE.
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Affiliation(s)
- Jing Wang
- Department of Nephrology and Rheumatology, Kunming Children's Hospital, Kunming, China, People's Republic of China
| | - Xiran Yang
- Department of Nephrology and Rheumatology, Kunming Children's Hospital, Kunming, China, People's Republic of China
| | - Yanhua Zhang
- Department of Nephrology and Rheumatology, Kunming Children's Hospital, Kunming, China, People's Republic of China
| | - Xuemei Jiang
- Department of Nephrology and Rheumatology, Kunming Children's Hospital, Kunming, China, People's Republic of China
| | - Yanfang Li
- Department of Nephrology and Rheumatology, Kunming Children's Hospital, Kunming, China, People's Republic of China
| | - Jingjing Cui
- Department of Nephrology and Rheumatology, Kunming Children's Hospital, Kunming, China, People's Republic of China
| | - Yabin Liao
- Department of Nephrology and Rheumatology, Kunming Children's Hospital, Kunming, China, People's Republic of China
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94
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Baig MMFA, Wong LY, Wu H. Development of mRNA nano-vaccines for COVID-19 prevention and its biochemical interactions with various disease conditions and age groups. J Drug Target 2024; 32:21-32. [PMID: 38010097 DOI: 10.1080/1061186x.2023.2288996] [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: 06/24/2023] [Accepted: 11/18/2023] [Indexed: 11/29/2023]
Abstract
This review has focused on the development of mRNA nano-vaccine and the biochemical interactions of anti-COVID-19 mRNA vaccines with various disease conditions and age groups. It studied five major groups of individuals with different disease conditions and ages, including allergic background, infarction background, adolescent, and adult (youngsters), pregnant women, and elderly. All five groups had been reported to have background-related adverse effects. Allergic background individuals were observed to have higher chances of experiencing allergic reactions and even anaphylaxis. Individuals with an infarction background had a higher risk of vaccine-induced diseases, e.g. pneumonitis and interstitial lung diseases. Pregnant women were seen to suffer from obstetric and gynecological adverse effects after receiving vaccinations. However, interestingly, the elderly individuals (> 65 years old) had experienced milder and less frequent adverse effects compared to the adolescent (<19 and >9 years old) and young adulthood (19-39 years old), or middle adulthood (40-59 years old) age groups, while middle to late adolescent (14-17 years old) was the riskiest age group to vaccine-induced cardiovascular manifestations.
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Affiliation(s)
- Mirza Muhammad Faran Ashraf Baig
- Department of Chemistry and the Hong Kong Branch of Chinese National Engineering Research Centre for Tissue Restoration, The Hong Kong University of Science and Technology, Hong Kong, China
| | - Lok Yin Wong
- Department of Chemistry and the Hong Kong Branch of Chinese National Engineering Research Centre for Tissue Restoration, The Hong Kong University of Science and Technology, Hong Kong, China
| | - Hongkai Wu
- Department of Chemistry and the Hong Kong Branch of Chinese National Engineering Research Centre for Tissue Restoration, The Hong Kong University of Science and Technology, Hong Kong, China
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95
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Feldman SR, Thyssen JP, Boeri M, Gerber R, Neary MP, Cha A, Hauber B, Cappelleri JC, Xenakis J, Leach C, Zeichner J. Adult, adolescent, and caregiver preferences for attributes of topical treatments for mild-to-moderate atopic dermatitis: a discrete-choice experiment. J DERMATOL TREAT 2024; 35:2304020. [PMID: 38221777 DOI: 10.1080/09546634.2024.2304020] [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: 10/19/2023] [Accepted: 01/03/2024] [Indexed: 01/16/2024]
Abstract
Purpose: Topical treatments for mild-to-moderate (MM) atopic dermatitis (AD) include emollients, corticosteroids, calcineurin inhibitors, a Janus kinase inhibitor, and a phosphodiesterase 4 inhibitor, which differ in multiple ways. This study aimed to quantify the conditional relative importance (CRI) of attributes of topical treatments for MM AD among adult and adolescent patients and caregivers of children with MM AD.Materials and methods: A discrete-choice experiment (DCE) survey was administered to US adults and adolescents with MM AD and caregivers of children with MM AD. Each choice task comprised 2 hypothetical topical treatments characterized by efficacy, adverse events, vehicle, and application frequency. Data were analyzed using a random-parameters logit model to calculate the CRI of each attribute.Results and conclusions: 300 adults, 331 adolescents, and 330 caregivers completed the DCE. Avoiding changes in skin color (CRI 29.0) and time until itch improves (26.6) were most important to adults, followed by time until clear/almost clear skin (17.8). Application frequency (3.0) did not have a statistically significant impact on adults' choices. Adolescents were less concerned about changes in skin color than adults or caregivers; caregivers were less concerned about time until clear/almost clear skin than patients. Physicians should consider age-relevant aspects of preferences in treatment discussions with patients and caregivers.
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Affiliation(s)
- Steven R Feldman
- Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Jacob P Thyssen
- Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Marco Boeri
- RTI Health Solutions, Belfast, UK
- School of Biological Sciences, Queen's University Belfast, Belfast, UK
| | | | | | - Amy Cha
- Pfizer Inc, New York, NY, USA
| | | | | | | | | | - Joshua Zeichner
- Department of Dermatology, Mount Sinai Hospital, New York, NY, USA
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96
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Crowley TB, Campbell I, Arulselvan A, Friedman D, Zackai EH, Geoffrion TR, Witmer C, Gaynor JW, McDonald-McGinn DM, Lambert MP. A case-control study of bleeding risk in children with 22q11.2 deletion syndrome undergoing cardiac surgery. Platelets 2024; 35:2290108. [PMID: 38099325 DOI: 10.1080/09537104.2023.2290108] [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: 08/21/2023] [Accepted: 11/27/2023] [Indexed: 12/18/2023]
Abstract
Previous research suggests that individuals with 22q11.2 deletion syndrome (DS) have an increased risk of bleeding following cardiac surgery. However, current guidelines for management of patients with 22q11.2DS do not provide specific recommendations for perioperative management. This study sought to identify specific risk factors for bleeding in this patient population. Examine the factors determining bleeding and transfusion requirements in patients with 22q11.2DS undergoing cardiac surgery. This was a single center review of patients who underwent cardiac surgery at the Children's Hospital of Philadelphia from 2000 to 2016. Data was extracted from the medical record. Frequency of bleeding events, laboratory values, and transfusion requirements were compared. We included 226 patients with 22q11.2DS and 506 controls. Bleeding events were identified in 13 patients with 22q11.2DS (5.8%) and 27 controls (5.3%). Platelet counts were lower among patients with 22q11.2DS than in control patients, but not statistically different comparing bleeding to not bleeding. Patients with 22q11.2DS received more transfusions (regardless of bleeding status). However, multivariate analysis showed only procedure type was associated with increased risk of bleeding (p = .012). The overall risk of bleeding when undergoing cardiac surgery is not different in patients with 22q11.2DS compared to non-deleted patients. Though platelet counts were lower in patients with 22q11.2DS, only procedure type was significantly associated with an increased risk of bleeding.
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Affiliation(s)
- T Blaine Crowley
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Ian Campbell
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Abinaya Arulselvan
- Division of Hematology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - David Friedman
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Elaine H Zackai
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Tracy R Geoffrion
- Department of Surgery, Children's Wisconsin, Milwaukee, WI, USA
- Division of Cardiothoracic Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Char Witmer
- Division of Hematology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - J William Gaynor
- Division of Cardiothoracic Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Donna M McDonald-McGinn
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
- Sapienza University, Rome, Italy
| | - Michele P Lambert
- Division of Hematology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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97
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Lin L, Lin J, Yan J. Association of maternal body mass index change with risk of large for gestational age among pregnant women with and without gestational diabetes mellitus: a retrospective cohort study. J Matern Fetal Neonatal Med 2024; 37:2316732. [PMID: 38360564 DOI: 10.1080/14767058.2024.2316732] [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: 02/17/2024]
Abstract
OBJECTIVE To investigate the associations of body mass index (BMI) change and large for gestational age (LGA) among prepregnancy normal-weight women with and without gestational diabetes mellitus (GDM). METHODS The retrospective study including 9515 normal-weight pregnant women (1331 women with GDM and 8184 without GDM) was conducted in Fujian Maternity and Child Health Hospital in 2020. The BMI change was calculated as gestational weight gain in kilograms by maternal height in meters. The binary logistic regression, stratified analyses, restricted cubic spline models and additive interaction analysis were adopted to reveal the relationship between BMI change and LGA. RESULTS Pregnant women with GDM had a lower level of BMI change but a higher incidence of LGA compared with those without GDM. After adjustment for covariates variables, we found that the risk of LGA was associated with the highest quartile of BMI change (OR = 1.89, 95%CI:1.27-2.8 for GDM and OR = 1.48,95%CI:1.27-1.75 for non-GDM). There were significant linear relationships of BMI change and LGA with the inflection point of 5.096 and 5.401 kg/m2 in GDM and non-GDM groups. Significant additive interaction was observed between parity and BMI change level concerning LGA. A significant difference in BMI change and gestational weight gain (GWG) for LGA prediction was detected. CONCLUSION Higher BMI changes were significantly associated with a higher risk of LGA in pregnant women with or without GDM in a linear dose-response relationship, with the threshold around 5.096 and 5.401 kg/m2, respectively. These suggested that BMI changes may be a useful predictor for the incidence of LGA in singleton pregnant women.
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Affiliation(s)
- Lihua Lin
- Department of Healthcare, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, P.R. China
| | - Juan Lin
- Department of women's health care, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, P.R. China
| | - Jianying Yan
- Department of Obstetrics, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, P.R. China
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98
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Shi S, Xiong C, Bie D, Fang Z, Wang J. Association between postoperative ibuprofen exposure and acute kidney injury after pediatric cardiac surgery. Ren Fail 2024; 46:2318417. [PMID: 38374700 PMCID: PMC10880564 DOI: 10.1080/0886022x.2024.2318417] [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: 09/13/2023] [Accepted: 02/09/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Acute kidney injury (AKI) is a common complication after pediatric cardiac surgery and is associated with worse outcomes. Ibuprofen is widely used in the perioperative period and can affect kidney function in children. However, the association between ibuprofen exposure and AKI after pediatric cardiac surgery has not been determined yet. METHODS In this retrospective cohort study, children undergoing cardiac surgery with cardiopulmonary bypass were studied. Exposure was defined as given ibuprofen in the first 7 days after surgery. Postoperative AKI was diagnosed using the KDIGO criteria. A multivariable Cox regression model was used to assess the association between ibuprofen exposure and postoperative AKI by taking ibuprofen as a time-varying covariate. RESULTS Among 1,112 included children, 198 of them (17.8%) experienced AKI. In total, 396 children (35.6%) were exposed to ibuprofen. AKI occurred less frequently among children who were administered ibuprofen than among those who were not (46 of 396 [11.6%] vs. 152 of 716 [21.2%], p < 0.001). Using the Cox regression model accounting for time-varying exposures, ibuprofen treatment was not associated with AKI (adjusted HR, 0.99; 95% CI 0.70-1.39, p = 0.932). This insignificant association was consistent across the sensitivity and subgroup analyses. CONCLUSIONS Postoperative ibuprofen exposure in pediatric patients undergoing cardiac surgery was not associated with an increased risk of AKI.
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Affiliation(s)
- Sheng Shi
- Department of Anesthesiology, National Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chao Xiong
- Department of Anesthesiology, National Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Dongyun Bie
- Department of Anesthesiology, National Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhongrong Fang
- Department of Anesthesiology, National Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianhui Wang
- Department of Anesthesiology, National Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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99
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Jiang H, Kong X, Bian W, Liu J, Xu Y, Cui A, Cao X. Clinical value of screening prenatal ultrasound combined with chromosomal microarrays in prenatal diagnosis of chromosomal abnormalities. J Matern Fetal Neonatal Med 2024; 37:2324348. [PMID: 38466173 DOI: 10.1080/14767058.2024.2324348] [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: 11/27/2023] [Accepted: 02/22/2024] [Indexed: 03/12/2024]
Abstract
OBJECTIVE To evaluate the clinical value of ultrasound findings in the screening of fetal chromosomal abnormalities and the analysis of risk factors for chromosome microarray analysis (CMA) abnormalities. METHODS We retrospectively analyzed the datasets of 15,899 pregnant women who underwent prenatal evaluations at Affiliated Maternity and Child Health Care Hospital of Nantong University between August 2018 and December 2022. Everyone underwent ultrasound screening, and those with abnormal findings underwent CMA to identify chromosomal abnormalities. RESULTS The detection rates for isolated ultrasound anomalies and combined ultrasound and CMA anomalies were 11.81% (1877/15,899) and 2.40% (381/15,899), respectively. Among all ultrasound abnormalities, detection rates for isolated ultrasound soft marker anomalies, isolated structural abnormalities, and both ultrasound soft marker anomalies with structural abnormalities were 82.91% (1872/2258), 15.99% (361/2258), and 1.11% (25/2258), respectively. The detection rate of abnormal chromosomes in pregnant women with abnormal ultrasound results was 16.87% (381/2258). The detection rates were 13.33% in cases with two or more ultrasound soft markers anomalies, 47.37% for two or more structural anomalies, and 48.00% for concomitant ultrasound soft marker and structural anomalies. CONCLUSIONS Enhanced detection rates of chromosomal anomalies in fetal malformations are achieved with specific ultrasound findings (NT thickening, cardiovascular abnormalities, and multiple soft markers) or when combined with high-risk factors (advanced maternal age, familial history, parental chromosomal anomalies, etc.). When the maternal age is over 35 and with ≥2 ultrasound soft marker anomalies accompanied with any high-risk factors, CMA testing can aid in the diagnosis of prenatal chromosomal abnormalities.
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Affiliation(s)
- Hongru Jiang
- Department of Medical Genetics and Prenatal Diagnosis, Affiliated Maternity and Child Health Care Hospital of Nantong University, Nantong City, China
| | - Xiangtian Kong
- Department of Medical Genetics and Prenatal Diagnosis, Affiliated Maternity and Child Health Care Hospital of Nantong University, Nantong City, China
| | - Wenjun Bian
- Department of Medical Genetics and Prenatal Diagnosis, Affiliated Maternity and Child Health Care Hospital of Nantong University, Nantong City, China
| | - Jiangyue Liu
- Department of Medical Genetics and Prenatal Diagnosis, Affiliated Maternity and Child Health Care Hospital of Nantong University, Nantong City, China
| | - Yuanyuan Xu
- Department of Medical Genetics and Prenatal Diagnosis, Affiliated Maternity and Child Health Care Hospital of Nantong University, Nantong City, China
| | - Aimin Cui
- Department of Medical Genetics and Prenatal Diagnosis, Affiliated Maternity and Child Health Care Hospital of Nantong University, Nantong City, China
| | - Xian Cao
- Department of Medical Genetics and Prenatal Diagnosis, Affiliated Maternity and Child Health Care Hospital of Nantong University, Nantong City, China
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100
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Zhou N, Chen O, Yuan X, Hu B. Endoscopic radial incision of a congenital antral web in a child. Endoscopy 2024; 56:E188-E189. [PMID: 38388949 PMCID: PMC10883875 DOI: 10.1055/a-2253-0879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Affiliation(s)
- Nuoya Zhou
- Department of Gastroenterology and Hepatology, West China Hospital of Sichuan University, Chengdu, China
| | - Ou Chen
- Department of Gastroenterology, Yaʼan Peopleʼs Hospital, Yaʼan, China
| | - Xianglei Yuan
- Department of Gastroenterology and Hepatology, West China Hospital of Sichuan University, Chengdu, China
| | - Bing Hu
- Department of Gastroenterology and Hepatology, West China Hospital of Sichuan University, Chengdu, China
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