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16 pages, 1591 KiB  
Article
Molecular and Drug Resistance Characteristics of Haemophilus influenzae Carried by Pediatric Patients with Adenoid Hypertrophy
by Nan Xiao, Jia-Hao Qin, Xiu-Ying Zhao and Lin Liu
Microorganisms 2025, 13(8), 1764; https://doi.org/10.3390/microorganisms13081764 - 29 Jul 2025
Viewed by 235
Abstract
Purpose: The adenoid microbiota plays a key role in adenoid hypertrophy (AH). This study explored the molecular epidemiology and antimicrobial resistance of Haemophilus. Influenzae (H. influenzae) strains in pediatric AH patients. Methods: Retrospective analysis of pediatric AH patients undergoing endoscopic adenoidectomy. [...] Read more.
Purpose: The adenoid microbiota plays a key role in adenoid hypertrophy (AH). This study explored the molecular epidemiology and antimicrobial resistance of Haemophilus. Influenzae (H. influenzae) strains in pediatric AH patients. Methods: Retrospective analysis of pediatric AH patients undergoing endoscopic adenoidectomy. Adenoid tissue samples were cultured to screen for pathogens. H. influenzae strains were identified by 16S rRNA sequencing and serotyped via q-PCR. Multilocus sequence typing (MLST) and ftsI gene analysis were conducted using PubMLST. β-lactamase genes (blaTEM-1, blaROB-1) were detected by PCR, and antibiotic susceptibility testing (AST) was performed using the Etest method. For imipenem-resistant strains, the acrRAB efflux pump gene cluster and ompP2 porin gene were sequenced and compared with those of the wild-type strain Rd KW20. Results: Over 8 months, 56 non-duplicate H. influenzae strains were isolated from 386 patients. The detection rate was highest in children under 5 years (30.5%) compared to those aged 5–10 years (13.4%) and 10–15 years (8.7%). Of 49 sub-cultured strains, all were non-typeable H. influenzae (NTHi). MLST identified 22 sequence types (STs) and 13 clonal complexes (CCs), with CC11 (26.5%), CC3 (14.3%), and CC107 (14.3%) being predominant. Common STs included ST103 (22.4%), ST57 (10.2%), and ST107 (10.2%). Most strains belonged to the ftsI group III-like+ (57.1%). β-lactamase positivity was 98.0% (48/49), with blaTEM-1 (95.9%) and blaROB-1 (18.4%) detected. AST showed low susceptibility to ampicillin (10.2%), amoxicillin–clavulanate (34.7%), azithromycin (12.2%), and trimethoprim–sulfamethoxazole (14.3%). Among the β-lactamase-positive strains, 44/48 were β-lactamase-positive ampicillin-resistant (BLPAR); none were β-lactamase-negative ampicillin-resistant (BLNAR). Imipenem susceptibility was 91.8% (45/49). No carbapenemases were found in the imipenem-resistant strains, but mutations in acrRAB (88.12–94.94% identity) and ompP2 (77.10–82.94% identity) were observed. Conclusions: BLPAR NTHi strains of CC11 are major epidemic strains in pediatric AH. Imipenem resistance in H. influenzae likely results from porin mutations rather than carbapenemase activity. Enhanced surveillance of H. influenzae’s role in AH and its resistance patterns is warranted. Full article
(This article belongs to the Section Medical Microbiology)
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9 pages, 998 KiB  
Article
Enteroviral Transverse Myelitis Presenting as Acute Ataxia in Children: A Case Series
by Luka Švitek, Dominik Ljubas, Nina Krajcar, Maja Vrdoljak Pažur, Ana Tripalo Batoš, Irena Tabain, Srđan Roglić and Lorna Stemberger Marić
Biomedicines 2025, 13(6), 1492; https://doi.org/10.3390/biomedicines13061492 - 18 Jun 2025
Viewed by 439
Abstract
Background: Enteroviruses, members of the Picornaviridae family, typically cause asymptomatic or mild infections. However, they can also result in central nervous system (CNS) involvement, with transverse myelitis (TM) occurring only on rare occasions. TM is a syndrome characterized by acute or subacute [...] Read more.
Background: Enteroviruses, members of the Picornaviridae family, typically cause asymptomatic or mild infections. However, they can also result in central nervous system (CNS) involvement, with transverse myelitis (TM) occurring only on rare occasions. TM is a syndrome characterized by acute or subacute spinal cord dysfunction, leading to neurological deficits below the level of the lesion. Case report: We report a case series of eight pediatric patients admitted over a three-month period, June to August 2024. All patients presented with ataxia and/or other neurological symptoms, alongside abnormal cerebrospinal fluid (CSF) findings. Although ataxia is commonly associated with cerebellitis, magnetic resonance imaging (MRI) in this cohort revealed findings consistent with TM. Notably, all patients demonstrated similar MRI abnormalities. The onset of symptoms occurred over a short time during an enterovirus epidemic. Enteroviral RNA was detected, or the virus was isolated in seven patients, while one patient had a close epidemiological link to the virus. All patients achieved full recovery following immunomodulatory therapy. Conclusions: This case series underscores that ataxia may be an atypical symptom associated with TM. Furthermore, there was a notable distinction between the clinical presentation and neuroradiological findings. Immunomodulatory therapy with immunoglobulins and corticosteroids has been shown to be effective and safe, supporting the hypothesis of an immune-mediated pathogenesis in these patients. Full article
(This article belongs to the Special Issue Pathogenesis, Diagnosis and Treatment of Infectious Diseases)
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12 pages, 564 KiB  
Article
An Epidemic of Parvovirus B19-Induced Aplastic Crises in Pediatric Patients with Hereditary Spherocytosis Following the COVID-19 Pandemic: A Single-Center Retrospective Study
by Paola Giordano, Valentina Palladino, Giuseppe Lassandro, Stella Spina and Giovanni Carlo Del Vecchio
Children 2025, 12(6), 772; https://doi.org/10.3390/children12060772 - 13 Jun 2025
Viewed by 643
Abstract
Background: Parvovirus B19 is the major cause of transient aplastic crisis in children with hereditary spherocytosis (HS) inhibiting erythropoiesis and leading to a severe drop in hemoglobin levels, requiring hospitalization and transfusional support. During the COVID-19 pandemic, the circulation of non-COVID respiratory viruses, [...] Read more.
Background: Parvovirus B19 is the major cause of transient aplastic crisis in children with hereditary spherocytosis (HS) inhibiting erythropoiesis and leading to a severe drop in hemoglobin levels, requiring hospitalization and transfusional support. During the COVID-19 pandemic, the circulation of non-COVID respiratory viruses, such as parvovirus B19, initially declined but subsequently increased abruptly following the relaxation of containment strategies. Moreover, it remains unclear whether this has resulted in a rise in parvovirus B19-induced aplastic crises among individuals with HS. Methods: This retrospective, single-center study conducted at the Pediatric University Hospital of Bari (Italy) aims to describe the clinical characteristics and frequency of parvovirus B19-induced aplastic crises in pediatric patients with HS before and after the COVID-19 Public Health Emergency of International Concern (PHEIC, 30 January 2020–5 May 2023). The study was divided into four distinct periods: Period A: from 1 December 2018 to 31 December 2019, representing one year before the declaration of the PHEIC; Period B: from 1 June 2023 to 30 June 2024, representing one year after the cessation of the PHEIC; Period C: before 1 December 2018; Period D: from 1 January 2020 to 31 May 2023, which refers to the pandemic period. Results: A total of 30 patients (55% of the study population, n = 55) experienced a parvovirus B19-induced aplastic crisis. The frequency of these crises in Period B was significantly higher than in Period A (p < 0.0001). Conclusions: This study suggests a substantial increase in parvovirus B19-induced aplastic crises among children with HS following the COVID-19 outbreak indicating a potential impact of public health containment strategies on parvovirus B19 infection rates. Full article
(This article belongs to the Section Pediatric Hematology & Oncology)
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10 pages, 235 KiB  
Article
Bronchiolitis: A Real-Life Report of Increasing Compliance to Treatment Guidelines
by Melodie O. Aricò, Francesco Accomando, Daniela Trotta, Anthea Mariani, Claudia Rossini, Claudio Cafagno, Letizia Lorusso, Enrico Valletta, Desiree Caselli and Maurizio Aricò
Children 2025, 12(5), 571; https://doi.org/10.3390/children12050571 - 28 Apr 2025
Viewed by 742
Abstract
Background: Bronchiolitis accounts for a substantial number of pediatric hospitalizations and its epidemiology closely parallels that of respiratory syncytial virus (RSV), its principal etiological agent. International guidelines recommend supportive therapy based primarily on oxygen supplementation and hydration. Methods: This study aimed to assess, [...] Read more.
Background: Bronchiolitis accounts for a substantial number of pediatric hospitalizations and its epidemiology closely parallels that of respiratory syncytial virus (RSV), its principal etiological agent. International guidelines recommend supportive therapy based primarily on oxygen supplementation and hydration. Methods: This study aimed to assess, across three pediatric wards, the impact of internal monitoring and targeted educational interventions on adherence to bronchiolitis management guidelines. Focus was placed on evaluating the effectiveness of tailored strategies in enhancing the appropriateness of treatment practices. Each center independently developed an audit and feedback strategy aligned with local practices and available resources. In Center 1, monthly staff meetings included guideline refreshers throughout the epidemic season. Center 2 appointed two attending physicians to monitor treatment prescriptions and report deviations. Center 3 established an internal protocol through staff consensus, followed by monthly review sessions. In this retrospective analysis, all consecutive patients admitted with bronchiolitis during the winter seasons of 2022–2023 and 2023–2024 (Period 2) were compared with those admitted in 2021–2022 (Period 1). Results: A total of 623 infants under 24 months of age were included, 451 (72%) of whom tested positive for RSV. Their median length of hospital stay was 6 days; 26 infants (4%) required intensive care, and no deaths were recorded. A comparative analysis of the treatment modalities used—high-flow nasal cannula (HFNC) oxygen therapy, inhaled medications, corticosteroids, and antibiotics—revealed a reduced use of non-recommended therapies (e.g., nebulized β2-agonists, steroids, and antibiotics) in Period 2, alongside heterogeneous patterns in HFNC use. Center-specific strategies, tailored to team dynamics and resource availability, effectively promoted greater adherence to evidence-based guidelines. Conclusions: Our findings suggest that structured internal interventions can lead to more appropriate bronchiolitis management and the improved standardization of care. Full article
(This article belongs to the Section Pediatric Pulmonary and Sleep Medicine)
19 pages, 707 KiB  
Systematic Review
Changes in Respiratory Viruses’ Activity in Children During the COVID-19 Pandemic: A Systematic Review
by Marco Maglione, Vincenzo Tipo, Emiliano Barbieri, Roberta Ragucci, Agnese Sara Ciccarelli, Chiara Esposito, Ludovica Carangelo and Antonietta Giannattasio
J. Clin. Med. 2025, 14(4), 1387; https://doi.org/10.3390/jcm14041387 - 19 Feb 2025
Cited by 3 | Viewed by 1413
Abstract
Background/Objectives: The impact of the coronavirus disease 2019 (COVID-19) pandemic on health was significant worldwide. The measures adopted to limit the spread of the virus had an indirect effect on the epidemiology of other infectious diseases with similar mechanisms of inter-human transmission. [...] Read more.
Background/Objectives: The impact of the coronavirus disease 2019 (COVID-19) pandemic on health was significant worldwide. The measures adopted to limit the spread of the virus had an indirect effect on the epidemiology of other infectious diseases with similar mechanisms of inter-human transmission. The present literature review analyzed the scenario of pediatric acute respiratory infections in the post-lockdown period compared to the pre-pandemic and lockdown periods. The different patterns of viruses’ outbreaks were evaluated according to the type of local COVID-19 restrictive measures and to the type of pathogen. Methods: Relevant scientific literature published between March 2020 and November 2024 was identified by means of electronic keyword searches in the PubMed, Scopus, and Cochrane Library databases. Results: Worldwide implementation of non-pharmacological public health interventions aimed at limiting the COVID-19 pandemic resulted in a measurable effect on the circulation of other common respiratory viruses, significantly affecting their usual seasonality. Most viruses significantly reduced their activity during the lockdown period but returned to or exceeded historical levels after discontinuation of preventive non-pharmacological measures. For many respiratory viruses, particularly respiratory syncytial virus, an off-season increase was reported. Conclusions: The non-pharmacological interventions, which effectively helped limit the COVID-19 pandemic, resulted in relevant epidemiologic changes in most common respiratory viruses. Given the different seasonality and clinical severity observed for some pathogens after lockdown, possible future off-season or more severe epidemics should be expected. Full article
(This article belongs to the Section Clinical Pediatrics)
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15 pages, 3307 KiB  
Article
Epidemiology and Genetic Evolutionary Analysis of Influenza Virus Among Children in Hainan Island, China, 2021–2023
by Meng Chang, Shengjie Shi, Yan Jin, Gaoyu Wang, Ruoyan Peng, Jing An, Yi Huang, Xiaoyuan Hu, Chuanning Tang, Yi Niu, Xiuying Tian, Wanxin Deng, Cheng Tang, Xiuji Cui, Jasper Fuk-Woo Chan, Yibo Jia and Feifei Yin
Pathogens 2025, 14(2), 142; https://doi.org/10.3390/pathogens14020142 - 3 Feb 2025
Viewed by 1332
Abstract
Background: During the COVID-19 pandemic, we continuously monitored the epidemiology of influenza virus among pediatric patients from January 2021 to December 2023 in Hainan Island, China. Methods: In this study, we collected 54,974 nasopharyngeal swab samples for influenza A Virus (IAV) testing and [...] Read more.
Background: During the COVID-19 pandemic, we continuously monitored the epidemiology of influenza virus among pediatric patients from January 2021 to December 2023 in Hainan Island, China. Methods: In this study, we collected 54,974 nasopharyngeal swab samples for influenza A Virus (IAV) testing and 53,151 samples for influenza B Virus (IBV) testing from pediatric outpatients. Additionally, we also collected 19,687 nasopharyngeal swab samples from pediatric inpatients for IAV and IBV testing. Outpatient samples were screened for influenza viruses (IVs) infection by the colloidal gold method. Targeted Next-Generation Sequencing (tNGS) was used to detect influenza virus infections in inpatients. Influenza virus types were identified by analyzing the HA/NA partial regions. Results: The findings revealed a significant decrease in the infection rate of IBV over the specified period, while the infection rate of IAV exhibited a rising trend. Additionally, B/Victoria lineage was the dominant epidemic strain in 2021, while the epidemic strains in 2022 and 2023 underwent a dynamic transformation from A/H3N2 to A/H1N1. Phylogenetic analysis revealed close relationships among the circulating strains. Nonetheless, because the sample size is limited, additional research is required. Conclusions: Our findings suggest that the predominant types of influenza viruses in the pediatric population are undergoing dynamic changes, influenced by the implementation and relaxation of non-pharmaceutical intervention measures. These findings highlight the need for adaptive influenza vaccination and containment strategies, particularly in tropical regions like Hainan, where climate and public health policies significantly impact viral transmission patterns. The insights gained from this study could inform more effective public health strategies in similar regions to mitigate the impact of influenza outbreaks in the future. Full article
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16 pages, 263 KiB  
Review
Pediatric Vaccine Hesitancy in the United States—The Growing Problem and Strategies for Management Including Motivational Interviewing
by Ashlesha Kaushik, Julia Fomicheva, Nathan Boonstra, Elizabeth Faber, Sandeep Gupta and Helen Kest
Vaccines 2025, 13(2), 115; https://doi.org/10.3390/vaccines13020115 - 24 Jan 2025
Cited by 3 | Viewed by 3860
Abstract
Vaccine hesitancy is a significant global issue and is recognized by the World Health Organization (WHO) as one of the most pressing threats to public health. Defined as the delay in acceptance or refusal of vaccines despite their availability, vaccine hesitancy undermines decades [...] Read more.
Vaccine hesitancy is a significant global issue and is recognized by the World Health Organization (WHO) as one of the most pressing threats to public health. Defined as the delay in acceptance or refusal of vaccines despite their availability, vaccine hesitancy undermines decades of progress in preventing vaccine-preventable diseases. The issue is complex, influenced by misinformation, distrust in healthcare systems, cultural beliefs, and access barriers. These challenges require innovative and empathetic solutions to increase vaccine acceptance. Addressing this growing epidemic requires a multifaceted approach, which involves broader strategies and policymaking and in addition, effective communication tools for clinicians. Motivational Interviewing (MI), a patient-centered communication technique, offers an effective strategy to address pediatric vaccine hesitancy by fostering trust, understanding, and informed decision-making. This review aims to explore the problem of pediatric vaccine hesitancy in the United States, examine its underlying factors, and highlight evidence-based strategies, including Motivational Interviewing, to address this growing concern in clinical and public health settings. It offers practical guidance for healthcare providers and pediatricians to tackle this growing problem effectively and emphasizes the need for a combined effort of communication, community outreach, education, and systemic policy to overcome vaccine hesitancy. Full article
12 pages, 2142 KiB  
Article
Circulation of Respiratory Syncytial Virus (RSV) in Poland Between Seasons of 2009/2010 and 2022/2023 Based on SENTINEL System
by Karol Szymański, Anna Poznańska, Katarzyna Kondratiuk, Ewelina Hallmann, Katarzyna Łuniewska, Aleksander Masny and Lidia B. Brydak
Microorganisms 2025, 13(1), 140; https://doi.org/10.3390/microorganisms13010140 - 11 Jan 2025
Cited by 1 | Viewed by 2033
Abstract
Respiratory Syncytial Virus (RSV) is a prevalent pathogen of the respiratory tract, posing a significant threat to individuals with compromised immune systems, particularly the elderly and neonates in hospital settings. The primary objective of this study was to identify a specific period within [...] Read more.
Respiratory Syncytial Virus (RSV) is a prevalent pathogen of the respiratory tract, posing a significant threat to individuals with compromised immune systems, particularly the elderly and neonates in hospital settings. The primary objective of this study was to identify a specific period within the epidemic season during which healthcare providers can anticipate an increased incidence of RSV infections and characterize the epidemic season in Poland. Molecular biology techniques were employed to diagnose samples at Sanitary Stations and the National Institute of Public Health (NIC) in Warsaw. Epidemiological data were collected using the SENTINEL surveillance system. In the 2020/2021 season, there were no reported cases of RSV due to the prioritization of SARS-CoV-2 diagnostics. Before the pandemic, the period of heightened RSV infection risk typically commenced in the 51st week or later, with a statistically significant correlation indicating that a later start was associated with a shorter season duration (p = 0.034). In post-pandemic seasons, the temporal distribution of RSV cases exhibited a notable shift, with earlier season onset, peak, and conclusion. Data indicate that RSV is predominantly diagnosed in pediatric populations; however, since the 2017/2018 season, there has been an increase in RSV diagnoses among other age groups. Given the observed shifts in the seasonal peak following the SARS-CoV-2 pandemic, ongoing surveillance is required to ascertain whether these changes are permanent or transient. Full article
(This article belongs to the Special Issue Human Respiratory Syncytial Virus—Biology, Diagnosis and Prevention)
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16 pages, 746 KiB  
Article
Bronchiolitis Severity Affects Blood Count and Inflammatory Marker Levels: A Real-Life Experience
by Antonella Gambadauro, Salvatore Mollica, Emanuela Rosa, Federica Xerra, Alessandra Li Pomi, Mariella Valenzise, Maria Francesca Messina, Agata Vitale, Eloisa Gitto, Malgorzata Wasniewska, Giuseppina Zirilli and Sara Manti
Viruses 2025, 17(1), 77; https://doi.org/10.3390/v17010077 - 9 Jan 2025
Viewed by 1768
Abstract
Background: Bronchiolitis is the most common cause of lower respiratory tract infection (LRTI) in the first year of life. We analyzed the association between complete blood count (CBC), c-reactive protein (CRP), and novel inflammatory indexes (NLR, PLR, MLR, ELR, LMR, NPR, LPR, LNR, [...] Read more.
Background: Bronchiolitis is the most common cause of lower respiratory tract infection (LRTI) in the first year of life. We analyzed the association between complete blood count (CBC), c-reactive protein (CRP), and novel inflammatory indexes (NLR, PLR, MLR, ELR, LMR, NPR, LPR, LNR, PNR, SII, SIRI) in predicting bronchiolitis severity at hospital admission. Methods: We retrospectively collected data from 95 infants hospitalized for bronchiolitis in a third-level hospital during three epidemic seasons. Five outcomes of severity were analyzed: BRAS; pediatric intensive care unit (PICU) admission; ventilatory support; intravenous (IV) rehydration; and length of stay (LOS). Results: Lower age and weight at admission were statistically associated with four of the five severity outcomes. Prolonged LOS (≥6 days) was associated with high values of total white blood cells, lymphocytes, and eosinophils. Only three inflammatory indexes (PLR, MLR, and PNR) showed a significant association with one outcome (prolonged LOS). A new index (RBC/AiW/1000) was statistically associated with each severity outcome for a value > 350. Conclusions: We proposed a comprehensive analysis of the association between CBC, CRP, and novel inflammatory indexes and bronchiolitis severity. RBC/AiW/1000 could represent a future predictive marker of disease severity at hospital admission in infants with bronchiolitis. Full article
(This article belongs to the Section Human Virology and Viral Diseases)
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19 pages, 7728 KiB  
Article
Genetic Diversity and Epidemiology of Enteroviruses and Rhinoviruses in Children Hospitalized with Acute Respiratory Infections in Novosibirsk, Russia (2023–2024)
by Alina R. Nokhova, Tereza A. Saroyan, Mariya V. Solomatina, Tatyana A. Gutova, Anastasiya A. Derko, Nikita A. Dubovitskiy, Tatyana A. Murashkina, Kirill A. Sharshov, Alexander M. Shestopalov and Olga G. Kurskaya
Viruses 2024, 16(12), 1924; https://doi.org/10.3390/v16121924 - 16 Dec 2024
Cited by 1 | Viewed by 1478
Abstract
Rhinoviruses and respiratory enteroviruses remain among the leading causes of acute respiratory infections, particularly in children. Little is known about the genetic diversity of enteroviruses and rhinoviruses in pediatric patients with acute respiratory infections in Russia. We assessed the prevalence of human rhinoviruses/enteroviruses [...] Read more.
Rhinoviruses and respiratory enteroviruses remain among the leading causes of acute respiratory infections, particularly in children. Little is known about the genetic diversity of enteroviruses and rhinoviruses in pediatric patients with acute respiratory infections in Russia. We assessed the prevalence of human rhinoviruses/enteroviruses (HRV/EV) in 1992 children aged 0 to 17 years hospitalized with acute respiratory infections during the 2023–2024 epidemic season using PCR. The detection rate of HRV/EV was 11% (220/1992). We performed typing of 58 HRV and 28 EV viruses by partial sequencing of the VP1 gene. Rhinovirus A was the most common among HRV, followed by rhinovirus C; rhinovirus B was detected in only three cases. Enteroviruses were represented by all four species, with the EV-D68 genotype being the most frequently detected. Phylogenetic analysis of the VP1 fragment of EV-D68 showed that all our sequences belonged to the B3 subclade. We identified the first case of EV-C105 infection in Russia in a two-year-old girl hospitalized with pneumonia. Phylogenetically, the Novosibirsk strain EV-C105 was closely related to a strain discovered in France in 2018. This research helped to fill a critical gap in understanding the epidemiological landscape of HRV/EV in pediatric populations within Russia. Full article
(This article belongs to the Special Issue Enteroviruses: Respiratory and Nervous System Infections)
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13 pages, 1421 KiB  
Article
Proportional Trends in Pediatric Opioid Prescribing Between 2005 and 2016 by Age Group, Sex, Ethnicity, Race, Language, and Payer Status from a Large Children’s Hospital in the Southwest United States
by Melissa Pielech, Eric Kruger, Samantha M. Portis, Khirsten J. Wilson, W. Evan Rivers and Kevin E. Vowles
Children 2024, 11(11), 1356; https://doi.org/10.3390/children11111356 - 8 Nov 2024
Viewed by 891
Abstract
Background/Objectives: Prescription opioid use before adulthood is typically effective for acute pain control and is also associated with adverse short- and long-term consequences. Methods: This study examined pediatric opioid prescribing trends over time across different age groups (early childhood, school age, adolescence, young [...] Read more.
Background/Objectives: Prescription opioid use before adulthood is typically effective for acute pain control and is also associated with adverse short- and long-term consequences. Methods: This study examined pediatric opioid prescribing trends over time across different age groups (early childhood, school age, adolescence, young adult) and sociodemographic subgroups (sex, ethnicity, race, language, payer type) from 2005 to 2016. Results: Utilizing 42,020 first outpatient opioid prescriptions for youth aged 0–21 years from a large US children’s hospital, this research found notable trends and disparities. Prescription rates increased by 35% from 2005–2007 to 2008–2010, then decreased by 14% from 2008–2010 to 2011–2013, and decreased again by 22% from 2011–2013 to 2014–2016. Chi-squared tests indicated significant changes in prescription rates across all sociodemographic subgroups, though only age group, ethnicity, and payer type (i.e., the party responsible for payment for hospital services) had changes with non-negligible effect sizes (Cramer’s V). Specifically, age group showed small to medium effects (V = 0.16), while ethnicity and payer demonstrated small effects (V = 0.10 each). This study highlights variations in opioid prescribing trends, particularly among different age groups, ethnicities, and payer statuses up to 2016. Conclusions: These findings reveal differing trends in pediatric opioid prescribing during the peak of the opioid epidemic, highlighting the importance of considering age and sociodemographic variables for understanding prescribing patterns fully and raising potential concerns about inequities in pain management. Future studies should explore similar trends from 2016 onward. Full article
(This article belongs to the Section Pediatric Anesthesiology, Pain Medicine and Palliative Care)
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10 pages, 934 KiB  
Article
Contribution of Other Respiratory Viruses During Influenza Epidemic Activity in Catalonia, Spain, 2008–2020
by Nuria Torner, N. Soldevila, L. Basile, M. M. Mosquera, P. de Molina, M. A. Marcos, A. Martínez, M. Jané, A. Domínguez and The Working Group for the Catalan Influenza and Acute Respiratory Infection Sentinel Surveillance Network (PIDIRAC)
Microorganisms 2024, 12(11), 2200; https://doi.org/10.3390/microorganisms12112200 - 31 Oct 2024
Cited by 1 | Viewed by 1058
Abstract
Background: During seasonal influenza activity, circulation of other respiratory viruses (ORVs) may contribute to the increased disease burden that is attributed to influenza without laboratory confirmation. The objective of this study was to characterize and evaluate the magnitude of this contribution over 12 [...] Read more.
Background: During seasonal influenza activity, circulation of other respiratory viruses (ORVs) may contribute to the increased disease burden that is attributed to influenza without laboratory confirmation. The objective of this study was to characterize and evaluate the magnitude of this contribution over 12 seasons of influenza using the Acute Respiratory Infection Sentinel Surveillance system in Catalonia (PIDIRAC). Methods: A retrospective descriptive study of isolations from respiratory samples obtained by the sentinel surveillance network of physicians was carried out from 2008 to 2020 in Catalonia, Spain. Information was collected on demographic variables (age, sex), influenza vaccination status, epidemic activity weeks each season, and influenza laboratory confirmation. Results: A total of 12,690 samples were collected, with 46% (5831) collected during peak influenza seasonal epidemic activity. In total, 49.6% of the sampled participants were male and 51.1% were aged <15 years. Of these, 73.7% (4298) of samples were positive for at least one respiratory virus; 79.7% (3425 samples) were positive for the influenza virus (IV), with 3067 samples positive for one IV type, 8 samples showing coinfection with two types of IV, and 350 showing coinfection of IV with more than one virus. The distribution of influenza viruses was 64.2% IVA, 35.2% IVB, and 0.1% IVC. Of the other respiratory viruses identified, there was a high proportion of human rhinovirus (32.3%), followed by human adenovirus (24.3%) and respiratory syncytial virus (18; 7%). Four percent were coinfected with two or more viruses other than influenza. The distribution of coinfections with ORVs and influenza by age groups presents a significant difference in proportions for 0–4, 5–14, 15–64 and >64 (21.5%, 10.8%, 8.2% and 7.6%: p < 0.001). A lower ORVs coinfection ratio was observed in the influenza-vaccinated population (11.9% vs. 17.4% OR: 0.64 IC 95% 0.36–1.14). Conclusions: During the weeks of seasonal influenza epidemic activity, other respiratory viruses contribute substantially, either individually or through the coinfection of two or more viruses, to the morbidity attributed to influenza viruses as influenza-like illness (ILI). The contribution of these viruses is especially significant in the pediatric and elderly population. Identifying the epidemiology of most clinically relevant respiratory viruses will aid the development of models of infection and allow for the development of targeted treatments, particularly for populations most vulnerable to respiratory viruses-induced diseases. Full article
(This article belongs to the Special Issue Emerging and Re-emerging Respiratory Viruses)
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18 pages, 1680 KiB  
Systematic Review
Glucagon, Metabolic Dysfunction-Associated Steatotic Liver Disease and Amino Acids in Humans and Animals without Diabetes Mellitus—An Evidence Map
by Katharina Maruszczak, Pia Koren, Konrad Radzikowski, Thomas Pixner, Malte Palm Suppli, Nicolai J. Wewer Albrechtsen, Daniel Weghuber and Gabriel Torbahn
Life 2024, 14(10), 1292; https://doi.org/10.3390/life14101292 - 12 Oct 2024
Viewed by 1888
Abstract
Introduction: Health systems are confronted with not only the growing worldwide childhood obesity epidemic but also associated comorbidities. These subsequently cause variations in distinct metabolic pathways, leading to metabolic dysfunction-associated steatotic liver disease (MASLD). The aim of this evidence map is to systematically [...] Read more.
Introduction: Health systems are confronted with not only the growing worldwide childhood obesity epidemic but also associated comorbidities. These subsequently cause variations in distinct metabolic pathways, leading to metabolic dysfunction-associated steatotic liver disease (MASLD). The aim of this evidence map is to systematically evaluate the evidence and to identify research gaps on glucagon-induced amino acid (AA) turnover and its metabolic interaction with MASLD. Methodology: A systematic literature search was conducted up to April 2023 in three electronic databases. Studies were required to include at least two of the main research areas, glucagon, AA metabolism and MASLD. Two independent reviewers screened titles and abstracts according to prespecified eligibility criteria, as well as full-text articles. Results are summarized in tables stratified by human and animal studies and study population age. Results: Thirty-four references were ultimately included. The publication years dated back to 1965 showed a great increase from 2012 to 2023. In total, there were 19 animal studies and 15 human studies. Among the human studies, except for two studies in adolescents, all the studies were conducted in adults. In human studies, the methods used to evaluate metabolic changes differed among hyperinsulinemic-euglycemic clamp and oral glucose tolerance tests. Thirteen studies focused on the metabolic effects of MASLD, while only two studies explored the interaction between MASLD, glucagon and AA metabolism in humans. The other 19 studies focused on metabolomics, beta cell function or just one topic of a research area and not on interactions between one another. Conclusion: Research on the interaction between MASLD, glucagon and AA metabolism in humans is sparse and complete lacking in pediatrics. Furthermore, longitudinal studies with a focus on hyperglucagonemia independent of diabetes but related to MASLD present an unambiguous research gap. Full article
(This article belongs to the Special Issue Feature Paper in Physiology and Pathology: 2nd Edition)
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10 pages, 1793 KiB  
Article
Post-Pandemic Epidemiology of Respiratory Infections among Pediatric Inpatients in a Tertiary Hospital in Shanghai, China
by Siyuan Lan, Changjuan Gu, Shuanglong Lu, Ning Zhou and Xiaohong Qiao
Children 2024, 11(9), 1127; https://doi.org/10.3390/children11091127 - 17 Sep 2024
Cited by 4 | Viewed by 1627
Abstract
Background: After the removal of the three-year epidemic control restrictions, Chinese children were confronted with heightened risks of respiratory infections. We aimed to investigate the post-pandemic (2023) epidemiology of respiratory infections among pediatric inpatients in a tertiary hospital in Shanghai, China, and compare [...] Read more.
Background: After the removal of the three-year epidemic control restrictions, Chinese children were confronted with heightened risks of respiratory infections. We aimed to investigate the post-pandemic (2023) epidemiology of respiratory infections among pediatric inpatients in a tertiary hospital in Shanghai, China, and compare it with the pre-pandemic (2019) levels. Methods: A total of 2644 pediatric inpatients were enrolled based on discharge time and divided into group 2019 (n = 1442) and group 2023 (n = 1202). Information on the demographic characteristics, diagnoses, and pathogen test results (Mycoplasma pneumoniae, MP; Chlamydia pneumoniae, CP; Legionella pneumophila, LP; Influenza A, IFA; Influenza B, IFB; Parainfluenza virus, PIV; respiratory syncytial virus, RSV; Coxsackie virus, COX; Adenovirus, ADV; Epstein–Barr virus, EBV) was collected and analyzed. Results: Significant increases were found in the overall test positivity rates (64.6% vs. 46.7%), mixed infection rates (17.4% vs. 9%), and proportion of severe cases (25.5% vs. 3.7%) after the pandemic than those before it. Compared with 2019, the incidences of MP, IFA, LP, RSV, and ADV remarkably increased, while those of IFB and COX decreased, with no obvious differences noted for CP, PIV, and EBV in 2023. A significantly higher MP-positive detection rate was noticed in children aged 1–6 years in 2023 than in 2019. The incidence of RSV infection began to rise in August 2023, earlier than the conventional epidemic season. Conclusions: Compared with the pre-pandemic levels, the overall test positivity rates of atypical pathogens and viruses among pediatric inpatients significantly increased, and alterations in the disease spectrum, epidemic season, and age of prevalence were observed after the COVID-19 pandemic. Full article
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Article
Trends in Cancer Incidence and Mortality in US Adolescents and Young Adults, 2016–2021
by Li Zhang, Joshua E. Muscat, Vernon M. Chinchilli and Chandrika G. Behura
Cancers 2024, 16(18), 3153; https://doi.org/10.3390/cancers16183153 - 14 Sep 2024
Cited by 9 | Viewed by 2781
Abstract
(1) Background: The incidence rate of early onset-cancer (<50) has increased since 1995. Among younger people, cancers in AYAs (aged 15–39 y) are often biologically distinct tumors from those treated in the pediatric and older adult population. The current study describes trends in [...] Read more.
(1) Background: The incidence rate of early onset-cancer (<50) has increased since 1995. Among younger people, cancers in AYAs (aged 15–39 y) are often biologically distinct tumors from those treated in the pediatric and older adult population. The current study describes trends in the United States for the most recent years including the first year of the COVID-19 epidemic. We aimed to describe the recent incidence and mortality trends of cancers in AYAs (aged 15–39 y). (2) Methods: We used data from the Surveillance, Epidemiology, and End Results (SEER 22) from 1 January 2016 to 31 December 2021. Age-adjusted incidence and mortality rates were assessed by SEER*Stat 8.4.3 for major cancer types by sex, race/ethnicity, age, and metropolitan/nonmetropolitan status. Time trends of age-adjusted incidence and mortality rates were examined by sex and metropolitan/nonmetropolitan status. (3) Results: Age-adjusted overall cancer incidence and mortality rates were stable during this study period. The age-adjusted incidence rates declined significantly for ependymoma, melanoma, carcinomas of lung, bronchus, and trachea, unspecified malignant neoplasms, and non-Hodgkin’s lymphoma. Significant increases were found for gastrointestinal tract cancers and non-Kaposi sarcomas. The age-adjusted mortality rate decreased for acute myeloid leukemia, melanoma, carcinomas of liver and intrahepatic bile ducts, kidney and, in women, leukemia. For some cancers, rates differed by sex, race, ethnicity, and geography. Monitoring the rates and time trends of AYA cancer emphasizes the distinct health concern for this age group. Full article
(This article belongs to the Section Cancer Epidemiology and Prevention)
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