649 research outputs found

    Protection of vaccine preventable diseases in a population of hiv-infected children: A 3 years prospective study

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    Human Immunodeficiency Virus (HIV) infected children have a 30–70% chance of being incompletely immunized and may not respond serologically with the same magnitude or durability as uninfected children. The aim of the study was to describe the rate of protective antibodies titre and the persistence of the response against four recommended vaccinations in HIV infected children and adolescents. A two-phase observational study was performed in which protective IgG antibodies to measles, mumps, rubella and hepatitis B were determined and monitored for 12 and 24 months, in 26 perinatally HIV-infected children. The rate of protection for rubella and hepatitis B was significantly lower in the HIV group compared to the control group (92% vs. 65% for rubella and 78.4% vs. 45.4% for hepatitis B; p < 0.05). Children who received primary vaccination after initiating combination antiretroviral therapy (cART) had a higher rate of response. Seronegative patients who received a booster dose of vaccine had a good immunological response. HIV infection is associated with a lower response to vaccines against rubella and hepatitis. The beginning of cART before vaccination may be associated with a better response. The evaluation of the serological response is crucial in children with HIV infection in order to evaluate the protection of vaccine preventable diseases

    Health-care organization for the management and surveillance of SARS-CoV-2 infection in children during pandemic in Campania region, Italy

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    Background: In comparison with adults, severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection in children has a milder course. The management of children with suspected or confirmed coronavirus disease (COVID-19) needs to be appropriately targeted. Methods: We designed a hub-and-spoke system to provide healthcare indications based on the use of telemedicine and stringent admission criteria, coordinate local stakeholders and disseminate information. Result: Between March 24th and September 24th 2020, the Hub Centre managed a total of 208 children (52% males, median age, 5.2, IQR 2–9.6 years) with suspected or confirmed COVID-19. Among them, 174 were managed in cooperation with family pediatricians and 34 with hospital-based physicians. One hundred-four (50%) received a final diagnosis of SARS-CoV-2 infection. Application of stringent criteria for hospital admission based on clinical conditions, risk factors and respect of biocontainment measures, allowed to manage the majority of cases (74, 71.1%) through telemedicine. Thirty children (28%) were hospitalized (median length 10 days, IQR 5–19 days), mainly due to the presence of persistent fever, mild respiratory distress or co-infection occurring in infant or children with underlying conditions. However, the reasons for admission slightly changed over time. Conclusion: An hub-and-spoke system is effective in coordinate territorial health-care structures involved in management paediatric COVID-19 cases through telemedicine and the definition of stringent hospital admission criteria. The management of children with COVID-19 should be based on clinical conditions, assessed on a case-by-case critical evaluation, as well as on isolation measures, but may vary according to local epidemiological changes

    Growth methods of c-axis oriented MgB2 thin films by pulsed laser deposition

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    High quality MgB2 thin films have been obtained by pulsed laser deposition both on MgO and on Al2O3 substrates using different methods. In the standard two-step procedure, an amorphous precursor layer is deposited at room temperature starting both from stoichiometric target and from boron target: after this first step, it is annealed in magnesium atmosphere in order to crystallize the superconducting phase. The so obtained films show a strong c-axis orientation, evidenced by XRD analysis, a critical temperature up to 38 K and very high critical fields along the basal planes, up to 22T at 15K. Also an in situ one step technique for the realization of superconducting MgB2 thin films has been developed. In this case, the presence of an argon buffer gas during deposition is crucial and we observe a strong dependence of the quality of the deposited film on the background gas pressure. The influence of the Ar atmosphere has been confirmed by time and space-resolved spectroscopy measurements on the emission spectrum of the plume. The Ar pressure modifies strongly the plasma kinetics by promoting excitation and ionization of the plume species, especially of the most volatile Mg atoms, increasing their internal energy.Comment: Paper presented at Boromag Workshop, Genoa 17-19 June 2002, in press on SUS

    Simple method for the characterization of intense Laguerre-Gauss vector vortex beams

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    We report on a method for the characterization of intense, structured optical fields through the analysis of the size and surface structures formed inside the annular ablation crater created on the target surface. In particular, we apply the technique to laser ablation of crystalline silicon induced by femtosecond vector vortex beams. We show that a rapid direct estimate of the beam waist parameter is obtained through a measure of the crater radii. The variation of the internal and external radii of the annular crater as a function of the laser pulse energy, at fixed number of pulses, provides another way to evaluate the beam spot size through numerical fitting of the obtained experimental data points. A reliable estimate of the spot size is of paramount importance to investigate pulsed laser-induced effects on the target material. Our experimental findings offer a facile way to characterize focused, high intensity complex optical vector beams which are more and more applied in laser-matter interaction experiments

    Performance and characteristics of the Newborn Hearing Screening Program in Campania region (Italy) between 2013 and 2019

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    Purpose: Universal newborn hearing screening (UNHS) in the first month of life is crucial for facilitating both early hearing detection and intervention (EHDI) of significant permanent hearing impairment (PHI). In Campania region, UNHS has been introduced in 2003 by the Regional Council Resolution and started on January 2007. The aim of this paper is to update a previous article describing the performance of the program since its implementation in the period between 2013 and 2019. Methods: A longitudinal retrospective study was carried at the Regional Reference Center III on 350,178 babies born in the analysis period. The paper reports the main results of overall coverage, referral rate, lost-to-follow-up rate,yield for PHI and shall determine various risk factor associations with hearing impairment Results: In Campania region, 318,878 newborns were enrolled at I level, with a coverage rate of 91.06%, 301,818 (86.18%) Well Infant Nurseries (WIN) and 17,060 (5.35%) Neonatal Intensive Care Unit (NICU) babies. PHI was identified in 413 children, 288 (69.73%) bilaterally and 125 (30.26%) unilaterally. The overall cumulative incidence rate of PHI was 1.29 per 1000 live-born infants (95% CI 1.17–1.42) with a quite steady tendency during the whole study period. Conclusions: This study confirms the feasibility and effectiveness of UNHS in Campania region also in a setting with major socioeconomic and health organization restrictions.The program meets quality benchmarks to evaluate the progress of UNHS. Nowadays, it is possible to achieve an early diagnosis of all types of HL avoiding the consequences of hearing deprivation

    A formula containing galacto- and fructo-oligosaccharides prevents intestinal and extra-intestinal infections : an observational study

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    BACKGROUND & AIM: The addition of prebiotics to infant formula modifies the composition of intestinal microflora. Aim of the study was to test the hypothesis that prebiotics reduce the incidence of intestinal and respiratory infections in healthy infants. METHODS: A prospective, randomized, placebo-controlled, open trial was performed. Healthy infants were enrolled and randomized to a formula additioned with a mixture of galacto- and fructo-oligosaccharides or to a control formula. The incidence of intestinal and respiratory tract infections and the anthropometric measures were monitored for 12 months. RESULTS: Three hundred and forty two infants (mean age 53.7+/-32.1 days) were enrolled. The incidence of gastroenteritis was lower in the supplemented group than in the controls (0.12+/-0.04 vs. 0.29+/-0.05 episodes/child/12 months; p=0.015). The number of children with more than 3 episodes tended to be lower in prebiotic group (17/60 vs. 29/65; p=0.06). The number of children with multiple antibiotic courses/year was lower in children receiving prebiotics (24/60 vs. 43/65; p=0.004). A transient increase in body weight was observed in children on prebiotics compared to controls during the first 6 months of follow-up. CONCLUSIONS: Prebiotic administration reduce intestinal and, possibly, respiratory infections in healthy infants during the first year of age

    Adherence to chronic medication in older populations: application of a common protocol among three European cohorts

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    Purpose: The purpose of this study was to evaluate and compare medication adherence to chronic therapies in older populations across different regions in Europe. Methods: This explorative study applied a harmonized method of data extraction and analysis from pharmacy claims databases of three European countries to compare medication adherence at a cross-country level. Data were obtained for the period between January 1, 2010, and December 31, 2011. Patients (aged >= 65 years) who newly initiated to oral antidiabetics, antihyperlipidemics, or antiosteoporotics were identified and followed for over a 12-month period. Main outcome measures were medication adherence (medication possession ratio, [MPR]; implementation) and persistence on index treatment. All country-specific data sets were prepared by employing a common data input model. Outcome measures were calculated for each country and pooled using random effect models. Results: In total, 39, 186 new users were analyzed. In pooled data from the three countries, suboptimal implementation (MPR <80%) was 52.45% (95% CI: 33.43-70.79) for antihyperlipidemics, 61.35% (95% CI: 52.83-69.22) for antiosteoporotics, and 30.33% (95% CI: 25.53-35.60) for oral antidiabetics. Similarly, rates of non-persistence (discontinuation) were 55.63% (95% CI: 35.24-74.29) for antihyperlipidemics, 60.24% (95% CI: 45.35-73.46) for antiosteoporotics, and 46.80% (95% CI: 36.40-57.4) for oral antidiabetics. Conclusion: Medication adherence was suboptimal with >50% of older people non-adherent to antihyperlipidemics and antiosteoporotics in the three European cohorts. However, the degree of variability in adherence rates among the three countries was high. A harmonized method of data extraction and analysis across health-related database in Europe is useful to compare medication-taking behavior at a cross-country level
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