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Berghea EC, Ionescu MD, Gheorghiu RM, Tincu IF, Cobilinschi CO, Craiu M, Bălgrădean M, Berghea F. Integrating Artificial Intelligence in Pediatric Healthcare: Parental Perceptions and Ethical Implications. Children (Basel) 2024; 11:240. [PMID: 38397353 PMCID: PMC10887612 DOI: 10.3390/children11020240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/30/2024] [Accepted: 02/09/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND Our study aimed to explore the way artificial intelligence (AI) utilization is perceived in pediatric medicine, examining its acceptance among patients (in this case represented by their adult parents), and identify the challenges it presents in order to understand the factors influencing its adoption in clinical settings. METHODS A structured questionnaire was applied to caregivers (parents or grandparents) of children who presented in tertiary pediatric clinics. RESULTS The most significant differentiations were identified in relation to the level of education (e.g., aversion to AI involvement was 22.2% among those with postgraduate degrees, 43.9% among those with university degrees, and 54.5% among those who only completed high school). The greatest fear among respondents regarding the medical use of AI was related to the possibility of errors occurring (70.1%). CONCLUSIONS The general attitude toward the use of AI can be considered positive, provided that it remains human-supervised, and that the technology used is explained in detail by the physician. However, there were large differences among groups (mainly defined by education level) in the way AI is perceived and accepted.
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Affiliation(s)
- Elena Camelia Berghea
- “Marie S. Curie” Emergency Children’s Clinical Hospital, Carol Davila University of Medicine and Pharmacy, 041451 Bucharest, Romania; (E.C.B.); (M.B.)
| | - Marcela Daniela Ionescu
- “Marie S. Curie” Emergency Children’s Clinical Hospital, Carol Davila University of Medicine and Pharmacy, 041451 Bucharest, Romania; (E.C.B.); (M.B.)
| | - Radu Marian Gheorghiu
- National Institute for Mother and Child Health “Alessandrescu-Rusescu”, Carol Davila University of Medicine and Pharmacy, 041249 Bucharest, Romania;
| | - Iulia Florentina Tincu
- Dr. Victor Gomoiu Clinical Children Hospital, Carol Davila University of Medicine and Pharmacy, 022102 Bucharest, Romania;
| | - Claudia Oana Cobilinschi
- Sfanta Maria Clinica Hospital, Carol Davila University of Medicine and Pharmacy, 011172 Bucharest, Romania; (C.O.C.); (F.B.)
| | - Mihai Craiu
- National Institute for Mother and Child Health “Alessandrescu-Rusescu”, Carol Davila University of Medicine and Pharmacy, 041249 Bucharest, Romania;
| | - Mihaela Bălgrădean
- “Marie S. Curie” Emergency Children’s Clinical Hospital, Carol Davila University of Medicine and Pharmacy, 041451 Bucharest, Romania; (E.C.B.); (M.B.)
| | - Florian Berghea
- Sfanta Maria Clinica Hospital, Carol Davila University of Medicine and Pharmacy, 011172 Bucharest, Romania; (C.O.C.); (F.B.)
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Miron VD, Raianu RO, Filimon C, Craiu M. Clinical Differences between SARS-CoV-2 and RSV Infections in Infants: Findings from a Case-Control Study. Viruses 2023; 16:63. [PMID: 38257763 PMCID: PMC10819890 DOI: 10.3390/v16010063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 12/27/2023] [Accepted: 12/29/2023] [Indexed: 01/24/2024] Open
Abstract
Infants are a unique pediatric group due to their high hospitalization rates and unfavorable outcomes from acute infectious diseases. Understanding the clinical differences and aftereffects of SARS-CoV-2 in comparison to other prevalent viruses in this age group, like RSV, is crucial for effective management. We conducted a retrospective case-control study of infants hospitalized with SARS-CoV-2 or respiratory syncytial virus (RSV) infection in one year, in a tertiary pediatric hospital in Bucharest, Romania. A total of 188 infants were included in the analysis in a 1:1 ratio (94 with SARS-CoV-2 infection and 94 with RSV infection). Infants with COVID-19 were 10.2 times more likely to have fever (p < 0.001) and 2.4 times more likely to have diarrhea (p = 0.016). Conversely, infants with RSV were 2.5 times more likely to have a cough (p < 0.001), 3.0 times more likely to have nasal congestion (p < 0.001), and 14.7 times more likely to present with dyspnea (p < 0.001). Increased lymphocyte count was more common in infants with RSV (p = 0.008), while lymphopenia was more frequent in infants with SARS-CoV-2 (p = 0.011). The median length of hospital stay was one day longer in infants with RSV infection (5 days vs. 4 days). Overall, infants with RSV infection had a 27.3-fold increased risk of developing respiratory failure (p < 0.001), while infants with COVID-19 had a 5.8-fold increased risk of laryngitis (p = 0.003). Our findings suggest that infants with SARS-CoV-2 infection may present with polymorphic symptoms, mostly dominated by fever, whereas infants with RSV often present with respiratory symptoms. Laboratory differentiation between the two infections is challenging; therefore, the use of rapid antigen or molecular diagnostic tests is crucial for accurate diagnosis, epidemiologically appropriate measures, and effective management. Continued surveillance of both viruses in infants, and beyond, and the implementation of specific control measures are needed to mitigate their impact on this vulnerable pediatric group.
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Affiliation(s)
| | - Raluca-Oana Raianu
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Claudiu Filimon
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Mihai Craiu
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- National Institute for Mother and Child Health “Alessandrescu-Rusescu”, 020395 Bucharest, Romania
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Săndulescu O, Streinu-Cercel A, Miron VD, Covăcescu SM, Streinu-Cercel A, Craiu M. Liver Transaminases in Pediatric Adenovirus Infection-A Five-Year Study in Two Major Reference Centers from Romania. Microorganisms 2023; 11:microorganisms11020302. [PMID: 36838267 PMCID: PMC9961354 DOI: 10.3390/microorganisms11020302] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/16/2023] [Accepted: 01/18/2023] [Indexed: 01/25/2023] Open
Abstract
Human adenovirus causes infections with a very heterogeneous clinical picture, and children are often the most frequently affected group. Interest in adenovirus has increased with the 2022 outbreak of severe acute hepatitis of unknown etiology as human adenovirus was considered as one of the possible etiological agents. We conducted a retrospective study over a 5-year period in two major tertiary hospitals in the Romanian capital with the aim to characterize the clinical picture and the dynamics of liver function tests in children with confirmed adenovirus infection. The study included 1416 children with a median age of 1.1 years (IQR: 0.3, 2.3 years). Digestive symptoms were predominant in 95.2% of children, mainly diarrhea (90.5%) and vomiting (50.5%), and 38.0% had respiratory symptoms. Increased transaminases were identified in 21.5% of patients. Age over 1 year, lethargy, vomiting and dehydration significantly increased the odds of liver cytolysis independent of other risk factors such as chronic conditions or co-infections. Aspartate aminotransferase (AST) was more commonly increased compared to alanine aminotransferase (ALT). Only six children had transaminase increases above 500 U/L, three of which had co-infections with rotavirus, Epstein-Barr virus (EBV), or respiratory syncytial virus (RSV). Liver function tests should be part of routine monitoring for pediatric patients with adenovirus infection. The current study fills a gap in current knowledge related to the frequency and the extent of liver involvement in human adenovirus infection among pediatric patients.
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Affiliation(s)
- Oana Săndulescu
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- National Institute for Infectious Diseases “Prof. Dr. Matei Balș”, 021105 Bucharest, Romania
| | - Anca Streinu-Cercel
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- National Institute for Infectious Diseases “Prof. Dr. Matei Balș”, 021105 Bucharest, Romania
| | - Victor Daniel Miron
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- National Institute of Mother and Child Health “Alessandrescu-Rusescu”, 020395 Bucharest, Romania
- Correspondence:
| | - Silvia Mirela Covăcescu
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- National Institute of Mother and Child Health “Alessandrescu-Rusescu”, 020395 Bucharest, Romania
| | - Adrian Streinu-Cercel
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- National Institute for Infectious Diseases “Prof. Dr. Matei Balș”, 021105 Bucharest, Romania
| | - Mihai Craiu
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- National Institute of Mother and Child Health “Alessandrescu-Rusescu”, 020395 Bucharest, Romania
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Ritivoiu ME, Drăgoi CM, Matei D, Stan IV, Nicolae AC, Craiu M, Dumitrescu IB, Ciolpan AA. Current and Future Therapeutic Approaches of Exocrine Pancreatic Insufficiency in Children with Cystic Fibrosis in the Era of Personalized Medicine. Pharmaceutics 2023; 15:pharmaceutics15010162. [PMID: 36678791 PMCID: PMC9862205 DOI: 10.3390/pharmaceutics15010162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/17/2022] [Accepted: 12/28/2022] [Indexed: 01/05/2023] Open
Abstract
This review presents current updates of pancreatic enzyme replacement therapy in children with cystic fibrosis based on literature published in the last decade and some special considerations regarding pancreatic enzyme replacement therapy in the era of new therapies, such as cystic fibrosis transmembrane conductance regulator modulator therapies. Few articles evaluate the efficacy of pancreatic enzyme replacement therapy in the pediatric population, and most studies also included children and adults with cystic fibrosis. Approximately 85% of cystic fibrosis patients have exocrine pancreatic insufficiency and need pancreatic enzyme replacement therapy. Fecal elastase is the most commonly used diagnostic test for exocrine pancreatic insufficiency, although this value can fluctuate over time. While it is used as a diagnostic test, it cannot be used for monitoring the effectiveness of pancreatic enzyme replacement therapy and for adjusting doses. Pancreatic enzyme replacement therapy, the actual treatment for exocrine pancreatic insufficiency, is essential in children with cystic fibrosis to prevent malabsorption and malnutrition and needs to be urgently initiated. This therapy presents many considerations for physicians, patients, and their families, including types and timing of administration, dose monitoring, and therapy failures. Based on clinical trials, pancreatic enzyme replacement therapy is considered effective and well-tolerated in children with cystic fibrosis. An important key point in cystic fibrosis treatment is the recent hypothesis that cystic fibrosis transmembrane conductance regulator modulators could improve pancreatic function, further studies being essential. Pancreatic enzyme replacement therapy is addressed a complication of the disease (exocrine pancreatic insufficiency), while modulators target the defective cystic fibrosis transmembrane conductance regulator protein. Exocrine pancreatic insufficiency in cystic fibrosis remains an active area of research in this era of cystic fibrosis transmembrane conductance regulator modulator therapies. This new therapy could represent an example of personalized medicine in cystic fibrosis patients, with each class of modulators being addressed to patients with specific genetic mutations.
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Affiliation(s)
- Mirela-Elena Ritivoiu
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Alessandrescu-Rusescu National Institute for Mother and Child Health, 020395 Bucharest, Romania
| | - Cristina Manuela Drăgoi
- Faculty of Pharmacy, “Carol Davila” University of Medicine and Pharmacy, 020956 Bucharest, Romania
- Correspondence: (C.M.D.); (A.C.N.)
| | - Dumitru Matei
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Alessandrescu-Rusescu National Institute for Mother and Child Health, 020395 Bucharest, Romania
| | - Iustina Violeta Stan
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Alessandrescu-Rusescu National Institute for Mother and Child Health, 020395 Bucharest, Romania
| | - Alina Crenguţa Nicolae
- Faculty of Pharmacy, “Carol Davila” University of Medicine and Pharmacy, 020956 Bucharest, Romania
- Correspondence: (C.M.D.); (A.C.N.)
| | - Mihai Craiu
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Alessandrescu-Rusescu National Institute for Mother and Child Health, 020395 Bucharest, Romania
| | - Ion-Bogdan Dumitrescu
- Faculty of Pharmacy, “Carol Davila” University of Medicine and Pharmacy, 020956 Bucharest, Romania
| | - Alina Angelica Ciolpan
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Alessandrescu-Rusescu National Institute for Mother and Child Health, 020395 Bucharest, Romania
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Miron VD, Săndulescu O, Craiu M. Comment on: "Prevalence, Antibiotic Susceptibility Profile and Associated Factors of Group A Streptococcal Pharyngitis Among Pediatric Patients with Acute Pharyngitis in Gondar, Northwest Ethiopia" [Letter]. Infect Drug Resist 2023; 16:2783-2785. [PMID: 37187485 PMCID: PMC10178995 DOI: 10.2147/idr.s418143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 05/03/2023] [Indexed: 05/17/2023] Open
Affiliation(s)
- Victor Daniel Miron
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Correspondence: Victor Daniel Miron, Carol Davila University of Medicine and Pharmacy, 127, Lacul Tei Street, Second District, Bucharest, 020382, Romania, Email
| | - Oana Săndulescu
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- National Institute for Infectious Diseases “Prof. Dr. Matei Balș”, Bucharest, Romania
| | - Mihai Craiu
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- National Institute for Mother and Child Health “Alessandrescu-Rusescu”, Bucharest, Romania
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Miron VD, Bar G, Filimon C, Craiu M. From COVID-19 to Influenza-Real-Life Clinical Practice in a Pediatric Hospital. Diagnostics (Basel) 2022; 12:diagnostics12051208. [PMID: 35626363 PMCID: PMC9140149 DOI: 10.3390/diagnostics12051208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/08/2022] [Accepted: 05/10/2022] [Indexed: 01/30/2023] Open
Abstract
The COVID-19 pandemic, through the restrictions and the non-pharmaceutical interventions implemented, has importantly impacted the circulation and epidemiology of respiratory viruses. Specifically, the 2020/21 season was entirely dominated by SARS-CoV-2, while influenza activity reached an all-time low, despite initial warnings that a double concurrent epidemic could be possible. The current season, 2021/22, started with the shift of circulating SARS-CoV-2 variants from delta to omicron, which then rapidly spread globally, as most countries, including Romania, removed all restrictions and compulsory non-pharmaceutical interventions. In this report we present the clinical reality observed in March 2022 in a tertiary paediatric hospital in Bucharest, Romania, where we observed a sudden surge in influenza cases, after two consecutive years (March 2020 to March 2022) when influenza had stopped circulating in our country. Thus, in March 2022 the positivity rate of rapid influenza antigen tests unexpectedly increased to 33.5%, paralleled by a decrease to 7.5% in the positivity rate of rapid SARS-CoV-2 antigen tests. This significant increase in the influenza attack rate was observed from the first week (14.9% positivity rate), through the fourth week of March (42.1% positivity rate, p < 0.001), while the COVID-19 attack rate displayed a significant decreasing trend (from 11.2% to 4.8%, p < 0.001). These data serve as a warning about relaxing restrictions in a precipitous approach with minimised vigilance. The evolution of these observations needs to be followed very carefully in all countries, particularly in settings where epidemiological interactions and non-pharmaceutical interventions have so far led to the extensive circulation of only one of these viruses, and we should now be prepared to perform a correct differential diagnosis between influenza and COVID-19, in order to ensure the best quality of care and personalized management of each case of respiratory infection. The results of active influenza surveillance studies for the whole 2021/22 season are awaited, in order to quantify the joint influenza—COVID-19 burden among children.
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Affiliation(s)
- Victor Daniel Miron
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.F.); (M.C.)
- National Institute for Mother and Child Health “Alessandrescu-Rusescu”, 020395 Bucharest, Romania;
- Correspondence:
| | - Gabriela Bar
- National Institute for Mother and Child Health “Alessandrescu-Rusescu”, 020395 Bucharest, Romania;
| | - Claudiu Filimon
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.F.); (M.C.)
| | - Mihai Craiu
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.F.); (M.C.)
- National Institute for Mother and Child Health “Alessandrescu-Rusescu”, 020395 Bucharest, Romania;
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Miron VD, Toma AR, Filimon C, Bar G, Craiu M. Optional Vaccines in Children—Knowledge, Attitudes, and Practices in Romanian Parents. Vaccines (Basel) 2022; 10:vaccines10030404. [PMID: 35335036 PMCID: PMC8955643 DOI: 10.3390/vaccines10030404] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/03/2022] [Accepted: 03/04/2022] [Indexed: 11/16/2022] Open
Abstract
Vaccination is one of the most useful medical interventions for controlling certain infectious diseases. The aim of current research is to identify some of the drivers of vaccine hesitancy or acceptance in a rather skeptical European population by addressing parental perception on optional vaccination (OV) perception. Novel tools, delivered by social media, were used in our research attempt. A validated questionnaire was distributed online among parents. Parental knowledge, attitudes and perceptions of OV were analyzed. The majority of parent respondents (55.1%) showed very good knowledge about vaccination and vaccine-preventable diseases, and 76.0% stated that they had given at least one optional vaccine to at least one of their children. The most common optional vaccine administered was the rotavirus vaccine. The level of knowledge appeared to be related to compliance with OV. Concurrently, the rate of vaccine acceptance in the NIP (National Immunization Program) was not correlated with the level of parental knowledge. In total, a high percentage of parents (77.6%) believed that OV can bring an additional health safety benefit to their children. This study shows the need to involve the medical community in a steady dialogue with parents about OV. Raising awareness by presenting clear and understandable information could be a game-changing intervention in mitigating the public health impact of OV-preventable diseases.
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Affiliation(s)
- Victor Daniel Miron
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.F.); (M.C.)
- National Institute for Mother and Child Health “Alessandrescu-Rusescu”, 020395 Bucharest, Romania;
- Correspondence:
| | - Andrei Răzvan Toma
- Central Military Emergency Hospital Dr. Carol Davila, 010825 Bucharest, Romania;
| | - Claudiu Filimon
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.F.); (M.C.)
| | - Gabriela Bar
- National Institute for Mother and Child Health “Alessandrescu-Rusescu”, 020395 Bucharest, Romania;
| | - Mihai Craiu
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.F.); (M.C.)
- National Institute for Mother and Child Health “Alessandrescu-Rusescu”, 020395 Bucharest, Romania;
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Craiu DC, Bastian AE, Zurac SA, Băilă SL, Croitoru M, Craiu M, Diaconu R, Vinţan MA, Bârcă DG. Brachial and subclavian arteries aneurysms due to tuberous sclerosis complex mechanisms - case report and literature review. Rom J Morphol Embryol 2022; 63:181-189. [PMID: 36074682 PMCID: PMC9593110 DOI: 10.47162/rjme.63.1.19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 08/26/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Tuberous sclerosis complex (TSC) is a rare autosomal dominant condition characterized by cutaneous, cerebral, and other multiorgan involvement. Aneurysms due to TSC pathogenic mechanism are rarely present, mainly aortic, renal, or intracranial and very few associated with peripheral circulation. A TSC patient, aged 31 years, who developed brachial and subclavian arteries aneurysms is presented. The question of a random association of the aneurysms with TSC versus aneurysms within pathogenic released mammalian target of rapamycin (mTOR) pathway effect was raised. CASE PRESENTATION Patient's file, available from the age of six months, was analyzed for demonstration of the TSC diagnosis. Patient was examined, and cerebral magnetic resonance imaging (MRI) was repeated. Surgery and angiographic reports and images were reviewed. Pathology of the aneurysmal wall available from surgery was reexamined and special stainings and immunohistochemistry markers were applied. Genetic characterization of the patient was performed. Definite TSC was diagnosed based on major criteria [ungual fibromas, shagreen patch, cortical tubers, subependymal nodules (SENs), subependymal giant cell astrocytoma (SEGA)], minor criteria (confetti skin lesions, dental enamel pits, gingival fibromas), genetic result showing heterozygous variant in exon 8 of TSC1 gene (c.733C>T-p.Arg245*). Pathology analysis revealed markedly thickened aneurysmal wall due to smooth muscle cells (SMCs) proliferation in media and neoformation vessels with similar characteristics in the aneurysmal wall. DISCUSSIONS AND CONCLUSIONS This is a rare case with aneurysms related to TSC, with an exceptional peripheral localization. Pathology exam is the key investigation in demonstrating the TSC-related pathogenic mechanism. A literature review showed 73 TSC cases presenting aneurysms published until now.
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Affiliation(s)
- Dana Cristina Craiu
- Discipline of Pediatric Neurology II, Department of Clinical Neurosciences, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Clinic of Pediatric Neurology, Prof. Dr. Alexandru Obregia Clinical Psychiatric Hospital, Bucharest, Romania
| | - Alexandra Eugenia Bastian
- Discipline of Pathology, Department II, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Laboratory of Pathology, Colentina University Hospital, Bucharest, Romania
| | - Sabina Andrada Zurac
- Discipline of Pathology, Department II, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Laboratory of Pathology, Colentina University Hospital, Bucharest, Romania
| | - Sorin Liviu Băilă
- Vascular Surgery Group, Ponderas Academic Hospital, Bucharest, Romania
| | - Marian Croitoru
- Prof. Dr. C.C. Iliescu Emergency Institute for Cardiovascular Diseases, Bucharest, Romania
| | - Mihai Craiu
- Department of Pediatrics and Medical Genetics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Pediatric Clinic II, Alessandrescu–Rusescu National Institute, Bucharest, Romania
| | - Radu Diaconu
- Department of Pediatrics, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania
- Department of Pediatrics, Filantropia Municipal Hospital, Craiova, Romania
| | - Mihaela-Adela Vinţan
- Department of Neuroscience, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Clinical Hospital for Children, Cluj-Napoca, Romania
| | - Diana Gabriela Bârcă
- Discipline of Pediatric Neurology II, Department of Clinical Neurosciences, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Clinic of Pediatric Neurology, Prof. Dr. Alexandru Obregia Clinical Psychiatric Hospital, Bucharest, Romania
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Miron VD, Filimon C, Cabel T, Mihăescu RI, Bar G, Leu D, Craiu M. Urinary tract infections in children: clinical and antimicrobial resistance data from Bucharest area, Romania. Germs 2021; 11:583-591. [DOI: 10.18683/germs.2021.1293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 11/28/2021] [Accepted: 11/29/2021] [Indexed: 11/08/2022]
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Miron VD, Craiu M. "Red throat" or acute pharyngitis - challenges in real life clinical practice. Germs 2021; 11:351-353. [PMID: 34722356 DOI: 10.18683/germs.2021.1271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Victor Daniel Miron
- MD, PhD student, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania, National Institute for Mother and Child Health "Alessandrescu-Rusescu”, Bd Lacul Tei 120, Bucharest, Romania
| | - Mihai Craiu
- MD, PhD, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania, National Institute for Mother and Child Health "Alessandrescu-Rusescu”, Bd Lacul Tei 120, Bucharest, Romania
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Miron VD, Bar G, Filimon C, Gaidamut VA, Craiu M. Streptococcal Pharyngitis in Children: A Tertiary Pediatric Hospital in Bucharest, Romania. J Glob Infect Dis 2021; 13:154-155. [PMID: 34703159 PMCID: PMC8491814 DOI: 10.4103/jgid.jgid_59_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/17/2021] [Accepted: 04/19/2021] [Indexed: 11/04/2022] Open
Affiliation(s)
- Victor Daniel Miron
- Department of Pediatrics, National Institute for Mother and Child Health "Alessandrescu-Rusescu", Bucharest, Romania.,Faculty of Medicine, Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Gabriela Bar
- Department of Pediatrics, National Institute for Mother and Child Health "Alessandrescu-Rusescu", Bucharest, Romania
| | - Claudiu Filimon
- Faculty of Medicine, General Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Vlad Alexandru Gaidamut
- Faculty of Medicine, General Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Mihai Craiu
- Department of Pediatrics, National Institute for Mother and Child Health "Alessandrescu-Rusescu", Bucharest, Romania.,Faculty of Medicine, Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
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Miron VD, Bar G, Filimon C, Gaidamut VA, Craiu M. Monitoring of Excess Body Weight in Children in the Emergency Department of a Tertiary Pediatric Hospital in Bucharest, Romania. Maedica (Bucur) 2021; 16:389-393. [PMID: 34925592 PMCID: PMC8643556 DOI: 10.26574/maedica.2021.16.3.389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Introduction: Excess body weight in children has become a public health issue in most countries. The aim of our study was to determine the prevalence of overweight and obesity in children over two years of age who presented at the Emergency Department of a tertiary pediatric hospital in Bucharest, Romania. Methods: Between July and August 2018, we conducted a prospective study among children who presented at the Emergency Department of "Alessandrescu-Rusescu" National Institute for Mother and Child Health, Bucharest, Romania. We collected data on weight, height and blood pressure classified by age and gender. Results: A total of 335 children aged 2 to 18 years were included in our study. A quarter of them had above normal body mass index values, 7.5% were overweight and 18.5% obese. Also, when measuring blood pressure, we observed increased values in 29.3% (n=98) of them. Among children with excess body weight, nearly a half (49.4%, n=47) had higher than normal blood pressure values. Conclusions: Excess body weight in children has become a public health issue in most countries. The aim of our study was to determine the prevalence of overweight and obesity in children over two years of age who presented at the Emergency Department of a tertiary pediatric hospital in Bucharest, Romania.
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Affiliation(s)
- Victor Daniel Miron
- "Alessandrescu-Rusescu" National Institute for Mother and Child Health, Bucharest, Romania
| | - Gabriela Bar
- "Alessandrescu-Rusescu" National Institute for Mother and Child Health, Bucharest, Romania
| | - Claudiu Filimon
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | | | - Mihai Craiu
- "Alessandrescu-Rusescu" National Institute for Mother and Child Health, Bucharest, Romania
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Santos-Valente E, Buntrock-Döpke H, Abou Taam R, Arasi S, Bakirtas A, Lozano Blasco J, Bønnelykke K, Craiu M, Cutrera R, Deschildre A, Elnazir B, Fleming L, Frey U, Gappa M, Nieto García A, Skamstrup Hansen K, Hanssens L, Jahnz-Rozyk K, Jesenak M, Kerzel S, Kopp MV, Koppelman GH, Krivec U, MacLeod KA, Mäkelä M, Melén E, Mezei G, Moeller A, Moreira A, Pohunek P, Minić P, Rutjes NWP, Sammut P, Schwerk N, Szépfalusi Z, Turkalj M, Tzotcheva I, Ulmeanu A, Verhulst S, Xepapadaki P, Niggel J, Vijverberg S, Maitland-van der Zee AH, Potočnik U, Reinartz SM, van Drunen CM, Kabesch M. Biologicals in childhood severe asthma: the European PERMEABLE survey on the status quo. ERJ Open Res 2021; 7:00143-2021. [PMID: 34409097 PMCID: PMC8365152 DOI: 10.1183/23120541.00143-2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 04/11/2021] [Indexed: 01/14/2023] Open
Abstract
Introduction Severe asthma is a rare disease in children, for which three biologicals, anti-immunoglobulin E, anti-interleukin-5 and anti-IL4RA antibodies, are available in European countries. While global guidelines exist on who should receive biologicals, knowledge is lacking on how those guidelines are implemented in real life and which unmet needs exist in the field. In this survey, we aimed to investigate the status quo and identify open questions in biological therapy of childhood asthma across Europe. Methods Structured interviews regarding experience with biologicals, regulations on access to the different treatment options, drug selection, therapy success and discontinuation of therapy were performed. Content analysis was used to analyse data. Results We interviewed 37 experts from 25 European countries and Turkey and found a considerable range in the number of children treated with biologicals per centre. All participating countries provide public access to at least one biological. Most countries allow different medical disciplines to prescribe biologicals to children with asthma, and only a few restrict therapy to specialised centres. We observed significant variation in the time point at which treatment success is assessed, in therapy duration and in the success rate of discontinuation. Most participating centres intend to apply a personalised medicine approach in the future to match patients a priori to available biologicals. Conclusion Substantial differences exist in the management of childhood severe asthma across Europe, and the need for further studies on biomarkers supporting selection of biologicals, on criteria to assess therapy response and on how/when to end therapy in stable patients is evident. This study reveals enormous differences in therapy with biologicals for childhood severe asthma across Europe, and demonstrates the urgent need for harmonisation in medication choice, definition of therapy success and how/when to discontinue treatmenthttps://bit.ly/3tnJMTY
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Affiliation(s)
- Elisangela Santos-Valente
- Dept of Pediatric Pneumology and Allergy, University Children's Hospital Regensburg (KUNO) at the Hospital St Hedwig of the Order of St John, University of Regensburg, Regensburg, Germany
| | - Heike Buntrock-Döpke
- Dept of Pediatric Pneumology and Allergy, University Children's Hospital Regensburg (KUNO) at the Hospital St Hedwig of the Order of St John, University of Regensburg, Regensburg, Germany.,Member of the Research and Development Campus Regensburg (WECARE) at the Hospital St Hedwig of the Order of St John, Regensburg, Germany
| | - Rola Abou Taam
- Service de pneumologie pédiatrique, AP-HP, Hôpital Necker Enfants-Malades, Paris, France
| | - Stefania Arasi
- Translational Research in Pediatric Specialities Area, Division of Allergy, Bambino Gesù Children's Research Hospital, IRCCS, Rome, Italy
| | - Arzu Bakirtas
- Dept of Pediatrics, Division of Pediatric Allergy and Asthma, Gazi University School of Medicine, Ankara, Turkey
| | - Jaime Lozano Blasco
- Dept of Pediatric Allergy and Clinical Immunology, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
| | - Klaus Bønnelykke
- Dept of Pediatrics, Herlev and Gentofte Hospital, University Hospital Copenhagen, Denmark
| | - Mihai Craiu
- Respiratory Dept, National Institute for Mother and Child Health "Alessandrescu-Rusescu", Bucharest, Romania
| | - Renato Cutrera
- Pediatric Pulmonology and Respiratory Intermediate Care Unit, Sleep and Long-Term Ventilation Unit, Academic Dept of Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Antoine Deschildre
- University of Lille, CHU Lille, Paediatric Pulmonology and Allergy Unit, Hôpital Jeanne de Flandre, Lille, France
| | - Basil Elnazir
- Children's Health Ireland (CHI) at Tallaght University Hospital, Dublin, Ireland.,Trinity College, Dublin, Ireland
| | - Louise Fleming
- Respiratory Paediatrics, National Heart and Lung Institute, Imperial College London, London, UK.,Paediatric Respiratory Medicine, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Urs Frey
- University Children's Hospital Basel, University of Basel, Basel, Switzerland
| | - Monika Gappa
- Evangelisches Krankenhaus Düsseldorf, Children's Hospital, Düsseldorf, Germany
| | - Antonio Nieto García
- Pediatric Allergy and Pneumology Unit, Children's Hospital La Fe and Health Research Institute La Fe, Valencia, Spain
| | | | - Laurence Hanssens
- Service de Pneumologie-Allergologie, Centre de reference de Mucoviscidose de l'ULB, Hôpital Universitaire des Enfants Reine Fabiola, Brussels, Belgium
| | - Karina Jahnz-Rozyk
- Dept of Internal Medicine, Pneumonology, Allergology and Clinical Immunology, Central Clinical Hospital of the Ministry of National Defense, Military Institute of Medicine, Warsaw, Poland
| | - Milos Jesenak
- Dept of Paediatrics, Jessenius Faculty of Medicine, Comenius University in Bratislava, Martin, Slovakia.,Dept of Clinical Immunology and Allergology, University Teaching Hospital in Martin, Martin, Slovakia
| | - Sebastian Kerzel
- Dept of Pediatric Pneumology and Allergy, University Children's Hospital Regensburg (KUNO) at the Hospital St Hedwig of the Order of St John, University of Regensburg, Regensburg, Germany
| | - Matthias V Kopp
- University Children's Hospital Bern, Inselspital, University of Bern, Switzerland.,German Center for Lung Research DZL, Airway Center North (ARCN) Lübeck and Biomedical Research in End-stage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
| | - Gerard H Koppelman
- Dept of Pediatric Pulmonology and Pediatric Allergology, University Medical Center Groningen, University of Groningen, Beatrix Children's Hospital, Groningen, The Netherlands.,Groningen Research Institute for Asthma and COPD, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Uros Krivec
- Dept of Paediatric Pulmology, University Children's Hospital Ljubljana, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | | | - Mika Mäkelä
- Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Erik Melén
- Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden.,Dept of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Györgyi Mezei
- Allergy Unit, First Dept of Pediatrics, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Alexander Moeller
- Division of Respiratory Medicine, University Children's Hospital Zurich and Childhood Research Center, Zurich, Switzerland
| | - Andre Moreira
- Serviço de Imunoalergologia, Centro Hospitalar Universitário de São João, Porto, Portugal.,EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Petr Pohunek
- Pediatric Pulmonology, Pediatric Dept, 2nd Faculty of Medicine, Charles University, Prague, University Hospital Motol, Prague, Czech Republic
| | - Predrag Minić
- Mother and Child Health Institute of Serbia, Belgrade, Serbia
| | - Niels W P Rutjes
- Dept of Paediatric Pulmonology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Patrick Sammut
- Dept of Paediatrics, Respiratory Medicine and Allergy, Mater Dei Hospital, Malta
| | - Nicolaus Schwerk
- Dept of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.,German Center for Lung Research, Biomedical Research in End Stage and Obstructive Lung Disease/BREATH, German Center for Lung Research, Hannover, Germany
| | - Zsolt Szépfalusi
- Division of Pediatric Pulmonology, Allergology and Endocrinology, Dept of Pediatrics and Adolescent Medicine, Comprehensive Center Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Mirjana Turkalj
- Srebrnjak Children's Hospital, Zagreb, and School of Medicine, University of Osijek "Josip Juraj Strossmayer", Osijek, and Catholic University of Croatia, Zagreb, Croatia
| | - Iren Tzotcheva
- Dept of Pediatrics, University Hospital for Emergency Medicine "N. I. Pirogov", Medical University, Sofia, Bulgaria
| | - Alexandru Ulmeanu
- "Grigore Alexandrescu" Emergency Hospital for Children, Bucharest, Romania
| | - Stijn Verhulst
- Dept of Pediatrics, Antwerp University Hospital, Edegem, Belgium.,Laboratory of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Paraskevi Xepapadaki
- Allergy Dept, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Susanne Vijverberg
- Dept of Respiratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.,Dept of Paediatric Respiratory Medicine and Allergy, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Anke H Maitland-van der Zee
- Dept of Respiratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.,Dept of Paediatric Respiratory Medicine and Allergy, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Uroš Potočnik
- Laboratory for Biochemistry, Molecular Biology and Genomics, Faculty of Chemistry and Chemical Engineering, University of Maribor, Maribor, Slovenia.,Centre for Human Molecular Genetics and Pharmacogenomics, Medical Faculty, University of Maribor, Maribor, Slovenia
| | - Susanne M Reinartz
- Dept of Otorhinolaryngology, Tergooi Hospitals, Hilversum, the Netherlands
| | - Cornelis M van Drunen
- Dept of Otorhinolaryngology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Michael Kabesch
- Dept of Pediatric Pneumology and Allergy, University Children's Hospital Regensburg (KUNO) at the Hospital St Hedwig of the Order of St John, University of Regensburg, Regensburg, Germany.,Member of the Research and Development Campus Regensburg (WECARE) at the Hospital St Hedwig of the Order of St John, Regensburg, Germany
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Guta A, Craiu M. STUDY ON PARENTAL PERCEPTION AND APPROACH REGARDING COMMUNITY ACQUIRED PNEUMONIA IN PRESCHOOL CHILDREN FROM ROMANIA Alexandra Guta1 , Mihai Craiu2 1 “Sf. Pantelimon” Emergency Clinical Hospital, Bucharest 2 Emergency Department (ED) of the “Alessandrescu Rusescu” National Institute for Mother and Child Health, “Carol Davila” University of Medicine and Pharmacy, Bucharest. Ro J Pediatr 2018. [DOI: 10.37897/rjp.2018.2.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Guţă A, Craiu M. Studiu asupra percepţiei şi al modului de abordare parental privind pneumonia comunitară la preşcolarii din România. Ro J Pediatr 2018. [DOI: 10.37897/rjp.2018.2.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Craiu M, Comanici VD, Stan IV. ANALIZA PERCEPŢIEI PARENTALE ASUPRA MEDICAŢIEI INHALATORII ŞI POTENŢIALELE EXPLICAŢII ALE EXCESULUI DE UTILIZARE OFF-LABEL A DEXAMETAZONEI LA COPIL ÎN ROMÂNIA. Ro J Pediatr 2017. [DOI: 10.37897/rjp.2017.4.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Craiu M, Comanici VD, Stan IV. PARENTAL PERCEPTION ON NEBULIZED MEDICATION AND POTENTIAL REASONS FOR OFF-LABEL USAGE OF DEXAMETHASONE IN CHILDREN FROM ROMANIA. Ro J Pediatr 2017. [DOI: 10.37897/rjp.2017.4.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Ketelaar ME, Van De Kant K, Dijk FN, Klaassen EMM, Grotenboer N, Nawijn MC, Dompeling E, Koppelman GH, Murray C, Foden P, Lowe L, Durrington H, Custovic A, Simpson A, Simpson AJ, Shaw DE, Sousa AR, Fleming LJ, Roberts G, Pandis I, Bansal AT, Corfield J, Wagers S, Djukanovic R, Chung KF, Sterk PJ, Vestbo J, Fowler SJ, Tebbutt SJ, Singh A, Shannon CP, Kim YW, Yang CX, Gauvreau GM, Fitzgerald JM, Boulet LP, O’Byrne PM, Begley N, Loudon A, Ray DW, Baos S, Cremades L, Calzada D, Lahoz C, Cárdaba B, Asosingh K, Lauruschkat C, Queisser K, Wanner N, Weiss K, Xu W, Erzurum S, Sokolowska M, Chen LY, Liu Y, Martinez-Anton A, Logun C, Alsaaty S, Cuento R, Cai R, Sun J, Quehenberger O, Armando A, Dennis E, Levine S, Shelhamer J, Choi K, Lazova S, Perenovska P, Miteva D, Priftis S, Petrova G, Yablanski V, Vlaev E, Rafailova H, Kumae T, Holmes LJ, Yorke J, Ryan DM, Chinratanapisit S, Matchimmadamrong K, Deerojanawong J, Karoonboonyanan W, Sritipsukho P, Youroukova V, Dimitrova D, Slavova Y, Lesichkova S, Tzocheva I, Parina S, Angelova S, Korsun N, Craiu M, Stan IV, Deliu M, Yavuz T, Sperrin M, Sahiner UM, Belgrave D, Sackesen CS, Kalayci Ö, Velikov P, Velikova T, Ivanova-Todorova E, Tumangelova-Yuzeir K, Kyurkchiev D, Megremis S, Constantinides B, Sotiropoulos AG, Xepapadaki P, Robertson D, Papadopoulos N, Wilkinson M, Portsmouth C, Ray D, Goodacre R, Valerieva A, Bobolea I, Vera DG, Gonzalez-Salazar G, Moreno CM, Rodriguez CF, De Las Cuevas Moreno N, Wang R, Satia I, Niven R, Smith JA, Southworth T, Plumb J, Gupta V, Pearson J, Ramis I, Lehner MD, Miralpeix M, Singh D, Satia I, Woodhead M, O’Byrne P, Smith JA, Forss C, Cook P, Brown S, Svedberg F, Stephenson K, Bertuzzi M, Bignell E, Enerbäck M, Cunoosamy D, Macdonald A, Liu C, Zhu L, Fukuda K, Zhang C, Ouyang S, Chen X, Qin L, Rachakonda S, Aronica M, Qin J, Li X, Larose MC, Archambault AS, Provost V, Chakir J, Laviolette M, Flamand N, Logan N, Ruckerl D, Allen JE, Sutherland TE, Hamelmann E, Vogelberg C, Goldstein S, Azzi GE, Engel M, Sigmund R, Szefler SJ, Mesquita R, Coentrão L, Veiga R, Paiva JA, Roncon-Albuquerque R, Porras WV, Moreno AG, Iglesias JM, Ramos GC, Acevedo YP, Alonso MAT, Del Mar Moro Moro M, Krcmova I, Novosad J, Hanania NA, Massanari M, Hecker H, Kassel E, Laforce C, Rickard K, Snelder S, Braunstahl GJ, Jones TL, Neville D, Heiden ER, Lanning E, Brown T, Rupani H, Babu KS, Chauhan AJ, Eldegeir MY, Chapman AA, Ferwana M, Caldron M. Abstracts from the 3rd International Severe Asthma Forum (ISAF). Clin Transl Allergy 2017. [PMCID: PMC5461526 DOI: 10.1186/s13601-017-0149-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Ribitzky-Eisner H, Minuhin Y, Greenberg D, Greenberg N, Chodick G, Craiu M, Leibovitz E. Epidemiologic and Microbiologic Characteristics of Occult Bacteremia Among Febrile Children in Southern Israel, Before and After Initiation of the Routine Antipneumococcal Immunization (2005-2012). Pediatr Neonatol 2016; 57:378-384. [PMID: 26738763 DOI: 10.1016/j.pedneo.2015.10.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 10/02/2015] [Accepted: 10/16/2015] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND Little is known about the incidence and dynamics of occult bacteremia (OB) among infants/young children following the introduction of pneumococcal conjugate vaccines (PCVs) into the national immunization program in Israel in 2009-2010. The aim of this study was to characterize the epidemiologic and microbiologic picture of OB among febrile infants/children aged 3-36 months in southern Israel, before and after PCVs introduction. METHODS Retrospective study enrolling all infants/young children attending the emergency room of a tertiary medical center in southern Israel with fever without source, discharged, and reported with a positive blood culture. RESULTS Of 453 true bacteremias, 89 (19.6%) were defined as OB. OB rate was 0.22%; a significant decrease was recorded in OB rates, with the highest rate during 2005 (0.34%) and the lowest during 2011 (0.15%). OB cases decreased in post-PCV (2010-2012) versus prevaccination period (2005-2009) from 66/22,256 cases (0.3%) to 23/13,213 cases (0.17%; p = 0.03). Most frequent single OB pathogens were Streptococcus pneumoniae, Streptococcus viridans spp., and Kingella kingae (39.3%, 10.1%, and 9.0%, respectively); Enterobacteriaceae spp. were isolated in 10 cases (11.2%). No changes were recorded in S. pneumoniae-OB cases; K. kingae-OB decreased significantly (p = 0.047). None of the S. pneumoniae serotypes isolated during 2011-2012 belonged to 13-valent PCV (PCV13). An increase in non PCV13 serotypes was recorded during 2011-2012 (3/3, 100% vs. 7/32, 21.9%, p = 0.01). CONCLUSION OB rates decreased significantly following the introduction of PCVs. S. pneumoniae was the most frequent isolated pathogen in OB, but in lower percentages compared with the medical literature. No PCV13 serotypes were detected as a cause of OB during 2011-2012.
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Affiliation(s)
- Haya Ribitzky-Eisner
- Pediatric Emergency Medicine Department, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva, Israel
| | - Yitamar Minuhin
- Pediatric Emergency Medicine Department, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva, Israel
| | - David Greenberg
- Pediatric Infectious Disease Unit 2, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva, Israel
| | - Ninel Greenberg
- Pediatric Emergency Medicine Department, Alfred Rusescu Children's Hospital, Carol Davila Medical School, Bucharest, Romania
| | - Gabriel Chodick
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Mihai Craiu
- Pediatric Emergency Medicine Department, Alfred Rusescu Children's Hospital, Carol Davila Medical School, Bucharest, Romania
| | - Eugene Leibovitz
- Pediatric Emergency Medicine Department, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva, Israel; Pediatric Infectious Disease Unit 2, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva, Israel.
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Fruchtman Y, Segev RW, Golan AA, Dalem Y, Tailakh MA, Novak V, Peled N, Craiu M, Leibovitz E. Epidemiological, diagnostic, clinical, and therapeutic aspects of Brucella bacteremia in children in southern Israel: a 7-year retrospective study (2005-2011). Vector Borne Zoonotic Dis 2015; 15:195-201. [PMID: 25793475 DOI: 10.1089/vbz.2014.1726] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Data on the various aspects of brucellosis in children living in southern Israel are missing. OBJECTIVES Our aim was to study the epidemiological, microbiological, diagnostic, clinical, therapeutic and outcome features of brucellosis in children <19 years of age in southern Israel during 2005-2011. PATIENTS AND METHODS The study population included all patients hospitalized with a diagnosis of brucellosis, established according to a clinical presentation compatible with brucellosis+presence of Brucella bacteremia (BB). RESULTS A total of 128 (50.8%) of 252 patients admitted with a diagnosis of brucellosis had BB (all with Brucella melitensis). All patients were of Muslim Bedouin ethnicity. The mean incidence of BB in southern Israel was 16 cases/100,000 Bedouin, with no significant changes during the study period. Overall duration of symptoms before diagnosis was 10.1±10.9 days. Fever at diagnosis was recorded in <20% of the patients. The most frequent symptoms were arthralgia (61.7%), weakness (32.8%), gastrointestinal disturbances (27.3%), myalgia (25%), and headache (18.8%). The main clinical findings included monoarthritis (36.7%), hepatosplenomegaly (25%), lymphadenopathy (17.2%), heart murmur (11.7%), and skin rash (9.4%), respectively. Anemia, leukopenia, thrombocytopenia, and pancytopenia were reported in 17.6%, 29.6%, 12.8%, and 2.3% of the patients, respectively. Twenty-nine (30.5%) patients with BB had serum agglutinin titers ≤1/160 (13, 13.7%%, had titers <1/160). Twenty-seven (93%) of the 29 patients aged 0-4 years were treated with gentamicin and trimethoprim-sulfamethoxazole; a total of 77 (60.2%) patients received gentamicin and doxycycline. CONCLUSIONS Childhood brucellosis remains an important public health problem in southern Israel. BB was diagnosed in >50% of the children with brucellosis, and B. melitensis was identified in all cases. Arthralgia, weakness, and gastrointestinal complaints were the most common symptoms, and monoarthritis, hepatosplenomegaly, and lymphadenopathy were the most common clinical findings. A considerable number of patients with BB had undetectable/low serum agglutinin titers, suggesting insufficient reliability on serology alone in diagnosis of brucellosis.
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Affiliation(s)
- Yariv Fruchtman
- 1 Pediatric Emergency Medicine Department, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev , Beer-Sheva, Israel
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Craiu D, Dragostin O, Dica A, Hoffman-Zacharska D, Gos M, Bastian AE, Gherghiceanu M, Rolfs A, Nahavandi N, Craiu M, Iliescu C. Rett-like onset in late-infantile neuronal ceroid lipofuscinosis (CLN7) caused by compound heterozygous mutation in the MFSD8 gene and review of the literature data on clinical onset signs. Eur J Paediatr Neurol 2015; 19:78-86. [PMID: 25439737 DOI: 10.1016/j.ejpn.2014.07.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 07/16/2014] [Accepted: 07/27/2014] [Indexed: 02/05/2023]
Abstract
BACKGROUND We present clinical and molecular findings of a patient with ceroid-lipofuscinosis CLN7, with a compound heterozygous mutation of the MFSD8 gene, with Rett syndrome clinical signs onset and a later development of full picture of vLINCL. CASE PRESENTATION A 7 years-old female patient with normal development until the age 12 months, developed Rett like clinical picture (psychomotor regression, microcephaly, stereotypic hands movements in the midline, hyperventilation episodes) present at the onset of her condition (age 18 months), features still present at the initial evaluation in our clinic at age 5 years. RESULTS MECP2 (methyl CpG binding protein 2) gene mutation was negative. At age 6 years she was readmitted for severe ataxia and blindness, seizures, and severe developmental regression leading to NCL (neuronal ceroid lipofuscinosis) suspicion. EEG showed slow background with IRDA (intermittent rhythmic delta activity). A conjunctive biopsy showed abnormal curvilinear and fingerprint lysosomal deposits, and genetic analysis revealed two heterozygous mutations of MFSD8 gene (c.881C > A p.Thr294Lys and c.754 + 2T > A) each inherited from carrier parents and a heterozygous variant (c.470A>C p.Asp157Ala) of CLN5 gene. CONCLUSION NCL should be suspected and MFSD8 genetic testing should also be considered in patients with Rett like phenotype at onset and negative MECP2 mutation. Such cases should be carefully and frequently re-evaluated in order to avoid delayed diagnosis and offer proper genetic advice to the family. In our knowledge, this might be the first case of CLN7 disease with Rett like onset described in the literature, which developed typical vLINCL clinical phenotype after age 5.5 years. A short review of the literature showing NCL onset modalities is presented.
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Affiliation(s)
- Dana Craiu
- "Carol Davila" University of Medicine Bucharest, Department of Neurology, Pediatric Neurology, Psychiatry, Neurosurgery, Discipline Pediatric Neurology, Romania; Pediatric Neurology Clinic, "Alexandru Obregia" Clinical Psychiatric Hospital, Şos. Berceni 10-12, Sector 4, Bucharest, Romania.
| | - Octavia Dragostin
- Pediatric Neurology Clinic, "Alexandru Obregia" Clinical Psychiatric Hospital, Şos. Berceni 10-12, Sector 4, Bucharest, Romania.
| | - Alice Dica
- Pediatric Neurology Clinic, Research Department, "Alexandru Obregia" Clinical Psychiatric Hospital, Şos. Berceni 10-12, Sector 4, Bucharest, Romania.
| | - Dorota Hoffman-Zacharska
- Department of Medical Genetics, Institute of Mother and Child, Kasprzaka 17A, 01-211 Warsaw, Poland.
| | - Monika Gos
- Department of Medical Genetics, Institute of Mother and Child, Kasprzaka 17A, 01-211 Warsaw, Poland.
| | - Alexandra Eugenia Bastian
- "Carol Davila" University of Medicine Bucharest, Department II, Dental Medicine, Pathology Discpline, Romania; Pathology Lab., Colentina University Hospital, Sos Stefan cel Mare 19-21, Sector 2, 020125 Bucharest, Romania.
| | - Mihaela Gherghiceanu
- Ultrastructural Pathology Lab., 'Victor Babes' National Institute of Pathology, 99-101 Spl. Independentei, 050096 Bucharest 5, Romania.
| | - Arndt Rolfs
- Albrecht-Kossel-Institute for Neurogenetics, Medical Faculty, University of Rostock, Gehlsheimerstrasse 20, 18157 Rostock, Germany; Centogene AG, Schillingallee 69, 18057 Rostock, Germany.
| | | | - Mihai Craiu
- "Carol Davila" University of Medicine Bucharest, Department of Pediatrics and Medical Genetics, Discipline Pediatrics, Romania; Pediatric II Clinic, "Alfred Rusescu" Clinical Pediatric Hospital, Institute of Mother and Child Health, B-dul Lacul Tei No. 120, Sector 2, Bucharest, Romania.
| | - Catrinel Iliescu
- "Carol Davila" University of Medicine Bucharest, Department of Neurology, Pediatric Neurology, Psychiatry, Neurosurgery, Discipline Pediatric Neurology, Romania; Pediatric Neurology Clinic, "Alexandru Obregia" Clinical Psychiatric Hospital, Şos. Berceni 10-12, Sector 4, Bucharest, Romania.
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Craiu M, Stan IV, Cochino AV. Intraosseous access – A classical method for vascular access that regains an important role as resuscitation tool. Ro J Pediatr 2014. [DOI: 10.37897/rjp.2014.3.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
75-80% of life threatening situations, with unexpected arrest, are documented out of hospital (1). This situation generates frequently a difficult resuscitation. Main cause for failure is delay in gaining vascular access for fluid and drug delivery (2). Intraosseous access (IO) is used for treatment in patients without a previously placed intravenous line that experience abrupt-onset life threatening situations (3). Authors revisit data from initial development of this method and document the role of IO access as a valuable tool during resuscitation according to European Resuscitation Council Guidelines 2010 (4). Particular aspects of technique, improvisations and real life trouble shooting issues are presented from a single pediatric Emergency Department experience.
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Craiu M, Stan IV, Cochino AV. Abordul intraosos, metoda clasică de acces vascular revenită în actualitate. Ro J Pediatr 2014. [DOI: 10.37897/rjp.2014.3.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
75-80% dintre situaţiile ameninţătoare de viaţă, cu stop cardio-respirator neaşteptat, se petrec în afara spitalului (1). De aceea este întâlnită frecvent situaţia unei resuscitări dificile. Principala cauză de eşec este obţinerea tardivă a unei căi de acces vascular pentru administrarea fluidelor şi medicaţiei necesare în aceste situaţii (2). Abordul intraosos este folosit în tratamentul pacienţilor aflaţi în situaţii ameninţătoare de viaţă şi care nu au alt acces vascular instalat anterior (3). Lucrarea de faţă trece în revistă aspecte ale dezvoltării acestei tehnici de acces vascular rapid şi aplicaţiile ei actuale în medicina de urgenţă, prin prisma noilor ghiduri de resuscitare la copil, apărute sub egida European Resuscitation Council (4).
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Popescu C, Craiu M. The utility of measuring FENO in monitoring asthmatic children. Ro J Pediatr 2014. [DOI: 10.37897/rjp.2014.2.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Purposes and objectives. Bronchial asthma is the most frequent chronic disease in children and in almost 50% of these cases, it occurs eosinophilic airway inflammation. The most important objective in monitoring asthma is preventing exacerbations by means of good communication between physician, patient and family, a good compliance of the latter and an accurate assessment of the asthmatic patient’s quality of life. Present study is examining correlation between asthma control and airways eosinophilic inflammation level in asthmatic children treated with ICS. Method and material. We evaluated 24 patients presented in emergency department of our hospital, during ten weeks in cold season. The assessment consisted in performing Asthma Control Test (ACT), measuring fraction of the exhaled nitric oxide (FeNO) and pulmonary function testing. Results and discussions. We documented a negative linear correlation of ACT score with FeNO (r = -0. 6286 (p < 0.01)). Conclusions. Measuring FeNO is a simple to perform, fast and noninvasive method. FeNO value is related to ACT score, between them being a negative linear correlation. Generating simple algorithms may improve control of disease and tailoring therapy asthmatic children.
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Popescu C, Craiu M. Utilitatea măsurării feNO în monitorizarea copiilor cu astm bronşic. Ro J Pediatr 2014. [DOI: 10.37897/rjp.2014.2.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Scopuri şi obiective. Astmul bronşic este cea mai frecventă boală cronică la copii. În peste 50% din cazurile pediatrice, inflamaţia căilor aeriene este eozinofilică. În monitorizarea astmului, cel mai important aspect este prevenirea exacerbărilor printr-o bună comunicare medic-pacient-familie şi o complianţă ridicată a acestora din urmă la tratament. Foarte importantă este şi evaluarea corectă a calităţii vieţii copilului cu astm. Studiul de faţă şi-a propus verificarea corelaţiei între nivelul de control al astmului şi nivelul de inflamaţie eozinofilică de la nivelul căilor aeriene la copiii aflaţi în tratament cu corticosteroizi inhalatorii (CSI). Material şi metodă. Am evaluat un număr de 24 pacienţi care s-au prezentat la compartimentul de primiri urgenţe al spitalului IOMC „Alfred Rusescu“ Bucureşti în cursul a zece săptămâni din anotimpul rece. Evaluarea a constat în efectuarea scorului Asthma Control Test (ACT), măsurarea fracţiei de Oxid Nitric din aerul expirat (FeNO) şi probe funcţionale respiratorii. Rezultate şi discuţii. Valoarea scorului ACT în funcţie de măsurarea FENO arată o corelaţie liniară şi negativă cu r = -0.6286 (p < 0,01). Concluzii. Măsurarea FeNO este o metodă simplă, rapidă şi neinvazivă. Valoarea FeNO este corelată cu scorul ACT, în mod liniar şi negativ. Crearea unor algoritmi simpli ar putea îmbunătăţi controlul şi monitorizarea evoluţiei şi ar permite personalizarea terapiei la copilul cu astm.
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Craiu D, Kaler S, Craiu M. Role of optic microscopy for early diagnosis of Menkes disease. Rom J Morphol Embryol 2014; 55:953-956. [PMID: 25329126 PMCID: PMC6456807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
We report the case of a male patient with a normal development in the first three months of life, presenting for global regression, central axial hypotonic syndrome, pyramidal syndrome, focal epileptic seizures, and a particular aspect of the hair - almost absent, short, sparse, lightly colored, at age of five months, becoming coarse, twisted (kinky hair) by the age of 21 months. Different diseases associate similar neurological and macroscopic aspect of the hair (biotinidase deficiency, argininosuccinic aciduria, aminoaciduria, giant axonal neuropathy, trichothiodistrophy and Menkes syndrome). The microscopic aspect of the patient's hair showing normal hair, silver colored hair, hair shafts twisting 1800, trichoclasis, and trichoptilosis, was highly characteristic for Menkes disease. Diagnosis was further supported by the low concentration of serum copper and ceruloplasmin and exclusion of other metabolic disorders with similar macroscopic aspect of the hair. Molecular genetic testing by multiplex PCR indicated deletion of exon 22 in the ATP7A gene situated in Xq21.1 region, consistent with the clinical and biochemical phenotype. Physicians should use microscopic evaluation of the hair more often when suspicion of Menkes disease is raised, aiming a narrow further diagnostic workup and early positive diagnosis and genetic advice for the affected families.
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Affiliation(s)
- Dana Craiu
- Discipline Pediatric Neurology, Department of Neurology, Pediatric Neurology, Psychiatry, Neurosurgery, Psychiatry for Children and Adolescents, "Carol Davila" University of Medicine and Pharmacy, Clinic of Pediatric Neurology, "Alexandru Obregia" Clinical Psychiatric Hospital, Bucharest, Romania;
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Craiu M, Stan IV. Features of severe asthma in young children from Romania. Pneumologia 2014; 63:44-47. [PMID: 24800595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Asthma is the most frequent chronic disease of childhood. In spite of significant improvement of treatment options and diagnostic tools, asthma remains in many patients uncontrolled. The term of "severe asthma" seems to be rather a large umbrella for a heterogeneous group of diseases. This paper is presenting our experience in two respiratory disease clinics that evaluate asthmatic children. Current study was designed to test an algorithm for daily practice in a special group of patients: children with previously diagnosed asthma or recurrent-wheezing, evaluated by family physician or pediatrician as severe disease ("Asthma Decalogue in Children"). Out of 313 referrals (during a six months inclusion time) we had 202 children completing study per-protocol. 49 (22.69%) had severe disease, but only 8 had severe asthma (3.7% of total patients and 18.6% of severe patients). They were older, with less male predominance and with more frequent rhino-conjunctivitis and D vitamin deficiency than other asthmatic children with less severe disease. Asthma Decalogue in Children seems to be an efficient tool to differentiate severe asthma from the rest of children with reactive airway diseases.
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Stan IV, Comănici V, Matei D, Craiu M. [The family practitioner's role in the management of patients with cystic fibrosis]. Pneumologia 2013; 62:161-165. [PMID: 24274000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Cystic fibrosis ormucoviscidosis (CF) is the most frequent monogenic genetic disease with autosomal dominant transmision in caucasians. Currently, the typical approach is referring the CF patient to specialized centers with multidisciplinary teams. The inherent questions appear: which is then the role of the general practitioner (GP)? Should the GP be confined to the pasive role of exchanging medical letters with the specialist, or should he take active part in monitoring the disease? Is it ethicallyand professionally correct for the GP to simply copy the treatment of a patient that hedidn't actually see for years, or to assume the palliative care in final stages of a patient who was actually taken care of only by the specialist? What are the families' expectations and what is the level of competence they expect from the GP? These are some of the questions we will try to answer, considering the expertise we accumulated in the regional center in "Alfred Rusescu" lnstitute for Protection of Mother and Child, where 16.22% (60 out of 370) of CF patients in Romania are monitored, and based on a questionnaire addressed to the CF patient's families.
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Affiliation(s)
- Mihai Craiu
- Institute for Mother and Child CareCarol Davila Medical UniversityMedLife Children's HospitalRomania
| | - Iustina Violeta Stan
- Institute for Mother and Child CareCarol Davila Medical UniversityRespiratory DiseasesRomania
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Tecu C, Mihai ME, Alexandrescu VI, Orăşanu D, Zapucioiu C, Matei D, Craiu M, Cochino A. The adenoviral infections in children admitted to hospital with pneumonia, acute bronchiolitis or respiratory viral infections. Roum Arch Microbiol Immunol 2012; 71:24-28. [PMID: 22838216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
UNLABELLED The objective of this study was to investigate the percent of infections with adenovirus (ADV) in children who had pneumonia, acute bronchiolitis or viral respiratory infections and were admitted to two pediatrics hospitals in Bucharest (Grigore Alexandrescu Hospital and Alfred Rusescu Hospital). SUBJECTS 70 children aged one month - five years, admitted to the above mentioned pediatrics hospitals in Bucharest, who were negative for the Respiratory Syncytial Virus (RSV) and the human Metapneumovirus (hMPV) by Reverse Transcription -Polymerase Chain Reaction (RT-PCR). 48 of them presented pneumonia upon admission to hospital, 6--acute bronchiolitis and 16 respiratory viral infections. Samples (nasal swabs) were taken from patients and introduced in viral transport medium. DIAGNOSTIC METHODS RT-PCR for RSV and hMPV, Multiplex PCR by seeplex multi-detection system with Seeplex RV/PB 18 ASE Detection for detection of 5 pneumonial bacteria and Real-Time PCR, Duplica Real Time Adenovirus Detection for ADV. RESULTS Of the total 70 patients negative for RSV, hMPV and 5 pneumonial bacteria (Streptococcus pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, Chlamydophila pneumoniae, Legionella pneumophila), 10 were ADV positive; none of the children < 6 months (N = 16) presented ADV infection. In the 6 months - 2 years group (N = 35), 6 were ADV positive. In the 2 - 5 years group (N = 19), 4 were ADV positive. CONCLUSIONS The percent of ADV infections in children hospitalized with acute respiratory infections (ARI) caused by neither RSV or hMPV is 14.2%. ADV is most frequently encountered in the 6 months - 2 years and then 2 - 5 years groups, but the most severe pneumonia forms can be seen in the 6 months - 2 years group. In children < 6 months with acute bronchiolitis ADV was not found to be an etiologic agent.
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Affiliation(s)
- Cristina Tecu
- National Institute of Research - Development for Microbiology and Immunology Cantacuzino, Respiratory Viral Infections Department, Bucharest.
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Craiu M, Iordachescu M, Stan I, Cochino A, Avram P, Ciomartan T, Brezan F. Alternative intraosseous infusion technique via spinal needle, valuable tool for paediatric resuscitation. Resuscitation 2010. [DOI: 10.1016/j.resuscitation.2010.09.312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sajin M, Craiu M, Iordachescu M, Stanescu A, Sajin AM. Evaluation of T-lymphocyte subtypes in the diagnosis of celiac disease. Rom J Morphol Embryol 2005; 45:119-25. [PMID: 15847385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
The objectives of this study were to verify comparatively clinical age reported antecedents and the morphological aspect of the intestinal mucosa in patients sensitive to gluten, hospitalised at IOMC ("Alfred Russescu" Hospital) in the last 7 years. Celiac disease is an inflammation most frequently affecting the proximal small intestine, depending on the presence of gluten in the diet, whose pathogenesis seems to be immunological in nature. 107 cases were divided in three groups following clinical manifestations types at hospitalisation time: typical digestive, untypical digestive and extra digestive manifestations. Intestinal biopsies, made with Crosby probe, in children aged between 1.3 and 8 years (one single case was diagnosed as late as at the age of 15), regardless of gender. Then we analysed morphologically (HE usual and PAS histochemical staining) and immunohistochemically (lymphocytes B, T with possible subtypes). The lesions were counted at the first biopsy according to the Marsh score. The immunohistochemical tests have indicated the prevalence of T lymphocytes (UCHL1, CD3, CD4, CD8, gamma-delta) both in the luminal epithelium with various degrees of aggression in lamina propria and also spread in stroma. B-lymphocytes (L26) are distributed prevalently nodular in stroma. In conclusion, it is CD4 T cells that are present in particular in the control of the gluten immune response in patients with Marsh I and Marsh III lesions.
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Affiliation(s)
- M Sajin
- Department of Pathology, Carol Davila University of Medicine and Pharmacy, Bucharest
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Craiu M, Stan I, Cernătescu I, Sajin M, Georgescu A, Avram P. [Pneumocystis pneumonia in infants]. Pneumologia 2005; 54:158-62. [PMID: 16536025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
The goal of this study is to present the clinical and evolutive features of Pneumocystis infection (PCP) in infants admitted in our clinic. We summarise these aspects from 17 cases (10 male and 7 female infants), admitted between 1st January 2004 and 31st May 2005. PCP infection is rare. It represents 1,5/1000 children (17 cases of 11328 total patients) admitted in our hospital. The risk factors for PCP were age between 6 weeks and 6 months (average 3,38 months) low birth weight (average = 2428 grams), low weight for age, prolonged hospital admission (88,23% of the 17 infants were abandoned in nursery). Only one of them had HIV infection and none presented neoplastic disease. The most prominent clinical aspect was tachypnea (average 78 breath/minute, maximum 130). 16 (94,11%) had difficult breathing with chest in-drawing and flaring of ala nasi. 14 (82,35%) had generalised cyanosis. Only two (11,72%) infants had fever. Radiologic aspects were evocative, with diffuse pulmonary involvement in almost all cases (88,23%). 6 infants (35,29%) had pneumothorax and 2 (11,76%) presented pneumomediastinum. Positive diagnosis was made by microscopic examination of secretions from endotracheal tube aspiration (Grocott methenamine silver stain and Romanowsky stain). 14 infants were ventilated with a good outcome--12 surviving infants (85,7%). All infants had a full course of intravenous Co-trimoxazole. The deceased infants had more risk factors--congenital heart disease 1 case, severe cerebral palsy with organic epilepsy 2 cases. The apparent increase of PCP cases can be related to the number of abandoned children in Romanian pediatric hospitals and nurseries.
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Affiliation(s)
- M Craiu
- Institutul de Ocrotire a Mamei şi Copilului, Alfred Rusescu, Clinica 1 Pediatrie.
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