ABSTRACT
Background and Aims: Evaluation of sun protection behavior and related factors in children aged between 6 and 18 years in Isfahan, Iran. Methods: This cross-sectional study was conducted at outpatient pediatric clinics affiliated with Isfahan University of Medical Sciences, Isfahan, Iran during the summer of 2021. A checklist was designed, and the interviewer used that to gather the required information including children's demographic characteristics, families' socioeconomic data, and sun-protective behaviors in children. Results: The mean ± standard deviation (SD) age of children was 10.54 ± 3.61. Among the study population, 63.7% of children were male. The most common skin phototypes were II and III (33.5% each). 83.8% of children used at least one method of sun protection (94.5% of girls, 77.6% of boys, p < 0.001). Wearing long-sleeved clothes was the most frequent UV-protection method (48%), while sunscreen application was the least prevalent method (28.1%). Sun protection behaviors were more frequent among urban children (86.7%, p = 0.009) and children with wealthy families (94%, p = 0.035). Sun protection methods were used by most of the children whose mothers applied sunscreen on a daily basis (90.2%, p = 0.002) and all of the children whose mothers held a master's degree or above (100%, p = 0.004). Conclusion: Children's sun protection behavior is directly associated with demographic characteristics, families' socioeconomic level and maternal usage of sun protection measures. It is necessary to provide information and education about sun protection methods and the risks of excessive sun exposure to families and children, as well as facilitate their access to these.
ABSTRACT
Today, MXenes with fascinating electronic, thermal, optical, and mechanical features have been broadly studied for biomedical applications, such as drug/gene delivery, photothermal/photodynamic therapy, antimicrobials/antivirals, sensing, tissue engineering, and regenerative medicine. In this context, various MXene-polymer composites have been designed to improve the characteristics such as physiological stability, sustained/controlled release behaviors, biodegradability, biocompatibility, selectivity/sensitivity, and functionality. Chitosan with advantages of ease of modification, biodegradability, antibacterial activities, non-toxicity, and biocompatibility can be considered as attractive materials for designing hybridized composites together with MXenes. These hybrid composites ought to be further explored for biomedical applications because of their unique properties such as high photothermal conversion efficiency, improved stability, selectivity/sensitivity, stimuli-responsiveness behaviors, and superior antibacterial features. These unique structural, functional, and biological attributes indicate that MXene-chitosan composites are attractive alternatives in biomedical engineering. However, several crucial aspects regarding the surface functionalization/modification, hybridization, nanotoxicological analyses, long-term biosafety assessments, biocompatibility, in vitro/in vivo evaluations, identification of optimization conditions, implementation of environmentally-benign synthesis techniques, and clinical translation studies are still need to be examined by researchers. Although very limited studies have revealed the great potentials of MXene-chitosan hybrids in biomedicine, the next steps should be toward the extensive research and detailed analyses in optimizing their properties and improving their functionality with a clinical and industrial outlook. Herein, recent developments in the use of MXene-chitosan composites with biomedical potentials are deliberated, with a focus on important challenges and future perspectives. In view of the fascinating properties and multifunctionality of MXene-chitosan composites, these hybrid materials can open significant new opportunities in the future for bio- and nano-medicine arena.
ABSTRACT
Recent studies have shown that several children diagnosed with COVID-19 have developed Kawasaki Disease (KD)-like symptoms. This systematic review aims to assess the demographic, laboratory, and clinical characteristics of children with KD-like syndrome during the COVID-19 pandemic and evaluate efficacy of treatments and patients' outcome. A comprehensive search was carried out systematically through PubMed, Scopus, and Web of Science (WoS), medRxiv, and bioRxiv by two reviewers independently for all studies or preprints data on the demographic, laboratory, and clinical characteristics of children with K.D-like signs during the COVID-19 outbreak. Overall, 378 studies were identified by the systematic search, of which 25 studies were included in the study. The included studies involved 599 patients in total. Thirteen studies (52%) were case reports or case series, and the rest (48%) were cohort studies. In 19 studies, patients were diagnosed with Multisystem inflammatory syndrome in children (MIS-C). In 16 studies COVID-19 was diagnosed in all patients based on their polymerase chain reaction result, serological findings, and computed tomography results. Higher C-reactive protein and erythrocyte sedimentation rate level were the most prevalent laboratory findings. In most studies, patients had leucopenia with marked lymphopenia, hypoalbuminemia, and increased ferritin, as well as hyponatremia. Abnormal echocardiography and respiratory outcomes were the most common clinical outcomes. In 11 studies, all patients required intensive care unit admission. Findings of the present systematic review show that the incidence of KD-like syndrome in the COVID-19 pandemic increased significantly. Moreover, this study offers new insights in the KD-like syndrome pathogenesis and clinical spectrum during COVID-19 pandemic.
ABSTRACT
BACKGROUND: Low vitamin D and diminished bone minerals with the potential for fractures are one of the nonapparent late effects of acute lymphoblastic leukemia (ALL). Chemotherapy and radiation were known as two important risk factors. We evaluated these late effects in ALL survivors who were treated with chemotherapy or chemo plus cranial radiation therapy. METHODS: In a case-control study, 33 of ALL survivors who were treated with chemotherapy (Group A), and 33 subjects who were treated with chemoplus cranial radiation (Group B) were compared against 33 matched age, sex, and pubertal stage of their healthy siblings (Group C). Standard anthropometric data were collected as well as Tanner staging for puberty, number of fractures since treatment, serum calcium (Ca), phosphorus (P), magnesium (Mg), alkaline phosphatase, parathyroid hormone, and 25-hydroxyvitamin D (25(OH) D). The independent t-test, one-way ANOVA, Chi-square test, and Tukey's test were used to analyze the data. RESULTS: The findings indicated that the mean serum levels of 25(OH) D in ALL survivors (i.e. Groups A and B) with age mean score of 11.2 years and 12.3 years, average treatment length: 3.25 years and average time after treatment completion: 4 years, was lower compared to the controls group (12.94 ± 6.69, 14.6 ± 8.1, 20.16 ± 10.83, respectively, P < 0.001) but no significant difference was observed between Group A and B in this regard (P > 0.05). Other clinical and laboratory parameters had no significant differences between the survivors and control. Vitamin D deficiency (<20 ng/ml) was observed in 27% of group A and 24% of group B and vitamin D insufficiency (20-30 ng/ml) in 72.7% and 69.6% survivors of Group A and B and 48.5% of controls group (P = 0.003). CONCLUSIONS: ALL treatment is associated with the increase in prevalence of vitamin D insufficiency in the childhood ALL survivors and since the low vitamin D level potentially increases the risk of low bone density, subsequent malignancies, and cardiovascular disease in the survivors, close follow-up of such patients are highly recommended to prevent the stated complications.
