Mild to moderate hypersensitivity reactions to beta-lactams in children: a single-centre retrospective review

[Abstract] Objective: Beta-lactam (BL) antibiotics are the most reported drugs in hypersensitivity reactions in children. More than 90% of these children tolerate the suspected drug after diagnostic work-up. Skin tests (STs) show low sensitivity. Our aim was to assess the performance of drug provocation tests (DPTs) without previous ST in mild and moderate delayed reactions and to propose a new DPT protocol. Design of the study: Charts from 213 children under 15 years of age referred for suspected BL allergy from 2011 to 1013 were reviewed. Prick, intradermal and patch tests were performed with major determinant penicilloyl-polylysine, minor determinant mixture, amoxicillin (AMX), cefuroxime, penicillin G and AMX-clavulamate. Children with negative skin tests underwent DPT. After an initial full dose of antibiotic, DPT was carried on for 3 days at home in patients reacting within the first 3 days of treatment. If the reaction took place from day 4 on of treatment, patients took the antibiotic for 5 days. Results: We included 108 girls and 105 boys. Mean age at the time of reaction was 3.66±3.06 years. 195 patients (91.5%) reacted to one BL. 154 reactions (67.2%) were non-immediate. Mild to moderate skin manifestations were most frequently reported. AMX-clavulanate was the most frequently involved (63.4%). DPT confirmed the diagnosis of drug hypersensitivity in 17 (7.3%) cases. These 17 patients had negative ST. Conclusion: In mild and moderate cases of BL hypersensitivity, diagnosis can be performed by DPT without previous ST

In situ synchrotron X-ray powder diffraction study of the early hydration of α-tricalcium phosphate/tricalcium silicate composite bone cement

Bioactivity, osteogenicity and mechanical properties of α-tricalcium phosphate (α-TCP) based phosphates cements can be improved by adding tricalcium silicate (C3S); however, the addition of C3S delays the precipitation and growth of calcium deficient hydroxyapatite (CDHA). Thus, the aim of this work was the study of in situ setting reaction of α-TCP/C3S composite bone cement under high energy X-ray generated by a synchrotron source within the first 72h. The results showed that the addition of C3S induces the precipitation of nanosized CDHA at early times depending on the added content. Calculated crystallite sizes showed that the higher the content of C3S, the smaller the crystal size at the beginning of the precipitation. These results are different from those obtained by conventional XRD method, suggesting that the proposed technique is a powerful tool in determining the composition and extent of reaction of CPCs surfaces in real time

Frequency and characteristics of cannabis and cocaine consumption in women and their children hospitalized in Maldonado Hospital

María Claudia Cabrera: Facultad de Medicina, Universidad de la República, Uruguay. Hospital de Maldonado, Administración de los Servicios de Salud del Estado (ASSE) Uruguay.-- María José Pérez: Facultad de Medicina, Universidad de la República, Uruguay. Hospital de Maldonado, Administración de los Servicios de Salud del Estado (ASSE) Uruguay.-- Carlos Zunino: Facultad de Medicina, Universidad de la República, Uruguay.-- Yohany Cabana: Hospital de Maldonado, Administración de los Servicios de Salud del Estado (ASSE) Uruguay -- Loreley García: Facultad de Medicina, Universidad de la República, Uruguay.-- Gustavo Giachetto: Facultad de Medicina, Universidad de la República, Uruguay.El consumo de pasta base de cocaína y marihuana durante el embarazo es un problema creciente. El objetivo de este estudio fue estimar la frecuencia del consumo de estas sustancias durante el embarazo en mujeres hospitalizados en el Hospital de Maldonado y describir las características de ellas y sus hijos. Se realizó un estudio transversal desde el 1º de enero de 2014 al 31 de enero de 2015. Para detectar el consumo se consideraron aquellas mujeres que auto declararon consumir cocaína o marihuana en algún momento del embarazo y las que a pesar de negarlo, presentaban factores de riesgo de consumo y metabolitos de estas drogas en muestras de orina. Las variables registradas de las mujeres en las que se detectó consumo fueron: edad, nivel de instrucción, ocupación, embarazos previos, controles del embarazo, droga consumida. Las de sus recién nacido: sexo, edad gestacional, datos antropométricos, Apgar, síndrome de abstinencia por escala de Finnegan. Ingresaron 684 embarazadas, en 26 se detectó consumo. La frecuencia de consumo de cocaína/pasta base de cocaína fue de 2.7% (2.1% - 3.3%) y de marihuana 1.5% (0.6% - 2.4%). En 16 fue por auto-reporte. La edad media materna fue 24,8 años. La mayoría de los recién nacidos presentaron datos antropométricos normales al nacer. Se diagnosticó síndrome abstinencia en 10. Ninguno requirió tratamiento. Es el primer reporte que estima la frecuencia de consumo en la institución mencionada aunque seguramente la magnitud del problema sea mayor. El auto-reporte tiene baja sensibilidad para la detección del consumo y no se complementó con otros métodos de detección de forma sistemática. El diseño de este trabajo no permitió conocer la repercusión perinatal del consumo.The consumption of cocaine base paste and marijuana during pregnancy is a growing problem. The aim of this study was to estimate the frequency of use of these substances during pregnancy in women hospitalized in Maldonado Hospital and to describe the characteristics of these women and their children. A cross-sectional study was conducted from 02/01/14 to 31/01/15. Women who self reported consuming during pregnancy or presented metabolites of these drugs in urine were detected. Maternal variables studied were: age, level of education, occupation, previous pregnancies, pregnancy checks, drug consumed. The newborn variables were sex, gestational age, anthropometric data, Apgar score and abstinence by Finnegan. 684 pregnant women were studied, in 26 of them consumption was detected. The frequency of cocaine/cocaine base paste was 2.7% (2.1% - 3.3%) and cannabis 1.5% (0.6% - 2.4%). In 16 it was by self-report. The mean maternal age was 24.8 years. Most of the newborns had normal birth anthropometric data. Abstinence syndrome was diagnosed in 10. None required treatment. This is the first report that estimates the frequency of consumption in this hospital but surely the problem is greater. Self-report has low sensitivity for the detection of consumption and systematical use of other methods of detection was lacking. The design of the investigation did not allow us to know the impact of consumption in perinatal outcomes

Genetic diversification of an invasive honey bee ectoparasite across sympatric and allopatric host populations

Invasive parasites are major threats to biodiversity. The honey bee ectoparasite, Varroa destructor, has shifted host and spread almost globally several decades ago. This pest is generally considered to be the main global threat to Western honey bees, Apis mellifera, although the damages it causes are not equivalent in all its new host’s populations. Due to the high virulence of this parasite and the viruses it vectors, beekeepers generally rely on acaricide treatments to keep their colonies alive. However, some populations of A. mellifera can survive without anthropogenic mite control, through the expression of diverse resistance and tolerance traits. Such surviving colonies are currently found throughout the globe, with the biggest populations being found in Sub- Saharan Africa and Latin America. Recently, genetic differences between mite populations infesting surviving and treated A. mellifera colonies in Europe were found, suggesting that adaptations of honey bees drive mite evolution. Yet, the prevalence of such co-evolutionary adaptations in other invasive populations of V. destructor remain unknown. Using the previous data from Europe and novel genetic data from V. destructor populations in South America and Africa, we here investigated whether mites display signs of adaptations to different host populations of diverse origins and undergoing differing management. Our results show that, contrary to the differences previously documented in Europe, mites infesting treated and untreated honey bee populations in Africa and South America are genetically similar. However, strong levels of genetic differentiation were found when comparing mites across continents, suggesting ongoing allopatric speciation despite a recent spread from genetically homogenous lineages. This study provides novel insights into the co-evolution of V. destructor and A. mellifera, and confirms that these species are ideal to investigate coevolution in newly established host- parasite systems.Agencia Nacional de Investigación e InnovaciónPrograma ECOS-Su

Genetic diversification of an invasive honey bee ectoparasite across sympatric and allopatric host populations.

Invasive parasites are major threats to biodiversity. The honey bee ectoparasite, Varroa destructor, has shifted host and spread almost globally several decades ago. This pest is generally considered to be the main global threat to Western honey bees, Apis mellifera, although the damages it causes are not equivalent in all its new host's populations. Due to the high virulence of this parasite and the viruses it vectors, beekeepers generally rely on acaricide treatments to keep their colonies alive. However, some populations of A. mellifera can survive without anthropogenic mite control, through the expression of diverse resistance and tolerance traits. Such surviving colonies are currently found throughout the globe, with the biggest populations being found in Sub-Saharan Africa and Latin America. Recently, genetic differences between mite populations infesting surviving and treated A. mellifera colonies in Europe were found, suggesting that adaptations of honey bees drive mite evolution. Yet, the prevalence of such co-evolutionary adaptations in other invasive populations of V. destructor remain unknown. Using the previous data from Europe and novel genetic data from V. destructor populations in South America and Africa, we here investigated whether mites display signs of adaptations to different host populations of diverse origins and undergoing differing management. Our results show that, contrary to the differences previously documented in Europe, mites infesting treated and untreated honey bee populations in Africa and South America are genetically similar. However, strong levels of genetic differentiation were found when comparing mites across continents, suggesting ongoing allopatric speciation despite a recent spread from genetically homogenous lineages. This study provides novel insights into the co-evolution of V. destructor and A. mellifera, and confirms that these species are ideal to investigate coevolution in newly established host-parasite systems

Using quality risk management in the plantibody HB-01 manufacturing by transgenic tobacco Plants for vaccine production

The production of biopharmaceuticals by transgenic plants is a promising choice to achieve the multi-kilogram amount of products needed to treat many human diseases. However, this scientific field is still lacking of approved specific guidelines regarding points to consider for manufacturing and application of these products. In such sense, the implementation of new manufacturing processes and quality systems using the quality risks management is recognized as something of prime importance in the current pharmaceutical industry. In this work, we summarize the application of the FMEA method to design the manufacturing process of a plantibody, employed in the hepatitis B vaccine production to ensure the vaccine high quality.Colegio de Farmacéuticos de la Provincia de Buenos Aire

Using quality risk management in the plantibody HB-01 manufacturing by transgenic tobacco Plants for vaccine production

The production of biopharmaceuticals by transgenic plants is a promising choice to achieve the multi-kilogram amount of products needed to treat many human diseases. However, this scientific field is still lacking of approved specific guidelines regarding points to consider for manufacturing and application of these products. In such sense, the implementation of new manufacturing processes and quality systems using the quality risks management is recognized as something of prime importance in the current pharmaceutical industry. In this work, we summarize the application of the FMEA method to design the manufacturing process of a plantibody, employed in the hepatitis B vaccine production to ensure the vaccine high quality.Colegio de Farmacéuticos de la Provincia de Buenos Aire

Experiencia de uso de hierro intravenoso para el tratamiento de la anemia en niños y adolescentes. Respuesta terapéutica y evolución

Introducción: El hierro de administración intravenosa (iv) está indicado en los casos en que el tratamiento oral no es posible. El objetivo de este trabajo fue describir el perfil de uso, respuesta terapéutica y seguridad de la administración de hierro iv en el tratamiento de la anemia ferropénica en niños, niñas y adolescentes (NNA) asistidos en un centro de referencia de Uruguay entre 2018 y 2023. Métodos: Estudio retrospectivo mediante revisión de historias. Incluyó todos los NNA que recibieron hierro iv. Se registraron variables sociodemográficas, comorbilidades, clínica y severidad de la anemia. Se evaluó: motivos de la indicación y tipo de hierro iv, dosis, tiempo de infusión, respuesta terapéutica y efectos adversos. Resultados: Se incluyeron 35 pacientes, mediana de edad 4 años; 51,4% de sexo masculino, con comorbilidades 37,1%. Todos los menores de 3 años presentaban factores de riesgo para anemia ferropénica, la falta de adherencia al hierro oral se asoció con mayor severidad de la anemia (p<0,05). Motivo principal de indicación de hierro iv fue: severidad de la anemia e inadecuada respuesta al hierro oral concomitante en 37,1%. Todos recibieron hierro sacarato; mediana de dosis: 2 mg/kg y de tiempo de infusión: 1 hora. Se registró un caso de edema y exantema de cara vinculado a la rápida infusión. La evolución fue satisfactoria. Conclusiones: La administración de hierro iv fue segura. Es necesario establecer consensos respecto a la posología y monitorización. Se requieren nuevos estudios para continuar evaluando la eficacia y seguridad del hierro iv en sus diversas formulaciones

Seroprevalencia de Toxoplasma gondii y factores de riesgo asociados en Felis catus en La Habana

In the framework of the investigation Seroprevalence of Toxoplasma gondii and associated risk factors in Feliscatus in Havana, this causal agent of toxoplasmosis, a re-emergent and cosmopolitan zoonosis that affects mammal and birds as intermediate hosts and felines as definitive hosts, was approached. In Cuba, a high seroprevalence of T. gondii in humans was reported in the capital; however, to date, the prevalence in the feline species (Felis catus) in Havana is unknown, mainly due to the absence of diagnosticians on the veterinary network and the complexity in sampling. For the above arguments, it was decided to determine the seroprevalence of T. gondii and to identify the risk factors associated with the presence of anti-T. gondii antibodies in Felis catus

Using quality risk management in the plantibody HB-01 manufacturing by transgenic tobacco Plants for vaccine production

The production of biopharmaceuticals by transgenic plants is a promising choice to achieve the multi-kilogram amount of products needed to treat many human diseases. However, this scientific field is still lacking of approved specific guidelines regarding points to consider for manufacturing and application of these products. In such sense, the implementation of new manufacturing processes and quality systems using the quality risks management is recognized as something of prime importance in the current pharmaceutical industry. In this work, we summarize the application of the FMEA method to design the manufacturing process of a plantibody, employed in the hepatitis B vaccine production to ensure the vaccine high quality.Colegio de Farmacéuticos de la Provincia de Buenos Aire