首页 > 最新文献

The Lancet. Child & adolescent health最新文献

英文 中文
The underestimated burden of tuberculosis in children. 被低估的儿童结核病负担。
Pub Date : 2024-12-01 Epub Date: 2024-11-05 DOI: 10.1016/S2352-4642(24)00297-9
Nicole Salazar-Austin, Lisa Marie Cranmer
{"title":"The underestimated burden of tuberculosis in children.","authors":"Nicole Salazar-Austin, Lisa Marie Cranmer","doi":"10.1016/S2352-4642(24)00297-9","DOIUrl":"10.1016/S2352-4642(24)00297-9","url":null,"abstract":"","PeriodicalId":94246,"journal":{"name":"The Lancet. Child & adolescent health","volume":" ","pages":"845-847"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mental health consequences of child marriage. 童婚对心理健康的影响。
Pub Date : 2024-12-01 Epub Date: 2024-09-17 DOI: 10.1016/S2352-4642(24)00202-5
Fiona Samuels, Suzanne Petroni, Rochelle A Burgess, Olubukola Omobowale, Jean Casey, Emma Sadd
{"title":"Mental health consequences of child marriage.","authors":"Fiona Samuels, Suzanne Petroni, Rochelle A Burgess, Olubukola Omobowale, Jean Casey, Emma Sadd","doi":"10.1016/S2352-4642(24)00202-5","DOIUrl":"10.1016/S2352-4642(24)00202-5","url":null,"abstract":"","PeriodicalId":94246,"journal":{"name":"The Lancet. Child & adolescent health","volume":" ","pages":"847-849"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Bridging the gap: a call for inclusive policy making in youth mental health care. 缩小差距:呼吁在青少年心理保健方面制定包容性政策。
Pub Date : 2024-12-01 Epub Date: 2024-08-05 DOI: 10.1016/S2352-4642(24)00209-8
Katerina Drakos
{"title":"Bridging the gap: a call for inclusive policy making in youth mental health care.","authors":"Katerina Drakos","doi":"10.1016/S2352-4642(24)00209-8","DOIUrl":"10.1016/S2352-4642(24)00209-8","url":null,"abstract":"","PeriodicalId":94246,"journal":{"name":"The Lancet. Child & adolescent health","volume":" ","pages":"855-857"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mycobacterium tuberculosis infection and tuberculosis disease in the first decade of life: a South African birth cohort study. 生命最初十年的结核分枝杆菌感染和结核病:南非出生队列研究。
Pub Date : 2024-12-01 Epub Date: 2024-11-05 DOI: 10.1016/S2352-4642(24)00256-6
Fernanda Bruzadelli Paulino da Costa, Mark P Nicol, Maresa Botha, Lesley Workman, Ricardo Alexandre Arcêncio, Heather J Zar, Leonardo Martinez
<p><strong>Background: </strong>Paediatric tuberculosis leads to more than 200 000 deaths annually. We aimed to investigate the incidence of Mycobacterium tuberculosis infection and tuberculosis disease in the first decade of life in the Drakenstein Child Health Study (DCHS), a South African cohort in a community with high tuberculosis and HIV incidence.</p><p><strong>Methods: </strong>In this prospective birth cohort study, we enrolled pregnant women aged 18 years or older who were between 20 and 28 weeks' of gestation in a peri-urban setting outside of Cape Town, South Africa. We followed up their children for tuberculosis until age 10 years. To measure M tuberculosis infection tuberculin skin tests were administered to children at age 6 months, 12 months, and then annually in children with a negative test, and at the time of a lower respiratory tract infection. Tuberculin skin test conversion was defined by an induration reaction of 10 mm or more. To measure tuberculosis disease, active surveillance was done throughout follow-up. Each episode of presumed tuberculosis disease was investigated using sputum induction, tested with Xpert MTB/RIF and liquid culture for M tuberculosis. Survival analyses were performed and multivariable Cox regression was used to measure factors associated with M tuberculosis infection or disease.</p><p><strong>Findings: </strong>Between March 5, 2012, and March 31, 2015, 1137 women and their 1143 children (248 [21·7%] of 1143 children were HIV-exposed, two [0·2%] children with HIV) were included in the analysis. Children were followed up for 8870 person-years (median follow-up 9·1 years [IQR 8·2-10·2]). The annual risk of tuberculin conversion during follow-up was 6·6 infections per 100 person-years (95% CI 5·8-7·3) but ranged from 4-9 infections per 100 person-years over the follow-up period. 98 children developed tuberculosis (1105 cases per 100 000 person-years; 95% CI 906-1347). The cumulative hazard of tuberculin conversion was 36% (95% CI 32-41) at age 8 years and the cumulative hazard of tuberculosis disease was 10% (8-12) at age 10 years. Preventive treatment was associated with a reduction in tuberculosis disease among children who had tuberculin conversion (adjusted hazard ratio 0·23 [95% CI 0·12-0·47]). Most cases of tuberculosis disease (78 [79%; 95% CI 69-86] of 98 children) occurred among children who had tuberculin skin test conversion but were not administered preventive treatment.</p><p><strong>Interpretation: </strong>In this prospective South African birth cohort, M tuberculosis transmission was consistently high throughout the first decade of life leading to approximately 10% of children developing tuberculosis disease. A multipronged approach to decrease paediatric tuberculosis is needed that combines preventive treatment for children at risk, reducing community M tuberculosis transmission, and active case finding.</p><p><strong>Funding: </strong>Bill & Melinda Gates Foundation, Medical Research
背景:小儿结核病每年导致 20 多万人死亡。德拉肯斯坦儿童健康研究(Drakenstein Child Health Study,DCHS)是南非一个结核病和艾滋病高发社区的一个队列,我们的目的是调查该研究中结核分枝杆菌感染和结核病在婴儿出生后头十年的发病率:在这项前瞻性出生队列研究中,我们在南非开普敦郊外的近郊区招募了年龄在 18 岁或 18 岁以上、妊娠期在 20 到 28 周之间的孕妇。我们对她们的孩子进行了结核病跟踪调查,直到他们 10 岁。为了测量 M 型结核病感染情况,我们在儿童 6 个月大和 12 个月大时对其进行了结核菌素皮试,然后每年对皮试呈阴性的儿童以及在下呼吸道感染时进行皮试。结核菌素皮试转阴的定义是压痕反应达到或超过 10 毫米。为了测量结核病,在整个随访过程中都进行了积极的监测。每次推测的结核病发作都要进行痰液诱导检查,并用 Xpert MTB/RIF 和液体培养法检测结核杆菌。研究人员进行了生存分析,并采用多变量考克斯回归法测定了与结核杆菌感染或疾病相关的因素:2012年3月5日至2015年3月31日期间,1137名妇女及其1143名子女(1143名子女中有248名[21-7%]暴露于HIV,2名[0-2%]感染HIV)被纳入分析。对儿童的随访时间为 8870 人年(中位数随访时间为 9-1 年 [IQR 8-2-10-2])。在随访期间,结核菌素转阴的年风险为每 100 人年 6-6 例(95% CI 5-8-7-3),但在随访期间,每 100 人年的感染率为 4-9 例。98 名儿童患上了结核病(每 10 万人年中有 1105 例;95% CI 906-1347)。8 岁时结核菌素转阴的累积风险为 36%(95% CI 32-41),10 岁时结核病的累积风险为 10%(8-12)。在结核菌素转阴的儿童中,预防性治疗与结核病发病率的降低有关(调整后的危险比为 0-23 [95% CI 0-12-0-47])。大多数结核病病例(98 名儿童中的 78 例 [79%;95% CI 69-86])发生在结核菌素皮试转阴但未接受预防性治疗的儿童中:在这一前瞻性南非出生队列中,M 型结核病的传播率在儿童出生后的头十年一直居高不下,导致约 10% 的儿童罹患结核病。需要采取多管齐下的方法来减少小儿结核病的发病率,将对高危儿童的预防性治疗、减少社区间的结核病传播和积极的病例发现结合起来:比尔及梅林达-盖茨基金会、南非医学研究委员会和南非国家研究基金会。
{"title":"Mycobacterium tuberculosis infection and tuberculosis disease in the first decade of life: a South African birth cohort study.","authors":"Fernanda Bruzadelli Paulino da Costa, Mark P Nicol, Maresa Botha, Lesley Workman, Ricardo Alexandre Arcêncio, Heather J Zar, Leonardo Martinez","doi":"10.1016/S2352-4642(24)00256-6","DOIUrl":"10.1016/S2352-4642(24)00256-6","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Paediatric tuberculosis leads to more than 200 000 deaths annually. We aimed to investigate the incidence of Mycobacterium tuberculosis infection and tuberculosis disease in the first decade of life in the Drakenstein Child Health Study (DCHS), a South African cohort in a community with high tuberculosis and HIV incidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this prospective birth cohort study, we enrolled pregnant women aged 18 years or older who were between 20 and 28 weeks' of gestation in a peri-urban setting outside of Cape Town, South Africa. We followed up their children for tuberculosis until age 10 years. To measure M tuberculosis infection tuberculin skin tests were administered to children at age 6 months, 12 months, and then annually in children with a negative test, and at the time of a lower respiratory tract infection. Tuberculin skin test conversion was defined by an induration reaction of 10 mm or more. To measure tuberculosis disease, active surveillance was done throughout follow-up. Each episode of presumed tuberculosis disease was investigated using sputum induction, tested with Xpert MTB/RIF and liquid culture for M tuberculosis. Survival analyses were performed and multivariable Cox regression was used to measure factors associated with M tuberculosis infection or disease.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;Between March 5, 2012, and March 31, 2015, 1137 women and their 1143 children (248 [21·7%] of 1143 children were HIV-exposed, two [0·2%] children with HIV) were included in the analysis. Children were followed up for 8870 person-years (median follow-up 9·1 years [IQR 8·2-10·2]). The annual risk of tuberculin conversion during follow-up was 6·6 infections per 100 person-years (95% CI 5·8-7·3) but ranged from 4-9 infections per 100 person-years over the follow-up period. 98 children developed tuberculosis (1105 cases per 100 000 person-years; 95% CI 906-1347). The cumulative hazard of tuberculin conversion was 36% (95% CI 32-41) at age 8 years and the cumulative hazard of tuberculosis disease was 10% (8-12) at age 10 years. Preventive treatment was associated with a reduction in tuberculosis disease among children who had tuberculin conversion (adjusted hazard ratio 0·23 [95% CI 0·12-0·47]). Most cases of tuberculosis disease (78 [79%; 95% CI 69-86] of 98 children) occurred among children who had tuberculin skin test conversion but were not administered preventive treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Interpretation: &lt;/strong&gt;In this prospective South African birth cohort, M tuberculosis transmission was consistently high throughout the first decade of life leading to approximately 10% of children developing tuberculosis disease. A multipronged approach to decrease paediatric tuberculosis is needed that combines preventive treatment for children at risk, reducing community M tuberculosis transmission, and active case finding.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Funding: &lt;/strong&gt;Bill & Melinda Gates Foundation, Medical Research ","PeriodicalId":94246,"journal":{"name":"The Lancet. Child & adolescent health","volume":" ","pages":"891-899"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Adolescents and the International Conference on Population and Development at 30. 青少年与国际人口与发展会议 30 周年。
Pub Date : 2024-12-01 Epub Date: 2024-09-11 DOI: 10.1016/S2352-4642(24)00235-9
Satvika Chalasani, Lauren Rumble, Prerna Banati, Sheri Bastien, Jose Roberto Luna, Suzanne Petroni
{"title":"Adolescents and the International Conference on Population and Development at 30.","authors":"Satvika Chalasani, Lauren Rumble, Prerna Banati, Sheri Bastien, Jose Roberto Luna, Suzanne Petroni","doi":"10.1016/S2352-4642(24)00235-9","DOIUrl":"10.1016/S2352-4642(24)00235-9","url":null,"abstract":"","PeriodicalId":94246,"journal":{"name":"The Lancet. Child & adolescent health","volume":" ","pages":"851-853"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
National, regional and provincial prevalence of childhood hypertension in China in 2020: a systematic review and modelling study. 2020年中国全国、地区和省级儿童高血压患病率:系统回顾和模型研究。
Pub Date : 2024-12-01 Epub Date: 2024-10-30 DOI: 10.1016/S2352-4642(24)00260-8
Jiali Zhou, Jing Wu, Denan Jiang, Shan Cai, Chenhao Zhang, Jiayao Ying, Jin Cao, Yi Song, Peige Song
<p><strong>Background: </strong>Childhood hypertension is a growing health concern in China. Accurate estimation of prevalence is essential but challenging due to the variability of blood pressure and the need for multiple occasions for confirmation. This study aimed to estimate the national, regional, and provincial prevalence of childhood hypertension in China in 2020.</p><p><strong>Methods: </strong>For this systematic review and modelling study, we did a comprehensive literature search of epidemiological studies reporting the prevalence of elevated blood pressure (EBP) or hypertension among Chinese children (aged 18 years or younger) that were published between Jan 1, 1990 and June 20, 2024 in PubMed, Embase, MEDLINE, China National Knowledge Infrastructure, Wanfang Data, and Chinese Science and Technology Journal Database. EBP was defined as blood pressure greater than or equal to the 95th percentile on a single occasion, and childhood hypertension as blood pressure greater than or equal to the 95th percentile consistently across three occasions. First, we estimated the prevalence of childhood EBP using a multi-level mixed-effects meta-regression and the pooled odds ratios (ORs) for factors associated with childhood EBP through random-effects meta-analysis. Second, the ratio of childhood EBP to childhood hypertension was calculated via random-effects meta-analysis, based on which the national and regional prevalence of childhood hypertension was imputed. Finally, we derived the provincial prevalence of childhood hypertension using an associated factor-based model. The review protocol was registered in PROSPERO (CRD42024537570).</p><p><strong>Findings: </strong>We identified 8872 records, of which 134 articles covering 22 431 861 children were included. In 2020, the overall prevalence of hypertension among Chinese children aged 6-18 years was 3·11% (95% CI 2·35-4·04), equivalent to 6·80 million (5·13-8·83) affected children. The prevalence of childhood hypertension ranged from 2·25% (1·54-2·75) for children aged 6 years to 2·01% (1·36-3·37) for those aged 18 years, peaking at 3·84% (2·97-4·94) for those aged 14 years. The overall prevalence was higher in boys (3·34% [2·53-4·35]) than in girls (2·85% [2·13-3·69]). Associations between four factors (overweight, obesity, salted food intake, and family history of hypertension) and childhood EBP were graded as highly suggestive evidence.</p><p><strong>Interpretation: </strong>This study reveals substantial regional and provincial variations in the prevalence of childhood hypertension in China. Our findings could inform targeted public health initiatives and optimise resource allocation to address this public health concern.</p><p><strong>Funding: </strong>This study was supported by the National Natural Science Foundation of China (72104211 and 82273654) and the Chao Kuang Piu High-tech Development Fund (2022RC019).</p><p><strong>Translation: </strong>For the Chinese translation of the abstract se
背景:儿童高血压是中国日益严重的健康问题。准确估计患病率至关重要,但由于血压的可变性和需要多次确认,因此具有挑战性。本研究旨在估算 2020 年中国全国、地区和省级儿童高血压患病率:在这项系统综述和模型研究中,我们对 1990 年 1 月 1 日至 2024 年 6 月 20 日期间发表在 PubMed、Embase、MEDLINE、中国国家知识基础设施、万方数据和中国科技期刊数据库中的有关中国儿童(18 岁及以下)血压升高(EBP)或高血压患病率的流行病学研究进行了全面的文献检索。EBP定义为单次血压大于或等于95百分位数,儿童高血压定义为三次血压均大于或等于95百分位数。首先,我们使用多水平混合效应荟萃回归估算了儿童 EBP 的患病率,并通过随机效应荟萃分析估算了与儿童 EBP 相关因素的集合赔率比(ORs)。其次,通过随机效应荟萃分析计算出儿童 EBP 与儿童高血压的比率,并在此基础上推算出全国和地区的儿童高血压患病率。最后,我们利用基于相关因素的模型得出了各省的儿童高血压患病率。研究方案已在 PROSPERO(CRD42024537570)上注册:我们发现了 8872 条记录,其中 134 篇文章涵盖 22 431 861 名儿童。2020年,中国6-18岁儿童高血压总患病率为3-11%(95% CI 2-35-4-04),相当于6-8千万(5-13-8-83)名患病儿童。儿童高血压患病率从6岁儿童的2-25%(1-54-2-75)到18岁儿童的2-01%(1-36-3-37)不等,14岁儿童的患病率最高,为3-84%(2-97-4-94)。男孩的总体患病率(3-34% [2-53-4-35])高于女孩(2-85% [2-13-3-69])。四项因素(超重、肥胖、腌制食物摄入量和高血压家族史)与儿童 EBP 之间的关系被评为高度提示性证据:本研究揭示了中国儿童高血压患病率在地区和省份间的巨大差异。我们的研究结果可为有针对性的公共卫生措施提供信息,并优化资源分配,以解决这一公共卫生问题:本研究得到了国家自然科学基金(72104211和82273654)和潮光飘高科技发展基金(2022RC019)的资助:摘要中译文见补充材料部分。
{"title":"National, regional and provincial prevalence of childhood hypertension in China in 2020: a systematic review and modelling study.","authors":"Jiali Zhou, Jing Wu, Denan Jiang, Shan Cai, Chenhao Zhang, Jiayao Ying, Jin Cao, Yi Song, Peige Song","doi":"10.1016/S2352-4642(24)00260-8","DOIUrl":"10.1016/S2352-4642(24)00260-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Childhood hypertension is a growing health concern in China. Accurate estimation of prevalence is essential but challenging due to the variability of blood pressure and the need for multiple occasions for confirmation. This study aimed to estimate the national, regional, and provincial prevalence of childhood hypertension in China in 2020.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;For this systematic review and modelling study, we did a comprehensive literature search of epidemiological studies reporting the prevalence of elevated blood pressure (EBP) or hypertension among Chinese children (aged 18 years or younger) that were published between Jan 1, 1990 and June 20, 2024 in PubMed, Embase, MEDLINE, China National Knowledge Infrastructure, Wanfang Data, and Chinese Science and Technology Journal Database. EBP was defined as blood pressure greater than or equal to the 95th percentile on a single occasion, and childhood hypertension as blood pressure greater than or equal to the 95th percentile consistently across three occasions. First, we estimated the prevalence of childhood EBP using a multi-level mixed-effects meta-regression and the pooled odds ratios (ORs) for factors associated with childhood EBP through random-effects meta-analysis. Second, the ratio of childhood EBP to childhood hypertension was calculated via random-effects meta-analysis, based on which the national and regional prevalence of childhood hypertension was imputed. Finally, we derived the provincial prevalence of childhood hypertension using an associated factor-based model. The review protocol was registered in PROSPERO (CRD42024537570).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;We identified 8872 records, of which 134 articles covering 22 431 861 children were included. In 2020, the overall prevalence of hypertension among Chinese children aged 6-18 years was 3·11% (95% CI 2·35-4·04), equivalent to 6·80 million (5·13-8·83) affected children. The prevalence of childhood hypertension ranged from 2·25% (1·54-2·75) for children aged 6 years to 2·01% (1·36-3·37) for those aged 18 years, peaking at 3·84% (2·97-4·94) for those aged 14 years. The overall prevalence was higher in boys (3·34% [2·53-4·35]) than in girls (2·85% [2·13-3·69]). Associations between four factors (overweight, obesity, salted food intake, and family history of hypertension) and childhood EBP were graded as highly suggestive evidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Interpretation: &lt;/strong&gt;This study reveals substantial regional and provincial variations in the prevalence of childhood hypertension in China. Our findings could inform targeted public health initiatives and optimise resource allocation to address this public health concern.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Funding: &lt;/strong&gt;This study was supported by the National Natural Science Foundation of China (72104211 and 82273654) and the Chao Kuang Piu High-tech Development Fund (2022RC019).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Translation: &lt;/strong&gt;For the Chinese translation of the abstract se","PeriodicalId":94246,"journal":{"name":"The Lancet. Child & adolescent health","volume":" ","pages":"872-881"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Endovascular thrombectomy for childhood stroke (Save ChildS Pro): an international, multicentre, prospective registry study. 儿童中风血管内血栓切除术(Save ChildS Pro):一项国际多中心前瞻性登记研究。
Pub Date : 2024-12-01 Epub Date: 2024-10-11 DOI: 10.1016/S2352-4642(24)00233-5
Peter B Sporns, Kartik Bhatia, Todd Abruzzo, Lisa Pabst, Stuart Fraser, Melissa G Chung, Warren Lo, Ahmed Othman, Sebastian Steinmetz, Ulf Jensen-Kondering, Stefan Schob, Daniel P O Kaiser, Wolfgang Marik, Christina Wendl, Ilka Kleffner, Hans Henkes, Hermann Kraehling, Thi Dan Linh Nguyen-Kim, René Chapot, Umut Yilmaz, Furene Wang, Muhammad Ubaid Hafeez, Flavio Requejo, Nicola Limbucci, Birgit Kauffmann, Markus Möhlenbruch, Omid Nikoubashman, Peter D Schellinger, Patricia Musolino, Ali Alawieh, Jenny Wilson, Dominik Grieb, Alexandra S Gersing, Thomas Liebig, Martin Olivieri, Jaroslava Paulasova Schwabova, Ales Tomek, Panagiotis Papanagiotou, Grégoire Boulouis, Olivier Naggara, Christine K Fox, Kirill Orlov, Alexandra Kuznetsova, Carmen Parra-Farinas, Prakash Muthusami, Robert W Regenhardt, Adam A Dmytriw, Tanja Burkard, Mesha Martinez, Daniel Brechbühl, Maja Steinlin, Lisa R Sun, Ameer E Hassan, André Kemmling, Sarah Lee, Heather J Fullerton, Jens Fiehler, Marios-Nikos Psychogios, Moritz Wildgruber
<p><strong>Background: </strong>Emerging evidence suggests that endovascular thrombectomy is beneficial for treatment of childhood stroke, but the safety and effectiveness of endovascular thrombectomy has not been compared with best medical treatment. We aimed to prospectively analyse functional outcomes of endovascular thrombectomy versus best medical treatment in children with intracranial arterial occlusion stroke.</p><p><strong>Methods: </strong>In this prospective registry study, 45 centres in 12 countries across Asia and Australia, Europe, North America, and South America reported functional outcomes for children aged between 28 days and 18 years presenting with arterial ischaemic stroke caused by a large-vessel or medium-vessel occlusion who received either endovascular thrombectomy plus best medical practice or best medical treatment alone. Intravenous thrombolysis was considered part of best medical treatment and therefore permitted in both groups. The primary outcome was the difference in median modified Rankin Scale (mRS) score between baseline (pre-stroke) and 90 days (±10 days) post-stroke, assessed by the Wilcoxon rank test (α=0·05). Efficacy outcomes in the endovascular thrombectomy and best medical treatment groups were compared in sensitivity analyses using propensity score matching. The Save ChildS Pro study is registered at the German Clinical Trials Registry, DRKS00018960.</p><p><strong>Findings: </strong>Between Jan 1, 2020, and Aug 31, 2023, of the 241 patients in the Save ChildS Pro registry, 208 were included in the analysis (115 [55%] boys and 93 [45%] girls). 117 patients underwent endovascular thrombectomy (median age 11 years [IQR 6-14]), and 91 patients received best medical treatment (6 years [3-12]; p<0·0001). The median Pediatric National Institutes of Health Stroke Scale (PedNIHSS) score on admission was 14 (IQR 10-19) in the endovascular thrombectomy group and 9 (5-13) in the best medical treatment group (p<0·0001). Both treatment groups had a median pre-stroke mRS score of 0 (IQR 0-0) at baseline. The change in median mRS score between baseline and 90 days was 1 (IQR 0-2) in the endovascular thrombectomy group and 2 (1-3) in the best medical treatment group (p=0·020). One (1%) patient developed a symptomatic intracranial haemorrhage (this patient was in the endovascular thrombectomy group). Six (5%) patients in the endovascular thrombectomy group and four (5%) patients in the best medical treatment group had died by day 90 (p=0·89). After propensity score matching for age, sex, and PedNIHSS score at hospital admission (n=79 from each group), the change in median mRS score between baseline and 90 days was 1 (IQR 0-2) in the endovascular thrombectomy group and 2 (1-3) in the best medical treatment group (p=0·029). Regarding the primary outcome for patients with suspected focal cerebral arteriopathy, endovascular thrombectomy (n=18) and best medical treatment (n=33) showed no difference in 90-day median mRS scores
背景:新的证据表明,血管内血栓切除术有利于治疗儿童中风,但血管内血栓切除术的安全性和有效性尚未与最佳药物治疗进行比较。我们旨在前瞻性地分析血管内血栓切除术与最佳药物治疗对颅内动脉闭塞性卒中儿童的功能性结果:在这项前瞻性登记研究中,亚洲、澳大利亚、欧洲、北美洲和南美洲 12 个国家的 45 个中心报告了年龄在 28 天至 18 岁之间、由大血管或中血管闭塞引起的动脉缺血性卒中患儿接受血管内血栓切除术加最佳医疗方法或仅接受最佳医疗方法的功能结果。静脉溶栓被认为是最佳医疗方法的一部分,因此两组患者均可接受。主要研究结果是基线(中风前)与中风后90天(±10天)的中位改良Rankin量表(mRS)评分的差异,采用Wilcoxon秩检验进行评估(α=0-05)。在使用倾向得分匹配法进行的敏感性分析中,比较了血管内血栓切除术组和最佳药物治疗组的疗效。Save ChildS Pro研究已在德国临床试验注册中心(DRKS00018960.Findings)注册:2020年1月1日至2023年8月31日期间,在Save ChildS Pro登记的241名患者中,有208名纳入了分析(115名[55%]男孩和93名[45%]女孩)。117名患者接受了血管内血栓切除术(中位年龄为11岁[IQR 6-14岁]),91名患者接受了最佳药物治疗(6岁[3-12岁];p解释:临床中心倾向于选择中风程度更严重(PedNIHSS评分更高)的儿童进行血管内血栓切除术。尽管如此,与最佳药物治疗相比,血管内血栓切除术仍能改善大血管或中血管闭塞儿科患者的功能预后。未来的研究需要调查血管内血栓切除术的积极作用是否仅限于年龄较大和病情较重的儿童:无。
{"title":"Endovascular thrombectomy for childhood stroke (Save ChildS Pro): an international, multicentre, prospective registry study.","authors":"Peter B Sporns, Kartik Bhatia, Todd Abruzzo, Lisa Pabst, Stuart Fraser, Melissa G Chung, Warren Lo, Ahmed Othman, Sebastian Steinmetz, Ulf Jensen-Kondering, Stefan Schob, Daniel P O Kaiser, Wolfgang Marik, Christina Wendl, Ilka Kleffner, Hans Henkes, Hermann Kraehling, Thi Dan Linh Nguyen-Kim, René Chapot, Umut Yilmaz, Furene Wang, Muhammad Ubaid Hafeez, Flavio Requejo, Nicola Limbucci, Birgit Kauffmann, Markus Möhlenbruch, Omid Nikoubashman, Peter D Schellinger, Patricia Musolino, Ali Alawieh, Jenny Wilson, Dominik Grieb, Alexandra S Gersing, Thomas Liebig, Martin Olivieri, Jaroslava Paulasova Schwabova, Ales Tomek, Panagiotis Papanagiotou, Grégoire Boulouis, Olivier Naggara, Christine K Fox, Kirill Orlov, Alexandra Kuznetsova, Carmen Parra-Farinas, Prakash Muthusami, Robert W Regenhardt, Adam A Dmytriw, Tanja Burkard, Mesha Martinez, Daniel Brechbühl, Maja Steinlin, Lisa R Sun, Ameer E Hassan, André Kemmling, Sarah Lee, Heather J Fullerton, Jens Fiehler, Marios-Nikos Psychogios, Moritz Wildgruber","doi":"10.1016/S2352-4642(24)00233-5","DOIUrl":"10.1016/S2352-4642(24)00233-5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Emerging evidence suggests that endovascular thrombectomy is beneficial for treatment of childhood stroke, but the safety and effectiveness of endovascular thrombectomy has not been compared with best medical treatment. We aimed to prospectively analyse functional outcomes of endovascular thrombectomy versus best medical treatment in children with intracranial arterial occlusion stroke.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this prospective registry study, 45 centres in 12 countries across Asia and Australia, Europe, North America, and South America reported functional outcomes for children aged between 28 days and 18 years presenting with arterial ischaemic stroke caused by a large-vessel or medium-vessel occlusion who received either endovascular thrombectomy plus best medical practice or best medical treatment alone. Intravenous thrombolysis was considered part of best medical treatment and therefore permitted in both groups. The primary outcome was the difference in median modified Rankin Scale (mRS) score between baseline (pre-stroke) and 90 days (±10 days) post-stroke, assessed by the Wilcoxon rank test (α=0·05). Efficacy outcomes in the endovascular thrombectomy and best medical treatment groups were compared in sensitivity analyses using propensity score matching. The Save ChildS Pro study is registered at the German Clinical Trials Registry, DRKS00018960.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;Between Jan 1, 2020, and Aug 31, 2023, of the 241 patients in the Save ChildS Pro registry, 208 were included in the analysis (115 [55%] boys and 93 [45%] girls). 117 patients underwent endovascular thrombectomy (median age 11 years [IQR 6-14]), and 91 patients received best medical treatment (6 years [3-12]; p&lt;0·0001). The median Pediatric National Institutes of Health Stroke Scale (PedNIHSS) score on admission was 14 (IQR 10-19) in the endovascular thrombectomy group and 9 (5-13) in the best medical treatment group (p&lt;0·0001). Both treatment groups had a median pre-stroke mRS score of 0 (IQR 0-0) at baseline. The change in median mRS score between baseline and 90 days was 1 (IQR 0-2) in the endovascular thrombectomy group and 2 (1-3) in the best medical treatment group (p=0·020). One (1%) patient developed a symptomatic intracranial haemorrhage (this patient was in the endovascular thrombectomy group). Six (5%) patients in the endovascular thrombectomy group and four (5%) patients in the best medical treatment group had died by day 90 (p=0·89). After propensity score matching for age, sex, and PedNIHSS score at hospital admission (n=79 from each group), the change in median mRS score between baseline and 90 days was 1 (IQR 0-2) in the endovascular thrombectomy group and 2 (1-3) in the best medical treatment group (p=0·029). Regarding the primary outcome for patients with suspected focal cerebral arteriopathy, endovascular thrombectomy (n=18) and best medical treatment (n=33) showed no difference in 90-day median mRS scores ","PeriodicalId":94246,"journal":{"name":"The Lancet. Child & adolescent health","volume":" ","pages":"882-890"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Paediatric endovascular thrombectomy: balancing strength of numbers and accuracy of precision medicine. 儿科血管内血栓切除术:平衡数量优势与精准医疗的准确性。
Pub Date : 2024-12-01 Epub Date: 2024-10-11 DOI: 10.1016/S2352-4642(24)00257-8
Manoëlle Kossorotoff
{"title":"Paediatric endovascular thrombectomy: balancing strength of numbers and accuracy of precision medicine.","authors":"Manoëlle Kossorotoff","doi":"10.1016/S2352-4642(24)00257-8","DOIUrl":"10.1016/S2352-4642(24)00257-8","url":null,"abstract":"","PeriodicalId":94246,"journal":{"name":"The Lancet. Child & adolescent health","volume":" ","pages":"844-845"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Asthma symptoms, severity, and control with and without a clinical diagnosis of asthma in early adolescence in sub-Saharan Africa: a multi-country, school-based, cross-sectional study. 撒哈拉以南非洲青少年早期哮喘症状、严重程度和控制情况:一项基于学校的多国横断面研究。
Pub Date : 2024-12-01 Epub Date: 2024-10-21 DOI: 10.1016/S2352-4642(24)00232-3
Victoria O Oyenuga, Gioia Mosler, Emmanuel Addo-Yobo, Olayinka O Adeyeye, Bernard Arhin, Farida Fortune, Christopher J Griffiths, Marian Kasekete, Elizabeth Mkutumula, Reratilwe Mphahlele, Hilda A Mujuru, Sofia Muyemayema, Rebecca Nantanda, Lovemore M Nkhalamba, Oluwafemi T Ojo, Sandra Kwarteng Owusu, Ismail Ticklay, Peter O Ubuane, Rafiuk C Yakubu, Lindsay Zurba, Refiloe Masekela, Jonathan Grigg
<p><strong>Background: </strong>Rapid urbanisation and population growth in sub-Saharan Africa has increased the incidence of asthma in children and adolescents. One major barrier to achieving good asthma control in these adolescents is obtaining a clinical diagnosis. To date, there are scant data on prevalence and severity of asthma in undiagnosed yet symptomatic adolescents. We therefore aimed to assess symptom prevalence and severity, the effect of symptoms on daily life, and objective evidence of asthma in young adolescents from sub-Saharan Africa with and without a clinical diagnosis of asthma by spirometry and fractional exhaled nitric oxide (FeNO).</p><p><strong>Methods: </strong>We designed a two-phase, multi-country, school-based, cross-sectional study to assess symptom prevalence and severity in sub-Saharan African adolescents. In phase 1 we surveyed young adolescents aged 12-14 years who were attending selected primary and secondary schools in Blantyre in Malawi, Durban in South Africa, Harare in Zimbabwe, Kampala in Uganda, Kumasi in Ghana, and Lagos in Nigeria. The adolescents were screened for asthma symptoms using the International Study of Asthma and Allergies in Children (ISAAC) questionnaire. Then, after opt-in consent, symptomatic adolescents were invited to complete a detailed survey on asthma severity, treatment, and exposure to environmental risk factors for phase 2. Adolescents performed the European Respiratory Society's diagnostic tests for childhood asthma. A positive asthma test was classified as a forced expiratory volume in 1 sec (FEV<sub>1</sub>) predicted under 80%, a FEV<sub>1</sub> under the lower limits of normal, or FEV<sub>1</sub> divided by forced vital capacity (FEV<sub>1</sub>/FVC) under the lower limits of normal; positive bronchodilator responsiveness or reversibility was defined as either an increase in absolute FEV<sub>1</sub> of 12% or more, or an increase of 200 mL or more, or both, after 400 μg of salbutamol (shortacting β2 agonist) administered via a metered-dose inhaler and spacer, or FeNO of 25 parts per billion or higher, or any combination of these. The study was registered with ClinicalTrials.gov (NCT03990402) and is complete.</p><p><strong>Findings: </strong>Between Nov 1, 2018, and Nov 1, 2021, we recruited 149 schools from six regions in six sub-Saharan countries to participate in the study. We administered phase 1 asthma questionnaires from Jan 20, 2019 to Nov 11, 2021, and from 27 407 adolescents who were screened, we obtained data for 27 272 (99·5%). Overall, 14 918 (54·7%) adolescents were female and 12 354 (45·3%) adolescents were male, and the mean age was 13 years (IQR 12-13); nearly all recruited adolescents were of black African ethnicity (26 821 [98·3%] of 27 272). In phase 1, a total of 3236 (11·9% [95% CI 11·5-12·3]) reported wheeze in the past 12 months, and 644 (19·9%) of 3236 had a formal clinical diagnosis of asthma. The prevalence of adolescents with asthma symptoms ranged fr
背景:撒哈拉以南非洲地区的快速城市化和人口增长增加了儿童和青少年的哮喘发病率。在这些青少年中实现良好的哮喘控制的一个主要障碍是获得临床诊断。迄今为止,有关未确诊但有症状的青少年哮喘发病率和严重程度的数据还很少。因此,我们旨在通过肺活量测定和一氧化氮呼气分数(FeNO)来评估撒哈拉以南非洲地区临床诊断为哮喘和未诊断为哮喘的青少年的症状发生率和严重程度、症状对日常生活的影响以及哮喘的客观证据:我们设计了一项分两个阶段、基于学校的多国横断面研究,以评估撒哈拉以南非洲青少年的症状发生率和严重程度。在第一阶段,我们对马拉维布兰太尔、南非德班、津巴布韦哈拉雷、乌干达坎帕拉、加纳库马西和尼日利亚拉各斯的部分中小学中 12-14 岁的青少年进行了调查。研究人员使用国际儿童哮喘和过敏症研究(ISAAC)问卷对这些青少年进行了哮喘症状筛查。然后,在征得同意后,邀请有症状的青少年完成关于哮喘严重程度、治疗和环境危险因素暴露的详细调查,以进行第二阶段的研究。青少年进行欧洲呼吸协会的儿童哮喘诊断测试。哮喘测试阳性的分类是:1 秒用力呼气容积(FEV1)预测值低于 80%,FEV1 低于正常值下限,或 FEV1 除以用力呼吸量(FEV1/FVC)低于正常值下限;支气管扩张剂阳性反应性或可逆性的定义是:通过计量吸入器和喷雾器吸入 400 微克沙丁胺醇(短效 β2 激动剂)后,FEV1 绝对值增加 12% 或以上,或增加 200 毫升或以上,或两者均增加。该研究已在ClinicalTrials.gov(NCT03990402)注册,研究结果已完成:2018年11月1日至2021年11月1日期间,我们招募了来自撒哈拉以南6个国家6个地区的149所学校参与研究。我们在 2019 年 1 月 20 日至 2021 年 11 月 11 日期间发放了第 1 阶段哮喘调查问卷,并从 27 407 名接受筛查的青少年中获得了 27 272 人(99-5%)的数据。总体而言,14 918 名(54-7%)青少年为女性,12 354 名(45-3%)青少年为男性,平均年龄为 13 岁(IQR 12-13);几乎所有被招募的青少年都是非洲黑人(27 272 人中有 26 821 人[98-3%])。在第一阶段,共有 3236 人(11-9% [95% CI 11-5-12-3])报告在过去 12 个月中出现过喘息,3236 人中有 644 人(19-9%)被正式临床诊断为哮喘。有哮喘症状的青少年发病率从南非德班的 23-8% 到马拉维布兰太尔的 4-2% 不等。根据 ISAAC 标准,3236 名青少年中有 2146 人(66-3%)报告了严重的哮喘症状,其中大多数人(2146 人中有 1672 人[77-9%])未经临床医生诊断患有哮喘。2019 年 7 月 16 日至 2021 年 11 月 26 日期间,我们对在第一阶段出现哮喘症状并同意进入第二阶段的 1654 名青少年进行了第二阶段问卷调查。在第二阶段的队列中,959(58-0%)人为女性,695(42-0%)人为男性,平均年龄为 13 岁(IQR 12-14)。在 1654 名参与者中,有 1546 人(93-5%)接受了一次或多次哮喘诊断测试。在 767 名症状严重的未确诊青少年中,有 374 人(占 48-8%)在一次或多次哮喘检测中呈阳性;在 415 名症状轻微至中度的未确诊青少年中,有 176 人(占 42-4%)在一次或多次哮喘检测中呈阳性。在第二阶段的 392 名经临床医生诊断患有哮喘的青少年中,有 294 人(75-0%)报告有严重的哮喘症状,其中有 94 人(32-0%)的严重症状患者没有使用任何哮喘药物。总的来说,撒哈拉以南非洲国家在第一和第二阶段的调查结果是一致的:在撒哈拉以南非洲地区,大部分有严重哮喘症状的青少年没有得到哮喘的正式诊断,因此没有接受适当的哮喘治疗。为改善撒哈拉以南非洲地区哮喘控制不佳的状况,应考虑在学校开展教育计划、改善诊断、治疗和筛查等潜在解决方案:资金来源:英国国家健康与护理研究所和英国医学研究委员会。
{"title":"Asthma symptoms, severity, and control with and without a clinical diagnosis of asthma in early adolescence in sub-Saharan Africa: a multi-country, school-based, cross-sectional study.","authors":"Victoria O Oyenuga, Gioia Mosler, Emmanuel Addo-Yobo, Olayinka O Adeyeye, Bernard Arhin, Farida Fortune, Christopher J Griffiths, Marian Kasekete, Elizabeth Mkutumula, Reratilwe Mphahlele, Hilda A Mujuru, Sofia Muyemayema, Rebecca Nantanda, Lovemore M Nkhalamba, Oluwafemi T Ojo, Sandra Kwarteng Owusu, Ismail Ticklay, Peter O Ubuane, Rafiuk C Yakubu, Lindsay Zurba, Refiloe Masekela, Jonathan Grigg","doi":"10.1016/S2352-4642(24)00232-3","DOIUrl":"10.1016/S2352-4642(24)00232-3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Rapid urbanisation and population growth in sub-Saharan Africa has increased the incidence of asthma in children and adolescents. One major barrier to achieving good asthma control in these adolescents is obtaining a clinical diagnosis. To date, there are scant data on prevalence and severity of asthma in undiagnosed yet symptomatic adolescents. We therefore aimed to assess symptom prevalence and severity, the effect of symptoms on daily life, and objective evidence of asthma in young adolescents from sub-Saharan Africa with and without a clinical diagnosis of asthma by spirometry and fractional exhaled nitric oxide (FeNO).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We designed a two-phase, multi-country, school-based, cross-sectional study to assess symptom prevalence and severity in sub-Saharan African adolescents. In phase 1 we surveyed young adolescents aged 12-14 years who were attending selected primary and secondary schools in Blantyre in Malawi, Durban in South Africa, Harare in Zimbabwe, Kampala in Uganda, Kumasi in Ghana, and Lagos in Nigeria. The adolescents were screened for asthma symptoms using the International Study of Asthma and Allergies in Children (ISAAC) questionnaire. Then, after opt-in consent, symptomatic adolescents were invited to complete a detailed survey on asthma severity, treatment, and exposure to environmental risk factors for phase 2. Adolescents performed the European Respiratory Society's diagnostic tests for childhood asthma. A positive asthma test was classified as a forced expiratory volume in 1 sec (FEV&lt;sub&gt;1&lt;/sub&gt;) predicted under 80%, a FEV&lt;sub&gt;1&lt;/sub&gt; under the lower limits of normal, or FEV&lt;sub&gt;1&lt;/sub&gt; divided by forced vital capacity (FEV&lt;sub&gt;1&lt;/sub&gt;/FVC) under the lower limits of normal; positive bronchodilator responsiveness or reversibility was defined as either an increase in absolute FEV&lt;sub&gt;1&lt;/sub&gt; of 12% or more, or an increase of 200 mL or more, or both, after 400 μg of salbutamol (shortacting β2 agonist) administered via a metered-dose inhaler and spacer, or FeNO of 25 parts per billion or higher, or any combination of these. The study was registered with ClinicalTrials.gov (NCT03990402) and is complete.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;Between Nov 1, 2018, and Nov 1, 2021, we recruited 149 schools from six regions in six sub-Saharan countries to participate in the study. We administered phase 1 asthma questionnaires from Jan 20, 2019 to Nov 11, 2021, and from 27 407 adolescents who were screened, we obtained data for 27 272 (99·5%). Overall, 14 918 (54·7%) adolescents were female and 12 354 (45·3%) adolescents were male, and the mean age was 13 years (IQR 12-13); nearly all recruited adolescents were of black African ethnicity (26 821 [98·3%] of 27 272). In phase 1, a total of 3236 (11·9% [95% CI 11·5-12·3]) reported wheeze in the past 12 months, and 644 (19·9%) of 3236 had a formal clinical diagnosis of asthma. The prevalence of adolescents with asthma symptoms ranged fr","PeriodicalId":94246,"journal":{"name":"The Lancet. Child & adolescent health","volume":" ","pages":"859-871"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hidden in plain sight: the threat of mpox to children and adolescents. 隐藏在众目睽睽之下:麻风病对儿童和青少年的威胁。
Pub Date : 2024-12-01 Epub Date: 2024-10-29 DOI: 10.1016/S2352-4642(24)00298-0
Nuria Sanchez Clemente, Kirsty Le Doare, Ezekiel Mupere, Jean B Nachega, Stephen Rulisa, Boghuma Titanji
{"title":"Hidden in plain sight: the threat of mpox to children and adolescents.","authors":"Nuria Sanchez Clemente, Kirsty Le Doare, Ezekiel Mupere, Jean B Nachega, Stephen Rulisa, Boghuma Titanji","doi":"10.1016/S2352-4642(24)00298-0","DOIUrl":"10.1016/S2352-4642(24)00298-0","url":null,"abstract":"","PeriodicalId":94246,"journal":{"name":"The Lancet. Child & adolescent health","volume":" ","pages":"849-851"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
The Lancet. Child & adolescent health
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1