scholarly journals Recommendations Of The Brazilian Society Of Nephrology Regarding Pediatric Patients On Renal Replacement Therapy During The Covid-19 Pandemic

2020 ◽  
Vol 42 (2 suppl 1) ◽  
pp. 32-35
Author(s):  
Marcelo de Sousa Tavares ◽  
Maria Goretti Moreira Guimarães Penido ◽  
Olberes Vitor Braga de Andrade ◽  
Vera Hermina Kalika Koch ◽  
Rejane de Paula Bernardes ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Pediatric Patients ◽  
Kidney Diseases ◽  
Age Groups ◽  
Clinical Manifestations ◽  
The Elderly ◽  
Brazilian Society ◽  
Specialized Care ◽  
Dialysis Facilities ◽  
The Impact

ABSTRACT Introduction The impact of the new coronavirus (SARS-COV-2) and its worldwide clinical manifestations (COVID-19) imposed specific regional recommendations for populations in need of specialized care, such as children and adolescents with kidney diseases, particularly in renal replacement therapies (RRT). We present the recommendations of the Brazilian Society of Nephrology regarding the treatment of pediatric patients with kidney diseases during the COVID-19 pandemic. Methods Articles and documents from medical societies and government agencies on specific recommendations for children on RRT in relation to COVID-19 as well as those focused on epidemiological aspects of this condition in Brazil Were evaluated and analyzed. Results We present recommendations on outpatient care, transportation to dialysis centers, peritoneal dialysis, hemodialysis, and kidney transplantation in children and adolescents during the COVID-19 pandemic in Brazil. Discussion Despite initial observations of higher mortality rates in specific age groups (the elderly) and with comorbidities (obese, diabetics, and those with cardiovascular diseases), patients with chronic kidney disease (CKD) on RRT are particularly prone to develop COVID-19. Specific measures must be taken to reduce the risk of contracting SARS-CoV-2 and developing COVID-19, especially during transport to dialysis facilities, as well as on arrival and in contact with other patients.

scholarly journals Quantifying the impact of air pollution on the urban population of Brazil

2007 ◽  
Vol 23 (suppl 4) ◽  
pp. S529-S536 ◽  
Author(s):  
Izabel Marcilio ◽  
Nelson Gouveia
Keyword(s):  
Air Pollution ◽  
Urban Population ◽  
Hospital Admissions ◽  
Age Groups ◽  
The Elderly ◽  
Impact Factors ◽  
Pollution Levels ◽  
Time Series Studies ◽  
The Impact ◽  
Respiratory Causes

This study aimed to quantify air pollution impact on morbidity and mortality in the Brazilian urban population using locally generated impact factors. Concentration-response coefficients were used to estimate the number of hospitalizations and deaths attributable to air pollution in seven Brazilian cities. Poisson regression coefficients (beta) were obtained from time-series studies conducted in Brazil. The study included individuals 65 years old and over and children under five. More than 600 deaths a year from respiratory causes in the elderly and 47 in children were attributable to mean air pollution levels, corresponding to 4.9% and 5.5% of all deaths from respiratory causes in these age groups. More than 4,000 hospital admissions for respiratory conditions were also attributable to air pollution. These results quantitatively demonstrate the currently observed contribution of air pollution to mortality and hospitalizations in Brazilian cities. Such assessment is thought to help support the planning of surveillance and control activities for air pollution in these and similar areas.

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

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.

scholarly journals 2765. Pediatric Mumps during the 2015–2017 Mumps Resurgence in the United States

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S975-S975
Author(s):  
Mariel Marlow ◽  
John Zhang ◽  
Nakia S Clemmons ◽  
Mona Marin ◽  
Manisha Patel ◽  
...  
Keyword(s):  
United States ◽  
Children And Adolescents ◽  
Surveillance System ◽  
Pediatric Patients ◽  
Age Groups ◽  
Exposure Period ◽  
The United States ◽  
College Campuses ◽  
Control And Prevention ◽  
Low Rate

Abstract Background Numerous mumps outbreaks occurred in the United States over the last decade, with outbreaks affecting young adults on college campuses being among the largest and most widely publicized. However, at least half of mumps cases and outbreaks occurred in other age-groups and settings. We describe reported mumps cases among children and adolescents during 2015 through 2017. Methods The Centers for Disease Control and Prevention (CDC) analyzed reports of confirmed and probable mumps cases in persons aged ≤18 years (defined here as pediatric mumps) transmitted electronically through the Nationally Notifiable Diseases Surveillance System (NNDSS) by the 52 reporting jurisdictions. Results Between January 1, 2015 and December 31, 2017, 49 jurisdictions reported 4,886 pediatric mumps cases (35% of all US reported cases, 13,807); 8 jurisdictions reported >100 cases each, representing 82% of all pediatric cases. Overall, 29 (1%) cases were in infants <1 yr, 406 (8%) were in children aged 1–4 years, 1,408 (29%) in children aged 5–10 years, 1,365 (28%) in adolescents aged 11–14 years, and 1,678 (34%) in adolescents aged 15–18 years. Most (3,548, 73%) cases did not travel outside the state during their exposure period; only 37 (1%) traveled outside the country. Cases in patients aged 1–4 years were more frequently non-outbreak associated (38%) than those in patients <1 years and 5–18 years (24% and 9%, respectively). Among 3,309 (68%) patients with known number of MMR doses received, 81% of those 5–18 years had ≥2 MMR doses, while 67% of those 1–4 years had ≥1 dose. Median time since last MMR dose for patients with 2 doses was 8 years (IQR: 4, 11 years). Four patients had meningitis and 1 had encephalitis; all were ≥10 years old and previously received 2 MMR doses. Of male mumps patients older than 10 years of age (2,113), 46 (2%) reported having orchitis; of these, 33 (72%) had 2 MMR doses. Sixty-four patients were hospitalized and there were no deaths. Conclusion About one-third of cases reported during the recent US mumps resurgence were in children and adolescents. The low rate of mumps complications compared with previous studies suggests mumps complications may not be adequately captured in national surveillance or identified by providers. Providers should remain vigilant that mumps can still occur among fully vaccinated pediatric patients, even those recently vaccinated. Disclosures All authors: No reported disclosures.

scholarly journals The Impact of Cold and Heat on Years of Life Lost in a Northwestern Chinese City with Temperate Continental Climate

2019 ◽  
Vol 16 (19) ◽  
pp. 3529 ◽  
Author(s):  
Jiangtao Liu ◽  
Yueling Ma ◽  
Yuhong Wang ◽  
Sheng Li ◽  
Shuyu Liu ◽  
...  
Keyword(s):  
Respiratory Diseases ◽  
Heat Waves ◽  
Age Groups ◽  
The Elderly ◽  
Years Of Life Lost ◽  
Weather Variables ◽  
Distributed Lag ◽  
Heat Effects ◽  
The Impact ◽  
Continental Climate

Cold spells and heat waves in a changing climate are well known as great public-health concerns due to their adverse effects on human health. However, very few studies have quantified health impacts of heat and cold in the region of Northwestern China. The purpose of the present study was to evaluate the effects of cold and heat on years of life lost (YLL) in Lanzhou, a city with temperate continental climate. We compiled a daily dataset including deaths, weather variables, and air pollutants in Lanzhou, China, from 2014–2017. We used a distributed lag non-linear model to estimate single-day and cumulative effects of heat and cold on daily YLL. Results indicated that both cold and heat were associated with increased YLL for registered residents in Lanzhou. Estimated heat effects appeared immediately in the first two days, while estimated cold effects lasted over a longer period (up to 30 days). Cold significantly increased the YLL of all residents except for males and those with respiratory diseases (≥65 years). Our results showed that both heat and cold had more pronounced effects on cardiovascular diseases compared to respiratory diseases. Males might be more vulnerable to heat, while females might suffer more YLL from cold. The effects of cold or heat on the elderly might appear earlier and last longer than those for other age groups.

Nuclear War: Fear of Children and Adolescents

1990 ◽  
Vol 7 (1) ◽  
pp. 2-4
Author(s):  
Neville J King ◽  
Kate Ollier ◽  
Eleonora Gullone
Keyword(s):  
Children And Adolescents ◽  
Middle Age ◽  
Age Groups ◽  
Psychological Development ◽  
Age Group ◽  
Nuclear War ◽  
Fear Survey Schedule ◽  
The Impact

ABSTRACTUsing an extended fear survey schedule, 72 per cent of a sample of 8 to 16 year old children and adolescents in Australia reported a lot of fear of nuclear war. Although a high proportion of respondents in all age groups expressed a lot of fear of nuclear war, significantly more respondents in the middle age group (11-13 years) were found to be afraid. Consistent with the findings on children's fears in general, significantly more females than males reported fear of nuclear war. Further research should be undertaken on the impact of the fear of nuclear war on the psychological development of children and adolescents.

scholarly journals The Impact of Non-optimum Ambient Temperature on Years of Life Lost: A Multi-county Observational Study in Hunan, China

2020 ◽  
Vol 17 (8) ◽  
pp. 2699
Author(s):  
Ling-Shuang Lv ◽  
Dong-Hui Jin ◽  
Wen-Jun Ma ◽  
Tao Liu ◽  
Yi-Qing Xu ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Ambient Temperature ◽  
Respiratory Disease ◽  
Age Groups ◽  
The Elderly ◽  
Cold Temperature ◽  
Years Of Life Lost ◽  
Distributed Lag ◽  
Preventative Measures ◽  
The Impact

The ambient temperature–health relationship is of growing interest as the climate changes. Previous studies have examined the association between ambient temperature and mortality or morbidity, however, there is little literature available on the ambient temperature effects on year of life lost (YLL). Thus, we aimed to quantify the YLL attributable to non-optimum ambient temperature. We obtained data from 1 January 2013 to 31 December 2017 of 70 counties in Hunan, China. In order to combine the effects of each county, we used YLL rate as a health outcome indicator. The YLL rate was equal to the total YLL divided by the population of each county, and multiplied by 100,000. We estimated the associations between ambient temperature and YLL with a distributed lag non-linear model (DNLM) in a single county, and then pooled them in a multivariate meta-regression. The daily mean YLL rates were 22.62 y/(p·100,000), 10.14 y/(p·100,000) and 2.33 y/(p·100,000) within the study period for non-accidental, cardiovascular, and respiratory disease death. Ambient temperature was responsible for advancing a substantial fraction of YLL, with attributable fractions of 10.73% (4.36–17.09%) and 16.44% (9.09–23.79%) for non-accidental and cardiovascular disease death, respectively. However, the ambient temperature effect was not significantly for respiratory disease death, corresponding to 5.47% (−2.65–13.60%). Most of the YLL burden was caused by a cold temperature than the optimum temperature, with an overall estimate of 10.27% (4.52–16.03%) and 15.94% (8.82–23.05%) for non-accidental and cardiovascular disease death, respectively. Cold and heat temperature-related YLLs were higher in the elderly and females than the young and males. Extreme cold temperature had an effect on all age groups in different kinds of disease-caused death. This study highlights that general preventative measures could be important for moderate temperatures, whereas quick and effective measures should be provided for extreme temperatures.

scholarly journals Mathematical modeling of vaccination rollout and NPIs lifting on COVID-19 transmission with VOC: a case study in Toronto, Canada

2021 ◽  
Author(s):  
Elena Aruffo ◽  
Pei Yuan ◽  
Yi Tan ◽  
Evgenia Gatov ◽  
Iain Moyles ◽  
...  
Keyword(s):  
Vaccination Coverage ◽  
Age Groups ◽  
Vaccination Strategy ◽  
The Elderly ◽  
Public Health Agencies ◽  
Initial Strategy ◽  
Working Age ◽  
Waning Immunity ◽  
Nonpharmaceutical Interventions ◽  
The Impact

ABSTRACT Background: Since December 2020, public health agencies have implemented a variety of vaccination strategies to curb the spread of SARS-CoV-2, along with pre-existing Nonpharmaceutical Interventions (NPIs). Initial strategy focused on vaccinating the elderly to prevent hospitalizations and deaths. With vaccines becoming available to the broader population, we aimed to determine the optimal strategy to enable the safe lifting of NPIs while avoiding virus resurgence. Methods: We developed a compartmental deterministic SEIR model to simulate the lifting of NPIs under different vaccination rollout scenarios. Using case and vaccination data from Toronto, Canada between December 28, 2020 and May 19, 2021, we estimated transmission throughout past stages of NPI escalation/relaxation to compare the impact of lifting NPIs on different dates on cases, hospitalizations, and deaths, given varying degrees of vaccine coverages by 20-year age groups, accounting for waning immunity. Results: We found that, once coverage among the elderly is high enough (80% with at least one dose), the main age groups to target are 20-39 and 40-59 years, whereby first-dose coverage of at least 70% by mid-June 2021 is needed to minimize the possibility of resurgence if NPIs are to be lifted in the summer. While a resurgence was observed for every scenario of NPI lifting, we also found that under an optimistic vaccination coverage (70% by mid-June, postponing reopening from August 2021 to September 2021can reduce case counts and severe outcomes by roughly 80% by December 31, 2021. Conclusions: Our results suggest that focusing the vaccination strategy on the working-age population can curb the spread of SARS-CoV-2. However, even with high vaccination coverage in adults, lifting NPIs to pre-pandemic levels is not advisable since a resurgence is expected to occur, especially with earlier reopening.

scholarly journals Synthesizing Multiple Stakeholder Perspectives on Using Virtual Reality to Improve the Periprocedural Experience in Children and Adolescents: Survey Study (Preprint)

2020 ◽  
Author(s):  
Naseem Ahmadpour ◽  
Andrew David Weatherall ◽  
Minal Menezes ◽  
Soojeong Yoo ◽  
Hanyang Hong ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Children And Adolescents ◽  
Patient Experience ◽  
Pediatric Patients ◽  
Age Groups ◽  
Holistic Approach ◽  
Psychological Needs ◽  
Survey Study ◽  
Medical Procedure ◽  
Design Strategies

BACKGROUND Virtual reality (VR) technology is a powerful tool for augmenting patient experience in pediatric settings. Incorporating the needs and values of stakeholders in the design of VR apps in health care can contribute to better outcomes and meaningful experiences for patients. OBJECTIVE We used a multiperspective approach to investigate how VR apps can be designed to improve the periprocedural experiences of children and adolescents, particularly those with severe anxiety. METHODS This study included a focus group (n=4) and a survey (n=56) of clinicians. Semistructured interviews were conducted with children and adolescents in an immunization clinic (n=3) and perioperative setting (n=65) and with parents and carers in an immunization clinic (n=3) and perioperative setting (n=35). RESULTS Qualitative data were examined to determine the experience and psychological needs and intervention and design strategies that may contribute to better experiences for children in three age groups (4-7, 8-11, and 12-17 years). Quantitative data were used to identify areas of priority for future VR interventions. CONCLUSIONS We propose a set of ten design considerations for the creation of future VR experiences for pediatric patients. Enhancing patient experience may be achieved by combining multiple VR solutions through a holistic approach considering the roles of clinicians and carers and the temporality of the patient’s experience. These situations require personalized solutions to fulfill the needs of pediatric patients before and during the medical procedure. In particular, communication should be placed at the center of preprocedure solutions, while emotional goals can be embedded into a procedure-focused VR app to help patients shift their focus in a meaningful way to build skills to manage their anxiety.

scholarly journals Synthesizing Multiple Stakeholder Perspectives on Using Virtual Reality to Improve the Periprocedural Experience in Children and Adolescents: Survey Study

10.2196/19752 ◽  
2020 ◽  
Vol 22 (7) ◽  
pp. e19752 ◽  
Author(s):  
Naseem Ahmadpour ◽  
Andrew David Weatherall ◽  
Minal Menezes ◽  
Soojeong Yoo ◽  
Hanyang Hong ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Children And Adolescents ◽  
Patient Experience ◽  
Pediatric Patients ◽  
Age Groups ◽  
Holistic Approach ◽  
Psychological Needs ◽  
Survey Study ◽  
Medical Procedure ◽  
Design Strategies

Background Virtual reality (VR) technology is a powerful tool for augmenting patient experience in pediatric settings. Incorporating the needs and values of stakeholders in the design of VR apps in health care can contribute to better outcomes and meaningful experiences for patients. Objective We used a multiperspective approach to investigate how VR apps can be designed to improve the periprocedural experiences of children and adolescents, particularly those with severe anxiety. Methods This study included a focus group (n=4) and a survey (n=56) of clinicians. Semistructured interviews were conducted with children and adolescents in an immunization clinic (n=3) and perioperative setting (n=65) and with parents and carers in an immunization clinic (n=3) and perioperative setting (n=35). Results Qualitative data were examined to determine the experience and psychological needs and intervention and design strategies that may contribute to better experiences for children in three age groups (4-7, 8-11, and 12-17 years). Quantitative data were used to identify areas of priority for future VR interventions. Conclusions We propose a set of ten design considerations for the creation of future VR experiences for pediatric patients. Enhancing patient experience may be achieved by combining multiple VR solutions through a holistic approach considering the roles of clinicians and carers and the temporality of the patient’s experience. These situations require personalized solutions to fulfill the needs of pediatric patients before and during the medical procedure. In particular, communication should be placed at the center of preprocedure solutions, while emotional goals can be embedded into a procedure-focused VR app to help patients shift their focus in a meaningful way to build skills to manage their anxiety.

scholarly journals Impact of the COVID-19 pandemic on orthopedic fracture characteristics in three hospitals in Turkey: A multi-center epidemiological study

2021 ◽  
Vol 32 (2) ◽  
pp. 323-332
Author(s):  
Sinan Oguzkaya ◽  
Abdulhamit Misir ◽  
Mustafa Ozcamdalli ◽  
Gokay Eken ◽  
Turan Bilge Kizkapan ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Femoral Fractures ◽  
Humeral Fracture ◽  
The Elderly ◽  
Proximal Femoral Fracture ◽  
Surgical Indication ◽  
Novel Coronavirus ◽  
Home Accidents ◽  
Epidemiological Characteristics ◽  
The Impact

Objectives: The aim of this study was to evaluate the impact of novel coronavirus-2019 (COVID-19) on the epidemiological characteristics of orthopedic fractures. Patients and methods: A total of 2,960 patients (1,755 males, 1,205 females; mean age: 39.6 years; range, 1 to 98 years) with orthopedic fractures were included in the study: 552 patients during the pandemic period (March 10th and July 1st, 2020) and 1,158 control patients in the same period 2019 and 1,250 control patients in 2018. Epidemiological characteristics, injury mechanisms, fracture locations and treatment details of the patients were analyzed and compared between 2018, 2019 and 2020 for adult and pediatric populations. Results: Of a total of 552 patients, 485 were adults and 67 were pediatric patients. In the control groups, of 1,158 patients (2019), 770 were adults and 378 were pediatric patients and, of 1,250 patients (2018), 857 were adults and 393 were pediatric patients. The proportion of proximal femur and hand fractures significantly increased during the pandemic period (p=0.025 and p=0.038, respectively). The most frequent surgical indication in the pandemic period was proximal femoral fracture. The proportion of home accidents as an injury mechanism significantly increased in the pandemic period compared to 2018 and 2019 (48.5% vs. 18.6% and 20.6%, respectively; p=0.000). The proportion of female pediatric patients significantly increased during the pandemic period compared to 2018 and 2019 (44.8% vs. 25.4% and 27.2%, respectively, p=0.004). The proportion of forearm fractures (p=0.001) also increased, and the proportion of tibia-fibula fractures (p=0.03) decreased. The most frequent surgical indication in pediatric patients was distal humeral fracture in both groups. Conclusion: During the pandemic period, proximal femoral fractures in the elderly remained a concern. In-home preventative strategies may be beneficial to reduce the incidence of hip fractures in the elderly.

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