Kako strokovni delavci vrtca vrednotijo stalno strokovno izpopolnjevanje kot element svojega profesionalnega razvoja

The study focuses on preschool teachers’ in-service training at selected Slovenian kindergartens. The paper presents the results of qualitative case-study. The research aimed to find out how preschool teachers evaluate in-service training received as a part the professional development and how the in-service training is regulated in their kindergartens. Data was collected via focus groups and semi-structured interviews, and processed in accordance with qualitative analysis principles. Results show that preschool teachers believe that in-service training is an important part of their professional development. Preschool teachers also believe they receive enough opportunities for in-service training within the selected kindergartens, but they also point out that in-service trainings should be differentiated according to the level of their professional development and current needs. The lack of financial resources and workload were reported as the two major barriers encountered in in-service training.V prispevku se osredotočamo na stalno strokovno izpopolnjevanje vzgojiteljev predšolskih otrok. Predstavljamo rezultate kvalitativne študije primera, ki je bila izvedena v izbranem javnem slovenskem vrtcu. Cilj raziskave je bil ugotoviti, kako strokovni delavci v tem vrtcu vrednotijo izpopolnjevanje kot del profesionalnega razvoja ter kako je stalno strokovno izpopolnjevanje v tem vrtcu urejeno. Podatki so bili zbrani z metodo fokusnih skupin in s polstrukturiranimi intervjuji, obdelanimi po načelih kvalitativne analize. Glede na rezultate vzgojitelji menijo, da je stalno strokovno izpopolnjevanje pomembno za njihov profesionalni razvoj. Prav tako vzgojitelji menijo, da imajo v izbranem vrtcu dovolj možnosti za stalno strokovno izpopolnjevanje, pri čemer pričakujejo diferenciacijo izpopolnjevanja glede na individualno raven profesionalnega razvoja in trenutne potrebe. Kot največji oviri za stalno strokovno izpopolnjevanje navajajo pomanjkanje finančnih sredstev in preobremenjenost

Stevens-Johnsonov sindrom in toksična epidermalna nekroliza pri otrocih: prikaz primerov in pregled literature

Stevens-Johnsonov sindrom (SJS) in toksična epidermalna nekroliza (TEN) sta redki življenje ogrožajoči bolezni, ki se kažeta z nastajanjem mehurjev ter odstopanjem povrhnjice kože in sluznic. Najpogosteje sta posledica imunsko sprožene reakcije na zdravilo, redkeje zaradi drugih vzrokov. Poleg prekinitve zdravljenja z zdravilom, ki je lahko sprožilo SJS/TEN, ali uvedbe zdravljenja bakterijske okužbe, če je ta kot vzročni dejavnik dokazana, uvedemo lokalno zdravljenje sprememb na očeh, koži in sluznicah, v težjih primerih pa še sistemsko zdravljenje z glukokortikosteroidi (GKS) in/ali intravenskimi imunoglobulini (IVIG). Za optimalni izid bolezni je bistveno sodelovanje med specialisti različnih strok. Prispevek predstavi skupino bolnikov, obravnavanih na Kliničnem oddelku za otroško alergologijo, revmatologijo in klinično imunologijo Pediatrične klinike UKC v Ljubljani in pregled literature. V letih 2011–2019 smo zdravili šest otrok s SJS/TEN. Pri štirih otrocih je bil sprožilni dejavnik zdravilo, pri enem okužba z Mycoplasmo pneumonie, pri enem bolniku pa etiologije nismo mogli opredeliti. Z GKS in IVIG so bili zdravljeni štirje otroci, en otrok z okužbo z M. pneumonie je bil zdravljen z azitromicinom in IVIG, en otrok pa je prejel le zdravila lokalno. Izid bolezni je bil pri vseh otrocih dober, in sicer tudi brez poznih posledic bolezni

Alterations in immunophenotype and metabolic profile of mononuclear cells during follow up in children with multisystem inflammatory syndrome (MIS-C)

IntroductionAlthough children seem to be less susceptible to COVID-19, some of them develop a rare but serious hyperinflammatory condition called multisystem inflammatory syndrome in children (MIS-C). While several studies describe the clinical conditions of acute MIS-C, the status of convalescent patients in the months after acute MIS-C is still unclear, especially the question of persistence of changes in the specific subpopulations of immune cells in the convalescent phase of the disease.MethodsWe therefore analyzed peripheral blood of 14 children with MIS-C at the onset of the disease (acute phase) and 2 to 6 months after disease onset (post-acute convalescent phase) for lymphocyte subsets and antigen-presenting cell (APC) phenotype. The results were compared with six healthy age-matched controls.ResultsAll major lymphocyte populations (B cells, CD4 + and CD8+ T cells, and NK cells) were decreased in the acute phase and normalized in the convalescent phase. T cell activation was increased in the acute phase, followed by an increased proportion of γ/δ-double-negative T cells (γ/δ DN Ts) in the convalescent phase. B cell differentiation was impaired in the acute phase with a decreased proportion of CD21 expressing, activated/memory, and class-switched memory B cells, which normalized in the convalescent phase. The proportion of plasmacytoid dendritic cells, conventional type 2 dendritic cells, and classical monocytes were decreased, while the proportion of conventional type 1 dendritic cells was increased in the acute phase. Importantly the population of plasmacytoid dendritic cells remained decreased in the convalescent phase, while other APC populations normalized. Immunometabolic analysis of peripheral blood mononuclear cells (PBMCs) in the convalescent MIS-C showed comparable mitochondrial respiration and glycolysis rates to healthy controls.ConclusionsWhile both immunophenotyping and immunometabolic analyzes showed that immune cells in the convalescent MIS-C phase normalized in many parameters, we found lower percentage of plasmablasts, lower expression of T cell co-receptors (CD3, CD4, and CD8), an increased percentage of γ/δ DN Ts and increased metabolic activity of CD3/CD28-stimulated T cells. Overall, the results suggest that inflammation persists for months after the onset of MIS-C, with significant alterations in some immune system parameters, which may also impair immune defense against viral infections

Future teachers’ attitudes and knowledge regarding the management of the potential students’ life-threatening allergic reactions in Slovenian schools

Poorly developed teachers’ competences for managing children’s allergies can pose a significant problem for the wellbeing of children in the preschool and school environment. The purpose of this study is to explore the attitudes and theoretical understanding of the management of allergic reactions in children among future teachers

Guidelines for the management of anaphylaxis in children and adolescents

Anaphylaxis is a severe life-threatening generalized or systemic hypersensitivity reaction. All doctors and other medical staff should be familiar with the treatment of anaphylaxis. Food, insect bites and drugs and are principal agents responsible for anaphylaxis in children and adolescents. In the absence of treatment, the reaction may rapidly progress with severe manifestations including fatal outcome. Intramuscular adrenaline is first-line therapy for anaphylaxis. Additional measures, such as removing the trigger, call for help, the correct position of the child or adolescent, high-flow oxygen, volume support, bronchodilator and adrenaline inhalations, systemic antihistamine and glucocorticoid, are supplementary to adrenaline. At discharge from hospital it is necessary to assess the risk of future anaphylaxis to determine the individualized management plan in case of anaphylaxis and to prescribe adrenaline auto-injector. Training of the child, parents and others who take care of the child, on when and how to use the self-injectable devices of adrenaline is necessary. Allergy assessment at an allergists office is obligatory in all children with a history of anaphylaxis in order to determine the cause of anaphylaxis, to provide detailed instructions on allergen avoidance and, if possible, to start with specific immunotherapy.</p

Alterations in immunophenotype and metabolic profile of mononuclear cells during follow up in children with multisystem inflammatory syndrome (MIS-C)

Introduction: Although children seem to be less susceptible to COVID-19, some of them develop a rare but serious hyperinflammatory condition called multisystem inflammatory syndrome in children (MIS-C). While several studies describe the clinical conditions of acute MIS-C, the status of convalescent patients in the months after acute MIS-C is still unclear, especially the question of persistence of changes in the specific subpopulations of immune cells in the convalescent phase of the disease. Methods: We therefore analyzed peripheral blood of 14 children with MIS-C at the onset of the disease (acute phase) and 2 to 6 months after disease onset (post-acute convalescent phase) for lymphocyte subsets and antigen-presenting cell (APC) phenotype. The results were compared with six healthy age-matched controls. Results: All major lymphocyte populations (B cells, CD4 + and CD8+ T cells, and NK cells) were decreased in the acute phase and normalized in the convalescent phase. T cell activation was increased in the acute phase, followed by an increased proportion of γ/δ-double-negative T cells (γ/δ DN Ts) in the convalescent phase. B cell differentiation was impaired in the acute phase with a decreased proportion of CD21 expressing, activated/memory, and class-switched memory B cells, which normalized in the convalescent phase. The proportion of plasmacytoid dendritic cells, conventional type 2 dendritic cells, and classical monocytes were decreased, while the proportion of conventional type 1 dendritic cells was increased in the acute phase. Importantly the population of plasmacytoid dendritic cells remained decreased in the convalescent phase, while other APC populations normalized. Immunometabolic analysis of peripheral blood mononuclear cells (PBMCs) in the convalescent MIS-C showed comparable mitochondrial respiration and glycolysis rates to healthy controls. Conclusions: While both immunophenotyping and immunometabolic analyzes showed that immune cells in the convalescent MIS-C phase normalized in many parameters, we found lower percentage of plasmablasts, lower expression of T cell co-receptors (CD3, CD4, and CD8), an increased percentage of γ/δ DN Ts and increased metabolic activity of CD3/CD28-stimulated T cells. Overall, the results suggest that inflammation persists for months after the onset of MIS-C, with significant alterations in some immune system parameters, which may also impair immune defense against viral infections

DataSheet_1_Alterations in immunophenotype and metabolic profile of mononuclear cells during follow up in children with multisystem inflammatory syndrome (MIS-C).pdf

IntroductionAlthough children seem to be less susceptible to COVID-19, some of them develop a rare but serious hyperinflammatory condition called multisystem inflammatory syndrome in children (MIS-C). While several studies describe the clinical conditions of acute MIS-C, the status of convalescent patients in the months after acute MIS-C is still unclear, especially the question of persistence of changes in the specific subpopulations of immune cells in the convalescent phase of the disease.MethodsWe therefore analyzed peripheral blood of 14 children with MIS-C at the onset of the disease (acute phase) and 2 to 6 months after disease onset (post-acute convalescent phase) for lymphocyte subsets and antigen-presenting cell (APC) phenotype. The results were compared with six healthy age-matched controls.ResultsAll major lymphocyte populations (B cells, CD4 + and CD8+ T cells, and NK cells) were decreased in the acute phase and normalized in the convalescent phase. T cell activation was increased in the acute phase, followed by an increased proportion of γ/δ-double-negative T cells (γ/δ DN Ts) in the convalescent phase. B cell differentiation was impaired in the acute phase with a decreased proportion of CD21 expressing, activated/memory, and class-switched memory B cells, which normalized in the convalescent phase. The proportion of plasmacytoid dendritic cells, conventional type 2 dendritic cells, and classical monocytes were decreased, while the proportion of conventional type 1 dendritic cells was increased in the acute phase. Importantly the population of plasmacytoid dendritic cells remained decreased in the convalescent phase, while other APC populations normalized. Immunometabolic analysis of peripheral blood mononuclear cells (PBMCs) in the convalescent MIS-C showed comparable mitochondrial respiration and glycolysis rates to healthy controls.ConclusionsWhile both immunophenotyping and immunometabolic analyzes showed that immune cells in the convalescent MIS-C phase normalized in many parameters, we found lower percentage of plasmablasts, lower expression of T cell co-receptors (CD3, CD4, and CD8), an increased percentage of γ/δ DN Ts and increased metabolic activity of CD3/CD28-stimulated T cells. Overall, the results suggest that inflammation persists for months after the onset of MIS-C, with significant alterations in some immune system parameters, which may also impair immune defense against viral infections.</p