Podcasts about mis c

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Hoy os cuento las cámaras que me llevé para el viaje a Madrid del pasado puente de la Constitución. Espero vuestros comentarios en la comunidad de Telegram: https://t.me/cienciaoficcion [Música] Buenos días, martes 17 de diciembre de 2024 y hoy voy a contar algo relacionado con el viaje que conté en el último episodio si no has escuchado ese episodio te invito a que lo escuches y sabrás dónde y qué hice en el puente de la constitución aquí en España y hoy voy a hablar de las cámaras como has visto en el título de las cámaras que me llevé para para usar en ese viaje me llevé varias cámaras ahora quien día que me lleve muchas ahora quien día que me lleve pocas bueno no creo que ya nadie quería que me lleve pocas me llevé varias cámaras me llevé varias cámaras me llevé para empezar una laica m4 todo manual con un objetivo carl face de hasta 2.0 de apertura bastante luminoso ahora contaré los carretes también me llevé la fuji film x100 vi v palito la 6 digital 40 megapixeles también con un 35 milímetros no no se si dicho que el calcés era 35 milímetros 35 milímetros 2.0 pues este también este es un 35 2.0 bueno es un 28 milímetros 2.0 pero como tiene un recorte el sensor digital pues es equivalente a 35 milímetros así que tanto en la cámara analógica como digital debe verse lo mismo si echa las fotos desde el mismo sitio para los que sois un poco menos que gustan la fotografía y estos números que estoy dando 35 milímetros es un un angular un gran angular para quien no se pade esto de fotografía en formato completo que es el un carrete 35 milímetros 50 milímetros se considera que es bueno se consideran además si miras y miras con un ojo abierto por el visor te das cuenta de que encaja lo que ve tu ojo con lo que ve la realidad si está todo bien hecho y no tiene ningún aumento para que veas algo más por fuera te das cuenta de que es lo que ve los humanos no 50 milímetros por menos milímetros es que caben más cosas en la foto así que pensé que para viaje grupos y demás pues venía bien y en la fuji fil pues no hay mucho que pensar porque el objetivo es fijo también me llevé cámara de foto y vídeo más bien vídeo que foto la insta 360 x4 que es la cámara 360 que alguna vez he subido ya algún blog entero grabado con ella por la calle y demás es una cámara que permite hacer fotos de 72 megapíxeles en toda la esfera que puede venir muy bien para sitios en los que hay muchas muchas cosas si quieres fotografiar retratar recordar el momento exacto en lo que estuviste y todo lo que ves de arriba abajo ahí no se escapa nadie y también es una cámara de vídeo obviamente es para lo que más se usa son 8 k entonces pues si luego haces un recorte de ese vídeo entre 60 pues se queda bastante chulo se queda bastante bien y nos pierde calidad eso sí 8 k lo usas cuando hay mucha luz y hay poca luz ocho k te estás haciendo un flaco favor porque hay más resolución entonces hay mucho ruido la imagen no se ve bien así que bueno a plena luz del día 8 k y ahora vas a grabar algo con menos luz 5 k está está muy bien entonces cuál era mi idea mi idea era grabar mi idea era grabar voy a poner un poco más cómodo no sé cómo me he sentado y de dar a un chino estoy como ahora mi idea era llevarme la laica la analógica con un carrete de ISO 800 un portrachos cientos con pre 3 y por qué 800 sino 400 habrá quien diga porque mi idea era no iba a llevar otra cámara digital que digo otra cámara analógica entonces mi idea era disparar en todas las situaciones de luz bueno casi todas cuando hay poca luz no pues con ella pues no tenés que decir mira pues ahora son las 3 de la tarde voy a disparar con la analógica pero no se me tiene un interior y aquí va a salir todo movido eso no quería que pasara entonces pues si tú tienes un carrete de ISO 800 y tienes y lo metes en una cámara de estas pues la regla del sun is 16 que es una regla que te hace a ojo más o menos medir la luz para cuando está soleado es que si tú disparas a velocidad 800 un carrete de ISO 800 a p...

Dr Marina Morgan, Consultant Clinical Microbiologist at Royal Devon and Exeter Hospital, is back once again, joining Dr George Moncrieff and Dr Roger Henderson in their deep dive into the world of viral rashes.  From Kawasaki disease to Covid-19-related skin issues, the trio explores the complexities of diagnosing and managing these, often misunderstood, conditions.  Key Takeaways:  Recognising the unique characteristics of Kawasaki disease, MIS-C, and toxic shock syndrome. Understanding how Covid-19 can present a wide spectrum of skin manifestations. Practical tips for primary care professionals to help identify urgent cases that require hospital referral.  Tune in for expert insights and practical advice to enhance your dermatological knowledge.  Thank you to our kind sponsor AproDerm, who provide a comprehensive range of quality emollients designed for the management of dry skin conditions, including eczema, psoriasis and ichthyosis.   To simplify the process of finding the most suitable emollient for each patient, they have developed a remarkable solution: the AproDerm Emollient Starter Pack. This pack conveniently combines all four of their emollients in a single prescription, enabling patients to identify their ideal emollient more efficiently, aiding both compliance and adherence.   Find out more: https://aproderm.com/aproderm-emollient-starter-pack/    LI: https://www.linkedin.com/company/fontus-health-ltd/   Got some feedback for us? Please rate and review Rash Decisions to help us keep creating educational podcasts for you.   Is there a dermatology topic you'd like us to explore? Email us at info@aproderm.com, and we'll do our best to cover it.  The views expressed in this podcast are of Dr George Moncrieff and Dr Roger Henderson. Fontus Health has not influenced, participated, or been involved in the programme, materials, or delivery of educational content. 

COVID and Flu: Updates, Insights, and Best Practices Link for free CME credit:  https://cmetracker.net/UTHSCSA/Publisher?page=pubOpen#/getCertificate/10097919 Join host Holly Wayment in this episode of Pediatrics Now as she welcomes back infectious disease expert Dr. Tess Barton from the University of Texas Health Science Center at San Antonio. Together, they dive into the latest developments in pediatric care concerning COVID-19, including the risk factors, the importance of vaccinations, and the current CDC recommendations. Dr. Barton shares her personal experiences with COVID and discusses the ongoing challenges and misconceptions surrounding the virus. She also sheds light on the rare but significant MIS-C condition in children and the importance of timely vaccinations to prevent severe outcomes. The conversation shifts to the upcoming flu season, where Dr. Barton provides insights into what to expect and the significance of flu vaccinations, especially in the context of the potential bird flu threat. The episode emphasizes the need for proactive measures to protect both children and adults against these respiratory viruses. This informative discussion is essential for pediatric practitioners and parents alike, offering practical advice on vaccination schedules and addressing vaccine hesitancy. Tune in for a comprehensive overview of managing COVID-19 and flu risks in the pediatric population.

In this World Shared Practice Forum Podcast, Drs. Adrienne Randolph and Aaron Bodansky explore the groundbreaking research findings that uncover the pathophysiological mechanism behind multisystem inflammatory syndrome in children (MIS-C). These findings shed light on the characteristic immune response of patients who develop MIS-C, and provide insight into the development of post-infectious auto-immune disease phenotypes. LEARNING OBJECTIVES - Describe the pathophysiology of MIS-C, including the clinical features and molecular immune response - Describe the immune dysregulation that results in MIS-C, including the role of autoantibodies and T-cell responses - Identify the potential connections between SARS-CoV-2 infection and the development of autoimmune responses - Recognize the implications of the study findings for other related conditions such as long COVID and sepsis AUTHORS Adrienne Randolph, MD, MSc Senior Associate in Critical Care Medicine, Department of Anesthesiology, Critical Care and Pain Medicine Boston Children's Hospital Professor of Anaesthesia and Pediatrics Harvard Medical School Aaron Bodansky, MD Assistant Professor Pediatric Critical Care University of California, San Francisco School of Medicine DATES Initial publication: September 24, 2024. ARTICLES REFERENCED Bodansky A, Mettelman RC, Sabatino JJ Jr, et al. Molecular mimicry in multisystem inflammatory syndrome in children. Nature. 2024;632(8025):622-629. doi:10.1038/s41586-024-07722-4. Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open access-and thus at no expense to the user.For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu CITATION Randolph AG, Bodansky A, Burns JP. Unveiling MIS-C's Immune Response: Molecular Mimicry. 09/2024. OPENPediatrics. https://soundcloud.com/openpediatrics/unveiling-mis-cs-immune-response-molecular-mimicry-by-a-randolph-and-a-bodansky-openpediatrics

TWiV discusses the spread of monkeypox virus clade 1b in Africa, COVID drops to tenth leading cause of death in the US, response to detection of poliovirus in Gaza, mechanism of MIS-C after SARS-CoV-2 infection, neonatal Fc receptor is a pan-arterivirus receptor, and antiviral immunity in plants mediated by protein arginine methyltransferase 6. Hosts: Vincent Racaniello, Dickson Despommier, Rich Condit, and Brianne Barker Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Become a patron of TWiV! Links for this episode MicrobeTV Discord Server Mpox widespread in Africa (CIDRAP) Africa declares Mpox emergency (Science) COVID drops to 10th leading cause of US deaths (MMWR) Response to detection of poliovirus in Gaza (WHO) Molecular mimicry in MIS-C (Nature) Neonatal Fc receptor is pan-arterivirus receptor (Nat Comm) Antiviral immunity in plants by protein arginine methytransferase 6 (Cell Host Micr) Letters read on TWiV 1141 Timestamps by Jolene. Thanks! Weekly Picks Brianne – Kate Douglass: Olympian and Statistician (Swimming in Data) Dickson – Women of recent note: Kamala Harris (Democratic Party presidential candidate); Katie Ladecky (10,000 meters); Sydney McLaughlin-Levrone (400 meter hurdles); Gabby Thomas, Sha'Carri Richardson, Melissa Jefferson, and Twanisha Terry (4 x 100 relay); women's basketball team Rich – Texas State University Forensic Anthropology Research Facility Vincent – Sea lion ‘camera crews' capture new footage of ocean floor Intro music is by Ronald Jenkees Send your virology questions and comments to twiv@microbe.tv Content in this podcast should not be construed as medical advice.

Tyler Harris, MD, a pediatric cardiologist at UPMC Children's Hospital of Pittsburgh, discusses MIS-C and specifically myocarditis (inflammation of the heart) that can occur in children who have been diagnosed with COVID-19 or have received the vaccine.

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Volvemos con programa grabado en la caseta de Banana cómics en el que Fernando, Rafa, Juanjo, Enrique y Jotaele comentamos la edición del Omnibus de La Patrulla-X por parte de Panini y su Back to Basics pa lueg comentar algunas lecturas: -El castigador: círculo de sangre (Panini) -Conan #2 (panini) -Vengadores, crepúsculo #1 -Laberintos (Planeta) 🎼 - El Mani - Ay que te como 🎼 - El pali - Sevilla tuvo una niña Puedes encontrarnos en: Facebook: https://www.facebook.com/tdtpodcast Twitter: @PodcastTDT tertuliadetebeos@gmail.com tertuliadetebeos.blogspot.com En Instagram: @tdtpodcast_ YouTube: https://www.youtube.com/tdtpodcast Y por supuesto, en Banana cómics, C/Castilla 8, Triana, Sevilla. www.bananacomics.es

In this episode of Kid's Corner, Dr. Liz Mumper discusses MIS-C (Multisystem Inflammatory Syndrome in Children) and the incidence of this diagnosis with COVID-19. Dr. Mumper also explains whether or not receiving COVID-19 vaccinations prevents MIS-C by breaking down this study: https://www.medrxiv.org/content/10.1101/2022.09.30.22280573v2.full-text MIS-C is also referred to as Pediatric Inflammatory Multisystem Syndrome temporally associated with SARS-COV2 (PIM-TS). Common symptoms of MIS-C in babies show as a rash and/or diarrhea. In older children, the symptoms are respiratory. MIS-C is similar to Kawasaki's disease, although the symptoms usually resolve in contrast to Kawasaki's disease. Treatment for MIS-C includes:• supportive care and observation• maintaining volume status as dehydration worsens symptoms• steroids• IVIG• Interleukin blockers• anti-coagulation• cardiology work-up with an EKG and cardiac echo Kid's Corner with Dr. Lizhttps://covid19criticalcare.com/courses/kids-corner-with-dr-liz/ FLCCC | Front Line COVID-19 Critical Care Alliancehttps://covid19criticalcare.com/ Donate to the Front Line Covid-19 Critical Care Alliance, Inc. to help educate medical professionals and the public in safe and effective ways to prevent and treat COVID-19. Click here to make a donation:https://frontlinecovid-19criticalcarealliance.salsalabs.org/donate/index.html Buy FLCCC gear:https://supportflccc.store/ Subscribe to our mailing list on our website:http://flccc.net/signup Disclaimer:
This video is not intended to provide assessment, diagnosis, treatment, or medical advice; it also does not constitute provision of healthcare services. The content provided in this video is for informational and educational purposes only. Please consult with a physician or healthcare professional regarding any medical or mental health related diagnosis or treatment. No information in this video should ever be considered as a substitute for advice from a healthcare professional.

This week we talk with Amberlee Rich from Idaho. Former art teacher turned homeschool mom and financial coach, Amberlee walks us through what made her decide to homeschool her children. Have you ever felt your child was not safe when you dropped them off at school?? Amberlee tells us about that experience.Soon after feeling unsafe in the school system, Amberlee's daughter was diagnosed with  MIS-C, a Multisystem Inflammatory Syndrome in Children (MIS-C). It is a rare condition associated with SARS-CoV-2 (the virus that causes COVID-19) that usually occurs 2-6 weeks after a child is infected with SARS-CoV-2. MIS-C causes different internal and external body parts to become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal tract. After Amberlee's daughter's diagnosis, she knew home was the best place for her kids. We talk about the importance of teaching financial literacy to our children starting at an early age and how you can incorporate it into your everyday homeschooling life (no extra curriculum needed!)Amberlee explains how she juggles teaching two kids at different levels, and how she picks the books they read. Are you wondering- how has homeschooling been going for ME?? Oh goodness- you don't want to miss this! I ask Amberlee how she handles the situation when her kids just want to be crazy and not pay attention to that pesky ol' school work, and her response is SO SIMPLE! We discuss, "Is homeschooling for everyone?" and when it might not be for you.  You can contact Amberlee by emailin Amberlee@richlivingcoaching.comSchedule a free Q&A Session with Amberlee to see how financial coaching can help you.Here are her social media links:TikTokFacebookInstagramWould you like to help keep this podcast going by sending me a small tip?paypal.me/TheHomeschoolHowToUnable to support the show monetarily but want to help me out in another way?No Problem! Share this link with friends and in your favorite homeschool group facebook page! http://thehomeschoolhowto.com/Do you want to help your children learn about true history, sound money, personal freedom, responsibility, entrepreneurship and individual rights? Then check out The Tuttle Twins books through my link:Cheryl's link to: The Tuttle Twinswith coupon code: Cheryl40for 40% off ages 5-11 book series and more!Treehouse Schoolhouse:Our resources are designed with family-style learning in mind, so they can be used across multiple ages. We design our curriculum to be easy to follow with minimal prep needed. Our products educate more than just a child's mind through music, poetry, art, nature, scripture, and rich literature.Cheryl's Treehouse Schoolhouse linkDiscount code for 10% off: TheHomeschoolHowToPodcastSupport the showInstagram: TheHomeschoolHowToPodcast Facebook: The Homeschool How To Podcast

Somos capaces de aprender a desarrollar lo que sea que tengamos en mente, usa a las demás personas como un reflejo de lo que necesitas trabajar de manera interna en ti y rodéate de gente que admires no que envidies. Learn more about your ad choices. Visit megaphone.fm/adchoices

In the fifth episode of season 2, Dr. U. Grant Baldwin, DBH, and panelists, explore the challenges of public health services during the COVID-19 pandemic, discuss the role of integrated care and behavioral health providers and how Doctors of Behavioral Health support public health efforts. Tune in to learn how integrated healthcare providers can best support public health efforts. Panelists include: Charla N. Burns, M.D., has more than two decades of excellence dedicated to the improvement of public health and the betterment of society, Dr. Burns has earned distinction as an epidemiologist and the multisystem inflammatory syndrome in children (MIS-C) team lead for the Texas Department of State Health Services. Since 2022, she has focused her efforts on planning, developing, and implementing field research studies with COVID-19 within the emerging and acute infectious disease unit at the State Department. Prior to her current role, Dr. Burns was employed at the CDC Foundation as an epidemiologist to combat the COVID-19 pandemic. To prepare for her medical career, Dr. Burns earned a Bachelor of Science in biochemistry/pre-medicine in 2000 from Louisiana State University and A&M College. In 2006, she attained a Doctor of Medicine from the UTMB John Sealy School of Medicine, followed by internal medicine residency training at Tulane University Medical Center and its affiliated clinics and hospitals. Well-qualified in her field, she has extensive experience in public speaking on health-related topics at medical conferences and community events. Dr. Burns' professional accomplishments include the LSU Greek Excellence Award, West Monroe High School Distinguished Alumni Award, Ouachita Parish School Board Certificate of Excellence, Young Conqueror under Forty Female of the Year, and recognition as "One Million Women in STEM." She is a life member of Alpha Kappa Alpha Sorority, Inc., an organization where she has proudly served for the past 25 years. Dedicated to civil advocacy, Dr. Burns serves as the treasurer of the board of directors for SHE VOTES, a nonpartisan non-profit organization that supports young women in becoming registered voters. She also lends her expertise as an advisory council member to the Cummings Graduate Institute for Behavioral Health Studies. --- Support this podcast: https://podcasters.spotify.com/pod/show/disruptors-at-work/support

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Welcome to "PICU Doc On Call," a podcast dedicated to current and aspiring intensivists. In this episode, Dr. Pradip Kamat and Dr. Rahul Damania discuss an interesting case of a 16-year-old male with high-grade fever and abdominal pain. The patient also presents with a rash and other concerning symptoms, leading to urgent medical attention. They provide a summary of the key elements from the case, including vital signs, physical examination findings, and laboratory and imaging results.Dr. Kamat then shares his thought process regarding the working diagnosis for this patient, considering several possibilities such as severe bacterial infection, atypical appendicitis or cholecystitis, toxic shock syndrome, and systemic inflammatory processes like Multisystem Inflammatory Syndrome in Children (MIS-C) and atypical Kawasaki disease.Moving on to the topic of vasopressors, Dr. Damania explains the importance of understanding how these medications work and their specific pharmacological properties. They discuss the classification of shock as cold or warm and the limitations of relying solely on clinical signs to categorize septic shock in children.They highlight the challenges in selecting the appropriate vasopressor, such as a lack of standardization in clinical examination and individual variability in response to medications. They emphasize the need for a comprehensive approach when evaluating and managing pediatric shock patients, considering multiple factors beyond traditional bedside signs.The hosts then engage in a rapid review of pressors, starting with a multiple-choice question regarding the choice of vasoactive infusion for a patient with toxic shock syndrome. They discuss the pros and cons of using norepinephrine (NE) in distributive shock and highlight its vasoconstrictive effects, inotropic activity, and potential side effects.They proceed to compare NE with epinephrine, explaining the differences in their actions on adrenergic receptors and their effects on various circulations. They mention that epinephrine acts on all adrenergic receptors and has hemodynamic and metabolic effects, redirecting cardiac output and increasing myocardial oxygen demand.Lastly, the hosts touch on phenylephrine, a vasopressor that acts on the alpha-1 receptor and elevates systemic vascular resistance (SVR) and pulmonary vascular resistance (PVR). They stress the importance of securing central line access when administering vasopressors to avoid harm to peripheral and systemic tissues.In conclusion, this episode provides valuable insights into the diagnosis and management of a complex pediatric case involving high-grade fever, abdominal pain, and shock. The hosts also offer a rapid review of common vasopressors, highlighting their mechanisms of action, pros, and cons.

This podcast discuss an overview and approach to multisystem inflammatory syndrome in children associated with SARS-CoV-2 infection in COVID-19, also known as [MIS-C]. The podcast was created by Mia Voyatzis, a second-year medical student at the University of Alberta, with the guidance of Dr. Lillian Lim, an Assistant Professor in Pediatric Rheumatology at the Stollery Children's Hospital of the University of Alberta.

Esto va por mi y por todas mis ancestras que me permitieron llegar con todo sus aprendizajes a través de las experiencias que atravesaron a este nivel de consciencia, por ti y por todas las relaciones que vas a construir en amor a partir de lo que sanes dentro de ti, y por todo lo hermoso que es disfrutar de ser mujer, canal divino y sagrado del universo en la tierra. En este episodio te comparto los aprendizajes clave que tuve que obtener e integrar para poder vivir por fin mi menstruación en amor, cosa que me di cuenta tenia que ver con memorias de dolor inconscientes que se vivieron mucho más atrás que yo. Deseando pueda ser una guía y señalamiento en tu camino de dónde comenzar a buscar para sanarlo de raíz.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes Coronavirus Disease 2019 (COVID-19), Multisystem Inflammatory Syndrome in Children (MIS-C), Adults (MIS-A), Neonates (MIS-N), and some Vaccinees (MIS-V). These are all considered clinically distinct diseases; however, the MIS-X diseases have overlapping symptoms and treatments with Kawasaki Disease (KD). MIS-C, MIS-A, MIS-N, and KD occur with increased frequencies several weeks following increased numbers of COVID-19 and for KD other pathogens. The incidence rate for MIS-C, MIS-A, MIS-N, and KD are typically a factor of roughly 5,000 lower than COVID-19 and for KD other pathogens. In this podcast, Dr. Darrell Ricke advances the hypothesis that MIS-C, MIS-A, MIS-N, MIS-V, and KD all represent a novel type of antibody-dependent enhanced (ADE) diseases associated with hyperactivation of granulocytes or mast cells. Symptoms for these diseases overlap those of histamine intolerance (HIT) coupled with pathogen associated symptoms. This ADE model proposes that antibody titer levels higher than primary immune response levels can hyperactivate granulocytes or mast cells to release inflammatory molecules including histamine; MIS-X and KD disease symptoms onset when histamine levels exceed the individual's tolerance level. The proposed ADE model purports that patient treatment with intravenous immunoglobulin (IVIG) is successful in treating the MIS-X disease because IVIG compete with pathogen antibodies for binding to Fc receptors on immune cells, thereby reducing the immune responses to the pathogen or vaccine protein. This model is further supported with the vaccine spike protein activating immune cells via envisioned Fc receptor binding. This ADE model proposes additional antihistamine and diamine oxidase (DAO) adjunctive treatments combined with current standard of care treatments for investigation.

Confira os temas do check-up de hoje: a nova definição de MIS-C pelo CDC, comparação de terapia cognitiva versus medicamentosa para o tratamento de transtorno de ansiedade, dados brasileiros sobre seguimento a longo prazo pós covid, rastreamento e profilaxia de infecções crônicas e oportunistas em reumatologia e desafios da obesidade para a fertilidade.

AMA's Vice President of Science, Medicine and Public Health Andrea Garcia, JD, MPH, discusses recent release by CDC, FDA regarding possible link between Pfizer's bivalent booster and stroke risk for those 65 and older. Also covering the potential increased risk of measles, mumps and rubella (MMR) for kindergartners given a decrease in pediatric vaccinations this year, as well as new findings regarding multisystem inflammatory syndrome (MIS-C) in children. American Medical Association CXO Todd Unger hosts.

In this week's episode, Dr. Shanmugam welcomes Dr. Mary Beth Son, the senior author and corresponding author of “Treatment of Multisystem Inflammatory Syndrome in Children: Understanding Differences in Results of Comparative Effectiveness Studies.” This study sought to determine whether the application of different MIS-C definitions and differing disease severity in patients participating in two separate comparative cohorts underlay discrepant results. Dr. Jon Hausmann, pediatric rheumatologist and host of “ACR on Air”, joins Dr. Shanmugam and Dr. Son to add to the significant expertise on this episode, with his own in both clinical pediatric and adult rheumatology. Here, Dr. Hausmann shares further insights on integrating the published literature with pediatric treatment of MIS-C. 

本節新聞重點： 1. 雙十國慶／剩餘任期打造韌性國家 蔡英文批中試圖滅台主權 2. 雙十國慶／國民黨部升旗典禮 朱立倫：若中華民國不見就沒台灣 柯文哲：中華民國仍是最大公約數 國慶不應啟爭端 3. 本土增3萬2068例 添中重症133例、57人死亡 新增8歲女童MIS-C個案 4. 水深8至10米處 潛水客拍到綠鬣蜥下潛畫面 5. 委內瑞拉雨量創紀錄 土石流釀22死50失蹤 日本自由行開放！日本 10/11 起免簽證即可入境...等

Drs. Jimmy McCluskey and Alice Sato discuss multisystem inflammatory syndrome in children (MIS-C) https://febrilepodcast.com/episodes/ (Episodes) |https://febrilepodcast.com/consult-notes/ ( Consult Notes) |https://febrilepodcast.captivate.fm/listen ( Subscribe) |https://twitter.com/febrilepodcast ( Twitter) |https://febrile.bigcartel.com/ ( Merch) | febrilepodcast@gmail.com

In COVID-19 clinical update #123, Dr. Griffin discusses rapid diagnostic testing in response to the monkeypox outbreak, leading causes of death in the US during the COVID-19 pandemic, antibody evasion by subvariants, broadly-neutralizing antibodies against emerging variants, factors associated with severe outcomes among hospitalized immunocompromised adults, measurement of the burden of hospitalizations during the pandemic, parental vaccine hesitancy in diverse communities, evaluating saliva sampling to improve access to diagnosis in low-resource settings, oral sabizabulin for high-risk hospitalized adults, lower-risk of multisystem inflammatory syndrome in children, and neurovascular injury with complement activation and inflammation during infection. Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Become a patron of TWiV! Links for this episode Monkeypox outbreak rapid testing response (CDC) Leading causes of death during pandemic (JAMA) FDA recommends vaccine update (FDA) Antibody evasion by subvariants (Nature) Broadly-Neutralizing antibodies against variants (Frontiers in Immunology) Severe outcomes factors in immunocompromised adults (CDC) Measurement of the burden of hospitalizations (OFID) Vaccine hesitancy among parents (Academic Pediatrics)  PAXLOVID patient eligibility screening checklist (FDA) Remdesivir fact sheet for providers (Veklury)  Bebtelovimab fact sheet for providers (FDA) Saliva evaluation to improve diagnostics (ASTMH) Oral Sabizabulin for high-risk adults (NEJM) Lower risk of MIS-C in children (CID) Neurovascular injury during infection (Brain) Paul Offit on TWiV 917 Contribute to FIMRC fundraiser at PWB Dr. Griffin's treatment guide (pdf) Letters read on TWiV 918 Timestamps by Jolene. Thanks! Intro music is by Ronald Jenkees Send your questions for Dr. Griffin to daniel@microbe.tv

In vielen der eigentlich seltenen Fälle schwerer COVID-Verläufe bei Kindern hatten diese ein Multisystemisches Entzündungssyndrom (MIS-C) entwickelt. Eine Studie aus den Vereinigten Arabischen Emiraten bestätigt nun die These, dass dafür genetische Prädispositionen entscheidend seien. Web: https://www.epochtimes.de Probeabo der Epoch Times Wochenzeitung: https://bit.ly/EpochProbeabo Twitter: https://twitter.com/EpochTimesDE YouTube: https://www.youtube.com/channel/UC81ACRSbWNgmnVSK6M1p_Ug Telegram: https://t.me/epochtimesde Gettr: https://gettr.com/user/epochtimesde Facebook: https://www.facebook.com/EpochTimesWelt/ Unseren Podcast finden Sie unter anderem auch hier: iTunes: https://podcasts.apple.com/at/podcast/etdpodcast/id1496589910 Spotify: https://open.spotify.com/show/277zmVduHgYooQyFIxPH97 Unterstützen Sie unabhängigen Journalismus: Per Paypal: http://bit.ly/SpendenEpochTimesDeutsch Per Banküberweisung (Epoch Times Europe GmbH, IBAN: DE 2110 0700 2405 2550 5400, BIC/SWIFT: DEUTDEDBBER, Verwendungszweck: Spenden) Vielen Dank! (c) 2022 Epoch Times

日本加護病房醫學會有統計兒童疑似腦症跟MIS-C的數字 https://www.jsicm.org/news/news220530.html 這是問卷通報形式，所以可能有低估。 新型コロナウイルス関連小児重症・中等症例発生状況速報 https://www.jsicm.org/news/upload/220621JSICM_jscts.pdf 今年以來到6月20日之前，蒐集218例兒童中重症住院案例。 過去這個月僅新增10例。 急性腦症佔 5.1%，11例。 MIS-C佔7.8%，17例。 哮吼CROUP佔10.6%，23例。 肺炎佔18.9%，41例。 抽搐佔23.5%，51例。 新型コロナウイルス感染症第 6 波における、中枢神経系の異常発生状況速報骨子 https://www.jsicm.org/news/upload/220527JSICM_covid19cnss.pdf 日本也發現Omicron這一波相對於之前，兒童的抽搐，意識不清，疑似腦症增加。未就學兒童最多，小學生次之，也有中學生和高中生的案例。這些案例有四成會收在PICU，有4~5成住在兒科病房。需要插管者佔2~3成，還會使用低溫療法或是類固醇pulse療法。 傳統上熱痙攣(熱性けいれん)多半發生在幼兒，超過六歲小學生僅佔2%。但新冠的熱痙攣小學生佔了兩成以上，發病年齡不同。雖有數例疑似急性腦症，目前死亡和重度後遺症全國僅有個位數例。 MIS-C兒童增8例 7個月大男嬰成最小個案 https://www.cna.com.tw/news/ahel/202206300185.aspx 台大估將進入MIS-C高峰 兒童2劑疫苗可有效預防 https://www.cna.com.tw/news/ahel/202206290179.aspx 歡迎追蹤前台大感染科醫師。04b的發聲管道！ 我的電子名片 https://lit.link/linshibi 希望大家當我的種子教師，推廣正確的新冠衛教。科學防疫，不要只以恐懼防疫！ 歡迎贊助林氏璧孔醫師喝咖啡，讓我可以在這個紛亂的時代，繼續分享知識努力做正確新冠相關衛教。 https://pay.firstory.me/user/linshibi Powered by Firstory Hosting

衛福部23日在行政院會報告「COVID-19疫情現況及應處作為」。根據衛福部報告，截至昨天為止，本土病例近一週新增36萬6628例，較前一週的45萬1358例下降19%，其中北北基宜、桃竹竹苗及花東地區各下降22%，中彰投下降17%，雲嘉嘉南下降12%，高屏下降20%。衛福部指出，全國仍為廣泛社區流行，但已過高峰，疫情逐漸下降，中重症病例數也下降。 台灣何時開放邊境？陳建仁：7、8月可考慮 https://www.cna.com.tw/news/ahel/202206230132.aspx 陳建仁今天在專訪時表示，大部分國家在考慮邊境解封時都必須視疫情狀況，通常是疫情高峰過後一個月到一個半月開始各種解封工作。疫情在高峰時，醫療量能會被病人占據，這時如果開放邊境解封就會有外國旅客進來，可能導致另一個高峰、病人很難得到好的醫療照顧。 陳建仁認為，台灣疫情正在下降階段，台灣邊境可能在7、8月可以考慮開放，那時全民第3劑接種涵蓋率也可能到達7成5，但仍呼籲18歲以下民眾以及老人家都應迅速接種疫苗。 7、8月開放邊境有可能 莊人祥提2大鬆綁方向 https://www.cna.com.tw/news/ahel/202206230201.aspx 未來邊境鬆綁有2大方向，一是放寬每週入境人次總量；二是鬆綁邊境條件，從目前只開放持有居留證者、本國籍人士及商務客入境，進一步開放探親、觀光等類別。 歡迎追蹤前台大感染科醫師。04b的發聲管道！ 我的電子名片 https://lit.link/linshibi 希望大家當我的種子教師，推廣正確的新冠衛教。科學防疫，不要只以恐懼防疫！ 歡迎贊助林氏璧孔醫師喝咖啡，讓我可以在這個紛亂的時代，繼續分享知識努力做正確新冠相關衛教。 https://pay.firstory.me/user/linshibi Powered by Firstory Hosting

Today, in this episode, we'll discuss the new “2021 Guideline for the Management of Kawasaki Disease”, the mysterious triggers that cause KD, the use of therapies such as IVIG, steroids, infliximab, anakinra, and compare multisystem inflammatory disease in children, or MIS-C (a condition very similar to Kawasaki Disease that is triggered by SARS COV-2). Joining us today is Dr. Mark Gorelik, lead Author of the “2021 Guideline for the Management of Kawasaki Disease”. He's an assistant professor of pediatrics at the Columbia University Vagelos College of Physicians and Surgeons, is a pediatric rheumatologist, an allergist and immunologist. His research focuses on vasculitis, including Kawasaki disease, and on immune dysregulation.   

本集錄音於6月16日晚間。 以下則是6月19日狀況： 本土新增個案連續3天維持5萬多例，數據較前一天下降5.7%，各地均持續下降或緩降趨勢，中南部正在脫離高原期，本週每日個案降至4萬多例有望；今天增一名3歲男童病逝。 羅一鈞下午表示，新增5萬561例本土個案，確診個案新增中重症285例（中症145例、重症140例），其中172例死亡。新增172例死亡個案，年齡介於3歲至90歲以上，皆屬重度感染個案，166例具慢性病史，100例未打滿3劑疫苗，68例從未接種疫苗，97人年齡超過80歲。 羅一鈞說，新增一名3歲男童死亡個案，本身有慢性腦部神經系統疾病，6月7日發燒至攝氏40度，至診所快篩陽性確診，6月11日出現咳嗽、嘔吐、活動力降低，家屬送至急診，發現呼吸喘及呼吸雜音，診斷為哮吼合併呼吸窘迫，入住兒科加護病房。醫療團隊給予氧氣、類固醇、瑞德西韋及免疫球蛋白等藥物，診治過程中，新診斷出糖尿病酮酸中毒，屬於糖尿病重症，因此給予胰島素治療，但14日仍不幸因敗血症休克、急性心肺衰竭，急救無效死亡，死因為哮吼合併心肺衰竭、糖尿病酮酸中毒。 國內12歲以下兒童重症累計62例，21例是腦炎、12名肺炎、3名敗血症、7例哮吼、12例MIS-C，2例共病（腦腫瘤、癲癇重積）及5例家中死亡，經法醫認定與COVID-19有關；上述個案已有18人死亡，5名合併腦炎、4人肺炎、2例敗血症、1例共病（腦腫瘤）、1例哮吼及5例家中死亡。 另外，今天的重症個案中，新增一名17歲青少年個案。羅一鈞說明，個案有慢性腦神經系統疾病，長期臥床，沒有接種過任何一劑疫苗，6月9日發燒、咳嗽、呼吸急促，及短暫抽搐，送至急診，檢驗陽性確診，醫師開立藥物返家服用，個案返家發生四肢間歇性發紫，13日再度赴急診。發現血氧濃度下降，X光顯示肺炎，因呼吸窘迫插管入住加護病房使用呼吸器，接受瑞德西韋、類固醇等藥物治療，目前仍在加護病房治療。 國內青少年重症累計8例（其中3人死亡），分別為肺炎5例，都有慢性病史、心肌炎、MIS-C及共病各1例。 今年1月至6月18日，本土輕症、無症狀個案累計320萬3423例、占99.61%，中症累計7507例、占0.23%，重症累計5118例、占0.16%。 3歲確診男童哮吼病逝 中南部疫情脫離高原期 https://www.cna.com.tw/news/ahel/202206190109.aspx 中央社疫情總覽 https://www.cna.com.tw/topic/newstopic/3829.aspx 疫情高原期緩解在望 陳其邁籲儘速評估幼兒疫苗 https://www.cna.com.tw/news/aloc/202206160255.aspx 血清抗體調查再度啟動 追Omicron社區隱形傳播鏈 https://www.cna.com.tw/news/ahel/202206160184.aspx 歡迎追蹤前台大感染科醫師。04b的發聲管道！ 我的電子名片 https://lit.link/linshibi 希望大家當我的種子教師，推廣正確的新冠衛教。科學防疫，不要只以恐懼防疫！ 歡迎贊助林氏璧孔醫師喝咖啡，讓我可以在這個紛亂的時代，繼續分享知識努力做正確新冠相關衛教。 https://pay.firstory.me/user/linshibi Powered by Firstory Hosting

There's been a bunch of good news this week about kids and COVID, including kids under 5 moving a touch closer to become eligible for vaccinationA Scandanavian study has shown that before babies are born, they get an immune benefit from their vaccinated mother. Another study has looked at a rare condition that can happen in kids after COVID, called MIS-C, and found vaccinated kids are way more protected from it And also both Pfizer and Moderna have moved slightly closer to being registered for kids under 5 in the USA.Also on today's show:* Are there rapid tests available to test for influenza?* I've noticed that cases seem to be falling. Is it just that it's being under reported? I haven't heard any mention of it in the media but it's the opposite of what I expected as we head into winter.AND WE'LL BE TAKING A BREAK FOR THE NEXT MONTH BECAUSE NORMAN IS ON HOLIDAYS. SO KEEP AN EYE ON THE FEED AND WE'LL BE BACK SOON.

There's been a bunch of good news this week about kids and COVID, including kids under 5 moving a touch closer to become eligible for vaccination A Scandanavian study has shown that before babies are born, they get an immune benefit from their vaccinated mother. Another study has looked at a rare condition that can happen in kids after COVID, called MIS-C, and found vaccinated kids are way more protected from it And also both Pfizer and Moderna have moved slightly closer to being registered for kids under 5 in the USA. Also on today's show: * Are there rapid tests available to test for influenza? * I've noticed that cases seem to be falling. Is it just that it's being under reported? I haven't heard any mention of it in the media but it's the opposite of what I expected as we head into winter. AND WE'LL BE TAKING A BREAK FOR THE NEXT MONTH BECAUSE NORMAN IS ON HOLIDAYS. SO KEEP AN EYE ON THE FEED AND WE'LL BE BACK SOON.

There's been a bunch of good news this week about kids and COVID, including kids under 5 moving a touch closer to become eligible for vaccination A Scandanavian study has shown that before babies are born, they get an immune benefit from their vaccinated mother. Another study has looked at a rare condition that can happen in kids after COVID, called MIS-C, and found vaccinated kids are way more protected from it And also both Pfizer and Moderna have moved slightly closer to being registered for kids under 5 in the USA. Also on today's show: * Are there rapid tests available to test for influenza? * I've noticed that cases seem to be falling. Is it just that it's being under reported? I haven't heard any mention of it in the media but it's the opposite of what I expected as we head into winter. AND WE'LL BE TAKING A BREAK FOR THE NEXT MONTH BECAUSE NORMAN IS ON HOLIDAYS. SO KEEP AN EYE ON THE FEED AND WE'LL BE BACK SOON.

1.台大醫院診治一名10歲男童，雖在4月底確診新冠輕症，2天就康復，但1個月後卻出現高燒、腹瀉、淋巴結腫大、血壓不穩、休克等症狀，被診斷為「多發性系統發炎症候群」（MIS-C），緊急送進加護病房，引起外界關切。中央流行疫情指揮中心今天在記者會中，邀請馬偕兒童醫院兒童感染科主治醫師黃瑽寧出席談「多發性系統發炎症候群」，及父母照顧確診孩童時應注意事項。 2.黃瑽寧說，「多發性系統發炎症候群」是感染COVID-19後的一種免疫反應，與確診輕症或中重症無關，國外研究致死率約1%到2%，這是因為病毒雖已清除，卻罕見出現高度炎性反應及多器官系統損傷，發生年齡介於0到19歲，以6到12歲最多，大人也有可能，但比例很低。 3.MIS-C通常是染疫康復後2至6週發生，目前國外研究亞洲人感染較少，在感染Omicron變異株康復後的發生率，比感染Delta變異株更低，可下降至1/4；不過，若有接種1劑COVID-19疫苗，「多發性系統發炎症候群」發生率可減少97%。 4.台灣青少年及兒童接種新冠疫苗比例比國外高，粗估染疫康復之後引起「多發性系統發炎症候群」的發生率約萬分之1，家長不必過度擔心，但仍應認識「多發性系統發炎症候群」的各種症狀。 5.MIS-C會出現發燒3天以上，且發炎指數上升，並具有2項以上臨床症狀，包括：出疹、低血壓或休克、心肌功能受損、凝血功能異常、急性腸胃道症狀（腹瀉、嘔吐或腹痛）。 6.黃瑽寧也談到兒童確診後，約有2/3的人會發燒，平均發燒到攝氏39度，平均發燒時間在1.7天上下，很多家長會慌張並焦慮，建議應給孩子用退燒藥，補充水分避免脫水，並在退燒後觀察孩子活動力，若孩子精神回來了，會討抱、討東西吃就代表沒有問題，若使用退燒藥後仍不退燒，當燒到41度時就是警訊，代表腦炎的前症，應送醫治療。 MIS-C兒童多系統發炎症候群 黃瑽寧粗估發生率萬分之1 https://www.cna.com.tw/news/ahel/202206060211.aspx 事實查核中心幫大家做了黃巧虎醫師今天在記者會上上課的筆記！ 記者會傳送門 https://youtu.be/KJKEB9YPWEw?t=1516 針對兒童染疫，家長有各種擔心和疑問，查小喵整理出黃瑽寧醫師的說明：

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【10分鐘快速瀏覽台灣各報重點】《新聞懶人包》天氣+美股+最新國內外焦點新聞。 清晨6點全台最早讀報~~主持人張慶玲 youtube直播影片： https://youtu.be/z0feqjMvGsI 【中廣新聞主播張慶玲】FB:https://www.fb.com/BCCNEWS0511

Toxic Shock Syndrome can be hard to recognize and differentiate from clinical entities such as Kawasaki, MIS-C, and DRESS. This brief podcast episode will raise awareness of situations in which TSS can occur and drive home important management pearls – like why you need to add Clindamycin. PEMBlog.com Follow @PEMTweets on Twitter Check out the […]

兒童新冠疫苗施打在即，整理一些資訊，希望能幫大家做決定。 6-11歲孩子要不要打疫苗？我個人是滿贊成黃瑽寧醫師所說的這三種狀況，稍稍補充如下： 1.若孩子沒打疫苗，怕接下來有染疫的風險，知道多半是輕症但也會擔心新冠後遺症，爸媽會擔心睡不著覺的話，那就去打。 2.若孩子打了疫苗，爸媽反而睡不著覺，擔心施打後不舒服，擔心疫苗未知的長期副作用，那就別打。 3.如果夫妻為此吵架意見不合，騎牆派的作法，就是先打一劑。因為mRNA疫苗第二劑不良反應，心肌炎的機率遠高於第一劑。打一劑已經有一定效果，之後就看12週後的狀況再做打算！ 老話一句，兒童疫苗施打率不是這次重症求清零的決戰點，年長者覆蓋率才是重中之重。兒童疫苗打也好不打也好，做出決定，就往前走吧。我們還有太多沒有磨合好的防疫政策需要繼續關注和努力。加油！ 臺灣兒科醫學會聲明稿 支持6-11歲兒童接種新冠肺炎疫苗 https://www.pediatr.org.tw/people/edu_info.asp?id=56 兒童COVID-19疫苗接種常見問答 https://www.cdc.gov.tw/Category/QAPage/GP9ID_QaDJzhta4tniP70g 何美鄉老師臉書發文 https://www.facebook.com/michelle.ho.58555/posts/10166152081660103 健康小孩感染covid後，住院與死亡的風險都不高，但風險不是零，利弊依父母／兒童自己的價值觀衡量。但兒童若有慢性病則強烈建議接種。 美國5-11歲兒童在OMICRON期間住院者，七成有以下慢性病。 https://www.facebook.com/michelle.ho.58555/posts/10166121620480103 包括：慢性病慢性肺病（11.4％）、慢性代謝疾病（3.9％）、血液疾病/血紅蛋白病（9.9％）、心血管疾病（14.9％）、神經系統疾病（33.4％）、免疫功能抑制疾病（13.8％）、腎臟疾病（3.2％）、胃腸道/肝臟疾病（2.1％）、風濕病/自身免疫/炎症性疾病（4.2％）、肥胖（21.3％）、胃管餵食者（9％）和輪椅使用者。 青少年只打一劑疫苗夠不夠？12歲以下兒童需不需接種新冠疫苗？｜黃瑽寧醫師健康講堂 https://youtu.be/TcCps58WgxM 黃瑽寧醫師｜終局之戰：軟著陸與新冠病毒共存，兒童疫苗打不打 https://www.parenting.com.tw/article/5092606 莫德納疫苗劑量較高，或許保護效果會更好，但副作用也會比較大。每次朋友問我6-11歲孩子要不要打疫苗？我的回答都一樣：若孩子沒打疫苗，爸媽會擔心睡不著覺的話，那就去打；反之若孩子打了疫苗，爸媽反而睡不著覺，那就別打。如果夫妻為此吵架，騎牆派的作法，就是先打一劑。根據青少年疫苗的經驗，接種一劑疫苗，就能預防多數小兒多系統發炎症候群（MIS-C）的發生，也已經夠好了。　 之前討論的集數 兒童莫德納兩劑隔12週 青少年第三劑 莫德納輝瑞副作用比一比 https://linshibi.pros.is/45bp8b 兒童小小孩還沒疫苗打 老人不能打疫苗 怎麼辦？ https://linshibi.pros.is/44qcre 兒童打莫德納或BNT？食藥署核准莫德納新冠疫苗用於6至11歲 https://linshibi.pros.is/44e2pg 兒童感染Omicron致死率是萬分之一嗎？學生停課政策及疫苗施打 https://linshibi.pros.is/45ggby 歡迎追蹤前台大感染科醫師。04b的發聲管道！ 我的電子名片 https://lit.link/linshibi 希望大家當我的種子教師，推廣正確的新冠衛教。科學防疫，不要只以恐懼防疫！ 歡迎贊助林氏璧孔醫師喝咖啡，讓我可以在這個紛亂的時代，繼續分享知識努力做正確新冠相關衛教。 https://pay.firstory.me/user/linshibi Powered by Firstory Hosting

這大概是台灣防疫政策改變為減災，準備走向共存後，我最常看到的一句話。 兒童小小孩還沒疫苗打，老人不能打疫苗，這些人要怎麼辦？太危險了！ 為何不買兒童疫苗？ 六歲以下根本沒疫苗可打。怎麼辦？ 是醫生說我們家的老人家不適合或不能打疫苗的。我們該怎麼辦？ 我的回答： 1.我很同意黃瑽寧醫師說的：12歲以下兒童，並不是新冠病毒重症及死亡的高危險群，重症死亡率極低，希望爸媽們不要過度擔心。多愛自己一些，好好照顧身心健康，快帶長輩去打疫苗才是根本之道。 請看黃瑽寧醫師的影片 兒童打不了疫苗，爸媽好擔心！兒童確診Omicron機率大不大？會不會有後遺症？ https://youtu.be/oTQ31X1r-y4 2.之前醫師回答你不適合打新冠疫苗，可能是考量你的慢性病加上當時台灣沒什麼疫情下的回答。現在開始在台灣應該也會有一定的機會接觸到病毒了，我建議您再和醫師確認一下，是否真的不適合打疫苗喔。相反來說，越有多重慢性病的人，也正是新冠染疫後高重症風險的人，打疫苗能獲得的好處更大才是。且疫苗現在種類多了，AZ，莫德納，高端，不久的未來應該還有Novavax，絕對無法施打疫苗的禁忌症，應該幾乎是沒有的。請再和醫師諮詢。 太多家長最近在恐慌兒童沒疫苗打，就算感染是輕症他也怕有腦霧或是後遺症的問題。我們用科學數據來看吧。 日本資料，後遺症和兒童多系統發炎症候群MIS-C比例甚低 https://linshibi.pros.is/42nzjl 更新日本小兒科長新冠（long COVID）資料 https://www.coreregistry.jp/CoreRegistry_COVID19_CRF_Dashboard/Home/DashBoardviewer 上次整理是19歲以下976人在確診一個月以上還持續有症狀僅有26人，2.7%。只看5~11歲兒童更低，每種症狀都僅有1~2人。這次應該多了更多Omicron案例。19歲以下1645人在確診一個月以上還持續有症狀有58人，3.5%。只看5~11歲兒童608人中更低，每種症狀都僅有2~3人。整體來說，日本兒童長新冠的比例並不高。 日本兒童疫情這兩年以來84萬確診，就四例死亡。真的別自己嚇自己。 至於香港那個兒童比較嚴重的報告，我在有話好說有解釋過。 https://youtu.be/aLi9Xw1yaXU?t=2829 擬採購5至11歲兒童疫苗 陳時中：談判已到最後階段 https://www.cna.com.tw/news/ahel/202204130110.aspx 歡迎追蹤前台大感染科醫師。04b的發聲管道！ 我的電子名片 https://lit.link/linshibi 希望大家當我的種子教師，推廣正確的新冠衛教。科學防疫，不要只以恐懼防疫！ 歡迎贊助林氏璧孔醫師喝咖啡，讓我可以在這個紛亂的時代，繼續分享知識努力做正確新冠相關衛教。 https://pay.firstory.me/user/linshibi Powered by Firstory Hosting

Tyler Harris, MD, a pediatric cardiologist at UPMC Children's Hospital of Pittsburgh, discusses MIS-C and specifically myocarditis (inflammation of the heart) that can occur in children who have been diagnosed with COVID-19 or have received the vaccine.

Experts discuss what they have experienced on the COVID-19 front line, including risk for serious illness, long-term effects and multisystem inflammatory syndrome in children (MIS-C).

Like Zoom birthdays and designer masks, multi-system inflammatory syndrome in children (MIS-C) is a unique product of the COVID-19 pandemic. Appearing about 4 weeks after COVID-19 infection has cleared, it likely represents a disordered immune response that can cause appendicitis-like GI symptoms, Kawasaki-like skin findings, and most alarmingly, cardiac dysfunction and pump failure. Recognizing MIS-C's presentation and having a diagnostic approach in mind will be increasingly important for pediatricians as we enter Omicron's afterglow. Today's episode will aim to cover that territory through a case-based presentation in addition to other typical disease processes on the differential.

Podcast summary of articles from the January 2022 edition of the Journal of Emergency Medicine from the American Academy of Emergency Medicine.  Topics include IVC ultrasound in trauma, opioids, landscaping injuries, EMS protocols, trichomonas, and MIS-C.  Guest speaker is Dr. Kathryn Oehlman.

這集來談談日本關於兒童新冠疫苗施打的資訊整理吧。日本已經批准讓5~11歲兒童施打BNT新冠疫苗。成人三分之一的劑量。 根據日本小兒感染症學會理事長，長崎大學小兒感染科森内浩幸教授的整理，有以下發現： 1.Omicron時代，明顯從幼稚園，保育園得的比例增高，不再多半是爸爸帶回來的。 2.日本小兒科也有長新冠（long COVID）研究了，19歲以下976人在確診一個月以上還持續有症狀僅有26人，2.7%。只看5~11歲兒童更低，每種症狀都僅有1~2人。兒童長新冠的比例並不高。 3.到1月16⽇前，日本集中治療學會僅確診11例兒童多系統發炎症候群MIS-C，無人死亡。當時日本10歲以下兒童確診約11萬人。發生率是萬分之一。 4.到2月22日前的資料，日本10歲以下兒童47萬人確診，43539人有住院，5人重症，0人死亡。 5.歐美2021年6月JAMA一篇跨洲際的研究指出，小於21歲MIS-C的發生率約為每百萬人中有316例。 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2780861 發生率大概是萬分之3，且一旦發生約有1.4%的致死率。 6.美國CDC到2021年11月初在5~11歲兒童確診有190萬人，其中造成至少8300起住院，94人死亡。致死率0.0049%。十萬分之5。美國到11月底總共通報5973例MIS-C，其中52⼈死亡。美國是因為這樣的數字，還有兒童也觀察到一定比例的長新冠，才決定給兒童施打疫苗的。 04b解讀： 台灣此刻是否真的值得幫兒童施打新冠疫苗？我覺得，難怪阿中部長說，專家在激辯中。這議題真的不好決定。台灣的兒童廣泛施打新冠疫苗，在Omicron的時代已經不太能防感染或是傳給他人，兒童本身本來就重症風險極低，然後亞洲兒童的慢性後遺症long COVID和兒童多系統發炎症候群MIS-C比例甚低的話，真的很難說一定是利大於弊。 且要打兒童的話應該要去買橘瓶的兒童劑型BNT。不是簡單的用大人劑型抽三分之一即可。雖然香港現在是這樣做啦，理論上抗原一樣應該效果會一樣，只是藥廠不會很高興。科科。 我個人沒有太多意見。一定要我說的話，個人認為新冠疫苗目前的重點是防重症，就該打在重症風險最高的人群即可。如果讓兒童大幅施打，比較像是在治療家長的焦慮吧。而如果家中有年長者同住，年長者不願意打不敢打而讓兒童打，個人覺得有些荒謬。 總之，就留給國內的兒科疫苗專家們繼續激辯吧。這題我真的沒很好的答案。 日本兒科學會對於兒童施打疫苗的檢討 by 長崎大學小兒感染科 森内浩幸 https://www.mhlw.go.jp/content/10601000/000895855.pdf 日本小兒感染症學會理事長森内浩幸介紹 https://www.jspid.jp/greeting/ 新冠病毒在兒童族群的特有表現~兒童多系統發炎症候群 https://www.cgmh.org.tw/cgmn/category.asp?id_seq=2110014#.YhLF6t9By3A 英國也批准兒童施打 https://www.gov.uk/government/news/jcvi-updates-advice-on-vaccinations-for-5-to-11-age-group　 英國對兒童施打新冠疫苗的態度：不緊急，主要目地可能是為了防止未來流行波的重症。不要影響到原本子宮頸癌疫苗還有MMR等疫苗的注射。（英國在兒童年齡層也已經絕大多數都得過有抗體了。好啦你想打就來打吧） Omicron變種病毒懶人包 傳染力 重症 疫苗有效性 要打加強針嗎？ https://linshibi.com/?p=39815 歡迎追蹤前台大感染科醫師。04b的發聲管道！ 我的電子名片 https://lit.link/linshibi 希望大家當我的種子教師，推廣正確的新冠衛教。科學防疫，不要只以恐懼防疫！ 歡迎贊助林氏璧孔醫師喝咖啡，讓我可以在這個紛亂的時代，繼續分享知識努力做正確新冠相關衛教。 https://pay.firstory.me/user/linshibi Powered by Firstory Hosting

The COVID 19 pandemic has brought with it the presence of a severe illness in children called Multisystem Inflammatory Syndrome in Children (MIS-C).  Pediatric specialists and scientists around the world have been researching and working to find out what this syndrome is and how to diagnose and treat it.  Dr. Nisha Agasthya is a pediatric intensivist at Wesley Children's Hospital who has spent the past two years studying and treating this condition in pediatric patients.   She joins Wesley Kidscast to provide a refresher on just what MIS-C is including diagnostic criteria and updates on how to manage patient's with this condition.  Below is the link to the MIS-C webinar that was mentioned in this podcast episode.  Please note that this recording occurred in Sept 2021 so while a majority of recommendations remain the same, please refer to this podcast recording for current guidelines as well as the updated guidance from the American College of Rheumatology linked below.   https://hcaconnect.webex.com/recordingservice/sites/hcaconnect/recording/6d260895ee3610398ef30050568fc16a/playback   American College of Rheumatology Clinical Guidance https://www.rheumatology.org/Portals/0/Files/ACR-COVID-19-Clinical-Guidance-Summary-MIS-C-Hyperinflammation.pdf  

這集詳細講了FDA專家小組討論八個小時，全票通過一票棄權，給予在兒童打BNT疫苗的緊急使用授權。我整理幾個重點： 1.輝瑞5歲至11歲兒童的臨床試驗，之前和大家分享過是個免疫橋接試驗，中和抗體在10微克的劑量之下和20多歲對照組相比產生的抗體量相當。 但這次也有公布有效性，注射疫苗者1518人，安慰劑750人中，前者僅有3人有症狀感染，後者有16人。算出來是90.7%的保護力。且前者都沒有發燒，後者有高達10人發燒。 不良反應的話，注射完第一劑發燒是2.5％，第二劑是6.5%。這個比例是比成年人低的。倦怠感則分別是33.6％和39.4％。 2.自疫情以來，美國有190萬兒童確診，8300人住院，其中三分之一需要住加護病房。今年大約有100例兒童死亡。另外還有5000多例多系統發炎症候群（MIS- C），這是一種罕見但非常嚴重的血管炎併發症，死亡率大概1~2%。新冠和流感在兒童住院患者的致死率大概都是千分之六，但需要加護病房的比例稍高。此外還有超過2000起學校停課，影響學生超過100萬人。另外還要考慮兒童也會有long COVID慢性後遺症，英國研究的比例大概是7~8%。 3.這確診數可能只是冰山一角。根據血清盛行率研究，今年5~6月美國兒童有抗體者已經高達42%。經過夏天Delta的疫情後，這個數字只可能更高。（但也有專家質疑，既然可能多半兒童都已得過，為何還需要在兒童廣泛打疫苗呢？） 4.一般的心肌炎發生的機率和疫苗引起的心肌炎一樣，都是十幾歲接近20歲的男性最多。根據這個流行病學看來，可以合理推測5~11歲心肌炎的機率應該不會比青少年高。且因為疫苗心肌炎住院的嚴重度，遠沒有因為新冠住院的嚴重度高。 5.FDA做了幾個模型來分析兒童施打疫苗的利弊。假設5歲至11歲的心肌炎機率與12歲到15歲相似，在假設不同盛行率的狀況下，疫苗可以預防掉的住院人數，多半還是超過因心肌炎住院的人數。因此還是那四個字，利大於弊。 6.許多專家擔心如果過了兒童EUA，會不會變成強制接種？不過FDA僅是審查這個疫苗在此年齡層施打是否安全且有效，是否給予EUA。至於是否強制，如何執行，那不是FDA要討論的事情。因此，最後還是全票通過。 04b解讀： 1.有一件事我有點擔心。兒童接種的是10微克，這是12歲以上民眾計量的三分之一。輝瑞因此這次推出了全新的橘頭包裝避免弄錯，另外這次還改了緩衝液，較穩定可在2～8度存放十週 ，克服了原本冷鏈保存的問題。這是好事，但這是否意味，兒童劑型可能要另外購買，不會算在目前民間購買的1500萬劑之中？ 輝瑞該不會賣更貴想再賺一波吧@@ 2.當然台灣是否要在現階段就給兒童接種，我個人是覺得完全不急的。就如同之前我也不是很贊成現階段就給青少年接種一樣。我們大可看國外兒童大量施打後的狀況，心肌炎是否嚴重，然後如同FDA一樣用台灣自己的數字來算利弊得失，從而決定是不是該給兒童接種新冠疫苗。比方說日本的資料，目前在19歲以下共確診26萬人，僅有2例死亡。嚴重度上似乎也有人種上的差異。 3.我們需要用科學的方式，來評估是否該在哪個族群施打疫苗。在75歲以上還有近三成的人連第一劑都還沒打的時候，討論打兒童，我個人覺得有點不切實際啦。 美國FDA專家委員會全票贊成BNT疫苗在5~11歲兒童施打 https://www.statnews.com/2021/10/26/fda-vrbpac-pfizer-vaccine-covid-kids/ 會議的live報導 https://www.statnews.com/2021/10/26/pfizer-covid19-vaccine-kids-vrbpac-fda/ 會議影片 https://youtu.be/laaL0_xKmmA 輝瑞/BNT疫苗臨床試驗 對5至11歲孩童防護力達9成 https://www.cna.com.tw/news/aopl/202110230019.aspx FDA：5-11歲兒童接種輝瑞/BNT疫苗 好處勝過風險 https://www.cna.com.tw/news/aopl/202110230109.aspx 美專家小組壓倒性通過 建議5至11歲童打輝瑞BNT疫苗 https://www.cna.com.tw/news/firstnews/202110270010.aspx 小額贊助支持本節目： https://pay.firstory.me/user/linshibi Powered by Firstory Hosting

With 180,000 reported COVID cases in kids last week alone, and school just getting started, Andy has a vital conversation with pediatric infectious disease specialist Dr. David Kimberlin about how the Delta variant has changed everything we thought we knew about children and COVID. They cover what David's seeing on the ground in his hospital in Birmingham, the latest on vaccines for kids under 12, and how to think about the incredibly complicated issue of in-person school. Plus, what parents can do to get school districts to re-think opposition to mask requirements.   Keep up with Andy on Twitter @ASlavitt and Instagram @andyslavitt.    Joining Lemonada Premium is a great way to support our show and get bonus content. Subscribe today at bit.ly/lemonadapremium.    Support the show by checking out our sponsors!   Click this link for a list of current sponsors and discount codes for this show and all Lemonada shows: https://lemonadamedia.com/sponsors/  Throughout the pandemic, CVS Health has been there, bringing quality, affordable health care closer to home—so it's never out of reach for anyone. 

Learn more at cvshealth.com.   Check out these resources from today's episode:    Read David's opinion piece in The Atlanta Journal-Constitution about the Delta varint and kids: https://www.ajc.com/opinion/opinion-delta-covid-variant-scares-this-pediatrician/G5T6QAKPCBBMVADBS4SKEVHHJ4/ The American Academy of Pediatrics tracks COVID cases in kids here: https://www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/children-and-covid-19-state-level-data-report/ Learn more about what the CDC has to say about MIS-C associated with COVID-19 in children: https://www.cdc.gov/mis/mis-c.html Check out the study in Science that David mentioned about household COVID-19 risk and in-person schooling: https://science.sciencemag.org/content/372/6546/1092 Listen to NIH Director Dr. Francis Collins discuss the timeline for a vaccine for kids under 12 on NPR: https://www.npr.org/sections/back-to-school-live-updates/2021/08/24/1030611406/a-vaccine-for-young-children-is-not-likely-until-the-end-of-year-nih-director-sa Find a COVID-19 vaccine site near you: https://www.vaccines.gov/  Order Andy's book, Preventable: The Inside Story of How Leadership Failures, Politics, and Selfishness Doomed the U.S. Coronavirus Response: https://us.macmillan.com/books/9781250770165    Stay up to date with us on Twitter, Facebook, and Instagram at @LemonadaMedia.    For additional resources, information, and a transcript of the episode, visit lemonadamedia.com/show/inthebubble. See omnystudio.com/listener for privacy information.