Bordetella pertussis: An underreported pathogen in pediatric respiratory infections, a prospective cohort study

Background: The incidence of pertussis has been increasing worldwide. In the Netherlands, the seroprevalence has risen higher than the reported cases, suggesting that laboratory tests for pertussis are considered infrequently and that even more pertussis cases are missed. The objective of our study was to determine the frequency of pertussis in clinically unsuspect cases compared to suspect cases with the intention of finding clinical predictors.Methods: The present prospective cohort study was part of a controlled clinical trial evaluating the impact of molecular diagnostics on clinical decision making in pediatric respiratory infections, performed during 2 winter seasons. For this study, in the first season pertussis was only tested in case of clinical suspicion, in the second season, pertussis was also tested without clinical suspicion. Multivariate and univariate analysis were performed using SPSS 18 and Statistical software 'R'.Results: In the two seasons respectively 22/209 (10,5%) and 49/373 (13,1%) cases were clinically suspected of pertussis. Bordetella pertussis was detected by real time RT-PCR in respectively 2/22 (9,1%) and 7/49 (14,3%) cases. In the second season an additional 7 cases of pertussis were found in clinically unsuspected cases (7/257 = 2,7%). These additional cases didn't differ in clinical presentation from children without a positive test for pertussis with respect to respiratory symptoms.Conclusions: Pertussis in children sometimes mimics viral respiratory tract infections. If pertussis diagnostics are based on clinical suspicion alone, about 1 in 5 cases (19%) is missed. Despite widely accepted clinical criteria, paroxysmal cough is not a good predictor of pertussis. To prevent spreading, physicians should include B. pertussis in ro

Self-efficacy did not predict the outcome of the transition to adult care in adolescents with inflammatory bowel disease

Aim: It can be difficult for adolescents with inflammatory bowel disease (IBD) to make the transition from paediatric to adult care. We studied the outcomes of this process and defined what constituted a successful transition. Methods: In 2008, 50 adolescents who attended our IBD transition clinic completed IBD-yourself, a self-efficacy questionnaire that we had previously developed and validated. We approached the subjects in 2014, two to six years after they transferred to adult care, and 35 agreed to take part in the current study. The outcome of transition was assessed by our newly developed Transition Yourself Score. In addition, the relationship between self-efficacy and the outcome of the transition was measured. Results: The mean age of the patients was 21.8 years, and 69% suffered from Crohn's disease. The transition process was successful in 63% of cases, moderately successful in 31% and failed in 6%. A successful transition was associated with effective use of medication and clinical remission at the time of transfer, but could not be predicted by self-efficacy. The Transition Yourself Score will be validated in future studies. Conclusion: Nearly two-thirds (63%) of the adolescents who attended the IBD transition clinic had a successful transition to adult care

Psychological Outcomes of a Cognitive Behavioral Therapy for Youth with Inflammatory Bowel Disease: Results of the HAPPY-IBD Randomized Controlled Trial at 6-and 12-Month Follow-Up

Youth with infammatory bowel disease (IBD) often experience psychological difculties, such as anxiety and depression. This randomized controlled study tested whether a 3-month disease-specifc cognitive behavioral therapy (CBT) in addition to standard medical care versus standard medical care only was efective in improving these youth’s psychological outcomes. As this study was aimed at prevention, we included 70 youth (10–25 years) with IBD and symptoms of subclinical anxiety and/ or depression, and measured psychological outcomes at 6- and 12-month follow-up. In general, participants in both groups showed improvements in anxiety, depression, health-related quality of life, social functioning, coping, and illness perceptions, sustained until 12 months follow-up. Overall, we found no diferences between those receiving additional CBT and those receiving standard medical care only. We assume that this can be explained by the perceived low burden (both somatically and psychologically) or heightened awareness of psychological difculties and IBD

Effectiveness of disease-specific cognitive-behavioural therapy on depression, anxiety, quality of life and the clinical course of disease in adolescents with inflammatory bowel disease

_Introduction:_ Adolescents with inflammatory bowel disease (IBD) show a higher prevalence of depression and anxiety, compared to youth with other chronic diseases. The inflammation-depression hypothesis might explain this association, and implies that treating depression can decrease intestinal inflammation and improve disease course. The present multicentre randomised controlled trial aims to test the effectiveness of an IBD-specific cognitive–behavioural therapy (CBT) protocol in reducing symptoms of subclinical depression and anxiety, while improving quality of life and disease course in adolescents with IBD. _Methods and analysis:_ Adolescents with IBD (10– 20 years) from 7 hospitals undergo screening

The impact on socio-emotional development and quality of life of language impairment in 8-year-old children

Aim To estimate the impact of different types of language disorders on socio-emotional development and health-related quality of life (HRQOL) in 8-year-old children. Method In a prospective cohort including 13 427 newborns, of 10 911 eligible children (66 excluded because of intellectual disability or foreign language, 2448 lost to follow-up due to house moves, refusal, death or other reasons) written consent was obtained from the parents of 6051 then 8-year-old children (55%). Questionnaires, completed by the parents of 4745 children (2323 males, 2412 females) and the teachers of 4771 children (2360 males, 2411 females), included validated measures to define type of language disorder and to assess socio-emotional development and HRQOL. Results In 377 (8.2%) children, speech/language disorders were identified. Children with receptive language disorders had more unfavourable scores for extraversion (9.7, 99% CI 9.3-10.1, p=0.006), school attitude (7.8, 99% CI 7.4-8.2; p < 0.001), agreeableness (9.1, 99% CI 8.6-9.6, p < 0.001; normal ranges 7-13), and quality of life (49.6, 99% CI 48.8-51.0, p < 0.001; normal range 40-60), as compared to children without these disorders. Pragmatic disorders and suspected autism were associated with the most unfavourable scores, for school attitude 8.1 (99% CI 6.9-9.3, p < 0.001) and 7.5 (99% CI 6.1-8.9, p=0.002), and for quality of life 42.9 (99% CI 40.3-45.5, p < 0.001) and 36.2 (99% CI 30.0-42.4, p < 0.001). Interpretation Language impairment at school age has a large impact on children's behaviour and daily life

The impact on socio-emotional development and quality of life of language impairment in 8-year-old children

Aim To estimate the impact of different types of language disorders on socio-emotional development and health-related quality of life (HRQOL) in 8-year-old children. Method In a prospective cohort including 13 427 newborns, of 10 911 eligible children (66 excluded because of intellectual disability or foreign language, 2448 lost to follow-up due to house moves, refusal, death or other reasons) written consent was obtained from the parents of 6051 then 8-year-old children (55%). Questionnaires, completed by the parents of 4745 children (2323 males, 2412 females) and the teachers of 4771 children (2360 males, 2411 females), included validated measures to define type of language disorder and to assess socio-emotional development and HRQOL. Results In 377 (8.2%) children, speech/language disorders were identified. Children with receptive language disorders had more unfavourable scores for extraversion (9.7, 99% CI 9.3-10.1, p=0.006), school attitude (7.8, 99% CI 7.4-8.2; p &lt; 0.001), agreeableness (9.1, 99% CI 8.6-9.6, p &lt; 0.001; normal ranges 7-13), and quality of life (49.6, 99% CI 48.8-51.0, p &lt; 0.001; normal range 40-60), as compared to children without these disorders. Pragmatic disorders and suspected autism were associated with the most unfavourable scores, for school attitude 8.1 (99% CI 6.9-9.3, p &lt; 0.001) and 7.5 (99% CI 6.1-8.9, p=0.002), and for quality of life 42.9 (99% CI 40.3-45.5, p &lt; 0.001) and 36.2 (99% CI 30.0-42.4, p &lt; 0.001). Interpretation Language impairment at school age has a large impact on children&apos;s behaviour and daily life

Determinants of proton pump inhibitor prescription behavior: a systematic scoping review protocol

A systematic scoping literature review to identify determinants of proton pump inhibitor prescription behavior

Self-efficacy did not predict the outcome of the transition to adult care in adolescents with inflammatory bowel disease

Aim: It can be difficult for adolescents with inflammatory bowel disease (IBD) to make the transition from paediatric to adult care. We studied the outcomes of this process and defined what constituted a successful transition. Methods: In 2008, 50 adolescents who attended our IBD transition clinic completed IBD-yourself, a self-efficacy questionnaire that we had previously developed and validated. We approached the subjects in 2014, two to six years after they transferred to adult care, and 35 agreed to take part in the current study. The outcome of transition was assessed by our newly developed Transition Yourself Score. In addition, the relationship between self-efficacy and the outcome of the transition was measured. Results: The mean age of the patients was 21.8 years, and 69% suffered from Crohn's disease. The transition process was successful in 63% of cases, moderately successful in 31% and failed in 6%. A successful transition was associated with effective use of medication and clinical remission at the time of transfer, but could not be predicted by self-efficacy. The Transition Yourself Score will be validated in future studies. Conclusion: Nearly two-thirds (63%) of the adolescents who attended the IBD transition clinic had a successful transition to adult care