Cavitary lung lesions and pneumothorax in a healthy patient with active coronavirus-19 (COVID-19) viral pneumonia

Severe respiratory sequelae drive morbidity-associated with coronavirus 2019 (COVID-19) disease. We report a case of COVID-19 pneumonia complicated by cavitary lesions and pneumothorax in a young healthy male. Pneumothorax management with catheter thoracostomy and rapid resolution of the cavitary lesions are described. An extensive work-up for other causes a cavitation was negative and the temporal correlation of the cavities with COVID-19 infection plus their rapid resolution suggest a direct relationship. We propose a mechanism for cavitation secondary to microangiopathy, a cause of cavitation in the vasculitides and a known feature of COVID-19.     

Depression and anxiety symptoms: onset, developmental course and risk factors during early childhood

Background:  Depressive and anxiety disorders are among the top ten leading causes of disabilities. We know little, however, about the onset, developmental course and early risk factors for depressive and anxiety symptoms (DAS).
Objective:  Model the developmental trajectories of DAS during early childhood and to identify risk factors for atypically high DAS.
Method:  Group-based developmental trajectories of DAS conditional on risk factors were estimated from annual maternal ratings (1½ to 5 years) in a large population sample ( n  =   1759).
Results:  DAS increased substantially in two of the three distinct trajectory groups identified: High-Rising (14.7%); Moderate-Rising (55.4%); and Low (29.9%). Two factors distinguished the High-Rising group from the other two: Difficult temperament at 5 months (High-Rising vs Moderate-Rising: OR = 1.32; 95% CI = 1.13–1.55; High-Rising vs Low: OR = 1.31, CI = 1.12–1.54) and maternal lifetime major depression (High-Rising vs Moderate-Rising: OR = 1.10; CI = 1.01–1.20; High-Rising vs Low: OR = 1.19; CI = 1.08–1.31). Two factors distinguished the High-Rising group from the Low group: High family dysfunction (OR = 1.24; CI = 1.03–1.5) and Low parental self-efficacy (OR = .71; CI = .54–.94).
Conclusions:  DAS tend to increase in frequency over the first 5 years of life. Atypically high level can be predicted from mother and child characteristics present before 6 months of age. Preventive interventions should be experimented with at risk infants and parents.     

Association between nonmaternal care in the first year of life and children's receptive language skills prior to school entry: the moderating role of socioeconomic status

BACKGROUND: Studies have suggested that nonmaternal care (NMC) may either carry risks or be beneficial for children's language development. However, few tested the possibility that NMC may be more or less protective for children with different family backgrounds. This study investigates the role of the family environment, as reflected in the socioeconomic status (SES), in the association between NMC in the first year of life and children's receptive language skills prior to school entry. METHOD: A representative sample of 2,297 Canadian children aged between 0 and 11 months at their first assessment was followed over 4 years. Receptive language skills were assessed with the Peabody Picture Vocabulary Test Revised (PPVT-R) when the child was 4 to 5 years old. RESULTS: After controlling for selection factors, SES was found to moderate the association between NMC and receptive language skills: Full-time NMC in the first year of life was associated with higher PPVT-R scores among children from low SES families (d = .58), but not among children from adequate SES families. CONCLUSION: Full-time NMC in infancy may contribute to reducing the cognitive inequalities between children of low and adequate SES.     

Comparison of the tolerability of an acellular pertussis-containing vaccine given as the fifth booster dose in differently primed children

Background

In 2005, an acellular pertussis-containing DTP-IPV-Hib vaccine for infants replaced the whole-cell combination vaccine in the National Immunisation Programme of the Netherlands. From 2008 onwards, an increase in local reactions to boosters was seen in an enhanced passive reporting system of adverse events following immunisation.

Method

A cross-sectional study was conducted to assess the difference in tolerability of a DTaP-IPV booster in four-year-old children primed in infancy with either three doses DTaP-IPV-Hib (aP-primed) or three doses of DTwP-IPV-Hib (wP-primed). Parents were asked to report in a questionnaire the local reactions and systemic adverse events that developed within one week after booster administration.

Results

Children in the aP-primed group experienced significantly more local reactions (36.1% versus 58.5%; OR 2.7; 95% CI 2.2-3.3) and also more systemic events (11.0% versus 20.6%; OR 2.2; 95% CI 1.6-3.0) after the DTaP-IPV booster than wP-primed children. Besides, aP-primed children more often used acetaminophen (13.1% versus 6.7%); were more frequently absent from school, preschool, crèche or other activities (4.2% versus 1.5%), and more often had contact with the healthcare system (4.5% versus 1.6%) within one week after the booster than wP-primed children.

Conclusion

The frequency of adverse events after DTaP-IPV booster immunisation in four year old children is higher in children primed with DTaP-IPV-Hib than in children primed with DTwP-IPV-Hib. However, for primary and booster vaccinations together, immunisation with acellular pertussis combination vaccines results in fewer adverse events than vaccination of whole cell combination vaccines. So, both the effectiveness and adverse events needs consideration in the discussion with regard to optimal timing of booster dose of DTaP-IPV.     

Longitudinal Association Between Peer Victimization and Sleep Problems in Preschoolers: The Moderating Role of Parenting

This study examined the moderating role of parental behaviors in the longitudinal link between peer victimization and sleep problems during preschool. The sample consisted of 1,181 children (594 girls) attending day care between the ages of 3 and 6 years. Participants were part of the Quebec Longitudinal Study of Child Development, a longitudinal study of child development led by the Institut de la Statistique du Quebec. Controlling for potential confounders, latent growth curve analyses revealed that the association between peer victimization and sleep problems varied depending on parents’ behaviors. Coercive parenting exacerbated the link between peer victimization and parasomnias. In contrast, positive parenting mitigated the link between peer victimization and insomnia. The findings suggest that persistent sleep problems at a young age may be an indicator of chronic peer victimization but that parents’ behaviors can play a key role in victimized children’s sleep problems.     

Childhood behavioral profiles leading to adolescent conduct disorder: risk trajectories for boys and girls

OBJECTIVE: To examine the link between childhood behavioral dimensions and adolescent conduct disorder (CD) among a large sample of boys and girls monitored longitudinally. METHOD: Teachers rated the behaviors of 1,569 children every year between kindergarten and grade 6. On the basis of these seven yearly ratings, groups of children who followed distinct trajectories on three behavioral dimensions--hyperactivity, fearfulness, and helpfulness--were identified with a semiparametric statistical analysis. Children were then categorized into one of eight behavioral profiles, representing different combinations of the trajectories. Logistic regressions were used to estimate the relation between the profiles and CD in adolescence (mean = 15.7 years). RESULTS: Boys had a significant risk for CD if they were hyperactive (odds ratio [OR] = 4.27; 95% confidence interval [CI], 1.8-10.16); hyperactive and unhelpful (OR = 2.83; CI, 1.07-7.46); or hyperactive, fearless, and unhelpful (OR = 3.93; CI, 1.27-12.17). Girls had a significant risk for CD only if they were both hyperactive and unhelpful (OR = 4.61; CI, 1.31-16.24). More boys than girls exhibited profiles of risk and met criteria for CD in adolescence. CONCLUSIONS: Sex-specific childhood behavioral profiles that represented risk for CD in adolescence were identified.There were sex differences in the prevalence of the childhood profiles representing risk for CD.     

House dust mite allergen exposure in infancy

BACKGROUND: Infancy may be a critical time for exposure to house dust mite allergens, when exposure to high levels can increase the risk of allergic sensitization and the development of asthma in later life. OBJECTIVE: To measure house dust mite allergen (Der p 1) concentration in the infants' environment and examine lifestyle factors which may influence mite allergen exposure. METHODS: Infants aged between 4 and 12 months (n = 134) from the western region of Sydney, Australia. participated. Reservoir dust samples were collected from four sites within each home: infant's bed, second bed (adult or second child's bed), lounge floor and sheepskins (where available). Settling aeroallergen was collected for 10-14 d in Petri dishes in the infant's room. Der p 1 was measured by ELISA. A questionnaire on types of bedding, sleeping and playing patterns of the infant was completed by the parents at the time of dust collection. RESULTS: All infants were exposed to at least one site with Der p 1 concentrations greater than 10 microg/g fine dust. The mean settling aeroallergen level in the infants' room was 24 ng De p l/m2 day and this was weakly related to bed allergen levels (r=0.21, P<0.05). Mattress type had a weak effect on Der p 1 levels as measured in the whole bed (P = 0.07), while bed cover and bed type had no effect (P>0.6). The mean product of time spent at a site and its allergen concentration was highest for beds in 69% of infants. CONCLUSION: The high level of allergen exposure in the environment of this group of infants places them at an increased risk of early sensitization and development of asthma. Any strategy to reduce asthma prevalence should address these high and avoidable levels.     

Anticipatory smooth-pursuit eye movements in man and monkey

A fundamental problem in the generation of goal-directed behaviour is caused by the inevitable latency of biological sensory systems. Behaviour which is fully synchronised with the triggering sensory event can only be executed if the occurrence of this event can be predicted based on prior information. Smooth-pursuit eye movements are a classical and well-established example of goal-directed behaviour. The execution of these eye movements is thought to be very closely linked to the processing of visual motion signals. Here, we show that healthy human subjects as well as trained rhesus monkeys are able to initiate smooth-pursuit eye movements in anticipation of a moving target. These anticipatory pursuit eye movements are scaled to the velocity of the expected target. Furthermore, we can exclude the possibility that anticipatory pursuit is simply an after-pursuit of the previous trial. Visually-guided pursuit is only marginally affected by the presence of a structured background. However, the presence of a structured background severely impedes the ability to perform anticipatory pursuit. More generally, our data provide additional evidence that the cognitive oculomotor repertoires of human and monkeys are similar, at least with respect of smooth-pursuit in the prediction of an appearing target.     

Trajectories of adolescent poly-substance use and their long-term social and economic outcomes for males from low-income backgrounds

European Child & Adolescent Psychiatry - Substance abuse is a significant public health concern that disproportionately burdens males and low-income communities. This study examined (1)...