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gondii has been isolated from black bears and a grizzly bear. The genetic diversity of isolates based on DNA from viable T. gondii isolates is discussed. Genetic typing of a total of 26 T. gondii samples from bears using 10 PCR-RFLP markers revealed 8 PCR-RFLP ToxoDB genotypes #1 (clonal type II) in 3 samples, #2 (clonal type III) in 8 samples, #4 (haplogroup 12) in 3 samples, #5 (haplogroup 12) in 3 samples, #74 in 5 samples, #90 in 1 sample, #147 in 1 sample, and #216 in 2 samples. These results suggest relatively high genetic diversity of T. gondii in bears. Overall, T. gondii isolates in bears range from those circulating in a domestic cycle (genotypes #1 and #2) to those mainly associated with wildlife (such as genotypes #4 and #5, together known as haplogroup 12). A patient who acquired clinical Trichinella spiralis infection after eating undercooked bear meat also acquired T. gondii infection. Freezing of infected meat kills T. gondii, including the strains isolated from bears.
Due to the pandemic, children are undergoing many changes in their daily lives.
We analyzed how parents perceive the effects of the contingency on their children through an online survey shared by digital media for 7 days.
We obtained 4000 responses. The most frequent difficulty of the children was online homeschooling (30.4%), followed by sleeping disorders (20.3%). The use of screens increased 30-80% in over 65% of children. Tantrum was detected in 34% and mood swings in 30% of children. The majority of parents (77.8%) considered that distance education does not guarantee children's education and that the level of learning acquired through online classes is not the same as that of face-to-face education (83.5%). In contrast, 70.6% of parents considered that it is not yet time to reopen schools, 78.8% believed that there is sufficient evidence to keep them closed, and 45% indicated that it is better not to return to campus this year. Regarding activities to improve mental health during the contingency, 51.3% have created home games, and 23.6% perform physical activity. However, 74.4% do not have the peace of mind to restart daily life. Among the positive aspects of the contingency, adaptability (35%) and family union (33.5%) were reported.
Health professionals in contact with children must be prepared for the problems that this contingency is generating and sensitize parents to observe their children and seek professional help on any alarm data on the emotional or behavioral state of the child.
Health professionals in contact with children must be prepared for the problems that this contingency is generating and sensitize parents to observe their children and seek professional help on any alarm data on the emotional or behavioral state of the child.Acute leukemia is the leading cause of death in children worldwide, particularly in developing countries where the growing number of cases with unfavorable prognosis and high risk of early relapse have positioned pediatric cancer as a priority. The late and imprecise diagnosis, malnutrition and unfavorable environmental conditions, and toxicity-associated therapy are some of the factors that compromise the success of the treatment and affect survival rates in vulnerable regions. An early and exhaustive classification of malignant neoplasms at the clinical debut and the proper follow-up of treatment's response constitute one of the most powerful prognostic factors. Remarkably, the ultrasensitive detection of residual and relapse clones that determine the minimal/measurable residual disease (MRD) has been a milestone in the comprehensive management of hematologic malignancies that favorably improve the complete remission cases. In this review, we discuss the scientific and technological advances applied to laboratory diagnosis in MRD determination from the multiparametric immunophenotyping to next-generation sequencing and cytomics. As a result of multidisciplinary research in the main concentration oncology centers and laboratories, residual leukemia detection strategies that combine molecular analysis and cellular markers are recommended as the most valuable tools, making them the paradigm for stratification campaigns in vulnerable regions.Pediatric acute respiratory distress syndrome (PARDS) is a frequent diagnosis in critical care. This inflammatory process has different stages characterized by mild-to-severe hypoxia, and the management will vary according to the severity. New definitions for pediatric patients were published in 2015; new epidemiological evidence revising those definitions has helped understand the mortality associated with PARDS and the impact on ventilation. The strategies to protect the lungs during mechanical ventilation have been successful in reducing mortality and complications. In clinical situations where high levels of critical support are limited, other therapies with a lower level of evidence can be attempted to gain time without worsening the ongoing pulmonary injury. We offer a complete narrative revision of this syndrome, with the critical management of these patients as a priority.
Viral respiratory infections in pediatric patients with hematopoietic stem cell transplantation (HSCT) significantly impact morbidity and mortality. It is necessary to determine the viral agents and their frequency of presentation to understand their impact on transplantation patients' evolution.
From January 2017 to December 2019, we conducted a cross-sectional, descriptive, and observational study of patients who underwent HSCT with a viral respiratory infection. Viral identification was performed using multiplex polymerase chain reaction for nine respiratory viruses. BMS777607 Descriptive statistics were performed with a report of central tendency measures and percentages.
Of the 54 pediatric patients who underwent HSCT, 59.2% presented an airway infection; in turn, at least one viral agent was identified in 59.3% of these patients. The most frequent viral agents were influenza (25.9%), human rhinovirus (18.5%), and respiratory syncytial virus (18.5%). Viral co-infections occurred in 36.8% of the cases. The reported complications were supplemental oxygen requirement (73.6%), support with mechanical ventilation (21%), admission to the pediatric intensive care unit (15.7%), and mortality associated with a viral respiratory infection (10.5%).
Viral respiratory infections are frequent in pediatric patients with HSCT; influenza A/B virus was the most frequent agent. As morbidity and mortality increase due to these infections in patients with HSCT, strategies are necessary for its prevention and timely treatment after transplantation.
Viral respiratory infections are frequent in pediatric patients with HSCT; influenza A/B virus was the most frequent agent. As morbidity and mortality increase due to these infections in patients with HSCT, strategies are necessary for its prevention and timely treatment after transplantation.
The Sun Protection Outreach Teaching by Students (SPOTS) program addresses an unmet need by training medical students to teach adolescents about skin cancer prevention and early detection.
To measure (1) changes in adolescents' knowledge, attitudes, and behaviors regarding sun protection and (2) the impact on medical students' confidence in skin cancer preventive counseling.
Pre-SPOTS and 1-month post-SPOTS program surveys were completed by adolescent participants and medical student instructors.
Amongst adolescent students, analysis of 1,142 pre-program surveys and 618 post-program surveys revealed statistically significant improvements in knowledge, attitudes, and behaviors. Among the favorable results, 26%, 41%, and 20% improvements over baseline were observed in SPF knowledge, preference for natural untanned skin, and intent to wear sunscreen, respectively (p < .001). One-third of adolescents reported having tried to increase sunscreen use. Amongst medical students, analysis of 78 pre-teaching and 74 post-teaching surveys revealed an increase in feeling "very confident" in counseling patients, from 23% pre-teaching to 82% post-teaching (p < .001).
SPOTS demonstrated a dual benefit to adolescents and medical students. The program is available for dermatologists to implement in their communities.
SPOTS demonstrated a dual benefit to adolescents and medical students. The program is available for dermatologists to implement in their communities.
In the absence of a cure, dementia is often managed by minimizing risk factors contributing to quality of life (QOL). Attitudes to dementia in older adults may differ from those in relatively younger adults. The aim was to conduct a systematic review of the literature to determine how QOL was assessed in adults, 65 years and older with dementia, and identify factors that influence the reported scores.
A systematic review of full-text articles addressing QOL in older adults with dementia, published in English from January 1995 to September 2020, was conducted using PubMed and PsycINFO. We included studies that assessed QOL and involved participants 65 years and older. Studies were evaluated for inclusion by 2 independent pairs of reviewers. We assessed the quality of the studies using the Joanna Briggs Institute's Critical Appraisal Checklist. Study characteristics and findings were summarized. Analysis was by narrative synthesis. We identified social and clinical factors influencing QOL scores.
Of the 1 to ensure that all perspectives are addressed.The discovery in mammals that fetal testes are required in order to develop the male phenotype inspired research efforts to elucidate the mechanisms underlying gonadal sex determination and differentiation in vertebrates. A pioneer work in 1966 that demonstrated the influence of incubation temperature on sexual phenotype in some reptilian species triggered great interest in the environment's role as a modulator of plasticity in sex determination. Several chelonian species have been used as animal models to test hypotheses concerning the mechanisms involved in temperature-dependent sex determination (TSD). This brief review intends to outline the history of scientific efforts that corroborate our current understanding of the state-of-the-art in TSD using chelonian species as a reference.
Endoscopic ultrasound routinely guides lymph node evaluation for the staging of a known or suspected lung cancer. Characteristics seen on B-mode imaging might help the observer decide on the lymph nodes of risk. The influence of nodal size on the predictivity of these characteristics and the agreement with which operators can combine these for malignancy risk prediction is to be determined.
We evaluated (1) if prospectively scored individual B-mode ultrasound features predict malignancy when further divided by size and (2) assessed if observers were able to reproducibly agree on still lymph node image malignancy risk.
Lymph nodes as visualized by EBUS were prospectively scored for B-mode characteristics. Still B-mode images were furthermore collected. After collection, a repeated scoring of a subset of lymph nodes was retrospectively performed (n = 11 observers).
Analysis of 490 lymph nodes revealed the short axis size is an objective measure for stratifying risk of malignancy (ROC area under the curve 0.
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