1,721,118 research outputs found

    The Impact of Viral Infections in Children with Community- acquired Pneumonia

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    For many years viral causes of community-acquired pneumonia were often been given limited attention. The number of published studies on influenza alone increased fivefold from 2001 to 2010. Specifically several studies have underlined that the involvement of viruses in community-acquired pneumonia has been underestimated, and this underestimation has been attributed to a lack of appropriate diagnostic methods. Now, with the advent of modern molecular assays, it is well recognized that viruses account for the largest proportion of community-acquired pneumonia in preschool children in both developed and developing countries. Respiratory syncytial virus, influenza virus, adenovirus, and parainfluenza virus are the major pathogens involved, but the relative importance of additional viruses (rhinoviruses, bocavirus, human metapneumovirus) is increasing and will be better defined by future research

    Immunization in adolescents : past, present and future

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    In the past, immunization programs worldwide mainly focused on the delivery of infant and early childhood vaccines. An increasing awareness of the importance of investing in adolescents’ health has led to the introduction of new vaccines targeted specifically to adolescents over the last ten years: this has improved the adolescent’s opportunities to protect from certain diseases for which they are at an increased risk. Safe and effective vaccines against human papilloma virus, Neisseria meningitides and Bordetella pertussis are recommended in many parts of the world; nevertheless, vaccination coverage in this age group is relatively low compared to coverage in infants. Barriers to adolescent immunization are believed to be complex and multifactorial but overcoming these barriers will be of primary importance for the future

    Probiotics: current evidences and new perspectives

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    Probiotics are viable microorganisms that can exert potential benefits to human health. Use of probiotics in different human diseases and clinical conditions has gained much attention in the last decades. Several data exist about the potential benefits of probiotics in pediatric age for the management of some clinical conditions, with different and sometimes contrasting results. Currently, strong evidences support the use of probiotics for treatment of acute infectious diarrhoea and prevention of antibiotic-associated diarrhoea: bacteria belonging to the genus of lactobacilli and Saccharomyces boulardii showed the stronger evidences of benefits in different clinical trials and meta-analysis [1,2]. For other pediatric diseases and clinical conditions, evidences of the benefits of a probiotic supplementation are still not so strong. The recommendation to administer a probiotics supplementation in preterm, very low birth weight neonates at risk of developing necrotizing enterocolitis has recently been criticized by a critical review of the literature that conclude that welldesigned clinical trials are still needed for suggesting its routinely use in these neonates [3]. Discussion is still ongoing about the benefits of probiotics in prevention or treatment of other pediatric diseases such as respiratory tract infections, urinary tract infections, Helicobacter pylori infection or allergic diseases. Clinical trials and meta-analysis about the use of probiotics in these pediatric clinical conditions have been published and still continued to be published; however, study designs are not always comparable and sometimes inadequate, species of probiotics used in the studies are different and the benefits demonstrated for one microorganism are not generalizable to other bacteria, results of the studies are still often not unequivocal or contrasting so that strong recommendations are still lacking. The use of probiotics has been suggested to be potentially beneficial for the management of gastrointestinal functional disorders, such as irritable bowel syndrome, again, with different results. These clinical conditions are supposed to be the result of a perturbation of the microbiota balance that leads to dysbiosis, responsible for the appearance of the characteristic symptoms. However, pathogenesis of gastrointestinal functional disorders appear to be much more complex and involve the nervous system and its bidirectional interactions with the intestine. Moreover, it has been hypothesized that intestinal microbial composition may itself influence end-points related to mood state, brain function, and mental outlook. A new fascinating perspective in studies about microbiota and probiotics is the characterization of the alterations of intestinal microbiome and their correlation with abnormalities in the bidirectional gut-brain interactions

    New insights into rotavirus vaccines

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    Rotavirus vaccines have shown to be effective and well tolerated in clinical trials. However it's crucial to point out that immunization occurs in "real-word" conditions different from ideal clinical trial settings. Thus, the impact of rotavirus vaccines in terms of effectiveness and safety needs to be evaluated in real-world conditions. Post-licensure data regarding vaccine impact, effectiveness and safety under routine use are now available and provide a "real-world view"

    Adverse drug reactions in newborns, infants and toddlers: pediatric pharmacovigilance between present and future

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    Introduction: The detection, assessment, understanding and prevention of adverse drug reactions (ADRs) are the primary aims of pharmacovigilance activities. Pediatric patients, especially all newborns and infants, are particularly at risk for experiencing drug-related adverse events. Areas covered: This review briefly analyzes the physiological peculiarities of pharmacodynamic and pharmacokinetic aspects of drugs in newborns, infants and toddlers and children. It also deals with specific pediatric pharmacovigilance aspects, such as the frequent use of unlicensed and/or off-label drugs in neonatal intensive care units in European countries and in Australia. This review reports on European, American and Canadian data about the incidence and type of pediatric ADRs, particularly focusing on neonates, infants and toddlers. Expert opinion: The awareness of pediatricians about the importance of reporting ADRs should be stimulated, new reporting systems should be encouraged and pediatric pharmacovigilance activities should be improved, first, by intensifying active post-marketing surveillance methods

    Pidotimod : the past and the present

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    At the end of 1990s, acute respiratory tract infections (ARTIs) were called the 'forgotten pandemic', with a clear dichotomy between developing and industrialised countries in mortality and morbidity, the main outcomes associated with ARTIs. This definition still applies 20 years later, when the introduction of new and safe antibiotics and vaccines has certainly contributed to controlling the most life-threatening ARTIs, but has not had a major impact on viral ARTIs in paediatric age. One functional approach to preventing and treating ARTIs is non-specifically increasing the immune response or enhancing the children's innate defence mechanisms. Different kinds of biologically active substances - called immunostimulants - of natural and synthetic origins and with different mechanisms of action have been introduced in some countries for the prevention of ARTIs in children. Recently, research focused on one of these compounds, Pidotimod, has attempted to better clarify and define its mechanisms of action both in vitro and in vivo. In this paper, we critically examine the most recent findings on Pidotimod. Certainly the improvement of research methodology in the last 20 years and the acquired knowledge in various fields of clinical immunology should be the starting point for research on Pidotimod. Preclinical research will be essential to better understand the mechanisms of action of this compound. However, in vivo studies, especially randomised control trials, will be necessary to establish the real efficacy of Pidotimod in the prevention of ARTIs in paediatric age

    Recurrent respiratory infections in children

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    Recent advances in management and prevention of acute lower respiratory tract infections in children are discussed
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