scholarly journals Impact of SARS-CoV-2 Pandemic on Bronchiolitis Hospitalizations: The Experience of an Italian Tertiary Center

Children ◽  
2021 ◽  
Vol 8 (7) ◽  
pp. 556
Author(s):  
Giacomo Stera ◽  
Luca Pierantoni ◽  
Riccardo Masetti ◽  
Davide Leardini ◽  
Carlotta Biagi ◽  
...  
Keyword(s):  
Oxygen Therapy ◽  
Pediatric Intensive Care ◽  
Cost Effective ◽  
Respiratory Illnesses ◽  
Epidemic Season ◽  
Tertiary Center ◽  
Different Seasons ◽  
The Common ◽  
Syncytial Virus ◽  
Rsv Respiratory Syncytial Virus

SARS-CoV-2 pandemic restrictions have deeply altered the common respiratory illnesses burden. The aim of this paper was to clarify how these measures may have influenced bronchiolitis epidemiology, exploring possible explanations. We studied 342 infants hospitalized for bronchiolitis at our center from four different epidemic seasons (October–April 2017–2018, 2018–2019, 2019–2020 and 2020–2021). March–April hospitalization rate, RSV (respiratory syncytial virus) infection, pediatric intensive care unit (PICU) admission and oxygen therapy administration data were compared among different seasons to outline any changes during the SARS-CoV-2 outbreak. In March–April, 30 (23.1%), 28 (24.6%) and 5 (5.1%) infants were hospitalized for bronchiolitis, respectively, in 2017–2018, 2018–2019 and 2019–2020, with a lower rate in March–April 2020 (p < 0.001). No hospitalizations for bronchiolitis occurred during the epidemic season of 2020–2021. No significant differences in RSV infections, oxygen therapy administration and PICU admissions across seasons were outlined. In conclusion, we report a severe decrease in hospitalizations for bronchiolitis at our center throughout the entire SARS-CoV-2 outbreak rather than only during the lockdown periods. This seems to suggest a pivotal role for the systematic implementation of cost-effective non-pharmaceutical interventions (NPIs) such as compulsory face masks and hand hygiene, which were deployed for the entire pandemic, in reducing the circulation of infectious agents.

scholarly journals Impact of the 2014 American Academy of Pediatrics recommendation and of the resulting limited financial coverage by the Italian Medicines Agency for palivizumab prophylaxis on the RSV-associated hospitalizations in preterm infants during the 2016–2017 epidemic season: a systematic review of seven Italian reports

2019 ◽  
Vol 45 (1) ◽  
Author(s):  
Renato Cutrera ◽  
Andrea Wolfler ◽  
Simonetta Picone ◽  
Giovanni A. Rossi ◽  
Giuliana Gualberti ◽  
...  
Keyword(s):  
Systematic Review ◽  
Intensive Care ◽  
American Academy ◽  
Intensive Care Units ◽  
Preterm Infants ◽  
Pediatric Intensive Care ◽  
Pediatric Intensive Care Units ◽  
Epidemic Season ◽  
American Academy Of Pediatrics ◽  
Syncytial Virus

Abstract Background The only pharmacologic prophylaxis against respiratory syncytial virus (RSV) infection in preterm infants is the humanized monoclonal antibody palivizumab. After the 2014 modification of the American Academy of Pediatrics (AAP) recommendations, the Italian Medicines Agency (AIFA) limited the financial coverage for palivizumab prescriptions to otherwise healthy preterm infants with < 29 weeks of gestational age (wGA) aged < 12 months at the beginning of the 2016–2017 RSV season. However, due to the effect on disease severity and hospitalizations following this limitation, shown by several Italian clinical studies, in November 2017 AIFA reinstated the financial coverage for these infants. In this systematic review, we critically summarize the data that show the importance of palivizumab prophylaxis. Methods Data from six Italian pediatric institutes and the Italian Network of Pediatric Intensive Care Units (TIPNet) were retrieved from the literature and considered. The epidemiologic information for infants 29–36 wGA, aged < 12 months and admitted for viral-induced acute lower respiratory tract infection were retrospectively reviewed. RSV-associated hospitalizations were compared between the season with running limitation, i.e. 2016–2017, versus 2 seasons before (2014–2015 and 2015–2016) and one season after (2017–2018) the AIFA limitation. Results During the 2016–2017 RSV epidemic season, when the AIFA limited the financial coverage of palivizumab prophylaxis based on the 2014 AAP recommendation, the study reports on a higher incidences of RSV bronchiolitis and greater respiratory function impairment. During this season, we also found an increase in hospitalizations and admissions to the Pediatric Intensive Care Units and longer hospital stays, incurring higher healthcare costs. During the 2016–2017 epidemic season, an overall increase in the number of RSV bronchiolitis cases was also observed in infants born full term, suggesting that the decreased prophylaxis in preterm infants may have caused a wider infection diffusion in groups of infants not considered to be at risk. Conclusions The Italian results support the use of palivizumab prophylaxis for otherwise healthy preterm (29–36 wGA) infants aged < 6 months at the beginning of the RSV season.

scholarly journals Palivizumab reimbursement criteria and neonatal RSV hospitalisation: a regional retrospective review

2021 ◽  
Vol 5 (1) ◽  
pp. e000985
Author(s):  
Valeria Belleudi ◽  
Federico Marchetti ◽  
Marco Finocchietti ◽  
Marina Davoli ◽  
Antonio Addis
Keyword(s):  
Respiratory Syncytial Virus ◽  
Gestational Age ◽  
Retrospective Review ◽  
Lower Prevalence ◽  
Different Seasons ◽  
Syncytial Virus

In Italy, reimbursement restrictions regarding palivizumab prophylaxis approved in 2016 have been revoked in 2017, restoring use in infants with Gestational Age (GA) >29 weeks. Respiratory Syncytial Virus (RSV) hospitalisations and prevalence of palivizumab use in infants aged <6 months during five seasons (2014–2019), were considered according to different GA. Although RSV hospitalisations rate showed no significant changes, during different seasons in all GA, lower prevalence of palivizumab use in 2016 (0.8% vs 0.3%), returned to a higher level following the revoke of restrictions. Changes in reimbursement criteria were not associated with neonatal RSV hospitalisations rate but with a significant impact on palivizumab use.

scholarly journals Lactoferrin affects rhinovirus B-14 entry into H1-HeLa cells

2021 ◽  
Vol 166 (4) ◽  
pp. 1203-1211
Author(s):  
Caio Bidueira Denani ◽  
Antonio Real-Hohn ◽  
Carlos Alberto Marques de Carvalho ◽  
Andre Marco de Oliveira Gomes ◽  
Rafael Braga Gonçalves
Keyword(s):  
Innate Immune System ◽  
Rna Viruses ◽  
Innate Immune ◽  
Bovine Lactoferrin ◽  
Respiratory Illnesses ◽  
Dna And Rna ◽  
Viral Particles ◽  
The Common ◽  
Additional Influence

AbstractLactoferrin is part of the innate immune system, with antiviral activity against numerous DNA and RNA viruses. Rhinoviruses, the leading cause of the common cold, are associated with exacerbation of respiratory illnesses such as asthma. Here, we explored the effect of bovine lactoferrin (BLf) on RV-B14 infectivity. Using different assays, we show that the effect of BLf is strongest during adhesion of the virus to the cell and entry. Tracking the internalisation of BLf and virus revealed a degree of colocalisation, although their interaction was only confirmed in vitro using empty viral particles, indicating a possible additional influence of BLf on other infection steps.

scholarly journals The Importance of Intraoperative Plain Radiographs during Cochlear Implant Surgery in Patients with Normal Anatomy

2021 ◽  
Vol 11 (9) ◽  
pp. 4144
Author(s):  
Ohad Cohen ◽  
Jean-Yves Sichel ◽  
Chanan Shaul ◽  
Itay Chen ◽  
J. Thomas Roland ◽  
...  
Keyword(s):  
Cochlear Implant ◽  
Electrode Array ◽  
Cost Effective ◽  
X Rays ◽  
Normal Anatomy ◽  
Electrode Arrays ◽  
Plain Radiographs ◽  
Hearing Function ◽  
Tertiary Center ◽  
Cochlear Implant Surgery

Although malpositioning of the cochlear implant (CI) electrode array is rare in patients with normal anatomy, when occurring it may result in reduced hearing outcome. In addition to intraoperative electrophysiologic tests, imaging is an important modality to assess correct electrode array placement. The purpose of this report was to assess the incidence and describe cases in which intraoperative plain radiographs detected a malpositioned array. Intraoperative anti-Stenver’s view plain X-rays are conducted routinely in all CI surgeries in our tertiary center before awakening the patient and breaking the sterile field. Data of patients undergoing 399 CI surgeries were retrospectively analyzed. A total of 355 had normal inner ear and temporal bone anatomy. Patients with intra or extracochlear malpositioned electrode arrays demonstrated in the intraoperative X-ray were described. There were four cases of electrode array malposition out of 355 implantations with normal anatomy (1.1%): two tip fold-overs, one extracochlear placement and one partial insertion. All electrodes were reinserted immediately; repeated radiographs were normal and the patients achieved good hearing function. Intraoperative plain anti-Stenver’s view X-rays are valuable to confirm electrode array location, allowing correction before the conclusion of surgery. These radiographs are cheaper, faster, and emit much less radiation than other imaging options, making them a viable cost-effective tool in patients with normal anatomy.

Weaning From Noninvasive Ventilatory Support in Infants With Severe Bronchiolitis: An Observational Study

2021 ◽  
Author(s):  
Julie Cassibba ◽  
Claire Freycon ◽  
Julia Doutau ◽  
Isabelle Pin ◽  
Alexandre Bellier ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Observational Study ◽  
Pediatric Intensive Care Unit ◽  
Positive Airway Pressure ◽  
Ventilatory Support ◽  
Winter Season ◽  
Pediatric Intensive Care ◽  
High Flow Nasal Cannula ◽  
Tertiary Center

Abstract Background: The aim of the study was to analyze the weaning success, the type of weaning procedures, and weaning duration in consecutive infants hospitalized over a winter season in a Pediatric Intensive Care Unit.Methods: A retrospective observational study in a pediatric intensive care unit in a tertiary center. Infants hospitalized for a severe bronchiolitis were included and the weaning procedure from continuous positive airway pressure (CPAP), noninvasive ventilation (NIV) or high flow nasal cannula (HFNC) was analyzed.Results: Data from 95 infants (median age 47 days) were analyzed. On admission, 26 (27%), 46 (49%) and 23 (24%) infants were supported by CPAP, NIV and HFNC, respectively. One (4%), nine (20%) and one (4%) infants failed weaning while supported by CPAP, NIV or HFNC, respectively (p=0.1). In infants supported by CPAP, CPAP was stopped directly in 5 patients (19%) while HFNC was used as an intermediate ventilatory support in 21 (81%). The duration of weaning was shorter for HFNC (17 hours, [IQR 0-26]) than for CPAP (24 hours, [14-40]) and NIV (28 hours, [19-49]) (p<0.01).Conclusions: The weaning phase represent a large proportion of noninvasive ventilatory support duration in infants with bronchiolitis. The weaning procedure following a “step down” strategy may lead to an increase in duration of weaning.

CHANGES IN SPRUCE BUDWORM DEFOLIATION WITH CROWN LEVEL

1996 ◽  
Vol 128 (6) ◽  
pp. 1109-1113 ◽  
Author(s):  
Harald Piene
Keyword(s):  
Nova Scotia ◽  
Choristoneura Fumiferana ◽  
Abies Balsamea ◽  
Spruce Budworm ◽  
Cost Effective ◽  
Balsam Fir ◽  
Crown Length ◽  
Cape Breton ◽  
Cost Effective Approach ◽  
The Common

AbstractDetailed estimates of defoliation caused by spruce budworm [Choristoneura fumiferana (Clem.)] over the crown length of young balsam fir [Abies balsamea (L.) Mill.] were made throughout a spruce budworm outbreak from 1976 to 1984 in the Cape Breton Highlands, Nova Scotia. The results show no clear tendency for a particular level of the crown to be damaged more heavily than any other. Thus, there is no reason to continue the common practice of taking samples from the mid-crown level on the assumption that they represent an ‘average’ level of defoliation either for high or low populations. Sampling from the bottom of the crown should provide a more convenient and cost-effective approach for estimating defoliation.

scholarly journals Our experience of clinico-pathological study of thyroid swelling

2018 ◽  
Vol 4 (5) ◽  
pp. 1156
Author(s):  
Vilas R. Kirdak ◽  
Sambhaji G. Chintale ◽  
Sonali P. Jatale ◽  
Kaleem A. Shaikh
Keyword(s):  
Cost Effective ◽  
Safe Procedure ◽  
Chi Square ◽  
Radiological Investigation ◽  
Statistical Tool ◽  
Fourth Decade ◽  
Chi Square Test ◽  
The Common ◽  
Thyroid Swelling ◽  
High Index Of Suspicion

<p class="abstract"><strong>Background:</strong> Diseases of thyroid gland are extremely common. Majority of palpable thyroid swellings are asymptomatic occurs in 5% of the population. The main objective of present study is to know the accuracy of FNAC in preoperative diagnosis of clinically palpable thyroid swelling and evaluate the efficiency of FNAC, USG, and TFT in differentiating between benign and malignant thyroid swelling and their confirmation by histopathological reports after operation.</p><p class="abstract"><strong>Methods:</strong> This prospective study is carried out in 120 cases of thyroid swelling attending to the ENT opd at our hospital. Pearson chi square test used as statistical tool to analyse the data. All patients informed written consent taken. The patients are subjected to detailed history with thorough clinical examination, pathological and radiological investigation. FNAC, USG and TFT were done in each case. The result of FNAC was interpreted.  </p><p class="abstract"><strong>Results:</strong> The present study includes 120 cases. All patient examined clinically, pathologically and radiological. The common age group of presentation of thyroid swelling is between second to fourth decade. Youngest patient is of 15 yrs. old and oldest is being 68 yrs of age. All 120 cases were evaluated preoperatively and provisional diagnosis was made on the basis of FNAC, TFT and USG. 111 Cases were operated out of total 120 cases. So, the overall accuracy of FNAC in comparisons to HPR is 99.15% with no false positive reports.</p><p class="abstract"><strong>Conclusions:</strong> The overall incidence of the malignancy in thyroid swelling varies from 10% to 30% according to various studies, in our study the overall incidence of malignancy in thyroid swelling was 5.8%. High index of suspicion should be kept in mind during physical examination for detection of malignancy. FNAC should be done in all cases preoperatively FNAC is safe procedure and cost effective.</p><p> </p>

scholarly journals ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VIÊM PHẾ QUẢN PHỔI NHIỄM RSV (Respiratory Syncytial Virus) Ở TRẺ EM TẠI BỆNH VIỆN SẢN NHI VĨNH PHÚC

2021 ◽  
Vol 505 (2) ◽  
Author(s):  
Hoàng Trung Thanh ◽  
Nguyễn Thị Yến ◽  
Phạm Thu Nga
Keyword(s):  
Respiratory Syncytial Virus ◽  
Syncytial Virus ◽  
Rsv Respiratory Syncytial Virus

Viêm phế quản phổi (VPQP) là bệnh lý thường gặp và là nguyên nhân chính gây tử vong ở trẻ em. Virus là nguyên nhân hàng đầu gây viêm phế quản phổi ở trẻ em, trong đó virus hợp bào hô hấp (RSV) là nguyên nhân thường gặp nhất. Mục tiêu: Mô tả một số đặc điểm lâm sàng, cận lâm sàng của bệnh nhân viêm phế quản phổi có nhiễm RSV dưới 5 tuổi tại Bệnh viện Sản Nhi Vĩnh Phúc. Đối tượng nghiên cứu: 206 bệnh nhân dưới 5 tuổi viêm phế quản phổi có nhiễm RSV trong thời gian từ 01/6/2020 đến 31/05/2021. Phương pháp nghiên cứu: tiến cứu, mô tả cắt ngang. Kết quả: VPQP nhiễm RSV chủ yếu gặp ở nhóm tuổi < 12 tháng tuổi (91,2%). Các triệu chứng lâm sàng thường gặp là ho, chảy mũi, khò khè, thở nhanh, rút lõm lồng ngực đều chiếm tỷ lệ cao (> 80%). 98,5% bệnh nhân nghe phổi có rale. Hầu hết bệnh nhân có số lượng bạch cầu và CRP bình thường. 90,3% bệnh nhân có hình ảnh tổn thương phổi trên phim Xquang phổi. Trong nghiên cứu của chúng tôi, có đến 51,5% bệnh nhân đủ tiêu chuẩn chẩn đoán VPQP nặng điều này cũng phù hợp với tỷ lệ trẻ < 2 tháng trong nghiên cứu chiếm tỷ lệ cao. Kết luận: RSV hay gặp gây viêm phế quản phổi ở trẻ < 12 tháng tuổi. Triệu chứng hay gặp là ho, chảy mũi, khò khè, thở nhanh, rút lõm lồng ngực. Số lượng bạch cầu và CRP thường bình thường.

Retrospective Review of Clinical and Chest X-Ray Findings in Children Admitted to a Community Hospital for Respiratory Syncytial Virus Infection

2018 ◽  
Vol 57 (14) ◽  
pp. 1686-1692 ◽  
Author(s):  
Denver Niles ◽  
Brett Larsen ◽  
Arvind Balaji ◽  
Dana Delaney ◽  
Elizabeth Campos ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Pediatric Intensive Care ◽  
Clinical Findings ◽  
X Rays ◽  
Radiological Findings ◽  
X Ray ◽  
Severe Group ◽  
Rsv Infection ◽  
Chest X Ray ◽  
Syncytial Virus

Introduction. We performed a retrospective study to evaluate demographics, clinical course, outcome, and radiological findings of children with respiratory syncytial virus (RSV) infection. Methods. Four hundred patients admitted between October 2013 and May 2016 were enrolled. Clinical and radiographic trends were evaluated for association with severity of RSV presentation. Severity was defined as hospitalization >2 days, pediatric intensive care unit admission, or need for mechanical ventilation. Results. Common clinical findings included fever (78.5%), coughing (97%), rhinorrhea/congestion (93%), and hypoxia (44.8%). Hypoxia was seen in 64.7% of the severe group compared with 32.0% in the nonsevere group ( P < .001). Airspace opacification was seen in 49.2% of chest X-rays of the severe group compared with 26.4% in the nonsevere group ( P < .001). Conclusion. Higher incidence of hypoxia or airspace opacification on chest X-ray may be predictors of poorer outcomes for patients with RSV infection.

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