RESUMO
Children commonly encounter primary headaches, with various factors playing a role in their onset. The daily routine notably contributes to the occurrence of primary headaches in children. This study aims to profile children experiencing headaches on weekends (WH) in comparison to those primarily having headaches midweek (MWH). Out of 109 children visiting a pediatric headache clinic, 60 prospectively filled out questionnaires regarding their headaches. The average age was 11.8 years, and 63% were of female sex. Most of the children suffered from migraine headaches (60%), while the rest suffered from tension-type headaches (TTH, 15%), mixed headaches (17%), or undetermined headaches (8%). None of the children suffered from a headache only on the weekend. In contrast, 14 (23%) children suffered from a headache exclusively in midweek. Children with learning difficulties were similarly distributed between the WH and the MWH groups (48% and 52%, respectively). Children without learning difficulties suffered significantly more from MWH compared to WH (79% vs. 21%, respectively). In conclusion, children did not suffer from WH alone. Self-reported triggers were not significantly different in WH and MWH patients. Proper profiling of headache types and triggers may lead to more accurate management of these patients.
RESUMO
Background: Radiographically-proven community-acquired alveolar pneumonia with pleural effusion (PE-CAP) has a less favourable outcome than pneumonia without pleural effusion (NPE-CAP). We assessed PE-CAP and NPE-CAP rate dynamics in children <60 months in southern Israel before and after 7- and 13-valent pneumococcal conjugate vaccine (PCV7/PCV13) implementation (2002-2016).Methods: An ongoing, prospective observational study. Our hospital serves a captive population of â¼75,000 children <60 months, enabling incidence calculation. PCV7/PCV13 were implemented in Israel in July 2009/November 2010, respectively. All chest radiographs (CXRs) were digitalized and analysed according to the WHO Standardization of Interpretation. Annual incidences of PE-CAP and NPE-CAP were calculated, 2002-2016. Incidence-rate ratios (IRRs) comparing PCV13 (2013-2016), PCV7 (2010-2011) and pre-PCV (2002-2008) periods were calculated.Results: Overall, 12,271 CAP episodes were identified; 159 (1.3%) PE-CAP and 12,112 (98.7%) NPE-CAP. In total, 65.8% and 34.2% were children <24 and 24-59 months, respectively; 61.0% and 39.0% were Bedouin and Jewish children, respectively. Following PCV7 introduction, PE-CAP rates declined by 48% (Incidence rate ratios [IRR] = 0.52; 0.26-1.03), while NPE-CAP rates declined by 20% (IRR = 0.80; 0.75-0.86). In the PCV13 period, PE-CAP and NPE-CAP rates further declined, resulting in overall 70% (IRR = 0.30; 0.18-0.50) and 55% (IRR = 0.45; 0.43-0.48) reductions, respectively, comparing the PCV13 and the pre-PCV periods. Similar trends were observed in all subgroups (Bedouin vs. Jewish and age < 24 months vs. 24-59 months).Conclusions: Following PCV7/PCV13 introduction, PE-CAP and NPE-CAP rates substantially declined. However, the rate dynamics were different, with steeper declines observed in PE-CAP rates, possibly deriving from differences in disease aetiology.
