Current Issue : April - June Volume : 2020 Issue Number : 2 Articles : 5 Articles
Background: Gaining a better understanding of the probability, timing and prediction of rehospitalisation amongst\npreterm babies could help improve outcomes. There is limited research addressing these topics amongst extremely\nand very preterm babies. In this context, unplanned rehospitalisations constitute an important, potentially\nmodifiable adverse event. We aimed to establish the probability, time-distribution and predictability of unplanned\nrehospitalisation within 30 days of discharge in a population of French preterm babies.\nMethods: This study used data from EPIPAGE 2, a population-based prospective study of French preterm babies.\nOnly those babies discharged home alive and whose parents responded to the one-year survey were eligible for\ninclusion in our study. For Kaplan-Meier analysis, the outcome was unplanned rehospitalisation censored at 30 days.\nFor predictive modelling, the outcome was binary, recording unplanned rehospitalisation within 30 days of\ndischarge. Predictors included routine clinical variables selected based on expert opinion.\nResults: Of 3841 eligible babies, 350 (9.1, 95% CI 8.2â??10.1) experienced an unplanned rehospitalisation within 30 days.\nThe probability of rehospitalisation progressed at a consistent rate over the 30 days. There were significant differences in\nrehospitalisation probability by gestational age. The cross-validated performance of a ten predictor model demonstrated\nlow discrimination and calibration. The area under the receiver operating characteristic curve was 0.62 (95% CI 0.59â??0.65).\nConclusions: Unplanned rehospitalisation within 30 days of discharge was infrequent and the probability of\nrehospitalisation progressed at a consistent rate. Lower gestational age increased the probability of rehospitalisation.\nPredictive models comprised of clinically important variables had limited predictive ability....
Background: Gut microbiota plays a critical role in many important physiological processes and is linked with\nvarious pulmonary infectious diseases. The relationship between pulmonary tuberculosis (PTB) and gut microbiota\nhas been poorly studied. The present study aimed to characterize gut microbiota in pediatric patients with PTB.\nMethods: A case-controlled study was executed for the characterization of gut microbiota in pediatric PTB patients.\nFecal samples were collected from the PTB patients and healthy controls upon admission. In addition, a one-month\nfollow-up assessment was performed to investigate alterations in the gut microbiota post anti-tuberculosis\ntreatment. 16SrDNA sequencing analysis of fecal DNA was completed on the Illumina MiSeq platform.\nResults: Compared with healthy controls, the gut microbiota of pediatric patients with PTB was characterized by\ndecreased microbial diversity. PTB patients further presented an up-regulation of the pro-inflammatory bacteria\nPrevotella, the opportunistic pathogen Enterococcus, as well as a reduction of beneficial bacteria including\nRuminococcaceae, Bifidobacteriaceae and prausnitzii. One-month after anti-tuberculosis therapy, the richness of gut\nmicrobiota in PTB patients was distinctly depleted.\nConclusions: The gut microbiota of pediatric patients with PTB was significantly distinct from healthy controls.\nAdditionally, the richness of gut microbiota in PTB patients decreased after one-month anti-tuberculosis treatment.\nIt is hypothesized that the homeostasis of gut microbiota in PTB patients may affect the pathogenies of PTB\nby de-regulation of the hostsâ?? immune status through the gut-lung axis....
The objective of this study was to identify risk factors and study the causes of\nneonatal mortality of LBW newborns referred to the Institute of Nutrition\nand Child Health. Material and Methods: This is a prospective descriptive\nand analytical study from March 1 to August 31, 2015, involving 250 newborns\nreferred to the Neonatology Department of the Institute of Child Nutrition\nand Health (INSE). Results: During our study period, we recorded\n1169 newborns, 250 of whom were referred, representing a referral frequency\nof 21.38%. The overall mortality rate for transferring newborns was 46.8%.\nRisk factors associated with neonatal mortality were gravidity (p = 0.0019),\nparity (p = 0.0323), occupational activities requiring physical effort (p =\n0.0257), birth weight (p = 0.0008) and prematurity (p = 0.0039). Conclusion:\nNeonatal mortality associated with referrals is a major health problem in developing\ncountries. There is currently no doubt that it is possible to significantly\nreduce perinatal mortality and morbidity rates by organizing the identification\nof â??mother-childâ? couples at risk, to refer them intently to centres\nbetter equipped with technical and human resources to care for them....
Background: Acute appendicitis (AA) is the most common surgical condition in children. Although a higher\nincidence of AA in summer has been reported, the reason for this observation remains unclear. The purpose of this\nstudy was to compare the clinical findings of AA patients who underwent appendectomies during the summer\nmonths with those who underwent the procedure during the non-summer months.\nMethods: The clinical data of 171 patients who underwent appendectomy from January 2013 to December 2016\nwere reviewed. The patients were divided into a summer group (from May to October) and a non-summer group\n(from November to April) based on the month when appendectomy was performed. All patients were under 18\nyears of age at the time of surgery. The medical records including laboratory data, computed tomography scans,\npathology reports and operative notes were reviewed.\nResults: The number of patients with AA was higher in the summer group than in the non-summer group (101 vs.\n70 patients). No significant differences in the laboratory results between the two groups of patients were observed.\nThe percentage of AA patients who presented with a fecalith was significantly lower in the summer group (33.6%)\nthan in the non-summer group (55.7%). No significant differences in the incidence of appendiceal perforations and\nabscesses, as well as postoperative complications were observed between the two groups.\nConclusions: The percentage of AA patients with fecaliths in summer was lower than that in the non-summer\nmonths. The increase in the number of AA patients in summer may be due to the increased occurrence of\nlymphoid hyperplasia, which may be correlated with the yearly outbreak of enterovirus infection during this period....
Background: There are scant data on the prevalence and clinical course of pertussis disease among infants with\npneumonia in low- and middle-income countries. While pertussis vaccination coverage is high (greater than equal to 90%) among\ninfants in Botswana, human immunodeficiency virus (HIV) infection affects nearly one-third of pregnancies.\nWe aimed to evaluate the prevalence and clinical course of pertussis disease in a cohort of HIV-unexposed\nuninfected (HUU), HIV-exposed uninfected (HEU), and HIV-infected infants with pneumonia in Botswana.\nMethods: We recruited children 1â??23 months of age with clinical pneumonia at a tertiary care hospital in\nGaborone, Botswana between April 2012 and June 2016. We obtained nasopharyngeal swab specimens at\nenrollment and tested these samples using a previously validated in-house real-time PCR assay that detects a\nunique sequence of the porin gene of Bordetella pertussis.\nResults: B. pertussis was identified in 1/248 (0.4%) HUU, 3/110 (2.7%) HEU, and 0/33 (0.0%) HIV-infected children. All\npertussis-associated pneumonia cases occurred in infants 1â??5 months of age (prevalence, 1.0% [1/103] in HUU and\n4.8% [3/62] in HEU infants). No HEU infants with pertussis-associated pneumonia were taking cotrimoxazole\nprophylaxis at the time of hospital presentation. One HUU infant with pertussis-associated pneumonia required\nintensive care unit admission for mechanical ventilation, but there were no deaths.\nConclusions: The prevalence of pertussis was low among infants and young children with pneumonia in\nBotswana. Although vaccination against pertussis in pregnancy is designed to prevent classical pertussis disease,\nreduction of pertussis-associated pneumonia might be an important additional benefit....
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