ABSTRACT
Background: SARS-CoV-2 is an emerging virus that has mainly affected adults; hence, most clinical information has been derived from that population. Most pediatric cases are mild and with nonspecific symptoms requiring outpatient management. Children are a major source of spread for most traditional respiratory viruses. Their role in SARS-CoV-2 transmission was thought to be relevant. Children under the age of two comprise a group that is more susceptible to infection since vaccines have not been approved for them until recently. The knowledge of clinical manifestation of COVID-19 in young children is scarce. Objectives: To describe the clinical, epidemiological, and demographic characteristics of children under 2 years old with confirmed COVID-19, who did not require hospitalization. Methods: This descriptive study was performed from May, 2020 to June, 2021. Children ages 0-2 years with COVID-19, confirmed by transcriptase-polymerase chain reaction assay that were performed in laboratories of the Red de Salud UC CHRISTUS Health Network, were selected to be contacted. If the parents accepted participating and their children were not hospitalized, a survey was sent to the patients' caregivers. Results: Of the 242 cases, 159 caregivers answered the survey (65.7%). The median age of the subjects was 14 months, and 53.5% were males. Fifty percent had comorbidities, of which one third corresponded to atopy. Ninety eight percent were secondary cases. Most of them were infected within their households (81%). The most frequent sources were their parents, followed by their grandparents. The most common symptom was fever (78%) followed by irritability (67.3%), rhinorrhea (66%), and fatigue (64.8%). Infants less than 6 months old more often presented with conjunctival congestion and less loss of appetite compared to older children (p < 0.05). Conclusions: This study provides valuable insights regarding COVID-19 in ambulatory young children. Most cases of SARS-CoV-2 infection in children under 2 years old do not require hospitalization. There was a slight male predominance, and the majority had been infected within their households. SARS-CoV-2 infection should be suspected in children under 2 years old presenting with fever, irritability, fatigue, and rhinorrhea. Children with positive household contacts and fever should also be tested for COVID-19.
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INTRODUCTION: Screening for Autism Spectrum Disorders (ASD) using the Modified Checklist for Autism in Toddlers, Revised with Follow-up (M-CHAT-R/F) increases early detection, allowing early interventions and improving prognosis. This tool is part of the management in case of suspected ASD in several clinical guidelines. The objective of this article was to conduct the concurrent and discrimi nant validation and the reliability analysis of M-CHAT-R/F in the Chilean population. PATIENTS AND METHOD: This is the second stage of the cross-cultural adaptation of cross-sectional design. M-CHAT- R/F was applied to a sample of 20 children with suspected ASD and 100 randomly selected healthy control children, aged between 16-30 months. Autism Diagnostic Observation Schedule (ADOS-2), considered as reference, was applied to the 20 patients of the clinical sample, to 20 children of the healthy control sample and to those cases of the healthy control sample with M-CHAT-R/F positive. Cronbach alpha was calculated, as well as M-CHAT-R/F and ADOS-2 correlation, sensitivity, and specificity analyses. RESULTS: In the healthy sample, M-CHAT-R/F was positive in two patients, with one of them positive and the other one negative for ASD with ADOS-2 test. In the clinical sample, M- CHAT-R/F was positive in all cases, three of them were negative in the ADOS-2 test. The Alfa relia bility of M-CHART-R/T was 0,889, the discriminant sensitivity and specificity were 100% and 98%, and the concurrent ones were 100% and 87.5% respectively. CONCLUSIONS: The Chilean M-CHAT- R/F version was reliable, sensitive and specific, similar to the original test, which opens the possibility for its use in clinical samples and for research. Validating M-CHAT-R/F is an ongoing process which must be further developed.
Subject(s)
Autism Spectrum Disorder/diagnosis , Mass Screening/methods , Case-Control Studies , Child, Preschool , Chile , Cross-Sectional Studies , Early Diagnosis , Female , Humans , Infant , Male , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
INTRODUCCIÓN: El tamizaje de los Trastornos del Espectro Autista (TEA) mediante el Modified Chec klist for Autism in Toddlers - Revised with Follow Up (M-CHAT-R/F) aumenta la detección precoz, posibilitando intervenciones tempranas y mejorando el pronóstico. Este instrumento es parte del algoritmo de manejo ante la sospecha de TEA en diversas guías clínicas. El objetivo fue realizar la validación concurrente, discriminante y el análisis de confiabilidad del M-CHAT-R/F en una pobla ción chilena. PACIENTES Y MÉTODO: Esta es la segunda etapa de la adaptación transcultural, de diseño transversal. Se aplicó M-CHAT-R/F a una muestra de 20 niños con sospecha de TEA y 100 niños de control sano seleccionados al azar, de 16-30 meses de edad. Se aplicó Autism Diagnostic Observation Schedule (ADOS-2), considerado como referencia, a los 20 pacientes de la muestra clínica, a 20 niños de la muestra de control sano y a aquellos casos de la muestra de control sano con M-CHAT-R/F po sitivo. Se calculó alfa de Cronbach, análisis de correlación de M-CHAT-R/F y ADOS-2 y sensibilidad y especificidad. RESULTADOS: En el grupo de control sano, M-CHAT-R/F resultó alterado en 2 pacien tes, siendo uno positivo y otro negativo para TEA con ADOS-2. En muestra clínica el M-CHAT-R/F fue positivo en todos, con test de ADOS-2 negativo en 3 casos. La confiabilidad Alfa del M-CHAT- R/F fue =0,889, la sensibilidad y especificidad discriminante de 100 y 98% y la concurrente 100% y 87,5% respectivamente. CONCLUSIÓN: M-CHAT-R/F en su versión chilena resultó fiable, sensible y específico de manera similar al original, lo cual abre la posibilidad de su utilización en población clínica y para investigación. La validación es un proceso continuo que se debe profundizar.
INTRODUCTION: Screening for Autism Spectrum Disorders (ASD) using the Modified Checklist for Autism in Toddlers, Revised with Follow-up (M-CHAT-R/F) increases early detection, allowing early interventions and improving prognosis. This tool is part of the management in case of suspected ASD in several clinical guidelines. The objective of this article was to conduct the concurrent and discrimi nant validation and the reliability analysis of M-CHAT-R/F in the Chilean population. PATIENTS AND METHOD: This is the second stage of the cross-cultural adaptation of cross-sectional design. M-CHAT- R/F was applied to a sample of 20 children with suspected ASD and 100 randomly selected healthy control children, aged between 16-30 months. Autism Diagnostic Observation Schedule (ADOS-2), considered as reference, was applied to the 20 patients of the clinical sample, to 20 children of the healthy control sample and to those cases of the healthy control sample with M-CHAT-R/F positive. Cronbach alpha was calculated, as well as M-CHAT-R/F and ADOS-2 correlation, sensitivity, and specificity analyses. RESULTS: In the healthy sample, M-CHAT-R/F was positive in two patients, with one of them positive and the other one negative for ASD with ADOS-2 test. In the clinical sample, M- CHAT-R/F was positive in all cases, three of them were negative in the ADOS-2 test. The Alfa relia bility of M-CHART-R/T was 0,889, the discriminant sensitivity and specificity were 100% and 98%, and the concurrent ones were 100% and 87.5% respectively. CONCLUSIONS: The Chilean M-CHAT- R/F version was reliable, sensitive and specific, similar to the original test, which opens the possibility for its use in clinical samples and for research. Validating M-CHAT-R/F is an ongoing process which must be further developed.
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Mass Screening/methods , Autism Spectrum Disorder/diagnosis , Case-Control Studies , Cross-Sectional Studies , Reproducibility of Results , Sensitivity and Specificity , Early DiagnosisSubject(s)
Humans , Male , Female , Infant , Child, Preschool , Psychiatric Status Rating Scales , Autistic Disorder/diagnosis , Culturally Competent Care , ChileSubject(s)
Autistic Disorder/diagnosis , Culturally Competent Care , Psychiatric Status Rating Scales , Child, Preschool , Chile , Female , Humans , Infant , MaleABSTRACT
BACKGROUND: Parents of children having congenital heart diseases (CHDs) develop symptoms of depression, distress, anxiety, and hopelessness more frequently than parents of healthy children. Associated with the described symptoms, parents may experience a lack of control and disempowerment, which decreases the parent's agency, a construct from development studies, and which may have negative consequences on adherence to treatment. The primary aim of this study was to assess the effect of medical treatment on well-being and agency in parents of children having CHDs, in Chile, and to compare it with reference values. METHODS: Forty parents of children having CHDs (before surgery and before hospital discharge) and 115 parents of healthy children were surveyed. The following scales were applied to this population: the General Health Questionnaire, the Basic Psychological Needs Scales, the Self-Determination Scale, the Beck Hopelessness Scale, and a socioeconomic survey. RESULTS: Children's surgery decreased parents' hopelessness (3.13 ± 0.35 and 2.18 ± 0.40, P = .04), and no significant differences were found in the remaining scales. Parents of children with CHDs scored significantly worse than parents of healthy children on the General Health Questionnaire (13.82 ± 1.03 and 9.21 ± 0.64, P = .001). This difference was not found using the others scales. CONCLUSION: Children's surgery has a positive effect on parent's hopelessness, but it does not have any impact on their well-being nor agency. Parents of children with CHD have a decreased well-being compared to parents of healthy children but have a similar level of agency. Socioeconomic level and gender may influence this association.
Subject(s)
Anxiety/psychology , Depression/psychology , Heart Defects, Congenital/surgery , Parents/psychology , Stress, Psychological/psychology , Adult , Case-Control Studies , Child, Preschool , Chile , Female , Hope , Humans , Infant , Infant, Newborn , Longitudinal Studies , Male , Mental Health , Poverty , Prospective Studies , Sex Factors , Social Class , Surveys and QuestionnairesABSTRACT
Objetivo: O preparo biomecânico tem como objetivo promover a limpeza, antissepsia e modelagem do sistema de canais radiculares favorecendo a eliminação de bactérias e seus produtos, tecido pulpar vivo ou degenerado, dentina, e debris dentinários contaminados, criando um espaço adequado para a obturação do sistema de canais radiculares. O presente estudo teve como objetivo comparar os sistemas Protaper e Waveone na produção de debris dentinários no interior do canal e a compactação de debris na região de istmos em raízes mesiais de molares inferiores. Material e Métodos: Foram selecionados 20 raízes mesiais de molares inferiores de dentes humanos. A instrumentação dos canais foi realizada com o sistema Protaper e WaveOne de acordo as especificações do fabricante. O volume de irrigante total empregado foi de 21 e 16 ml respectivamente. Em seguida, os dentes foram seccionados em planos transversais a 2,4 e 6mm do ápice e analisadas mediante estereomicroscopia com magnificação de 40 X. Qualquer material presente no interior do canal ou itsmo foi quantificado como debris. Resultados: Não houve diferença estatisticamente significante (p<0.05) na acumulação de debris em todas as secções. Protaper obteve maior porcentagem de limpeza de istmos em todas as secções, Conclusão: Os resultados sugerem que o volume de irrigação parece não ter influência na remoção de debris do interior do canal, mas sim na limpeza de istmos.
Aim: Biomechanical preparation aims to promote cleaning and shaping of the root canal system, bacteria and their products, live or degenerated pulp tissue, dentin, and contaminated dentin debris, creating adequate space for the obturation of the root canal system. The present study aimed to compare the Protaper and Waveone systems on the production of dentinal debris inside the canal and compression of debris in the area of isthmuses in mesial roots of mandibular molars. Material and Methods:Twenty mesial roots of mandibular molars of human teeth where selected. The instrumentation of the canals was performed with Protaper and WaveOne system according to the manufacturer's specifications. The total volume of irrigant employed was 21 and 16 ml respectively. Then, the teeth were sectioned in transverse sections at 2, 4 and 6mm from the apex and analyzed by stereomicroscopy with a magnification of 40 X. Any material present within the canal or isthmus was quantified as debris. Results: No statistically significant differences (p <0.05) in the accumulation of debris in all sections were found. Protaper had a higher percentage of cleaning isthmuses in all sections, Conclusions: The results suggest that the volume of irrigation seems to have no influence on the removal of debris from the interior of the canals, although, showed betteristhmus cleaning.
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Se estimó la productividad primaria aérea neta (PPAN), ciclado y eficiencia del uso de nutrientes (EUN) de 3 plantaciones experimentales de Pinus taeda L. de 20 años, del norte de la provincia de Misiones, Argentina. La PPAN fue 34,8 ±1,5Mgúha¹1úaño¹01 y la caída al mantillo, 16 ±1,1Mgúha-1úaño¹1. El incremento medio anual del fuste fue 20 por ciento mayor que en plantaciones comerciales de Misiones y cercano al extremo superior del intervalo para plantaciones de pinos tropicales y subtropicales. El requerimiento y absorción de C fue 18 y 16Mgúha¹1úaño-1 respectivamente. El requerimiento de N, P, K, Ca y Mg (kgúha¹1úaño¹1) fue respectivamente 298, 15, 63, 70 y 15; y la absorción (kgúha¹1úaño¹1) fue 161, 8, 36, 70 y 15. Los requerimientos se asignaron principalmente a las hojas y fuste. El retorno de nutrientes constituyó 70-90 por ciento de la absorción anual. La eficiencia de reabsorción foliar de N y P fue 40 por ciento, y la del K 44 por ciento; la proficiencia de N y P fue completa. La eficiencia en el uso de los nutrientes (EUN) del N fue mayor que en bosques tropicales. Comparada con plantaciones tropicales de suelos menos fértiles, la plantación misionera presentó mayor PPAN, absorción y retorno de nutrientes pero menor EUN, principalmente de N y P. No fue evidente la potencial limitación por P probablemente debido al legado de materia orgánica y nutrientes del bosque húmedo precedente, que suministró la demanda inicial de nutrientes de la plantación de primera rotación y a la rápida descomposición del mantillo que continúa la provisión nutritiva
