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healthcare seeking trends in acute respiratory infections among children of Pakistan

World Journal of Clinical Infectious Diseases 2017年第3期7卷 38-45页

作者： Hana Mahmood Samina Mohsin Khan Saleem Abbasi Yahya Sheraz International Research Force/Maternal Neonatal and Child Health Research Network (MNCHRN) ARI Research Cell Children Hospital Pakistan Institute of Medical Sciences (PIMS) Department of Public Health Shaheed Zulfiqar Ali Bhutto Medical University (SZABMU) MNCHRN and ARI Research Cell Children Hospital PIMS SZABMU International Research Force

AIM To assess healthcare seeking trends among Pakistani children with acute respiratory infections through comparative analysis between demographic health surveys(DHS) 2006-2007 and 2012-2013. METHODS Data of the last born children 0-24 mo of age of the sampled households from both the DHS was analyzedafter seeking permission from the DHS open access website. These were children who had suffered from cough and/or breathing difficulty in the past two weeks and sought health care thereafter. The trends of health care seeking were determined separately for the individual, household and community level according to the study parameters. χ2 test was applied to compare these trends. A P-value of children in 2006-2007 there were 1590 with acute respiratory infections(ARI) according to case definition along with 2142 out of 3419 children in 2012-2013 DHS, whose data was analyzed. During 2006-2007, 69% cases sought healthcare for ARI which improved to 79% in 2012-2013. Additionally, it was revealed that when compared between 2006-2007 and 2012-2013, improvement in care seeking practices was observed among illiterate mothers(64% vs 77%) although there was minimal change in those literate. Similarly, those women working also showed an increase in healthcare seeking from 67% to 79%. Additionally, those belonging to low and middle socioeconomic class showed a marked increase as compared to those in the higher class where there was no significant change. Whereas those living in rural communities also showed an increase from 66% to 78%.CONCLUSION Increasing health budget, improving maternal education and strengthening multi-sectoral coordination are among the effective strategies to improve outcomes associated with healthcare seeking in ARI.

关键词： Acute respiratory infections Demographic health surveys Comparison Pneumonia healthcare seeking

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Molecular and epidemiologic characterization of Wilms tumor from Baghdad, Iraq

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World Journal of Pediatrics 2018年第6期14卷 585-593页

作者： Hannah M.Phelps Mazin F.Al-Jadiry Natasha M.Corbitt Janene M.Pierce Bingshan Li Qiang Wei Raina R.Flores Hernan Correa Stefania Uccini Haydar Frangoul Adel R.Alsaadawi Safaa A.F.Al-Badri Amir F.Al-Darraji Raghad M.Al-Saeed Salma A.Al-Hadad Harold N.LovvornⅢ Vanderbilt University School of Medicine 2215 Garland AvenueNashvilleTN 37232-9780USA Oncology Unit Children’s Welfare Teaching HospitalBaghdad University Medical CityBaghdadIraq Department of P ediatric Surgery Vanderbilt University Medical CenterNashvilleUSA Department of Molecular Physiology and Bioph ysics Vanderbilt University School of MedicineNashvilleUSA Division of P ediatric Pathology Vanderbilt University Medical CenterNashvilleUSA Department of Clinical and Molecular Medicine Sapienza UniversityRomeItaly Division of P ediatric Hematology and Oncology Vanderbilt University Medical CenterNashvilleUSA Department of P athology Baghdad University Medical CityBaghdadIraq Oncology Unit Children’s Welfare Teaching HospitalWasit University College of MedicineWasitIraq

Background Wilms tumor (WT) is the most common childhood kidney cancer worldwide, yet its incidence and clinical behavior vary according to race and access to adequate healthcare resources. To guide and streamline therapy in the war-torn and resource-constrained city of Baghdad, Iraq, we conducted a first-ever molecular analysis of 20 WT specimens to characterize the biological features of this lethal disease within this challenged population. Methods Next-generation sequencing of ten target genes associated with WT development and treatment resistance (WT1, CTNNB1, WTX, IGF2, CITED1, SIX2, p53, N-MYC, CRABP2, and TOP2A) was completed. Immunohistochemistry was performed for 6 marker proteins of WT (WT1, CTNNB1, NCAM, CITED1, SIX2, and p53). Patient outcomes were compiled. Results Mutations were detected in previously described WT 'hot spots' (e.g., WT1 and CTNNB1) as well as novel loci that may be unique to the Iraqi population. Immunohistochemistry showed expression domains most typical of blastemal-predominant WT. Remarkably, despite the challenges facing families and care providers, only one child, with combined WT1 and CTNNB1 mutations, was confirmed dead from disease. Median clinical follow-up was 40.5 months (range 6–78 months). Conclusions These data suggest that WT biology within a population of Iraqi children manifests features both similar to and unique from disease variants in other regions of the world. These observations will help to risk stratify WT patients living in this difficult environment to more or less intensive therapies and to focus treatment on cell-specific targets.

关键词： Iraq Low- and middle-income countries Next-generation sequencing Pediatric cancer Wilms tumor

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Promptly reporting of critical laboratory values in pediatrics:A work in progress

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World Journal of Clinical Pediatrics 2018年第5期7卷 105-110页

作者： Consolato Sergi Department of Laboratory Medicine and Pathology Stollery Children’s HospitalUniversity of AlbertaEdmontonAB T6G 2B7Canada

In the 21st century,the determination of alert thresholds remains the most challenging and controversial issue in clinical ***-analytical,analytical,and postanalytical matters will consolidate or undermine the fate of any laboratory ***-analytical issues need to be cleared off before the laboratory physician can dispatch the result to the pediatrician in *** it is cleared off,the classification of essential laboratory results is *** is more than an academic exercise and may be subdivided in the order of priority we handle it to inform promptly and safely the primary ***,we are applying new modes of making sure relevant information is transmitted without interrupting the standard workflow of the primary physicians in charge for the child,who eventually need a fast line of action for results that may be lifethreatening.

关键词： Communication Laboratory healthcare Prioritization Quality

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快速中耳置管治疗对于患有慢性渗出性中耳炎的9～11岁儿童不能改善发展结局

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英国医学杂志中文版 2007年第5期10卷 305-306页

作者： Paradise JL Feldman HM Campbell TF 李静 children's hospital of Pittsburgh Pittsburgh PAUSA

问题：对于患有慢性渗出性中耳炎9—11岁的儿童，快速中耳置管治疗是否比延迟置管更能有效改善结局？

关键词：渗出性中耳炎置管治疗儿童慢性

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Barriers to Utilization of Postnatal Care: A Qualitative Study in Guinea

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Open Journal of Obstetrics and Gynecology 2021年第4期11卷 391-402页

作者： Mamadou Dioulde Balde Aissatou Diallo Anne Marie Soumah Alpha Oumar Sall Boubacar Alpha Diallo Fanta Barry Amadou Oury Touré Alpha Amadou Barry Sadan Camara Center for Research in Reproductive Health/Cellule de recherche en santé de la reproduction en Guinée (CERREGUI) Conakry Guinée University hospital Donka Clinic of Gynecology and Obstetrics Conakry Guinea

Maternal mortality remains very high in developing countries. In Guinea, it is 550 maternal deaths in 100.000 living birth. More than half of these deaths occur in the postpartum period. Hence the interests to have a better understanding of the factors that hinder the realization of post-natal care (PNC) arise. It is for this reason that the objective of this study is to identify barriers to the use of post-natal care in Guinea. Methods: A qualitative study was conducted in the prefectures of Kindia and Dubréka, in the Administrative Region of Kindia (Guinea) in April and May 2014. Fourteen focus group discussions of women and girls of the community, as well as fifteen individual in-depth interviews (9 with women and 6 with healthcare providers). Results: Most women do their PNC during their child vaccination or in case of postpartum complications. Financial constraints are the main barrier to using postnatal care identified by participants. In general, distance from the health center associated with lack of transport mean and insufficient staffs are factors related to the health system. In addition, poor reception of clients, women’s experience during childbirth, poor programming for PNC as well as the lack of trust and confidentiality between clients and health care providers are the barriers related to health p

关键词： Barriers Postnatal Consultation Maternal Mortality Guinea

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China’s unwavering determination in protecting pregnancy and perinatal health

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The Innovation 2022年第6期3卷 35-36页

作者： Haitong Zhe Sun Qingyi Xiang Siyuan Xu Haizhen Dai Jing Fang Hao Tang Tao Xue Haikun Wang Kun Tang Yuming Guo Xiaoxia Bai Department of Obstetrics Women’s HospitalSchool of MedicineZhejiang UniversityHangzhou 310006China Yusuf Hamied Department of Chemistry University of CambridgeCambridge CB21EWUK School of Clinical Medicine University of CambridgeCambridge CB20SPUK Institute of Reproductive and child Health National Health Commission Key Laboratory of Reproductive HealthPeking UniversityBeijing 100191China School of Atmospheric Sciences Nanjing UniversityNanjing 210023China Vanke School of Public Health Tsinghua UniversityBeijing 100084China School of Public Health and Preventive Medicine Monash UniversityMelbourneVIC 3004Australia Key Laboratory of Women’s Reproductive Health Hangzhou 310006China

ACHIEVEMENTS AND CHALLENGES Before the advent ofmodern medicine,childbirth carried extremely high risk of mortality,both maternal and perinatal(the period beginning at the 20–28th week of gestation and ending at 1–4 weeks after delivery).Fortunately,with advances in prenatal healthcare,the prevalence of maternal and perinatal mortalities has significantly reduced.A press conference held on May 30,2022,by the National Health Commission of the People’s Republic of China,reviewed the major progress and achievements in Chinese maternal and child health over the past *** highlighted that the maternal mortality rate dropped to 161 per million in 2021,the lowest level in recorded history.

关键词： mortality pregnancy maternal

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Dolutegravir as First-or Second-Line Treatment for HIV-1 Infection in children

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四川生理科学杂志 2021年第10期43卷 1670-1670页

作者： Anna Turkova From the Medical Research Council Clinical Trials Unit at University College London Institute of Clinical Trials and Methodology (A.T. E.W. S.A. T.S. B.W. C.S. D.F. D.M.G.) the University College London Great Ormond Street Institute of Child Health (N.K.) and the Department of Global Health and Development London School of Hygiene and Tropical Medicine (S.B.) London and Heartlands Hospital University Hospitals Birmingham NHS Foundation Trust Birmingham (S.B.W.) - all in the United Kingdom the University of Zimbabwe Harare (H.A.M. M.B.-D. G.M.) Baylor College of Medicine Fort Portal (A.R.K. P.A. D.B.) the Joint Clinical Research Center Mbarara (A. Lugemwa S.M. L.A.) and the Joint Clinical Research Center (C.M.K. E.K. V.M.) Makerere University-Johns Hopkins University Research Collaboration (P.M. L.B.-M. G.M.A.) and Makerere University (V.M.) Kampala - all in Uganda the Perinatal HIV Research Unit University of the Witwatersrand Johannesburg (A.V. N.R. E.V. A. Liberty) the Family Centre for Research with Ubuntu the Department of Paediatrics and Child Health Stellenbosch University Tygerberg (M.F.C.) the Department of Paediatrics and Children Health King Edward VIII Hospital University of KwaZulu-Natal (M.A.) and the Africa Health Research Institute (O.B. N.K.) Durban - all in South Africa the Program for HIV Prevention and Treatment-Institut de Recherche pour le Développement Research Unit Faculty of Associated Medical Sciences Chiang Mai University Chiang Mai (T.R.C. S.C.) the Faculty of Medicine Chulalongkorn University (T.P.) and HIV-NAT (HIV Netherlands Australia Thailand Research Collaboration) Thai Red Cross AIDS Research Center Bangkok (T.P.) and Prapokklao Hospital Chanthaburi (C.N.) - all in Thailand the First Department of Medicine Division of Infectious Diseases University Medical Center Hamburg-Eppendorf Hamburg Germany (R.K.) the Department of Pharmacy Radboud Institute for Health Sciences Radboud University Medical Center Nijmegen the

Results:From September 2016 through June 2018,a total of 707 children and adolescents who weighed at least 14 kg were randomly assigned to receive dolutegravir-based ART(350 participants)or standard care(357).The median age was 12.2 years(range,2.9 to 18.0),the median weight was 30.7 kg(range,14.0 to 85.0),and 49%of the participants were *** design,311 participants(44%)started first-line ART(with 92%of those in the standard-care group receiving efavirenz-based ART),and 396(56%)started second-line ART(with 98%of those in the standard-care group receiving boosted protease inhibitor-based ART).The median follow-up was 142 *** 96 weeks,47 participants in the dolutegravir group and 75 in the standard-care group had treatment failure(estimated probability,0.14 vs.0.22;difference,-0.08;95%confidence interval,-0.14 to-0.03;P=0.004).Treatment effects were similar with first-and second-line therapies(P=0.16 for heterogeneity).A total of 35 participants in the dolutegravir group and 40 in the standard-care group had at least one serious adverse event(P=0.53),and 73 and 86,respectively,had at least one adverse event of grade 3 or higher(P=0.24).At least one ART-modifying adverse event occurred in 5 participants in the dolutegravir group and in 17 in the standard-care group(P=0.01).

关键词： avi assigned boost

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FURTHER STUDIES ON THE MONGOLIAN JIRD MODEL OF GIARDIA LAMBLIA

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中华医学杂志(英文版) 1988年第11期101卷 846-846页

作者： Wu Yue-sheng Wang Zheng-yi Lu Si-qi Ji Ai-ping Zhang Chang-huai Beijing Tropical Medicine Research Institute Beijing Department of Pathology Beijing Friendship Hospital Beijing

Seventy-seven Mongolian jirds Merioes unguiculatus) were inoculated by gavage with Giardia lamblia cysts isolated from the stool of an infected child. Cyst excretion, trophozoite distribution and the pathological changes in the small intestines of the infected jirds were studied. One (12.570) of 8 animals became infected with only 5 cysts. 104 cysts or more/jird was infectious in nearly all the animals. Most of infected animals (83To) excreted cysts inter- mittently. The latent period was related to the size of inoculum. Maximal cyst excretion usually occur- red at 16+5 days. In most jirds, no cysts coulds be found in stools 21+4 days after infection. The extent of trophozoite colonization and its distribu- tion in the small intestine varied with the duration of infection, but not with the number of Giardia found in the feces. No tissue invasion by G. lamblia was demonstrated, but histopathological lesions did occur. The reduction of the villi vs. crypts ratio may indicate that the small intestine villi were co vered with relatively immature enterocytes, which may partially account for the malabsorption in giar diasis.

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Hypothyroidism during pregnancy: Controversy over screening and intervention

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World Journal of Obstetrics and Gynecology 2018年第1期7卷 1-16页

作者： Abdel Hameed Mirghani Dirar Atul Kalhan Endocrinology and Diabetes Center Prince Abdel Aziz Bin Musaad Hospital Department of Diabetes and Endocrinology Royal Glamorgan Hospital

Thyroid hormones are critical for foetal neurological development and maternal health. Maternal hypothyroidism during pregnancy is associated with adverse impact on health of the mother as well as the progeny. Reduced thyroid hormone levels predispose the child to develop mental retardation and cognitive delay in early life. In the mother, hypothyroidism during pregnancy is associated with spontaneous abortion, placental abruption, preterm delivery and hypertensive disorders. Therefore, screening and therapeutic intervention is justified to prevent foetal as well as maternal co-morbidities. In view of impact of such a large-scale screening and intervention program on limited healthcare resources, it is debatable if a targeted rather than universal screening program will result in comparable outcomes. In addition, there is an ongoing debate regarding best evidence-based practice for the management of isolated hypothyroxinaemia, subclinical hypothyroidism and euthyroid women with autoimmune hypothyroidism. We have carried out a review of the literature; firstly, to determine whether universal screening for asymptomatic women in early pregnancy would be cost-effective. Secondly, we have retrospectively reviewed the literature to analyse the evidence regarding the impact of therapeutic intervention in women with subclinical hypothyroidism.

关键词： Targeted screening Thyroid peroxidase antibodies Isolated hypothyroxinaemia Spontaneous abortion Overt hypothyroidism Placental abruption Universal screening Hypothyroidism during pregnancy Subclinical hypothyroidism Autoimmune hypothyroidism

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Associations of One-carbon Metabolism-related Vitamins with Gestational Diabetes Mellitus Risk: A Dose-Response Meta-Analysis

Associations of One-carbon Metabolism-related Vitamins with ...

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中国营养学会第十五届全国营养科学大会

作者：李娜娜 Jicheng Jiang Leilei Guo Zhengzhou Central hospital Affiliated to Zhengzhou University 河南省人民医院华中阜外医院郑州大学附属华中阜外医院

The global prevalence of gestational diabetes mellitus(GDM) has been in climbing trend and estimated to be 16.9% worldwide in women(20-49 years) varying with population characteristics and the diagnostic criteria used. Thus, early GDM prevention is critical and urgent from a public health and maternal and child health perspective. Although a number of factors have been implicated in GDM risk including the obesity epidemic, excess gestational weight gain, family history of diabetes, physical inactivity, advanced maternal age and genetic factors, there is an ongoing urgent need to identify more easily modifiable risk factors. In the rencent years, emerging evidence suggested the conflicting relationship between one-carbon metabolism-related vitamins(maternal folate and vitamin B12) and GDM risk. We aim to comprehensively estimate the existing evidence for the association of GDM risk with maternal red blood cell(RBC) and plasma/serum folate, dose and duration of folic acid supplement(FAS) intake and vitamin B12 separately. Methods We have used the Meta-analysis of Observational Studies in Epidemiology(MOOSE) checklist. A systematic literature search was conducted using PubMed, Web of science databases, China National Knowledge Infrastructure(CNKI), and Wanfang Databases through March 26, 2021. Two independent investigators extracted the following information from eligible studies: tittle, first author, year of publication, study design, country, number of participants/GDM, mean age and or range, exposure of folate status or B12, criteria of GDM assessment and date, effect size, and covariates adjusted. The methodological quality of the enrolled cohort/case-control studies were assessed using Newcastle–Ottawa Scale(NOS), and the cross sectional studies using Agency for healthcare Research and Quality(USA)(AHRQ). We used odds ratio(OR) with 95% confidence intervals(CI) to pool the association of each exposure with GDM. For the highest versus the lowest category meta-anal

关键词： Gestational Diabetes Mellitus Folate Vitamin B12 Meta-analysis

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