4% had an underlying medical condition (UMC), 63.6% were RSV-A positive, 25.2% were RSV-B positive, 0.6% were positive for both, and 10.6% could not be typed. Both RSV subtypes peaked in January-March of each year. RSV A-positive children were more likely to present with decreased appetite but less likely to have viral co-detection than RSV B-positive children. Independent factors associated with RSV disease severity included cycle threshold value, vitamin D level, age, UMC, prematurity and severity score, but not RSV subtypes.
RSV subtypes co-circulated and had similar severity profiles; future preventive and treatment measures should target both subtypes.
RSV subtypes co-circulated and had similar severity profiles; future preventive and treatment measures should target both subtypes.
Cardiovascular complications with myocarditis in multisystem inflammatory syndrome in children (MIS-C) associated with severe acute respiratory syndrome coronavirus 2 infection have been reported, but the optimal therapeutic strategy remains unknown.
A retrospective cohort study included 19 patients with acute left ventricular systolic dysfunction associated with MIS-C, average years of age 13.2 ± 3.8, treated from April 2020 to April 2021.
Treatment failure (TF) was observed in 8 patients (in the intravenous immunoglobulin [IVIG] group 7/10; in the corticosteroid [CS] group 1/9). The independent risk factor for TF was IVIG treatment (odds ratio [OR] 18.6, 95% confidence interval [CI] 1.6-222.93, P = 0.02). Patients initially treated with CS became afebrile during in-hospital day 1 (1.5, interquartile range [IQR] 1-2), while IVIG-treated patients became afebrile on in-hospital day 4 (IQR 2-4.25), after CS was added. The C-reactive protein (CRP) significantly declined in CS-treated patients on day 2 (P = 0.01), while in the IVIG group, CRP decreased significantly on the fourth day (P = 0.04). Sodium and albumin levels were higher on third in-hospital day in the CS group than in the IVIG group (P = 0.015, P = 0.03). A significant improvement and normalization of ejection fraction (EF) during the first 3 days was observed only in the CS group (P = 0.005). ICU stays were shorter in the CS group (4, IQR 2-5.5) than in the IVIG group (IVIG group 7, IQR 6-8.5) (P = 0.002).
Among children with MIS-C with cardiovascular involvement, treatment with CS was associated with faster normalization of LV EF, fever, laboratory analysis, and shorter ICU than IVIG-treated patients.
Among children with MIS-C with cardiovascular involvement, treatment with CS was associated with faster normalization of LV EF, fever, laboratory analysis, and shorter ICU than IVIG-treated patients.We report early results from a prospective primary care bronchiolitis surveillance study in France in which a 10-week delayed epidemic was detected from February to March 2021. Among 225 children under 2 years with swab testing for a first bronchiolitis episode, 55% had a positive test for RSV, 0 for influenza, and 1 for severe acute respiratory syndrome coronavirus 2.
This study aimed to assess the effects of the combination of a low-fat plant-based diet and soybeans on the frequency and severity of menopausal hot flashes.
Postmenopausal women (n = 38) reporting two or more hot flashes/day were randomly assigned to a low-fat, vegan diet, including ½ cup (86 g) of cooked soybeans daily, or to no diet changes for 12 weeks. Frequency and severity of hot flashes were recorded using a mobile application, and vasomotor, psychosocial, physical, and sexual symptoms were assessed using the Menopause-Specific Quality of Life Questionnaire. Significance was assessed using t-tests (continuous outcomes) and chi-squared/McNemar tests (binary outcomes).
Total hot flashes decreased 79% in the intervention group (P < 0.001) and 49% in the control group (P = 0.002; between-group P = 0.01). https://www.selleckchem.com/products/3-3-cgamp.html Moderate-to-severe hot flashes decreased 84% in the intervention group (P < 0.001) and 42% in the control group P = 0.009; between-group P = 0.01). From 0 to 12 weeks, 59% (10/17) of intervent the 12-week study period, the majority of intervention-group participants became free of moderate-to-severe hot flashes.Video Summaryhttp//links.lww.com/MENO/A785.
To develop a decision support intervention that can be used with women experiencing menopausal symptoms to facilitate treatment shared decision making.
Our research team contacted patients with reported menopausal symptoms by telephone to obtain consent and administer a baseline survey. Subsequently, we sent participants a booklet on the treatment of menopausal symptoms. A nurse educator then contacted participants by telephone to review the booklet and guide them through a structured decision counseling exercise designed to help clarify treatment preference. A 60-day endpoint telephone survey was completed.
Forty-eight consenting participants completed the baseline survey and 37 (77%) also completed a decision counseling session. At baseline, 19 of the women who had decision counseling were not being treated for menopausal symptoms and 18 were being treated. After decision counseling, 13 (68%) participants who were not being treated and 14 (78%) who were being treated identified a preferred treatment. Comparison of baseline and endpoint survey data showed that participant treatment knowledge increased (P = 0.007) and treatment decisional conflict decreased (P < 0.001). Furthermore, 71% of participants reported that they had received new information about treatment and 94% said they believed better prepared to discuss treatment with their healthcare provider.
Nurse-led decision counseling increased participant treatment knowledge, reduced treatment decisional conflict, and helped to clarify treatment preference. Implementation of this strategy could help to facilitate provider-patient shared decision making about the treatment of menopausal symptoms.
Nurse-led decision counseling increased participant treatment knowledge, reduced treatment decisional conflict, and helped to clarify treatment preference. Implementation of this strategy could help to facilitate provider-patient shared decision making about the treatment of menopausal symptoms.
4% had an underlying medical condition (UMC), 63.6% were RSV-A positive, 25.2% were RSV-B positive, 0.6% were positive for both, and 10.6% could not be typed. Both RSV subtypes peaked in January-March of each year. RSV A-positive children were more likely to present with decreased appetite but less likely to have viral co-detection than RSV B-positive children. Independent factors associated with RSV disease severity included cycle threshold value, vitamin D level, age, UMC, prematurity and severity score, but not RSV subtypes.
RSV subtypes co-circulated and had similar severity profiles; future preventive and treatment measures should target both subtypes.
RSV subtypes co-circulated and had similar severity profiles; future preventive and treatment measures should target both subtypes.
Cardiovascular complications with myocarditis in multisystem inflammatory syndrome in children (MIS-C) associated with severe acute respiratory syndrome coronavirus 2 infection have been reported, but the optimal therapeutic strategy remains unknown.
A retrospective cohort study included 19 patients with acute left ventricular systolic dysfunction associated with MIS-C, average years of age 13.2 ± 3.8, treated from April 2020 to April 2021.
Treatment failure (TF) was observed in 8 patients (in the intravenous immunoglobulin [IVIG] group 7/10; in the corticosteroid [CS] group 1/9). The independent risk factor for TF was IVIG treatment (odds ratio [OR] 18.6, 95% confidence interval [CI] 1.6-222.93, P = 0.02). Patients initially treated with CS became afebrile during in-hospital day 1 (1.5, interquartile range [IQR] 1-2), while IVIG-treated patients became afebrile on in-hospital day 4 (IQR 2-4.25), after CS was added. The C-reactive protein (CRP) significantly declined in CS-treated patients on day 2 (P = 0.01), while in the IVIG group, CRP decreased significantly on the fourth day (P = 0.04). Sodium and albumin levels were higher on third in-hospital day in the CS group than in the IVIG group (P = 0.015, P = 0.03). A significant improvement and normalization of ejection fraction (EF) during the first 3 days was observed only in the CS group (P = 0.005). ICU stays were shorter in the CS group (4, IQR 2-5.5) than in the IVIG group (IVIG group 7, IQR 6-8.5) (P = 0.002).
Among children with MIS-C with cardiovascular involvement, treatment with CS was associated with faster normalization of LV EF, fever, laboratory analysis, and shorter ICU than IVIG-treated patients.
Among children with MIS-C with cardiovascular involvement, treatment with CS was associated with faster normalization of LV EF, fever, laboratory analysis, and shorter ICU than IVIG-treated patients.We report early results from a prospective primary care bronchiolitis surveillance study in France in which a 10-week delayed epidemic was detected from February to March 2021. Among 225 children under 2 years with swab testing for a first bronchiolitis episode, 55% had a positive test for RSV, 0 for influenza, and 1 for severe acute respiratory syndrome coronavirus 2.
This study aimed to assess the effects of the combination of a low-fat plant-based diet and soybeans on the frequency and severity of menopausal hot flashes.
Postmenopausal women (n = 38) reporting two or more hot flashes/day were randomly assigned to a low-fat, vegan diet, including ½ cup (86 g) of cooked soybeans daily, or to no diet changes for 12 weeks. Frequency and severity of hot flashes were recorded using a mobile application, and vasomotor, psychosocial, physical, and sexual symptoms were assessed using the Menopause-Specific Quality of Life Questionnaire. Significance was assessed using t-tests (continuous outcomes) and chi-squared/McNemar tests (binary outcomes).
Total hot flashes decreased 79% in the intervention group (P < 0.001) and 49% in the control group (P = 0.002; between-group P = 0.01). https://www.selleckchem.com/products/3-3-cgamp.html Moderate-to-severe hot flashes decreased 84% in the intervention group (P < 0.001) and 42% in the control group P = 0.009; between-group P = 0.01). From 0 to 12 weeks, 59% (10/17) of intervent the 12-week study period, the majority of intervention-group participants became free of moderate-to-severe hot flashes.Video Summaryhttp//links.lww.com/MENO/A785.
To develop a decision support intervention that can be used with women experiencing menopausal symptoms to facilitate treatment shared decision making.
Our research team contacted patients with reported menopausal symptoms by telephone to obtain consent and administer a baseline survey. Subsequently, we sent participants a booklet on the treatment of menopausal symptoms. A nurse educator then contacted participants by telephone to review the booklet and guide them through a structured decision counseling exercise designed to help clarify treatment preference. A 60-day endpoint telephone survey was completed.
Forty-eight consenting participants completed the baseline survey and 37 (77%) also completed a decision counseling session. At baseline, 19 of the women who had decision counseling were not being treated for menopausal symptoms and 18 were being treated. After decision counseling, 13 (68%) participants who were not being treated and 14 (78%) who were being treated identified a preferred treatment. Comparison of baseline and endpoint survey data showed that participant treatment knowledge increased (P = 0.007) and treatment decisional conflict decreased (P < 0.001). Furthermore, 71% of participants reported that they had received new information about treatment and 94% said they believed better prepared to discuss treatment with their healthcare provider.
Nurse-led decision counseling increased participant treatment knowledge, reduced treatment decisional conflict, and helped to clarify treatment preference. Implementation of this strategy could help to facilitate provider-patient shared decision making about the treatment of menopausal symptoms.
Nurse-led decision counseling increased participant treatment knowledge, reduced treatment decisional conflict, and helped to clarify treatment preference. Implementation of this strategy could help to facilitate provider-patient shared decision making about the treatment of menopausal symptoms.
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