10 research outputs found
Θεραπευτικές προσεγγίσεις και πρόγνωση της λοίμωξης COVID-19 σε παιδιά και εφήβους: συστηματική ανασκόπηση και μετα-ανάλυση
No full textΠαρ’ όλο που η λοίμωξη της COVID-19 επηρεάζει σε μεγαλύτερο βαθμό τους ενήλικες, μόλις το 5% των περιπτώσεων αφορά παιδιά και εφήβους, με την πλειονότητα τους να είναι ασυμπτωματικοί. Τα ελλιπή δεδομένα σχετικά με αυτή την ηλικιακή ομάδα, ενισχύουν την σημαντικότητα περαιτέρω αναζήτησης και ανάπτυξης κατάλληλων θεραπευτικών προσεγγίσεων, με σκοπό την αποφυγή των επιπλοκών. Σκοπός λοιπόν της συστηματικής ανασκόπησης και μετα-ανάλυσης είναι η διερεύνηση και η ανάλυση των περιστατικών της COVID-19 σε παιδιά και εφήβους παγκοσμίως, στοχεύοντας στην καταγραφή των θεραπευτικών πρωτοκόλλων που ακολουθήθηκαν και της αντιμετώπισης της νόσου. Πραγματοποιήθηκε αναζήτηση στις ηλεκτρονικές βάσεις δεδομένων Pubmed, Google Scholar, Scopus και Embase, μέχρις τις 15 Απριλίου 2020. Σύμφωνα με τα δεδομένα των επιλέξιμων ερευνών, το σύνολο των ασθενών διεγνώσθη με COVID-19 μέσω RT-PCR είτε σε ρινοφαρυγγικά και φαρυγγικά επιχρίσματα ή στα κόπρανα. Η γενική κατάσταση των ασθενών περιεγράφηκε ως καλή, με ελάχιστες εξαιρέσεις, ενώ τα παιδιά και η έφηβοι που έλαβαν θεραπεία, στην πλειοψηφία τους είχαν πλήρη ανάρρωση χωρίς επιπλοκές. Τα περιστατικά θανάτου που καταγράφηκαν, δεν μπορούσαν να αξιολογηθούν πλήρως, διότι δεν μπορούσε να επιβεβαιωθεί η COVID-19, ως πιθανή αιτία θανάτου. Λόγω της συνεχιζόμενης και μεταβαλλόμενης κατάστασης που δημιούργησε η πανδημίας της COVID-19, κρίνεται σημαντικό να αξιολογούνται τα δεδομένα τόσο στον γενικό όσο και στον παιδιατρικό πληθυσμό, με σκοπό την όσο το δυνατόν καλύτερη αντιμετώπιση της υφιστάμενης κατάστασης και αναζήτησης της αποτελεσματικότερης θεραπείαςAlthough COVID-19 infection affects adults to a greater extent, only 5% of cases concern children and adolescents, with the majority of them being asymptomatic. The lack of data regarding this age group reinforces the importance of further research and development of appropriate therapeutic approaches, in order to avoid complications. Therefore, the purpose of this systematic review and meta-analysis is to investigate and analyze the worldwide cases of COVID-19 in children and adolescents, researching the therapeutic protocols and treatment followed. The online databases Pubmed, Google Scholar, Scopus and Embase were searched up to 15 April 2020. According to the data of the eligible studies, all patients were diagnosed with COVID-19 by RT-PCR in either nasopharyngeal and pharyngeal swabs or stool. The general condition of patients was described as good, with few exceptions, while treated children and adolescents, in the majority, had full recovery without complications. The recorded deaths could not be fully evaluated because COVID-19 was not confirmed as a possible cause of death. Due to the ongoing and changing situation created by the COVID-19 pandemic, it is important to evaluate data in both general and pediatric populations, in order to best address the current situation and search for the most effective treatment
Σύνδρομο εντεροκολίτιδας επαγόμενο σε πρωτείνη τροφής (FPIES) - Κλινική και ανοσολογική εικόνα παιδιατρικού πληθυσμού
No full textΕισαγωγή: To Σύνδρομο Εντεροκολίτιδας Επαγόμενο από Τροφικές Πρωτεΐνες (FPIES), αφορά ένα σύνδρομο μη-IgE μεσολαβούμενης τροφικής αλλεργίας, που συνήθως παρουσιάζεται κατά τη βρεφική ηλικία και κυρίως σε βρέφη κάτω των 9 μηνών. Σκοπός: Σκοπός της παρούσας μελέτης ήταν να εμπλουτίσουμε τα δεδομένα σχετικά με το FPIES στην Ελλάδα και η διερεύνηση της συχνότητας εμφάνισης του συνδρόμου εντεροκολίτιδας σε σχέση με το είδος της τροφής σε παιδιατρικούς ασθενείς. Υλικό-Μέθοδος: Υλικό της μελέτης αποτέλεσαν 49 περιστατικά του συνδρόμου που καταγράφηκαν στο Γενικό Νοσοκομείο Παίδων Πεντέλης στην Παιδιατρική Κλινική, στην Μονάδα Αλλεργικών και Αναπνευστικών Παθήσεων κατά την χρονική περίοδο 2006-2016. Αποτελέσματα: Τα αποτελέσματα έδειξαν ότι η πλειοψηφία των περιστατικών οφείλεται σε κατανάλωση ψαριού (55.6%). Η μέση ηλικία εμφάνισης των συμπτωμάτων ήταν οι 12 μήνες (εύρος 0.5-120 μήνες). Σχεδόν το σύνολο του δείγματος παρουσίασε εμετό (93.5%), ενώ λήθαργο παρουσίασε το 39.1% των περιστατικών και διάρροια το 30.4%. Παρατηρήσαμε, ότι τα παιδιά με FPIES σε γάλα αγελάδος, σε σχέση με τα παιδιά με FPIES σε άλλα τρόφιμα, παρουσίαζαν λιγότερο συχνά εμετούς (72.7% vs. 100%, p=0.012) και περισσότερο συχνά διάρροια (72.7% vs. 14.7%), p=0.001). Παρατηρήθηκε δε, ότι τα παιδιά με FPIES στο ψάρι είχαν συχνότερα παρουσιάσει άσθμα κάποια στιγμή στο παρελθόν σε σχέση με τα παιδιά με FPIES σε άλλα τρόφιμα (36% vs. 5%, p=0.027). Επιπλέον, το 12.8% έχει εμφανίσει κάποιο επεισόδιο γαστροοισοφαγικής παλινδρόμησης. Συμπέρασμα: Υπάρχει η ανάγκη για διενέργεια προοπτικών μελετών κοόρτης σε εθνικό επίπεδο, ώστε να προσδιορισθεί καλύτερα η φυσική πορεία και ο επιπολασμός του FPIES. Επιπλέον, μελέτες για την παθοφυσιολογία του FPIES, τον εντοπισμό πιθανών βιοδεικτών και νέων θεραπειών είναι απαραίτητες για τη βελτίωση της φροντίδας των ασθενών με FPIES. Τέλος, είναι σημαντική η ενημέρωση και η επιμόρφωση των παιδιάτρων, ώστε να είναι ευαισθητοποιημένος ο θεράπων ιατρός για την αναγνώριση και αντιμετώπιση μιας οξείας νόσου, που μπορεί να έχει εξαιρετικά δυσμενή εξέλιξη για τον ασθενή.Introduction: Food Protein Induced Enterocolitis Syndrome (FPIES), refers to a non-IgE mediated food allergy syndrome, usually occurring in infancy and especially in infants under 9 months of age. Aim: The purpose of this study was to enrich the data on FPIES in Greece and to investigate the incidence of enterocolitis syndrome in relation to the type of food in pediatric patients. Material and methods: Study material consisted of 49 cases of the syndrome recorded at the Children's General Hospital of Penteli, in the Department of Allergy and Respiratory Diseases, during the period 2006-2016. Results: The results showed that the majority of cases were due to fish consumption (55.6%). The mean age of symptoms was 12 months (range 0.5-120 months). Almost the entire sample exhibited vomiting (93.5%), while lethargy showed 39.1% of the incidents and diarrhea was 30.4%. We observed that children with FPIES in cows' milk, compared to FPIES children in other foods, had less frequent vomiting (72.7% vs. 100%, p = 0.012) and more often diarrhea (72.7% vs. 14.7% , p = 0.001). It was observed that children with FPIES in fish had more often asthma at a time in the past than children with FPIES in other foods (36% vs. 5%, p = 0.027). In addition, 12.8% have experienced an episode of gastroesophageal reflux. Conclusion: There is a need to conduct prospective cohort studies at national level to better identify the physical course and prevalence of FPIES. In addition, studies on the pathophysiology of FPIES, the identification of potential biomarkers and new therapies are necessary to improve the care of patients with FPIES. Finally, it is important to inform and educate pediatricians in order to sensitize the physician to identify and treat the acute onset of FPIES, which can be extremely unfavorable for the patient
A Case of COVID-19-Related Thrombocytopenia and Leukopenia in an Adolescent with Mild Symptoms
No full textSince the beginning of the COVID-19 pandemic, there have been numerous reports and reviews on the complications caused by the disease, analyzing the acute and chronic consequences. The main symptoms of SARS-CoV-2 are dry cough, fever, and fatigue. COVID-19 appears to affect all systems, including renal, cardiovascular, circulatory, and respiratory systems, causing chronic obstructive pulmonary disease. We report on a 14-year-old male adolescent, who presented with thrombocytopenia (platelet count 92 × 109 /L) and leukopenia (white blood count 4.2 × 103 /μL) that was observed two months ago. Ten days before the first blood test, a viral infection with nasal congestion and runny nose was reported, without other accompanying symptoms. Viral antibodies screening revealed positivity for all the three specific COVID-19 antibodies. Further haematological evaluation with bone marrow aspiration revealed non-specific dysplastic features of the red cell and megakaryocyte progenitors. Although haematological alterations due to COVID-19 infection are available from adult patients’ reports, the effect of COVID-19 infection in the pediatric population is underestimated and this is the first case with such haematological involvement. Noteworthy, in the current case, the impact of the COVID-19 infection was not related to the severity of the disease, as the symptoms were mild. In similar cases, bone marrow aspiration would not be performed as a part of routine work-up. Thus, it is important when evaluating pediatric patients with COVID-19 infection to search and report those alterations in order to better understand the impact and the spectrum of clinical manifestations of the specific viral infection in children and adolescents
Clinical Features, Risk Factors, and Complications Among Pediatric Patients With Pandemic Influenza A (H1N1)
No full text Objective. The authors aimed to describe the epidemiological characteristics, clinical features, risk factors for severe disease, and complications in children with laboratory-confirmed pandemic influenza A (H1N1). Methods. H1N1 was confirmed by performing reverse-transcriptase polymerase chain reaction (RT-PCR) assay on oropharyngeal swab specimens. The medical charts of a subset of the evaluated patients were reviewed retrospectively; another subset was enrolled prospectively. Results. A total of 51 patients (44 [86%] > 5 years) were identified to have laboratory-confirmed H1N1. Fever was the most common presenting symptom (92%). Of the 15 hospitalized patients, 4 had asthma, and 5 were overweight or obese. All but 1 of these 9 patients developed influenza-related complications. Overall, 10 of the 15 hospitalized patients (67%) developed an influenza-related complication (6 bronchitis and 4 pneumonia). Conclusion. In this cohort, most children with confirmed H1N1 infection experience an uncomplicated viral illness. Nevertheless, underlying asthma and obesity may aggravate their clinical course. </jats:p
Adolescent Idiopathic Scoliosis and Mental Health Disorders: A Narrative Review of the Literature †
No full textAdolescent idiopathic scoliosis (AIS) is the most common type of scoliosis. The condition begins in puberty, affects 1–4% of adolescents, and disproportionately affects young women. Our aim was to comprehensively examine the association between AIS and risk for depression, anxiety, eating disorders, psychotic disorders, and personality dysfunctional mechanisms. Methods: Literature review of related articles published in PubMed, Google Scholar, and Scopus up to 15 July 2021. Results: A total of 30 studies were deemed eligible, examining the effects of AIS upon mental health, and using appropriate psychometric inventories. Studies highlighted the association of brace treatment with elevated anxiety. In addition, mental health conditions and traits (e.g., anxiety and depressive symptoms, neuroticism) were detected more frequently amongst AIS patients compared to healthy controls. Conclusions: AIS represents a risk factor for mental health disorders. More longitudinal studies, utilizing accurate psychometric instruments, are warranted, to reveal the current impact of AIS on the mental health of youngsters, along with the tailoring of well-targeted interventions to reduce the burden of mental health issues in adulthood
Sexual Activity in Adolescents and Young Adults through COVID-19 Pandemic
No full textDuring the COVID-19 pandemic, it has been postulated that the sexual life of adolescent and young adults has been impacted in various aspects, potentially affecting their well-being. Our aim is to investigate the potential changes in the sexual activity and relationships of adolescents and young adults during the COVID-19 pandemic. In general, a decrease in sexual desire was reported during the COVID-19 pandemic, in both genders. Fewer sexual intercourses and bonding behaviors between partners were associated with loneliness and depressive symptoms. On the contrary, an increase in sexual desire was expressed in a few people, with masturbation to be the most preferable means of satisfaction. The present paper highlights the multifaceted impact of COVID-19 upon the sexual life of adolescents and young adults during the ongoing pandemic. The changes observed in their sexual activity and relationships, could provide the basis of future preventive and educational programs
Sexual Activity in Adolescents and Young Adults through COVID-19 Pandemic
No full textDuring the COVID-19 pandemic, it has been postulated that the sexual life of adolescent and young adults has been impacted in various aspects, potentially affecting their well-being. Our aim is to investigate the potential changes in the sexual activity and relationships of adolescents and young adults during the COVID-19 pandemic. In general, a decrease in sexual desire was reported during the COVID-19 pandemic, in both genders. Fewer sexual intercourses and bonding behaviors between partners were associated with loneliness and depressive symptoms. On the contrary, an increase in sexual desire was expressed in a few people, with masturbation to be the most preferable means of satisfaction. The present paper highlights the multifaceted impact of COVID-19 upon the sexual life of adolescents and young adults during the ongoing pandemic. The changes observed in their sexual activity and relationships, could provide the basis of future preventive and educational programs
Obesity in Children and Adolescents during COVID-19 Pandemic
No full textBackground: The COVID-19 pandemic has led to special circumstances and changes to everyday life due to the worldwide measures that were imposed such as lockdowns. This review aims to evaluate obesity in children, adolescents and young adults during the COVID-19 pandemic. Methods: A literature search was conducted to evaluate pertinent studies up to 10 November 2020. Results: A total of 15 articles were eligible; 9 identified 17,028,111 children, adolescents and young adults from 5–25 years old, 5 pertained to studies with an age admixture (n = 20,521) and one study included parents with children 5–18 years old (n = 584). During the COVID-19 era, children, adolescents and young adults gained weight. Changes in dietary behaviors, increased food intake and unhealthy food choices including potatoes, meat and sugary drinks were noted during the ongoing COVID-19 pandemic. Food insecurity associated with financial reasons represents another concern. Moreover, as the restrictions imposed reduced movements out of the house, physical activity was limited, representing another risk factor for weight gain. Conclusions: COVID-19 restrictions disrupted the everyday routine of children, adolescents and young adults and elicited changes in their eating behaviors and physical activity. To protect them, health care providers should highlight the risk of obesity and provide prevention strategies, ensuring also parental participation. Worldwide policies, guidelines and precautionary measures should ideally be established
Weekly Personal Ozone Exposure and Respiratory Health in a Panel of Greek Schoolchildren
No full textBACKGROUND: The association of ozone exposure with respiratory outcomes has been investigated in epidemiologic studies mainly including asthmatic children. The findings reported had methodological gaps and inconsistencies.OBJECTIVES: We aimed to investigate effects of personal ozone exposure on various respiratory outcomes in school-age children generally representative of the population during their normal activities.METHODS: We conducted a panel study in a representative sample of school-age children in the two major cities of Greece, Athens and Thessaloniki. We followed 188, 10- to 11-y-old, elementary school students for 5 wk spread throughout the 2013–2014 academic year, during which ozone was measured using personal samplers. At the end of each study week, spirometry was performed by trained physicians, and the fractional concentration of nitric oxide in exhaled air (FeNO) was measured. Students kept a daily time–activity–symptom diary and measured PEF (peak expiratory flow) using peak flow meters. Mixed models accounting for repeated measurements were applied.RESULTS: An increase of 10 μg/m3 in weekly ozone concentration was associated with a decrease in FVC (forced vital capacity) and FEV1 (forced expiratory volume in 1 s) of 0.03 L [95% confidence interval (CI): −0.05, −0.01] and 0.01 L (95% CI: −0.03, 0.003) respectively. The same increase in exposure was associated with a 11.10% (95% CI: 4.23, 18.43) increase in FeNO and 19% (95% CI: −0.53, 42.75) increase in days with any symptom. The effect estimates were robust to PM10 adjustment. No inverse association was found between ozone exposure and PEF.CONCLUSIONS: The study provides evidence that airway inflammation and the frequency of respiratory symptoms increase, whereas lung function decreases with increased ozone exposure in schoolchildren. https://doi.org/10.1289/EHP635.</p
