Background We aimed to systematically review the clinical and laboratory features of patients with the multisystem inflam-matory syndrome in pediatrics diagnosed during the COVID-19 pandemic.Data sources A literature ...Background We aimed to systematically review the clinical and laboratory features of patients with the multisystem inflam-matory syndrome in pediatrics diagnosed during the COVID-19 pandemic.Data sources A literature search in Web of Science,PubMed,Scopus,and Science Direct was made up to June 29,2020.Results Analysis of 15 articles(318 COVID-19 patients)revealed that although many patients presented with the typical multisystem inflammatory syndrome in pediatrics,Kawasaki-like features as fever(82.4%),polymorphous maculopapular exanthema(63.7%),oral mucosal changes(58.1%),conjunctival injections(56.0%),edematous extremities(40.7%),and cervical lymphadenopathy(28.5%),atypical gastrointestinal(79.4%)and neurocognitive symptoms(31.8%)were also com-mon.They had elevated serum lactic acid dehydrogenase,D-dimer,C-reactive protein,procalcitonin,interleukin-6,troponin I levels,and lymphopenia.Nearly 77.0%developed hypotension,and 68.1%went into shock,while 41.1%had acute kidney injury.Intensive care was needed in 73.7%of cases;13.2%were intubated,and 37.9%required mechanical ventilation.Intravenous immunoglobulins and steroids were given in 87.7%and 56.9%of the patients,respectively,and anticoagulants were utilized in 67.0%.Pediatric patients were discharged after a hospital stay of 6.77 days on average(95%CI 4.93-8.6).Conclusions Recognizing the typical and atypical presentation of the multisystem inflammatory syndrome in pediatric COVID-19 patients has important implications in identifying children at risk.Monitoring cardiac and renal decompensation and early interventions in patients with multisystem inflammatory syndrome is critical to prevent further morbidity.展开更多
The rainfed region in Iraq comprises an area of more than 5 million ha of forest,grazing and farmland areas.Except the plains,the region suffers from moderate to severe water erosion due mainly to overgrazing and land...The rainfed region in Iraq comprises an area of more than 5 million ha of forest,grazing and farmland areas.Except the plains,the region suffers from moderate to severe water erosion due mainly to overgrazing and land mismanagement.Due to population growth and the shortage in water resources,an expansion in land used for agriculture in the region is expected.Terracing is an option when utilizing sloping land for agricultural production.A terrace design criterion was developed for the region in which terrace spacing was determined using the Revised Universal Soil Loss Equation(RUSLE);terrace channel specifications were determined using conventional hydraulic computations.Analyses showed that terracing is feasible on rolling and hilly sloping land in the high rainfall zone(seasonal rainfall 4600 mm)where economic crops are grown to offset the high cost of terrace construction and maintenance.In the medium and low rainfall zones(seasonal rainfall 400–600 mm and 300–400 mm),terracing for water erosion control is generally not needed on cultivated land less than 10%in slope where wheat and barley crops are normally grown;however,pioneer research projects are needed to assess the feasibility of terraces of the level(detention)type to conserve rain water in these two zones for a more successful rainfed farming venture.展开更多
文摘Background We aimed to systematically review the clinical and laboratory features of patients with the multisystem inflam-matory syndrome in pediatrics diagnosed during the COVID-19 pandemic.Data sources A literature search in Web of Science,PubMed,Scopus,and Science Direct was made up to June 29,2020.Results Analysis of 15 articles(318 COVID-19 patients)revealed that although many patients presented with the typical multisystem inflammatory syndrome in pediatrics,Kawasaki-like features as fever(82.4%),polymorphous maculopapular exanthema(63.7%),oral mucosal changes(58.1%),conjunctival injections(56.0%),edematous extremities(40.7%),and cervical lymphadenopathy(28.5%),atypical gastrointestinal(79.4%)and neurocognitive symptoms(31.8%)were also com-mon.They had elevated serum lactic acid dehydrogenase,D-dimer,C-reactive protein,procalcitonin,interleukin-6,troponin I levels,and lymphopenia.Nearly 77.0%developed hypotension,and 68.1%went into shock,while 41.1%had acute kidney injury.Intensive care was needed in 73.7%of cases;13.2%were intubated,and 37.9%required mechanical ventilation.Intravenous immunoglobulins and steroids were given in 87.7%and 56.9%of the patients,respectively,and anticoagulants were utilized in 67.0%.Pediatric patients were discharged after a hospital stay of 6.77 days on average(95%CI 4.93-8.6).Conclusions Recognizing the typical and atypical presentation of the multisystem inflammatory syndrome in pediatric COVID-19 patients has important implications in identifying children at risk.Monitoring cardiac and renal decompensation and early interventions in patients with multisystem inflammatory syndrome is critical to prevent further morbidity.
文摘The rainfed region in Iraq comprises an area of more than 5 million ha of forest,grazing and farmland areas.Except the plains,the region suffers from moderate to severe water erosion due mainly to overgrazing and land mismanagement.Due to population growth and the shortage in water resources,an expansion in land used for agriculture in the region is expected.Terracing is an option when utilizing sloping land for agricultural production.A terrace design criterion was developed for the region in which terrace spacing was determined using the Revised Universal Soil Loss Equation(RUSLE);terrace channel specifications were determined using conventional hydraulic computations.Analyses showed that terracing is feasible on rolling and hilly sloping land in the high rainfall zone(seasonal rainfall 4600 mm)where economic crops are grown to offset the high cost of terrace construction and maintenance.In the medium and low rainfall zones(seasonal rainfall 400–600 mm and 300–400 mm),terracing for water erosion control is generally not needed on cultivated land less than 10%in slope where wheat and barley crops are normally grown;however,pioneer research projects are needed to assess the feasibility of terraces of the level(detention)type to conserve rain water in these two zones for a more successful rainfed farming venture.
