RESUMO
Introducción: La calidad de vida relacionada con la salud (CVRS) y los estados de ánimo son indicadores cruciales del bienestar en adolescentes, pero su relación con estudiantes de Antioquia, Colombia, no ha sido ampliamente estudiada. Objetivo: Determinar la CVRS y los estados de ánimo en escolares de Antioquia-Colombia. Materiales y métodos: Estudio transversal con 1957 escolares de 9 a 20 años. Se aplicaron mediciones de CVRS, ansiedad, depresión, hostilidad y alegría, actividad física, comportamiento sedentario, apoyo social de padres y nivel socioeconómico. Resultados: La calidad de vida alta (CVA) es más elevada en hombres, personas con alegría, estudiantes con apoyo de padres, activos físicamente y personas de nivel socioeconómico alto y medio. AL aumentar un año de edad, disminuye en un 15 % la CVA, y al aumentar la depresión, la ansiedad y el comportamiento sedentario disminuye la CVA. Además, los niveles de depresión y ansiedad son mayores en mujeres, estudiantes mayores, sin apoyo de los padres y personas sedentarias. Conclusiones: La CVRS se asocia con estados de ánimo, actividad física, comportamiento sedentario y apoyo de los padres; mientras que los estados de ánimo se asocian con el sexo, el apoyo de los padres, la CVS y el sedentarismo.
Introduction: Even though health-related quality of life (HRQL) and mood states are key indicators of the well-being of adolescents, their relationship has not been analyzed in students from Antioquia, Colombia. Objective: To determine HRQL and mood states in schoolchildren from Antioquia. Materials and methods: A cross-sectional study was conducted on 1,957 schoolchildren and adolescents aged between 9 and 20 years. Measurements of HRQL, anxiety, depression, hostility and happiness, physical activity, sedentary behavior, parental social support, and socioeconomic status were applied. Results: A high quality of life (HQL) was observed more frequently in male participants, students with parental support, physically active, and those belonging to medium and high socioeconomic status. HQL decreased 15% as their age increased by one year. Also, HQL was reduced when depression, anxiety, and sedentary behavior increased. Furthermore, depression and anxiety levels were higher in women, older students, as well as in those without parental control and with sedentary behavior. Conclusions: HRQL is associated with mood states, physical activity, sedentary behavior, and parental support. In contrast, mood states are related to gender, parental support, HQL, and sedentary lifestyle.
Introdução: A qualidade de vida relacionada à saúde (CVRS) e os estados de humor são indicadores cruciais de bem-estar em adolescentes, mas sua relação com estudantes de Antioquia, Colômbia, não foi amplamente estudada. Objetivo: Determinar a CVRS e os estados de humor em escolares de Antioquia-Colômbia. Materiais e métodos: Estudo transversal com 1.957 escolares de 9 a 20 anos. Foram aplicadas medidas de QVRS, ansiedade, depressão, hostilidade e felicidade, atividade física, comportamento sedentário, apoio social dos pais e nível socioeconômico. Resultados: A alta qualidade de vida (CVA) é maior em homens, pessoas com alegria, estudantes com apoio parental, fisicamente ativos e pessoas de nível socioeconômico alto e médio. À medida que a idade aumenta em um ano, diminui em 15% o CVA, e ao aumentar a depressão, a ansiedade e o comportamento sedentário aumentam, o CVA diminui. Além disso, os níveis de depressão e ansiedade são mais elevados nas mulheres, nos estudantes mais velhos, sem apoio dos pais e nas pessoas sedentárias. Conclusões: A QVRS está associada a estados de humor, atividade física, comportamento sedentário e apoio parental; enquanto os estados de humor estão associados ao sexo, apoio parental, CVS e estilo de vida sedentário.
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto Jovem , Saúde , Emoções , Felicidade , HostilidadeRESUMO
OBJECTIVE: To identify vulnerability factors associated with unsuccessful tuberculosis treatment outcomes between 2011 and 2021 in Manaus, Amazonas. METHOD: Ecological study using tuberculosis case notification data from the Notifiable Diseases Information System, from 2011 to 2021, of residents in Manaus. The variables refer to treatment outcomes and patient vulnerability, according to the theoretical model: individual, programmatic and social. The analysis tested the association between vulnerability and tuberculosis treatment non-success, measured by the occurrence of death, loss to follow-up or treatment default. The Odds Ratio estimate with confidence interval was obtained by logistic regression, according to a hierarchical model. RESULTS: The following factors were more likely to lead to unsuccessful tuberculosis treatment: individual vulnerability (age group 20 to 29 years and over 60 years, indigenous race, HIV+, drug use); programmatic vulnerability (not having an HIV test), social vulnerability (special population). CONCLUSION: Individual vulnerability was more strongly associated with non-success. Intervention is needed to explore the points of greatest individual vulnerability, enabling effective action to prevent unsuccessful tuberculosis treatment.
Assuntos
Falha de Tratamento , Tuberculose , Humanos , Adulto , Brasil , Masculino , Tuberculose/tratamento farmacológico , Adulto Jovem , Pessoa de Meia-Idade , Feminino , Adolescente , Populações Vulneráveis , Criança , Pré-Escolar , Lactente , Idoso , Fatores de RiscoRESUMO
PURPOSE: Investigate if speech perception skills can differentiate school children with Specific Reading Disorders (SRD) with and without Persistent Speech Sound Disorders (PSSD). METHODS: 80 children, regularly enrolled in the 2nd (N=1), 3rd (N=28), 4th (N=29), 5th (N=15) and 6th (N=7) grades participated in the study. Control Group (CG) (N=48): no complaints, no speech alteration; and Resarch Group (RG) (N=32) - with SRD, RGI (N=15) without PSSD and RGII (N=17) with PSSD. Two tests evaluated auditory input reception: Simplified evaluation of auditory processing; and Perception task of nonwords, with Portuguese language structure (DNPLS). Data was analyzed by: Likelihood Ratio Test, Kruskal-Wallis test, Dunn test with Bonferroni correction, Mann-Whitney test, Spearman correlation, and construction of a ROC curve to obtain a threshold value for the correct answers in the perception of non-words test. RESULTS: Control and RGI showed higher correct answer scores than RGII. There was no difference between the correct answer distributions of the Control and RGI, and RGI and RGII in the test of DNPLS and the number of correct answers in the CG was higher than in the RGII. CONCLUSION: The ability to discriminate non-words enabled the differentiated between school-aged children with SRD associated with PSSD and typical children, thus characterizing this group for presenting a number of correct answers lower than 30.5, considering the task proposed to discriminate non-words. These results suggest that the presence of PSSD worsens the performance in speech perception of the schoolchildren with SRD.
OBJETIVO: Investigar se a habilidade de percepção de fala pode diferenciar escolares com Transtorno específico de aprendizagem (TAp) com e sem Transtorno Persistente dos Sons da Fala (TPSF). MÉTODO: Participaram da pesquisa 80 crianças, regularmente matriculadas no 2º (N=1), 3º (N=28), 4º (N=29), 5º (N=15), e 6º (N=7) anos, assim reunidos: Grupo Controle (N= 48) - sem queixas, sem alteração de fala; e Grupos Pesquisa (N = 32) - com TAp, sendo GPI (N = 15) sem TPSF e, GPII (N = 17), com TPSF. Duas provas avaliaram input auditivo: Avaliação simplificada do processamento auditivo; e Tarefa de percepção de pseudopalavras com estrutura da língua portuguesa - TDP. Os dados foram analisados pelos testes: Razão de Verossimilhanças, Kruskal-Wallis, Dunn com correção de Bonferroni, Mann-Whitney, correlação de Spearman, além da construção de uma curva ROC para obter um valor de corte para o número de acertos na prova de percepção de não palavras. RESULTADOS: Controle e GPI mostraram maiores escores de acerto que GPII. Não houve diferença entre as distribuições de acertos do Controle e GPI e do GPI e GPII na TDP e o número de acertos do GC foi maior que o do GPII. CONCLUSÃO: A habilidade de discriminação de pseudopalavras diferenciou os escolares com TAp e TPSF das crianças sem TPSF, caracterizando, assim esse grupo por apresentar número de acertos menor que 30,5, considerada a tarefa proposta para discriminar pseudopalavras. Esses resultados sugerem que a presença do TPSF piorou o desempenho em percepção de fala dos escolares com TAp.
Assuntos
Percepção da Fala , Transtorno Fonológico , Humanos , Percepção da Fala/fisiologia , Criança , Transtorno Fonológico/fisiopatologia , Transtorno Fonológico/diagnóstico , Masculino , Feminino , Estudos de Casos e Controles , Transtorno de Aprendizagem Específico/fisiopatologia , Dislexia/fisiopatologia , Dislexia/diagnósticoRESUMO
Coal mining activities release harmful air pollutants, which affect children's health, particularly the lung function. Brazil has a large coal reserve in the southern region, where a coal-fired power plant and two coal mines are located. The study aimed to evaluate the prevalence of altered respiratory function and associated factors in children living in this region. A cross-sectional study was conducted in seven cities. It collected socioeconomic and demographic, prenatal and postnatal care, neonatal outcomes, child health information as well as lung function and air quality. The study included 396 children who lived in a high socio-environmental vulnerability due to low education levels and family income, high percentage of unemployed and families with a high bedroom density. There was a high prevalence of preterm birth, low birth weight and long-term exposure to environmental conditions. The most common respiratory problem in the parents was rhinitis, while in the children was wheezing and pneumonia. The prevalence of respiratory function alteration in the region was 7.78%. Variables associated with altered respiratory function were passive smoking, low birth weight, history of wheezing. The concentration of pollutants was equivalent when comparing stations within the coal mining host town (Candiota) and surrounding towns.
Assuntos
Fatores Socioeconômicos , Humanos , Brasil/epidemiologia , Estudos Transversais , Feminino , Masculino , Criança , Pré-Escolar , Testes de Função Respiratória , Prevalência , Minas de Carvão , Recém-Nascido , Lactente , Exposição Ambiental/efeitos adversos , Poluentes Atmosféricos/análise , Poluentes Atmosféricos/efeitos adversos , Fatores de Risco , Pulmão/fisiopatologiaRESUMO
OBJECTIVES: Identify the frequency of recurrent violence in cases reported in Espírito Santo and the associated factors. METHODS: Cross-sectional study. Which included data on violence in Espírito Santo from 2011 to 2018, from the Notifiable Diseases Information System, and, Statistical analyzes were performed using the chi-square test and Poisson regression. RESULTS: 54.2% (N:14.966) of reported cases of violence are repeated, and higher prevalences were associated with female sex (PR:1.54), child (PR: 1.29) or elderly victims (PR: 1.25), the presence of disabilities/disorders (PR:1.42) and occurrence in urban/peri-urban areas (PR: 1.10). Furthermore, there is a greater frequency of injuries caused by a single aggressor (PR: 1.20), man (PR: 1.28), aged 25 or over (PR: 1.09), known to the victim (PR: 2.81) and at home (PR: 1.69). CONCLUSION: The reported cases of violence showed a high frequency of recurrence, and were associated with the studied characteristics of the victim, the aggressor and the event.
Assuntos
Recidiva , Violência , Humanos , Masculino , Estudos Transversais , Feminino , Adulto , Violência/estatística & dados numéricos , Criança , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Adolescente , Brasil/epidemiologia , Pré-Escolar , Lactente , Prevalência , Ferimentos e Lesões/epidemiologiaRESUMO
The etiology of tinea capitis changes over time, mainly due to trends in migration. We report 19 cases of tinea capitis caused by Microsporum audouinii, an uncommon agent in South America, all of them confirmed by molecular methods. All patients were male. The average age was 6.1 years. Fifteen patients were residents of Rio de Janeiro city and four were from neighboring cities. Among the patients submitted to follow-up, griseofulvin was prescribed for eight of them. Due to medication shortages, terbinafine was prescribed for five patients, needing to be switched in three cases, with a bigger total average time until clinical improvement. The study reaffirms the emergence of a new etiological agent in Rio de Janeiro, Brazil.
The etiology of tinea capitis changes over time, mainly due to migratory flows. We report 19 cases of tinea capitis caused by Microsporum audouinii, an uncommon agent in South America, all of them confirmed by molecular methods. The study reaffirms the emergence of a new etiological agent in Rio de Janeiro, Brazil.
Assuntos
Antifúngicos , Griseofulvina , Microsporum , Terbinafina , Tinha do Couro Cabeludo , Humanos , Tinha do Couro Cabeludo/microbiologia , Tinha do Couro Cabeludo/tratamento farmacológico , Tinha do Couro Cabeludo/epidemiologia , Brasil/epidemiologia , Microsporum/isolamento & purificação , Masculino , Antifúngicos/uso terapêutico , Criança , Pré-Escolar , Griseofulvina/uso terapêutico , Terbinafina/uso terapêutico , Adolescente , LactenteRESUMO
INTRODUCTION: The increase in the production of substances to enhance the quality of life, the biodiversity of the different ecosystems in Mexico, and the unique characteristics of pediatric patients, contribute to intoxications within this population. METHOD: Analytical retrospective study of admissions to pediatric emergency care due to poisoning in < 16-year-old (2016 to 2020). Included variables were age, gender, type of toxic substance, exposure characteristics, and the season of the year. Frequencies, percentages, range, average and standard deviation were obteined. In the bivariate análisis, the Chi square test was used. A p-value < 0.05 was considered statistically significant. RESULTS: Over 5 years, there were 459 cases, with a prevalence of 3.16%. No gender predominance was observed. The most common was caused by venomous animals (28.5%), followed by medication ingestion (27.6%). Only 5% of cases were suicide attempts, the rest were accidental (95%). Children up to 5 years old were more commonly by medication ingestion, hydrocarbons, or household products (p = 0.03, p = 0.0001), while the causes in older children were contact with venomous animals and ingestion of stimulants drugs (alcohol, amphetamines, cannabis, cocaine) (p = 0.0001, p = 0.006). Intoxication with quaternary ammonium herbicides was lethal in all cases. CONCLUSIONS: Children under the age of 5 are more susceptible to intoxication from common household products. Older kids tend to be more frequently a combination of stimulants drugs.
INTRODUCCIÓN: El aumento en la producción de sustancias para mejorar la calidad de vida, la biodiversidad de los diferentes ecosistemas en México, así como las características propias de los pacientes pediátricos, contribuyen a la intoxicación dentro de esta población. MÉTODO: Estudio retrospectivo analítico de los ingresos por envenenamiento en niños menores de 16 años en urgencias pediátricas (2016 a 2020). Se analizaron la edad, el sexo, el tipo de xenobiótico, las características de exposición y la estación del año. Se obtuvieron frecuencias, porcentajes, rango, promedio y desviación estándar. En el análisis bivariado se utilizó la prueba chi al cuadrado, considerando estadísticamente significativo un valor p < 0.05. RESULTADOS: En el periodo de 5 años se atendieron 459 casos, con una prevalencia del 3.16%. No se observó predominio de sexo. La intoxicación más frecuente fue por animales venenosos (28.5%), seguida de la ingesta de medicamentos (27.6%). El 95% de los casos fueron accidentales y el 5% por intento de suicidio. En los menores de 5 años, lo más frecuente fue la ingesta de medicamentos, hidrocarburos o productos de uso doméstico (p = 0.03, p = 0.0001), mientras que en los mayores de 6 años fue por contacto con animales venenosos e ingesta de drogas estimulantes (alcohol, anfetaminas, cannabis, cocaína) (p = 0.0001, p = 0.006). El 100% de los intoxicados por herbicida cuaternario de amonio fallecieron. CONCLUSIONES: Los menores de 5 años son más propensos a la intoxicación con productos que se utilizan en sus propios domicilios. En los mayores de 6 años es más frecuente la combinación de drogas estimulantes.
Assuntos
Intoxicação , Humanos , México/epidemiologia , Masculino , Feminino , Estudos Retrospectivos , Criança , Pré-Escolar , Intoxicação/epidemiologia , Adolescente , Lactente , Prevalência , Tentativa de Suicídio/estatística & dados numéricos , Estações do Ano , Emergências , Serviço Hospitalar de Emergência/estatística & dados numéricosRESUMO
INTRODUCTION: Epstein-Barr virus (EBV) infection, with a global prevalence exceeding 95%, typically manifests in children as infectious mononucleosis. However, clinical practice frequently encounters diverse atypical presentations characterized by multisystem involvement, often resulting in an unfavorable clinical course. Our objective is to describe the clinical manifestations and results of EBV infection in a tertiary pediatric hospital in Mexico. METHOD: An observational, transversal, retrospective, and descriptive study that included a systematic review of medical records (2012-2022) of patients under 18 years of age with detectable EBV particles in peripheral blood. RESULTS: The study included 26 patients with a median age of 5 years and a male predominance of 53.8%. Predominant symptoms were fever (85%) and lymphadenopathy (35%). Sixty-five percent had severe and atypical manifestations, including pneumonia and hepatic, hematologic-oncologic, and autoimmune diseases. Anemia, thrombocytopenia and leukopenia were common, with lymphocytosis in 19% of cases. The median EBV viral load was 2816 copies/mL (range: 555-355,500 copies/mL). Four deaths related to EBV infection were reported. Viral load in these cases also varied widely from 594 to 121,000 copies/mL. Supportive care was administered to 85% of patients, while others received antiviral treatment, steroids, and rituximab. CONCLUSION: Atypical manifestations were common, especially in children with multisystem involvement. EBV should be considered as a potential contributor to a diverse spectrum of clinical presentations, emphasizing the need for comprehensive evaluation and awareness in clinical diagnosis.
INTRODUCCIÓN: La infección por el virus de Epstein-Barr (VEB) tiene una prevalencia mundial superior al 95%. Se considera que en los niños se manifiesta principalmente como mononucleosis infecciosa; sin embargo, en la práctica clínica, a menudo encontramos numerosas manifestaciones atípicas con compromiso multisistémico que llevan a un curso desfavorable. Nuestro objetivo es describir las manifestaciones clínicas y los resultados de la infección por VEB en un hospital pediátrico de tercer nivel en México. MÉTODO: Estudio observacional, transversal, retrospectivo y descriptivo, en el cual se revisaron sistemáticamente los expedientes médicos de pacientes menores de 18 años con una detección positiva de partículas de VEB en sangre periférica en el periodo 2012-2022. RESULTADOS: Se incluyeron 26 pacientes con una mediana de edad de 5 años y predominio de varones (53.8%). El 65% presentaron manifestaciones graves y atípicas, incluyendo enfermedades respiratorias, hepáticas, hematooncológicas y autoinmunitarias. Los síntomas más frecuentes fueron fiebre (85%) y linfadenopatía (35%). El 54% presentaron manifestaciones atípicas, incluyendo linfohistiocitosis hemofagocítica, neumonía y neoplasia. La anemia, la trombocitopenia y la leucocitopenia fueron comunes, mientras que el 19% presentaron linfocitosis. La media de la carga viral fue de 2816 copias/ml (555-355,500). Se informaron cuatro muertes atribuidas a la infección por VEB, con valores de carga viral de 594 a 121,000 copias/ml. El 85% de los pacientes recibieron solo tratamiento sintomático, mientras que otros recibieron antivirales, esteroides y rituximab. CONCLUSIÓN: Las manifestaciones atípicas se observaron comúnmente, en especial en niños con compromiso multisistémico. El VEB debe considerarse como un potencial factor contribuyente en el diagnóstico de una amplia gama de manifestaciones clínicas.
Assuntos
Infecções por Vírus Epstein-Barr , Centros de Atenção Terciária , Humanos , México/epidemiologia , Masculino , Feminino , Infecções por Vírus Epstein-Barr/epidemiologia , Infecções por Vírus Epstein-Barr/diagnóstico , Criança , Estudos Retrospectivos , Pré-Escolar , Adolescente , Lactente , Estudos Transversais , Carga Viral , Hospitalização/estatística & dados numéricos , Herpesvirus Humano 4/isolamento & purificação , Herpesvirus Humano 4/genética , Febre/virologia , Linfadenopatia/virologiaRESUMO
BACKGROUND: Intramuscular vascular malformations (IVMs) are rare developmental congenital structural abnormalities. Their clinical diagnosis is difficult, and imaging studies are essential to determine the type and extent of vessels involved. Treatment can be challenging and must be managed by a multidisciplinary team. METHODS: A descriptive, observational, retrospective, longitudinal study of clinical records of patients diagnosed with IVMs who were evaluated at the vascular anomalies clinic from January 2011 to December 2021 was performed. Demographic, clinical, imaging, diagnosis, treatment, and response data were collected. RESULTS: Seven patients (five females and two males) with a mean age of 13.66 years (standard deviation 5.82 years) were included in the study. In all cases, the clinical diagnosis was venous and lymphatic malformation. The radiological findings were dilated and tortuous vascular structures or multilobulated lesions with septa inside, with or without vascular flow; these findings allowed diagnosis in all cases. Treatment modalities included sclerotherapy in five patients, surgical resection in two, medical treatment with sirolimus in three, and surveillance in one. Subsequent clinical evolution was favorable in all patients, with decreased pain in six (partial in four and total in two) and size reduction in one patient. CONCLUSION: IVMs in our pediatric population most frequently affect the lower extremities. The main symptoms and signs were pain on exertion and volume increase. Treatment can be challenging given the extension and depth of the malformations, so a combination of therapeutic modalities may be necessary to obtain the best outcome.
INTRODUCCIÓN: Las malformaciones vasculares intramusculares (MVI) son anomalías estructurales congénitas del desarrollo raras. Su diagnóstico clínico es difícil y los estudios de imagen son fundamentales para determinar su tipo y extensión. Su tratamiento puede ser un desafío y debe ser dirigido por un equipo multidisciplinario. MÉTODOS: Se realizó un estudio descriptivo, observacional, retrospectivo y longitudinal de los expedientes clínicos de pacientes con diagnóstico de MVI que fueron valorados en la Clínica de Anomalías Vasculares desde enero 2011 a diciembre 2021. Se recolectaron datos demográficos, clínicos, imagenológicos, diagnóstico, tratamiento y respuesta al mismo. RESULTADOS: Se incluyeron 7 pacientes (5 mujeres y 2 hombres) con una edad media de 13.66 años (DE 5.82 años). En todos, el diagnóstico clínico fue malformación venosa y/o linfática. Los hallazgos radiológicos mediante ultrasonido y/o resonancia magnética nuclear fueron estructuras vasculares dilatadas y tortuosas o lesiones multilobuladas con septos en su interior, con o sin flujo vascular; y en todos los casos permitieron hacer el diagnóstico. El tratamiento fue escleroterapia en 5 pacientes, resección quirúrgica en 2, tratamiento con Sirolimus en 3 y vigilancia en 1. La evolución clínica posterior fue favorable en todos, con disminución del dolor en 6 (parcial en 4 y total en 2) y reducción del tamaño en 1 paciente. CONCLUSIÓN: Las MVI en nuestra población pediátrica, afectan con mayor frecuencia las extremidades inferiores. Los principales síntomas fueron dolor de esfuerzo y aumento de volumen. Su tratamiento puede ser un reto dada su extensión y profundidad, por lo que la combinación de modalidades terapéuticas puede ser necesarias para obtener el mejor desenlace.
Assuntos
Escleroterapia , Malformações Vasculares , Humanos , Estudos Retrospectivos , Feminino , Masculino , Criança , Adolescente , Malformações Vasculares/terapia , Malformações Vasculares/diagnóstico , Estudos Longitudinais , Escleroterapia/métodos , Sirolimo/administração & dosagem , Anormalidades Linfáticas/terapia , Anormalidades Linfáticas/diagnóstico , Anormalidades Linfáticas/patologia , Pré-Escolar , Músculo Esquelético/irrigação sanguínea , Resultado do TratamentoRESUMO
INTRODUCTION: Linear IgA bullous dermatosis (LABD) is a rare autoimmune disease. Although dapsone is the initial treatment, other immunomodulators are used in resistant cases or when dapsone is unavailable. CASE REPORT: A 12-year-old Mexican child, with no relevant medical history, developed in May 2023 a disseminated dermatosis affecting all body segments, including mucous membranes, characterized by erythematous patches and plaques evolving into the formation of serous and serosanguinous blisters and vesicles, distributed in a "string of pearls" pattern. LABD was suspected and confirmed by skin biopsy, which showed a subepidermal blister with neutrophilic infiltration and linear Immunoglobulin A deposits at the dermo-epidermal junction by direct immunofluorescence. Treatment with prednisone (2 mg/kg/day) and cyclosporine (5 mg/kg/day) resulted in improvement and lesion remission within 2 weeks. Both drugs needed to be discontinued for 3 months due to intermittent blistering. Cyclosporine was continued as maintenance therapy at a dose of 4 mg/kg/day for 8 months. CONCLUSIONS: The report highlights the use of cyclosporine as an alternative immunomodulator for DAAL, an immunosuppressive agent used in autoimmune disorders. Few cases, including this one, have described complete remission and control of the dermatosis with cyclosporine, accompanied by prednisone at the start of treatment.
INTRODUCCIÓN: La dermatosis ampollosa por IgA lineal es una enfermedad autoinmunitaria rara. Aunque la dapsona es el tratamiento inicial, se usan otros inmunomoduladores en casos resistentes o cuando la dapsona no está disponible. CASO CLÍNICO: Un niño mexicano de 12 años, sin antecedentes relevantes, desarrolló en mayo de 2023 una dermatosis diseminada a todos los segmentos corporales, incluyendo las mucosas, caracterizada por manchas y placas eritematosas que evolucionaron hacia la formación de ampollas y vesículas serosas y serohemáticas, distribuidas en forma de «cadena de perlas¼. Se sospechó dermatosis ampollosa por IgA lineal y se confirmó mediante biopsia cutánea, que mostró una ampolla subepidérmica con infiltrado neutrófilo y depósitos lineales de IgA en la unión dermoepidérmica mediante inmunofluorescencia directa. El tratamiento con prednisona (2 mg/kg al día) y ciclosporina (5 mg/kg al día) resultó en mejoría y la remisión de las lesiones a las 2 semanas. Fue necesario dejar ambos fármacos durante 3 meses debido a la aparición intermitente de ampollas. Se dejó ciclosporina como terapia de mantenimiento a dosis de 4 mg/kg al día por 8 meses. CONCLUSIONES: El reporte destaca el uso de ciclosporina como inmunomodulador alternativo para la dermatosis ampollosa por IgA lineal, un agente inmunosupresor utilizado en trastornos autoinmunitarios. Pocos casos, incluido este, han descrito la remisión completa y el control de la dermatosis con ciclosporina, acompañada de prednisona al inicio del tratamiento.
Assuntos
Ciclosporina , Imunossupressores , Dermatose Linear Bolhosa por IgA , Prednisona , Humanos , Ciclosporina/administração & dosagem , Ciclosporina/uso terapêutico , Criança , Dermatose Linear Bolhosa por IgA/tratamento farmacológico , Dermatose Linear Bolhosa por IgA/diagnóstico , Dermatose Linear Bolhosa por IgA/patologia , Prednisona/administração & dosagem , Prednisona/uso terapêutico , Imunossupressores/administração & dosagem , Imunossupressores/uso terapêutico , Masculino , Glucocorticoides/administração & dosagem , Quimioterapia Combinada , Resultado do Tratamento , MéxicoRESUMO
BACKGROUND: Pilomatricoma is a common benign adnexal neoplasm in children. There are few epidemiological studies on this subject, with most relying solely on descriptive statistics. METHODS: A cross-sectional study conducted in two tertiary hospitals in Mexico City from January 2017 to December 2023. Clinical and electronic records of patients with histopathological diagnosis of pilomatricoma, both sexes, under 18 years old, with any type of present comorbidity were selected. Records of patients with diagnosis not confirmed by histopathology or incomplete records were not included in the study. RESULTS: Fifty-two cases with pilomatrixoma were included in the study, showing a total of 74 lesions. About 23.1% of the cases had multiple pilomatrixomas. 40.4% of the cases experienced pain; this symptom was associated with lesions > 15 mm in diameter and with multiple pilomatrixomas. Risk factors for lesions > 15 mm included age under 8 years, positive tent sign, tumor evolution longer than a year, and a non-classical clinical variety. The head and neck were the most commonly affected areas. The left upper extremity presented larger pilomatrixomas (median 18.5 mm) and occurred more frequently in adolescent patients (mean age 12.1 years) compared to other body areas. CONCLUSIONS: Pilomatrixoma in children shows clinical diversity, with specific findings based on size, number, and anatomical location.
INTRODUCCIÓN: El pilomatricoma es una neoplasia anexial benigna frecuente en la infancia. Hay muy pocos estudios epidemiológicos al respecto y la mayoría solo han utilizado estadística descriptiva. MÉTODOS: Estudio transversal realizado en dos hospitales de concentración de la Ciudad de México de enero de 2017 a diciembre de 2023. Se seleccionaron expedientes clínicos y electrónicos de pacientes con diagnóstico histopatológico de pilomatricoma, ambos sexos, menores de 18 años, con cualquier tipo de comorbilidad presente. No se incluyeron los expedientes de pacientes con diagnóstico no confirmado por histopatología o expediente incompleto. RESULTADOS: Se incluyeron 52 casos con diagnóstico de pilomatricoma que mostraron un total de 74 lesiones. El 23.1% de los pacientes tuvieron pilomatricomas múltiples. El 40.4% experimentaron dolor; este signo se asoció con lesiones de diámetro superior a 15 mm y pilomatricomas múltiples. La edad menor de 8 años, el signo de la tienda de campaña positivo, un tiempo de evolución mayor de 1 año y una variedad clínica no clásica son factores de riesgo asociados con las lesiones mayores de 15 mm. La cabeza y el cuello fueron las áreas más comúnmente afectadas por estos tumores. La extremidad superior izquierda presento pilomatricomas de mayor tamaño (mediana 18.5 mm), y ocurrieron más en pacientes adolescentes (media 12.1 años), en comparación con otras áreas del cuerpo. CONCLUSIONES: El pilomatricoma en niños muestra diversidad clínica. Presenta hallazgos y asociaciones específicas según el tamaño, el número y la ubicación anatómica.
Assuntos
Doenças do Cabelo , Pilomatrixoma , Neoplasias Cutâneas , Humanos , Pilomatrixoma/patologia , Pilomatrixoma/epidemiologia , Pilomatrixoma/diagnóstico , México/epidemiologia , Masculino , Criança , Feminino , Estudos Transversais , Adolescente , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/epidemiologia , Pré-Escolar , Doenças do Cabelo/epidemiologia , Doenças do Cabelo/patologia , Fatores de Risco , Lactente , Dor/epidemiologia , Dor/etiologiaRESUMO
Influenza circulation was significantly affected in 2020-21 by the COVID-19 pandemic. During this time, few influenza cases were recorded. However, in the summer of 2021-22, an increase in atypical influenza cases was observed, leading to the resurgence of influenza in the southernmost state of Brazil, Rio Grande do Sul (RS). The present study aimed to identify the circulation of FLUAV, FLUBV and SARS-CoV-2 and characterize the influenza genomes in respiratory samples using high-throughput sequencing technology (HTS). Respiratory samples (n = 694) from patients in RS were selected between July 2021 and August 2022. The samples were typed using reverse transcriptase real-time PCR (RT-qPCR) and showed 32% (223/694) of the samples to be positive for SARS-CoV-2, 7% for FLUAV (H3) (49/694). FLUBV was not detected. RT-qPCR data also resulted in FLUAV and SARS-CoV-2 co-infections in 1.7% (4/223) of samples tested. Whole genome sequencing of FLUAV produced 15 complete genomes of the H3N2 subtype, phylogenetically classified in the 3C.2a1b.2a.2a.3 subclade and revealing the dominance of viruses in the southern region of Brazil. Mutation analysis identified 72 amino acid substitutions in all genes, highlighting ongoing genetic evolution with potential implications for vaccine effectiveness, viral fitness, and pathogenicity. This study underscores limitations in current surveillance systems, advocating for comprehensive data inclusion to enhance understanding of influenza epidemiology in southern Brazil. These findings contribute valuable insights to inform more effective public health responses and underscore the critical need for continuous genomic surveillance.
Assuntos
COVID-19 , Genoma Viral , Influenza Humana , Filogenia , SARS-CoV-2 , Humanos , Brasil/epidemiologia , COVID-19/epidemiologia , COVID-19/virologia , SARS-CoV-2/genética , SARS-CoV-2/classificação , SARS-CoV-2/isolamento & purificação , Influenza Humana/epidemiologia , Influenza Humana/virologia , Pessoa de Meia-Idade , Adulto , Feminino , Genoma Viral/genética , Masculino , Adulto Jovem , Idoso , Adolescente , Surtos de Doenças , Sequenciamento Completo do Genoma , Criança , Pré-Escolar , Lactente , Coinfecção/epidemiologia , Coinfecção/virologia , Sequenciamento de Nucleotídeos em Larga Escala , Idoso de 80 Anos ou mais , GenômicaRESUMO
BACKGROUND: Klebsiella pneumoniae is the major cause of nosocomial infections worldwide and is related to a worsening increase in Multidrug-Resistant Bacteria (MDR) and virulence genes that seriously affect immunosuppressed patients, long-stay intensive care patients, elderly individuals, and children. Whole-Genome Sequencing (WGS) has resulted in a useful strategy for characterizing the genomic components of clinically important bacteria, such as K. pneumoniae, enabling them to monitor genetic changes and understand transmission, highlighting the risk of dissemination of resistance and virulence associated genes in hospitals. In this study, we report on WGS 14 clinical isolates of K. pneumoniae from a pediatric hospital biobank of Guayaquil, Ecuador. RESULTS: The main findings revealed pronounced genetic heterogeneity among the isolates. Multilocus sequencing type ST45 was the predominant lineage among non-KPC isolates, whereas ST629 was found more frequently among KPC isolates. Phylogenetic analysis suggested local transmission dynamics. Comparative genomic analysis revealed a core set of 3511 conserved genes and an open pangenome in neonatal isolates. The diversity of MLSTs and capsular types, and the high genetic diversity among these isolates indicate high intraspecific variability. In terms of virulence factors, we identified genes associated with adherence, biofilm formation, immune evasion, secretion systems, multidrug efflux pump transporters, and a notably high number of genes related to iron uptake. A large number of these genes were detected in the ST45 isolate, whereas iron uptake yersiniabactin genes were found exclusively in the non-KPC isolates. We observed high resistance to commonly used antibiotics and determined that these isolates exhibited multidrug resistance including ß-lactams, aminoglycosides, fluoroquinolones, quinolones, trimetropins, fosfomycin and macrolides; additionally, resistance-associated point mutations and cross-resistance genes were identified in all the isolates. We also report the first K. pneumoniae KPC-3 gene producers in Ecuador. CONCLUSIONS: Our WGS results for clinical isolates highlight the importance of MDR in neonatal K. pneumoniae infections and their genetic diversity. WGS will be an imperative strategy for the surveillance of K. pneumoniae in Ecuador, and will contribute to identifying effective treatment strategies for K. pneumoniae infections in critical units in patients at stratified risk.
Assuntos
Farmacorresistência Bacteriana Múltipla , Genoma Bacteriano , Hospitais Pediátricos , Klebsiella pneumoniae , Filogenia , Sequenciamento Completo do Genoma , Humanos , Equador , Klebsiella pneumoniae/genética , Klebsiella pneumoniae/isolamento & purificação , Klebsiella pneumoniae/efeitos dos fármacos , Farmacorresistência Bacteriana Múltipla/genética , Criança , Infecções por Klebsiella/microbiologia , Infecções por Klebsiella/epidemiologia , Fatores de Virulência/genética , Tipagem de Sequências Multilocus , Pré-Escolar , Lactente , Variação GenéticaRESUMO
BACKGROUND: This study aims to verify the relationship between screen and sleep time, body mass index (BMI) and immunological factors with telomere length according to leisure-time physical activity (PA) in children and adolescents. METHODS: A cross-sectional study involving a sample of 476 schoolchildren of both sexes, aged seven to 17 years, from a community in southern Brazil. Behavioral variables (PA, sleep time, and screen time) were self-reported using a questionnaire. PA was classified as inactive and any PA (doing some physical activity). The associations of screen time, sleep time, BMI, and immunologic factors with telomere length were tested using multiple linear regression models, with the sample divided according to the schoolchildren's leisure-time physical activity practices. RESULTS: An inverse association between BMI and telomere length (ß: -0.239; 95% CI: -0.468; -0.010) and a direct association of leukocytes (ß: 0.151; 95% CI: 0.029; 0.278) and neutrophils (ß: 0.131; 95% CI: 0.008; 0.254) with telomeres were found in the inactive students. No association was found between screen time and sleep time and telomeres. No association was found among students who engaged in any PA. CONCLUSION: The associations between telomeres, BMI, and immunologic factors were found only in inactive students. These results suggest that the association between BMI and immunological factors and telomere length may be influenced by physical activity.
Assuntos
Índice de Massa Corporal , Exercício Físico , Sono , Telômero , Humanos , Masculino , Feminino , Estudos Transversais , Criança , Adolescente , Brasil , Tempo de Tela , Atividades de Lazer , Fatores Imunológicos , Modelos LinearesAssuntos
Ecocardiografia , Genótipo , Humanos , Ecocardiografia/métodos , Masculino , Criança , Feminino , Mutação , Proteínas Quinases Ativadas por AMPRESUMO
OBJECTIVE: A hedgehog family ligand, namely, sonic hedgehog (SHH), was reported to be important in the development of bladder and ureter smooth muscle. In this prospective study, we aimed to determine protein expression of SHH in resected ureterovesical junction (UVJ) segments of children with vesicoureteral reflux (VUR). MATERIALS AND METHODS: The study group included 19 children; 12 (63%) girls, 7 (37%) boys, who had ureteroneocystostomy operation; 3 (15.7%) right sided, 7 (36.8%) left sided, 9 (47.3%) bilateral, due to primary VUR between years 2015 and 2018. Totally, 28 UVJ segments were examined for Western Blot analysis to determine related protein expression levels. RESULTS: The mean Western blot band area of SHH gene pathway related protein was 3880.69 (2059.55-13941.61) while the mean area of ß-Actin, the house-keeping gene, was 20180.25 (9530.39-26709.75) (p = 0.001). Correlation analyses between grade of reflux and protein expression of SHH gene pathways revealed no significant relation (p = 0.300). When the UV samples were grouped as low- and high-grade reflux and compared in terms of SHH protein expression levels, no statistically significant difference was found between groups (p = 0.818). CONCLUSION: We concluded that SHH signaling molecule which is effective in development of bladder and ureter smooth musculature might also be effective in etiopathology of reflux.
OBJETIVO: Se ha informado que el ligando sonic hedgehog (SHH) es importante en el desarrollo de los músculos lisos de la vejiga y el uréter. Nuestro objetivo fue determinar la expresión proteica de SHH en los segmentos de la unión ureterovesical de niños con reflujo vesicoureteral (RVU). MATERIALES Y MÉTODOS: El grupo de estudio incluyó a 19 niños; 12 (63%) niñas, 7 (37%) niños, que tuvieron operación de ureteroneocistostomía (UNC); 3 (15.7%) derecho, 7 (36.8%) izquierdo, 9 (47.3%) bilateral, por RVU primario entre los años 2015-2018. Se examinaron un total de 28 segmentos de la unión ureterovesical para análisis de transferencia Western para determinar los niveles de expresión de proteínas relacionadas en las muestras. RESULTADOS: El área media de la banda de transferencia Western de la proteína relacionada con la vía del gen SHH fue de 3880.69 (2059.55-13941.61), mientras que el área media de la ß-actina, el gen de limpieza, fue de 20180.25 (9530.39-26709.75) (p = 0.001). Los análisis de correlación entre el grado de reflujo y la expresión de proteínas de las vías del gen SHH no revelaron una relación significativa (p = 0.300). CONCLUSIÓN: Concluimos que la molécula de señalización SHH también podría ser efectiva en la etiopatología del reflujo vesicoureteral.
Assuntos
Proteínas Hedgehog , Transdução de Sinais , Bexiga Urinária , Refluxo Vesicoureteral , Proteínas Hedgehog/metabolismo , Proteínas Hedgehog/genética , Humanos , Masculino , Feminino , Refluxo Vesicoureteral/genética , Estudos Prospectivos , Bexiga Urinária/metabolismo , Pré-Escolar , Criança , Ureter/metabolismo , LactenteRESUMO
OBJECTIVE: This study assessed patient's satisfaction after orthodontic treatment in the postgraduate orthodontic clinic of the Dental School at the University of Athens (Athens, Greece), and investigated possible correlations between satisfaction after orthodontic treatment and life satisfaction, alongside the influence of age, gender, severity of initial orthodontic malocclusion and duration of retention period. MATERIAL AND METHODS: Patients aged 12 years and above, who had recently completed comprehensive orthodontic treatment, participated completing two questionnaires: a 37-item questionnaire, validated for assessing orthodontic treatment satisfaction; and the 5-item Satisfaction with Life Scale, a valid and reliable measure of life satisfaction. Scores from each questionnaire were summed for each patient. Demographic details, Index of Orthodontic Treatment Need (IOTN) and the duration of the retention period up to questionnaire completion were collected. Multiple regression analysis assessed the relationship between the questionnaires and the evaluated variables. RESULTS: A total of 150 patients answered the questionnaires, being 82 women (55%) and 68 men (45%). The mean age of patients was 18.87 ± 5.97 years (range: 12-47). Most patients expressed satisfaction with treatment outcomes (grades 5 and 6). Satisfaction with orthodontic treatment showed a significant correlation with life satisfaction (p=0.002), but not with gender, age, dental/esthetic components of IOTN, or the duration of the retention period. CONCLUSION: Satisfaction after orthodontic treatment exhibited a significant correlation with life satisfaction, but it was not affected by gender, age, dental/esthetic components of IOTN, or the duration of the retention period.
Assuntos
Índice de Necessidade de Tratamento Ortodôntico , Má Oclusão , Ortodontia Corretiva , Satisfação do Paciente , Humanos , Feminino , Masculino , Criança , Adolescente , Ortodontia Corretiva/psicologia , Má Oclusão/terapia , Má Oclusão/psicologia , Adulto , Inquéritos e Questionários , Adulto Jovem , Pessoa de Meia-Idade , Fatores Sexuais , Fatores Etários , Qualidade de Vida , Resultado do Tratamento , Satisfação Pessoal , Estética Dentária , Contenções OrtodônticasRESUMO
INTRODUCTION: The long pathway that the canines take as they emerge into the maxillary arch makes them vulnerable to disruption during their natural emergence time. The process of planning treatment for impacted maxillary canine (IMC) presents significant challenges, underscoring the need for careful consideration and expertise. OBJECTIVE: The aim of this article was to shed light on these complexities by discussing clinical case studies involving IMC, providing insights into the intricacies of their management. CONCLUSIONS: The management of IMC within orthodontics presents a multifaceted challenge that include the necessity for precise diagnostic processes, prudent use of cone beam computed tomography (CBCT), the strategic selection between open and closed exposure techniques, a in-depth understanding of the specific orthodontic biomechanics involved, and a keen awareness of potential adverse outcomes such as ankylosis, prolonged treatment times, root resorption, and additional complications.
Assuntos
Tomografia Computadorizada de Feixe Cônico , Dente Canino , Maxila , Dente Impactado , Dente Impactado/terapia , Dente Impactado/diagnóstico por imagem , Humanos , Dente Canino/diagnóstico por imagem , Maxila/diagnóstico por imagem , Planejamento de Assistência ao Paciente , Extrusão Ortodôntica/métodos , Reabsorção da Raiz/diagnóstico por imagem , Reabsorção da Raiz/terapia , Feminino , Adolescente , Fenômenos Biomecânicos , Masculino , Anquilose Dental/terapia , Anquilose Dental/diagnóstico por imagem , Criança , Técnicas de Movimentação Dentária/métodosRESUMO
INTRODUCTION: Patients with Class II, division 1 malocclusion generally seek treatment to improve facial esthetics. Therefore, the orthodontist needs to know the changes in the soft profile produced by functional appliances. OBJECTIVE: This study evaluated the soft tissue profile changes in patients treated during the peak of the pubertal growth spurt. METHODS: Thirty selected patients were randomized into three treatment groups: Twin Block (TB), Herbst with dental anchorage (HDA), and Herbst with skeletal anchorage (HSA). All patients had computed tomographic images: pretreatment (T1) and after 12 months of active treatment (T2). Twenty-four soft tissue cephalometric measures were analyzed. The normality of all data was assessed by the Shapiro-Wilk test. Intragroup comparisons were analyzed using the t-paired test; the inter-group comparisons were determined through ANOVA and the post-hoc Tukey test. RESULTS: At T1, no significant differences were observed between groups. At T2, in the intragroup comparison, facial soft tissue changes were statistically significant in the three groups for the lower lip, sulcus inferioris, facial soft tissue convexity in HDA group and TB group, and H angle in HDA group and HSA group, and soft tissue pogonium in TB group. In the inter-group comparison, no statistically significant differences were observed. CONCLUSION: It can be concluded that there were significant changes in soft tissue measurements that benefited Class II, division 1 patient's facial profile treated with the functional appliances Twin Block, Herbst, and Herbst with skeletal anchorage. Nevertheless, no significant differences were detected among the effects obtained by the three treatment protocols.
Assuntos
Cefalometria , Face , Má Oclusão Classe II de Angle , Aparelhos Ortodônticos Funcionais , Humanos , Adolescente , Face/anatomia & histologia , Face/diagnóstico por imagem , Má Oclusão Classe II de Angle/terapia , Má Oclusão Classe II de Angle/diagnóstico por imagem , Masculino , Feminino , Procedimentos de Ancoragem Ortodôntica/instrumentação , Tomografia Computadorizada por Raios X , Lábio/diagnóstico por imagem , Desenho de Aparelho Ortodôntico , CriançaRESUMO
OBJECTIVE: The aim of this study was to describe the epidemiological characteristics of pediatric patients with sickle cell disease (SCD) and evaluate the use of medicinal plants in these patients concomitantly with their drug treatment. METHODS: This is a review of the medical records of pediatric patients at a public institution with tertiary care. The selection criterion was to be a child or adolescent with SCD undergoing pediatric follow-up at this outpatient clinic. In the medical records of the patients selected, records of the use of plants for medicinal purposes were sought. RESULTS: In total, 154 records (100% of total active patients followed in this clinic) were reviewed: 99 children and 55 adolescents. The predominant genotype was SS (58.4%), followed by SC (29.2%). The use of at least one medication for SCD was reported in 95.5% of the medical records. The use of medicinal plants was reported by 70.1% of patients, with 276 citations in the medical records referring to 64 different types of plants. Six plants were used for the treatment of SCD, the main one being Lemonvine/Ora-pro-nóbis (Pereskia aculeata). The use of medicinal plants was reported for flu-like symptoms and/or COVID-19 (both for prevention and treatment) by 60.5% of the citations, with 35 different plants reported for this use, exclusively or not. This use was followed by pain symptoms (14.2% of citations). CONCLUSIONS: The majority of patients in this study use both conventional and traditional/complementary/alternative medicine, highlighting the need for more studies in the area, with a special focus on patient safety.