1,721,160 research outputs found
Children and Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Transmission: A Step Closer to Better Understanding and Evidence-Based Interventions?
No full textNo abstract availabl
Congenital toxoplasmosis treatment
No full textObjectives: Congenital toxoplasmosis is a particular manifestation of T. gondii infection, which may present as a mild or severe neonatal disease. This pathology remains a difficult challenge in terms of therapy for the pediatrician and gynecologist. In this article we have set ourselves the objective to provide an overview of the main aspects of the disease, with particular attention to the treatment,
based on the information in the literature.
Results: Two kinds of treatment are currently available: prenatal and postnatal. When pregnant
women seroconvert, spiramycin is administered in order to prevent the mother-to-child transmission.
When the fetal infection is confirmed the association of pyrimethamine and sulfadiazine is
prescribed. After the birth the specific therapy is based on the administration of pyrimethamine
and sulfadiazine. However, to date, there is not strong evidence on the effectiveness of treatment,
whether prenatal or postnatal.
Conclusions: The studies undertaken so far have not given satisfactory answers. Doubleblind
randomized controlled trials would be required, but for obvious ethical reasons they cannot
be achieved
Can Interferon-γ Release Assays Be Useful for Monitoring the Response to Anti-tuberculosis Treatment?: A Systematic Review and Meta-analysis
No full textThe number of studies which evaluated interferon-gamma release assays (IGRAs) results after anti-tuberculosis (TB) treatment has been rapidly increasing. The aim of this study was to investigate the potential use of IGRAs (QFT-GIT, T-SPOT.TB, QFT-Plus) in assessing the response to anti-TB treatment. We searched all studies in English language published from 1 October 2011 to 18 November 2018 in PubMed, Web of Science, and Scopus. Our search included the term "tuberculosis treatment AND interferon-γ release assay". We included studies evaluating the performance of commercial IGRAs (including QFT-GIT, T-SPOT.TB and QFT-Plus) before and after the anti-TB treatment. We performed subgroup analysis based on the age (children, adults), type of TB (active, latent, active and latent, and contacts exposed to MDR defined as MDR LTBI), type of IGRAs (QFT-GIT and T-SPOT.TB), and follow-up interval (2, 3, 4, 6, 9 months). Of the 18 included studies, 12 used QFT-GIT for assessment of IGRA performance after therapy, 1 used T-SPOT.TB, and 3 used both QFT-GIT and T-SPOT.TB. Since then, only two studies have assessed the QFT-Plus performance during therapy. According to the results of the meta-analysis, the pooled rate of positive IGRAs (QFT-GIT and T-SPOT.TB) following anti-TB therapy was estimated at 76% [95% CI 70-81%] and no difference was found compared to the pooled positive rate of IGRAs before initiation of therapy which was 76% [95% CI 60-89%]. The subgroup analysis showed that the pooled rate of positive IGRAs (QFT-GIT and T-SPOT.TB) after anti-TB therapy was significantly higher in monitoring active TB subjects [80% (95% CI 74-88%)] than LTBI [71% (95% CI 70-81%)]. Available data are now sufficient to suggest that monitoring changes in the IGRAs (QFT-GIT and T-SPOT.TB) response during anti-TB treatment may have limited use in evaluating the effectiveness of treatment, while the monitoring changes in QFT-Plus during anti-tubercular treatment are recommended to determine treatment efficacy or for treatment monitoring. Further research is needed to establish the efficacy of this new assay as marker on a larger scale for treatment monitoring
Involvement of type I immune responses in swine-origin H1N1 influenza virus infection.
No full textSwine-origin H1N1 influenza virus (S-OIV) appeared in 2009 with a higher incidence rate among children. Although fever was the most common symptom, some complicated cases occurred. We evaluated the percentages of effector T cells, B cells, and regulatory T cells in peripheral blood from 5 children infected by S-OIV (1 with acute necrotizing encephalitis, 2 with pneumonia, and 2 without complications), 5 children with seasonal influenza, and 5 healthy children. We found higher percentages of T-bet(+) CD4(+)CD8(+) T cells, monocytes, and B cells, granzyme B(+) and perforin(+) CD4(+), and CD8(+) T cells in affected children with both seasonal and H1N1 influenza than in controls, whereas both groups demonstrated similar percentages of CD4(+)CD25(+)Foxp3(+) regulatory T cells. In infected children with complications we observed high percentages of perforin(+) and interferon-γ(+) CD4(+) and CD8(+) T cells associated with low percentages of T regulatory cells. Our data suggest a dysregulation of antipathogen type I immune responses in complicated S-OIV infections
Pediatric hepatitis C infection: to treat or not to treat... what's the best for the child?
No full textOBJECTIVES: Pediatric hepatitis C mainly occurs through mother to child transmission, to date. Children usually present a mild disease, but they are not spared from its long-term complications. Thus this infection cannot be underestimated in children and intervention is necessary. Current treatment is based on the administration of pegylated-interferon associated with ribavirin, but few studies evaluated the efficacy and safety of this therapeutic protocol. Moreover, there is still no clarity on who, when and how to treat pediatric patients. This article, based on the information in literature, provides an overview of the main aspects of the disease, with particular attention to treatment.
METHODOLOGY AND RESULTS: We describe the different treatment options available. About the association peginterferon plus ribavirin, we analyze thirteen non-randomized studies and one trial, found in recent literature. These studies are not directly compared because of differences in age, type of infection (vertical or not), viral genotypes and duration of treatment, between groups enrolled. The overall sustained viral response rate ranges from 28.6% to 81.8%. The rate of treatment success is higher in children infected with genotypes 2 and 3 than with other genotypes. The therapy does not induce severe adverse effects and children present better tolerance to antiviral than adults.
CONCLUSIONS: The pharmacological efficacy of peginterferon and ribavirin seems to be proven by data collected in studies cited, but there are different opinions about who, when and how to treat children infected. Thus, further research is needed to define the best management of vertical acquired hepatitis C
“Evaluation of a mathematical model proposed to predict the diagnosis of tuberculosis in children with cervical lymph node enlargement”.
No full textThe differential diagnosis between TB and NTB lymphadenitis is
still a clinical challenge because a definitive cultural diagnosis is
not always achievable. Moreover, microbiological analyses still
requires a long time for definitive results, and a delayed diagnosis
is associated with an increased risk of disseminated disease.
Indeed, the proposed model still deserve attention due to its
possible ability in suggesting a hard diagnosis in a easy, rapid, noninvasive
and non-expensive way, but it needs to be improved by
multicentric studies based on national scale
Paediatric long COVID studies should focus on clinical evaluations that examine the impact on daily life not just self-reported symptoms
No full textNo abstract availabl
Non-infectious makers of Kawasaki syndrome: tangible or elusive triggers?
No full textA well-balanced description of the non-infectious causes of Kawasaki syndrome is discussed in this editorial
Congenital cytomegalovirus infection: current strategies and future perspective
No full textCytomegalovirus is the most common cause of congenital infections in humans and it produces considerable morbidity in newborns. Congenital cytomegalovirus infection can be symptomatic or not at birth, but about 10-20% of them will exhibit neurological damage when followed up. Sensorineural hearing loss is the most frequent long-term consequence and is not manifest invariably at birth or in the neonatal period but in many cases becoms clinically apparent in later childhood. There are growing evidences that newborns with symptomatic congenital cytomegalovirus infection would benefit from treatment with either ganciclovir or valganciclovir, the most widely studied drugs in this setting. It is not yet clear if children with asymptomatic or pauci-symptomatic infection at birth would benefit from treatment. Studies evaluating treatment and long-term follow-up of infants with both symptomatic and asymptomatic infection are necessary, in order to definitely evaluate the short and long-term effectiveness and safety of both ganciclovir and valganciclovir and to identify risk factors associated to the development of long-term sequelae. In this way it will be possible to select those children that might benefit for treatment. The present study reviews current concepts on epidemiology, clinical manifestations, diagnosis, treatment, future strategies and prognosis of children with congenital cytomegalovirus infection
- …
