69 research outputs found
Methicillin-Resistant Staphylococcus Aureus and Pulmonary Outcome in People with Cystic Fibrosis: A European Cystic Fibrosis Patient Registry Data Analysis
No full textPrevalence and New Phenotypic and Radiologic Findings in Congenital Onychodysplasia of the Index Finger
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Assessment Of Pulmonary Function By Nitrogen Washout And Spirometry In Preschool Age Children
No full textPeriorbital Cellulitis in the Era of Haemophilus Influenzae Type B Vaccine: Predisposing Factors and Etiologic Agents in Hospitalized Children
No full textThe effect of calcium intake and physical activity on bone quantitative ultrasound measurements in children: a pilot study
No full textTreatment of Anticonvulsant Hypersensitivity Syndrome with Intravenous Immunoglobulins and Corticosteroids
No full text Anticonvulsant hypersensitivity syndrome is a specific severe idiosyncratic reaction to the aromatic antiepileptic drugs. The most frequent presenting symptoms are fever and rash, lymphadenopathy owing to lymphoid hyperplasia, hepatitis, and interstitial nephritis. Severe skin reactions (Stevens-Johnson syndrome or toxic epidermal necrolysis) have also been reported. Early detection is crucial owing to the high mortality rate. Although withdrawal of the offending drug is critical, the optimal treatment approach remains controversial. Previous studies report a severe course and prolonged hospital stay for cutaneous drug-related reactions, including referral to a burn center, skin débridement, and allograft skin coverage. The aim of the present report is to describe four adolescents with antiepileptic drug hypersensitivity syndrome who were treated with intravenous immunoglobulin and systemic corticosteroids. All recovered completely following an uncomplicated and relatively short course and hospitalization. Findings indicate that this regimen might be a promising treatment option in this patient population. Larger, controlled trials are needed to reach a definitive conclusion. ( J Child Neurol 2006;21:380—384; DOI 10.2310/7010.2006.00122). </jats:p
Incidence, Prevalence and Patterns of Stenotrophomonas Maltophilia Infection in People with Cystic Fibrosis across Europe
No full textINTRODUCTION
Progressive airway disease with recurrent infections is a hallmark of cystic fibrosis (CF). While Pseudomonas aeruginosa and Staphylococcus aureus are the most common pathogens, emerging bacteria such as Stenotrophomonas maltophilia (SM), non-tuberculous mycobacteria, and Achromobacter species are increasingly identified. SM, a gram-negative bacterium, has been cultured from the sputum of people with CF (pwCF) with variable prevalence across countries. While its role remains debated, a 2012 review suggests that chronic SM may be a marker of more severe lung disease [1]. The clinical impact of Stenotrophomonas maltophilia in European pwCF remains underexplored, highlighting the need for better epidemiological data to guide research and care.
AIMS
Aims of this study are to estimate the prevalence and incidence of SM in Europe, to compare the clinical characteristics of pwCF according to their SM infection status and to characterize the most common patterns of infection during a period of 6 years (2018-2023).
METHODS
This longitudinal study is based on data provided by the European Cystic Fibrosis Society Patient Registry (ECFSPR), which collects demographic and clinical data of pwCF from 42 countries in Europe. Data are collected annually, according to specific inclusion criteria and standardized definitions.
In the ECFSPR, SM status is classified as negative, intermittent, or chronic, based on standardized criteria [2]. Demographics and clinical outcomes within SM-negative, intermittent, and chronic groups in 2023 were described and the differences among groups were assessed using Pearson’s Chi-squared test for categorical and Kruskal-Wallis test for continuous variables.
SM overall incidence and prevalence from 2008 to 2023 were computed. Prevalence was the proportion of infected (both intermittent and chronic together) in each year, while incidence was the number of newly infected individuals divided by those uninfected in the previous year. To assess whether trends in prevalence and incidence over time were statistically significant, logistic regression models were applied, using infection status as the response variable and calendar year as a continuous explanatory variable. Additional models were then fitted, accounting for time of introduction of Cystic Fibrosis Transmembrane conductance Regulator (CFTR) modulators and COVID-19 pandemic (pre- or post- period).
Chronic and intermittent SM infection were used as response variables in further logistic regression models to assess whether a significant trend existed with age at follow-up, included as a continuous explanatory variable, also accounting for CFTR modulator use.
Infection patterns from 2018–2023 were used to classify patients accordingly.
Analyses were run using R Core Team versions 4.5.0.
RESULTS
In 2023, ECFSPR included 52977 pwCF, of whom 51566 (97.3%) had complete information regarding SM infection status.
The overall prevalence of SM (including both chronic and intermittent cases) in 2023 ranged from 0.26% in Romania to 19.3% in Serbia, accounting for 5.0% (95% CI: 4.8 to 5.2) across Europe. Four small countries did not report any SM detection.
Age, gender, BMI in adults, BMI z-score in children, and the country’s income category (all p<.05) differed across the three infection groups: SM-negative (49010, 95%), intermittent (2000, 3.9%), and chronic (556, 1.1%). SM-chronic had the highest median age (28.7y) and lowest BMI (22.1 kg/m2), while SM-intermittent were the youngest (16.5y), and SM-negative had the highest BMI (22.5 kg/m2).
In contrast, genotype (p=0.7) and use of pancreatic enzymes (p=0.2) showed no significant differences. All concomitant infections—chronic P. aeruginosa, chronic S. aureus, MRSA, H. influenzae, Achromobacter spp., and nontuberculous mycobacteria—differed significantly across groups (all p<.001), with highest prevalence in those chronically infected with SM; only chronic Burkholderia cepacia complex showed a borderline difference (p=.041).
The prevalence of SM increases significantly with age (p2019), a significant trend was observed (p<.001); furthermore, the stratified analysis revealed a significant rise in SM prevalence from 2008 to 2019 (p<.001), followed by a significant decline from 2020 to 2023 (p<.001).
Among 32,724 pwCF, 64 distinct infection patterns were identified. Most (24,594, 75.2%) showed no infection, while 24.8% (8,130) showed infection in at least one year and 11.1% (3640) for at least 2 years. Specifically, one year (13.7%), two years (5.3%), three years (2.8%), four years (1.5%), five years (0.8%), and six years (0.6%). Only 1.6% (524) of pwCF showed a continuous infection, remaining positive through 2023.
CONCLUSIONS
This large multinational analysis offers a detailed view of SM infection in the European CF population, revealing that while most individuals remained uninfected, nearly one-quarter experienced infection between 2018 and 2023. Chronic infection was strongly age-associated and consistently linked to a higher burden of co-infections. The shifting temporal trends—marked by a rise in prevalence up to 2019 and a subsequent decline during the CFTR modulator and post-COVID era—suggest that both medical advancements and broader changes in healthcare practices may significantly shape SM epidemiology. These findings highlight the need for continued surveillance to guide care and inform future research
Remittances, household expenditure and investment in Guatemala
No full textThe author uses a large household data set from Guatemala to analyze how the receipt of internal remittances (from Guatemala) and international remittances (from the United States) affects the marginal spending behavior of households on various consumption and investment goods. Contrary to other studies, the author finds that households receiving remittances actually spend less at the margin on consumption-food and consumer goods and durables-than do households receiving no remittances. Instead of spending on consumption, households receiving remittances tend to spend more on investment goods, like education, health, and housing. The analysis shows that a large amount of remittance money goes into education. At the margin, households receiving internal and international remittances spend 45 and 58 percent more, respectively, on education, than do households with no remittances. These increased expenditures on education represent investment in human capital. Like other studies, the author finds that remittance-receiving households spend more at the margin on housing. These increased expenditures on housing represent a type of investment for the migrant, as well as a means for boosting local economic development by creating new income and employment opportunities for skilled and unskilled workers.Housing&Human Habitats,VN-Acb Mis -- IFC-00535908,Economic Conditions and Volatility,Health Monitoring&Evaluation,Municipal Housing and Land
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