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1.
In. Cabo Córdoba, Estefanía; D'acosta Castillo, Lucía; Delfino Sosa, Marcos; Hermida Calleros, Natalia; Mogni Graña, Analhí. Manual de lactancia materna para profesionales de la salud. Montevideo, Bibliomédica, 2024. p.309-318, tab.
Monography in Spanish | LILACS, UY-BNMED, BNUY | ID: biblio-1570528
3.
Arch. argent. pediatr ; 121(6): e202310113, dic. 2023. graf
Article in Spanish | LILACS, BINACIS | ID: biblio-1518738

ABSTRACT

La muerte súbita de un lactante puede ser de causa explicada, indeterminada ­si no se investigó en forma suficiente­ o inexplicada ­cuando una investigación completa no permite determinar su causa­. La muerte súbita inexplicada, o síndrome de muerte súbita infantil, afecta en particular a las poblaciones más vulnerables. La muerte de estos niños que nacen con alteraciones del neurodesarrollo es la parte visible de una problemática que se origina en el embarazo. Disminuir la cantidad de niños vulnerables depende de políticas de salud y, sobre todo, de lograr mejorar las condiciones de vida de la población. Son acciones a largo plazo. Conocer a fondo los factores de riesgo que pueden desencadenar la muerte inesperada es lo que se puede hacer ya. La actualización de las recomendaciones sobre sueño seguro refleja nuevos conocimientos basados en la evidencia científica y un enfoque integral de los aspectos socioculturales relacionados con esta problemática.


Sudden unexpected infant death may be explained, cause by an etiology, unexplained but insufficiently investigated, or unexplained when a full investigation fails to determine the cause. Unexplained sudden death in infancy or sudden infant death syndrome particularly affects the most vulnerable populations. The death of these children who are born with alterations in their neurodevelopment is the visible part of a problem that originates in pregnancy. Reducing the number of vulnerable children depends on health policies and, above all, on improving the living conditions of the population. These are long-term actions. Knowing in depth the risk factors that can trigger unexpected death is what can be done now. The update of the recommendations on safe sleep reflects new knowledge based on scientific evidence and a comprehensive approach to the sociocultural aspects related to this problem.


Subject(s)
Humans , Pregnancy , Infant, Newborn , Infant , Sudden Infant Death/etiology , Sudden Infant Death/prevention & control , Sleep , Knowledge , Parturition , Health Policy
5.
HU rev ; 49: 1-6, 20230000.
Article in Portuguese | LILACS | ID: biblio-1562163

ABSTRACT

Introdução: A síndrome da morte súbita do lactente (SMSL) pode ser definida como a morte inesperada de uma criança menor de um ano durante o sono, de causa inexplicada mesmo após necrópsia. É uma condição com fatores de risco conhecidos e, em sua maioria, modificáveis. Objetivo: Destacar as evidências científicas nas quais se baseiam as recomendações da Academia Americana de Pediatria e da Sociedade Brasileira de Pediatria para prevenção da SMSL. Métodos: Revisão da literatura a partir da revisão das recomendações das sociedades para prevenção de SMSL, em busca de evidências que corroborem cada recomendação. Resultados: As recomendações para prevenção da SMSL incluem dormir em posição supina; utilizar uma superfície firme, plana e não inclinada para dormir; aleitamento materno pelo maior tempo possível; dormir no quarto dos pais nos seis primeiros meses de vida; manter o berço livre de objetos macios; oferecer a chupeta durante o sono; evitar a exposição ao tabagismo; não utilizar monitores cardiorrespiratórios. Para todas essas recomendações, foram apresentadas evidências científicas provenientes, de forma majoritária, de estudos de caso-controle. Conclusão: As recomendações para prevenção da SMSL são baseadas em evidências científicas suficientes, e é preciso que os profissionais da saúde que atendem a crianças pequenas e suas famílias estejam sempre atualizados e atentos a elas, promovendo de forma ativa a segurança do sono.


Background: Sudden Infant Death Syndrome (SIDS), defined as the unexpected death of a child under one year of age during sleep, of unexplained cause even after autopsy, is a condition with known and mostly modifiable risk factors.Objective: To highlight the scientific evidence on which the recommendations of the American Academy of Pediatrics and the Brazilian Society of Pediatrics for SIDS prevention are based. Methods: Literature review based on the societies' recommendations for SIDS prevention, searching for evidence that supports each recommendation. Results:The recommendations for SIDS prevention include placing the infant in a supine position for sleep; using a firm, flat, and non-inclined sleep surface; breastfeeding for as long as possible; room-sharing with parents for the first six months of life; keeping the crib free from soft objects; offering a pacifier during sleep; avoiding exposure to smoking; not using cardiorespiratory monitors. For all these recommendations, scientific evidence was presented, predominantly from case-control studies. Conclusion: The recommendations for SIDS prevention are based on sufficient scientific evidence, and healthcare professionals who care for young children and their families need to stay updated and attentive to them, actively promoting sleep safety.


Subject(s)
Sudden Infant Death , Child Care , Supine Position , Delivery of Health Care , Disease Prevention
6.
Journal of Forensic Medicine ; (6): 433-440, 2023.
Article in English | WPRIM | ID: wpr-1009374

ABSTRACT

OBJECTIVES@#The common differentially expressed mRNAs in brain, heart and liver tissues of deceased sudden infant death syndrome (SIDS) and infectious sudden death in infancy (ISDI) confirmed by autopsy was screened by bioinformatics to explore the common molecular markers and pathogenesis of SIDS and ISDI.@*METHODS@#The datasets of GSE70422 and GSE136992 were downloaded, the limma of R software was used to screen differentially expressed mRNA in different tissue samples of SIDS and ISDI decedents for overlapping analysis. The clusterProfiler of R software was used to conduct gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. The protein-protein interaction (PPI) network was constructed by STRING database, while the hub gene was screened by cytoHubba plug-in.@*RESULTS@#Compared with the control group, there were 19 significant differentially expressed genes in the tissue samples of SIDS and ISDI decedents, among which 16 in the heart tissue and 3 in the liver tissue, and the astrotactin 1 (ASTN1) gene expression difference in the heart tissue was most significant. The PPI network identified Ras homolog family member A (RHOA), integrin subunit alpha 1 (ITGA1), and H2B clustered histone 5 (H2BC5) were hub genes. The analysis of GO and KEGG showed that differentially expressed genes were enriched in the molecular pathways of actin cytoskeleton regulation, focal adhesion and response to mycophenolic acid.@*CONCLUSIONS@#ASTN1, RHOA and ITGA1 may participate in the development of SIDS and ISDI. The enrichment of differentially expressed genes in immune and inflammatory pathways suggests a common molecular regulatory mechanism between SIDS and ISDI. These findings are expected to provide new biomarkers for molecular anatomy and forensic identification of SIDS and ISDI.


Subject(s)
Humans , Infant , Gene Expression Profiling , Sudden Infant Death/genetics , Gene Regulatory Networks , Protein Interaction Maps/genetics , Computational Biology
7.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1509252

ABSTRACT

Objetivo: identificar publicações que abordam a educação em saúde relacionada à prevenção da Síndrome da Morte Súbita em Lactentes. Método: revisão integrativa realizada no PubMed, Portal Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Cochrane Reviews, Scientific Electronic Library Online e a Biblioteca Virtual em Saúde. Incluíram-se aquelas nas línguas inglesa, espanhola e portuguesa, sem recorte temporal, disponíveis gratuitamente, independentemente do delineamento. Excluíram-se duplicidades, literatura cinzenta, editoriais e cuja população eram prematuros. Resultados: identificou-se duas categorias de análise: temas para educação em saúde e barreiras e facilitadores de aderência às recomendações de prevenção. O profissional de saúde deve estimular as boas práticas de saúde, identificando barreiras e facilitadores para a adesão às recomendações. Conclusão: o profissional deve trazer a ideia de que todo bebê tem risco potencial para a síndrome da morte súbita e utilizar as estratégias disponíveis para tirá-lo da situação de vulnerabilidade.


Objectives: : identifying the current scientific production in relation to Nursing knowledge and practices on medical waste in pediatric units. Method: integrative review in the Scielo, Cinahl, Web of Science, Pubmed, Scopus and Embase databases, between the years 2016 to 2021, totalizing 13 articles. Results: the findings pointed to three main categories: knowledge and practices in relation to Medical Waste, permanent education like a tool for the disposal of Medical Waste; and sustainability in the context of Medical Waste and its relationship with social responsibility. Conclusion: it is necessary to provide the opportunity for periodic training, as well as the use of self-explanatory instruments that can help all health professionals, especially the Nursing professionals, at the time of practice. It was checked the presence of gaps was verified with studies showing Medical Waste and Pediatric Nursing.


Objetivos:identificar la producción científica actual en relación a los conocimientos y prácticas de enfermería sobre los Residuos Sanitarios en las unidades de pediatría. Método: revisión integrativa en las bases de datos Scielo, Cinahl, Web of Science, Pubmed, Scopus y Embase, con un marco temporal de 2016 a 2021, totalizando 13 artículos. Resultados:los hallazgos apuntaron a tres categorías principales: conocimientos y prácticas en relación a los Residuos Sanitarios, educación permanente con una herramienta para la disposición de los Residuos Sanitarios y sostenibilidad en el contexto de los Residuos Sanitarios y su relación con la responsabilidad social. Conclusión: es necesario brindar oportunidades de capacitación periódica, así como el uso de instrumentos autoexplicativos que puedan ayudar todos los profesionales de la salud, especialmente a los profesionales de Enfermería, en el momento de la práctica. Se verifico la presencia de lagunas en los estudios que destacan los Residuos Sanitarios y la Enfermería Pediátrica.


Subject(s)
Humans , Male , Female , Infant , Sudden Infant Death/prevention & control , Health Knowledge, Attitudes, Practice , Medical Waste/prevention & control
9.
Evid. actual. práct. ambul ; 24(3): e006940, 2021.
Article in Spanish | LILACS, UNISALUD, BINACIS | ID: biblio-1348755

ABSTRACT

El chupete es un dispositivo utilizado para calmar a los lactantes y niños pequeños; sin embargo, se lo asocia a efectos nocivos. Muchas veces en la consulta los cuidadores solicitan la opinión de los profesionales de la salud sobre su uso; por este motivo, decidimos realizar una búsqueda bibliográfica de la mejor evidencia disponible. En base a la información recabada y analizada, concluimos que la introducción precoz del chupete (antes de las dos semanas de vida) no afectaría el amamantamiento hasta los seis meses, y que en niños con lactancia materna bien establecida y madres motivadas para amamantar, no influye en el destete precoz. Además existe evidencia débil a favor del uso del chupete para reducir el riesgo del síndrome de muerte súbita del lactante, mientras que su uso durante la dentición primaria se asocia al desarrollo de mordida cruzada posterior. (AU)


The pacifier is a device used to soo the infants and young children; however, it is associated with harmful effects. Many times during consultation, caregivers ask for the opinion of health professionals about its use; for this reason, we decided to perform a literature search of the best available evidence. Based on the collected and analyzed information, we concluded that the early introduction of the pacifier (before two weeks of life) would not affect breastfeeding until six months of age, and that in children with well-established breastfeeding and mothers motivated to breastfeed, it does not influence early weaning. Furthermore, there is weak evidence in favor of pacifier use to reduce the risk of sudden infant death syndrome, while its use during primary dentition is associated with the development of posterior crossbite. (AU)


Subject(s)
Humans , Male , Infant , Weaning , Breast Feeding , Pacifiers , Sudden Infant Death/prevention & control , Randomized Controlled Trials as Topic , Meta-Analysis as Topic , Risk Factors , Malocclusion
10.
Rev. chil. pediatr ; 91(4): 529-535, ago. 2020. tab
Article in Spanish | LILACS | ID: biblio-1138667

ABSTRACT

INTRODUCCIÓN: La Academia Americana de Pediatría recomienda que los lactantes menores de un año duerman en posición supina para prevenir el síndrome de muerte súbita en lactantes (SMSL). OBJETIVO: Describir la posición en que duermen un grupo de lactantes y factores de riesgo asociados al SMSL. SUJETOS Y MÉTODO: Estudio piloto, prospectivo concurrente, de lactantes < 45 días de vida en control sano en Centro Médico San Joaquín UC Christus. Criterios de exclusión: prematurez (edad gestacional < 37 semanas) y patología de base (respiratorias, metabólicas, cardiológicas). Se aplicó encuesta al cuidador principal respecto a datos demográficos y hábitos de sueño, basada en encuesta BISQ (Brief Screening Questionnaire for Infant Sleep Problems) validada en español, dado la inexistencia de instru mentos para < 3 meses. RESULTADOS: Se obtuvo muestra de 100 lactantes de edad 16,78 ± 12,88 días de vida, siendo 57% mujeres. La madre fue el principal informante (84%). El 79% de los lactantes dor mían en decúbito supino, 19% lo hacía de lado y 2% en prono. El 66% dormía en cuna en habitación de los padres, 31% en la cama de los padres. El 74% se quedaban dormidos durante la alimentación. El 28% de los lactantes estaban expuestos a tabaquismo pasivo. El 91% cuidadores estaba informa do sobre la posición segura de sueño, siendo el principal informante el pediatra (54%). CONCLUSIONES: En esta muestra se encontró alto porcentaje de lactantes < 45 días que duermen en posición no segura, siendo frecuente el colecho. Es importante implementar campañas locales de prevención del SMSL que refuercen el hábito de dormir seguro.


INTRODUCTION: The American Academy of Pediatrics recommends, through the implementation of the "Back to Sleep (BTS)" campaign, the supine sleeping position for infant sleeping since it prevents to prevent Sudden Infant Death Syndrome (SIDS). OBJECTIVE: To describe the sleeping position of a group of infants and the risk factors associated with sudden infant death syndrome (SIDS). SUBJECTS AND METHOD: Prospective pilot study, including infants < 45 days of life in well-child care visits at a medical center. Exclusion criteria: Preterm-born infant (gestational age < 37 weeks) and/or comorbidities (pulmonary, metabolic, cardiologic). A brief parental questionnaire was conducted regarding general demographic data and sleep habits. The questioner was based on the BISQ - Spanish version, due to the lack of validated instruments for infants < 3-month-old. RESULTS: We included a sample of 100 infants between 16.78 ± 12.88 days old (57% girls). Mothers were the main information source (84%). 79% of the infants slept in supine position, 19% slept on their sides, and 2% in prone position. Regarding the place where the infants slept, 66% did in their crib in the parents' room and 31% slept in parents' bed. 74% of infants fell asleep while being fed. 28% of infants were exposed to passive smoking at home. 91% of parents were informed about safe sleep positions, reporting that pediatricians were the main source of information (54%). CONCLUSION: We found a high percentage of infants < 45 days of life who slept in an unsafe position, and frequently co-sleep with their parents. Thus, it is important to implement local SIDS prevention campaigns to reinforce safe infant sleep.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Sleep , Sudden Infant Death/etiology , Sudden Infant Death/prevention & control , Supine Position , Infant Care/methods , Logistic Models , Chile , Pilot Projects , Prospective Studies , Risk Factors , Practice Guidelines as Topic , Protective Factors , Infant Care/standards , Infant Care/statistics & numerical data
11.
Arch. argent. pediatr ; 118(3): s107-s117, jun. 2020. tab, ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1117412

ABSTRACT

El contacto piel a piel al nacer (COPAP) entre madres y recién nacidos a término sanos es fundamental en los estándares de la Iniciativa Hospital Amigo de la Madre y el Niño de Unicef. El COPAP inmediatamente después del nacimiento favorece la estabilidad cardiorrespiratoria, la prevalencia y duración de la lactancia materna y el vínculo madre-hijo, y disminuye el estrés materno. Existe preocupación por los casos de colapso súbito inesperado posnatal durante el COPAP con el bebé en decúbito prono sobre el torso desnudo materno. Si bien es infrecuente, evoluciona en el 50 % de los casos como evento grave de aparente amenaza a la vida y la otra mitad fallece (muerte súbita e inesperada neonatal temprana). Durante el COPAP y, al menos, las primeras 2 horas después del parto, el personal de Sala de Partos y recuperación debe observar y evaluar cualquier parámetro que implique una descompensación del bebé.


Early skin-to-skin contact (SSC) between mothers and healthy term newborns is a key part of the Unicef Baby Friendly Initiative Standards. SSC immediately after birth provides cardio-respiratory stability, improves prevalence and duration of breastfeeding, improves maternal-infant bonding and decreases maternal stress. There is a concern about cases of sudden unexpected postnatal collapse during a period of SSC with the infant prone on the mother ́s chest. Said collapse includes both severe apparent life-threatening event and sudden unexpected early neonatal death in the first week of life. Even if considered rare, consequences are serious with death in half of the cases and remaining disability in majority of the cases reported. For these reasons during SSC and for at least the first 2 hours after delivery, health care personnel in the delivery and recovery room should observe and assess for any sign of decompensation in the infant


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Sudden Infant Death/prevention & control , Kangaroo-Mother Care Method , Object Attachment , Touch/physiology , Breast Feeding , Mother-Child Relations
12.
13.
Arch. argent. pediatr ; 117(3): 164-170, jun. 2019. ilus, graf, tab, map
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1001188

ABSTRACT

Introducción. La mortalidad infantil incluye defunciones de menores de un año. La proporción de muerte súbita inesperada infantil (MSII) varía entre países y según las causas de muerte consideradas. Objetivo. Describir la variación espacial y temporal de MSII en Argentina entre 1991 y 2014 utilizando la Clasificación Internacional de Enfermedades, décima revisión. Materiales y métodos. A partir de la información de defunciones infantiles (Dirección de Estadísticas e Información de Salud), se calculó el porcentaje de MSII sobre el total de muertes infantiles y la frecuencia de las causas que la componían a nivel nacional, regional y provincial. El riesgo de muerte y la tendencia secular se calcularon con regresión de Poisson. Para detectar agrupamientos departamentales con porcentajes de MSII significativamente diferentes a los nacionales, se utilizó el programa SaTScan v9.1.1. Resultados. En Argentina, entre 1991 y 2014, fallecieron 267 552 menores de un año; el 7 % fueron MSII; la tendencia secular de estas causas fue negativa y estadísticamente significativa; el riesgo de MSII fue de 0,86, y se observó una gran heterogeneidad espacial. A nivel nacional, la causa más frecuente fue síndrome de la muerte súbita del lactante, con diferencias interregionales. Nueve agrupamientos departamentales tuvieron riesgo de MSII entre 4,36 y 1,24, significativamente diferentes al resto del país. Conclusiones. La proporción de MSII y de las causas que la componen presenta heterogeneidad interregional con predominio de códigos relacionados con diagnósticos imprecisos en las regiones más desfavorecidas y de síndrome de muerte súbita del lactante en las más desarrolladas.


Introduction. Infant mortality comprises deaths among infants younger than one year old. The proportion of sudden unexpected death in infancy (SUDI) varies by country and based on the cause of death. Objective. To describe the spatial and temporal variation of SUDI in Argentina between 1991 and 2014 according to the International Classification of Diseases, tenth revision. Materials and methods. Based on infant death data (provided by the Health Statistics and Information Department), we estimated the percentage of SUDI over the total number of infant deaths and the frequency of causes of death at a provincial, regional, and national level. The risk for death and the secular trend were estimated using a Poisson regression. The SaTScan software, v9.1.1, was used to detect clusters of districts where the percentage of SUDI was significantly different from the national percentage. Results. In Argentina, between 1991 and 2014, 267 552 infants younger than 1 year died; 7 % corresponded to SUDI; the secular trend of causes was negative and statistically significant; the risk for SUDI was 0.86, and a great spatial heterogeneity was observed. At a national level, the most common cause was sudden infant death syndrome, with inter-regional differences. In nine district clusters, the risk for SUDI ranged between 4.36 and 1.24, which is significantly different from the rest of the country. Conclusions. The proportion of SUDI and its causes show inter-regional heterogeneity; codes related to inaccurate diagnoses predominated in more unfavorable regions, while sudden infant death syndrome was prevalent in the more developed regions.


Subject(s)
Humans , Infant, Newborn , Infant , Argentina , Sudden Infant Death , Epidemiology , Risk Factors
15.
Epidemiology and Health ; : 2019011-2019.
Article in English | WPRIM | ID: wpr-785775

ABSTRACT

Cutaneous leishmaniasis (CL) is most common form of leishmaniasis and is characterized by ulcerative skin lesions. The objective of this study was to conduct a systematic review and meta-analysis of clinical trials that compared the efficacy of miltefosine and glucantime for the treatment of CL. We searched the following databases: Cochrane, PubMed, Embase, Scopus, Web of Science, ProQuest, Cochrane Central Register of Controlled Trials, International Clinical Trials Registry Platform search portal of World Health Organization, Sid, Irandoc, Magiran, and clinicaltrials.gov. We used keywords including “miltefosine,” “glucantime,” and “Leishmania.” The quality of studies was assessed using the Cochrane risk of bias tool. A random-effects model was employed for the analysis. We assessed heterogeneity by the chi-square test and the I² index statistic. When heterogeneity was present, meta-regression analyses were performed. The Egger method was used to assess publication bias; when it was significant, the trim-and-fill method was used to test and adjust for publication bias. A total of 1,570 reports were identified, of which 10 studies were included in the meta-analysis. In the meta-analysis, there was no significant difference between the efficacy of miltefosine and glucantime; however, subgroup analysis showed that, regarding parasite species other than Leishmania braziliensis, miltefosine was significantly superior to glucantime (intention to treat; relative risk, 1.15; 95% confidence interval, 1.01 to 1.32). In the meta-regression, only the glucantime injection type was significant at the p=0.1 level. The Egger test found statistically significant publication bias; however, including the 3 missing studies in the trim-and-fill analysis did not change the results. This meta-analysis found that miltefosine seems to be more effective than glucantime, at least in species other than L. braziliensis, for treating CL.


Subject(s)
Bias , Leishmania braziliensis , Leishmaniasis , Leishmaniasis, Cutaneous , Methods , Parasites , Population Characteristics , Publication Bias , Skin , Sudden Infant Death , Ulcer , World Health Organization
16.
Article in English | WPRIM | ID: wpr-739630

ABSTRACT

Malnutrition is one of the most important health issues in developing countries, which might have adverse effects on the physical and intellectual health of children. The search process was started to find Persian and English articles published until September 2017 regarding the prevalence of malnutrition in children under the age of six in Iran using national and international databases including SID, Magiran, Irandoc, IranMedex, PubMed, Medline, Scopus, and ISI Web of Science. The data were analyzed using meta-analysis methods and the random effects model. The heterogeneity of studies was analyzed using the I² index. The data were analyzed using R and STATA software (ver. 11.2). Twenty seven articles conducted from 2002 to 2016 were collected to be included in the meta-analysis process. The total sample size was 161,941 patients in an age range of 0-6 years. The final estimate of the prevalence of different forms of malnutrition through meta-analysis of data extracted from studies in Iran was as follows: severe underweight (1%; 95% confidence interval [CI], 1–1), moderate underweight (6%; 95% CI, 5–7), mild underweight (25%; 95% CI, 21–28), severe short stature (3%; 95% CI, 2–3), moderate short stature (8%; 95% CI, 6–9), mild short stature (21%; 95% CI, 17–24), severe slimness (1%; 95% CI, 1–1), moderate slimness (5%; 95% CI, 4–5) and mild slimness (20%; 95% CI, 17–24). Considering that the prevalence of malnutrition is relatively high in Iran, health authorities should plan to improve the nutritional status of children.


Subject(s)
Child , Humans , Child Nutrition Disorders , Developing Countries , Growth Disorders , Iran , Malnutrition , Nutritional Status , Population Characteristics , Prevalence , Sample Size , Sudden Infant Death , Thinness , Weight Loss
17.
Epidemiology and Health ; : e2019011-2019.
Article in English | WPRIM | ID: wpr-763751

ABSTRACT

Cutaneous leishmaniasis (CL) is most common form of leishmaniasis and is characterized by ulcerative skin lesions. The objective of this study was to conduct a systematic review and meta-analysis of clinical trials that compared the efficacy of miltefosine and glucantime for the treatment of CL. We searched the following databases: Cochrane, PubMed, Embase, Scopus, Web of Science, ProQuest, Cochrane Central Register of Controlled Trials, International Clinical Trials Registry Platform search portal of World Health Organization, Sid, Irandoc, Magiran, and clinicaltrials.gov. We used keywords including “miltefosine,” “glucantime,” and “Leishmania.” The quality of studies was assessed using the Cochrane risk of bias tool. A random-effects model was employed for the analysis. We assessed heterogeneity by the chi-square test and the I² index statistic. When heterogeneity was present, meta-regression analyses were performed. The Egger method was used to assess publication bias; when it was significant, the trim-and-fill method was used to test and adjust for publication bias. A total of 1,570 reports were identified, of which 10 studies were included in the meta-analysis. In the meta-analysis, there was no significant difference between the efficacy of miltefosine and glucantime; however, subgroup analysis showed that, regarding parasite species other than Leishmania braziliensis, miltefosine was significantly superior to glucantime (intention to treat; relative risk, 1.15; 95% confidence interval, 1.01 to 1.32). In the meta-regression, only the glucantime injection type was significant at the p=0.1 level. The Egger test found statistically significant publication bias; however, including the 3 missing studies in the trim-and-fill analysis did not change the results. This meta-analysis found that miltefosine seems to be more effective than glucantime, at least in species other than L. braziliensis, for treating CL.


Subject(s)
Bias , Leishmania braziliensis , Leishmaniasis , Leishmaniasis, Cutaneous , Methods , Parasites , Population Characteristics , Publication Bias , Skin , Sudden Infant Death , Ulcer , World Health Organization
18.
Med. leg. Costa Rica ; 35(1): 65-74, ene.-mar. 2018. tab, graf
Article in Spanish | LILACS | ID: biblio-894339

ABSTRACT

Resumen El síndrome de muerte súbita del lactante es la principal causa de muerte infantil post neonatal en los países desarrollados. El mismo se caracteriza por una muerte repentina e inexplicable de un infante menor a un año. La compleja interacción de múltiples factores en su patogénesis se ilustra con la teoría del triple riesgo, la cual involucra un infante vulnerable en un periodo crítico de su desarrollo ante un factor de riesgo externo. Por medio de educación a los cuidadores y padres se ha documentado una disminución importante en su incidencia, aunque la misma continúa siendo muy alta.


Abstract Sudden infant death syndrome is the leading cause of post neonatal infant death in the developed countries. It is characterized for the sudden and unexplained death of an infant younger than one year old. The interaction of multiple factors in its pathogenesis is illustrated by the triple risk theory, which involves a vulnerable infant at a critical moment of its development facing an external risk factor. Through education to caregivers and parents a drop in incidence has been documented, although it is still very high.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Sudden Infant Death , Infant, Newborn , Cause of Death , Infant Death
19.
Article in Korean | WPRIM | ID: wpr-758534

ABSTRACT

The causal relationship between cigarette smoking during pregnancy and adverse maternal and child health outcomes, such as preterm birth, low birth weight, and sudden infant death syndrome are well known. In addition, cigarette compounds are neurotoxic even at extremely low levels. Thirdhand smoke (THS) is the contamination that persists after secondhand tobacco smoke has been emitted into air. It refers to the tobacco-related gases and particles that become embedded in materials such as carpets, walls, furniture, blankets, and toys. THS is not strictly smoke but chemicals that adhere to surfaces from which they can be released back into the air, undergo chemical transformations, and/or accumulate. The concept of THS is a relatively new phenomenon in the environmental and public health field. Currently, the hazards of THS are not as well documented as the hazards of secondhand smoke. Furthermore, its health effects and biological effects are largely unknown. This review summarizes recent research progress in reproductive toxicology studies that use animal models and in vitro systems, studies of environmental contamination by THS, human exposure studies, and priorities for further research. Future research must be conducted to facilitate hazard identification, and exposure and risk assessment to address its health effect on susceptible populations, such as pregnant women and children. In addition, policies and laws concerning tobacco smoke will need to be reviewed and possibly revised with the role of THS considered as an indispensable component of a broader tobacco control strategy in maternal and child health.


Subject(s)
Child , Female , Humans , Infant, Newborn , Pregnancy , Child Health , Floors and Floorcoverings , Gases , In Vitro Techniques , Infant, Low Birth Weight , Interior Design and Furnishings , Jurisprudence , Maternal Health , Models, Animal , Play and Playthings , Pregnant Women , Premature Birth , Public Health , Risk Assessment , Smoke , Smoking , Sudden Infant Death , Nicotiana , Tobacco Products , Tobacco Smoke Pollution , Toxicology
20.
Article in English | WPRIM | ID: wpr-716526

ABSTRACT

BACKGROUND: There has been a campaign by the National Education on Sleeping Habits and Living Environment, to reduce the incidence of sudden infant death syndrome (SIDS). However, more than 100 infants die suddenly and unexplainably before the age of 1 year in Korea. Long QT syndrome (LQTS), an inheritable cardiac disease, has been reported to likely be associated with up to 14% of SIDS cases. However, genetic studies of the association between SIDS and LQTS have not yet been conducted in Korea. METHODS: We conducted genetic analysis using genomic DNA extracted from paraffin-embedded tissue blocks from 200 SIDS cases autopsied between 2005 and 2013. We analyzed the following genetic mutations associated with LQTS, KCNQ1, SCN5A, KCNE1, KCNE2, KCNJ2, and CAV3. RESULTS: Of the 200 SIDS cases, 58% involved male infants (116 male and 84 female infants, respectively), the mean age was 140 days (median, 107 days; range, 24–270 days), and they were all of Asian-Korean ethnicity. SIDS IA category criteria comprised 45 cases (22.5%) while the rest were SIDS IB. Fifteen infants (7.5%) had R1193Q in SCN5A, of doubtful pathogenicity, and no pathogenic LQTS variants were observed. CONCLUSION: This genetic investigation of LQTS in SIDS showed a low diagnostic yield. These findings suggest that LQTS molecular autopsy could be cautiously conducted in selected cases with family involvement to improve the available genetic counseling information. Meanwhile, a national SIDS registry should be established to document and evaluate the genetic risk of SIDS in Korea.


Subject(s)
Female , Humans , Infant , Male , Autopsy , DNA , Education , Genetic Counseling , Heart Diseases , Incidence , Korea , Long QT Syndrome , Retrospective Studies , Sudden Infant Death , Virulence
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