Follow-up Formula Consumption in 3- to 4-Year-Olds and Respiratory Infections: An RCT

PEDIATRICS ◽  
2014 ◽  
Vol 133 (6) ◽  
pp. X19-X19
2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Reiko Miyahara ◽  
Kensuke Takahashi ◽  
Nguyen Thi Hien Anh ◽  
Vu Dinh Thiem ◽  
Motoi Suzuki ◽  
...  

Abstract Exposure to environmental tobacco smoke (ETS) is an important modifiable risk factor for child hospitalization, although its contribution is not well documented in countries where ETS due to maternal tobacco smoking is negligible. We conducted a birth cohort study of 1999 neonates between May 2009 and May 2010 in Nha Trang, Vietnam, to evaluate paternal tobacco smoking as a risk factor for infectious and non-infectious diseases. Hospitalizations during a 24-month observation period were identified using hospital records. The effect of paternal exposure during pregnancy and infancy on infectious disease incidence was evaluated using Poisson regression models. In total, 35.6% of 1624 children who attended follow-up visits required at least one hospitalization by 2 years of age, and the most common reason for hospitalization was lower respiratory tract infection (LRTI). Paternal tobacco smoking independently increased the risk of LRTI 1.76-fold (95% CI: 1.24–2.51) after adjusting for possible confounders but was not associated with any other cause of hospitalization. The population attributable fraction indicated that effective interventions to prevent paternal smoking in the presence of children would reduce LRTI-related hospitalizations by 14.8% in this epidemiological setting.


2001 ◽  
Vol 119 (4) ◽  
pp. 142-145 ◽  
Author(s):  
Páris Ali Ramadan ◽  
Francisco Barreto de Araújo ◽  
Mario Ferreira Junior

CONTEXT: Routine immunization of groups at high risk for influenza has been progressively implemented as a matter of Brazilian public health policy. Although the benefits of the vaccination for healthy young adults are still controversial, it has been offered yearly to hundreds of thousands of Brazilian workers, generally as part of wellness initiatives in the workplace. OBJECTIVE: To study the characteristics of subjects that accepted or refused to be vaccinated against influenza and to report on respiratory symptoms in both groups, one year after the campaign date. DESIGN: A prospective observational study. SETTING: Workers at a subsidiary of an international bank in São Paulo, Brazil. PARTICIPANTS: 124 persons that did not accept and 145 that voluntarily accepted the vaccine completed 12 months of follow-up. MAIN MEASUREMENTS: Data concerning gender, age, tobacco use, and any history of chronic respiratory illness such as asthma, bronchitis, rhinitis, and repetitive upper-respiratory infections, were recorded at the time of vaccination. After that, workers were asked monthly by questionnaire or telephone about respiratory symptoms, days of work lost and medical consultations. RESULTS: The results showed statistically significant differences regarding age (P = 0.004) with the vaccinated group (V) being younger than the non-vaccinated (NV) one, and with reference to previous repetitive upper-respiratory infections being higher among the V group (P < 0.0001). During the follow-up, the V group reported more occurrences of upper respiratory symptoms (P < 0.0001), due to both non-influenza (P < 0.0001) and influenza-like illness (P = 0.045). Differences were also found between V and NV groups concerning days off work and number of medical consultations due to upper-respiratory symptoms and non-influenza illness. Gender and history of repetitive upper-respiratory infections were the best predictors of influenza-like illness-related events. CONCLUSIONS: The making of previous reference to repetitive upper-respiratory infections was a major difference between those who accepted or rejected the vaccine. The vaccination itself was not sufficient to reduce the number of occurrences of respiratory symptoms and related absenteeism to levels similar to those found among non-vaccinated people.


PEDIATRICS ◽  
2004 ◽  
Vol 113 (5) ◽  
pp. 1352-1356 ◽  
Author(s):  
D. H. Howard ◽  
J. E. McGowan

2020 ◽  
Author(s):  
Guillaume Grenet ◽  
Samia Mekhaldi ◽  
Sabine MAINBOURG ◽  
Marine AUFFRET ◽  
Catherine Cornu ◽  
...  

Background Association between DPP4 inhibitors and respiratory infection remains unclear. CardioVascular Outcomes Trials (CVOTs) conducted before the COVID-19 pandemic are available. We aimed to estimate the effect of DPP4 inhibitors on the risk of respiratory infections. Methods We updated a previous systematic review and meta-analysis, searching for CVOTs assessing a DPP4 inhibitor in patients with type 2 diabetes mellitus. We focused on placebo-controlled CVOTs. Our primary outcome was 'any respiratory infection'. We added a sensitivity analysis integrating non-CVOTs and active-controlled CVOTs. Findings We included 47 714 patients in five placebo-controlled CVOTs. Median follow-up ranged from 1.5 years to 3 years. 4 369 events of overall respiratory infection were reported (rate of 9.2%). DPP4 inhibitors were not associated with a different risk compared to placebo (RR = 0.99 [95%CI: 0.93; 1.04]). The sensitivity analysis integrating the non-CVOTs studies and the active-controlled CVOT reached 11 349 events among 82 644 participants (rate of 13.7%). DPP4 inhibitors were not associated with a different risk of overall respiratory infection (RR = 1.00 [95% CI: 0.97; 1.03]). Interpretation Our up-dated meta-analysis provides the most powerful and least biased estimation of the association of DPP4 inhibitors and the risk of overall (non COVID-19) respiratory infection. We did not find any effect of the DPP4 inhibitors on the risk of respiratory infection. Our results support the recently published practical recommendations for the management of diabetes in patients with COVID-19, suggesting that DPP4 inhibitors should not be discontinued regarding the COVID-19 pandemic.


2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
A Laín ◽  
F Pumarola ◽  
C Giné ◽  
L García ◽  
P Barila ◽  
...  

Abstract Aim In the last years several treatments for tracheomalacia have been reported. However, management of this entity is still a complex matter. This study presents a case diagnosed of severe proximal tracheomalacia managed by external tracheal resorbable plates. Case Report A seven-year-old child was tracheostomized in the neonatal period in relation to severe generalized tracheomalacia in association with swallowing incoordination and recurrent respiratory infections. Data to point out of his personal history were prematurity, a mosaic type genetic anomaly, cognitive and development impairment, and bilateral hypoacusia. After improvement of the neurological status and his feeding and swallow problems he was evaluated by the Airway Unit of our centre. Dynamic transnasal flexible laryngotracheobronchoscopy showed severe tracheomalacia. The collapse was 100% in the proximal airway (from the subglotis to the middle part of the trachea) and decannulation was not possible. Given the extent, localization, and proximity of the tracheomalacia to the vocal cords a surgical approach with external bioresorbable plates was indicated. By a transcervical approach, dissection of the larynx and cervical trachea was carried out. Two 2.5 cm multiperforated plates of ‘poly [L-lactide-co-glycolide] copolymer’ were modeled and fixed to the anteromedial laryngotracheal surface. Direct intraoperative endoscopy defined the proper location to fix the plates and showed significant improvement of the collapse thanks to the rigidification of the airway. Three weeks after the procedure endoscopic control was realized and the patient was successfully decannulated. He remains asymptomatic with a 6 months follow-up. No complications were reported. Conclusion Extraluminal stabilization with resorbable plates can be a safe and effective option for selected patients with localized tracheomalacias. It represents a valid alternative for the management of this complex entity.


2020 ◽  
Vol 129 (10) ◽  
pp. 988-995 ◽  
Author(s):  
Sean M Parsel ◽  
Alaa E Mohammed ◽  
Daniel Fort ◽  
Blair M Barton ◽  
Edward D McCoul

Objective: To examine the use of intramuscular corticosteroid (IMCS) injections for treatment of acute upper respiratory infections (URI) and the influence on healthcare utilization. Methods: This retrospective cohort study used patient encounter data from a large multicenter regional health care system between 2013 and 2017. Adult patients diagnosed with acute URI (acute pharyngitis, acute sinusitis, acute otitis media, and URI not otherwise specified) during ambulatory encounters were included. Follow-up encounters for a diagnosis of acute URI within 60 days were identified and patient characteristics, encounter details, and procedure codes were retrieved. Frequency data was used to calculate IMCS injection administration prevalence, utilization trends, and associations with covariates. Follow-up data for return encounters within 60 days for the same diagnosis was examined. Results: Of the 153 848 initial encounters, 34 600 (22.5%) patients received IMCS injection for acute URI. Injection rates varied from 0.85% to 49.1% depending on specialty and practitioner type. Internal medicine, family medicine, urgent care, and otorhinolaryngology clinics most commonly administered IMCS. 3788 patients returned for a second encounter of which 751 (19.8%) received an injection. IMCS injection during the first encounter was associated with increased odds of repeat visit within 60 days (OR: 1.74; 95% CI: 1.61–1.88). Conclusion: IMCS use in the treatment of acute URI is highly prevalent despite lack of evidence for impact and safety. Prevalence is variable across multiple medical and surgical specialties including otorhinolaryngology. Administration of IMCS injection may contribute to the likelihood of a subsequent healthcare visit for the same indication.


2020 ◽  
Vol 10 ◽  
pp. 204512532095956
Author(s):  
Matthew Butler ◽  
Felicity Bano ◽  
Marilia Calcia ◽  
Isabel McMullen ◽  
Chun Chiang Sin Fai Lam ◽  
...  

There is both uncertainty regarding the safety of clozapine in COVID-19 patients owing to limited published data and a lack of consensus on continuing clozapine in patients with severe respiratory infections. COVID-19 is known to induce an acute immune response which can affect haematological parameters associated with clozapine monitoring, and systemic infection may reduce clozapine clearance. Clozapine, which has been associated with worse outcomes in some pneumonias, may in theory worsen outcomes in COVID-19. Despite these concerns, there are some data to indicate it is safe to continue clozapine in COVID-19 infection. In this retrospective case series, we describe our experiences of clozapine prescribing and disease progression of eight SARS-CoV-2 positive patients on medical wards in a major London teaching hospital. In four cases clozapine was stopped during the hospital admission. A COVID-19 pneumonia developed in four patients: three of these required intensive care unit admission for an average of 34 days. At the time of writing, three patients had died (two directly from COVID-19 pneumonia), two remained in general hospital wards, two were recovering in the community and one had been transferred to an inpatient psychiatric hospital. Follow-up length varied but in each case was not more than 104 days. Delirium was the most common adverse neuropsychiatric event, and in one case a relapse of psychosis occurred after cessation of clozapine. This retrospective case series illustrates the safe use of clozapine during COVID-19 infection. Our experiences suggest that consideration should be made to continuing clozapine even in those most unwell with COVID-19. We also identify areas which require larger scale hypothesis-testing research.


Neurosurgery ◽  
1983 ◽  
Vol 13 (4) ◽  
pp. 420-426 ◽  
Author(s):  
Charles R. West ◽  
Anthony M. Avellanosa ◽  
Nilou R. Barua ◽  
Arun Patel ◽  
Chung I. Hong

Abstract Twenty-five adults who harbored malignant gliomas received 72 courses of intraarterial 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) (100 mg/m2) and 67 courses of systemic vincristine (1.0 mg/m2) and procarbazine (100 mg/m2) as induction therapy (BVP) followed by 106 courses of systemic 1-(2-chloroethyl)-3-(4-methylcyclohexyl)-1-nitrosourea (methyl-CCNU) (130 mg/m2), vincristine, and procarbazine as maintenance therapy (MVP). With a 6-week interval between each treatment, the median and range for the number of courses of BVP were 3 and 1 to 4 and those for MVP were 3 and 0 to 14, respectively. Fifteen patients (60%) responded to both BVP and MVP, and 10 (40%) did not. The overall median survival time was 12.7 months (range, 1.8 to 48.5+ months). Two of 3 patients who had recurrent gliomas responded and survived for 37+ to 45+ months. Seven of 10 who had nonirradiated glioblastomas responded and survived for 9 to 22 months. Four who had nonirradiated anaplastic astrocytomas all responded and survived for 38+ to 48.5+ months. Two who also received radiotherapy (1 glioblastoma and 1 primitive neuroectodermal tumor) benefited and survived for 16.9 and 28.5+ months. All who did not respond favorably died within 8 months. During the infusion of BCNU, complications included transient orbital and head pain, periorbital and scleral erythema in all patients, and a focal seizure in 1 (4%). During the 6-month induction periods, leukopenia and thrombocytopenia occurred in 1 (4%), deep vein thrombosis occurred in 9 (36%), pulmonary emboli occurred in 8 (32%), upper respiratory infections occurred in 6 (24%), pneumonia occurred in 9 (36%), and herpes zoster occurred in 1 (4%). During maintenance therapy, seizures occurred in 4 (16%) and leukopenia and/or thrombocytopenia occurred by the fifth course in 6 of 9 who received 5 to 14 treatments.


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