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age-specific causes of upper gastrointestinal bleeding in children

World Journal of Gastroenterology 2023年第47期29卷 6095-6110页

作者： Marija Kocic Petar Rasic Vuk Marusic Dragan Prokic Djordje Savic Maja Milickovic Ivana Kitic Tanja Mijovic Adrijan Sarajlija Department of Gastroenterology Hepatology and NutritionMother and Child Health Care Institute of Serbia“Dr.Vukan Cupic”Belgrade 11000Serbia Department of Abdominal Surgery Mother and Child Health Care Institute of Serbia“Dr.Vukan Cupic”Belgrade 11000Serbia Institute of Epidemiology Faculty of MedicineUniversity of BelgradeBelgrade 11000Serbia Faculty of Medicine University of BelgradeBelgrade 11000Serbia Pediatric Day Care Hospital Department Mother and Child Health Care Institute of Serbia“Dr.Vukan Cupic”Belgrade 11000Serbia Department of Abdominal Surgery Mother and Child Health Care Institute of Serbia“Dr.Vukan Cupic”Radoja Dakica 6-8Belgrade 11000Serbia

The etiology of upper gastrointestinal bleeding(UGIB)varies by age,from newborns to adolescents,with some of the causes overlapping between age groups.While particular causes such as vitamin K deficiency and cow’s milk protein allergy are limited to specific age groups,occurring only in neonates and infants,others such as erosive esophagitis and gastritis may be identified at all ages.Furthermore,the incidence of UGIB is variable throughout the world and in different hospital settings.In North America and Europe,most UGIBs are nonvariceal,associated with erosive esophagitis,gastritis,and gastric and duodenal ulcers.In recent years,the most common causes in some Middle Eastern and Far Eastern countries are becoming similar to those in Western countries.However,variceal bleeding still predominates in certain parts of the world,especially in South Asia.The most severe hemorrhage arises from variceal bleeding,peptic ulceration,and disseminated intravascular coagulation.Hematemesis is a credible indicator of a UGI source of bleeding in the majority of patients.Being familiar with the most likely UGIB causes in specific ages and geographic areas is especially important for adequate orientation in clinical settings,the use of proper diagnostic tests, and rapid initiation of the therapy. The fundamental approach to the management of UGIBincludes an immediate assessment of severity, detecting possible causes, and providing hemodynamic stability,followed by early endoscopy. Unusual UGIB causes must always be considered when establishing a diagnosis inthe pediatric population because some of them are unique to children. Endoscopic techniques are of significantdiagnostic value, and combined with medicaments, may be used for the management of acute bleeding. Finally,surgical treatment is reserved for the most severe bleeding.

关键词： Upper gastrointestinal bleeding age-specific Epidemiology Pediatric Unusual cause

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A five-compartment model of age-specific transmissibility of SARS-CoV-2

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Infectious Diseases of Poverty 2020年第4期9卷 35-49页

作者： Ze-Yu Zhao Yuan-Zhao Zhu Jing-Wen Xu Shi-Xiong Hu Qing-Qing Hu Zhao Lei Jia Rui Xing-Chun Liu Yao Wang Meng Yang Li Luo Shan-Shan Yu Jia Li Ruo-Yun Liu Fang Xie Ying-Ying Su Yi-Chen Chiang Ben-Hua Zhao Jing-An Cui Ling Yin Yan-Hua Su Qing-Long Zhao Li-Dong Gao Tian-Mu Chen State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics School of Public HealthXiamen University4221-117 South Xiang'an RoadXiang'an DistrictXiamen City 361102Fujian ProvincePeople's Republic of China Hunan Provincial Center for Disease Control and Prevention 405 Furong Middle Road Section OneKaifu DistrictChangsha City 410001Hunan ProvincePeople's Republic of China Division of Public Health School of MedicineUniversity of Utah201 Presidents CircleSalt Lake CityUT 84112USA Department of Mathematics School of ScienceBeijing University of Civil Engineering and ArchitectureBeijingPeople's Republic of China Shenzhen Institutes of Advanced Technology Chinese Academy of SciencesShenzhenGuangdong ProvincePeople's Republic of China Jilin Provincial Center for Disease Control and Prevention 3145 Jingyang Big RoadLvyuan DistrictChangchun 130062Jilin ProvincePeople's Republic of China

Background:The novel coronavirus,severe acute respiratory syndrome coronavirus 2(SARS-CoV-2,also called 2019-nCoV)causes different morbidity risks to individuals in different age groups.This study attempts to quantify the age-specific transmissibility using a mathematical model.Methods:An epidemiological model with five compartments(susceptible-exposed-symptomatic-asymptomatic-recovered/removed[SEIAR])was developed based on observed transmission features.Coronavirus disease 2019(COVID-19)cases were divided into four age groups:group 1,those≤14years old;group 2,those 15 to 44years old;group 3,those 45 to 64years old;and group 4,those≥65 years old.The model was initially based on cases(including imported cases and secondary cases)collected in Hunan Province from January 5 to February 19,2020.Another dataset,from Jilin Province,was used to test the model.Results:The age-specific SEIAR model fitted the data well in each age group(Page group 4 to 3(median:β43=7.71×10-9;SAR43=3.86×10-8),followed by group 3 to 4(median:β34=3.07×10-9;SAR34=1.53×10-8),group 2 to 2(median:β22=1.24×10-9;SAR22=6.21×10-9),and group 3 to 1(median:β31=4.10×10-10;SAR31=2.08×10-9).The lowest transmissibility was from age group 3 to 3(median:β33=1.64×10-19;SAR33=8.19×10-19),followed by group 4 to 4(median:β44=3.66×10-17;SAR44=1.83×10-16),group 3 to 2(median:β32=1.21×10-16;SAR32=6.06×10-16),and group 1 to 4(median:β14=7.20×10-14;SAR14=3.60×10-13).In Jilin Province,the highest transmissibility occurred from age group 4 to 4(median:β43=4.27×10-8;SAR43=2.13×10-7),followed by group 3 to 4(median:β34=1.81×10-8;SAR34=9.03×10-8).Conclusions:SARS-CoV-2 exhibits high transmissibility between middle-aged(45 to 64 years old)and elderly(≥65 years old)people.Children(≤14 years old)have very low susceptibility to COVID-19.This study will improve our understanding of the transmission feature of SARS-CoV-2 in different age groups and suggest the most prevention measures should be applied to middle-age

关键词： Transmissibility SARS-CoV-2 COVID-19 Compartmental model age-specific dynamics

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