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[PMID]:29297068
[Au] Autor:Xu G; Strathearn L; Liu B; Bao W
[Ad] Endereço:Department of Epidemiology, University of Iowa College of Public Health, Iowa City.
[Ti] Título:Prevalence of Autism Spectrum Disorder Among US Children and Adolescents, 2014-2016.
[So] Source:JAMA;319(1):81-82, 2018 01 02.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Transtorno do Espectro Autista/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Feminino
Inquéritos Epidemiológicos
Seres Humanos
Masculino
Prevalência
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180311
[Lr] Data última revisão:
180311
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180104
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.17812


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[PMID]:27770708
[Au] Autor:Glorennec P; Lucas JP; Mercat AC; Roudot AC; Le Bot B
[Ad] Endereço:EHESP, School of Public Health, Sorbonne Paris Cité, - Avenue du Professeur Léon-Bernard, CS 74312, 35043 Rennes cedex, France; Irset Inserm, UMR 1085-Institut de Recherche sur la Santé, l'Environnement et le Travail, Rennes, France. Electronic address: Philippe.glorennec@ehesp.fr.
[Ti] Título:Environmental and dietary exposure of young children to inorganic trace elements.
[So] Source:Environ Int;97:28-36, 2016 12.
[Is] ISSN:1873-6750
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Children are exposed to toxic metals and metalloids via their diet and environment. Our objective was to assess the aggregate chronic exposure of children aged 3-6years, living in France, to As, Cd, Cr, Cu, Mn, Pb, Sb, Sr, and V present in diet, tap water, air, soil and floor dust in the years 2007-2009. Dietary data came from the French Total Diet Study, while concentrations in residential tap water, soil and indoor floor dust came from the 'Plomb-Habitat' nationwide representative survey on children's lead exposure at home. Indoor air concentrations were assumed to be equal to outdoor air concentrations, which were retrieved from regulatory measurements networks. Human exposure factors were retrieved from literature. Data were combined with Monte Carlo simulations. Median exposures were 1.7, 0.3, 10.2, 34.1, 60.3, 0.7, 0.1, 44.3, 1.5 and 95th percentiles were 4.4, 0.5, 15.8, 61.3, 98.3, 2.5, 0.1, 111.1, 2.9µg/kgbw/d for As, Cd, Cr, Cu, Mn, Pb, Sb, Sr, and V respectively. Dietary exposures dominate aggregate exposures, with the notable exception of Pb - for which soils and indoor floor dust ingestion contribute most at the 95th percentile. The strengths of this study are that it aggregates exposures that are often estimated separately, and uses a large amount of representative data. This assessment is limited to main diet and residential exposure, and does not take into account the relative bioavailability of compounds. These results could be used to help target prevention strategies.
[Mh] Termos MeSH primário: Poluentes Ambientais/toxicidade
Oligoelementos/toxicidade
[Mh] Termos MeSH secundário: Poluição do Ar em Ambientes Fechados/efeitos adversos
Criança
Pré-Escolar
Exposição Dietética/efeitos adversos
Poeira/análise
Exposição Ambiental/efeitos adversos
Monitoramento Ambiental/métodos
Feminino
França
Intoxicação por Metais Pesados
Seres Humanos
Masculino
Poluentes do Solo/análise
Poluentes do Solo/toxicidade
Poluentes Químicos da Água/análise
Poluentes Químicos da Água/toxicidade
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Dust); 0 (Environmental Pollutants); 0 (Soil Pollutants); 0 (Trace Elements); 0 (Water Pollutants, Chemical)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180311
[Lr] Data última revisão:
180311
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161023
[St] Status:MEDLINE


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[PMID]:29505530
[Au] Autor:Shao H; Liu P; Zhang H; Chen C; Lin X
[Ad] Endereço:Department of Pediatric Surgery, The First Affiliated Hospital of Wenzhou Medical University.
[Ti] Título:Noncystoscopic removal of retained ureteral stents in children: A retrospective study from a single-center.
[So] Source:Medicine (Baltimore);97(1):e9540, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Cystoscopic technique is the current common method of retrieving double J ureteral stent in most pediatric urological centers. In this study, we evaluated the feasibility and efficacy of a novel noncystoscopic method to remove retained ureteral stents in pediatric patients.We reviewed all medical records from a total of 102 patients who were treated in our hospital between January 2013 and December 2016 to remove the double J ureteral stent retained into the ureter. The pediatric patients were divided into 2 groups based on different surgical options: cystoscopic group and noncystoscopic group. The surgery time (including time for instrument preparation), operation time, expenses, postoperative urination discomfort, and hospitalization were compared between the 2 groups.The noncystoscopic group took significantly less time for surgery and operation than the cystoscopic group (surgery time:7.40 ±â€Š3.75 vs 18.42 ±â€Š2.77 min, P <.05; operation time: 3.54 ±â€Š2.03 vs 4.48 ±â€Š2.04 min, P <.05). The mean spending for patients in the noncystoscopic group were less than that in the cystoscopic group ($736.70 ±â€Š105.96 vs $618.23 ±â€Š110.31, P <.05). There were less children with postoperative urination discomforts in the noncystoscopic group than that in the cystoscopic group (8 vs 20 cases, χ = 4.241, P <.05). The mean hospitalization of the noncystoscopic group was shorter than that of the cystoscopic group (3.20 ±â€Š1.25 vs 4.13 ±â€Š1.63 d, P <.05). The differences in all comparison projects were significant.The noncystoscopic procedure is a safe and viable technique that may be used successfully in pediatric urology. This novel procedure which is much safer and more affordable provides an alternative solution to remove retained ureteral stents in child patients.
[Mh] Termos MeSH primário: Remoção de Dispositivo/métodos
Stents
Ureter
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Cistoscopia/utilização
Remoção de Dispositivo/estatística & dados numéricos
Feminino
Seres Humanos
Lactente
Masculino
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180306
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009540


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[PMID]:29505511
[Au] Autor:Grzybowski A; Elikowski W; Gaca-Wysocka M
[Ad] Endereço:Department of Ophthalmology, Poznan City Hospital, Poznan.
[Ti] Título:Cardiovascular risk factors in patients with combined central retinal vein occlusion and cilioretinal artery occlusion: Case report.
[So] Source:Medicine (Baltimore);97(1):e9255, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: To analyze cardiovascular risk factors and comorbidity of acute unilateral visual loss due to combined central retinal vein occlusion (CRVO) and cilioretinal artery occlusion (CLRAO). PATIENT CONCERNS: Among patients with retinal vein or artery occlusion hospitalized at the Department of Ophthalmology between January 2011 and August 2017, subjects with combined CRVO/CLRAO were selected. All of them underwent ophthalmologic and cardiologic examination, including fluorescein angiography, optical coherence tomography, 12-lead electrocardiogram, transthoracic and transesophageal echocardiography, carotid Doppler sonography, cerebral magnetic resonance imaging, and a panel of laboratory tests. DIAGNOSES: Four subjects with coexisting CRVO and CLRAO were found among 146 patients with retinal vein or artery occlusion. There were no other types of concomitance of CRVO and retinal artery occlusion. INTERVENTIONS: All patients were treated with low molecular heparin in a full dose for 2 weeks, then with 1 mg/kg once daily for the next 2 weeks, followed by acetylsalicylic acid 75 mg/kg/d. Other medication included long-term statins, angiotensin-converting-enzyme inhibitor in 3 patients and beta-blocker in one patient. OUTCOMES: All patients with CRVO/CLRAO presented multiple cardiovascular risk factors, including hypertension, obesity, hyperlipidemia, chronic nicotine addiction, and a positive family history of coronary artery disease or stroke. In all of them, echocardiography revealed left ventricular hypertrophy and atherosclerotic lesions in the descending aorta; in addition, 3 patients had insignificant atherosclerotic plaques in the carotid artery. Also, in 3 subjects, focal ischemic cerebral changes were diagnosed. LESSONS: Patients with combined CRVO and CLRAO present numerous cardiovascular risk factors and abnormalities on imaging examinations, which should be routinely evaluated and treated.
[Mh] Termos MeSH primário: Oclusão da Artéria Retiniana/complicações
Oclusão da Veia Retiniana/complicações
Transtornos da Visão/etiologia
[Mh] Termos MeSH secundário: Adulto
Idoso de 80 Anos ou mais
Artérias Carótidas/diagnóstico por imagem
Pré-Escolar
Ecocardiografia Transesofagiana
Feminino
Seres Humanos
Imagem por Ressonância Magnética
Masculino
Meia-Idade
Neuroimagem
Oclusão da Artéria Retiniana/diagnóstico por imagem
Oclusão da Veia Retiniana/diagnóstico por imagem
Fatores de Risco
Transtornos da Visão/diagnóstico por imagem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180306
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009255


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[PMID]:29505508
[Au] Autor:Li W; Cheng X; Guo L; Li H; Sun C; Cui X; Zhang Q; Song G
[Ad] Endereço:Department of ICU, Affiliated Children's Hospital of Capital Institute of Pediatrics.
[Ti] Título:Association between serum 25-hydroxyvitamin D concentration and pulmonary infection in children.
[So] Source:Medicine (Baltimore);97(1):e9060, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We assessed the relationship between serum 25-hydroxyvitamin D (25(OH)D) level and community-acquired pneumonia (CAP) among Chinese children.This observational study examined children aged 3 days to 14 years (n = 1582) from the Capital Institute of Pediatrics in 2009 to 2011. There were 797 children in the CAP group and 785 controls. The CAP group was divided into 2 groups: a pneumonia group and pneumonia-induced sepsis group. The serum 25(OH)D level was estimated using micro whole blood chemiluminescence.The average serum 25(OH)D level in all samples was 25.32 ±â€Š14.07 ng/mL, with the CAP group showing a lower value than the control group (P < .001). There were also significant differences between the pneumonia group and pneumonia-induced sepsis group (P < .001). In the pneumonia-induced sepsis group, significant differences in serum 25(OH)D levels were observed in children who received mechanical ventilation or presenting with multiple organ dysfunction (P < .01).All serum 25(OH)D levels in the pneumonia group and pneumonia-induced sepsis group were below normal levels, particularly in the sepsis group. A lower serum 25(OH)D level was associated with more serious symptoms in CAP children. Children with low serum 25(OH)D levels may be at higher risk of receiving mechanical ventilation and presenting with multiple organ dysfunction. These findings suggest that vitamin D supplements are beneficial for the treatment and prevention of CAP.
[Mh] Termos MeSH primário: Pneumonia/sangue
Deficiência de Vitamina D/complicações
Vitamina D/análogos & derivados
[Mh] Termos MeSH secundário: Adolescente
Estudos de Casos e Controles
Criança
Pré-Escolar
Infecções Comunitárias Adquiridas/sangue
Infecções Comunitárias Adquiridas/etiologia
Feminino
Seres Humanos
Lactente
Recém-Nascido
Masculino
Estado Nutricional
Pneumonia/etiologia
Curva ROC
Estações do Ano
Sepse/sangue
Sepse/etiologia
Vitamina D/sangue
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
1406-16-2 (Vitamin D); 64719-49-9 (25-hydroxyvitamin D)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180306
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009060


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[PMID]:29499664
[Au] Autor:Kim WJ; Kim MM
[Ad] Endereço:Department of Ophthalmology, Yeungnam University College of Medicine, 170, Hyeonchung-ro, Nam-gu, Daegu, 42415, South Korea.
[Ti] Título:The fast exodrift after the first surgical treatment of exotropia and its correlation with surgical outcome of second surgery.
[So] Source:BMC Ophthalmol;18(1):67, 2018 Mar 02.
[Is] ISSN:1471-2415
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: To compare the rate of exodrift after a second surgery for recurrent exotropia, in patients grouped to fast versus slow exodrift after their first surgery. To determine whether there is a correlation with surgical outcome, and to evaluate the factors associated with fast exodrift. METHODS: Patients with recurrent intermittent exotropia, who underwent contralateral lateral rectus recession and medial rectus resection as the second surgery and were followed up for 24 months postoperatively between January 1991 and January 2013, were reviewed retrospectively. The patients were divided into two groups according to the rate of exodrift after the first surgery: Group F, patients exhibiting fast exodrift after the first surgery (> 10 prism diopters [PD] before postoperative month 6); and Group S, patients exhibiting slow exodrift after the first surgery (≤10 PD before postoperative month 6). The difference in the clinical course over the 24 months after the second surgery between the two groups and factors associated with fast exodrift were analyzed. RESULTS: In total, 106 patients with recurrent exotropia were enrolled in this study. Of these, 68 (64.2%) and 38 (35.8%) patients were included in group F and S, respectively. Group F showed more exodrift compared with groups S over the 24-month postoperative period; however, there was no significant difference in the clinical course between the two groups during that time (p = 0.54, repeated-measure ANOVA). In logistic analysis, immediate postoperative deviation after the first surgery was associated with fast exodrift (p <  0.001). CONCLUSION: Although patients with recurrent exotropia had shown fast exodrift after the first surgery, no significant difference in the surgical outcome was observed after the second surgery according to the rate of exodrift after the first surgery.
[Mh] Termos MeSH primário: Exotropia/cirurgia
Músculos Oculomotores/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Criança
Pré-Escolar
Exotropia/diagnóstico
Exotropia/fisiopatologia
Movimentos Oculares/fisiologia
Feminino
Seguimentos
Seres Humanos
Masculino
Músculos Oculomotores/fisiopatologia
Procedimentos Cirúrgicos Oftalmológicos
Prognóstico
Recidiva
Reoperação
Estudos Retrospectivos
Visão Binocular/fisiologia
Acuidade Visual
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180304
[St] Status:MEDLINE
[do] DOI:10.1186/s12886-018-0722-5


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[PMID]:29474397
[Au] Autor:Cranmer JN; Dettinger J; Calkins K; Kibore M; Gachuno O; Walker D
[Ad] Endereço:Emory University, Atlanta, Georgia, United States of America.
[Ti] Título:Beyond signal functions in global obstetric care: Using a clinical cascade to measure emergency obstetric readiness.
[So] Source:PLoS One;13(2):e0184252, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Globally, the rate of reduction in delivery-associated maternal and perinatal mortality has been slow compared to improvements in post-delivery mortality in children under five. Improving clinical readiness for basic obstetric emergencies is crucial for reducing facility-based maternal deaths. Emergency readiness is commonly assessed using tracers derived from the maternal signal functions model. OBJECTIVE-METHOD: We compare emergency readiness using the signal functions model and a novel clinical cascade. The cascades model readiness as the proportion of facilities with resources to identify the emergency (stage 1), treat it (stage 2) and monitor-modify therapy (stage 3). Data were collected from 44 Kenyan clinics as part of an implementation trial. FINDINGS: Although most facilities (77.0%) stock maternal signal function tracer drugs, far fewer have resources to practically identify and treat emergencies. In hypertensive emergencies for example, 38.6% of facilities have resources to identify the emergency (Stage 1 readiness, including sphygmomanometer, stethoscope, urine collection device, protein test). 6.8% have the resources to treat the emergency (Stage 2, consumables (IV Kit, fluids), durable goods (IV pole) and drugs (magnesium sulfate and hydralazine). No facilities could monitor or modify therapy (Stage 3). Across five maternal emergencies, the signal functions overestimate readiness by 54.5%. A consistent, step-wise pattern of readiness loss across signal functions and care stage emerged and was profoundly consistent at 33.0%. SIGNIFICANCE: Comparing estimates from the maternal signal functions and cascades illustrates four themes. First, signal functions overestimate practical readiness by 55%. Second, the cascade's intuitive indicators can support cross-sector health system or program planners to more precisely measure and improve emergency care. Third, adding few variables to existing readiness inventories permits step-wise modeling of readiness loss and can inform more precise interventions. Fourth, the novel aggregate readiness loss indicator provides an innovative and intuitive approach for modeling health system emergency readiness. Additional testing in diverse contexts is warranted.
[Mh] Termos MeSH primário: Parto Obstétrico
Serviços de Saúde Materna/organização & administração
[Mh] Termos MeSH secundário: Pré-Escolar
Feminino
Seres Humanos
Lactente
Mortalidade Infantil
Recém-Nascido
Quênia/epidemiologia
Gravidez
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180224
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0184252


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[PMID]:29447196
[Au] Autor:Verani JR; Massora S; Acácio S; Dos Santos RT; Vubil D; Pimenta F; Moura I; Whitney CG; Costa MH; Macete E; Matsinhe MB; Carvalho MDG; Sigaúque B
[Ad] Endereço:Respiratory Diseases Branch, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America.
[Ti] Título:Nasopharyngeal carriage of Streptococcus pneumoniae among HIV-infected and -uninfected children <5 years of age before introduction of pneumococcal conjugate vaccine in Mozambique.
[So] Source:PLoS One;13(2):e0191113, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Nasopharyngeal carriage is a precursor for pneumococcal disease and can be useful for evaluating pneumococcal conjugate vaccine (PCV) impact. We studied pre-PCV pneumococcal carriage among HIV-infected and -uninfected children in Mozambique. Between October 2012 and March 2013, we enrolled HIV-infected children age <5 years presenting for routine care at seven HIV clinics in 3 sites, including Maputo (urban-south), Nampula (urban-north), and Manhiça (rural-south). We also enrolled a random sample of HIV-uninfected children <5 years old from a demographic surveillance site in Manhiça. A single nasopharyngeal swab was obtained and cultured following enrichment in Todd Hewitt broth with yeast extract and rabbit serum. Pneumococcal isolates were serotyped by Quellung reaction and multiplex polymerase chain reaction. Factors associated with pneumococcal carriage were examined using logistic regression. Overall pneumococcal carriage prevalence was 80.5% (585/727), with similar prevalences among HIV-infected (81.5%, 339/416) and HIV-uninfected (79.1%, 246/311) children, and across age strata. Among HIV-infected, after adjusting for recent antibiotic use and hospitalization, there was no significant association between study site and colonization: Maputo (74.8%, 92/123), Nampula (83.7%, 82/98), Manhiça (84.6%, 165/195). Among HIV-uninfected, report of having been born to an HIV-infected mother was not associated with colonization. Among 601 pneumococcal isolates from 585 children, serotypes 19F (13.5%), 23F (13.1%), 6A (9.2%), 6B (6.2%) and 19A (5.2%) were most common. The proportion of serotypes included in the 10- and 13-valent vaccines was 44.9% and 61.7%, respectively, with no significant differences by HIV status or age group. Overall 36.9% (n = 268) of children were colonized with a PCV10 serotype and 49.7% (n = 361) with a PCV13 serotype. Pneumococcal carriage was common, with little variation by geographic region, age, or HIV status. PCV10 was introduced in April 2013; ongoing carriage studies will examine the benefits of PCV10 among HIV-infected and-uninfected children.
[Mh] Termos MeSH primário: Infecções Pneumocócicas/imunologia
Vacinas Pneumocócicas/administração & dosagem
Vacinas Pneumocócicas/uso terapêutico
[Mh] Termos MeSH secundário: Portador Sadio/epidemiologia
Pré-Escolar
Feminino
Infecções por HIV/imunologia
Infecções por HIV/microbiologia
Seres Humanos
Lactente
Recém-Nascido
Masculino
Testes de Sensibilidade Microbiana/métodos
Moçambique/epidemiologia
Nasofaringe/imunologia
Infecções Pneumocócicas/fisiopatologia
Prevalência
População Rural
Sorogrupo
Streptococcus pneumoniae/imunologia
Streptococcus pneumoniae/patogenicidade
Vacinas Conjugadas/administração & dosagem
Vacinas Conjugadas/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (10-valent pneumococcal conjugate vaccine); 0 (Pneumococcal Vaccines); 0 (Vaccines, Conjugate)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180216
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191113


  9 / 829581 MEDLINE  
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[PMID]:29447176
[Au] Autor:Svefors P; Selling KE; Shaheen R; Khan AI; Persson LÅ; Lindholm L
[Ad] Endereço:International Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
[Ti] Título:Cost-effectiveness of prenatal food and micronutrient interventions on under-five mortality and stunting: Analysis of data from the MINIMat randomized trial, Bangladesh.
[So] Source:PLoS One;13(2):e0191260, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Nutrition interventions may have favourable as well as unfavourable effects. The Maternal and Infant Nutrition Interventions in Matlab (MINIMat), with early prenatal food and micronutrient supplementation, reduced infant mortality and were reported to be very cost-effective. However, the multiple micronutrients (MMS) supplement was associated with an increased risk of stunted growth in infancy and early childhood. This unfavourable outcome was not included in the previous cost-effectiveness analysis. The aim of this study is to evaluate whether the MINIMat interventions remain cost-effective in view of both favourable (decreased under-five-years mortality) and unfavourable (increased stunting) outcomes. METHOD: Pregnant women in rural Bangladesh, where food insecurity still is prevalent, were randomized to early (E) or usual (U) invitation to be given food supplementation and daily doses of 30 mg, or 60 mg iron with 400 µg of folic acid, or MMS with 15 micronutrients including 30 mg iron and 400 µg of folic acid. E reduced stunting at 4.5 years compared with U, MMS increased stunting at 4.5 years compared with Fe60, while the combination EMMS reduced infant mortality compared with UFe60. The outcome measure used was disability adjusted life years (DALYs), a measure of overall disease burden that combines years of life lost due to premature mortality (under five-year mortality) and years lived with disability (stunting). Incremental cost effectiveness ratios were calculated using cost data from already published studies. RESULTS: By incrementing UFe60 (standard practice) to EMMS, one DALY could be averted at a cost of US$24. CONCLUSION: When both favourable and unfavourable outcomes were included in the analysis, early prenatal food and multiple micronutrient interventions remained highly cost effective and seem to be meaningful from a public health perspective.
[Mh] Termos MeSH primário: Transtornos do Crescimento/etiologia
Fenômenos Fisiológicos da Nutrição do Lactente/economia
Micronutrientes/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Bangladesh/epidemiologia
Pré-Escolar
Análise Custo-Benefício/métodos
Suplementos Nutricionais
Feminino
Ácido Fólico
Abastecimento de Alimentos
Transtornos do Crescimento/tratamento farmacológico
Transtornos do Crescimento/mortalidade
Seres Humanos
Lactente
Mortalidade Infantil
Fenômenos Fisiológicos da Nutrição do Lactente/efeitos dos fármacos
Fenômenos Fisiológicos da Nutrição do Lactente/fisiologia
Recém-Nascido
Ferro
Masculino
Micronutrientes/administração & dosagem
Política Nutricional
Gravidez
Cuidado Pré-Natal
Fenômenos Fisiológicos da Nutrição Pré-Natal
Oligoelementos
Vitaminas
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Micronutrients); 0 (Trace Elements); 0 (Vitamins); 935E97BOY8 (Folic Acid); E1UOL152H7 (Iron)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180216
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191260


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[PMID]:29447169
[Au] Autor:Eom H; Park Y; Kim J; Yang JS; Kang H; Kim K; Chun BC; Park O; Hong JI
[Ad] Endereço:Division of Vaccine-Preventable Diseases Control and National Immunization Program, Korea Center for Disease Control and Prevention, Cheongju-si, Chungcheongbuk-do, Republic of Korea.
[Ti] Título:Occurrence of measles in a country with elimination status: Amplifying measles infection in hospitalized children due to imported virus.
[So] Source:PLoS One;13(2):e0188957, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The Republic of Korea declared measles elimination in 2006. However, a measles outbreak occurred in 2013. This study aimed to identify the epidemiological characteristics of the sources of infection and the pattern of measles transmission in 2013 in South Korea. We utilized surveillance data, epidemiological data, immunization registry data, and genetic information. We describe the epidemiological characteristics of all measles case patients (sex, age distribution, vaccination status, sources of infection) as well as details of the outbreak (the pattern of transmission, duration, mean age of patients, and generation time). In 2013, a total of 107 measles cases were notified. Most patients were infants (43.0%) and unvaccinated individuals (60.7%). We identified 4 imported and 103 import-related cases. A total of 105 cases were related to four outbreaks that occurred in Gyeongnam, northern Gyeonggi, southern Gyeonggi, and Seoul. The predominant circulating genotype was B3 type, which was identified in the Gyeongnam, northern Gyeonggi, and southern Gyeonggi outbreaks. The B3 type had not been in circulation in South Korea in the previous 3 years; virologic evidence suggests that these outbreaks were import-related. Most measles cases in South Korea have been associated with imported measles virus. Although Korea has maintained a high level of herd immunity, clustering of susceptible people can cause such measles outbreaks.
[Mh] Termos MeSH primário: Sarampo/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Criança
Pré-Escolar
Surtos de Doenças
Feminino
Hospitalização
Seres Humanos
Lactente
Masculino
República da Coreia/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180216
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0188957



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