CLINICAL MANIFESTATIONS OF CHILDREN AND ADOLESCENTS WITH COVID-19: REPORT OF THE FIRST 115 CASES FROM SABARÁ HOSPITAL INFANTIL

ABSTRACT Objective: To describe the clinical manifestations and severity of children and adolescents affected by COVID-19 treated at Sabará Hospital Infantil. Methods: This is a cross-sectional, retrospective, and observational study. All cases of COVID-19 confirmed by RT-qPCR of patients seen at the hospital (emergency room, first-aid room, and ICU) were analyzed. The severity of the cases was classified according to the Chinese Consensus. Results: Among the 115 children included, a predominance of boys (57%) was verified, and the median age was two years. A total of 22 children were hospitalized, 12 in the ICU. Of the total, 26% had comorbidities with a predominance of asthma (13%). Fever, cough, and nasal discharge were the most frequent symptoms. Respiratory symptoms were reported by 58% of children and gastrointestinal symptoms, by 34%. Three children were asymptomatic, 81 (70%) had upper airway symptoms, 15 (13%) had mild pneumonia, and 16 (14%) had severe pneumonia. Hospitalized children were younger than non-hospitalized children (7 months vs. 36 months). In hospitalized patients, a higher frequency of irritability, dyspnea, drowsiness, respiratory distress, low oxygen saturation, and hepatomegaly was observed. Chest radiography was performed in 69 children with 45% of abnormal exams. No child required mechanical ventilation and there were no deaths. Conclusions: Most of children and adolescents affected by COVID-19 had mild upper airway symptoms. Clinical manifestations of COVID-19 were more severe among younger children who exhibited gastrointestinal and respiratory symptoms more frequently.

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Celiac Disease in Kosovar Albanian Children: Evaluation of Clinical Features and Diagnosis

Current Pediatric Reviews ◽

10.2174/1573396316666200116093753 ◽

2020 ◽

Vol 16 (3) ◽

pp. 241-247

Author(s):

Atifete Ramosaj-Morina ◽

Alije Keka-Sylaj ◽

Arbana Baloku Zejnullahu ◽

Lidvana Spahiu ◽

Virgjina Hasbahta ◽

...

Keyword(s):

Celiac Disease ◽

Disease Onset ◽

Clinical Manifestations ◽

Gastrointestinal Symptoms ◽

Dominant Mode ◽

Primary School Children ◽

Cross Sectional ◽

Classical Form ◽

Wide Range ◽

The Mean

Background: Celiac disease is an immune-mediated disorder characterized by variable clinical manifestations, specific antibodies, HLA-DQ2/DQ8 haplotypes, and enteropathy. Objectives: The aim of this study was to present the clinical spectrum and patterns of celiac disease in Kosovar Albanian children. Methods: A cross-sectional retrospective study was performed with Albanian children aged 0-18 years, treated for celiac disease in the Pediatric Clinic, University Clinical Center of Kosovo from 2005 to 2016. Results: During the study period, 63 children were treated for celiac disease. The mean age at diagnosis was 5.5 years (SD ± 3.31). The mean age at celiac disease onset was 3.3 years (SD ± 2.02), while the mean delay from the first symptoms indicative of celiac disease to diagnosis was 2.2 years (SD ± 2.09). More than 70% of the patients were diagnosed in the first 7 years of life, mainly presented with gastrointestinal symptoms, while primary school children and adolescents mostly showed atypical symptoms (p<0.001). The classical form of celiac disease occurred in 78% of the cases. Sixty (95%) patients carried HLA-DQ2.5, DQ2.2 and/or HLA-DQ8 heterodimers, and only three of them tested negative. Conclusions: Kosovo, as the majority of developing countries, is still facing the classical form of celiac disease as the dominant mode of presentation; as a result, most children with other forms of the celiac disease remain undiagnosed. : Physicians should be aware of the wide range of clinical presentations and utilize low testing thresholds in order to prevent potential long-term problems associated with untreated celiac disease.

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Clinical and laboratory findings in elderly with Community-Acquired Pneumonia in Babol, northern Iran – 2017-2019

Current Issues in Pharmacy and Medical Sciences ◽

10.2478/cipms-2021-0027 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Saleh Habibi ◽

Arefeh Babazadeh ◽

Soheil Ebrahimpour ◽

Parisa Sabbagh ◽

Mehran Shokri

Keyword(s):

Older Adults ◽

Age Groups ◽

Clinical Manifestations ◽

Gastrointestinal Symptoms ◽

Vital Signs ◽

The Elderly ◽

Community Acquired Pneumonia ◽

Northern Iran ◽

Laboratory Findings ◽

Cross Sectional

Abstract Morbidity and mortality are higher in older adults with community-acquired pneumonia (CAP) than in other age groups. Also, CAP in older adults has various clinical manifestations with other. A higher mortality rate in the elderly with CAP may contribute to a delay in management. Consequently, the purpose of this study was to investigate the clinical and laboratory manifestations of CAP in the elderly. This cross-sectional study was conducted on 221 elderly patients with CAP who were admitted to Ayatollah Rouhani Hospital, in Babol, northern of Iran, in 2017-2019. Patient outcomes included 170 cases that recovered from CAP, and 51 cases that died of complications. Patients were evaluated in terms of their clinical and laboratory manifestations. The most common symptoms of pneumonia were cough (79.6%), sputum (73.8%), weakness (72.9%), fever (56%), dyspnea (46.2%). The most frequent underlying disease was ischemic heart disease (43.9%). In our study, clinical and laboratory characteristics in older patients with CAP were evaluated and compared with other studies confirming past findings, but there were differences in some cases, such as vital signs, gastrointestinal symptoms, and disturbance of the level of consciousness. Therefore, it recommends carefully taking the patients’ initial histories and accurately recording their clinical and laboratory symptoms.

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High prevalence of exercise-induced stridor during Parkrun: a cross-sectional field-based evaluation

BMJ Open Respiratory Research ◽

10.1136/bmjresp-2020-000618 ◽

2020 ◽

Vol 7 (1) ◽

pp. e000618

Author(s):

Joe Sails ◽

James H Hull ◽

Hayden Allen ◽

Liam Darville ◽

Emil S Walsted ◽

...

Keyword(s):

Respiratory Symptoms ◽

Phase 1 ◽

Upper Airway ◽

Peak Exercise ◽

Inspiratory Stridor ◽

Cross Sectional ◽

Respiratory Dysfunction ◽

Objective Evidence ◽

Abnormal Breathing ◽

Exercise Induced

Background and objectiveThe differential diagnosis for exercise-associated breathlessness is broad, however, when a young athletic individual presents with respiratory symptoms, they are most often prescribed inhaler therapy for presumed exercise-induced asthma (EIA). The purpose of this study was therefore to use a novel sound-based approach to assessment to evaluate the prevalence of exertional respiratory symptoms and characterise abnormal breathing sounds in a large cohort of recreationally active individuals.MethodsCross-sectional field-based evaluation of individuals completing Parkrun.Phase 1Prerace, clinical assessment and baseline spirometry were conducted. At peak exercise and immediately postrace, breathing was monitored continuously using a smartphone. Recordings were analysed retrospectively and coded for signs of the predominant respiratory noise.Phase 2A subpopulation that reported symptoms with at least one audible sign of respiratory dysfunction was randomly selected and invited to attend the laboratory on a separate occasion to undergo objective clinical workup to confirm or refute EIA.ResultsForty-eight participants (22.6%) had at least one audible sign of respiratory dysfunction; inspiratory stridor (9.9%), expiratory wheeze (3.3%), combined stridor+wheeze (3.3%), cough (6.1%). Over one-third of the cohort (38.2%) were classified as symptomatic. Ten individuals attended a follow-up appointment, however, only one had objective evidence of EIA.ConclusionsThe most common audible sign, detected in approximately 1 in 10 individuals, was inspiratory stridor, a characteristic feature of upper airway closure occurring during exercise. Further work is now required to further validate the precision and feasibility of this diagnostic approach in cohorts reporting exertional breathing difficulty.

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Prevalence of gastroenteritis among 4-year-old children in South Australia

Epidemiology and Infection ◽

10.1017/s0950268803008288 ◽

2003 ◽

Vol 130 (3) ◽

pp. 443-451 ◽

Cited By ~ 4

Author(s):

J. S. HEYWORTH ◽

P. BAGHURST ◽

K. A. McCAUL

Keyword(s):

Risk Factors ◽

Respiratory Symptoms ◽

School Health ◽

Respiratory Infections ◽

Gastrointestinal Symptoms ◽

South Australia ◽

Antibiotic Use ◽

Medical Attention ◽

Cross Sectional Survey ◽

Cross Sectional

The aim of this study was to determine the prevalence of gastroenteritis among children aged 4 years in South Australia. A cross-sectional survey of 9543 South Australian children aged 4 years was undertaken. Parents completed a questionnaire on behalf of their child who had attended a pre-school health check in 1998. The questionnaire covered gastrointestinal and respiratory symptoms experienced by the child in the previous 2 weeks and other risk factors for gastroenteritis. The 2-week prevalence of gastroenteritis among 4-year-old children was 14·2%. The major risk factors for gastroenteritis were presence of persons who had gastroenteritis inside the home, contact with persons who had gastroenteritis outside the home, antibiotic use and sore throat. Medical attention was sought for 20% of children who had gastroenteritis. Gastroenteritis is a significant cause of morbidity among young children and presents a considerable burden on the community. A substantial proportion of these occurrences of highly credible gastrointestinal symptoms may be manifestations of respiratory infections.

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S274 – Smoker's Nose

Otolaryngology ◽

10.1016/j.otohns.2008.05.450 ◽

2008 ◽

Vol 139 (2_suppl) ◽

pp. P166-P167

Author(s):

Thomas Kjaergaard ◽

Milada Småstuen Cvancarova ◽

Sverre Steinsvåg

Keyword(s):

Cigarette Smoking ◽

Smoking Status ◽

Upper Airway ◽

Cigarette Consumption ◽

Etiologic Factor ◽

Dependent Manner ◽

Cross Sectional ◽

Obstructive Sleep ◽

Airway Symptoms ◽

Vas Scores

Objectives Do smokers have more upper airway symptoms than non-smokers? Despite extensive knowledge about the health-damaging effects of smoking, little is known about whether and to what extent smoking causes complaints from the upper airway. The main objectives of our study: 1) evaluate the role of cigarette smoking in relation to upper airway symptoms, and 2) study the dose response relationship between daily cigarette consumption and upper airway symptoms. Methods 2294 consecutive patients referred to ENT specialist for evaluation of obstructive sleep apnea, snoring or nose-related complaints were included in this cross-sectional study. Subjects completed a detailed questionnaire including Visual Analogue Scales (VAS), grading 13 upper airway symptoms. In addition, smoking habits were registered. Associations between VAS recordings and smoking status were evaluated by multivariate analysis based on regression analysis and Anova, adjusting for age, sex, body mass index, asthma, and allergy. Differences of 10% or more were considered clinically relevant. The study was conducted in the period 2005–2007. Results Smokers had between 12 and 27% higher VAS scores in 8 out of 13 symptoms compared with non-smokers (p<0,001). Further, VAS scores were related to the daily cigarette consumption in a dose-dependent manner within the majority of the symptom categories. Conclusions Our study indicates that cigarette smoking is an important etiologic factor for upper airway symptoms. The results give support to campaigns against smoking even in an upper airway perspective. Cessation of smoking should be considered, accepted, and used as a therapeutic measure when dealing with smokers presenting with upper airway complaints.

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Clinical and Paraclinical Screening for Celiac Disease in Children with Intractable Epilepsy

Neurology Research International ◽

10.1155/2021/1639745 ◽

2021 ◽

Vol 2021 ◽

pp. 1-4

Author(s):

Golnaz Ghazizadeh Esslami ◽

Bahar Allahverdi ◽

Reza Shervin Badv ◽

Morteza Heidari ◽

Nahid Khosroshahi ◽

...

Keyword(s):

Celiac Disease ◽

Serological Test ◽

Venous Blood ◽

Clinical Manifestations ◽

Gastrointestinal Symptoms ◽

Intractable Epilepsy ◽

Underlying Disease ◽

Growth Disorders ◽

Serological Tests ◽

Cross Sectional

Background. Celiac disease is the inflammatory entropy caused by hypersensitivity to gluten, which occurs in susceptible individuals. Some studies have suggested a link between celiac disease and epilepsy in children. Our aim was to screen for clinical and paraclinical features of celiac disease in children with intractable epilepsy. Methods. This was a cross-sectional study. Children aged 2 to 18 years with refractory epilepsy that referred to the pediatric neurology clinic within one year (2018–2019) were enrolled. Demographic and clinical characteristics of patients, especially clinical manifestations of celiac disease, were recorded in a questionnaire. A venous blood sample was sent to determine the total IgA, anti-tTG (IgA), and anti-endomysial antibody (IgA). Endoscopy was performed in cases where the celiac serological test was positive. Results. Seventy children with idiopathic drug-resistant epilepsy (44 boys) were evaluated. The height-for-age index was 49.2% and the weight-for-age index was 38.2% less than normal. Constipation (48.6%), anorexia (25.7%), and abdominal pain (21.4%) were the most common gastrointestinal symptoms. Celiac serological tests were negative in all children. Therefore, endoscopy and bowel biopsy were not performed in any case. Conclusion. Celiac disease was not found in any patient with intractable epilepsy. Gastrointestinal symptoms and growth disorders in this group may be related to the underlying disease or medications and not to celiac disease.

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Recurrent Abdominal Pain in School Age Children

QJM ◽

10.1093/qjmed/hcab113.054 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Ahmed Mohammed Hamdy Saber ◽

Ahmed Tohamy Ahmed Ibrahim ◽

Ola Adel Abdellah Mahdy

Keyword(s):

Abdominal Pain ◽

Urine Analysis ◽

Clinical Manifestations ◽

Gastrointestinal Symptoms ◽

Recurrent Abdominal Pain ◽

School Age Children ◽

Stool Examination ◽

School Age ◽

Functional Abdominal Pain ◽

Cross Sectional

Abstract Background Abdominal pain defined as any type of pain or discomfort that occurs in any area from the lower chest to the groin. Abdominal pain is symptom of a wide variety of mild to serious diseases, disorders, conditions. Abdominal pain can result from infection, malignancy, inflammation, obstruction and other abnormal processes. Aim of the Work To define the causes of recurrent abdominal pain among a sample of school age children. Subjects and Methods This cross sectional study was carried out to evaluate those children who presented to the Pediatric Outpatient Clinic, Children Hospital, Ain Shams University because of recurrent abdominal pain they were diagnosed in the pediatric Gastroenterology unit between June 2016 and July 2017. History taking included full analysis of abdominal pain, associated gastrointestinal symptoms and associated systemic manifestations. Examination included anthropometric measurements, general and local abdominal examination. Routine investigations included complete blood counts, urine analysis and culture, microscopic stool examination and pelviabdominal US. Other specific investigations were selected according to clinical manifestations to reach an organic cause. After reaching the definitive diagnosis, patients were classified into 2 groups organic causes and functional abdominal pain. Results During the study period, 100 children presented with recurrent abdominal pain. Results revealed that only 28% of the recurrent abdominal pain causes were attributed to organic factors; the most commonly encountered organic causes of recurrent abdominal pain were urinary tract infection (12%) while 72% of children presented with functional recurrent abdominal pain. The most common causes of function recurrent abdominal pain in our study was irritable bowel syndrome. Conclusion Most of the cases of RAP among school age children are due to functional abdominal pain (72%).

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Adverse Respiratory Symptoms and Environmental Exposures among Children and Adolescents following Hurricane Katrina

Public Health Reports ◽

10.1177/003335491112600611 ◽

2011 ◽

Vol 126 (6) ◽

pp. 853-860 ◽

Cited By ~ 19

Author(s):

Barbara Rath ◽

Elizabeth A. Young ◽

Amy Harris ◽

Keith Perrin ◽

Daniel R. Bronfin ◽

...

Keyword(s):

Children And Adolescents ◽

Hurricane Katrina ◽

New Orleans ◽

Respiratory Symptoms ◽

Environmental Exposures ◽

Flood Damage ◽

Storm Damage ◽

Cross Sectional ◽

Convenience Sample ◽

At Home

Objectives. Children and adolescents are especially vulnerable to environmental exposures and their respiratory effects. Following Hurricane Katrina in 2005, residents experienced multiple adverse environmental exposures. We characterized the association between upper respiratory symptoms (URS) and lower respiratory symptoms (LRS) and environmental exposures among children and adolescents affected by Hurricane Katrina. Methods. We conducted a cross-sectional study following the return of the population to New Orleans after Hurricane Katrina (October 2005 and February 2006) among a convenience sample of children and adolescents attending New Orleans health facilities. We used uni-, bi-, and multivariable analyses to describe participants, exposures, and associations with URS/LRS. Results. Of 1,243 participants, 47% were Caucasian, 50% were male, and 72% were younger than 11 years of age. Multiple environmental exposures were identified during and after the storm and at current residences: roof/glass/storm damage (50%), outside mold (22%), dust (18%), and flood damage (15%). Self-reported URS and LRS (76% and 36%, respectively) were higher after the hurricane than before the hurricane (22% and 9%, respectively, p<0.0001). Roof/glass/storm damage at home was associated with URS (adjusted odds ratio [AOR] = 1.59, 95% confidence interval [CI] = 1.15, 2.21) and LRS (AOR=1.35, 95% CI 1.01, 1.80), while mold growth at home was associated with LRS (AOR=1.47, 95% CI 1.02, 2.12). Conclusions. Children and adolescents affected by Hurricane Katrina experienced environmental exposures associated with increased prevalence of reported URS and LRS. Additional research is needed to investigate the long-term health impacts of Hurricane Katrina.

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Airway inflammatory profile among cleaning workers from different workplaces

10.21203/rs.3.rs-488777/v1 ◽

2021 ◽

Author(s):

Edineia Rosa da Paz ◽

Cynthia Mafra Fonseca de Lima ◽

Soraia Nogueira Felix ◽

Bruna Schaeffer ◽

Clóvis Eduardo Santos Galvão ◽

...

Keyword(s):

Airway Inflammation ◽

Respiratory Symptoms ◽

Significant Proportion ◽

Upper Airway ◽

Cross Sectional Study ◽

Clinical Trial Registration ◽

Cross Sectional ◽

Asthma Symptoms ◽

Active Population ◽

And Control

Abstract Background: Cleaning workers represent a significant proportion of the active population worldwide, with poor remuneration, particularly in developing countries. Despite this, they remain a relatively poorly studied occupational group. They are constantly exposed to agents that can cause symptoms and respiratory problems.Objective: To investigate the airway inflammation and respiratory symptoms of cleaning workers from different workplaces. Methods We performed a cross-sectional study on the prevalence of upper airway inflammation and symptoms of asthma/rhinitis related to cleaning work, according to workplace.167 participants were divided into four groups: Hospital (H), University (U), Housekeeper (Ho) and Control (C). A nasal swab was collected for upper airway inflammation evaluation. Clinical profiles and respiratory symptom employee evaluations were performed using specific questionnaires (ECRHS and ISAAC).Results: Cleaning workers showed increased neutrophils and lymphocytes; Hospital and University showed increased macrophages compared to the Housekeeper and Control. Hospital and Housekeeper showed increased eosinophils when they performed cleaning services for up to one year and also reported having more asthma symptoms than the Control. Cleaning workers showed increased rhinitis symptoms. The University group showed increased rhinitis symptoms aggravated by the workplace compared with the Hospital and Housekeeper. Cleaning workers showed an increased affirmative response when direct asked about rhinitis symptoms compared to Control.Conclusions: Cleaning workers showed airway inflammation, asthma symptoms and rhinitis, regardless of the occupational environment to which they were exposed and also showed increased rhinitis and asthma symptoms. Hospital cleaning workers showed increased macrophages, lymphocytes and eosinophils compared to the others. The length of time spent performing cleaning work was not related to nasal inflammation or respiratory symptoms in this population. However, there are differences in workplaces. Clinical Trial registration number NCT03311048, October 16, 2017. Availble at: https://clinicaltrials.gov/ct2/show/NCT03311048 (retrospectively registered).

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Esophageal manometry in systemic sclerosis: findings and association with clinical manifestations

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.66.1.48 ◽

2020 ◽

Vol 66 (1) ◽

pp. 48-54

Author(s):

Juliana Markus ◽

Rogério de Melo Costa Pinto ◽

Abadia Gilda Buso Matoso ◽

Roberto Ranza

Keyword(s):

Systemic Sclerosis ◽

Clinical Manifestations ◽

Gastrointestinal Symptoms ◽

Autoimmune Disorder ◽

Cross Sectional Study ◽

Unknown Etiology ◽

Chi Square ◽

Cross Sectional ◽

Chi Square Test ◽

Diffuse Form

SUMMARY INTRODUCTION Systemic sclerosis (SSC) is an autoimmune disorder that affects several organs of unknown etiology, characterized by vascular damage and fibrosis of the skin and organs. Among the organs involved are the esophagus and the lung. OBJECTIVES To relate the profile of changes in esophageal electromanometry (EM), the profile of skin involvement, interstitial pneumopathy (ILD), and esophageal symptoms in SSC patients. METHODS This is an observational, cross-sectional study carried out at the SSC outpatient clinic of the Hospital de Clínicas of the Federal University of Uberlândia. After approval by the Ethics Committee and signed the terms of consent, 50 patients were initially enrolled, from 04/12/2014 to 06/25/2015. They were submitted to the usual investigations according to the clinical picture. The statistical analysis was descriptive in percentage, means, and standard deviation. The Chi-square test was used to evaluate the relationship between EM, high-resolution tomography, and esophageal symptoms. RESULTS 91.9% of the patients had some manometric alterations. 37.8% had involvement of the esophageal body and lower esophageal sphincter. 37.8% had ILD. 24.3% presented the diffuse form of SSC. No association was found between manometric changes and clinical manifestations (cutaneous, pulmonary, and gastrointestinal symptoms). CONCLUSION The present study confirms that esophageal motility alterations detected by EM are frequent in SSC patients, but may not be related to cutaneous extension involvement, the presence of ILD, or the gastrointestinal complaints of patients.

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