Adverse events following measles-mumps-rubella-varicella vaccination and the case of seizures: A post marketing active surveillance in Puglia Italian region, 2017-2018

Since 2012, the Italian Ministry of Health has recommended to improve the surveillance of adverse events following the measles-mumps-rubella-varicella (MMRV) tetravalent vaccine that was provided in the official immunization schedule of some Italian regions for children during the second year of life. This recommendation was based on data from some surveys that showed an additional risk of seizure following the administration of this vaccine. Responding to the Ministry commitment, the Puglia Region launched, from May 2017 to November 2018, a post-marketing active surveillance program of adverse events following MMRV immunization (AEFIs). Immunized children (second year of life) were enrolled on a voluntary basis, AEFIs diaries were used, and their parents were interviewed 25 days after the immunization. There were 2540 children enrolled; 2149/2540 (84.6%) completed the post-vaccination follow-up. Of these, 992 AEFIs were registered with a reporting rate of 46.2 × 100 doses: 883/992 (89.0%) AEFIs were not serious, while 109/992 (11.0%) were serious. For serious AEFIs, the evaluation of causality assessment was performed using the algorithm proposed by the World Health Organisation (WHO): 82/109 consistent causal associations to MMRV immunization were detected (reporting rate of consistent AEFIs: 3.8 × 100 follow-up). All serious AEFIs consistently associated with immunization resulted completely resolved at the follow-up. The reporting rate of seizure consistently associated with immunization was 0.05 × 100, lower than data previous published in the literature that did not report the causality assessment. Because no emerging signals were detected, our data from the active surveillance program confirmed the safety profile of the MMRV vaccine

Effectiveness of SARS-CoV-2 Vaccines for Short- and Long-Term Immunity: A General Overview for the Pandemic Contrast

Background: The recent COVID-19 pandemic produced a significant increase in cases and an emergency state was induced worldwide. The current knowledge about the COVID-19 disease concerning diagnoses, patient tracking, the treatment protocol, and vaccines provides a consistent contribution for the primary prevention of the viral infection and decreasing the severity of the SARS-CoV-2 disease. The aim of the present investigation was to produce a general overview about the current findings for the COVID-19 disease, SARS-CoV-2 interaction mechanisms with the host, therapies and vaccines’ immunization findings. Methods: A literature overview was produced in order to evaluate the state-of-art in SARS-CoV-2 diagnoses, prognoses, therapies, and prevention. Results: Concerning to the interaction mechanisms with the host, the virus binds to target with its Spike proteins on its surface and uses it as an anchor. The Spike protein targets the ACE2 cell receptor and enters into the cells by using a special enzyme (TMPRSS2). Once the virion is quietly accommodated, it releases its RNA. Proteins and RNA are used in the Golgi apparatus to produce more viruses that are released. Concerning the therapies, different protocols have been developed in observance of the disease severity and comorbidity with a consistent reduction in the mortality rate. Currently, different vaccines are currently in phase IV but a remarkable difference in efficiency has been detected concerning the more recent SARS-CoV-2 variants. Conclusions: Among the many questions in this pandemic state, the one that recurs most is knowing why some people become more seriously ill than others who instead contract the infection as if it was a trivial flu. More studies are necessary to investigate the efficiency of the treatment protocols and vaccines for the more recent detected SARS-CoV-2 variant

Functional breastfeeding: from nutritive sucking to oral health

Functional breastfeeding plays a key role in the correct psychophysical and neuromotor development ofa child, and it has repercussions on craniofacial complex growth and functioning. The consequences of notbreastfeeding seem to have not only aesthetic complications but can cause significant functional orthodonticrepercussions. Each study on breastfeeding has shown how breast milk protects against acute otitis media,pneumonia, syncytial virus, bronchitis, asthma, gastroenteritis, Sudden Infant Death Syndrome (SIDS),leukaemia, obesity, allergies and even constitutes a protective factor against habitual infant snoring and inreduction of the risk of obstructive apnea. By exercising his muscles, the child strengthens his zygomaticprocesses so that nasal airways have good drainage capacity and consequently a low predisposition tosinus and respiratory infections. Dentists have a fundamental role in the prevention of maternal-infantoral health, and by assisting its management, they can even implement the best development of a child’simmune system. The “primary” function of the dentist which is concretized in encouraging the planning ofthe first early visits of the interception of spoiled habits and incorrect lifestyles, together with the “internal”one of the intestinal and oral microbiota of the child together with breastfeeding have an indirect yetsignificant consequence of favoring the harmonic growth of the orofacial complex

Functional breastfeeding: From nutritive sucking to oral health

Functional breastfeeding plays a key role in the correct psychophysical and neuromotor development of a child, and it has repercussions on craniofacial complex growth and functioning. The consequences of not breastfeeding seem to have not only aesthetic complications but can cause significant functional orthodontic repercussions. Each study on breastfeeding has shown how breast milk protects against acute otitis media, pneumonia, syncytial virus, bronchitis, asthma, gastroenteritis, Sudden Infant Death Syndrome (SIDS), leukaemia, obesity, allergies and even constitutes a protective factor against habitual infant snoring and in reduction of the risk of obstructive apnea. By exercising his muscles, the child strengthens his zygomatic processes so that nasal airways have good drainage capacity and consequently a low predisposition to sinus and respiratory infections. Dentists have a fundamental role in the prevention of maternal-infant oral health, and by assisting its management, they can even implement the best development of a child’s immune system. The “primary” function of the dentist which is concretized in encouraging the planning of the first early visits of the interception of spoiled habits and incorrect lifestyles, together with the “internal” one of the intestinal and oral microbiota of the child together with breastfeeding have an indirect yet significant consequence of favoring the harmonic growth of the orofacial complex

A systematic review and individual patient data meta-analysis on intra-abdominal hypertension in critically ill patients: the wake-up project World initiative on Abdominal Hypertension Epidemiology, a Unifying Project (WAKE-Up!)

Intra-abdominal hypertension (IAH), defined as a pathologically increase in intraabdominal pressure, is commonly found in critically ill patients. While IAH has been associated with several abdominal as well as extra-abdominal conditions, few studies have examined the occurrence of IAH in relation to mortality. The aim of this paper was to evaluate the prognostic role of IAH and its risk factors at admission in critically ill patients across a wide range of settings and countries. An individual patient meta-analysis of all available data and a systematic review of published (in full or as abstract) medical databases and studies between 1996 and June 2012 were performed. The search was limited to "clinical trials" and "randomized controlled trials", "adults", using the terms "intra-abdominal pressure", "intraabdominal hypertension" combined with any of the terms "outcome" and "mortality". All together data on 2707 patients, representing 21 centers from 11 countries was obtained. Data on 1038 patients were not analysed because of the following exclusion criteria: no LAP value on admission (N.=712), absence of information on ICU outcome (N.=195), age 95 years (N.=131). Data from 1669 individual patients (19 centers from 9 countries) were analyzed in the meta-analysis. Presence of IAH was defined as a sustained increase in LAP equal to or above 12 mmHg. At admission the mean overall LAP was 9.9\ub15.0 mmHg, with 463 patients (27.7%) presenting IAH with a mean LAP of 16.3\ub13.4 mmHg. The only independent predictors for IAH were SOFA score and fluid balance on the day of admission. Five hundred thirteen patients (30.8%) died in intensive care. The independent predictors for intensive care mortality were IAH, SAPS II score, SOFA score and admission category. This systematic review and individual patient data meta-analysis shows that IAH is frequently present in critically ill patients and it is an independent predictor for mortality