Clinical, virologic and immunologic profiles of a young infant with severe acute respiratory syndrome

The clinical findings, plasma viral load, cytokines and chemokines of a 4-month-old infant with severe acute respiratory syndrome (SARS) were assessed at different phases of the disease. Ribavirin failed to inhibit SARS coronavirus (SARS-CoV) replication. One-step real time reverse transcription-polymerase chain reaction for plasma SARS-CoV RNA quantification was useful for early diagnosis and monitoring viremia. © 2005 Lippincott Williams & Wilkins.link_to_subscribed_fulltex

The six-minute walk test in healthy children: Reliability and validity

The aim of this study was to assess the reliability and validity of the 6-min walk test (6MWT) in healthy children. Chinese secondary school students were randomly recruited. They attended the current authors' unit on two occasions, separated by 2 weeks. Physical examination and standardised maximum incremental exercise testing on a treadmill were performed on the first visit. Spirometry and 6MWT were carried out on the second visit. A randomly selected subgroup was invited to return for repeat 6MWT at an interval of 2-4 weeks. Seventy-eight subjects were recruited; however, four failed to achieve maximal effort on exercise test. The final group included 43 young females and the mean±SD age of the subjects was 14.2±1.2 yrs. Physical examination was unremarkable in all cases. The mean±SD per cent predicted forced expiratory volume in one second was 91.4±10.2%. Concurrent validity was demonstrated by good correlation between the 6-min walking distance and maximum oxygen uptake determined on the exercise treadmill. Test-retest reliability was undertaken in 52 subjects, and the intraclass correlation coefficient (95% confidence interval) was calculated as 0.94 (0.89-0.96). In addition, Bland and Altman plots demonstrated a high degree of repeatability. In healthy children, the 6-min walk test is a reliable and valid functional test for assessing exercise tolerance and endurance. Copyright © ERS Journals Ltd 2005.link_to_subscribed_fulltex

Neuropsychological, behavioral, and adaptive functioning of Swiss children with congenital central hypoventilation syndrome

This study collected data about developmental problems in a cohort of children with congenital central hypoventilation syndrome. In 2003, in Switzerland, 11 children with this disease were registered. Nine of them gave their informed consent to participate in the study and were examined. Clinical assessments were conducted, including examinations of neuropsychological, behavioral, and adaptive functions using Kaufman-Assessment Battery for Children, Child Behavior Checklist, and Vineland Adaptive Behavior Scales. The mean age (+/- standard deviation) was 7.5 +/- 2.5 years. The cognitive tests showed problems in working memory functions with a near-to-normal full-range intelligence quotient (87.4 +/- 23.3). The children showed normal values (t-values > 67) on problem scales of behavior, although 5 of the 9 children showed elevated values on the attention and on the social interaction problem scales. Adaptive function problems were identified in communication and daily living skills

Serial analysis of plasma proteomic signatures in pediatric patients with severe acute respiratory syndrome and correlation with viral load

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Severe acute respiratory syndrome (SARS): Chest radiographic features in children

Background: Severe acute respiratory syndrome (SARS) is a recently recognized condition of viral origin associated with substantial morbidity and mortality rates in adults. Little information is available on its radiologic manifestations in children. Objective: The goal of this study was to characterize the radiographic presentation of children with SARS. Materials and methods: We abstracted data (n = 62) on the radiologic appearance and course of SARS in pediatric patients with suspect (n = 25) or probable (n = 37) SARS, diagnosed in five hospital sites located in three cities: Toronto, Singapore, and Hong Kong. Available chest radiographs and thoracic CTs were reviewed for the presence of the following radiographic findings: airspace disease, air bronchograms, airways inflammation and peribronchial thickening, interstitial disease, pleural effusion, and hilar adenopathy. Results: A total of 62 patients (suspect = 25, probable = 37) were evaluated for SARS. Patient ages ranged from 5.5 months to 17 years and 11.5 months (average, 6 years and 10 months) with a female-to-male ratio of 32:30. Forty-one patients (66.1%) were in close contact with other probable, suspect, or quarantined cases; 10 patients (16.1%) had recently traveled to WHO-designated affected areas within 10 days; and 7 patients (11.2%) were transferred from other hospitals that had SARS patients. Three patients, who did not have close/hospital contact or travel history to affected areas, were classified as SARS cases based on their clinical signs and symptoms and on the fact that they were living in an endemic area. The most prominent clinical presentations were fever, with a temperature over 38 °C (100%), cough (62.9%), rhinorrhea (22.6%), myalgia (17.7%), chills (14.5%), and headache (11.3%). Other findings included sore throat (9.7%), gastro-intestinal symptoms (9.7%), rigor (8.1%), and lethargy (6.5%). In general, fever and cough were the most common clinical presentations amongst younger pediatric SARS cases (age < 10 years), whereas, in addition to these symptoms, headache, myalgia, sore throat, chills, and/or rigor were common in older patients (age≥10 years). The chest radiographs of 35.5% of patients were normal. The most prominent radiological findings that were observed in the remaining patients were areas of consolidation (45.2%), often peripheral with multifocal lesions in 22.6%. Peribronchial thickening was noted on chest radiographs of 14.5% of patients. Pleural effusion was observed only in one patient (age 17 years and 11.5 months), whereas interstitial disease was not observed in any patient. Conclusion: In pediatric cases, SARS manifests with nonspecific radiographic features making radiological differentiation difficult, especially from other commonly encountered childhood respiratory viral illnesses causing airspace disease. The radiographic presentation of suspected SARS cases ranged from normal to mild perihilar peribronchial thickening. The radiographic presentations, as expected, were relatively more pronounced in the SARS probable cases.link_to_subscribed_fulltex

Multilevel factors affecting healthcare workers’ perceived stress and risk of infection during COVID-19 pandemic

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Understanding, perceptions and self-use of complementary and alternative medicine (CAM) among Malaysian pharmacy students

Background: In recent times the basic understanding, perceptions and CAM use among undergraduate health sciences students have become a topic of interest. This study was aimed to investigate the understanding, perceptions and self-use of CAM among pharmacy students in Malaysia.Methods: This cross-sectional study was conducted on 500 systematically sampled pharmacy students from two private and one public university. A validated, self-administered questionnaire comprised of seven sections was used to gather the data. A systematic sampling was applied to recruit the students. Both descriptive and inferential statistics were applied using SPSSversion 18.Results: Overall, the students tend to disagree that complementary therapies (CM) are a threat to public health (mean score = 3.6) and agreed that CMs include ideas and methods from which conventional medicine could benefit (mean score = 4.7). More than half (57.8%) of the participants were currently using CAM while 77.6% had used it previously. Among the current CAM modalities used by the students, CM (21.9%) was found to be the most frequently used CAM followed by Traditional Chinese Medicine (TCM) (21%). Most of the students (74.8%) believed that lack of scientific evidence is one of the most important barriers obstructing them to use CAM. More than half of the students perceived TCM (62.8%) and music therapy (53.8%) to be effective. Majority of them (69.3%) asserted that CAM knowledge is necessary to be a well-rounded professional.Conclusions: This study reveals a high-percentage of pharmacy students who were using or had previously used at least one type of CAM. Students of higher professional years tend to agree that CMs include ideas and methods from which conventional medicine could benefit