Diagnostic accuracy of Saliva Reverse Transcription Polymerase Chain Reaction (RT-PCR) compared to Nasopharyngeal Swab Reverse Transcription Polymerase Chain Reaction (RT-PCR) in the detection of SARS-COV-2 in pediatric patients ages 0-18 years old: A meta-analysis

OBJECTIVES@#COVID-19, SARS-COV-2, Nasopharyngeal RT-PCR, Saliva RT-PCR, Children, 0- 18 years old.@*METHODOLOGY@#A metanalysis was done to synthesize the diagnostic accuracy of saliva RT-PCR compared to the nasopharyngeal RT-PCR in the detection of SARS-COV 2 in pediatric patients ages 0-18 years old. Five studies published from January to September 2021 were analyzed using the "midas" command of STATA14. MIDAS command is a comprehensive program of statistical and graphical routines for undertaking meta-analysis of diagnostic test performance in Stata. The index and reference tests (gold standard) are dichotomous. Primary data synthesis is performed within the bivariate mixed-effects regression framework focused on making inferences about average sensitivity and specificity. @*RESULTS@#The World Health Organization’s acceptable sensitivity and specificity for products used in COVID-19 diagnostics is ≥ 80% and ≥ 97% respectively. The results of this metanalysis showed the pooled sensitivity of Saliva RT-PCR as compared to the Nasopharyngeal RT-PCR is at 87% (81-92% at 95% CI) and the pooled specificity is at 97% (95% CI: 96-98%). @*CONCLUSION@#This metanalysis demonstrates that saliva can be used as an alternative specimen for SARS-COV-2 diagnostic testing in children. Aside from the acceptable pooled specificity and sensitivity, the use of saliva offers several advantages. However, the authors recommend to include more studies for future metanalysis research, to further increase sample size, and to include both symptomatic and asymptomatic pediatric age group participants. A future prospective research study comparing the two diagnostic modalities is likewise recommended.

The Prevalence of Intestinal Protozoan Infections among Children in Southwest Sumba Based on the Type of Water Sources.

BACKGROUND: Intestinal protozoan infection is a public health problem in Indonesia, particularly in regions lacking clean water sources such as Perokonda and Perobatang villages, Southwest Sumba Regency, East Nusa Tenggara Province. The residents of Perokonda and Perobatang villages use wells and unprotected open springs respectively. Therefore, this study aims to determine the prevalence of intestinal protozoan infections in these two villages. MATERIALS AND METHODS: This was a cross-sectional study, carried out in Perokonda and Perobatang from August 2016 to August 2017. A total of 291 children aged 6 months to 18 years were used as subjects. Furthermore, fecal examinations were carried out by preparing smears, which were stained with lugol solution and examined under the microscopes by four experienced technicians. The data were processed using SPSS version 20 and analyzed by chi-square test. RESULTS: Among the 291 samples, the prevalence of intestinal protozoan infections was 20%, with 23.4% in Perokonda and 17.2% in Perobatang. The predominant species found were Blastocystis hominis (34.5%), Giardia lamblia (19.0%), and Entamoeba coli (15.5%). Moreover, approximately 69.0% of single infections were found while 31.0% were mixed and associated with 2 to 3 protozoan species. There were no significant differences between the prevalence of intestinal protozoan infections and the children in Perokonda and Perobatang villages (confidence interval 0.83 - 2.62, P = 0.19). CONCLUSION: The type of water sources has no relationship with the species of intestinal protozoan infecting children in Perokonda and Perobatang.

Caries prevalence among 18 years old, an epidemiological survey in Israel.

BACKGROUND: There is a lack of evidence on caries prevalence among 18 years old Israeli young adults with only a scarce evidence regarding this index age group. In the last few years dental care policy in Israel underwent substantial changes and a major reform in dental services was led by the Israeli Ministry of Health, including coverage of dental care for children by the state. In addition, a cessation of community water fluoridation was in a debate. The objective of the current study was to describe prevalence of caries among 18 years old Israeli young adults and to evaluate possible associations with personal and demographic variables. METHODS: The study was a cross sectional clustered survey. Participants were recruited to the study at their first day of military service. Participants completed a questionnaire for personal and demographic data, including: age, country of birth, education, and current smoking status. Then participants underwent clinical evaluation included DMFT and caries free rates. No radiographic evaluation was included in the current study. Univariate and multivariate statistical analysis were performed. RESULTS: A total of 702 participants were included in the study, 58.4% were males. Their mean age was 19.03 ± 0.65 years, 91.3% of the participants were born in Israel. Mean DMFT was 1.95 ± 2.67, and 46.7% (n = 328) were caries free. Higher DMFT score was significantly associated with participant's parents' education, country of birth, and smoking status. Lower caries free rates were significantly associated with participant's parents' education, and smoking status. After linear regression for total DMFT, all variables were significant predictors to higher DMFT, except father's education, while logistic regression for caries free, only mother's education was found to be a significant predictor. CONCLUSIONS: The current study presents encouraging low DMFT levels. Participants in this study were not included in the dental care services reform, and did enjoy the benefits of water fluoridation, enabling the results to play an important baseline data for future reference. Additionally, results should be considered when planning intervention programs for at risk groups. TRIAL REGISTRATION: This study was registered in ClinicalTrials.gov (Identifier No. NCT02958891 , November 8th, 2016) and was approved by the IDF Institutional Review Board (#1524-2015).

Laparoscopic Sleeve Gastrectomy for Adolescents Under 18 Years Old with Severe Obesity.

INTRODUCTION: Laparoscopic sleeve gastrectomy (LSG) is a widely accepted stand-alone bariatric operation. Data on adolescent patients undergoing LSG are limited. The aim of this study was to demonstrate that LSG is safe and effective for patients strictly under 18 years old with severe obesity. METHODS: Prospectively collected data from consecutive patients undergoing LSG were retrospectively analyzed. Patients with more than 1-year follow-up were included in the analysis for weight loss and comorbidity evaluation. Quality of life (QoL) was evaluated using the Short-Form 36 questionnaire. RESULTS: Eighty-four patients under 18 years old (range: 15-17 years) underwent LSG. Median weight was 128 kg and median body mass index (BMI) 43.7 kg/m2. Median duration of surgery was 68.5 min. One major complication was recorded: a patient developed severe pneumonia that necessitated ventilatory support in intensive care unit and intravenous antibiotic treatment. Mortality was null. Median length of hospital stay was 4 days. Six, 12, and 24 months after LSG, median BMI decreased significantly to 34.3, 29.8, and 28.8 kg/m2, respectively (p < 0.001), with a mean percentage of total body weight loss of 29.1% at 2 years. Obesity-related comorbidities improved at 1 year, while all SF-36 scale scores of QoL assessment improved significantly. CONCLUSION: This study suggests that LSG is safe and effective for patients under 18 years old, resulting in significant weight loss, comorbidity remission, and QoL improvement. Careful patient selection after adequate risk versus benefit evaluation by an expert multidisciplinary team is essential.

Investigation on Status of Chemotherapy Drugs for Discharged Patients Under 18 Years Old in Our Hospital and Its Potential Risks / 中国药学杂志

OBJECTIVE: To investigate the actual data of chemotherapy drugs for discharged patients under 18 years old in our hospital, and to firstly provide the real status and risk of chemotherapy drugs during carrying and use at home. METHODS A retrospective research was adopted to statistically analyze 1 955 discharged orders of the patients, under the age of 18, with chemotherapy drugs in our hospital from December 1, 2017 to May 31, 2018. RESULTS: During the sampling period, there were 153 patients with chemotherapy drugs discharged under the age of 18 years old. Thirty kinds of chemotherapy drugs were involved, and 17 drugs with the remaining drug amount regarding to its dosage regimen. CONCLUSION: It was found that it is common and necessary to continue treatment with chemotherapy drugs after discharged. One drug needs to be refrigerated and the other needs to be kept in a shade place, which is difficult to reach the preservation conditions during the journey. There is a residual amount of medications over its usage for young patients, of the total 1 955 medical orders, 898 have the problem of residual amount, which account for 57.11% in cancer patients and 7.09% in non-cancer patients, respectively. For pharmacists,it is time exploring medication education and follow-up for discharged patients, especially for young patients and their guardians.

Useful tools for the age 18 estimation in forensic radiology / 中国法医学杂志

The age of 18 is an important criterion in judicial trial, immigrant and competitive sports. Consequentially, the estimation of age 18 is a key issue in forensic practice and research. The extremitas sternalis claviculae, iliac crest, third molar, and the proximal limb of the limb bone were usually used as indictors of age 18. The results of the previous studies demonstrated that those indictors could be beneficial to the estimation of age 18. The X-ray, CT, ultrasound and MRI of different indictors were widely utilized for the estimation of age 18, particularly the thin-layer CT. But due to the non-radiation, MRI will be a trend for forensic age estimation in the future. Whilst in the previous studies, the descriptive analysis was applied for the estimation of age 18, but due to the low statistic efficiency, it is unsuitable for forensic age estimation, and the future studies should pay attention to the high efficiency statistical methods, for instance, the ROC curve or the data mining.