Infections and immunodeficiency in Down syndrome

Ram, G. S.; Chinen, Javier

doi:10.1111/j.1365-2249.2011.04335.x

Cited by 358 publications

(316 citation statements)

References 80 publications

(90 reference statements)

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“…However, it could also be argued that some deaths among adults with ID are ultimately less avoidable owing to the conditions associated with ID. For example, immune defects common in adults with Down syndrome may make such adults more prone to infection 87 and, subsequently, less amenable to treatment.…”

Section: Introductionmentioning

confidence: 99%

An evaluation of the effectiveness of annual health checks and quality of health care for adults with intellectual disability: an observational study using a primary care database

Carey

Hosking

Harris

et al. 2017

Health Serv Deliv Res

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Background People with intellectual disability (ID) have poorer health than the general population; however, there is a lack of comprehensive national data describing their health-care needs and utilisation. Annual health checks for adults with ID have been incentivised through primary care since 2009, but only half of those eligible for such a health check receive one. It is unclear what impact health checks have had on important health outcomes, such as emergency hospitalisation. Objectives To evaluate whether or not annual health checks for adults with ID have reduced emergency hospitalisation, and to describe health, health care and mortality for adults with ID. Design A retrospective matched cohort study using primary care data linked to national hospital admissions and mortality data sets. Setting A total of 451 English general practices contributing data to Clinical Practice Research Datalink (CPRD). Participants A total of 21,859 adults with ID compared with 152,846 age-, gender- and practice-matched controls without ID registered during 2009–13. Interventions None. Main outcome measures Emergency hospital admissions. Other outcomes – preventable admissions for ambulatory care sensitive conditions, and mortality. Data sources CPRD, Hospital Episodes Statistics and Office for National Statistics. Results Compared with the general population, adults with ID had higher levels of recorded comorbidity and were more likely to consult in primary care. However, they were less likely to have long doctor consultations, and had lower continuity of care. They had higher mortality rates [hazard ratio (HR) 3.6, 95% confidence interval (CI) 3.3 to 3.9], with 37.0% of deaths classified as being amenable to health-care intervention (HR 5.9, 95% CI 5.1 to 6.8). They were more likely to have emergency hospital admissions [incidence rate ratio (IRR) 2.82, 95% CI 2.66 to 2.98], with 33.7% deemed preventable compared with 17.3% in controls (IRR 5.62, 95% CI 5.14 to 6.13). Health checks for adults with ID had no effect on overall emergency admissions compared with controls (IRR 0.96, 95% CI 0.87 to 1.07), although there was a relative reduction in emergency admissions for ambulatory care-sensitive conditions (IRR 0.82, 95% CI 0.69 to 0.99). Practices with high health check participation also showed a relative fall in preventable emergency admissions for their patients with ID, compared with practices with minimal participation (IRR 0.73, 95% CI 0.57 to 0.95). There were large variations in the health check-related content that was recorded on electronic records. Limitations Patients with milder ID not known to health services were not identified. We could not comment on the quality of health checks. Conclusions Compared with the general population, adults with ID have more chronic diseases and greater primary and secondary care utilisation. With more than one-third of deaths potentially amenable to health-care interventions, improvements in access to, and quality of, health care are required. In primary care, better continuity of care and longer appointment times are important examples that we identified. Although annual health checks can also improve access, not every eligible adult with ID receives one, and health check content varies by practice. Health checks had no impact on overall emergency admissions, but they appeared influential in reducing preventable emergency admissions. Future work No formal cost-effectiveness analysis of annual health checks was performed, but this could be attempted in relation to our estimates of a reduction in preventable emergency admissions. Funding The National Institute for Health Research Health Services and Delivery Research programme.

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Section: Introductionmentioning

confidence: 99%

An evaluation of the effectiveness of annual health checks and quality of health care for adults with intellectual disability: an observational study using a primary care database

Carey

Hosking

Harris

et al. 2017

Health Serv Deliv Res

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“…Los pacientes con SD presentan una elevada frecuencia de infecciones, particularmente del tracto respiratorio, las que se caracterizan por ser de duración prolongada y mayor gravedad 42 . Garrison y cols.…”

Section: Patología Infecciosaunclassified

El niño con Síndrome de Down en la Unidad de Cuidados Intensivos

F¹,

F²,

B³

et al. 2017

Rev. chil. pediatr.

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“…Integrin β-2 merupakan reseptor adesi sel yang terdapat pada neutrofil, berfungsi untuk melekatkan neutrofil pada endotelium kapiler darah yang akan mengalami ekstravasasi dan bermigrasi menuju ke injury site 9 . Pada anak down syndrome produksi integrin β-2 yang tidak seimbang menyebabkan gangguan adesi neutrofil ke endotelium , sehingga jumlah neutrofil yang akan berkemotaksis ke injury site akan menurun 10 . Selain perbedaan jumlah neutrofil, terdapat perbedaan lain di rongga mulut anak down syndrome dan anak sehat secara deskriptif yaitu jumlah volume GCF 11 .…”

Section: Diskusiunclassified

ANALISIS PERBEDAAN JUMLAH NEUTROFIL ANTARA ANAK DOWN SYNDROME DAN ANAK SEHAT - Studi Pada SLB-C Widya Bhakti Semarang dan Mi Mirfa’ul Ulum

Wulandari¹,

Christiono²,

Ringga³

2017

ODONTO : Dental Journal

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Background: Down syndrome (DS) is a congenital disorder caused by abnormalities of chromosome 21, resulting in migration defect of neutrophils, specifically in GCF as a marker of increasing periodontal infection. This study aimed to analyze the difference in neutrophil numbers between down syndrome and healthy children. Method: This research was an analytic observational with cross sectional design, and divided into two groups. The control group is consisted of healthy children and the other is consisted of down syndrome children. GCF was taken using paper point number 45-50 for 30 seconds, then it smeared into object glass and painted with giemsa staining. Observations was done by light microscopy with 1000 times magnification. Result:The result of studies with p<0.05 was indicating a significant difference of neutrophil numbers between children with down syndrome and the healthy group. Conclusion: This study concluded that there was a difference in neutrophil numbers due to the migration defect of neutrophils in children with down syndrome, that can cause proneness to periodontal infections.

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Infections and immunodeficiency in Down syndrome

Cited by 358 publications

References 80 publications

An evaluation of the effectiveness of annual health checks and quality of health care for adults with intellectual disability: an observational study using a primary care database

An evaluation of the effectiveness of annual health checks and quality of health care for adults with intellectual disability: an observational study using a primary care database

El niño con Síndrome de Down en la Unidad de Cuidados Intensivos

ANALISIS PERBEDAAN JUMLAH NEUTROFIL ANTARA ANAK DOWN SYNDROME DAN ANAK SEHAT - Studi Pada SLB-C Widya Bhakti Semarang dan Mi Mirfa’ul Ulum

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