scholarly journals Nasopharyngeal Meningococcal Carriage among Children and Adolescents in Turkey in 2018: An Unexpected High Serogroup X Carriage

Children ◽  
2021 ◽  
Vol 8 (10) ◽  
pp. 871
Author(s):  
Mahmut Can Kizil ◽  
Omer Kilic ◽  
Mehmet Ceyhan ◽  
Merve Iseri Nepesov ◽  
Adem Karbuz ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Control Strategies ◽  
Age Groups ◽  
Antibiotic Use ◽  
Age Group ◽  
Upper Respiratory Tract ◽  
Carriage Rate ◽  
Significant Difference ◽  
Tract Infections ◽  
The Impact

Meningococcal carriage studies and transmission modeling can predict IMD epidemiology and used to define invasive meningococcal disease (IMD) control strategies. In this multicenter study, we aimed to evaluate the prevalence of nasopharyngeal Neisseria meningitidis (Nm) carriage, serogroup distribution, and related risk factors in Turkey. Nasopharyngeal samples were collected from a total of 1267 children and adolescents and were tested with rt-PCR. Nm carriage was detected in 96 participants (7.5%, 95% CI 6.1–9.0), with the peak age at 13 years (12.5%). Regarding age groups, Nm carriage rate was 7% in the 0–5 age group, was 6.9%in the 6–10 age group, was 7.9% in the 11–14 age group, and was 9.3% in the 15–18 age group. There was no statistically significant difference between the groups (p > 0.05). The serogroup distribution was as follows: 25% MenX, 9.4% MenA, 9.4% MenB, 2.1% MenC, 3.1% MenW, 2.1% for MenY, and 48.9% for non-groupable. The Nm carriage rate was higher in children with previous upper respiratory tract infections and with a high number of household members, whereas it was lower in children with antibiotic use in the last month (p < 0.05 for all). In this study, MenX is the predominant carriage strain. The geographical distribution of Nm strains varies, but serogroup distribution in the same country might change in a matter of years. Adequate surveillance and/or a proper carriage study is paramount for accurate/dynamic serogroup distribution and the impact of the proposed vaccination.

Characteristics of monitored diabetic patients by glycated haemoglobin (HbA1c)

2016 ◽  
Vol 5 (05) ◽  
pp. 4563
Author(s):  
Tariq A. Zafar
Keyword(s):  
Blood Glucose ◽  
Glycemic Control ◽  
Glycated Haemoglobin ◽  
Poor Glycemic Control ◽  
Diabetic Patients ◽  
Age Group ◽  
Hba1c Test ◽  
Significant Difference ◽  
Tract Infections ◽  
The Impact

Glycated haemoglobin (HbA1c) test indicates the blood glucose levels for the previous two to three months. Using HbA1c test may overcome many of the practical issues and prevent infections such as urinary tract infections (UTIs). The study aimed to evaluate the impact of glycemic control using HbA1c test to understand patient characteristics and UTIs prevalence. Glycemic control was evaluated by measuring HbA1c for a total of 208 diabetes patients who were regularly attending diabetes center in Al-Noor specialist hospital in Makkah.  The results showed that good and moderate glycemic controlled patients were 14.9% and 16.9% respectively while the poor glycemic patients were 68.3%. Among the good improved glycemic control, 83.9% were females, 48.4% were from age group (15-44y). Among the moderately improved glycemic control, 68.4% were females, 54.3% were from age group (45-64 y) with no significant difference. The total number of the patients with positive UTIs was 55 (26.4%) while the total number of patients with negative was UTIs 153 (73.6%). Among the positive UTIs, 76.3% were with poor glycemic control while only 12.3% and 11% were moderate and good improved glycemic control respectively. Among the negative UTIs, 65.3% were with poor glycemic control while only 19% and 15.7% were with moderate and good improved glycemic control respectively.  Prevalence of UTIs among diabetic patients was not significant (p > 0.05). It was concluded that HbA1c was useful monitoring tool for diabetes mellitus and may lead to improved outcomes. Using a HbA1c test may overcome many of the practical issues that affect the blood glucose tests.

scholarly journals Rapid Multiplex Testing for Upper Respiratory Pathogens in the Emergency Department: A Randomized Controlled Trial

2019 ◽  
Author(s):  
Larissa May ◽  
Grant Tatro ◽  
Eduard Poltavskiy ◽  
Benjamin Mooso ◽  
Simson Hon ◽  
...  
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Usual Care ◽  
Controlled Trial ◽  
Antibiotic Use ◽  
Respiratory Pathogens ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Tract Infections ◽  
The Impact

Abstract Background Acute upper respiratory tract infections are a common cause of Emergency Department (ED) visits and often result in unnecessary antibiotic treatment.  Methods We conducted a randomized clinical trial to evaluate the impact of a rapid, multi-pathogen respiratory panel (RP) test versus usual care (control). Patients were eligible if they were ≥12 months old, had symptoms of upper respiratory infection or influenza like illness, and were not on antibiotics. The primary outcome was antibiotic prescription; secondary outcomes included antiviral prescription, disposition, and length of stay (ClinicalTrials.gov# NCT02957136). Results Of 191 patients enrolled, 93 (49%) received RP testing; 98 (51%) received usual care. Fifty-three (57%) RP and 7 (7%) control patients had a virus detected and reported during the ED visit (p=0.0001). Twenty (22%) RP patients and 33 (34%) usual care patients received antibiotics during the ED visit (-12% [95% CI -25%, 0.4%]; p=0.06/0.08); 9 RP patients received antibiotics despite having a virus detected. The magnitude of antibiotic reduction was greater in children (-19%) versus adults (-9%; post-hoc analysis). There was no difference in antiviral use, length of stay, or disposition. Conclusions Rapid RP testing was associated with a trend towards decreased antibiotic use, suggesting a potential benefit from more rapid viral tests in the ED. Future studies should determine if specific groups are more likely to benefit from testing and evaluate relative cost and effectiveness of broad testing, focused testing, and a combined diagnostic and antimicrobial stewardship approach.

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 A RANDOMISED CONTROL STUDY TO COMPARE THE EFFICACY OF CEFUROXIME, CLARITHROMYCIN, AND LEVOFLOXACIN IN THE MANAGEMENT OF PAEDIATRIC UPPER RESPIRATORY TRACT INFECTION

2021 ◽  
pp. 103-106
Author(s):  
GOUTHAMI PADUGUNDLA ◽  
JYOTHIRMAYEE V ◽  
BETHALA RAVALI ◽  
JAGILLAPURAM ARUNDHATHI ◽  
THAKUR SRILATHA ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Age Distribution ◽  
Age Groups ◽  
Efficacy Rate ◽  
Pool Data ◽  
Upper Respiratory Tract ◽  
Cure Rate ◽  
Significant Difference ◽  
Upper Respiratory ◽  
Tract Infections

Background: The upper respiratory infections cause considerable morbidity mainly in children due to the fact that they mainly affect children. Accordingly, a study was conducted on antibiotics to compare the effectiveness of clarithromycin, cefuroxime, and levofloxacin for treating upper respiratory tract infections (URTI) in children. Methods: A prospective observational study for a period of 6 months was conducted in the pediatrics department of RVM hospital. Outpatients under the age of 14 years given antibiotics for the treatment of URTI were included in the study. A total of 99 study subjects were included in the study, divided into three groups each containing 33 sample sizes (clarithromycin, cefuroxime, and levofloxacin). Patient data was collected using a form and verbal consent was obtained from patients/patient representatives, and drugs were given using the lottery method. Follow-up was done and noted for the 3rd, 5th, 7th day through telephonic calls, and the collected data were evaluated using statistical analysis. Results: Pool data from 99 patients shows that many patients belong to 0–5 years age groups (age distribution), and males were more than female (gender distribution). Clarithromycin (cure rate 3 days) and cefuroxime (cure rate 5 days) showed an equal rate of cure percentage (94%), while levofloxacin for 3–5 days with a 3% failure rate. A significant difference of p<0.05 (p=0.000) was observed and no adverse events were noted. Conclusion: The study findings showed, out of 3 drugs, clarithromycin and cefuroxime showed an equal efficacy rate of 94%, but clarithromycin showed shorter duration of outcome, i.e., 3 days. Hence, clarithromycin is effective than the other two drugs in the treatment of URTI.

scholarly journals 0915 Sleep Patterns and the Effect of Late Bedtime on School-Age Children and Adolescents: Preliminary Results

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A348-A348
Author(s):  
P Matsangas ◽  
S Gratsia ◽  
A Cocos ◽  
H Vastardis ◽  
N L Shattuck
Keyword(s):  
Children And Adolescents ◽  
Sleep Duration ◽  
Sleep Disturbances ◽  
Age Groups ◽  
School Age Children ◽  
School Age ◽  
Age Group ◽  
Sleep Patterns ◽  
Sleep Deficit ◽  
The Impact

Abstract Introduction School-age children (6-13yrs) and teenagers (14-17yrs) should receive 9-11hrs and 8-10hrs of sleep/day, respectively. Several studies have shown, however, that these age groups are chronically sleep deprived. Our study assessed the sleep patterns of a sample of children and teenagers in Athens, Greece. The study is part of a larger project investigating the association between orthodontic treatment and sleep disturbances. Methods Participants (N=27; 69% females; 21 school-age children 9-13yrs, 6 teenagers 14-17yrs) were under treatment in the Orthodontic Clinic of the National and Kapodistrian University. Sleep was assessed with actigraphy/logs for 59±19 days. Results Participants slept on average 7.36±0.42hrs/day. Nighttime sleep was on average 7.23±0.43hrs (percentage sleep: 87.3%±3.38%). Four (14.8%) participants napped at least once/week. Compared to the lowest sleep duration recommended for their age group, participants showed a chronic sleep deficit of 1.42±0.52hrs/day (range: 0.32-2.15hrs). The younger age group had an average sleep deficit of ~1.6hrs compared to ~0.8hrs for the teenagers (p=0.006). During the school year, daily sleep duration increased by ~0.73hrs on weekends (7.78±0.67hrs) compared to school nights (7.05±0.48hrs; p&lt;0.001). On average, school-age participants slept from 23:13 (±31min) until 7:19 (±22min) on school nights and from 23:23 (±2:72hrs) until 8:49 (±39min) on weekends. Teenagers slept from 00:34 (±36min) until 7:40 (±14min) on school nights and from 01:34 (±41min) until 10:34 (±48min) on weekends. Conclusion Our findings verify earlier survey results showing that restricted sleep is a problem for children and adolescents in Greece. To our surprise, both age groups go to bed quite late. The impact of late bedtime on sleep duration, however, is larger in the younger group due to their larger sleep needs. In contrast to earlier research in rural areas, napping was not common in our urban sample, probably due to extracurricular activities and studying at home. Support N/A

scholarly journals Evaluation of the Do Bugs Need Drugs? Program in British Columbia: Can We Curb Antibiotic Prescribing?

2011 ◽  
Vol 22 (1) ◽  
pp. 19-24 ◽  
Author(s):  
Rachel M. McKay ◽  
Linda Vrbova ◽  
Elaine Fuertes ◽  
Mei Chong ◽  
Samara David ◽  
...  
Keyword(s):  
Program Implementation ◽  
Health Care Professionals ◽  
Respiratory Tract Infections ◽  
Antibiotic Use ◽  
Educational Material ◽  
Upper Respiratory Tract Infections ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Tract Infections ◽  
The Impact

OBJECTIVE: Antibiotic resistance is accelerated by the overuse of antibiotics. Do Bugs Need Drugs? is an educational program adapted in British Columbia to target both the public and health care professionals, with the aim of reducing unnecessary prescribing. The current article presents a descriptive evaluation of the impact of the program over the first four years.METHOD: Program implementation was measured by the amount of educational material distributed and the level of participation in educational sessions. The impact of the program was assessed by measuring changes in knowledge and prescribing habits of participating physicians, and by investigating provincial trends in antibiotic use.METHOD: Program implementation was measured by the amount of educational material distributed and the level of participation in educational sessions. The impact of the program was assessed by measuring changes in knowledge and prescribing habits of participating physicians, and by investigating provincial trends in antibiotic use.RESULTS: A total of 51,367 children, assisted-living residents and health care professionals have participated in the program since its inception in the fall of 2005. Pre- and postcourse assessments of participating physicians indicated significant improvements in clinical knowledge and appropriate antibiotic treatment of upper respiratory tract infections. Overall rates of antibiotic use in the province have stabilized since 2006. The rates of consumption of fluoroquinolones and macrolides have levelled off since 2005. Utilization rates for acute bronchitis are at the same level as when the program was first implemented, but rates for other acute upper respiratory tract infections of interest have declined.CONCLUSIONS: The Do Bugs Need Drugs? program significantly improves physician antibiotic prescription decisions and is ecologically associated with desirable change in population antibiotic consumption patterns.

scholarly journals 049 Real world evidence (RWE) on impact of age on long-term persistence to disease modifying therapies (DMTS) in relapsing-remitting multiple sclerosis (RRMS) in australia

2019 ◽  
Vol 90 (e7) ◽  
pp. A16.3-A17
Author(s):  
Andrew Kornberg ◽  
Tim Spelman ◽  
Mark Schulz ◽  
Birendra Arora ◽  
Eric Chung ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Interferon Beta ◽  
Relative Rate ◽  
Age Groups ◽  
Dimethyl Fumarate ◽  
Age Group ◽  
Kaplan Meier ◽  
Increased Risk ◽  
Significant Difference ◽  
The Impact

BackgroundAge has been independently associated with higher rates of treatment discontinuation in multiple sclerosis.ObjectiveThe current study examines the impact of age on persistence for all reimbursed DMTs for RRMS in Australia.MethodsThe Pharmaceutical Benefits Scheme (PBS) 10% sample supplied by the Department of Human Services was used in this study. Eligible patients must have received a script for a reimbursed DMT for RRMS between September 2011 and February 2016. Patients were classified into five age-groups (ages 18–30; 31–40; 41–50; 51–60; 61+) and defined as persistent if their DMT script was filled within 4 months. Persistence was derived using the Kaplan-Meier method and hazard ratios (HR) to represent the relative rate of drop-off of different age groups.ResultsPatients aged 18–30 (n=250) had a 44% increased risk of discontinuation (HR 1.44 (95%CI: 1.22–1.72) compared to the ‘all ages’ cohort (n=1,866); no significant difference was observed for any other age group (HRs between 1.08 and 0.92). Patients in this 18–30 age-group had a significantly higher risk of discontinuation on injectable therapy (glatiramer acetate, interferon beta-1a, interferon beta-1b) compared to those on non-injectable therapy (dimethyl fumarate, fingolimod, natalizumab, teriflunomide) (HR 2.42 (95% CI: 1.63–3.61).ConclusionsPatients aged 18–30 were the least persistent age group in this study. Patients aged 18–30 were less persistent on injectable than non-injectable DMTs.

scholarly journals Decrease of Antibiotic Consumption in Children with Upper Respiratory Tract Infections after Implementation of an Intervention Program in Cyprus

2011 ◽  
Vol 56 (3) ◽  
pp. 1658-1661 ◽  
Author(s):  
V. Papaevangelou ◽  
A. Rousounides ◽  
A. Hadjipanagis ◽  
A. Katsioulis ◽  
M. Theodoridou ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Intervention Program ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Upper Respiratory Tract ◽  
Attitudes And Practices ◽  
Consumption Reduction ◽  
Upper Respiratory ◽  
Tract Infections ◽  
The Impact

ABSTRACTTo assess the impact of intervention on antibiotic misuse in children, parents' and pediatricians' knowledge, attitudes, and practices (KAP) concerning antibiotic use were evaluated pre- and postintervention in Larnaca (Cyprus) and Limassol (Cyprus). Concurrently, pediatricians documented upper respiratory tract infection (URTI) visits and pharmacists provided antibiotic consumption data. Intervention was implemented for parents and pediatricians residing in Larnaca. The consumption/URTI incidence index was significantly reduced in Larnaca but not in Limassol. Parental responses to a KAP questionnaire remained unchanged; therefore, antibiotic consumption reduction is attributable to pediatricians' education.

Pressure-Flow Measurements for Selected Nasal Sound Segments Produced by Normal Children and Adolescents

2003 ◽  
Vol 40 (2) ◽  
pp. 158-164 ◽  
Author(s):  
Bonnie E. Smith ◽  
Thomas W. Guyette ◽  
Yash Patil ◽  
Timothy S. Brannan
Keyword(s):  
Children And Adolescents ◽  
Sound Production ◽  
Speech Therapy ◽  
Function Analysis ◽  
Age Groups ◽  
Upper Respiratory Tract ◽  
Nasal Airflow ◽  
Normal Children ◽  
Flow Measurements ◽  
Tract Infections

Objective The purpose of this prospective study was to: (1) report simultaneous oral-nasal pressures, nasal airflow rates, and velopharyngeal orifice areas for nasal sounds produced by children and adolescents; (2) determine whether data could be statistically classified by age, sex, or utterance type; and (3) provide guidelines for determining typical from atypical productions. Participants The study involved 56 subjects, with two boys and two girls representing each age from 5 to 18 years. Subjects had no history of speech therapy, were judged as having normal speech and resonance at the time of testing, and had no upper respiratory tract infections or allergies at the time of testing. Methods All subjects repeated /ma/ and “hamper” at normal pitch and loudness after an examiner model. Mean oral-nasal pressures, nasal airflow rates, and velopharyngeal orifice areas were calculated for each subject's utterances. A discriminate function analysis determined whether data could be grouped by age and sex. Results Significant differences in mean data for age groups of 5 to 9 years, 10 to 13 years, and 14 to 18 years were observed. Data showed decreases in pressures and increases in nasal airflow and orifice areas with age. Variability in pressure stayed consistent or decreased with age, but variability in nasal airflow and orifice areas increased with age. Conclusions We propose a scheme for categorizing velopharyngeal function for oral and nasal sound production to be used in clinical testing.

scholarly journals Vitamin D in the prevention of exacerbations of asthma in preschoolers (DIVA): protocol for a multicentre randomised placebo-controlled triple-blind trial

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e033075 ◽  
Author(s):  
Megan E Jensen ◽  
Francine M Ducharme ◽  
Nathalie Alos ◽  
Geneviève Mailhot ◽  
Benoît Mâsse ◽  
...  
Keyword(s):  
Vitamin D ◽  
Age Groups ◽  
Vitamin D Insufficiency ◽  
Phase Iii ◽  
High Morbidity ◽  
Upper Respiratory Tract ◽  
Asthma Exacerbations ◽  
Ethical Approval ◽  
Tract Infections ◽  
The Impact

IntroductionPreschoolers have the highest rate of emergency visits and hospitalisations for asthma exacerbations of all age groups, with most triggered by upper respiratory tract infections (URTIs) and occurring in the fall or winter. Vitamin D insufficiency is highly prevalent in Canadian preschoolers with recurrent asthma exacerbations, particularly in winter. It is associated with more URTIs and, in patients with asthma, more oral corticosteroid (OCS) use. Although evidence suggests that vitamin D supplements significantly decrease URTIs and asthma exacerbations requiring OCS, there is insufficient data in preschoolers. This study aims to determine the impact of vitamin D3 supplementation on exacerbations requiring OCS, in preschoolers with recurrent URTI-induced asthma exacerbations.Methods and analysisThis is a phase III, randomised, triple-blind, placebo-controlled, parallel-group multicentre trial of vitamin D3 supplementation in children aged 1–5 years, with asthma triggered by URTIs and a recent history of frequent URTIs and OCS use. Children (n=865) will be recruited in the fall and early winter and followed for 7 months. They will be randomised to either the (1) intervention: two oral boluses of 100 000 international unit (IU) vitamin D3 (3.5 months apart) with 400 IU vitamin D3 daily; or (2) control: identical placebo boluses with daily placebo. The primary outcome is the number of exacerbations requiring OCS per child, documented by medical and pharmacy records. Secondary outcomes include number of laboratory-confirmed viral URTIs, exacerbation duration and severity, parent functional status, healthcare use, treatment deintensification, cost and safety.Ethics and disseminationThis study has received ethical approval from all sites. Results will be disseminated via international conferences and manuscripts targeting paediatricians and respirologists, and to families of asthmatic children via our Quebec parents–partners outreach programme. If proven effective, findings may markedly influence the management of URTI-induced asthma in high-morbidity preschoolers and could be directly implemented into practice with an update to clinical guidelines.Trial registration numberNCT03365687.

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