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López-Lacort M, Muñoz-Quiles C, Díez-Domingo J, Orrico-Sánchez A. Effectiveness of self-financed rotavirus vaccines on acute gastroenteritis primary care episodes using real-world data in Spain: a propensity score-matched analysis of cohort study. Eur J Pediatr 2024:10.1007/s00431-024-05536-0. [PMID: 38584228 DOI: 10.1007/s00431-024-05536-0] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 03/15/2024] [Accepted: 03/20/2024] [Indexed: 04/09/2024]
Abstract
The objective of this study was to estimate, by a novel spatiotemporal approach in an environment of non-funded rotavirus (RV) vaccines, the RV vaccine effectiveness (VE) to prevent acute gastroenteritis primary care (AGE-PC)-attended episodes, demonstrating how indirect protection leads to underestimation of direct VE under high vaccine coverage (VC). This population-based retrospective cohort study used electronic healthcare registries including all children 2 months-5 years old, born from 2009 to 2018 in the Valencia Region (Spain). Direct RV VE preventing AGE-PC episodes was estimated using propensity score matching and Poisson regressions stratified by VC, adjusted by age and calendar season. Indirect VE was estimated by Poisson regression comparing AGE-PC rates in unvaccinated children among the different VC levels. A total of 563,442 children were included for the RV VC estimation; of them, 360,576 were included in the birth-cohort for VE analysis. RV VC showed strong variability among districts and seasons, rising on average from 21% in 2009/2010 to 55% in 2017/2018. The highest direct VE was found in vaccinated children from districts with 0-30% RV VC (16.4%) and the lowest in those from districts with ≥ 70% RV VC (9.7%). The indirect protection in unvaccinated children raised from 6 to 16.6% for those living with 20-30% and ≥ 70% VC, respectively. CONCLUSION Considering that RV is the causative agent in 20% of AGE cases, a direct effectiveness of 82% preventing AGE-PC episodes due to RV could be deduced using a novel spatiotemporal approach. A reduction of 17% of AGE-PC episodes in unvaccinated was observed in areas with VC over 70% because of indirect protection. WHAT IS KNOWN • The effectiveness of RV vaccines preventing hospitalizations due to RV-acute gastroenteritis (RV-AGE) has been extensively studied. However, RV also burdens the primary care (PC) setting, and data on vaccine effectiveness (VE) in preventing AGE-PC visits are scarce. • The RV vaccine distribution in Spain (non-funded), with large differences in vaccine coverage (VC) among healthcare districts, provides an ideal scenario to assess the actual VE in preventing AGE-PC consultations, including the direct and indirect protection. WHAT IS NEW • A direct effectiveness of 82% preventing AGE-PC episodes due to RV could be deduced using a novel spatiotemporal approach. A reduction of 17% of AGE-PC episodes in unvaccinated was observed in areas with high VC because of indirect protection. • These findings, together with existing data on the impact on hospitalizations due to RV-AGE, offer valuable insights for implementing vaccination initiatives in countries that have not yet commenced such programs.
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Affiliation(s)
- Mónica López-Lacort
- Vaccine Research Unit, Fundación Para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana, FISABIO-Public Health, Avda. Cataluña, 21. 46020, Valencia, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Cintia Muñoz-Quiles
- Vaccine Research Unit, Fundación Para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana, FISABIO-Public Health, Avda. Cataluña, 21. 46020, Valencia, Spain.
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain.
| | - Javier Díez-Domingo
- Vaccine Research Unit, Fundación Para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana, FISABIO-Public Health, Avda. Cataluña, 21. 46020, Valencia, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Universidad Católica de Valencia San Vicente Mártir, Carrer de Quevedo, 2, 46001, Valencia, Spain
| | - Alejandro Orrico-Sánchez
- Vaccine Research Unit, Fundación Para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana, FISABIO-Public Health, Avda. Cataluña, 21. 46020, Valencia, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Universidad Católica de Valencia San Vicente Mártir, Carrer de Quevedo, 2, 46001, Valencia, Spain
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Abstract
Rotavirus is the most common cause of severe diarrhea among infants and young children and is responsible for more than 200,000 pediatric deaths per year. There is currently no pharmacological treatment for rotavirus infection in clinical activity. Although cholesterol synthesis has been proven to play a key role in the infections of multiple viruses, little is known about the relationship between cholesterol biosynthesis and rotavirus replication. The models of rotavirus infected two cell lines and a human small intestinal organoid were used. We investigated the effects of cholesterol biosynthesis, including inhibition, enhancement, and their combinations on rotavirus replication on these models. The knockdown of 3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR) was built by small hairpin RNAs in Caco2 cells. In all these models, inhibition of cholesterol synthesis by statins or HMGCR knockdown had a significant inhibitory effect on rotavirus replication. The result was further confirmed by the other inhibitors: 6-fluoromevalonate, Zaragozic acid A and U18666A, in the cholesterol biosynthesis pathway. Conversely, enhancement of cholesterol production increased rotavirus replication, suggesting that cholesterol homeostasis is relevant for rotavirus replication. The effects of all these compounds toward rotavirus were further confirmed with a clinical rotavirus isolate. We concluded that rotavirus replication is dependent on cholesterol biosynthesis. To be specific, inhibition of cholesterol synthesis can downregulate rotavirus replication; on the contrary, rotavirus replication is upregulated. Statin treatment is potentially an effective novel clinical anti-rotavirus strategy.
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Affiliation(s)
- Shihao Ding
- Department Of Gastroenterology And Hepatology, Na-1001, Erasmus MC – University Medical Center Rotterdam, CA Rotterdam, Netherlands,Department of Endocrinology and Metabolism, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands,Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, Netherlands,CONTACT Shihao Ding Department Of Gastroenterology And Hepatology, Na-1001, Erasmus MC – University Medical Center Rotterdam, CA Rotterdam, Netherlands
| | - Bingting Yu
- Department Of Gastroenterology And Hepatology, Na-1001, Erasmus MC – University Medical Center Rotterdam, CA Rotterdam, Netherlands
| | - Anneke J. van Vuuren
- Department Of Gastroenterology And Hepatology, Na-1001, Erasmus MC – University Medical Center Rotterdam, CA Rotterdam, Netherlands
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Babji S, Sindhu KN, Selvarajan S, Ramani S, Venugopal S, Khakha SA, Hemavathy P, Ganesan SK, Giri S, Reju S, Gopalakrishnan K, Ninan B, Iturriza-Gomara M, Srikanth P, Kang G. Persistence of G10P[11] neonatal rotavirus infections in southern India. J Clin Virol 2021; 144:104989. [PMID: 34607240 PMCID: PMC8556361 DOI: 10.1016/j.jcv.2021.104989] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 02/23/2021] [Revised: 09/06/2021] [Accepted: 09/23/2021] [Indexed: 12/16/2022]
Abstract
Background: Neonatal rotavirus infections are predominantly caused by distinct genotypes restricted to this age-group and are mostly asymptomatic. Method: Stool samples from neonates admitted for >48 h in neonatal intensive care units (NICUs) in Vellore (2014–2015) and Chennai (2015–2016) in southern India, and from neonates born at hospitals in Vellore but not admitted to NICUs (2015–2016) were tested for rotavirus by ELISA and genotyped by hemi-nested RT-PCR. Results: Of 791 neonates, 150 and 336 were recruited from Vellore and Chennai NICUs, and 305 were born in five hospitals in Vellore. Positivity rates in the three settings were 49.3% (74/150), 29.5% (99/336) and 54% (164/305), respectively. G10P[11] was the commonly identified genotype in 87.8% (65/74), 94.9% (94/99) and 98.2% (161/164) of the neonates in Vellore and Chennai NICUs, and those born at Vellore hospitals, respectively. Neonates delivered by lower segment cesarian section (LSCS) at Vellore hospitals, not admitted to NICUs, had a significantly higher odds of acquiring rotavirus infection compared to those delivered vaginally [p = 0.002, OR = 2.4 (1.4–4.3)]. Conclusions: This report demonstrates the persistence of G10P[11] strain in Vellore and Chennai, indicating widespread neonatal G10P[11] strain in southern India and their persistence over two decades, leading to interesting questions about strain stability.
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Affiliation(s)
- Sudhir Babji
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | | | - Sribal Selvarajan
- Department of Microbiology, Sri Ramachandra Medical College and Research Institute, Chennai, India
| | - Sasirekha Ramani
- Baylor College of Medicine, Houston, TX, United States of America
| | - Srinivasan Venugopal
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Shainey Alokit Khakha
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Priya Hemavathy
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Santhosh Kumar Ganesan
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Sidhartha Giri
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Sudhabharathi Reju
- Department of Microbiology, Sri Ramachandra Medical College and Research Institute, Chennai, India
| | - Krithika Gopalakrishnan
- Department of Microbiology, Sri Ramachandra Medical College and Research Institute, Chennai, India
| | - Binu Ninan
- Department of Neonatology, Sri Ramachandra Medical College and Research Institute, Chennai, India
| | - Miren Iturriza-Gomara
- NIHR Health Protection Research Unit in Gastrointestinal Infections at University of Liverpool, Liverpool, United Kingdom of Great Britain
| | - Padma Srikanth
- Department of Microbiology, Sri Ramachandra Medical College and Research Institute, Chennai, India
| | - Gagandeep Kang
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India.
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Ogawa C, Kidokoro H, Ishihara N, Tsuji T, Kurahashi H, Hattori A, Suzuki M, Ogaya S, Ito Y, Fukasawa T, Kubota T, Okumura A, Saitoh S, Natsume J. Splenial Lesions in Benign Convulsions With Gastroenteritis Associated With Rotavirus Infection. Pediatr Neurol 2020; 109:79-84. [PMID: 32303390 DOI: 10.1016/j.pediatrneurol.2019.05.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 02/27/2019] [Revised: 04/28/2019] [Accepted: 05/02/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To investigate clinical risk factors for acute magnetic resonance imaging (MRI) abnormalities in patients with benign convulsions with mild gastroenteritis or benign infantile epilepsy. STUDY DESIGN We investigated clinical and diffusion-weighted imaging findings in 32 patients with benign convulsions with mild gastroenteritis and 22 patients with benign infantile epilepsy who underwent MRI within seven days of seizure onset between 2010 and 2015. RESULTS Diffusion-weighted imaging showed signal hyperintensity in the splenium of the corpus callosum in seven patients with benign convulsions with mild gastroenteritis, but no abnormalities in patients with benign infantile epilepsy. Patients with benign convulsions with mild gastroenteritis with splenial lesions showed a higher rate of rotavirus detection from feces (P = 0.006), higher serum level of C-reactive protein (P = 0.04), and shorter interval between seizure onset and MRI (P = 0.002) than patients with benign convulsions with mild gastroenteritis without splenial lesions. Multivariate analysis revealed rotavirus infection as a significant risk factor for splenial lesions on diffusion-weighted imaging in patients with benign convulsions with mild gastroenteritis (P = 0.02). CONCLUSIONS Splenial lesions are often seen during acute period in patients with benign convulsions with mild gastroenteritis. Rotavirus infection is a risk factor for splenial lesions in patients with benign convulsions with mild gastroenteritis, suggesting the role of rotavirus to cause edema in the corpus callosum. From our observations, benign convulsions with mild gastroenteritis with a splenial lesion on diffusion-weighted imaging suggests good outcomes, and extensive evaluation of these patients may be unnecessary.
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Affiliation(s)
- Chikako Ogawa
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiroyuki Kidokoro
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan; Brain and Mind Research Center, Nagoya University, Nagoya, Japan
| | - Naoko Ishihara
- Department of Pediatrics, Fujita Health University, Toyoake, Japan
| | - Takeshi Tsuji
- Department of Pediatrics, Okazaki City Hospital, Okazaki, Japan
| | | | - Ayako Hattori
- Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Motomasa Suzuki
- Department of Neurology, Aichi Children's Health and Medical Center, Obu, Japan
| | - Shunsuke Ogaya
- Department of Pediatrics, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, Japan
| | - Yuji Ito
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | | | - Tetsuo Kubota
- Department of Pediatrics, Anjo Kosei Hospital, Anjo, Japan
| | - Akihisa Okumura
- Department of Pediatrics, Aichi Medical University, Nagakute, Japan
| | - Shinji Saitoh
- Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Jun Natsume
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan; Brain and Mind Research Center, Nagoya University, Nagoya, Japan; Department of Developmental Disability Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.
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Trivedi M, Jain A, Shah D, Gupta P. Rotavirus Gastroenteritis Associated with Encephalopathy, Myositis, Transaminitis and Hypoalbuminemia. Indian J Pediatr 2019; 86:642-644. [PMID: 31020591 DOI: 10.1007/s12098-019-02959-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 12/01/2018] [Accepted: 04/09/2019] [Indexed: 10/26/2022]
Abstract
Rotavirus is a common cause of acute gastroenteritis in children. Manifestations of rotavirus gastroenteritis beyond gastrointestinal tract are rare. Rotavirus has been reported to be associated with encephalopathy, myositis and elevated liver enzymes; but simultaneous presentation of all these conditions in the same child is extremely rare. The authors report a case of 17-mo-old girl who presented with acute rotavirus gastroenteritis with G3 + G9P[8] strain associated with hypernatremia, encephalopathy, myositis, transaminitis and hypoalbuminemia. Child had complete recovery with no neurological sequalae on follow-up, and liver enzymes and albumin returned to normal. The authors suggest that rotavirus infection should be considered in the differential diagnosis of a child with encephalopathy or myositis, particularly if associated with acute diarrhea.
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Affiliation(s)
- Maharshi Trivedi
- Department of Pediatrics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, 110095, India
| | - Abhishek Jain
- Department of Pediatrics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, 110095, India
| | - Dheeraj Shah
- Department of Pediatrics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, 110095, India.
| | - Piyush Gupta
- Department of Pediatrics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, 110095, India
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Abstract
Background Rotavirus (RV) infection in neonates can be mild or even asymptomatic. In RV infection, jaundice is often reported, but the relationship between jaundice and RV infection has not been studied. This study aimed to determine the importance of asymptomatic RV screening in neonates with jaundice. Methods Neonates from the neonatal intensive care unit (NICU) of Chonbuk National University Hospital, those transferred from local obstetrics and gynecology hospitals and outpatient clinics were selected from 2014 to 2017. The study included only infants aged between 3 and 28 days. Jaundice was defined according to gestational age and birth age, in accordance with the American Academy of Pediatrics guidelines criteria. RV infection was confirmed by a stool test, and RV screening and laboratory tests were performed at admission. Results Among 596 patients, 166 patients had jaundice. RV infection was observed in 70 (42%) jaundice patients. There were 36 (22%) jaundice patients with asymptomatic RV infection. Patients with onset of jaundice 3–7 days after birth had a high incidence of RV infection. When the RV test was positive, the risk of jaundice was significantly high [odds ratio (OR) 1.89; 95% confidence interval (CI), 1.20–2.98; p = 0.006]. Conclusions Infants with the onset of jaundice > 3 days after birth were likely to have RV infection. Therefore, we suggest that screening tests for RV infection be included as part of the evaluation of jaundiced infants presenting to NICU. Electronic supplementary material The online version of this article (10.1186/s12887-018-1352-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nu Ri Hwang
- Department of Pediatrics, Chonbuk National University Medical School, 20, Geonjiro Deokjin-gu, Jeonju-si, Jeollabuk-do, 54907, South Korea
| | - Jin Kyu Kim
- Department of Pediatrics, Chonbuk National University Medical School, 20, Geonjiro Deokjin-gu, Jeonju-si, Jeollabuk-do, 54907, South Korea. .,Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea.
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Coldiron ME, Guindo O, Makarimi R, Soumana I, Matar Seck A, Garba S, Macher E, Isanaka S, Grais RF. Safety of a heat-stable rotavirus vaccine among children in Niger: Data from a phase 3, randomized, double-blind, placebo-controlled trial. Vaccine 2018; 36:3674-3680. [PMID: 29752026 DOI: 10.1016/j.vaccine.2018.05.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 05/02/2018] [Accepted: 05/03/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Rotavirus remains a major cause of diarrhea among children under 5 years of age. The efficacy of RotaSIIL, a pentavalent rotavirus vaccine, was shown in an event-driven trial in Niger. We describe the two-year safety follow-up of this trial. METHODS Follow-up of safety outcomes began upon administration of the first dose of RotaSIIL or placebo. Adverse events were followed until 28 days after the third dose, and serious adverse events were followed until 2 years of age. Suspected cases of intussusception were evaluated at first point of contact and then referred to hospital for surgical evaluation. Causes of death were obtained by chart review and verbal autopsy. Passive surveillance was carried out in health centers. Community health workers carried out active surveillance in villages. Between-group differences were evaluated using the chi-squared test and Fisher's exact test. RESULTS A total of 4092 children were randomized, and 4086 received at least one dose of RotaSIIL or placebo, constituting the intention-to-treat population, who accrued a total of 7385 child-years of follow-up time. At two years of follow-up, 58 (2.8%) participants who received RotaSIIL and 49 (2.4%) participants who received placebo had died (p = 0.38). Most deaths were due to infectious causes common to the study area. One participant had confirmed intussusception, 542 days after receiving the third dose of RotaSIIL. A total of 395 (19.3%) participants receiving RotaSIIL and 419 (20.5%) participants receiving placebo experienced any serious adverse event (p = 0.36). Most serious adverse events were hospitalizations due to infection (malaria, lower respiratory tract infection and gastroenteritis) or marasmus. Overall, 1474 (72.1%) participants receiving RotaSIIL and 1456 (71.1%) participants receiving placebo had at least one adverse event (p = 0.49) in the follow-up period. CONCLUSIONS At two years of follow-up, RotaSIIL was found to be safe. TRIAL REGISTRATION ClinicalTrials.gov: NCT02145000.
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Affiliation(s)
| | | | | | | | | | | | - Emilie Macher
- Médecins Sans Frontières, 78 rue de Lausanne, Geneva, Switzerland.
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Gómez-Rial J, Curras-Tuala MJ, Talavero-González C, Rodríguez-Tenreiro C, Vilanova-Trillo L, Gómez-Carballa A, Rivero-Calle I, Justicia-Grande A, Pardo-Seco J, Redondo-Collazo L, Salas A, Martinón-Torres F. Salivary epidermal growth factor correlates with hospitalization length in rotavirus infection. BMC Infect Dis 2017; 17:370. [PMID: 28558652 PMCID: PMC5450176 DOI: 10.1186/s12879-017-2463-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 05/15/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The IFI27 interferon gene expression has been found to be largely increased in rotavirus (RV)-infected patients. IFI27 gene encodes for a protein of unknown function, very recently linked to epidermal proliferation and related to the epidermal growth factor (EGF) protein. The EGF is a low-molecular-weight polypeptide that is mainly produced by submandibular and parotid glands, and it plays an important physiological role in the maintenance of oro-esophageal and gastric tissue integrity. Our aim was to determine salivary EGF levels in RV-infected patients in order to establish its potential relationship with IFI27 increased expression and EGF-mediated mucosal protection in RV infection. METHODS We conducted a prospective comparative study using saliva samples from 27 infants infected with RV (sampled at recruitment during hospital admission and at convalescence, i.e. at least 3 months after recovery) and from 36 healthy control children. RESULTS Median (SD) EGF salivary concentration was 777 (529) pg/ml in RV-infected group at acute phase and 356 (242) pg/m at convalescence, while it was 337 (119) pg/ml in the healthy control group. A significant association was found between EGF levels and hospitalization length of stay (P-value = 0.022; r2 = -0.63). CONCLUSIONS The salivary levels of EGF are significantly increased during the acute phase of natural RV infection, and relate to length of hospitalization. Further assessment of this non-invasive biomarker in RV disease is warranted.
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Affiliation(s)
- J. Gómez-Rial
- Grupo de Investigación en Genética, Vacunas, Infecciones y Pediatría (GENVIP), Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Galicia Spain
- Laboratorio de Inmunología, Servicio de Análisis Clínicos, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Galicia Spain
| | - M. J. Curras-Tuala
- Grupo de Investigación en Genética, Vacunas, Infecciones y Pediatría (GENVIP), Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Galicia Spain
| | - C. Talavero-González
- Grupo de Investigación en Genética, Vacunas, Infecciones y Pediatría (GENVIP), Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Galicia Spain
- Laboratorio de Inmunología, Servicio de Análisis Clínicos, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Galicia Spain
| | - C. Rodríguez-Tenreiro
- Grupo de Investigación en Genética, Vacunas, Infecciones y Pediatría (GENVIP), Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Galicia Spain
| | - L. Vilanova-Trillo
- Grupo de Investigación en Genética, Vacunas, Infecciones y Pediatría (GENVIP), Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Galicia Spain
| | - A. Gómez-Carballa
- Grupo de Investigación en Genética, Vacunas, Infecciones y Pediatría (GENVIP), Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Galicia Spain
- Unidade de Xenética, Departamento de Anatomía Patolóxica e Ciencias Forenses, Instituto de Ciencias Forenses, Facultade de Medicina, Universidade de Santiago de Compostela, Santiago de Compostela, Galicia Spain
- GenPob Research Group, Instituto de Investigaciones Sanitarias (IDIS), Hospital Clínico Universitario de Santiago, Santiago de Compostela, Galicia Spain
| | - I. Rivero-Calle
- Grupo de Investigación en Genética, Vacunas, Infecciones y Pediatría (GENVIP), Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Galicia Spain
- Translational Pediatrics and Infectious Diseases, Department of Pediatrics, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Galicia Spain
| | - A. Justicia-Grande
- Grupo de Investigación en Genética, Vacunas, Infecciones y Pediatría (GENVIP), Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Galicia Spain
- Translational Pediatrics and Infectious Diseases, Department of Pediatrics, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Galicia Spain
| | - J. Pardo-Seco
- Grupo de Investigación en Genética, Vacunas, Infecciones y Pediatría (GENVIP), Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Galicia Spain
- Unidade de Xenética, Departamento de Anatomía Patolóxica e Ciencias Forenses, Instituto de Ciencias Forenses, Facultade de Medicina, Universidade de Santiago de Compostela, Santiago de Compostela, Galicia Spain
- GenPob Research Group, Instituto de Investigaciones Sanitarias (IDIS), Hospital Clínico Universitario de Santiago, Santiago de Compostela, Galicia Spain
| | - L. Redondo-Collazo
- Grupo de Investigación en Genética, Vacunas, Infecciones y Pediatría (GENVIP), Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Galicia Spain
- Translational Pediatrics and Infectious Diseases, Department of Pediatrics, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Galicia Spain
| | - A. Salas
- Grupo de Investigación en Genética, Vacunas, Infecciones y Pediatría (GENVIP), Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Galicia Spain
- Unidade de Xenética, Departamento de Anatomía Patolóxica e Ciencias Forenses, Instituto de Ciencias Forenses, Facultade de Medicina, Universidade de Santiago de Compostela, Santiago de Compostela, Galicia Spain
- GenPob Research Group, Instituto de Investigaciones Sanitarias (IDIS), Hospital Clínico Universitario de Santiago, Santiago de Compostela, Galicia Spain
| | - F. Martinón-Torres
- Grupo de Investigación en Genética, Vacunas, Infecciones y Pediatría (GENVIP), Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Galicia Spain
- Translational Pediatrics and Infectious Diseases, Department of Pediatrics, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Galicia Spain
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Buccigrossi V, Russo C, Guarino A, de Freitas MB, Guarino A. Mechanisms of antidiarrhoeal effects by diosmectite in human intestinal cells. Gut Pathog 2017; 9:23. [PMID: 28450899 PMCID: PMC5404323 DOI: 10.1186/s13099-017-0172-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 04/11/2017] [Indexed: 12/16/2022] Open
Abstract
Background Rotavirus (RV) induces diarrhoea through a sequence of enterotoxic and cytotoxic effects. The former are NSP4-dependent, induce calcium-dependent chloride secretion and involve oxidative stress. Diosmectite (DS) is a natural clay that has been recommended as an active therapy for diarrhoea, but the mechanism of its effect is not clear. Electrical parameters may be used to measure the direct enterotoxic and cytotoxic effects in polar epithelial intestinal cells. To investigate the effects of DS on RV-induced enterotoxic and cytotoxic damage. Caco-2 cells were used as a model of RV infection to evaluate chloride secretion, epithelial integrity, oxidative stress and viral infectivity in Ussing chambers. Results Diosmectite reduced the expression of NSP4 and oxidative stress, resulting in a strong inhibition of chloride secretion. Preincubating RV with DS reduced the cytotoxic effect. Finally, the viral load was reduced by DS but not by control clay. This result suggests that DS specifically affects the early events of RV infection protecting the enterocyte, whereas it does not restore already-established cell damage. Conclusion These findings indicate that DS exerts an anti-diarrhoeal effect by inhibiting viral replication and the expression of NSP4. Both ion secretion and cell damage induced by RV are strongly inhibited consequent to the antiviral effect, which explains its clinical efficacy.
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Affiliation(s)
- Vittoria Buccigrossi
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, via S. Pansini 5, 80131 Naples, Italy
| | - Carla Russo
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, via S. Pansini 5, 80131 Naples, Italy
| | - Amedeo Guarino
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, via S. Pansini 5, 80131 Naples, Italy
| | - Maiara Brusco de Freitas
- Department of Nutrition, Federal University of Santa Catarina, Florianópolis, Santa Catarina Brazil
| | - Alfredo Guarino
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, via S. Pansini 5, 80131 Naples, Italy
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10
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Lopez-Lacort M, Collado S, Díez-Gandía A, Díez-Domingo J. Rotavirus, vaccine failure or diagnostic error? Vaccine 2016; 34:5912-5. [PMID: 27789146 DOI: 10.1016/j.vaccine.2016.10.032] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 10/11/2016] [Accepted: 10/12/2016] [Indexed: 11/22/2022]
Abstract
Immunochromatography (ICG) is highly used in clinical settings for rotavirus (RV) diagnosis. The specificity of the tests differs by brand type and is not 100%, therefore its use when the prevalence of the disease is low (i.e. in vaccinated children) may result in a proportion of false positive diagnoses. In some areas, vaccine effectiveness studies or surveillance is done using ICG. Our objective was to estimate the validity of ICG test in vaccinated children, and estimate the number of false positive results in the Valencian Region of Spain, where all RV infections are diagnosed using ICG and are not confirmed by PCR. Population based registries were used to identify all results from the RV antigen tests performed between January 2008 and June 2012 in children under 37months. Hospitalization and vaccination status of the patients were obtained by linking different databases through a unique identification number. The Positive Predictive Value of the ICG test depending on the vaccination status of the child, hospitalization and the rotavirus season was estimated by a Bayesian model of latent classes. Of the 48,833 tests with valid results, 9429 were done in vaccinated children, and of those 3963 (42%) during the rotavirus season. The prevalence of positive results in vaccinated varied from 2.9 to 21.4% of the tests depending on the hospitalization and seasonality. The estimated PPV also varied from 27.1 to 84.6% when stratified by these two parameters. Globally it is calculated that approximately 267 out of the 520 (51.3%) positives in vaccinated children were false positive tests. The large percentage of false positives, due to an excessive number of tests in vaccinated and out of the RV season, if interpreted as vaccine failures, can cause a loss of confidence in the vaccine and lower the estimates of vaccine effectiveness.
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11
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Sun X, Guo N, Li J, Yan X, He Z, Li D, Jin M, Xie G, Pang L, Zhang Q, Liu N, Duan ZJ. Rotavirus infection and histo-blood group antigens in the children hospitalized with diarrhoea in China. Clin Microbiol Infect 2016; 22:740.e1-3. [PMID: 27345178 DOI: 10.1016/j.cmi.2016.06.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 04/23/2016] [Accepted: 06/12/2016] [Indexed: 01/13/2023]
Abstract
To explore the association between rotavirus (RV) infection and histo-blood group antigens (HBGAs), a cross-sectional study was conducted in children hospitalized with diarrhoea in China from November 2014 to February 2015. In total, 424 sets of stool, saliva and buccal cell samples were collected. For the 125 RV-negative samples, 92% (104/125) were secretors/partial secretors, 8% (10/125) were non-secretors. Among the 299 RV-positive samples, 277 were P[8] and 22 were P[4]. All P[4] and P[8] positive individuals were secretors/partial secretors except for one P[8] (0.3%, 1/299), which was a non-secretor. These findings indicate that P[8] and P[4] RVs preferably infect secretors/partial secretors (p <0.001).
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Affiliation(s)
- X Sun
- Key Laboratory of Medical Virology and Viral Diseases, Ministry of Health of the People's Republic of China, Beijing, China; National Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
| | - N Guo
- Key Laboratory of Medical Virology and Viral Diseases, Ministry of Health of the People's Republic of China, Beijing, China; National Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
| | - J Li
- Key Laboratory of Medical Virology and Viral Diseases, Ministry of Health of the People's Republic of China, Beijing, China; National Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
| | - X Yan
- Centre for Disease Control and Prevention of Lulong County, Hebei, China
| | - Z He
- Chenzou No.1 People's Hospital, Hunan, China
| | - D Li
- Key Laboratory of Medical Virology and Viral Diseases, Ministry of Health of the People's Republic of China, Beijing, China; National Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
| | - M Jin
- Key Laboratory of Medical Virology and Viral Diseases, Ministry of Health of the People's Republic of China, Beijing, China; National Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
| | - G Xie
- Key Laboratory of Medical Virology and Viral Diseases, Ministry of Health of the People's Republic of China, Beijing, China; National Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
| | - L Pang
- Key Laboratory of Medical Virology and Viral Diseases, Ministry of Health of the People's Republic of China, Beijing, China; National Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
| | - Q Zhang
- Key Laboratory of Medical Virology and Viral Diseases, Ministry of Health of the People's Republic of China, Beijing, China; National Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
| | - N Liu
- Key Laboratory of Medical Virology and Viral Diseases, Ministry of Health of the People's Republic of China, Beijing, China; National Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
| | - Z-J Duan
- Key Laboratory of Medical Virology and Viral Diseases, Ministry of Health of the People's Republic of China, Beijing, China; National Institute for Viral Disease Control and Prevention, China CDC, Beijing, China.
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12
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Krawczyk A, Lewis MG, Venkatesh BT, Nair SN. Effect of Exclusive Breastfeeding on Rotavirus Infection among Children. Indian J Pediatr 2016; 83:220-5. [PMID: 26307755 DOI: 10.1007/s12098-015-1854-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Accepted: 07/16/2015] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To assess, whether exclusive breastfeeding plays a protective role in Rotavirus infection among children under age of five and to estimate whether breastfeeding has an impact on reducing the severity and symptoms among children infected with Rotavirus. METHODS A systematic search was performed in Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE/PubMEd (from 1980 to present), ScienceDirect (from 1980 to present), OVID (from 1980 to present) and regional database IndMED. All the studies along with the research publications with descriptive, case series, cross sectional, case control and cohort studies (prospective and retrospective) that provided effectiveness of exclusive breastfeeding were considered for this review. Two review authors independently scrutinized the studies and extracted the data. In case of disagreement, the senior reviewer was consulted. RESULTS Total seven studies qualified for the systematic review in which 6 studies qualified for meta-analysis. Exclusive breastfeeding was found to be effective in prevention of Rotavirus infection and in reducing the risk of Rotavirus infection among children (OR = 0.62, 95 % CI = 0.48-0.81). CONCLUSIONS This systematic review suggests that there is significant benefit in prevention of Rotavirus diarrhea among children by practicing exclusive breastfeeding throughout first 6 mo of life. Thereby, this study provides next reason to promote exclusive breastfeeding practice among mothers.
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13
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Moradi-Lakeh M, Shakerian S, Yaghoubi M, Esteghamati A, Shokraneh F, Baradaran HR, Ghanaee RM. Rotavirus Infection in Children with Acute Gastroenteritis in Iran: A Systematic Review and Meta-analysis. Int J Prev Med 2014; 5:1213-23. [PMID: 25400878 PMCID: PMC4223939] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 08/06/2014] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND The recent studies show that Rotavirus is important cause of the acute gastroenteritis. The aim of this review is to estimate the number of Rotavirus infection among Iranian children by performing a systematic review and estimating a pooled data. METHODS We performed a systematic literature review in relevant databases including PUBMED, MEDLINE, OVID, SID, MAGIRAN, and IRANMEDEX. Search in databases was done in October 10, 2013. Meta-analysis was performed using the STATA statistical package version 11. We assessed heterogeneity by Q-test and used random model for pooling measures of proportion of Rotavirus infection among Iranian children with diarrhea (and 95% confidence intervals [CI]). Sub group analysis between in-patient and outpatient group were done and publication bias was assessed by Egger and Begg tests. RESULTS A total of 154 records were identified in our searching. There were 36 studies including a total of 15,368 children with diarrhea. Out of 15,368 children, 6,338 were positive for Rotavirus gastroenteritis. Overall pooled estimate of infection with Rotavirus among cases of gastroenteritis was 0.35 (95% CI, 0.28-0.41). Pooled estimates for hospitalized children and outpatient subgroups were 0.39 (95% CI, 0.30-0.48), and 0.31 (95% CI, 0.23-0.38), respectively. CONCLUSIONS This study supports the importance of Rotavirus in the Iranian population such as common cause of diarrhea among children. Therefore, decision to adopt immunization programs to prevent Rotavirus infection might be helpful in Iran.
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Affiliation(s)
- Maziar Moradi-Lakeh
- Department of Community Medicine, Gastro-Intestinal and Liver Disease Research Center, Iran University of Medical Sciences, Tehran, Iran,Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Sareh Shakerian
- Department of Educational Management, Economics and policy, School of Medical Education, Shahid Beheshti University of Medical Sciences and Health Services, Tehran, Iran,Correspondence to: Dr. Sareh Shakerian, School of Medical Education, Shahid Beheshti University of Medical Sciences and Health Services, Tehran, Iran.
| | - Mohsen Yaghoubi
- Department of Community Medicine, Clinical Knowledge Management Unit, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Abdoulreza Esteghamati
- Department of Pediatrics, Akbarabadi Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Frahad Shokraneh
- Cochrane Schizophrenia Group, Institute of Mental Health, A Partnership Between The University of Nottingham and Nottinghamshire Healthcare NHS Trust, UK
| | - Hamid-Reza Baradaran
- Department of Epidemiology, School of Public Health, Iran University of Medical Science, Iran University of Medical Sciences, Tehran, Iran
| | - Roxana Mansour Ghanaee
- Pediatric Infections Research Center, Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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14
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Ferrara P, Pierri F, Zenzeri L, Vena F, Ianniello F, Chiaretti A. Post-infectious glomerulonephritis with nephrotic syndrome secondary to rotavirus infection. Med Mal Infect 2013; 43:398-400. [PMID: 23978516 DOI: 10.1016/j.medmal.2013.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Revised: 06/05/2013] [Accepted: 07/18/2013] [Indexed: 11/18/2022]
Affiliation(s)
- P Ferrara
- Institute of pediatrics, "A. Gemelli" university hospital, L.go A. Gemelli, 8, 00168 Rome, Italy.
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15
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Jang YY, Lee KH. Transient splenial lesion of the corpus callosum in a case of benign convulsion associated with rotaviral gastroenteritis. Korean J Pediatr 2010; 53:859-62. [PMID: 21189973 PMCID: PMC3005219 DOI: 10.3345/kjp.2010.53.9.859] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2010] [Revised: 06/22/2010] [Accepted: 07/20/2010] [Indexed: 12/03/2022]
Abstract
Transient magnetic resonance (MR) signal changes in the splenium of the corpus callosum (SCC) arise from many different conditions, including encephalopathy or encephalitis caused by infection, seizures, metabolic derangements, and asphyxia. Few case reports exist on reversible SCC lesions associated with rotavirus infection. A benign convulsion with mild gastroenteritis (CwG) is frequently associated with rotaviral infections. This entity is characterized by normal laboratory findings, electroencephalogram, neuroimaging, and good prognosis. We report a case of a 2.5-year-old Korean girl with rotavirus-associated CwG demonstrating a reversible SCC lesion on diffusion-weighted MR images. She developed 2 episodes of brief generalized tonic-clonic seizure with mild acute gastroenteritis without any other neurologic abnormality. Stool test for rotavirus antigen was positive. Brain MRI done on the day of admission showed a linear high signal intensity and decreased apparent diffusion coefficient values on the SCC. The lesion completely disappeared on follow-up MRI 6 days later. The patient fully recovered without any sequelae.
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Affiliation(s)
- Yoon Young Jang
- Department of Pediatrics, College of Medicine, Daegu Catholic University, Daegu, Korea
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