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Philip-Alliez C, Fievet L, Serratrice N, Seiler M, Le Gall M, Charavet C, Catherine JH. Cone Beam-CT-Based Bone Volume Assessments of Alveolar Synthetic Bone Graft GlassBONE™ in Cleft Lip and Palate Patients: A Retrospective Study. J Maxillofac Oral Surg 2024; 23:342-352. [PMID: 38601220 PMCID: PMC11001803 DOI: 10.1007/s12663-023-02056-6] [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] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 10/26/2023] [Indexed: 04/12/2024] Open
Abstract
Background Clefts of the lip and palate (CLP) are facial deformities that require multiple surgical procedures during childhood. One of these steps consists of filling the alveolar space with bone graft, traditionally removed from the iliac crest. However, this procedure could be invasive in children. Aim Here, we aimed to evaluate the outcomes of GlassBONE™ graft, a bioactive glass used as a bone substitute, as an alternative to the deleterious autologous bone graft in children. Materials & methods Retrospective monocentric study with 17 children aged 7.5 ± 2.2 yo [3.8-13.3 yo] carrying CLP. This technique has been established at La Timone Children hospital (Assistance Publique - Hôpitaux de Marseille) since 2011. Clinical (scar, graft rejection and periodontal status) and radiological (both panoramic radiographs and cone beam-CT) follow-up was conducted one year after the graft. The primary outcome was the reduction of the cleft volume, and secondary was the eruption of the adjacent tooth through the graft. Results GlassBONE™ permitted a significant reduction in the cleft volume by 42.4 ± 27.7% [0.6-81.1%] (p < 0.0001), corresponding to a filling of 57.6 ± 27.7% of the alveolar cleft. GlassBONE™ is well tolerated, ensuring satifactory clinical results (improvement in both scar and periodontal coverage), as well as the physiological evolution of the germs through the biomaterial. GlassBONE™ appears particularly suitable for small volumes, and we were able to determine a minimum volume of approximtely 0.259 + / - 0.155 cc required for a successful bone fusion. Conclusion The bioactive glass GlassBONE™ could be safely used in children with small CLP cases, providing satisfactory clinical and radiological results.
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Affiliation(s)
- C. Philip-Alliez
- Department of Orthodontics, La Timone Hospital (Assistance Publique - Hôpitaux de Marseille), Marseille, France
- UMR-T24 Ifsttar Aix-Marseille Université/Université Gustave Eiffel, Marseille, France
| | - L. Fievet
- Department of Pediatric Surgery, CHU La Réunion, Saint-Denis, France
| | - N. Serratrice
- Department of Neurosurgery, La Timone Hospital (Assistance Publique - Hôpitaux de Marseille), Marseille, France
| | - M. Seiler
- Department of Orthodontics, La Timone Hospital (Assistance Publique - Hôpitaux de Marseille), Marseille, France
| | - M. Le Gall
- Department of Orthodontics, La Timone Hospital (Assistance Publique - Hôpitaux de Marseille), Marseille, France
| | - C. Charavet
- Département d’Orthodontie, Faculté de Chirurgie Dentaire, Université Côte d’Azur, Nice, France
- Unité d’Orthodontie, Institut de Médecine Bucco-Dentaire, CHU de Nice, Nice, France
- Laboratoire MICORALIS UPR 7354, Université Côte d’Azur, Nice, France
| | - J. H. Catherine
- Department of Oral Surgery, La Timone Hospital (Assistance Publique - Hôpitaux de Marseille), Marseille, France
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Altmann-Schneider I, Kellenberger CJ, Pistorius SM, Saladin C, Schäfer D, Arslan N, Fischer HL, Seiler M. Artificial intelligence-based detection of paediatric appendicular skeletal fractures: performance and limitations for common fracture types and locations. Pediatr Radiol 2024; 54:136-145. [PMID: 38099929 PMCID: PMC10776701 DOI: 10.1007/s00247-023-05822-3] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/17/2023] [Accepted: 11/20/2023] [Indexed: 01/10/2024]
Abstract
BACKGROUND Research into artificial intelligence (AI)-based fracture detection in children is scarce and has disregarded the detection of indirect fracture signs and dislocations. OBJECTIVE To assess the diagnostic accuracy of an existing AI-tool for the detection of fractures, indirect fracture signs, and dislocations. MATERIALS AND METHODS An AI software, BoneView (Gleamer, Paris, France), was assessed for diagnostic accuracy of fracture detection using paediatric radiology consensus diagnoses as reference. Radiographs from a single emergency department were enrolled retrospectively going back from December 2021, limited to 1,000 radiographs per body part. Enrolment criteria were as follows: suspected fractures of the forearm, lower leg, or elbow; age 0-18 years; and radiographs in at least two projections. RESULTS Lower leg radiographs showed 607 fractures. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were high (87.5%, 87.5%, 98.3%, 98.3%, respectively). Detection rate was low for toddler's fractures, trampoline fractures, and proximal tibial Salter-Harris-II fractures. Forearm radiographs showed 1,137 fractures. Sensitivity, specificity, PPV, and NPV were high (92.9%, 98.1%, 98.4%, 91.7%, respectively). Radial and ulnar bowing fractures were not reliably detected (one out of 11 radial bowing fractures and zero out of seven ulnar bowing fractures were correctly detected). Detection rate was low for styloid process avulsions, proximal radial buckle, and complete olecranon fractures. Elbow radiographs showed 517 fractures. Sensitivity and NPV were moderate (80.5%, 84.7%, respectively). Specificity and PPV were high (94.9%, 93.3%, respectively). For joint effusion, sensitivity, specificity, PPV, and NPV were moderate (85.1%, 85.7%, 89.5%, 80%, respectively). For elbow dislocations, sensitivity and PPV were low (65.8%, 50%, respectively). Specificity and NPV were high (97.7%, 98.8%, respectively). CONCLUSIONS The diagnostic performance of BoneView is promising for forearm and lower leg fractures. However, improvement is mandatory before clinicians can rely solely on AI-based paediatric fracture detection using this software.
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Affiliation(s)
- Irmhild Altmann-Schneider
- Department of Diagnostic Imaging, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland.
- Paediatric Emergency Department, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland.
| | - Christian J Kellenberger
- Department of Diagnostic Imaging, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland
- Paediatric Emergency Department, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland
| | - Sarah-Maria Pistorius
- Department of Diagnostic Imaging, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland
- Paediatric Emergency Department, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland
| | - Camilla Saladin
- Department of Diagnostic Imaging, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland
- Paediatric Emergency Department, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland
| | - Debora Schäfer
- Children's Research Centre, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland
| | - Nidanur Arslan
- Children's Research Centre, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland
| | - Hanna L Fischer
- Children's Research Centre, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland
| | - Michelle Seiler
- Paediatric Emergency Department, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland
- Children's Research Centre, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland
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3
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Haas C, Salzmann AP, Binz TM, Staubli G, Seiler M, Steuer AE. Analytical description of adolescent binge drinking patients. BMC Pediatr 2023; 23:512. [PMID: 37845619 PMCID: PMC10577939 DOI: 10.1186/s12887-023-04325-2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 09/23/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Binge drinking is a widespread health compromising behavior among adolescents and young adults, leading to significant health problems, injuries and mortality. However, data on alcohol consumption is often unreliable, as it is mainly based on self-reporting surveys. In this five-year study (2014-2019) at the University Children's Hospital Zurich, we analyzed blood samples from adolescent binge drinking patients to investigate blood alcohol concentrations (BACs), co-ingestion of drugs, assess compliance between self-reported and measured substance use, and test for genetic components of innate alcohol tolerance. Furthermore, hair analysis was performed to retrospectively access drug exposure and to evaluate the potential of hair analysis to assess binge drinking. METHODS In a prospective, single-center study, patients with alcohol intoxications aged 16 years and younger were included. Blood and hair samples were analyzed by sensitive liquid chromatography - tandem mass spectrometry drug analysis. HTTLPR genotyping was performed with PCR and fragment analysis. RESULTS Among 72 cases, 72 blood and 13 hair samples were analyzed. BACs ranged from 0.08-3.20‰ (mean 1.63‰, median 1.60‰), while a mean concentration of 3.64 pg/mg hair (median 3.0 pg/mg) of the alcohol marker ethyl glucuronide (EtG) was detected in eleven hair samples, providing no evidence of chronic excessive drinking. In 47% of the cases, co-ingested drugs were qualitatively detected next to ethanol, but only 9% of the detected drugs had blood concentrations classified as pharmacologically active. Cannabis consumption (22%) and stimulant intake (16%) were the most frequently observed drugs. Compliance between patients' statements and measured substances matched well. Although we investigated the genetic contribution to innate alcohol tolerance via the 5-HTTLPR polymorphism, the diverse genetic background of the cohort and small sample size did not allow any conclusions to be drawn. CONCLUSION Almost half of our binge drinking patients tested positive for other substances, primarily cannabis. We anticipate that our study enhances understanding of consumption behavior of young people and encourage continued efforts to address the harmful effects of binge drinking and co-occurring substance use.
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Affiliation(s)
- Cordula Haas
- Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland.
| | | | - Tina Maria Binz
- Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - Georg Staubli
- Pediatric Emergency Department and Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland
| | - Michelle Seiler
- Pediatric Emergency Department and Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland
| | - Andrea Eva Steuer
- Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
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Weber DM, Kraus R, Wirth-Welle R, Andreisek G, Gnannt R, Guéro S, Neeser HR, Seiler M. Paediatric fractures of carpal bones other than the scaphoid. Hand Surg Rehabil 2023; 42:406-412. [PMID: 37356568 DOI: 10.1016/j.hansur.2023.06.009] [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] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 06/13/2023] [Accepted: 06/13/2023] [Indexed: 06/27/2023]
Abstract
OBJECTIVES Fractures of carpal bones other than the scaphoid are rare in children. The aim of this study was to analyze results and identify risk factors for an unfavorable outcome. MATERIAL AND METHODS Children and adolescents up to the age of 16 years who sustained a carpal fracture other than in the scaphoid between 2004 and 2021 were reviewed in this single-center retrospective study. RESULTS In a series of 209 children and adolescents with carpal fractures, 22 had fractures other than the scaphoid. Mean age was 13 years (range 8-16) years, with a total of 41 fractures, with highest incidences for the capitate (10), trapezium (6), triquetrum (4) and pisiform (4). Twenty-nine of these 41 fractures were missed on initial X-ray. Non-displaced fractures were treated with a short arm spica cast including the thumb. Four patients were operated on for displacement fracture or carpometacarpal subluxation. All fractures united, and patients returned to full activities. At the final consultation at a median 14 months (range 6-89) post-injury, all patients with non-displaced fractures were free of symptoms, with excellent Mayo Wrist Scores (MWS). However, three patients with operated trapezium fractures developed early radiological signs of osteoarthritis, two of them with residual pain and MWS rated only good. CONCLUSION Non-displaced pediatric carpal fractures treated by forearm cast have excellent prognosis. Fractures of the trapezium with displacement or first carpometacarpal subluxation incur a risk of osteoarthritis despite anatomical reduction and internal fixation.
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Affiliation(s)
- Daniel M Weber
- Division of Paediatric Hand Surgery and Children's Research Centre, University Children's Hospital Zurich, University of Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland.
| | - Ralf Kraus
- Klinikum Bad Hersfeld, Seilerweg 29, Bad Hersfeld, Germany.
| | - Ruth Wirth-Welle
- Division of Hand Surgery, Kantonsspital, Frauenfeld, Pfaffenholzstrasse 4, 8501 Frauenfeld, Switzerland.
| | - Gustav Andreisek
- Department of Radiology, Kantonsspital, Münsterlingen, Spitalcampus 1, 8596 Münsterlingen, Switzerland.
| | - Ralph Gnannt
- Paediatric Department of Radiology and Children's Research Centre, University Children's Hospital Zurich, University of Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland.
| | - Stéphane Guéro
- Division of Paediatric Orthopedics, Hôpital Necker-Enfants Malades, 149 rue de Sèvres, 75015 Paris, France.
| | - Hannah R Neeser
- Division of Paediatric Hand Surgery and Children's Research Centre, University Children's Hospital Zurich, University of Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland.
| | - Michelle Seiler
- Paediatric Emergency Department and Children's Research Centre, University Children's Hospital Zurich, University of Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland.
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5
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Goldman RD, Hart RJ, Bone JN, Seiler M, Olson PG, Keitel K, Manzano S, Gualco G, Krupik D, Schroter S, Weigert RM, Chung S, Thompson GC, Muhammad N, Shah P, Gaucher NO, Hou M, Griffiths J, Lunoe MM, Evers M, Pharisa Rochat C, Nelson CE, Gal M, Baumer-Mouradian SH. Willingness to vaccinate children against COVID-19 declined during the pandemic. Vaccine 2023; 41:2495-2502. [PMID: 36889992 PMCID: PMC9977620 DOI: 10.1016/j.vaccine.2023.02.069] [Citation(s) in RCA: 1] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 02/08/2023] [Accepted: 02/23/2023] [Indexed: 03/06/2023]
Abstract
OBJECTIVES To document the level of vaccine hesitancy in caregivers' of children younger than 12 years of age over the course of the pandemic in Pediatric Emergency Departments (ED). Study design Ongoing multicenter, cross-sectional survey of caregivers presenting to 19 pediatric EDs in the USA, Canada, Israel, and Switzerland during first months of the pandemic (phase1), when vaccines were approved for adults (phase2) and most recently when vaccines were approved for children (phase3). RESULTS Willingness to vaccinate rate declined over the study period (59.7%, 56.1% and 52.1% in the three phases). Caregivers who are fully vaccinated, who have higher education, and those worried their child had COVID-19 upon arrival to the ED, were more likely to plan to vaccinate in all three phases. Mothers were less likely to vaccinate early in the pandemic, but this hesitancy attenuated in later phases. Older caregivers were more willing to vaccinate, and caregivers of older children were less likely to vaccinate their children in phase 3. During the last phase, willingness to vaccinate was lowest in those who had a primary care provider but did not rely on their advice for medical decisions (34%). Those with no primary care provider and those who do and rely on their medical advice, had similar rates of willingness to vaccinate (55.1% and 52.1%, respectively). CONCLUSIONS COVID-19 vaccine hesitancy is widespread and growing over time, and public health measures should further try to leverage identified factors associated with hesitancy in order to enhance vaccination rates among children.
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Affiliation(s)
- R D Goldman
- The Pediatric Research in Emergency Therapeutics (PRETx) Program, Division of Emergency Medicine, Department of Pediatrics, University of British Columbia, and BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada.
| | - R J Hart
- Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Louisville, Louisville, KY, USA
| | - J N Bone
- Research Informatics, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - M Seiler
- Emergency Department, University Children's Hospital Zurich, Zurich, Switzerland
| | - P G Olson
- Department of Pediatrics, Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - K Keitel
- Pediatric Emergency Medicine, Inselspital University Hospital of Bern, Bern, Switzerland
| | - S Manzano
- Department of Pediatric Emergency Medicine, Geneva Children's Hospital, Geneva University Hospitals, and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - G Gualco
- Pediatric Emergency Department, Pediatric Institute of Italian part of Switzerland, Ticino, Switzerland
| | - D Krupik
- Pediatric Emergency Unit, Ziv Medical Center, and Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - S Schroter
- Division of Pediatric Emergency Medicine, Department of Pediatrics, University of California, San Diego, La Jolla, California and Rady Children's Hospital San Diego, San Diego, CA, USA
| | - R M Weigert
- Department of Pediatric Emergency Medicine, Children's Minnesota, Minneapolis, MN, USA
| | - S Chung
- Pediatric Emergency Medicine, Oregon Health & Science University, Portland, OR, USA
| | - G C Thompson
- Pediatrics and Emergency Medicine, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - N Muhammad
- Division of Pediatric Emergency Medicine, Advocate Children's Hospital, Oak Lawn, IL, USA
| | - P Shah
- Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA
| | - N O Gaucher
- Department of Pediatric Emergency Medicine and Research Center, Department of Pediatrics, CHU Sainte-Justine, 3175 Ch Cote Sainte-Catherine, Montreal, Canada
| | - M Hou
- The Pediatric Research in Emergency Therapeutics (PRETx) Program, Division of Emergency Medicine, Department of Pediatrics, University of British Columbia, and BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - J Griffiths
- The Pediatric Research in Emergency Therapeutics (PRETx) Program, Division of Emergency Medicine, Department of Pediatrics, University of British Columbia, and BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - M M Lunoe
- Division of Pediatric Emergency Medicine, UPMC Children's Hospital of Pittsburgh, PA, USA
| | - M Evers
- Division of Pediatric Pediatric Emergency Medicine, UH Rainbow Babies and Children's Hospital, 11100 Euclid Ave, Cleveland, OH, USA
| | - C Pharisa Rochat
- Division of Pediatric Emergency Medicine, Department of Pediatrics, Fribourg Hospital HFR, Fribourg, Switzerland
| | - C E Nelson
- Division of Emergency Medicine, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Wilmington, DE, USA
| | - M Gal
- Pediatric Emergency Department, Kaplan Medical Centre, Rehovot, Israel
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Kohns Vasconcelos M, Meyer Sauteur PM, Keitel K, Santoro R, Egli A, Coslovsky M, Seiler M, Lurà M, Köhler H, Loevy N, Kahlert CR, Heininger U, Van den Anker J, Bielicki JA. Detection of mostly viral pathogens and high proportion of antibiotic treatment initiation in hospitalised children with community-acquired pneumonia in Switzerland - baseline findings from the first two years of the KIDS-STEP trial. Swiss Med Wkly 2023; 153:40040. [PMID: 36800889 DOI: 10.57187/smw.2023.40040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
AIMS OF THE STUDY Globally, since the introduction of conjugate-vaccines against encapsulated bacteria, respiratory viruses have caused most hospitalisations for community-acquired pneumonia. The aim of this study was to describe pathogens detected and their association with clinical findings in Switzerland. METHODS Baseline data were analysed for all trial participants enrolled between September 2018 and September 2020 into the KIDS-STEP Trial, a randomised controlled superiority trial on the effect of betamethasone on clinical stabilisation of children admitted with community-acquired pneumonia. Data included clinical presentation, antibiotic use and results of pathogen detection. In addition to routine sampling, nasopharyngeal specimens were analysed for respiratory pathogens using a panel polymerase chain reaction test covering 18 viral and 4 bacterial pathogens. RESULTS 138 children with a median age of 3 years were enrolled at the eight trial sites. Fever (obligatory for enrolment) had been present for median 5 days before admission. Most common symptoms were reduced activity (129, 93.5%) and reduced oral intake (108, 78.3%). Oxygen saturation <92% was found in 43 (31.2%). Forty-three participants (29.0%) were already on antibiotic treatment prior to admission and 104 participants (75.4%) received antibiotic treatment on admission. Pathogen testing results were available from 132 children: 31 (23.5%) had respiratory syncytial virus detected, 21 (15.9%) human metapneumovirus. The pathogens detected showed expected seasonal and age preponderance and were not associated with chest X-ray findings. CONCLUSIONS In the context of the predominantly viral pathogens detected, the majority of antibiotic treatment is probably unnecessary. The ongoing trial, as well as other studies, will be able to provide comparative pathogen detection data to compare pre- and post-COVID-19-pandemic settings.
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Affiliation(s)
- Malte Kohns Vasconcelos
- Department of Infectious Diseases and Vaccinology, University of Basel Children's Hospital (UKBB), SwitzerlandX.,Department of Paediatric Pharmacology, University of Basel Children's Hospital (UKBB), Basel, Switzerland.,Institute for Medical Microbiology and Hospital Hygiene, Heinrich Heine University Düsseldorf, Germany
| | - Patrick M Meyer Sauteur
- Division of Infectious Diseases and Hospital Epidemiology, University Children's Hospital Zurich, Switzerland
| | - Kristina Keitel
- Department of Paediatric Emergency Medicine, Department of Paediatrics, University Children's Hospital, Inselspital, University of Bern, Switzerland.,Swiss Tropical and Public Health Institute, University of Basel, Switzerland
| | - Regina Santoro
- Paediatric Research Centre, University of Basel Children's Hospital (UKBB), Basel, Switzerland
| | - Adrian Egli
- Clinical Bacteriology and Mycology, University Hospital Basel, and Applied Microbiology Research, University of Basel, Switzerland
| | | | - Michelle Seiler
- Paediatric Emergency Department, University Children's Hospital Zurich, Switzerland
| | - Marco Lurà
- Division of Paediatric Pulmonology, Children's Hospital Lucerne, Switzerland
| | - Henrik Köhler
- Paediatric Emergency Unit, Children's Hospital Aarau (KSA), Switzerland
| | - Natasha Loevy
- Paediatric Platform for Clinical Research, Department of Woman, Child and Adolescent Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Christian R Kahlert
- Infectious Diseases and Hospital Epidemiology, Children's Hospital of Eastern Switzerland, St Gallen, Switzerland
| | - Ulrich Heininger
- Department of Infectious Diseases and Vaccinology, University of Basel Children's Hospital (UKBB), SwitzerlandX
| | - Johannes Van den Anker
- Department of Paediatric Pharmacology, University of Basel Children's Hospital (UKBB), Basel, Switzerland
| | - Julia A Bielicki
- Department of Infectious Diseases and Vaccinology, University of Basel Children's Hospital (UKBB), SwitzerlandX.,Department of Paediatric Pharmacology, University of Basel Children's Hospital (UKBB), Basel, Switzerland
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Crowther LM, Poms M, Zandl-Lang M, Abela L, Hartmann H, Seiler M, Mathis D, Plecko B. Metabolomics analysis of antiquitin deficiency in cultured human cells and plasma: Relevance to pyridoxine-dependent epilepsy. J Inherit Metab Dis 2023; 46:129-142. [PMID: 36225138 PMCID: PMC10092344 DOI: 10.1002/jimd.12569] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 10/09/2022] [Accepted: 10/10/2022] [Indexed: 01/19/2023]
Abstract
Deficiency of antiquitin (α-aminoadipic semialdehyde dehydrogenase), an enzyme involved in lysine degradation and encoded by ALDH7A1, is the major cause of vitamin B6 -dependent epilepsy (PDE-ALDH7A1). Despite seizure control with high dose pyridoxine (PN), developmental delay still occurs in approximately 70% of patients. We aimed to investigate metabolic perturbations due to possible previously unidentified roles of antiquitin, which may contribute to developmental delay, as well as metabolic effects of high dose pyridoxine supplementation reflecting the high doses used for seizure control in patients with PDE-ALDH7A1. Untargeted metabolomics by high resolution mass spectrometry (HRMS) was used to analyze plasma of patients with PDE-ALDH7A1 and two independently generated lines of cultured ReNcell CX human neuronal progenitor cells (NPCs) with CRISPR/Cas mediated antiquitin deficiency. Accumulation of lysine pathway metabolites in antiquitin-deficient NPCs and western-blot analysis confirmed knockdown of ALDH7A1. Metabolomics analysis of antiquitin-deficient NPCs in conditions of lysine restriction and PN supplementation identified changes in metabolites related to the transmethylation and transsulfuration pathways and osmolytes, indicating a possible unrecognized role of antiquitin outside the lysine degradation pathway. Analysis of plasma samples of PN treated patients with PDE-ALDH7A1 and antiquitin-deficient NPCs cultured in conditions comparable to the patient plasma samples demonstrated perturbation of metabolites of the gamma-glutamyl cycle, suggesting potential oxidative stress-related effects in PN-treated patients with PDE-ALDH7A1. We postulate that a model of human NPCs with CRISPR/Cas mediated antiquitin deficiency is well suited to characterize previously unreported roles of antiquitin, relevant to this most prevalent form of pyridoxine-dependent epilepsy.
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Affiliation(s)
- Lisa M Crowther
- Division of Child Neurology, University Children's Hospital Zurich, Zurich, Switzerland
- CRC Clinical Research Center, University Children's Hospital Zurich, Zurich, Switzerland
- Radiz-Rare Disease Intiative Zurich, Clinical Research Priority Program for Rare Diseases, University of Zurich, Zurich, Switzerland
| | - Martin Poms
- Division of Child Neurology, University Children's Hospital Zurich, Zurich, Switzerland
- CRC Clinical Research Center, University Children's Hospital Zurich, Zurich, Switzerland
- Radiz-Rare Disease Intiative Zurich, Clinical Research Priority Program for Rare Diseases, University of Zurich, Zurich, Switzerland
- Department of Clinical Chemistry and Biochemistry, University Children's Hospital Zurich, Zurich, Switzerland
| | - Martina Zandl-Lang
- Department of Pediatrics and Adolescent Medicine, Division of General Pediatrics, Medical University of Graz, Graz, Austria
| | - Lucia Abela
- Division of Child Neurology, University Children's Hospital Zurich, Zurich, Switzerland
- Molecular Neurosciences, Developmental Neuroscience, UCL Institute of Child Health, London, UK
| | - Hans Hartmann
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | - Michelle Seiler
- Pediatric Emergency Department, University Children's Hospital Zurich, Zurich, Switzerland
| | - Déborah Mathis
- Department of Clinical Chemistry and Biochemistry, University Children's Hospital Zurich, Zurich, Switzerland
- University Institute of Clinical Chemistry, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Barbara Plecko
- Division of Child Neurology, University Children's Hospital Zurich, Zurich, Switzerland
- CRC Clinical Research Center, University Children's Hospital Zurich, Zurich, Switzerland
- Radiz-Rare Disease Intiative Zurich, Clinical Research Priority Program for Rare Diseases, University of Zurich, Zurich, Switzerland
- Department of Pediatrics and Adolescent Medicine, Division of General Pediatrics, Medical University of Graz, Graz, Austria
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8
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Seiler M, Schiestl C. [Tongue Lacerations in Children. The Zurich Tongue Scheme]. Praxis (Bern 1994) 2022; 111:922-926. [PMID: 36475366 DOI: 10.1024/1661-8157/a003944] [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] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Tongue Lacerations in Children. The Zurich Tongue Scheme Abstract. Treating injured children is part of everyday life at a pediatrician's office or in an emergency department. Among the most common injuries are lacerations, mainly of the head, but the tongue can also be affected. Lacerations of the tongue mostly occur in early childhood due to fall when the child bites its tongue. No evidence-based treatment recommendations exist, even though such injuries are common. It makes a huge difference to the parents and children affected whether the treatment consists of a primary wound closure in general anesthesia or spontaneous healing can be awaited. In this article, the development and implementation of the Zurich Tongue Scheme will be discussed, the first evidence-based treatment recommendations for uncomplicated tongue lacerations in children.
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Affiliation(s)
- Michelle Seiler
- Interdisziplinäre Notfallstation, Universitäts-Kinderspital Zürich - Eleonorenstiftung, Zürich, Schweiz
- Forschungszentrum für das Kind, Universitäts-Kinderspital Zürich, Universität Zürich, Zürich, Schweiz
| | - Clemens Schiestl
- Forschungszentrum für das Kind, Universitäts-Kinderspital Zürich, Universität Zürich, Zürich, Schweiz
- Abteilung für Plastisch-Rekonstruktive Chirurgie Universitäts-Kinderspital Zürich - Eleonorenstiftung, Zürich, Schweiz
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9
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Goldman RD, Seiler M, Olson PG, Hart RJ, Bone JN, Baumer-Mouradian SH. Factors associated with unvaccinated caregivers who plan to vaccinate their children. Prev Med 2022; 162:107121. [PMID: 35863584 PMCID: PMC9290374 DOI: 10.1016/j.ypmed.2022.107121] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/24/2022] [Accepted: 06/15/2022] [Indexed: 12/02/2022]
Abstract
Vaccine hesitancy is complex and a threat to global public health during the ongoing COVID-19 pandemic. Our objective was to determine factors associated with caregivers' willingness to vaccinate children despite not being immunized themselves against COVID-19. The International COVID-19 Parental Attitude Study (COVIPAS), a multinational cohort study, recruited caregivers of children 0-18 years old in 21 Emergency Departments (EDs) in USA, Canada, Israel, and Switzerland during November-December 2021. Of a total of 4536 caregivers who completed the survey, 882 (19.4%) were unvaccinated, and 62 (7.0%) of the unvaccinated planned to vaccinate their children. Unvaccinated caregivers with children that had their childhood vaccines up-to-date (OR 3.03 (1.36, 8.09), p = 0.01), and those very worried their child has COVID-19 in the ED (OR 3.11 (1.44, 6.34), p < 0.01) were much more likely to plan to immunize their children. Primary care providers and public health agencies should not assume that unvaccinated parents will not vaccinate their children. Determining child's vaccination status and parental level of concern about COVID-19 may help identify caregivers who are open to give their children the vaccine.
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Affiliation(s)
- R D Goldman
- The Pediatric Research in Emergency Therapeutics (PRETx) Program, Division of Emergency Medicine, Department of Pediatrics, University of British Columbia, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada.
| | - M Seiler
- Emergency Department, University Children's Hospital Zurich, Zurich, Switzerland.
| | - P G Olson
- Department of Pediatrics, Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, Los Angeles, CA, United States.
| | - R J Hart
- Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Louisville, Louisville, KY, United States.
| | - J N Bone
- Research Informatics, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada.
| | - S H Baumer-Mouradian
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, United States.
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10
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Baumer-Mouradian SH, Hart RJ, Bone JN, Seiler M, Olson P, Keitel K, Manzano S, Gualco G, Krupik D, Schroter S, Weigert RM, Chung S, Thompson GC, Muhammad N, Shah P, Gaucher NO, Lunoe MM, Evers M, Pharisa Rochat C, Nelson CE, Shefler Gal M, Doucas A, Goldman RD. Should COVID-19 Vaccines Be Mandated in Schools? - An International Caregiver Perspective. Vaccine 2022; 40:5384-5390. [PMID: 35945047 PMCID: PMC9339978 DOI: 10.1016/j.vaccine.2022.07.038] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 07/13/2022] [Accepted: 07/21/2022] [Indexed: 11/08/2022]
Abstract
Objectives Caregiver attitudes toward mandating COVID-19 vaccines for their children are poorly understood. We aimed to determine caregiver acceptability of COVID-19 vaccine mandates for schools/daycares and assess if opposition to mandates would result in removal of children from the educational system. Study Design Perform a cross-sectional, anonymous survey of adult caregivers with children ≤ 18 years presenting to 21 pediatric emergency departments in the United States, Canada, Israel, and Switzerland, November 1st through December 31st, 2021. The primary outcome was caregiver acceptance rates for school vaccine mandates, and the secondary outcomes included factors associated with mandate acceptance and caregiver intention to remove the child from school. Results Of 4,393 completed surveys, 37% of caregivers were opposed to any school vaccine mandate. Caregiver acceptance was lowest for daycare settings (33%) and increased as the child’s level of education increased, college (55%). 26% of caregivers report a high likelihood (score of 8–10 on 0–10 scale) to remove their child from school if the vaccine became mandatory. Child safety was caregivers’ greatest concern over vaccine mandates. A multivariable model demonstrated intent to vaccinate their child for COVID-19 (OR = 8.9, 95% CI 7.3 to 10.8; P < 0.001) and prior COVID-19 vaccination for the caregiver (OR = 3.8, 95% CI 3.0 to 4.9; P < 0.001) had the greatest odds of increasing mandate acceptance for any school level. Conclusions Many caregivers are resistant to COVID-19 vaccine mandates for schools, and acceptance varies with school level. One-fourth of caregivers plan to remove their child from the educational system if vaccines become mandated.
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11
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Bataenjer R, Grotzer M, Seiler M. For Infants With Fractures: Involvement of a Child Protection Team Is Mandatory With Few Exceptions. Pediatr Emerg Care 2022; 38:e724-e730. [PMID: 35100770 DOI: 10.1097/pec.0000000000002325] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The objective of this study was to compare the frequency at which abuse is detected in institutions with mandatory skeletal surveys for infants with fractures to that in institutions with discretionary referral to child protection teams (CPTs). METHODS A retrospective chart review of all infants with fractures diagnosed at an emergency department from 2014 to 2018 was conducted to analyze factors leading to a discretionary referral to CPTs and to identify the frequency of nonaccidental trauma. RESULTS Seventy-two infants with a median age of 6 months were included in this study. The most frequent fracture site was the skull (73.6%), followed by fractures of the femur (12.5%) and the upper arm and forearm (each 4.2%). Discretionary referral to a CPT occurred in only 25% of cases, and abuse was detected in 2.8%. CONCLUSIONS The abuse detection rate in institutions with discretionary CPT referral is lower than that in institutions with mandatory skeletal surveys. Therefore, we recommend that in institutions with no mandatory skeletal surveys for infants with fractures, every infant with a fracture must be discussed with a CPT.
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Affiliation(s)
- Reto Bataenjer
- From the Pediatric Emergency Department, University Children's Hospital
| | - Michael Grotzer
- Children's Research Center, University Children's Hospital and University of Zurich, Zurich, Switzerland
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12
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Abstract
OBJECTIVES Unplanned return visits (URVs) to emergency departments (EDs) account internationally for 2.5% to 5.2% of all consultations. ED crowding is an increasing challenge, and URVs seem to contribute to this problem. This study aimed to assess factors for URVs at the ED of a tertiary children's hospital to analyze if they are jointly responsible for the steadily rising amount of treated patients. METHODS All patients with an URV to a pediatric ED in Switzerland between January and December 2013 were included in the study. Data were taken retrospectively from the electronic patient files, and different variables were defined and analyzed. RESULTS URVs occurred at an incidence of 4.6%, and mostly concerned infants and toddlers (46%). URVs were independent of weekdays and mostly occurred between 10 am and 10 pm. In 84.2% of the cases, the URVs were judged as unnecessary, and in 15.8%, a hospitalization was indicated, mainly for children with a worsening respiratory illness. CONCLUSIONS The occurrence of URVs in our ED was within the incidence reported in the literature. While URVs lead to hospitalization in some patients, the majority of URVs were unnecessary from a medical point of view. These results indicate that a correct evaluation of the child's health state by parents is often challenging and requires repeated medical attendance following a first ED visit, especially in infants with airway diseases and infections. Intensive counseling and scheduled short-term follow-up consultation at the pediatrician's office could prevent URVs to the ED.
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13
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Davis A, Sunderji A, Marneni S, Seiler M, Hall J, Cotanda CP, Klein E, Brown J, Gelernter R, Griffiths M, Hoeffe J, Gualco G, Mater A, Manzano S, Thompson G, Ahmed S, Ali S, Goldman R. 29 Caregiver-Reported Delay in Presentation to Pediatric Emergency Departments for Fear of Contracting COVID-19: A multinational cross-sectional study. Paediatr Child Health 2021. [PMCID: PMC8689878 DOI: 10.1093/pch/pxab061.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Indexed: 11/12/2022] Open
Abstract
Abstract
Primary Subject area
Public Health and Preventive Medicine
Background
Visits to pediatric emergency departments have decreased up to 75% during the pandemic, with corresponding increases in high acuity visits, inpatient admissions, and intensive care unit admissions compared to historical cohorts.
Objectives
To determine if caregivers of children presenting to pediatric emergency departments (EDs) during the COVID-19 pandemic are delaying presenting to care for fear of contracting COVID-19. Secondary objectives were to: a) evaluate potential predictors of delay; b) describe the proportion of children whose symptoms worsened during time to presentation.
Design/Methods
A multicentre cross-sectional survey study of caregivers accompanying their children aged 0-19 years old to 16 pediatric EDs in 6 countries, from May-June 2020. An anonymous online survey, completed by caregivers via RedCAP, included caregiver and child demographics, presenting complaints, if they delayed presentation and whether symptoms worsened during this interval, as well as caregiver concerns about the child or caregiver having COVID-19 at the time of ED visit.
Results
Of 1543 caregivers completing the survey, 287 (18.6%) reported a delay in seeking ED care due to concerns of contracting COVID-19 in the hospital. Of those, 124 (43.2%) stated their child’s symptoms worsened during the waiting interval. Caregiver relationship to child [mother] (OR 1.85, 95% CI 1.27-2.76), presence of chronic illness in child (OR 1.78. 95% CI 1.14-2.79), younger age of caregiver (OR 0.965, 95% CI 0.943-0.986), and caregiver concerns about lost work during the pandemic (OR 1.08, 95% CI 1.04-1.12), were independently associated with a COVID-19-related delayed presentation in multivariate regression analysis.
Conclusion
Almost one in five caregivers reported delaying ED presentation for their ill or injured child, specifically due to fear of contracting COVID-19 while in hospital. Mothers, younger caregivers, caregivers of children with chronic illness, and those concerned about lost work were at highest risk for delay.
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Affiliation(s)
| | | | | | | | - Jeanine Hall
- Children’s Hospital Los Angeles USC Keck School of Medicine
| | | | - Eileen Klein
- Seattle Children’s Hospital and University of Washington School of Medicine
| | - Julie Brown
- Seattle Children’s Hospital and University of Washington School of Medicine
| | - Renana Gelernter
- Shamir Medical Center and Sackler Faculty of Medicine Tel Aviv University
| | - Mark Griffiths
- Children’s Healthcare of Atlanta Emory School of Medicine
| | | | | | - Ahmed Mater
- Jim Pattison Children’s Hospital and University of Saskatchewan
| | | | | | | | | | - Ran Goldman
- University of British Columbia and BC Children’s Hospital Research Institute
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14
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Paioni P, Jäggi VF, Tilen R, Seiler M, Baumann P, Bräm DS, Jetzer C, Haid RTU, Goetschi AN, Goers R, Müller D, Coman Schmid D, Meyer zu Schwabedissen HE, Rinn B, Berger C, Krämer SD. Gentamicin Population Pharmacokinetics in Pediatric Patients-A Prospective Study with Data Analysis Using the saemix Package in R. Pharmaceutics 2021; 13:1596. [PMID: 34683889 PMCID: PMC8541459 DOI: 10.3390/pharmaceutics13101596] [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] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 09/21/2021] [Accepted: 09/26/2021] [Indexed: 01/13/2023] Open
Abstract
The aminoglycoside gentamicin is used for the empirical treatment of pediatric infections. It has a narrow therapeutic window. In this prospective study at University Children's Hospital Zurich, Switzerland, we aimed to characterize the pharmacokinetics of gentamicin in pediatric patients and predict plasma concentrations at typical recommended doses. We recruited 109 patients aged from 1 day to 14 years, receiving gentamicin (7.5 mg/kg at age ≥ 7 d or 5 mg/kg). Plasma levels were determined 30 min, 4 h and 24 h after the infusion was stopped and then transferred, together with patient data, to the secure BioMedIT node Leonhard Med. Population pharmacokinetic modeling was performed with the open-source R package saemix on the SwissPKcdw platform in Leonhard Med. Data followed a two-compartment model. Bodyweight, plasma creatinine and urea were identified as covariates for clearance, with bodyweight as a covariate for central and peripheral volumes of distribution. Simulations with 7.5 mg/kg revealed a 95% CI of 13.0-21.2 mg/L plasma concentration at 30 min after the stopping of a 30-min infusion. At 24 h, 95% of simulated plasma levels were <1.8 mg/L. Our study revealed that the recommended dosing is appropriate. It showed that population pharmacokinetic modeling using R provides high flexibility in a secure environment.
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Affiliation(s)
- Paolo Paioni
- Division of Infectious Diseases and Hospital Epidemiology, University Children’s Hospital Zurich, Steinwiesstrasse 75, CH-8032 Zurich, Switzerland; (V.F.J.); (R.T.)
| | - Vera F. Jäggi
- Division of Infectious Diseases and Hospital Epidemiology, University Children’s Hospital Zurich, Steinwiesstrasse 75, CH-8032 Zurich, Switzerland; (V.F.J.); (R.T.)
| | - Romy Tilen
- Division of Infectious Diseases and Hospital Epidemiology, University Children’s Hospital Zurich, Steinwiesstrasse 75, CH-8032 Zurich, Switzerland; (V.F.J.); (R.T.)
- Biopharmacy, Department Pharmaceutical Sciences, University Basel, Klingelbergstrasse 50, CH-4056 Basel, Switzerland; (R.G.); (H.E.M.z.S.)
| | - Michelle Seiler
- Pediatric Emergency Department, University Children’s Hospital Zurich, Steinwiesstrasse 75, CH-8032 Zurich, Switzerland;
| | - Philipp Baumann
- Department of Intensive Care and Neonatology, University Children’s Hospital Zurich, Steinwiesstrasse 75, CH-8032 Zurich, Switzerland;
| | - Dominic S. Bräm
- Biopharmacy, Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, ETH Zurich, Vladimir-Prelog-Weg 4, CH-8093 Zurich, Switzerland; (D.S.B.); (C.J.); (R.T.U.H.); (A.N.G.)
| | - Carole Jetzer
- Biopharmacy, Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, ETH Zurich, Vladimir-Prelog-Weg 4, CH-8093 Zurich, Switzerland; (D.S.B.); (C.J.); (R.T.U.H.); (A.N.G.)
| | - Robin T. U. Haid
- Biopharmacy, Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, ETH Zurich, Vladimir-Prelog-Weg 4, CH-8093 Zurich, Switzerland; (D.S.B.); (C.J.); (R.T.U.H.); (A.N.G.)
| | - Aljoscha N. Goetschi
- Biopharmacy, Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, ETH Zurich, Vladimir-Prelog-Weg 4, CH-8093 Zurich, Switzerland; (D.S.B.); (C.J.); (R.T.U.H.); (A.N.G.)
| | - Roland Goers
- Biopharmacy, Department Pharmaceutical Sciences, University Basel, Klingelbergstrasse 50, CH-4056 Basel, Switzerland; (R.G.); (H.E.M.z.S.)
| | - Daniel Müller
- Institute of Clinical Chemistry, University Hospital Zurich, Rämistr. 100, CH-8091 Zurich, Switzerland;
| | - Diana Coman Schmid
- Scientific IT Services, ETH Zurich, Binzmühlestrasse 130, CH-8092 Zurich, Switzerland; (D.C.S.); (B.R.)
- SIB Swiss Institute of Bioinformatics, Quartier Sorge-Batiment Amphipole, CH-1015 Lausanne, Switzerland
| | | | - Bernd Rinn
- Scientific IT Services, ETH Zurich, Binzmühlestrasse 130, CH-8092 Zurich, Switzerland; (D.C.S.); (B.R.)
- SIB Swiss Institute of Bioinformatics, Quartier Sorge-Batiment Amphipole, CH-1015 Lausanne, Switzerland
| | - Christoph Berger
- Division of Infectious Diseases and Hospital Epidemiology, University Children’s Hospital Zurich, Steinwiesstrasse 75, CH-8032 Zurich, Switzerland; (V.F.J.); (R.T.)
| | - Stefanie D. Krämer
- Biopharmacy, Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, ETH Zurich, Vladimir-Prelog-Weg 4, CH-8093 Zurich, Switzerland; (D.S.B.); (C.J.); (R.T.U.H.); (A.N.G.)
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15
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Davis AL, Sunderji A, Marneni SR, Seiler M, Hall JE, Cotanda CP, Klein EJ, Brown JC, Gelernter R, Griffiths MA, Hoeffe J, Gualco G, Mater A, Manzano S, Thompson GC, Ahmed S, Ali S, Goldman RD. Caregiver-reported delay in presentation to pediatric emergency departments for fear of contracting COVID-19: a multi-national cross-sectional study. CAN J EMERG MED 2021; 23:778-786. [PMID: 34402036 PMCID: PMC8366744 DOI: 10.1007/s43678-021-00174-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [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: 12/15/2020] [Accepted: 06/28/2021] [Indexed: 11/24/2022]
Abstract
Objective To determine if caregivers of children presenting to pediatric emergency departments (EDs) during the COVID-19 pandemic are delaying presenting to care for fear of contracting COVID-19. Methods This was a pre-planned secondary analysis of a cross-sectional survey study of caregivers accompanying their children aged 0–19 years to 16 pediatric EDs in 5 countries from May to June 2020. An anonymous online survey, completed by caregivers via RedCAP, included caregiver and child demographics, presenting complaints, if they delayed presentation and whether symptoms worsened during this interval, as well as caregiver concern about the child or caregiver having COVID-19 at the time of ED visit. Results Of 1543 caregivers completing the survey, 287 (18.6%) reported a delay in seeking ED care due to concerns of contracting COVID-19 in the hospital. Of those, 124 (43.2%) stated their child’s symptoms worsened during the waiting interval. Caregiver relationship to child [mother] (OR 1.85, 95% CI 1.27–2.76), presence of chronic illness in child (OR 1.78. 95% CI 1.14–2.79), younger age of caregiver (OR 0.965, 95% CI 0.943–0.986), and caregiver concerns about lost work during the pandemic (OR 1.08, 95% CI 1.04–1.12) were independently associated with a COVID-19-related delayed presentation in multivariable regression analysis. Conclusions Almost one in five caregivers reported delaying ED presentation for their ill or injured child specifically due to fear of contracting COVID-19 while in hospital, with mothers, younger caregivers, caregivers of children with chronic illness, and those concerned about lost work more likely to report delaying ED presentation. Supplementary Information The online version contains supplementary material available at 10.1007/s43678-021-00174-z.
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Affiliation(s)
- Adrienne L Davis
- Pediatric Emergency Medicine, Hospital for Sick Children and Department of Pediatrics, University of Toronto, 555 University Ave, Toronto, ON, M5G 1X8, Canada.
| | - Alia Sunderji
- Pediatric Emergency Medicine, Hospital for Sick Children and Department of Pediatrics, University of Toronto, 555 University Ave, Toronto, ON, M5G 1X8, Canada
| | - Shashidhar R Marneni
- Division of Pediatric Emergency Medicine, Children's Medical Center of Dallas, UT Southwestern Medical Center, Dallas, TX, USA
| | - Michelle Seiler
- Emergency Department, University Children's Hospital Zurich, Zurich, Switzerland
| | - Jeanine E Hall
- Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, USC Keck School of Medicine, Los Angeles, CA, USA
| | | | - Eileen J Klein
- Seattle Children's Hospital and University of Washington School of Medicine, Seattle, WA, USA
| | - Julie C Brown
- Seattle Children's Hospital and University of Washington School of Medicine, Seattle, WA, USA
| | - Renana Gelernter
- Pediatric Emergency Medicine Unit, Shamir Medical Center, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Mark A Griffiths
- Division of Pediatric Emergency Medicine, Children's Healthcare of Atlanta, Emory School of Medicine, Atlanta, GA, USA
| | - Julia Hoeffe
- Pediatric Emergency Medicine, Inselspital University Hospital of Bern, Bern, Switzerland
| | - Gianluca Gualco
- Pediatric Emergency Department, Pediatric Institute of Italian Part of Switzerland, Ticino, Switzerland
| | - Ahmed Mater
- Pediatric Emergency Medicine, Jim Pattison Children's Hospital, University of Saskatchewan, Saskatoon, SK, Canada
| | - Sergio Manzano
- Department of Pediatric Emergency Medicine, Geneva Children's Hospital, Geneva University Hospitals, and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Graham C Thompson
- Pediatrics and Emergency Medicine, Alberta Children's Hospital and University of Calgary, Calgary, AB, Canada
| | - Sara Ahmed
- Department of Emergency Medicine, Mary Bridge Children's Hospital, Tacoma, WA, USA
| | - Samina Ali
- Department of Pediatrics, Faculty of Medicine and Dentistry, Women and Children's Health Research Institute, University of Alberta, Edmonton, AB, Canada
| | - Ran D Goldman
- The Pediatric Research in Emergency Therapeutics (PRETx) Program, Division of Emergency Medicine, Department of Pediatrics, University of British Columbia, BC Children's Hospital Research Institute, Vancouver, BC, Canada
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16
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Meyer Sauteur PM, Seiler M, Berger C. Inguinal lymphadenopathy in a teenager. Arch Dis Child 2021; 106:630. [PMID: 32943388 DOI: 10.1136/archdischild-2020-320111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/31/2020] [Indexed: 11/04/2022]
Affiliation(s)
- Patrick M Meyer Sauteur
- Division of Infectious Diseases and Hospital Epidemiology, University Children's Hospital Zurich, Zurich, Switzerland
| | - Michelle Seiler
- Emergency Department, University Children's Hospital Zurich, Zurich, Switzerland
| | - Christoph Berger
- Division of Infectious Diseases and Hospital Epidemiology, University Children's Hospital Zurich, Zurich, Switzerland
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17
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Seiler M, Staubli G, Hoeffe J, Gualco G, Manzano S, Goldman RD. A tale of two parts of Switzerland: regional differences in the impact of the COVID-19 pandemic on parents. BMC Public Health 2021; 21:1275. [PMID: 34193102 PMCID: PMC8242280 DOI: 10.1186/s12889-021-11315-5] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 06/18/2021] [Indexed: 01/22/2023] Open
Abstract
Background We aimed to document the impact of the coronavirus disease 2019 (COVID-19) pandemic on regions within a European country. Methods Parents arriving at two pediatric emergency departments (EDs) in North of Switzerland and two in South of Switzerland completed an online survey during the first peak of the pandemic (April–June 2020). They were asked to rate their concern about their children or themselves having COVID-19. Results A total of 662 respondents completed the survey. Parents in the South were significantly more exposed to someone tested positive for COVID-19 than in the North (13.9 and 4.7%, respectively; P < 0.001). Parents in the South were much more concerned than in the North that they (mean 4.61 and 3.32, respectively; P < 0.001) or their child (mean 4.79 and 3.17, respectively; P < 0.001) had COVID-19. Parents reported their children wore facemasks significantly more often in the South than in the North (71.5 and 23.5%, respectively; P < 0.001). Conclusion The COVID-19 pandemic resulted in significant regional differences among families arriving at EDs in Switzerland. Public health agencies should consider regional strategies, rather than country-wide guidelines, in future pandemics and for vaccination against COVID-19 for children. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11315-5.
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Affiliation(s)
- Michelle Seiler
- Pediatric Emergency Department, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland.
| | - Georg Staubli
- Pediatric Emergency Department, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland
| | - Julia Hoeffe
- Pediatric Emergency Department, Inselspital University Hospital of Bern, Bern, Switzerland
| | - Gianluca Gualco
- Pediatric Emergency Department, Pediatric Institute of Italian part of Switzerland, Bellinzona, Switzerland
| | - Sergio Manzano
- Pediatric Emergency Department, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Ran D Goldman
- The Pediatric Research in Emergency Therapeutics (PRETx) Program, Division of Emergency Medicine, Department of Pediatrics, University of British Columbia, and BC Children's Hospital Research Institute, Vancouver, BC, Canada
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18
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Goldman RD, Staubli G, Cotanda CP, Brown JC, Hoeffe J, Seiler M, Gelernter R, Hall JE, Griffiths MA, Davis AL, Manzano S, Mater A, Ahmed S, Sheridan D, Hansen M, Ali S, Thompson GC, Shimizu N, Klein EJ. Factors associated with parents' willingness to enroll their children in trials for COVID-19 vaccination. Hum Vaccin Immunother 2021; 17:1607-1611. [PMID: 33228458 PMCID: PMC8115755 DOI: 10.1080/21645515.2020.1834325] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [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: 09/06/2020] [Accepted: 10/03/2020] [Indexed: 10/22/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has taken an unprecedented global toll and vaccination is needed to restore healthy living. Timely inclusion of children in vaccination trials is critical. We surveyed caregivers of children seeking care in 17 Emergency Departments (ED) across 6 countries during the peak of the pandemic to identify factors associated with intent to participate in COVID-19 vaccine trials. Questions about child and parent characteristics, COVID-19 expressed concerns and parental attitudes toward participation in a trial were asked.Of 2768 completed surveys, 18.4% parents stated they would enroll their child in a clinical trial for a COVID-19 vaccine and 14.4% would agree to a randomized placebo-controlled study. Factors associated with willingness to participate were parents agreeing to enroll in a COVID-19 vaccine trial themselves (Odds Ratio (OR) 32.9, 95% Confidence Interval (CI) (21.9-51.2)) having an older child (OR 1.0 (1.0-1.01)), having children who received all vaccinations based on their country schedule (OR 2.67 (1.35-5.71)) and parents with high school education or lower (OR 1.79 (1.18-2.74)). Mothers were less likely to enroll their child in a trial (OR 0.68 (0.47-0.97)). Only one fifth of families surveyed will consider enrolling their child in a vaccine trial. Parental interest in participation, history of vaccinating their child, and the child being older all are associated with parents allowing their child to participate in a COVID vaccine trial. This information may help decision-makers and researchers shape their strategies for trial design and participation engagement in upcoming COVID19 vaccination trials.
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Affiliation(s)
- Ran D. Goldman
- The Pediatric Research in Emergency Therapeutics (Pretx) Program, Division of Emergency Medicine, Department of Pediatrics, University of British Columbia, and BC Children’s Hospital Research Institute, Vancouver, BC, Canada
| | - Georg Staubli
- Emergency Department, University Children’s Hospital Zurich, Zurich, Switzerland
| | | | - Julie C. Brown
- Department of Pediatrics, Seattle Children’s Hospital and University of Washington School of Medicine, Seattle, WA, USA
| | - Julia Hoeffe
- Pediatric Emergency Medicine, Inselspital University Hospital of Bern, Bern, Switzerland
| | - Michelle Seiler
- Emergency Department, University Children’s Hospital Zurich, Zurich, Switzerland
| | - Renana Gelernter
- Pediatric Emergency Medicine Unit, Shamir Medical Center (Assaf Harofeh), and Sackler Faculty of Medicine, Tel Aviv University, Be'er Ya'akov, Israel
| | - Jeanine E. Hall
- Division of Emergency and Transport Medicine, Children’s Hospital Los Angeles, USC Keck School of Medicine, Los Angeles, CA, USA
| | - Mark A. Griffiths
- Division of Pediatric Emergency Medicine, Children’s Healthcare of Atlanta, Emory School of Medicine, Atlanta, GA, USA
| | - Adrienne L. Davis
- Pediatric Emergency Medicine, Hospital for Sick Children and University of Toronto, Toronto, ON, Canada
| | - Sergio Manzano
- Department of Pediatric Emergency Medicine, Geneva Children’s Hospital, Geneva University Hospitals, and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Ahmed Mater
- Pediatric Emergency Medicine, Jim Pattison Children’s Hospital, and University of Saskatchewan, Saskatoon, SK, Canada
| | - Sara Ahmed
- Department of Emergency Medicine, Mary Bridge Children’s Hospital, Tacoma, WA, USA
| | - David Sheridan
- Emergency Medicine, Oregon Health & Science University, Doernbecher Children’s Hospital, Portland, OR, USA
| | - Matt Hansen
- Emergency Medicine, Oregon Health & Science University, Doernbecher Children’s Hospital, Portland, OR, USA
| | - Samina Ali
- Departments of Pediatrics and Emergency Medicine, Stollery Children’s Hospital, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Graham C. Thompson
- Pediatrics and Emergency Medicine, Alberta Children’s Hospital and University of Calgary, Calgary, AB, Canada
| | - Naoki Shimizu
- Division of Critical Care, Department of Pediatrics, St. Marianna University School of Medicine, Tokyo, Japan
| | - Eileen J. Klein
- Department of Pediatrics, Seattle Children’s Hospital and University of Washington School of Medicine, Seattle, WA, USA
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Seiler M, Gerstenberg A, Kalisch M, Kennedy U, Scheer HS, Weber DM. Non-operative treatment versus suture refixation of the nail plate in paediatric fingernail avulsion injuries. J Hand Surg Eur Vol 2021; 46:523-529. [PMID: 33092450 DOI: 10.1177/1753193420965390] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The study compared a non-operative treatment, consisting of ointment dressing only, with the standard surgical nail plate refixation for simple fingernail avulsion injuries in children. A non-inferiority hypothesis was tested in a single-centre, prospective cohort study. The quality of the new nail was the primary outcome and was assessed with the Nail Appearance Score. The secondary outcome was patient and parental satisfaction, which was assessed with the Patients' and Parental Nail Satisfaction Score. Fifty-one patients were enrolled; 39 (76%) chose the non-operative treatment and 12 (24%) the standard operative therapy. Comparison of the two groups confirmed the non-inferiority hypothesis with a risk difference for the new nail of -0.02 with a 95% confidence interval of (-0.05, 0.01). The outcome was excellent in all fingers with no significant differences regarding either the primary or secondary outcome. In view of associated risks and costs for surgery, we recommend ointment dressings for such injuries.Level of evidence: II.
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Affiliation(s)
- Michelle Seiler
- Paediatric Emergency Department, University Children's Hospital Zurich, Zurich, Switzerland.,Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland
| | - Anja Gerstenberg
- Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland.,Division of Hand Surgery, University Children's Hospital Zurich, Zurich, Switzerland
| | | | - Uchenna Kennedy
- Division of Hand Surgery, University Children's Hospital Zurich, Zurich, Switzerland
| | - Helene S Scheer
- Division of Hand Surgery, University Children's Hospital Zurich, Zurich, Switzerland
| | - Daniel M Weber
- Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland.,Division of Hand Surgery, University Children's Hospital Zurich, Zurich, Switzerland
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20
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Seiler M, Goldman RD, Staubli G, Hoeffe J, Gualco G, Manzano S, Part Of The International Covid-Parental Attitude Study Covipas Group. Parents' intent to vaccinate against influenza during the COVID-19 pandemic in two regions in Switzerland. Swiss Med Wkly 2021; 151:w20508. [PMID: 34002802 DOI: 10.4414/smw.2021.20508] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
AIMS OF THE STUDY The COVID-19 pandemic is likely to overlap with the seasonal influenza epidemic, increasing the risk of overextending the health system capacity in Switzerland. Influenza vaccine uptake has remained low in most countries, including Switzerland. The aim of the study was to determine parents’ intentions towards influenza vaccination of their children, as well as themselves, and to assess regional differences. METHODS Parents presenting to four paediatric emergency departments (Zurich, Bern, Bellinzona, Geneva) were asked to complete an online survey during and after the first lockdown of the COVID-19 pandemic (April to June 2020). The anonymised survey included demographic information, vaccination history and intentions to vaccinate against influenza, as well as attitudes towards future vaccination against COVID-19. RESULTS The majority of children (92%; 602/654) were up-to-date on their vaccination schedule. In 2019/2020, 7.2% (47/654) were vaccinated against influenza. Children with chronic illnesses were more frequently vaccinated than healthy children (19.2% vs 5.6%; p = 0.002). For the coming winter season, 111 (17%) parents stated they plan to vaccinate their children against influenza, more than double the rate from last year, and 383 (59.2%) parents suggested they will vaccinate against COVID-19 once a vaccine is available. Regional differences between “German” and “Latin” Switzerland were found for parents’ intent to have their children vaccinated against influenza next season (Zurich and Bern 14.3%, Bellinzona and Geneva 27.2%, p <0.001), but not for a hypothetical vaccination against COVID-19 (Zurich and Bern 59.1%, Bellinzona and Geneva 59.7%, p = 0.894). CONCLUSIONS The COVID-19 pandemic resulted in a substantial increase of parents’ intention to vaccinate their children against influenza, especially in hard-hit “Latin” Switzerland. The Swiss government and public health organisations can leverage these regional results to promote influenza vaccination among children for the coming seasons.
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Affiliation(s)
- Michelle Seiler
- Paediatric Emergency Department, University Children's Hospital Zurich, Switzerland
| | - Ran D Goldman
- The Pediatric Research in Emergency Therapeutics (PRETx) Program, Division of Emergency Medicine, Department of Pediatrics, University of British Columbia, and BC Children's Hospital Research Institute, Vancouver, Canada
| | - Georg Staubli
- Paediatric Emergency Department, University Children's Hospital Zurich, Switzerland
| | - Julia Hoeffe
- Paediatric Emergency Department, Inselspital University Hospital of Bern, Switzerland
| | - Gianluca Gualco
- Paediatric Emergency Department, Paediatric Institute of Italian Part of Switzerland, Bellinzona, Switzerland
| | - Sergio Manzano
- Paediatric Emergency Department, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Switzerland
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21
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Seiler M, Goldman RD, Staubli G, Hoeffe J, Gualco G, Manzano S. Parents' intent to vaccinate against influenza during the COVID-19 pandemic im two regions in Switzerland. Swiss Med Wkly 2021; 151:w20508. [PMID: 35275392] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Abstract
AIMS OF THE STUDY The COVID-19 pandemic is likely to overlap with the seasonal influenza epidemic, increasing the risk of overextending the health system capacity in Switzerland. Influenza vaccine uptake has remained low in most countries, including Switzerland. The aim of the study was to determine parents' intentions towards influenza vaccination of their children as well as themselves, and to assess regional differences. METHODS Parents presenting to four pediatric emergency departments (PEDs; Zurich, Bern, Bellinzona, Geneva) were asked to complete an online survey during and after the first lockdown of the COVID-19 pandemic (April - June 2020). The anonymized survey included demographic information, vaccination history and intentions to vaccinate against influenza, as well as attitudes towards future vaccination against COVID-19. RESULTS The majority of children (92%; 602/654) were up-to-date on their vaccination schedule. In 2019/2020, 7.2% (47/654) were vaccinated against influenza. Children with chronic illnesses were more frequently vaccinated compared to healthy children (19.2% vs 5.6%; p = 0.002). For the coming winter season, 111 (17%) parents stated they plan to vaccinate their children against influenza, more than double the rate from last year, and 383 (59.2%) parents suggest they will vaccinate against COVID-19 once a vaccine is available. Regional differences between "German" and "Latin" Switzerland were found for parents' intent to have their children vaccinated against influenza next season (Zurich and Bern 14.3%, Bellinzona and Geneva 27.2%, p < 0.001) but not for a hypothetical vaccination against COVID-19 (Zurich and Bern 59.1%, Bellinzona and Geneva 59.7%, p = 0.894). CONCLUSIONS The COVID-19 pandemic resulted in a substantial increase of parents' intention to vaccinating their children against influenza, especially in hard-hit "Latin" Switzerland. The Swiss government and public health organizations can leverage these regional results to promote influenza vaccination among children for the coming seasons.
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Affiliation(s)
- Michelle Seiler
- Pediatric Emergency Department | Steinwiesstrasse 75 | Zurich | 8032 | SWITZERLAND | +41442663210
| | - Ran D Goldman
- The Pediatric Research in Emergency Therapeutics (PRETx) Program, Division of Emergency Medicine, Department of Pediatrics, University of British Columbia, and BC Children's Hospital Research Institute, Vancouver, Canada
| | - Georg Staubli
- Pediatric Emergency Department, University Children's Hospital Zurich, Zurich, Switzerland
| | - Julia Hoeffe
- Pediatric Emergency Medicine, Inselspital University Hospital of Bern, Bern, Switzerland
| | - Gianluca Gualco
- Pediatric Emergency Department, Pediatric Institute of Italian Part of Switzerland, Bellinzona, Switzerland
| | - Sergio Manzano
- Department of Pediatric Emergency Medicine, Geneva Children's Hospital, Geneva University Hospitals, and Faculty of Medicine, University of Geneva, Geneva, Switzerland
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22
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Tie H, Welp H, Martens S, Seiler M, Albers P, Müller KM, Li Z, Martens S. Impact of Cardiac Fibrosis and Collagens on Right Ventricular Failure and Acute Kidney Injury in Patients after Continuous-Flow Left Ventricular Assist Devices. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725647] [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: 10/21/2022]
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23
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Seiler M. [Blended Learning with Virtual Pediatric Emergency Patients for Students]. Praxis (Bern 1994) 2021; 110:936. [PMID: 34875864 DOI: 10.1024/1661-8157/a003754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
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24
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Goldman RD, McGregor S, Marneni SR, Katsuta T, Griffiths MA, Hall JE, Seiler M, Klein EJ, Cotanda CP, Gelernter R, Hoeffe J, Davis AL, Gualco G, Mater A, Manzano S, Thompson GC, Ahmed S, Ali S, Brown JC. Willingness to Vaccinate Children against Influenza after the Coronavirus Disease 2019 Pandemic. J Pediatr 2021; 228:87-93.e2. [PMID: 32771480 PMCID: PMC7410815 DOI: 10.1016/j.jpeds.2020.08.005] [Citation(s) in RCA: 74] [Impact Index Per Article: 24.7] [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: 07/22/2020] [Revised: 07/24/2020] [Accepted: 08/04/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To determine factors associated with parents who plan to vaccinate their children against influenza next year, especially those who did not vaccinate against influenza last year using a global survey. STUDY DESIGN A survey of caregivers accompanying their children aged 1-19 years old in 17 pediatric emergency departments in 6 countries at the peak of the coronavirus disease 2019 (COVID-19) pandemic. Anonymous online survey included caregiver and child demographic information, vaccination history and future intentions, and concern about the child and caregiver having COVID-19 at the time of emergency department visit. RESULTS Of 2422 surveys, 1314 (54.2%) caregivers stated they plan to vaccinate their child against influenza next year, an increase of 15.8% from the previous year. Of 1459 caregivers who did not vaccinate their children last year, 418 (28.6%) plan to do so next year. Factors predicting willingness to change and vaccinate included child's up-to-date vaccination status (aOR 2.03, 95% CI 1.29-3.32, P = .003); caregivers' influenza vaccine history (aOR 3.26, 95% CI 2.41-4.40, P < .010), and level of concern their child had COVID-19 (aOR 1.09, 95% CI 1.01-1.17, P = .022). CONCLUSIONS Changes in risk perception due to COVID-19, and previous vaccination, may serve to influence decision-making among caregivers regarding influenza vaccination in the coming season. To promote influenza vaccination among children, public health programs can leverage this information.
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Affiliation(s)
- Ran D. Goldman
- The Pediatric Research in Emergency Therapeutics (PRETx) Program, Division of Emergency Medicine, Department of Pediatrics, University of British Columbia, and BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Sophie McGregor
- The Pediatric Research in Emergency Therapeutics (PRETx) Program, Division of Emergency Medicine, Department of Pediatrics, University of British Columbia, and BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Shashidhar R. Marneni
- Division of Pediatric Emergency Medicine, Children's Medical Center of Dallas, UT Southwestern Medical Center, Dallas, TX
| | - Tomohiro Katsuta
- Division of Critical Care, Department of Pediatrics, St. Marianna University School of Medicine, Tokyo, Japan
| | - Mark A. Griffiths
- Division of Pediatric Emergency Medicine, Children's Healthcare of Atlanta, Emory School of Medicine, Atlanta, GA
| | - Jeanine E. Hall
- Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, USC Keck School of Medicine, Los Angeles, CA
| | - Michelle Seiler
- Emergency Department, University Children's Hospital Zurich, Zurich, Switzerland
| | - Eileen J. Klein
- Seattle Children's Hospital and University of Washington School of Medicine, Seattle, WA
| | | | - Renana Gelernter
- Pediatric Emergency Medicine Unit, Shamir Medical Center, and Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Julia Hoeffe
- Pediatric Emergency Medicine, Inselspital University Hospital of Bern, Bern, Switzerland
| | - Adrienne L. Davis
- Pediatric Emergency Medicine, Hospital for Sick Children and University of Toronto, Ontario, Canada
| | - Gianluca Gualco
- Pediatric Emergency Department, Pediatric Institute of Italian part of Switzerland, Ticino, Switzerland
| | - Ahmed Mater
- Pediatric Emergency Medicine, Jim Pattison Children's Hospital, and University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Sergio Manzano
- Department of Pediatric Emergency Medicine, Geneva Children's Hospital, Geneva University Hospitals, and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Graham C. Thompson
- Pediatrics and Emergency Medicine, Alberta Children's Hospital and University of Calgary, Calgary, Alberta, Canada
| | - Sara Ahmed
- Department of Emergency Medicine, Mary Bridge Children's Hospital, Tacoma, WA
| | - Samina Ali
- Department of Pediatrics, Faculty of Medicine & Dentistry, Women and Children's Health Research Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Julie C. Brown
- Seattle Children's Hospital and University of Washington School of Medicine, Seattle, WA
| | - International COVID-19 Parental Attitude Study (COVIPAS) GroupAhmedSarahDrMDAliSaminaDrMDCM, FRCPCBrownJulie C.DrMDCraigSimonDrMBBS, FACEM, MPE, MPHDavisAdrienne L.DrMD, MScGaucherNathalieDrMD, FRCPC, PhDGianlucaGualcoDrMDGoldmanRanDrMDGriffithsMarkDrMDHallJeanine E.DrMDHansenMattDrMD, MCRHurtThomas L.DrMD, MEDKellyChristopherDrMDKleinEileen J.DrMD, MPHKozerEranDrMDMarneniShashidharDrMDMaterAhmedDrMD, FRCPC, FAAPMistryRakeshDrMD, MSParraCristinaDrPhDPoonaiNaveenDrMD, FRCPCRaoArjunDrMDSheridanDavidDrMD, MCRShimizuNaokiDrMD, PhDYueEsther L.DrMD
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25
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Goldman RD, Yan TD, Seiler M, Parra Cotanda C, Brown JC, Klein EJ, Hoeffe J, Gelernter R, Hall JE, Davis AL, Griffiths MA, Mater A, Manzano S, Gualco G, Shimizu N, Hurt TL, Ahmed S, Hansen M, Sheridan D, Ali S, Thompson GC, Gaucher N, Staubli G. Caregiver willingness to vaccinate their children against COVID-19: Cross sectional survey. Vaccine 2020; 38:7668-7673. [PMID: 33071002 PMCID: PMC7547568 DOI: 10.1016/j.vaccine.2020.09.084] [Citation(s) in RCA: 225] [Impact Index Per Article: 56.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/16/2020] [Accepted: 09/29/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND More than 100 COVID-19 vaccine candidates are in development since the SARS-CoV-2 genetic sequence was published in January 2020. The uptake of a COVID-19 vaccine among children will be instrumental in limiting the spread of the disease as herd immunity may require vaccine coverage of up to 80% of the population. Prior history of pandemic vaccine coverage was as low as 40% among children in the United States during the 2009 H1N1 influenza pandemic. PURPOSE To investigate predictors associated with global caregivers' intent to vaccinate their children against COVID-19, when the vaccine becomes available. METHOD An international cross sectional survey of 1541 caregivers arriving with their children to 16 pediatric Emergency Departments (ED) across six countries from March 26 to May 31, 2020. RESULTS 65% (n = 1005) of caregivers reported that they intend to vaccinate their child against COVID-19, once a vaccine is available. A univariate and subsequent multivariate analysis found that increased intended uptake was associated with children that were older, children with no chronic illness, when fathers completed the survey, children up-to-date on their vaccination schedule, recent history of vaccination against influenza, and caregivers concerned their child had COVID-19 at the time of survey completion in the ED. The most common reason reported by caregivers intending to vaccinate was to protect their child (62%), and the most common reason reported by caregivers refusing vaccination was the vaccine's novelty (52%). CONCLUSIONS The majority of caregivers intend to vaccinate their children against COVID-19, though uptake will likely be associated with specific factors such as child and caregiver demographics and vaccination history. Public health strategies need to address barriers to uptake by providing evidence about an upcoming COVID-19 vaccine's safety and efficacy, highlighting the risks and consequences of infection in children, and educating caregivers on the role of vaccination.
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Affiliation(s)
- Ran D Goldman
- The Pediatric Research in Emergency Therapeutics (PRETx) Program, Division of Emergency Medicine, Department of Pediatrics, University of British Columbia, and BC Children's Hospital Research Institute, Vancouver, BC, Canada.
| | - Tyler D Yan
- The Pediatric Research in Emergency Therapeutics (PRETx) Program, Division of Emergency Medicine, Department of Pediatrics, University of British Columbia, and BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Michelle Seiler
- Emergency Department, University Children's Hospital Zurich, Zurich, Switzerland
| | | | - Julie C Brown
- Seattle Children's Hospital and University of Washington School of Medicine, Seattle, WA, USA
| | - Eileen J Klein
- Seattle Children's Hospital and University of Washington School of Medicine, Seattle, WA, USA
| | - Julia Hoeffe
- Pediatric Emergency Medicine, Inselspital University Hospital of Bern, Bern, Switzerland
| | - Renana Gelernter
- Pediatric Emergency Medicine Unit, Assaf Harofeh Medical Center, and Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Jeanine E Hall
- Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, USC Keck School of Medicine, Los Angeles, CA, USA
| | - Adrienne L Davis
- Pediatric Emergency Medicine, Hospital for Sick Children and University of Toronto, ON, Canada
| | - Mark A Griffiths
- Division of Pediatric Emergency Medicine, Children's Healthcare of Atlanta, Emory School of Medicine, Atlanta, GA, USA
| | - Ahmed Mater
- Pediatric Emergency Medicine, Jim Pattison Children's Hospital, and University of Saskatchewan, Saskatoon, SK, Canada
| | - Sergio Manzano
- Department of Pediatric Emergency Medicine, Geneva Children's Hospital, Geneva University Hospitals, and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Gianluca Gualco
- Pediatric Emergency Department, Pediatric Institute of Italian part of Switzerland, Ticino, Switzerland
| | - Naoki Shimizu
- Department of Pediatrics, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Thomas L Hurt
- Department of Emergency Medicine, Mary Bridge Children's Hospital, Tacoma, WA, USA
| | - Sara Ahmed
- Department of Emergency Medicine, Mary Bridge Children's Hospital, Tacoma, WA, USA
| | - Matt Hansen
- Emergency Medicine, Oregon Health and Science University, Doernbecher Children's Hospital, Portland, OR, USA
| | - David Sheridan
- Emergency Medicine, Oregon Health & Science University, Doernbecher Children's Hospital, Portland, OR, USA
| | - Samina Ali
- Departments of Pediatrics, Faculty of Medicine & Dentistry, Women and Children's Health Research Institute, University of Alberta, Edmonton, AB, Canada
| | - Graham C Thompson
- Pediatrics and Emergency Medicine, Alberta Children's Hospital and University of Calgary, Calgary, AB, Canada
| | - Nathalie Gaucher
- Pediatric Emergency Medicine CHU Sainte-Justine, Université de Montréal, Montréal, Quebec, Canada
| | - Georg Staubli
- Emergency Department, University Children's Hospital Zurich, Zurich, Switzerland
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26
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Meyer Sauteur PM, Theiler M, Buettcher M, Seiler M, Weibel L, Berger C. Frequency and Clinical Presentation of Mucocutaneous Disease Due to Mycoplasma pneumoniae Infection in Children With Community-Acquired Pneumonia. JAMA Dermatol 2020; 156:144-150. [PMID: 31851288 DOI: 10.1001/jamadermatol.2019.3602] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Importance The diagnosis of Mycoplasma pneumoniae infection as the cause of mucocutaneous disease is challenging because current diagnostic tests are not able to differentiate M pneumoniae infection from carriage. Objective To examine the frequency and clinical presentation of M pneumoniae-induced mucocutaneous disease in children with community-acquired pneumonia (CAP) using improved diagnostics. Design, Setting, and Participants This prospective, longitudinal cohort study included 152 children aged 3 to 18 years with CAP enrolled in a CAP study from May 1, 2016, to April 30, 2017, at the University Children's Hospital Zurich. Children were inpatients or outpatients with clinically defined CAP according to the British Thoracic Society guidelines. Data analysis was performed from July 10, 2017, to June 29, 2018. Main Outcomes and Measures Frequency and clinical presentation of M pneumoniae-induced mucocutaneous disease in childhood CAP. Mycoplasma pneumoniae infection was diagnosed by polymerase chain reaction (PCR) of oropharyngeal samples and confirmed with the measurement of specific peripheral blood IgM antibody-secreting cells by enzyme-linked immunospot assay to differentiate M pneumoniae-infected patients from carriers with CAP caused by other pathogens. Mucocutaneous disease was defined as any eruptive lesion that involved skin and/or mucous membranes occurring during the CAP episode. Results Among 152 enrolled children with CAP (median [interquartile range] age, 5.7 [4.3-8.9] years; 84 [55.3%] male), 44 (28.9%) tested positive for M pneumoniae by PCR; of these, 10 children (22.7%) developed mucocutaneous lesions. All 10 patients with mucocutaneous eruptions tested positive for specific IgM antibody-secreting cells. Skin manifestations were found in 3 cases (2.8%) of M pneumoniae PCR-negative CAP (P < .001). The spectrum of M pneumoniae-induced mucocutaneous disease included M pneumoniae-induced rash and mucositis (3 cases [6.8%]), urticaria (2 cases [4.5%]), and maculopapular skin eruptions (5 cases [11.4%]). Two patients had ocular involvement as the sole mucosal manifestation (bilateral anterior uveitis and nonpurulent conjunctivitis). Patients with M pneumoniae-induced mucocutaneous disease had longer duration of prodromal fever (median [interquartile range], 10.5 [8.3-11.8] vs 7.0 [5.5-9.5] days; P = .02) and higher C-reactive protein levels (median [interquartile range], 31 [22-59] vs 16 [7-23] mg/L; P = .04) than patients with CAP due to M pneumoniae without mucocutaneous manifestations. They were also more likely to require oxygen (5 [50%] vs 1 [5%]; P = .007), to require hospitalization (7 [70%] vs 4 [19%]; P = .01), and to develop long-term sequelae (3 [30%] vs 0; P = .03). Conclusions and Relevance Mucocutaneous disease occurred significantly more frequently in children with CAP due to M pneumoniae than in children with CAP of other origins. Mycoplasma pneumoniae-induced mucocutaneous disease was associated with increased systemic inflammation, morbidity, and a higher risk of long-term sequelae.
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Affiliation(s)
- Patrick M Meyer Sauteur
- Division of Infectious Diseases and Hospital Epidemiology, University Children's Hospital Zurich, Zurich, Switzerland
| | - Martin Theiler
- Division of Pediatric Dermatology, University Children's Hospital Zurich, Zurich, Switzerland.,Dermatology Department, University Hospital Zurich, Zurich, Switzerland
| | - Michael Buettcher
- Division of Infectious Diseases, Children's Hospital Lucerne, Lucerne, Switzerland
| | - Michelle Seiler
- Emergency Department, University Children's Hospital Zurich, Zurich, Switzerland
| | - Lisa Weibel
- Division of Pediatric Dermatology, University Children's Hospital Zurich, Zurich, Switzerland.,Dermatology Department, University Hospital Zurich, Zurich, Switzerland
| | - Christoph Berger
- Division of Infectious Diseases and Hospital Epidemiology, University Children's Hospital Zurich, Zurich, Switzerland
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27
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Meyer Sauteur PM, Krautter S, Ambroggio L, Seiler M, Paioni P, Relly C, Capaul R, Kellenberger C, Haas T, Gysin C, Bachmann LM, van Rossum AMC, Berger C. Improved Diagnostics Help to Identify Clinical Features and Biomarkers That Predict Mycoplasma pneumoniae Community-acquired Pneumonia in Children. Clin Infect Dis 2020; 71:1645-1654. [PMID: 31665253 PMCID: PMC7108170 DOI: 10.1093/cid/ciz1059] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 10/23/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND There are no reliable signs or symptoms that differentiate Mycoplasma pneumoniae (Mp) infection in community-acquired pneumonia (CAP) from other etiologies. Additionally, current diagnostic tests do not reliably distinguish between Mp infection and carriage. We previously determined that the measurement of Mp-specific immunoglobulin M antibody-secreting cells (ASCs) by enzyme-linked immunospot assay allowed for differentiation between infection and carriage. Using this new diagnostic test, we aimed to identify clinical and laboratory features associated with Mp infection. METHODS This is a prospective cohort study of children, 3-18 years of age, with CAP from 2016 to 2017. Clinical features and biomarkers were compared between Mp-positive and -negative groups by Mann-Whitney U test or Fisher exact test, as appropriate. Area under the receiver operating characteristic curve (AUC) differences and optimal thresholds were determined by using the DeLong test and Youden J statistic, respectively. RESULTS Of 63 CAP patients, 29 were Mp-positive (46%). Mp positivity was statistically associated with older age (median, 8.6 vs 4.7 years), no underlying disease, family with respiratory symptoms, prior antibiotic treatment, prolonged prodromal respiratory symptoms and fever, and extrapulmonary (skin) manifestations. Lower levels of C-reactive protein, white blood cell count, absolute neutrophil count, and procalcitonin (PCT), specifically PCT <0.25 μg/L, were statistically associated with Mp infection. A combination of age >5 years (AUC = 0.77), prodromal fever and respiratory symptoms >6 days (AUC = 0.79), and PCT <0.25 μg/L (AUC = 0.81) improved diagnostic performance (AUC = 0.90) (P = .05). CONCLUSIONS A combination of clinical features and biomarkers may aid physicians in identifying patients at high risk for Mp CAP.
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Affiliation(s)
- Patrick M Meyer Sauteur
- Division of Infectious Diseases and Hospital Epidemiology, University Children’s Hospital Zurich, Zurich, Switzerland
| | - Selina Krautter
- Division of Infectious Diseases and Hospital Epidemiology, University Children’s Hospital Zurich, Zurich, Switzerland
| | - Lilliam Ambroggio
- Emergency Medicine and Hospital Medicine, Children’s Hospital Colorado, Denver, Colorado, USA
| | - Michelle Seiler
- Emergency Department, University Children’s Hospital Zurich, Zurich, Switzerland
| | - Paolo Paioni
- Division of Infectious Diseases and Hospital Epidemiology, University Children’s Hospital Zurich, Zurich, Switzerland
| | - Christa Relly
- Division of Infectious Diseases and Hospital Epidemiology, University Children’s Hospital Zurich, Zurich, Switzerland
| | - Riccarda Capaul
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Christian Kellenberger
- Division of Diagnostic Imaging, University Children’s Hospital Zurich, Zurich, Switzerland
| | - Thorsten Haas
- Division of Anesthesiology, University Children’s Hospital Zurich, Zurich, Switzerland
| | - Claudine Gysin
- Division of Otolaryngology, University Children’s Hospital Zurich, Zurich, Switzerland
| | | | - Annemarie M C van Rossum
- Department of Pediatrics, Division of Pediatric Infectious Diseases and Immunology, Erasmus MC University Medical Center–Sophia Children’s Hospital, Rotterdam, The Netherlands
| | - Christoph Berger
- Division of Infectious Diseases and Hospital Epidemiology, University Children’s Hospital Zurich, Zurich, Switzerland
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Goldman RD, Marneni SR, Seiler M, Brown JC, Klein EJ, Cotanda CP, Gelernter R, Yan TD, Hoeffe J, Davis AL, Griffiths MA, Hall JE, Gualco G, Mater A, Manzano S, Thompson GC, Ahmed S, Ali S, Shimizu N. Caregivers' Willingness to Accept Expedited Vaccine Research During the COVID-19 Pandemic: A Cross-sectional Survey. Clin Ther 2020; 42:2124-2133. [PMID: 33067013 PMCID: PMC7532744 DOI: 10.1016/j.clinthera.2020.09.012] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 09/11/2020] [Accepted: 09/22/2020] [Indexed: 01/01/2023]
Abstract
Purpose This study determined the predictors of caregivers' willingness to accept an accelerated regulatory process for the development of vaccines against coronavirus disease 2019 (COVID-19). Methods An international cross-sectional survey was administered to 2557 caregivers of children in 17 pediatric emergency departments (EDs) across 6 countries from March 26, 2020, to June 30, 2020. Caregivers were asked to select 1 of 4 choices with which they most agreed regarding a proposed COVID-19 vaccine–approval process, in addition to questions regarding demographic characteristics, the ED visit, and attitudes about COVID-19. Univariate analyses were conducted using the Mann–Whitney U test for comparing non–normally distributed continuous variables, an independent t test for comparing normally distributed continuous variables, and a χ2 or Fisher exact test for categorical variables. Multivariate logistic regression analysis was used for determining independent factors associated with caregivers' willingness to accept abridged development of a COVID-19 vaccine. A P value of <0.05 was considered significant. Findings Almost half (1101/2557; 43%) of caregivers reported that they were willing to accept less rigorous testing and postresearch approval of a new COVID-19 vaccine. Independent factors associated with caregivers' willingness to accept expedited COVID-19 vaccine research included having children who were up to date on the vaccination schedule (odds ratio [OR] = 1.72; 95% CI, 1.29–2.31), caregivers' concern about having had COVID-19 themselves at the time of survey completion in the ED (OR = 1.1; 95% CI, 1.05–1.16), and caregivers' intent to have their children vaccinated against COVID-19 if a vaccine were to become available (OR = 1.84; 95% CI, 1.54–2.21). Compared with fathers, mothers completing the survey were less likely to approve of changes in the vaccine-development process (OR = 0.641; 95% CI, 0.529–0.775). Implications Less than half of caregivers in this worldwide sample were willing to accept abbreviated COVID-19 vaccine testing. As a part of an effort to increase acceptance and uptake of a new vaccine, especially in order to protect children, public health strategies and individual providers should understand caregivers' attitudes toward the approval of a vaccine and consult them appropriately. Half of caregivers accept an abridged process for rapid COVID-19 vaccine approval. Seeking fast approval associated with caregiver’s gender, intent to vaccinate child. Concern about own COVID-19 infection associated with preferring expedited approval.
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Affiliation(s)
- Ran D Goldman
- The Pediatric Research in Emergency Therapeutics Program, Division of Emergency Medicine, Department of Pediatrics, University of British Columbia, British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada.
| | - Shashidhar R Marneni
- Department of Pediatric Emergency Medicine, Children's Medical Center of Dallas, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Michelle Seiler
- Emergency Department, University Children's Hospital Zurich, Zurich, Switzerland
| | - Julie C Brown
- Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA, USA
| | - Eileen J Klein
- Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA, USA
| | | | - Renana Gelernter
- Pediatric Emergency Medicine Unit, Shamir Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tyler D Yan
- The Pediatric Research in Emergency Therapeutics Program, Division of Emergency Medicine, Department of Pediatrics, University of British Columbia, British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Julia Hoeffe
- Division of Pediatric Emergency Medicine, Inselspital University Hospital of Bern, Bern, Switzerland
| | - Adrienne L Davis
- Division of Pediatric Emergency Medicine, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
| | - Mark A Griffiths
- Division of Pediatric Emergency Medicine, Children's Healthcare of Atlanta, Emory School of Medicine, Atlanta, GA, USA
| | - Jeanine E Hall
- Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - Gianluca Gualco
- Pediatric Emergency Department, Pediatric Institute of Italian Part of Switzerland, Ticino, Switzerland
| | - Ahmed Mater
- Division of Pediatric Emergency Medicine, Jim Pattison Children's Hospital, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Sergio Manzano
- Department of Pediatric Emergency Medicine, Geneva Children's Hospital, Geneva University Hospitals, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Graham C Thompson
- Division of Pediatrics and Emergency Medicine, Alberta Children's Hospital and University of Calgary, Calgary, Alberta, Canada
| | - Sara Ahmed
- Department of Emergency Medicine, Mary Bridge Children's Hospital, Tacoma, WA, USA
| | - Samina Ali
- Department of Pediatrics, Faculty of Medicine and Dentistry, Women and Children's Health Research Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Naoki Shimizu
- Department of Pediatrics, St. Marianna University School of Medicine, Kawasaki, Japan
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Meyer Sauteur PM, Seiler M, Trück J, Unger WWJ, Paioni P, Relly C, Staubli G, Haas T, Gysin C, M Bachmann L, van Rossum AMC, Berger C. Diagnosis of Mycoplasma pneumoniae Pneumonia with Measurement of Specific Antibody-Secreting Cells. Am J Respir Crit Care Med 2020; 200:1066-1069. [PMID: 31251669 PMCID: PMC6794114 DOI: 10.1164/rccm.201904-0860le] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | - Johannes Trück
- University Children's Hospital ZurichZurich, Switzerland
| | - Wendy W J Unger
- Erasmus MC University Medical Center-Sophia Children's HospitalRotterdam, the Netherlandsand
| | - Paolo Paioni
- University Children's Hospital ZurichZurich, Switzerland
| | - Christa Relly
- University Children's Hospital ZurichZurich, Switzerland
| | - Georg Staubli
- University Children's Hospital ZurichZurich, Switzerland
| | - Thorsten Haas
- University Children's Hospital ZurichZurich, Switzerland
| | - Claudine Gysin
- University Children's Hospital ZurichZurich, Switzerland
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30
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Weber DM, Seiler M, Subotic U, Kalisch M, Weil R. Buddy taping versus splint immobilization for paediatric finger fractures: a randomized controlled trial. J Hand Surg Eur Vol 2019; 44:640-647. [PMID: 30704329 DOI: 10.1177/1753193418822692] [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] [Indexed: 02/03/2023]
Abstract
The purpose of this single-centre randomized controlled trial was to assess the non-inferiority of buddy taping versus splint immobilization of extra-articular paediatric finger fractures. Secondary fracture displacement was the primary outcome; patient comfort, cost and range of finger motion were secondary outcomes. Ninety-nine children were randomly assigned to taping or splinting. Sixty-nine fractures were undisplaced; 31 were displaced and required reduction before taping or splinting. Secondary displacement occurred in one patient in the taping and three in the splinting group. The risk difference was below the predefined non-inferiority level of 5%. All secondary displacements occurred in the 31 displaced fractures after reduction and were in little fingers. Patient comfort was significantly higher and cost lower in the taping group. We conclude from this study the non-inferiority of buddy taping versus splint immobilization of extra-articular paediatric finger fractures in general. We advise treatment may need to be individualized for patients with displaced fractures because we cannot make any absolute conclusions for these fractures. Level of evidence: I.
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Affiliation(s)
- Daniel M Weber
- 1 Division of Hand Surgery, University Children's Hospital, Zurich, Switzerland.,2 Children's Research Center, University Children's Hospital, Zurich, Switzerland
| | - Michelle Seiler
- 2 Children's Research Center, University Children's Hospital, Zurich, Switzerland.,3 Division of Emergency Medicine, University Children's Hospital, Zurich, Switzerland
| | - Ulrike Subotic
- 1 Division of Hand Surgery, University Children's Hospital, Zurich, Switzerland.,2 Children's Research Center, University Children's Hospital, Zurich, Switzerland
| | - Markus Kalisch
- 4 Seminar for Statistics, ETH Zurich, Zurich, Switzerland
| | - Robert Weil
- 1 Division of Hand Surgery, University Children's Hospital, Zurich, Switzerland.,2 Children's Research Center, University Children's Hospital, Zurich, Switzerland
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31
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Seiler M, Staubli G. Ketamine procedural analgosedation before and after introducing nitrous oxide 70% in a paediatric emergency department. Swiss Med Wkly 2019; 149:w20027. [DOI: 10.4414/smw.2019.20027] [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: 11/18/2022] Open
Affiliation(s)
- Michelle Seiler
- Paediatric Emergency Department, University Children’s Hospital Zurich, Switzerland
| | - Georg Staubli
- Paediatric Emergency Department, University Children’s Hospital Zurich, Switzerland
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32
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Seiler M, Staubli G, Landolt MA. Combined nitrous oxide 70% with intranasal fentanyl for procedural analgosedation in children: a prospective, randomised, double-blind, placebo-controlled trial. Emerg Med J 2019; 36:142-147. [PMID: 30630844 DOI: 10.1136/emermed-2018-207892] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 06/14/2018] [Revised: 10/19/2018] [Accepted: 12/08/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Nitrous oxide 70% (N2O 70%) is an excellent medication for procedural analgosedation (PAS), yet the limit of its analgesic power remains uncertain; therefore, a combination with intranasal fentanyl (INF) was suggested. However, this combination seems to result in a higher rate of vomiting and deeper sedation. This study aimed at assessing the analgesic efficacy, sedation depth and rate of adverse events of PAS with N2O 70% with and without INF. METHODS Patients aged 2-16 years who qualified for PAS with N2O 70% were randomly assigned to receive either INF or placebo prior to N2O inhalation in this randomised, double-blind study, which was performed in a tertiary children's hospital ED between September 2015 and October 2017. Behaviour during the procedure was evaluated using the Face, Leg, Activity, Cry and Consolability (FLACC) scale and the Modified Behavioural Pain Scale (MBPS); analgesic efficacy was assessed with a self-reported pain scale. Sedation depth using the validated University of Michigan Sedation Scale and adverse events in the ED and during the following 12 hours were documented. RESULTS A total of 402 patients were included; 3 did not tolerate N2O and therefore had to be excluded. Overall, 399 patients were analysed, of whom 201 (50.4%) received INF. No significant group differences with regard to FLACC scale score, self-reported pain, MBPS score and sedation depth were found. In addition, the two groups did not differ with regard to all types of adverse events. CONCLUSION Combining N2O 70% with INF resulted in no differences with regard to FLACC scale score, self-reported pain, MBPS score, patient and parental satisfaction rate, sedation depth, and adverse events. TRIAL REGISTRATION NUMBER NCT02533908.
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Affiliation(s)
- Michelle Seiler
- Pediatric Emergency Department, University Children's Hospital Zurich, Zurich, Switzerland
| | - Georg Staubli
- Pediatric Emergency Department, University Children's Hospital Zurich, Zurich, Switzerland
| | - Markus A Landolt
- Department of Psychosomatics and Psychiatry, University Children's Hospital Zurich, Zurich, Switzerland
- Division of Child and Adolescent Health Psychology, Department of Psychology, University of Zurich, Zurich, Switzerland
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33
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Papuc SM, Abela L, Steindl K, Begemann A, Simmons TL, Schmitt B, Zweier M, Oneda B, Socher E, Crowther LM, Wohlrab G, Gogoll L, Poms M, Seiler M, Papik M, Baldinger R, Baumer A, Asadollahi R, Kroell-Seger J, Schmid R, Iff T, Schmitt-Mechelke T, Otten K, Hackenberg A, Addor MC, Klein A, Azzarello-Burri S, Sticht H, Joset P, Plecko B, Rauch A. The role of recessive inheritance in early-onset epileptic encephalopathies: a combined whole-exome sequencing and copy number study. Eur J Hum Genet 2018; 27:408-421. [PMID: 30552426 PMCID: PMC6460568 DOI: 10.1038/s41431-018-0299-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [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: 03/21/2018] [Revised: 10/05/2018] [Accepted: 10/25/2018] [Indexed: 11/16/2022] Open
Abstract
Early-onset epileptic encephalopathy (EE) and combined developmental and epileptic encephalopathies (DEE) are clinically and genetically heterogeneous severely devastating conditions. Recent studies emphasized de novo variants as major underlying cause suggesting a generally low-recurrence risk. In order to better understand the full genetic landscape of EE and DEE, we performed high-resolution chromosomal microarray analysis in combination with whole-exome sequencing in 63 deeply phenotyped independent patients. After bioinformatic filtering for rare variants, diagnostic yield was improved for recessive disorders by manual data curation as well as molecular modeling of missense variants and untargeted plasma-metabolomics in selected patients. In total, we yielded a diagnosis in ∼42% of cases with causative copy number variants in 6 patients (∼10%) and causative sequence variants in 16 established disease genes in 20 patients (∼32%), including compound heterozygosity for causative sequence and copy number variants in one patient. In total, 38% of diagnosed cases were caused by recessive genes, of which two cases escaped automatic calling due to one allele occurring de novo. Notably, we found the recessive gene SPATA5 causative in as much as 3% of our cohort, indicating that it may have been underdiagnosed in previous studies. We further support candidacy for neurodevelopmental disorders of four previously described genes (PIK3AP1, GTF3C3, UFC1, and WRAP53), three of which also followed a recessive inheritance pattern. Our results therefore confirm the importance of de novo causative gene variants in EE/DEE, but additionally illustrate the major role of mostly compound heterozygous or hemizygous recessive inheritance and consequently high-recurrence risk.
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Affiliation(s)
- Sorina M Papuc
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich, 8952, Switzerland.,Victor Babes National Institute of Pathology, Bucharest, 050096, Romania
| | - Lucia Abela
- Division of Child Neurology, University Children's Hospital Zurich, Zurich, 8032, Switzerland.,CRC Clinical Research Center University, Children's Hospital Zurich, Zurich, 8032, Switzerland.,radiz-Rare Disease Initiative Zürich, Clinical Research Priority Program for Rare Diseases University of Zurich, Zurich, 8032, Switzerland
| | - Katharina Steindl
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich, 8952, Switzerland
| | - Anaïs Begemann
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich, 8952, Switzerland
| | - Thomas L Simmons
- Division of Child Neurology, University Children's Hospital Zurich, Zurich, 8032, Switzerland
| | - Bernhard Schmitt
- Division of Child Neurology, University Children's Hospital Zurich, Zurich, 8032, Switzerland.,CRC Clinical Research Center University, Children's Hospital Zurich, Zurich, 8032, Switzerland
| | - Markus Zweier
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich, 8952, Switzerland
| | - Beatrice Oneda
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich, 8952, Switzerland
| | - Eileen Socher
- Institute of Biochemistry, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, 91054, Germany
| | - Lisa M Crowther
- Division of Child Neurology, University Children's Hospital Zurich, Zurich, 8032, Switzerland
| | - Gabriele Wohlrab
- Division of Child Neurology, University Children's Hospital Zurich, Zurich, 8032, Switzerland
| | - Laura Gogoll
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich, 8952, Switzerland
| | - Martin Poms
- Division of Child Neurology, University Children's Hospital Zurich, Zurich, 8032, Switzerland
| | - Michelle Seiler
- Pediatric Emergency Department, University Children's Hospital Zurich, Zurich, 8032, Switzerland
| | - Michael Papik
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich, 8952, Switzerland
| | - Rosa Baldinger
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich, 8952, Switzerland
| | - Alessandra Baumer
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich, 8952, Switzerland
| | - Reza Asadollahi
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich, 8952, Switzerland
| | - Judith Kroell-Seger
- Children's department, Swiss Epilepsy Centre, Clinic Lengg, Zurich, 8000, Switzerland
| | - Regula Schmid
- Division of Child Neurology, Kantonsspital Winterthur, Winterthur, 8401, Switzerland
| | - Tobias Iff
- Municipal Hospital of Zurich Triemli, Zurich, 8063, Switzerland
| | | | - Karoline Otten
- Children's department, Swiss Epilepsy Centre, Clinic Lengg, Zurich, 8000, Switzerland
| | - Annette Hackenberg
- Division of Child Neurology, University Children's Hospital Zurich, Zurich, 8032, Switzerland
| | - Marie-Claude Addor
- Department of Woman-Mother-Child, University Medical Center CHUV, Lausanne, 1015, Switzerland
| | - Andrea Klein
- Division of Paediatric Neurology, University Childerns Hospital Basel, UKBB, 4031, Basel, Switzerland.,Division of Paediatric Neurology, Development and Rehabilitation, University Children's Hospital, 3010, Bern, Switzerland
| | - Silvia Azzarello-Burri
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich, 8952, Switzerland
| | - Heinrich Sticht
- Institute of Biochemistry, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, 91054, Germany
| | - Pascal Joset
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich, 8952, Switzerland
| | - Barbara Plecko
- Division of Child Neurology, University Children's Hospital Zurich, Zurich, 8032, Switzerland.,CRC Clinical Research Center University, Children's Hospital Zurich, Zurich, 8032, Switzerland.,radiz-Rare Disease Initiative Zürich, Clinical Research Priority Program for Rare Diseases University of Zurich, Zurich, 8032, Switzerland.,Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, 8057, Switzerland.,Division of General Pediatrics, Department of Pediatrics, Medical University of Graz, 8036, Graz, Austria
| | - Anita Rauch
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich, 8952, Switzerland. .,radiz-Rare Disease Initiative Zürich, Clinical Research Priority Program for Rare Diseases University of Zurich, Zurich, 8032, Switzerland. .,Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, 8057, Switzerland. .,Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, 8057, Switzerland.
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Abstract
AIMS OF THE STUDY Tongue lacerations are common in children, occurring mostly from falls or sports injuries. Optimal treatment of tongue lacerations is a challenge for paediatricians due to contradictory recommendations and a lack of current guidelines. It remains unclear which tongue lacerations should be sutured and which would benefit from spontaneous healing, which is a promising alternative. In recent years, the treatment of choice in our paediatric emergency department (ED) has shifted from generally suturing the wounds to more frequently advising secondary wound healing. The aim of this study was to analyse tongue lacerations treated at our ED in order to develop guidance for the optimal management of tongue lacerations in children. METHODS This retrospective study was conducted to assess tongue lacerations at the ED of a University Children's Hospital Zurich from January 2010 to August 2015. All families were contacted for informed consent and photo documentation of the healed tongue. Clinical records of all the patients included were reviewed and different variables were defined and analysed. RESULTS A total of 73 children with tongue lacerations were included (75.3% boys, mean age ± standard deviation 4.0 ± 2.6 years). The mean size of the lacerations was 12.4 ± 8.3 mm, with affected tongue borders in 51 cases (69.9%) and a through-and-through laceration in 23 patients (31.5%). A primary wound closure was performed in 12 children (16.4%). These wounds were significantly larger than those of the secondary wound healing group (21 ± 10 mm compared to 10.8 ± 6.8 mm), presented gaping wound edges with the tongue at rest more frequently (91.7% compared to 32.8%), and showed through-and-through lacerations more often (91.7% compared to 19.7%). The group with wound suturing needed longer to recover (median 13 days compared to 6.2 days) and had a higher rate of complications (25 vs 3.3%). CONCLUSIONS Suturing is not required in gaping tongue lacerations less than 2 cm long that do not involve the tip of the tongue. The Zurich Tongue Scheme was developed as a guide for clinicians when deciding which tongue lacerations need suturing.
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Affiliation(s)
- Michelle Seiler
- Paediatric Emergency Department, University Children's Hospital Zurich, Switzerland
| | | | - Georg Staubli
- Paediatric Emergency Department, University Children's Hospital Zurich, Switzerland
| | - Clemens Schiestl
- Division of Plastic and Reconstructive Surgery, University Children's Hospital Zurich, Switzerland
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35
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Kähkönen T, Suominen M, Halleen J, Haapaniemi T, Tanaka A, Seiler M, Bernoulli J. Humanized mouse models of triple-negative and triple-positive breast cancer for preclinical validation of novel immuno-oncology therapies. Eur J Cancer 2018. [DOI: 10.1016/j.ejca.2018.01.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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36
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Sindermann J, Rohde C, Kavakbasi E, Seiler M, Welp H, Müller-Tidow C, Hoffmeier A. Epigenetic Alterations in Cardiac Sarcoma. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1628011] [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: 10/28/2022]
Affiliation(s)
- J. Sindermann
- Department of Cardiothoracic Surgery, University of Münster, Münster, Germany
| | - C. Rohde
- Department of Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - E. Kavakbasi
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany
| | - M. Seiler
- Department of Cardiothoracic Surgery, University of Münster, Münster, Germany
| | - H. Welp
- Department of Cardiothoracic Surgery, University of Münster, Münster, Germany
| | - C. Müller-Tidow
- Department of Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - A. Hoffmeier
- Department of Cardiothoracic Surgery, University of Münster, Münster, Germany
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Buonamici S, Yoshimi A, Thomas M, Seiler M, Chan B, Csibi A, Fekkes P, Klimek V, Kumar P, Lee S, Padron E, Pazolli E, Goldberg J, Sahmoud T, Taylor J, Warmuth M, Yu L, Zhu P, Abdel-Wahab O, Smith P. Characterization of Novel Oral Splicing Modulator, H3B-8800, Identifies the Mechanistic Basis for its Preferential Lethality Towards Spliceosome-Mutant Myeloid Malignancy Models. Leuk Res 2017. [DOI: 10.1016/s0145-2126(17)30133-9] [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: 11/15/2022]
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38
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Mupo A, Seiler M, Sathiaseelan V, Pance A, Yang Y, Agrawal AA, Iorio F, Bautista R, Pacharne S, Tzelepis K, Manes N, Wright P, Papaemmanuil E, Kent DG, Campbell PC, Buonamici S, Bolli N, Vassiliou GS. Hemopoietic-specific Sf3b1-K700E knock-in mice display the splicing defect seen in human MDS but develop anemia without ring sideroblasts. Leukemia 2017; 31:720-727. [PMID: 27604819 PMCID: PMC5336192 DOI: 10.1038/leu.2016.251] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 08/19/2016] [Indexed: 02/06/2023]
Abstract
Heterozygous somatic mutations affecting the spliceosome gene SF3B1 drive age-related clonal hematopoiesis, myelodysplastic syndromes (MDS) and other neoplasms. To study their role in such disorders, we generated knock-in mice with hematopoietic-specific expression of Sf3b1-K700E, the commonest type of SF3B1 mutation in MDS. Sf3b1K700E/+ animals had impaired erythropoiesis and progressive anemia without ringed sideroblasts, as well as reduced hematopoietic stem cell numbers and host-repopulating fitness. To understand the molecular basis of these observations, we analyzed global RNA splicing in Sf3b1K700E/+ hematopoietic cells. Aberrant splicing was associated with the usage of cryptic 3' splice and branchpoint sites, as described for human SF3B1 mutants. However, we found a little overlap between aberrantly spliced mRNAs in mouse versus human, suggesting that anemia may be a consequence of globally disrupted splicing. Furthermore, the murine orthologues of genes associated with ring sideroblasts in human MDS, including Abcb7 and Tmem14c, were not aberrantly spliced in Sf3b1K700E/+ mice. Our findings demonstrate that, despite significant differences in affected transcripts, there is overlap in the phenotypes associated with SF3B1-K700E between human and mouse. Future studies should focus on understanding the basis of these similarities and differences as a means of deciphering the consequences of spliceosome gene mutations in MDS.
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Affiliation(s)
- A Mupo
- Haematological Cancer Genetics, Wellcome Sanger Institute, Hinxton, Cambridge, UK
| | - M Seiler
- H3 Biomedicine, Inc., Cambridge, MA, USA
| | | | - A Pance
- Malaria Programme, Wellcome Sanger Institute, Hinxton, Cambridge, UK
| | - Y Yang
- Haematological Cancer Genetics, Wellcome Sanger Institute, Hinxton, Cambridge, UK
| | | | - F Iorio
- European Bioinformatics, Institute, Hinxton, Cambridge, UK
| | - R Bautista
- LIMS Compute and Infrastructure, Wellcome Sanger Institute, Hinxton, Cambridge, UK
| | - S Pacharne
- Haematological Cancer Genetics, Wellcome Sanger Institute, Hinxton, Cambridge, UK
| | - K Tzelepis
- Haematological Cancer Genetics, Wellcome Sanger Institute, Hinxton, Cambridge, UK
| | - N Manes
- Haematological Cancer Genetics, Wellcome Sanger Institute, Hinxton, Cambridge, UK
| | - P Wright
- Department of Pathology, Cambridge University Hospitals NHS Trust, Cambridge, UK
| | - E Papaemmanuil
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - D G Kent
- Cambridge Stem Cell Institute, Cambridge, UK
| | - P C Campbell
- Cancer Genome Project, Wellcome Trust Sanger Institute, Hinxton, Cambridge, UK
| | | | - N Bolli
- Cancer Genome Project, Wellcome Trust Sanger Institute, Hinxton, Cambridge, UK
- Dipartimento di Oncologia ed Onco-Ematologia, Universita' degli Studi di Milano, Milano, Italy
- Dipartimento di Ematologia ed Onco-Ematologia Pediatrica, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - G S Vassiliou
- Haematological Cancer Genetics, Wellcome Sanger Institute, Hinxton, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge, UK
- Department of Haematology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
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Melisko M, Yardley DA, Blackwell K, Forero A, Ma C, Montero A, Daniel BR, Wright G, Fehrenbacher L, Chew H, Ferrario C, Nanda R, Seiler M, Guthrie T, Vance K, Ouellette G, He Y, Bagley RG, Zhang J, Vahdat LT. Abstract OT1-03-15: The METRIC trial: A randomized international study of the antibody-drug conjugate glembatumumab vedotin (GV or CDX-011) in patients with metastatic gpNMB-overexpressing triple-negative breast cancer (TNBC). Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-ot1-03-15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Glycoprotein NMB (gpNMB) is an internalizable transmembrane protein overexpressed in approximately 20% of breast cancer (BC), including approximately 40% of TNBC. gpNMB is a poor prognostic marker in BC (Rose CCR 2010) and preclinically has been implicated in tumor invasion, metastasis, and angiogenesis. GV is a novel antibody-drug conjugate targeting the potent cytotoxin monomethylauristatin E (MMAE) to gpNMB overexpressing cancer cells.
In a Phase I/II study and the Phase II "EMERGE" study, GV demonstrated promising activity with TNBC patients (pts) deriving the greatest benefit and exhibiting the highest degree of gpNMB overexpression. GV was well-tolerated with the most frequent treatment-related toxicities consisting of rash, neutropenia, and neuropathy. In subset analyses of the EMERGE trial, objective response rate (ORR) was 30% (7/23) for GV vs. 9% (1/11) for investigator's choice in tumors with gpNMB overexpression (>25% of tumor epithelium); 18% (5/28) vs. 0% (0/11) in TNBC; and 40% (4/10) vs. 0% (0/6) in gpNMB-overexpressing TNBC for GV and IC respectively, with apparent improvements in progression-free survival (PFS; hazard ratio (HR) = 0.11) and overall survival (OS; HR = 0.14).
Trial design
The METRIC Trial (NCT#01997333) is an international (USA, CA, Aus), two-arm phase II study. Pts are randomized 2:1 to GV (1.88 mg/kg IV q 21 days) or capecitabine, a current standard of care for this population (2,500 mg/m2 daily for d1-14, q21 days) until progression or intolerance. Crossover is not permitted.
Eligibility criteria
Key eligibility criteria include: >25% of tumor epithelium gpNMB+ by central immunohistochemistry (IHC) screening of archival tissue; estrogen receptor and progesterone receptor <10% and HER2 negative [0-1+ IHC, or ISH copy number <4.0/ratio <2.0] by local assessment; ECOG 0-1; taxane resistance; anthracycline exposure (if indicated); <2 chemotherapy regimens for advanced BC; measurable disease; no persistent Grade >2 toxicity.
Specific aims
The primary endpoint is PFS per independent, blinded central review committee according to RECIST 1.1. Secondary endpoints are ORR, duration of response, OS, safety, pharmacokinetics and pharmacodynamics. Exploratory endpoints are quality of life and/or cancer-related pain.
Statistical methods and target accrual
The trial has 85% power to detect a PFS HR of 0.64 with two sided α = 0.05. The hypothesized median PFS is 4.0 months for capecitabine and 6.25 months for GV. Target accrual is open for 300 pts.
Citation Format: Melisko M, Yardley DA, Blackwell K, Forero A, Ma C, Montero A, Daniel BR, Wright G, Fehrenbacher L, Chew H, Ferrario C, Nanda R, Seiler Jr M, Guthrie T, Vance K, Ouellette G, He Y, Bagley RG, Zhang J, Vahdat LT. The METRIC trial: A randomized international study of the antibody-drug conjugate glembatumumab vedotin (GV or CDX-011) in patients with metastatic gpNMB-overexpressing triple-negative breast cancer (TNBC). [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr OT1-03-15.
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Affiliation(s)
- M Melisko
- University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA; Sarah Cannon Research Institute/Tennessee Oncology, PLLC; Duke University Medical Center; University of Alabama; Washington University; Cleveland Clinic; Chattanooga Oncology Hematology Associates; Florida Cancer Specialists; Kaiser Permanente; University of California Davis Comprehensive Cancer Center; Segal Cancer Center-Jewish General Hospital; University of Chicago; Crescent City Research Consortium, LLC; Baptist Cancer Institute; Alabama Oncology; Celldex Therapeutics, Inc.; Weill Cornell Medical College
| | - DA Yardley
- University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA; Sarah Cannon Research Institute/Tennessee Oncology, PLLC; Duke University Medical Center; University of Alabama; Washington University; Cleveland Clinic; Chattanooga Oncology Hematology Associates; Florida Cancer Specialists; Kaiser Permanente; University of California Davis Comprehensive Cancer Center; Segal Cancer Center-Jewish General Hospital; University of Chicago; Crescent City Research Consortium, LLC; Baptist Cancer Institute; Alabama Oncology; Celldex Therapeutics, Inc.; Weill Cornell Medical College
| | - K Blackwell
- University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA; Sarah Cannon Research Institute/Tennessee Oncology, PLLC; Duke University Medical Center; University of Alabama; Washington University; Cleveland Clinic; Chattanooga Oncology Hematology Associates; Florida Cancer Specialists; Kaiser Permanente; University of California Davis Comprehensive Cancer Center; Segal Cancer Center-Jewish General Hospital; University of Chicago; Crescent City Research Consortium, LLC; Baptist Cancer Institute; Alabama Oncology; Celldex Therapeutics, Inc.; Weill Cornell Medical College
| | - A Forero
- University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA; Sarah Cannon Research Institute/Tennessee Oncology, PLLC; Duke University Medical Center; University of Alabama; Washington University; Cleveland Clinic; Chattanooga Oncology Hematology Associates; Florida Cancer Specialists; Kaiser Permanente; University of California Davis Comprehensive Cancer Center; Segal Cancer Center-Jewish General Hospital; University of Chicago; Crescent City Research Consortium, LLC; Baptist Cancer Institute; Alabama Oncology; Celldex Therapeutics, Inc.; Weill Cornell Medical College
| | - C Ma
- University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA; Sarah Cannon Research Institute/Tennessee Oncology, PLLC; Duke University Medical Center; University of Alabama; Washington University; Cleveland Clinic; Chattanooga Oncology Hematology Associates; Florida Cancer Specialists; Kaiser Permanente; University of California Davis Comprehensive Cancer Center; Segal Cancer Center-Jewish General Hospital; University of Chicago; Crescent City Research Consortium, LLC; Baptist Cancer Institute; Alabama Oncology; Celldex Therapeutics, Inc.; Weill Cornell Medical College
| | - A Montero
- University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA; Sarah Cannon Research Institute/Tennessee Oncology, PLLC; Duke University Medical Center; University of Alabama; Washington University; Cleveland Clinic; Chattanooga Oncology Hematology Associates; Florida Cancer Specialists; Kaiser Permanente; University of California Davis Comprehensive Cancer Center; Segal Cancer Center-Jewish General Hospital; University of Chicago; Crescent City Research Consortium, LLC; Baptist Cancer Institute; Alabama Oncology; Celldex Therapeutics, Inc.; Weill Cornell Medical College
| | - BR Daniel
- University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA; Sarah Cannon Research Institute/Tennessee Oncology, PLLC; Duke University Medical Center; University of Alabama; Washington University; Cleveland Clinic; Chattanooga Oncology Hematology Associates; Florida Cancer Specialists; Kaiser Permanente; University of California Davis Comprehensive Cancer Center; Segal Cancer Center-Jewish General Hospital; University of Chicago; Crescent City Research Consortium, LLC; Baptist Cancer Institute; Alabama Oncology; Celldex Therapeutics, Inc.; Weill Cornell Medical College
| | - G Wright
- University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA; Sarah Cannon Research Institute/Tennessee Oncology, PLLC; Duke University Medical Center; University of Alabama; Washington University; Cleveland Clinic; Chattanooga Oncology Hematology Associates; Florida Cancer Specialists; Kaiser Permanente; University of California Davis Comprehensive Cancer Center; Segal Cancer Center-Jewish General Hospital; University of Chicago; Crescent City Research Consortium, LLC; Baptist Cancer Institute; Alabama Oncology; Celldex Therapeutics, Inc.; Weill Cornell Medical College
| | - L Fehrenbacher
- University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA; Sarah Cannon Research Institute/Tennessee Oncology, PLLC; Duke University Medical Center; University of Alabama; Washington University; Cleveland Clinic; Chattanooga Oncology Hematology Associates; Florida Cancer Specialists; Kaiser Permanente; University of California Davis Comprehensive Cancer Center; Segal Cancer Center-Jewish General Hospital; University of Chicago; Crescent City Research Consortium, LLC; Baptist Cancer Institute; Alabama Oncology; Celldex Therapeutics, Inc.; Weill Cornell Medical College
| | - H Chew
- University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA; Sarah Cannon Research Institute/Tennessee Oncology, PLLC; Duke University Medical Center; University of Alabama; Washington University; Cleveland Clinic; Chattanooga Oncology Hematology Associates; Florida Cancer Specialists; Kaiser Permanente; University of California Davis Comprehensive Cancer Center; Segal Cancer Center-Jewish General Hospital; University of Chicago; Crescent City Research Consortium, LLC; Baptist Cancer Institute; Alabama Oncology; Celldex Therapeutics, Inc.; Weill Cornell Medical College
| | - C Ferrario
- University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA; Sarah Cannon Research Institute/Tennessee Oncology, PLLC; Duke University Medical Center; University of Alabama; Washington University; Cleveland Clinic; Chattanooga Oncology Hematology Associates; Florida Cancer Specialists; Kaiser Permanente; University of California Davis Comprehensive Cancer Center; Segal Cancer Center-Jewish General Hospital; University of Chicago; Crescent City Research Consortium, LLC; Baptist Cancer Institute; Alabama Oncology; Celldex Therapeutics, Inc.; Weill Cornell Medical College
| | - R Nanda
- University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA; Sarah Cannon Research Institute/Tennessee Oncology, PLLC; Duke University Medical Center; University of Alabama; Washington University; Cleveland Clinic; Chattanooga Oncology Hematology Associates; Florida Cancer Specialists; Kaiser Permanente; University of California Davis Comprehensive Cancer Center; Segal Cancer Center-Jewish General Hospital; University of Chicago; Crescent City Research Consortium, LLC; Baptist Cancer Institute; Alabama Oncology; Celldex Therapeutics, Inc.; Weill Cornell Medical College
| | - M Seiler
- University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA; Sarah Cannon Research Institute/Tennessee Oncology, PLLC; Duke University Medical Center; University of Alabama; Washington University; Cleveland Clinic; Chattanooga Oncology Hematology Associates; Florida Cancer Specialists; Kaiser Permanente; University of California Davis Comprehensive Cancer Center; Segal Cancer Center-Jewish General Hospital; University of Chicago; Crescent City Research Consortium, LLC; Baptist Cancer Institute; Alabama Oncology; Celldex Therapeutics, Inc.; Weill Cornell Medical College
| | - T Guthrie
- University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA; Sarah Cannon Research Institute/Tennessee Oncology, PLLC; Duke University Medical Center; University of Alabama; Washington University; Cleveland Clinic; Chattanooga Oncology Hematology Associates; Florida Cancer Specialists; Kaiser Permanente; University of California Davis Comprehensive Cancer Center; Segal Cancer Center-Jewish General Hospital; University of Chicago; Crescent City Research Consortium, LLC; Baptist Cancer Institute; Alabama Oncology; Celldex Therapeutics, Inc.; Weill Cornell Medical College
| | - K Vance
- University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA; Sarah Cannon Research Institute/Tennessee Oncology, PLLC; Duke University Medical Center; University of Alabama; Washington University; Cleveland Clinic; Chattanooga Oncology Hematology Associates; Florida Cancer Specialists; Kaiser Permanente; University of California Davis Comprehensive Cancer Center; Segal Cancer Center-Jewish General Hospital; University of Chicago; Crescent City Research Consortium, LLC; Baptist Cancer Institute; Alabama Oncology; Celldex Therapeutics, Inc.; Weill Cornell Medical College
| | - G Ouellette
- University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA; Sarah Cannon Research Institute/Tennessee Oncology, PLLC; Duke University Medical Center; University of Alabama; Washington University; Cleveland Clinic; Chattanooga Oncology Hematology Associates; Florida Cancer Specialists; Kaiser Permanente; University of California Davis Comprehensive Cancer Center; Segal Cancer Center-Jewish General Hospital; University of Chicago; Crescent City Research Consortium, LLC; Baptist Cancer Institute; Alabama Oncology; Celldex Therapeutics, Inc.; Weill Cornell Medical College
| | - Y He
- University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA; Sarah Cannon Research Institute/Tennessee Oncology, PLLC; Duke University Medical Center; University of Alabama; Washington University; Cleveland Clinic; Chattanooga Oncology Hematology Associates; Florida Cancer Specialists; Kaiser Permanente; University of California Davis Comprehensive Cancer Center; Segal Cancer Center-Jewish General Hospital; University of Chicago; Crescent City Research Consortium, LLC; Baptist Cancer Institute; Alabama Oncology; Celldex Therapeutics, Inc.; Weill Cornell Medical College
| | - RG Bagley
- University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA; Sarah Cannon Research Institute/Tennessee Oncology, PLLC; Duke University Medical Center; University of Alabama; Washington University; Cleveland Clinic; Chattanooga Oncology Hematology Associates; Florida Cancer Specialists; Kaiser Permanente; University of California Davis Comprehensive Cancer Center; Segal Cancer Center-Jewish General Hospital; University of Chicago; Crescent City Research Consortium, LLC; Baptist Cancer Institute; Alabama Oncology; Celldex Therapeutics, Inc.; Weill Cornell Medical College
| | - J Zhang
- University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA; Sarah Cannon Research Institute/Tennessee Oncology, PLLC; Duke University Medical Center; University of Alabama; Washington University; Cleveland Clinic; Chattanooga Oncology Hematology Associates; Florida Cancer Specialists; Kaiser Permanente; University of California Davis Comprehensive Cancer Center; Segal Cancer Center-Jewish General Hospital; University of Chicago; Crescent City Research Consortium, LLC; Baptist Cancer Institute; Alabama Oncology; Celldex Therapeutics, Inc.; Weill Cornell Medical College
| | - LT Vahdat
- University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA; Sarah Cannon Research Institute/Tennessee Oncology, PLLC; Duke University Medical Center; University of Alabama; Washington University; Cleveland Clinic; Chattanooga Oncology Hematology Associates; Florida Cancer Specialists; Kaiser Permanente; University of California Davis Comprehensive Cancer Center; Segal Cancer Center-Jewish General Hospital; University of Chicago; Crescent City Research Consortium, LLC; Baptist Cancer Institute; Alabama Oncology; Celldex Therapeutics, Inc.; Weill Cornell Medical College
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Seiler M, Holderied M, Schwitzer C. Habitat selection and use in the Critically Endangered Sahamalaza sportive lemur Lepilemur sahamalazensis in altered habitat. ENDANGER SPECIES RES 2014. [DOI: 10.3354/esr00596] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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De Marchis GM, Katan M, Weck A, Fluri F, Foerch C, Findling O, Schuetz P, Buhl D, El-Koussy M, Gensicke H, Seiler M, Morgenthaler N, Mattle HP, Mueller B, Christ-Crain M, Arnold M. Copeptin adds prognostic information after ischemic stroke: Results from the CoRisk study. Neurology 2013; 80:1278-86. [DOI: 10.1212/wnl.0b013e3182887944] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Aramant R, Seiler M, Ehinger B, Bergström A, Gustavii B, Brundin P, Adolph AR. Transplantation of human embryonic retina to adult rat retina. Restor Neurol Neurosci 2012; 2:9-22. [PMID: 21551868 DOI: 10.3233/rnn-1990-2102] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Human embryonic retinas (postconceptional age 3-10 weeks) with or without retinal pigment epithelium were grafted to the retina of immuno-suppressed adult rat hosts. The development of the xenografts was followed up to 37 weeks of total age by histology and by immunohistochemistry for S-antigen. The donor tissue became rearranged in folded sheets with rosettes. The grafts developed approximately according to their intrinsic timetable, but with a developmental delay in the later stages. Occasionally, the grafts were well fused with the host retina. At 13 weeks of total age, the grafts contained areas of inner plexiform layer with presumptive ganglion cells, one neuroblastic layer, and cone precursor cells around rosettes. At 19 weeks, an outer plexiform layer and inner segments of the cones started to form. At 20 weeks, the first immunoreactivity for S-antigen was observed in photoreceptor precursors. Cone inner segments were clearly distinguishable at 28 weeks, and more S-antigen-positive rods were seen. At 31 weeks, rods were more differentiated, showing S-antigen-positive inner and outer segments. An inner limiting membrane with an apparent ganglion cell layer was only seen in one cograft of retina and retinal pigment epithelium at 37 weeks, indicating an important role of retinal pigment epithelium for graft differentiation. This study shows that human embryonic retina can be grafted to immuno-suppressed adult rat retina with long-term survival. A high degree of maturation can be obtained in the grafted tissue comparable to the layering of newborn human retina. It appears that most cell types develop. This model opens up possibilities for studying human retinal development with the goal of reaching a treatment for human degenerative retinal disorders.
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Affiliation(s)
- R Aramant
- Eye Research Institute, Boston, MA 02114 (U.S.A.)
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Enders S, Seiler M. Thermodynamische Fragestellungen bei der Anwendung von hyperverzweigten Polymeren. CHEM-ING-TECH 2012. [DOI: 10.1002/cite.201250369] [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: 11/08/2022]
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De Marchis G, Katan M, Weck A, Mattle H, Breckenfeld C, Schütz P, Foerch C, Seiler M, Hein F, Papassotiriou J, Christ-Crain M, Arnold M. 16. Validation of Copeptin as prognostic marker in ischemic stroke. Clin Neurophysiol 2011. [DOI: 10.1016/j.clinph.2010.10.022] [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: 10/18/2022]
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Irfan M, Seiler M, Smirnova I, Arlt W. Melt Dispersion Method: Die Entwicklung von Prozess und Formulierung. CHEM-ING-TECH 2009. [DOI: 10.1002/cite.200950436] [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: 11/09/2022]
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Seiler M, Vogt M, Bröcker S, Schwab P, Kühn A, Ziegler F. Absorptionkältemaschinen: Verfahrenssimulation mit neuen Arbeitspaaren basierend auf ionischen Flüssigkeiten. CHEM-ING-TECH 2009. [DOI: 10.1002/cite.200950438] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Ehinger B, Zucker C, Bergström A, Seiler M, Aramant R, Adolph A. Electron microscopy of human first trimester and rat mid-term retinal cell transplants with long development time. Neuroophthalmology 2009. [DOI: 10.3109/01658109209058125] [Citation(s) in RCA: 5] [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] [Indexed: 11/13/2022] Open
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