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Prata F, Ragusa A, Civitella A, Tuzzolo P, Tedesco F, Cacciatore L, Iannuzzi A, Callè P, Raso G, Fantozzi M, Pira M, Ricci M, Pino M, Minore A, Basile S, Testa A, Crimi VG, Deanesi N, Travino A, D'Addurno G, Scarpa RM, Papalia R. Robot-assisted partial nephrectomy using the novel Hugo™ RAS system: Feasibility, setting and perioperative outcomes of the first off-clamp series. Urologia 2024:3915603231220109. [PMID: 38174713 DOI: 10.1177/03915603231220109] [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] [Indexed: 01/05/2024]
Abstract
INTRODUCTION Hugo Robot-Assisted Surgery (RAS) System has been conceived with enhanced modularity but its role for nephron-sparing surgery setting still remains poorly explored. We aimed to describe our experience in robot-assisted partial nephrectomy (RAPN) with a three-arms setting for the first off-clamp series using the new Hugo RAS System. METHODS Patients were placed on an extended flank position at the margin of the surgical bed with a slightly flexion (45°). The first 11 mm robotic trocar (camera port) was placed along the pararectal line 14 ± 2 cm far from the umbilicus. The pneumoperitoneum was then induced through the AirSeal system (SurgiQuest, Milford, Connecticut, USA©). Two more 8 mm operative robotic ports were placed under direct vision, either 8 ± 1 cm far from optic's port. Two 12 mm laparoscopic ports for bed-assistant were placed between robotic ports. Monopolar curved shears, fenestrated grasper, and large needle driver were used in a three-instruments configuration. RESULTS Off-clamp RAPN was successfully performed in seven patients with cT1 renal masses using a trans-peritoneal route. Median port placement and docking time was 6 min (IQR, 4-8 min). Hemostasis was achieved through renorraphy using a single transfix stitch with sliding clips technique. There was no need for additional ports placement. No intraoperative complications occurred, no clashing of robotic instruments or between the robotic arms was observed. No technical failures of the system occurred. Median console time was 83 min (IQR, 68-115 min). Median estimated blood loss were 200 ml (IQR, 50-400 ml). All patients were discharged between post-operative day 2 and 3, without the need of hospital readmission. No complications were recorded within the first 30 post-operative days. CONCLUSIONS We performed the first series of off-clamp RAPN using the novel HUGO RAS System. This novel robotic platform showed an easy-friendly docking system, providing excellent perioperative outcomes with a simple three-arms configuration.
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Affiliation(s)
- F Prata
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - A Ragusa
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - A Civitella
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - P Tuzzolo
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - F Tedesco
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - L Cacciatore
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - A Iannuzzi
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - P Callè
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - G Raso
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - M Fantozzi
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - M Pira
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - M Ricci
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - M Pino
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - A Minore
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - S Basile
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - A Testa
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - V G Crimi
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - N Deanesi
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - A Travino
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - G D'Addurno
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - R M Scarpa
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - R Papalia
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
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Rodrigues F, Marlow R, Gouveia C, Correia P, Brett A, Silva C, Gameiro I, Rua I, Dias J, Martins M, Diogo R, Lopes T, Hipólito E, Moreira D, Costa Alves M, Prata F, Labrusco M, Gomes S, Fernandes A, Andrade A, Granjo Morais C, João Virtuoso M, Manuel Zarcos M, Teresa Raposo A, Boon A, Finn A. Prospective study of loss of health-related quality adjusted life years in children and their families due to uncomplicated and hospitalised varicella. Vaccine 2023; 41:1182-1189. [PMID: 36522267 DOI: 10.1016/j.vaccine.2022.12.011] [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: 09/16/2022] [Revised: 11/06/2022] [Accepted: 12/01/2022] [Indexed: 12/15/2022]
Abstract
INTRODUCTION AND AIMS Although usually benign, varicella can lead to serious complications and sometimes long-term sequelae. Vaccines are safe and effective but not yet included in immunisation programmes in many countries. We aimed to quantify the impact on health-related quality of life (HRQoL) in terms of quality-adjusted life years (QALY) in children with varicella and their families, key to assessing cost-utility in countries with low mortality due to this infection. METHODS Children with varicella in the community and admitted to hospitals in Portugal were included over 18 months from January 2019. Children's and carers' HRQoL losses were assessed prospectively using standard multi-attribute utility instruments for measuring HRQoL (EQ-5D and CHU9D), from presentation to recovery, allowing the calculation of QALYs. RESULTS Among 109 families with children with varicella recruited from attendees at a pediatric emergency service (community arm), the mean HRQoL loss/child was 2.0 days (95 % CI 1.9-2.2, n = 101) (mean 5.4 QALYs/1000 children (95 % CI 5.3-6.1) and 1.3 days/primary carer (95 % CI 1.2-1.6, n = 103) (mean 3.6 QALYs /1000 carers (95 % CI 3.4-4.4). Among 114 families with children admitted to hospital because of severe varicella or a complication (hospital arm), the mean HRQoL loss/child was 9.8 days (95 % CI 9.4-10.6, n = 114) (mean 26.8 QALYs /1000 children (95 % CI 25.8-29.0) and 8.5 days/primary carer (95 % CI 7.4-9.6, n = 114) (mean 23.4 QALYs/1000 carers (95 % CI 20.3-26.2). Mean QALY losses/1000 patients were particularly high for bone and joint infections [67.5 (95 % CI 43.9-97.6)]. Estimates for children's QALYs lost using the CHU9D tool were well correlated with those obtained using EQ-5D, but substantially lower. CONCLUSIONS The impact of varicella on HRQoL is substantial. We report the first measurements of QALYs lost in hospitalised children and in the families of children both in the community and admitted to hospital, providing important information to guide vaccination policy recommendations.
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Affiliation(s)
- Fernanda Rodrigues
- Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Av. Afonso Romão, 3000-602 Coimbra, Portugal; Faculdade de Medicina, Universidade de Coimbra, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal.
| | - Robin Marlow
- Bristol Vaccine Centre, Schools of Population Health Sciences and of Cellular and Molecular Medicine, University of Bristol, BS2 8AE, UK
| | - Catarina Gouveia
- Hospital D. Estefânia, Centro Hospitalar Lisboa Central, Rua Jacinta Marto, 1150-191 Lisboa, Portugal
| | - Paula Correia
- Hospital Prof. Doutor Fernando Fonseca, IC 19, 2720-276 Amadora, Portugal
| | - Ana Brett
- Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Av. Afonso Romão, 3000-602 Coimbra, Portugal; Faculdade de Medicina, Universidade de Coimbra, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal
| | - Catarina Silva
- Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Av. Afonso Romão, 3000-602 Coimbra, Portugal
| | - Inês Gameiro
- Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Av. Afonso Romão, 3000-602 Coimbra, Portugal
| | - Inês Rua
- Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Av. Afonso Romão, 3000-602 Coimbra, Portugal
| | - João Dias
- Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Av. Afonso Romão, 3000-602 Coimbra, Portugal
| | - Marta Martins
- Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Av. Afonso Romão, 3000-602 Coimbra, Portugal
| | - Rui Diogo
- Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Av. Afonso Romão, 3000-602 Coimbra, Portugal
| | - Teresa Lopes
- Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Av. Afonso Romão, 3000-602 Coimbra, Portugal
| | - Elsa Hipólito
- Hospital Infante D. Pedro, Av. Dr. Artur Ravara, 3810-164 Aveiro, Portugal
| | - Diana Moreira
- Centro Hospitalar de Vila Nova de Gaia/Espinho (Unidade 2), Rua Dr. Francisco Sá Carneiro, 4400-129 Vila Nova de Gaia, Portugal
| | - Manuela Costa Alves
- Hospital de Braga, Rua das Comunidades Lusíadas 133, 4710-243 Braga, Portugal
| | - Filipa Prata
- Hospital Santa Maria, Centro Hospitalar Lisboa Norte, Av. Prof. Egas Moniz, 1649-028 Lisboa, Portugal
| | - Miguel Labrusco
- Hospital Beatriz Ângelo, Av. Carlos Teixeira, 2674-514 Loures, Portugal
| | - Susana Gomes
- Hospital do Espírito Santo, Largo Senhor da Pobreza, 7000-811 Évora, Portugal
| | - Alexandre Fernandes
- Centro Materno Infantil do Norte, Largo da Maternidade de Júlio Dinis, 4050-651 Porto, Portugal
| | - Alexandra Andrade
- Hospital Nélio Mendonça, Av. Luís de Camões 6180, 9000-177 Funchal, Portugal
| | - Catarina Granjo Morais
- Centro Hospitalar e Universitário de S. João, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Maria João Virtuoso
- Hospital de Faro, Centro Hospitalar e Universitário do Algarve, Rua Leão Penedo, 8000-386 Faro, Portugal
| | - Maria Manuel Zarcos
- Hospital de Santo André, Centro Hospitalar Leiria Pombal, Rua de Santo André, 2410-197 Leiria, Portugal
| | - Ana Teresa Raposo
- Hospital do Divino Espírito Santo, Av. D. Manuel I, 9500-370 Ponta Delgada, Portugal
| | - Adam Boon
- Bristol Vaccine Centre, Schools of Population Health Sciences and of Cellular and Molecular Medicine, University of Bristol, BS2 8AE, UK
| | - Adam Finn
- Bristol Vaccine Centre, Schools of Population Health Sciences and of Cellular and Molecular Medicine, University of Bristol, BS2 8AE, UK
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Anceschi U, Amparore D, Siena G, Cocci A, Checcucci E, Prata F, De Cillis S, Flammia R, Tufano A, Quarà A, Ortenzi M, Brassetti A, Bove A, Tuderti G, D’Annunzio S, Viola L, Sessa F, Spatafora P, Fiori C, Varvello F, Minervini A, Ferrari G, Porpiglia F, Cindolo L, Simone G. A novel outcomes categorization for current minimally invasive ejaculation-sparing treatments of benign prostatic hyperplasia: Results of a multicentric series. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00069-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Bove A, Brassetti A, Anceschi U, D’Annunzio S, Ferriero M, Mastroianni R, Tuderti G, Misuraca L, Iannuzzi A, Prata F, Ragusa A, Gallucci M, Simone G. Identifying candidates for one-night stay robot assisted simple prostatectomy: Single center analysis. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01179-x] [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: 02/12/2023]
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Prata F, Iannuzzi A, Ragusa A, Anceschi U, Flammia R, Tufano A, Bravi C, Brassetti A, Tuderti G, Minervini A, Mari A, Capitanio U, Montorsi F, Autorino R, Veccia A, Fiori C, Porpiglia F, Eun D, Lee J, Deerwesh I, Sundaram C, Steward J, Mottrie A, Leonardo C, Simone G. Analysis of CKD progression for purely Off-Clamp and On-Clamp robotic partial nephrectomy for high nephrometry renal masses: Results of a multicentric series. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00906-5] [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: 02/12/2023]
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Anceschi U, Amparore D, Prata F, Checcucci E, Bove A, De Cillis S, Iannuzzi A, Quarà A, Ragusa A, Ortenzi M, Misuraca L, Zampa A, Cartolano S, Spadaro G, Tuderti G, Brassetti A, Ferriero M, Mastroianni R, D’Annunzio S, Guaglianone S, Fiori C, Porpiglia F, Simone G. Predictors of BPH6 achievement for urethral-sparing robot-assisted simple prostatectomy: Results of a multicentric series. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00065-9] [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: 02/12/2023]
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Bove A, Brassetti A, Anceschi U, Amparore D, De Cillis S, Quarà A, Ortenzi M, Checcucci E, Fiori C, D’Annunzio S, Ferriero M, Mastroianni R, Tuderti G, Iannuzzi A, Prata F, Ragusa A, Gallucci M, Porpiglia F, Simone G. Novel composite BPH3 trifecta performance for Robotic Assisted Simple Prostatectomy (RASP) vs. BPH6: A multicenter outcomes comparison. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01177-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Gama da Silva A, Completo S, Fonseca M, Prata F, Marques JG. Oral hairy leukoplakia: A sign of severe human immunodeficiency virus-mediated immunosuppression. J Paediatr Child Health 2022; 58:2125. [PMID: 34866272 DOI: 10.1111/jpc.15843] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 11/22/2021] [Indexed: 11/29/2022]
Affiliation(s)
- António Gama da Silva
- Department of Pediatrics, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - Sara Completo
- Child and Youth Department, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal
| | - Madalena Fonseca
- Department of Pediatrics, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - Filipa Prata
- Department of Pediatrics, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - José Gonçalo Marques
- Department of Pediatrics, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
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Esperto F, Prata F, Civitella A, Tuzzolo P, Crimi V, Deanesi N, Minore A, Ragusa A, Tedesco F, Testa A, Alcini A, Flammia G, Salerno A, Papalia R, Scarpa R. Radical cystectomy video consensus: a simple and effective way to improve awareness of patients undergoing radical cystectomy. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01122-3] [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: 11/05/2022] Open
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Lyons A, Thompson L, Chappell E, Ene L, Galli L, Goetghebuer T, Jourdain G, Noguera-Julian A, Kahlert CR, Königs C, Kosalaraksa P, Lumbiganon P, Marczyńska M, Marques L, Navarro M, Naver L, Okhonskaia L, Prata F, Puthanakit T, Ramos JT, Samarina A, Thorne C, Voronin E, Turkova A, Giaquinto C, Judd A, Collins IJ. Outcomes of etravirine-based antiretroviral treatment in treatment-experienced children and adolescents living with HIV in Europe and Thailand. Antivir Ther 2022; 27:13596535221092182. [PMID: 36029009 DOI: 10.1177/13596535221092182] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Etravirine (ETR) is approved as a component of second or third-line antiretroviral treatment (ART) for children living with HIV. We assessed the outcomes of ETR-based ART in children in routine care in Europe and Thailand. METHODS Data on children aged <18 years at ETR start were pooled from 17 observational cohorts. Characteristics at ETR start, immunological and virological outcomes at 12 months, discontinuations, adverse events (AEs) and serious adverse events (SAEs) were described. Follow-up was censored at ETR discontinuation, death or last visit. RESULTS 177 children ever received ETR. At ETR start, median [IQR] age was 15 [12,16] years, CD4 count 480 [287, 713] cells/mm3, 70% had exposure to ≥3 ART classes and 20% had viral load (VL) <50 copies/mL. 95% received ETR in combination with ≥1 potent drug class, mostly protease inhibitor-based regimens. Median time on ETR was 24 [7, 48] months. Amongst those on ETR at 12 months (n=141), 69% had VL<50 copies/mL. Median CD4 increase since ETR start (n=83) was 147 [16, 267] cells/mm3. Overall, 81 (46%) discontinued ETR by last follow-up. Median time to discontinuation was 23 [8, 47] months. Common reasons for discontinuation were treatment simplification (19%), treatment failure (16%) and toxicity (12%). Eight children (5%) had AEs causally associated with ETR, all dermatological/hypersensitivity reactions. Two were SAEs, both Stevens-Johnson Syndrome in children on regimens containing ETR and darunavir and were causally related to either drugs; both resolved following ART discontinuation. CONCLUSION Children receiving ETR were predominantly highly treatment-experienced, over two-thirds were virally suppressed at 12 months.
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Affiliation(s)
- Alex Lyons
- MRC Clinical Trials Unit at UCL, 4919University College London, London, UK
| | - Lindsay Thompson
- MRC Clinical Trials Unit at UCL, 4919University College London, London, UK
| | - Elizabeth Chappell
- MRC Clinical Trials Unit at UCL, 4919University College London, London, UK
| | - Luminita Ene
- Clinical Department of Infectious Diseases (HIV Department), Dr. Victor Babeș Hospital for Infectious and Tropical Diseases, Bucharest, Romania
| | - Luisa Galli
- Infectious Disease Unit, Meyer Children's Hospital, Department of Health Sciences, University of Florence, Florence, Italy
| | | | - Gonzague Jourdain
- Institut de recherche pour le développement (IRD)-PHPT, Marseille, France
- Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Antoni Noguera-Julian
- Infectious Diseases and Systemic Inflammatory Response in Pediatrics, Infectious Diseases Unit, Department of Pediatrics, Sant Joan de Déu Hospital Research Foundation, Barcelona, Spain
| | - Christian R Kahlert
- Infectious Diseases and Hospital Epidemiology, Children's Hospital of Eastern Switzerland and Cantonal Hospital, St Gallen, Switzerland
| | - Christoph Königs
- Department for Children and Adolescents, Division for Stem Cell Transplantation and Immunology, University Hospital Frankfurt/Main, Frankfurt, Germany
| | - Pope Kosalaraksa
- Department of Pediatrics, Khon Kaen University, Khon Kaen, Thailand
| | | | - Magdalena Marczyńska
- Hospital of Infectious Diseases, 37803Medical University of Warsaw, Warsaw, Poland
| | - Laura Marques
- Centro Hospitalar e Universitário do Porto, Porto, Portugal
| | - Marissa Navarro
- Hospital General Universitario "Gregorio Marañón", Madrid, Spain
- 16734Universidad Complutense, Madrid, Spain
- 559924Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Madrid, Spain
- Red de Investigación Translacional en Infectología Pediátrica, RITIP, Madrid, Spain
| | - Lars Naver
- Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden
| | - Liubov Okhonskaia
- Federal Budgetary Institution "Republican Clinical Infectious Hospital" of the Ministry of Health of the Russian Federation, Saint-Petersburg, Russian Federation
| | | | - Thanyawee Puthanakit
- Department of Pediatrics, Faculty of Medicine, 26683Chulalongkorn University and HIVNAT, Thai Red Cross AIDS Research Center, Bangkok, Thailand
| | - Jose T Ramos
- Departamento de Salud Pública y Materno-infantil, Universidad Complutense, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Anna Samarina
- The City HIV Centre, St Petersburg City AIDS Center, St Petersburg, Russian Federation
| | - Claire Thorne
- University College London Great Ormond Street Institute of Child Health, London, UK
| | - Evgeny Voronin
- Federal Budgetary Institution "Republican Clinical Infectious Hospital" of the Ministry of Health of the Russian Federation, Saint-Petersburg, Russian Federation
| | - Anna Turkova
- MRC Clinical Trials Unit at UCL, 4919University College London, London, UK
- 4956Great Ormond Street Hospital, London, UK
| | - Carlo Giaquinto
- 561043Paediatric European Network for the Treatment of AIDS (Penta), Padova, Italy
| | - Ali Judd
- MRC Clinical Trials Unit at UCL, 4919University College London, London, UK
| | - Intira J Collins
- MRC Clinical Trials Unit at UCL, 4919University College London, London, UK
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Jesson J, Crichton S, Quartagno M, Yotebieng M, Abrams EJ, Chokephaibulkit K, Le Coeur S, Aké‐Assi M, Patel K, Pinto J, Paul M, Vreeman R, Davies M, Ben‐Farhat J, Van Dyke R, Judd A, Mofenson L, Vicari M, Seage G, Bekker L, Essajee S, Gibb D, Penazzato M, Collins IJ, Wools‐Kaloustian K, Slogrove A, Powis K, Williams P, Matshaba M, Thahane L, Nyasulu P, Lukhele B, Mwita L, Kekitiinwa‐Rukyalekere A, Wanless S, Goetghebuer T, Thorne C, Warszawski J, Galli L, van Rossum AM, Giaquinto C, Marczynska M, Marques L, Prata F, Ene L, Okhonskaya L, Navarro M, Frick A, Naver L, Kahlert C, Volokha A, Chappell E, Pape JW, Rouzier V, Marcelin A, Succi R, Sohn AH, Kariminia A, Edmonds A, Lelo P, Lyamuya R, Ogalo EA, Odhiambo FA, Haas AD, Bolton C, Muhairwe J, Tweya H, Sylla M, D'Almeida M, Renner L, Abzug MJ, Oleske J, Purswani M, Teasdale C, Nuwagaba‐Biribonwoha H, Goodall R, Leroy V. Growth and CD4 patterns of adolescents living with perinatally acquired HIV worldwide, a CIPHER cohort collaboration analysis. J Int AIDS Soc 2022; 25:e25871. [PMID: 35255197 PMCID: PMC8901148 DOI: 10.1002/jia2.25871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 12/20/2021] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Adolescents living with HIV are subject to multiple co-morbidities, including growth retardation and immunodeficiency. We describe growth and CD4 evolution during adolescence using data from the Collaborative Initiative for Paediatric HIV Education and Research (CIPHER) global project. METHODS Data were collected between 1994 and 2015 from 11 CIPHER networks worldwide. Adolescents with perinatally acquired HIV infection (APH) who initiated antiretroviral therapy (ART) before age 10 years, with at least one height or CD4 count measurement while aged 10-17 years, were included. Growth was measured using height-for-age Z-scores (HAZ, stunting if <-2 SD, WHO growth charts). Linear mixed-effects models were used to study the evolution of each outcome between ages 10 and 17. For growth, sex-specific models with fractional polynomials were used to model non-linear relationships for age at ART initiation, HAZ at age 10 and time, defined as current age from 10 to 17 years of age. RESULTS A total of 20,939 and 19,557 APH were included for the growth and CD4 analyses, respectively. Half were females, two-thirds lived in East and Southern Africa, and median age at ART initiation ranged from <3 years in North America and Europe to >7 years in sub-Saharan African regions. At age 10, stunting ranged from 6% in North America and Europe to 39% in the Asia-Pacific; 19% overall had CD4 counts <500 cells/mm3 . Across adolescence, higher HAZ was observed in females and among those in high-income countries. APH with stunting at age 10 and those with late ART initiation (after age 5) had the largest HAZ gains during adolescence, but these gains were insufficient to catch-up with non-stunted, early ART-treated adolescents. From age 10 to 16 years, mean CD4 counts declined from 768 to 607 cells/mm3 . This decline was observed across all regions, in males and females. CONCLUSIONS Growth patterns during adolescence differed substantially by sex and region, while CD4 patterns were similar, with an observed CD4 decline that needs further investigation. Early diagnosis and timely initiation of treatment in early childhood to prevent growth retardation and immunodeficiency are critical to improving APH growth and CD4 outcomes by the time they reach adulthood.
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Civitella A, Prata F, Tuzzolo P, Romei L, Crimi V, Tedesco F, Ragusa A, Cacciatore L, Deanesi N, Testa A, Flammia G, Alcini A, Salerno A, Prata S, Esperto F, Scarpa R, Papalia R. Laparoscopic versus ultrasound guided Transversus Abdominis Plane (TAP) block for postoperative analgesia after radical prostatectomy: A randomized controlled trial. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00109-9] [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: 11/29/2022]
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13
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Romei L, Tuzzolo P, Civitella A, Prata F, Crimi V, Esperto F, Prof. Papalia R, Prof. Scarpa R. Bladder NIRS: A non-invasive method functional to distinguish between detrusor underactivity (DU) and Bladder Outlet Obstruction (BOO) in men with LUTS. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00924-1] [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: 11/04/2022]
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14
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Bernardo M, Martins J, Martins M, Prata F, Costa-Reis P, Ferrão A, João Palaré M. Autoimmune haemolytic anaemia following SARS-CoV-2 infection in a child: A clue to a systemic autoimmune disease. Pediatr Blood Cancer 2022; 69:e29481. [PMID: 34842350 DOI: 10.1002/pbc.29481] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 11/07/2021] [Accepted: 11/08/2021] [Indexed: 01/14/2023]
Affiliation(s)
- Miguel Bernardo
- Haematology Unit, Paediatrics Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal.,Paediatrics Department, Hospital São Pedro de Vila Real, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Joana Martins
- Infectious Diseases and Immunodeficiency Unit, Paediatrics Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal.,Paediatrics Department, Hospital Garcia de Orta, EPE, Almada, Portugal
| | - Miguel Martins
- Haematology Unit, Paediatrics Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal.,Paediatrics Department, Centro Hospitalar Universitário Cova da Beira EPE, Covilhã, Portugal
| | - Filipa Prata
- Infectious Diseases and Immunodeficiency Unit, Paediatrics Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal.,Clínica Universitária de Pediatria, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Patrícia Costa-Reis
- Clínica Universitária de Pediatria, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Paediatric Rheumatology Unit, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - Anabela Ferrão
- Haematology Unit, Paediatrics Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal.,Clínica Universitária de Pediatria, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Maria João Palaré
- Haematology Unit, Paediatrics Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal.,Clínica Universitária de Pediatria, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
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Chappell E, Kohns Vasconcelos M, Goodall RL, Galli L, Goetghebuer T, Noguera‐Julian A, Rodrigues LC, Scherpbier H, Smit C, Bamford A, Crichton S, Navarro ML, Ramos JT, Warszawski J, Spolou V, Chiappini E, Venturini E, Prata F, Kahlert C, Marczynska M, Marques L, Naver L, Thorne C, Gibb DM, Giaquinto C, Judd A, Collins IJ. Children living with HIV in Europe: do migrants have worse treatment outcomes? HIV Med 2022; 23:186-196. [PMID: 34596323 PMCID: PMC9293243 DOI: 10.1111/hiv.13177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 09/10/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To assess the effect of migrant status on treatment outcomes among children living with HIV in Europe. METHODS Children aged < 18 years at the start of antiretroviral therapy (ART) in European paediatric HIV observational cohorts where ≥ 5% of children were migrants (defined as born abroad) were included. Three outcomes were considered: (i) severe immunosuppression-for-age; (ii) viraemic viral load (≥ 400 copies/mL) at 1 year after ART initiation; and (iii) AIDS/death after ART initiation. The effect of migrant status was assessed using univariable and multivariable logistic and Cox models. RESULTS Of 2620 children included across 12 European countries, 56% were migrants. At ART initiation, migrant children were older than domestic-born children (median 6.1 vs. 0.9 years, p < 0.001), with slightly higher proportions being severely immunocompromised (35% vs. 33%) and with active tuberculosis (2% vs. 1%), but a lower proportion with an AIDS diagnosis (14% vs. 19%) (all p < 0.001). At 1 year after beginning ART, a lower proportion of migrant children were viraemic (18% vs. 24%) but there was no difference in multivariable analysis (p = 0.702), and no difference in severe immunosuppression (p = 0.409). However, there was a trend towards higher risk of AIDS/death in migrant children (adjusted hazard ratio = 1.51, 95% confidence interval: 0.96-2.38, p = 0.072). CONCLUSIONS After adjusting for characteristics at ART initiation, migrant children have virological and immunological outcomes at 1 year of ART that are comparable to those who are domestic-born, possibly indicating equity in access to healthcare in Europe. However, there was some evidence of a difference in AIDS-free survival, which warrants further monitoring.
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Affiliation(s)
| | - Malte Kohns Vasconcelos
- Department of Infectious Disease EpidemiologyLondon School of Hygiene and Tropical MedicineLondonUK
- Institute for Medical Microbiology and Hospital HygieneHeinrich Heine University DüsseldorfDüsseldorfGermany
- Paediatric Infectious Diseases Research GroupInstitute for Infection and ImmunitySt. George's, University of LondonLondonUK
| | | | - Luisa Galli
- Infectious Disease UnitDepartment of Health SciencesMeyer Children's HospitalUniversity of FlorenceFlorenceItaly
| | - Tessa Goetghebuer
- Department of PediatricsHôpital St PierreUniversité libre de BruxellesBruxellesBelgium
| | - Antoni Noguera‐Julian
- Infectious Diseases and Systemic Inflammatory Response in Pediatrics, Infectious Diseases UnitDepartment of PediatricsSant Joan de Déu Hospital Research FoundationBarcelonaSpain
- Center for Biomedical Network Research on Epidemiology and Public Health (CIBERESP)MadridSpain
- Department of PediatricsUniversity of BarcelonaBarcelonaSpain
- Translational Research Network in Pediatric Infectious Diseases (RITIP)MadridSpain
| | - Laura C. Rodrigues
- Department of Infectious Disease EpidemiologyLondon School of Hygiene and Tropical MedicineLondonUK
| | - Henriette Scherpbier
- Emma Children's Hospital/Amsterdam University Medical CentreAmsterdamThe Netherlands
| | - Colette Smit
- Stichting HIV MonitoringAmsterdamThe Netherlands
| | - Alasdair Bamford
- MRC Clinical Trials Unit at UCLLondonUK
- Great Ormond Street Hospital for Children NHS TrustLondonUK
- University College London Great Ormond Street Institute of Child HealthLondonUK
| | | | - Marissa Luisa Navarro
- Translational Research Network in Pediatric Infectious Diseases (RITIP)MadridSpain
- Hospital General Universitario "Gregorio Marañón"MadridSpain
- Universidad ComplutenseMadridSpain
- Instituto de Investigación Sanitaria Gregorio Marañón (IISGM)MadridSpain
| | - Jose T. Ramos
- Departamento de Salud Pública y Materno‐infantilUniversidad ComplutenseHospital Clínico San CarlosInstituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC)MadridSpain
| | - Josiane Warszawski
- Service d'Epidémiologie et Santé PubliqueAP‐HPHôpital BicêtreLe Kremlin‐BicêtreFrance
- Unité de Recherche Clinique Paris Descartes Necker CochinAP‐HPParisFrance
| | - Vana Spolou
- First Department of PaediatricsInfectious Diseases Unit, “Agia Sophia” Childrens' HospitalAthensGreece
| | - Elena Chiappini
- Infectious Disease UnitDepartment of Health SciencesMeyer Children's HospitalUniversity of FlorenceFlorenceItaly
| | - Elisabetta Venturini
- Infectious Disease UnitDepartment of Health SciencesMeyer Children's HospitalUniversity of FlorenceFlorenceItaly
| | | | - Christian Kahlert
- Children's Hospital of Eastern Switzerland and Cantonal HospitalInfectious Diseases and Hospital EpidemiologySt GallenSwitzerland
| | | | - Laura Marques
- Centro Hospitalar e Universitário do PortoPortoPortugal
| | - Lars Naver
- Karolinska University Hospital and Karolinska InstitutetStockholmSweden
| | - Claire Thorne
- University College London Great Ormond Street Institute of Child HealthLondonUK
| | | | - Carlo Giaquinto
- Department of Women and Child HealthUniversity of PadovaPadovaItaly
| | - Ali Judd
- MRC Clinical Trials Unit at UCLLondonUK
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16
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Esperto F, Prata F, Civitella A, Tuzzolo P, Romei L, Crimi V, Deanesi N, Testa A, Scarpa R, Papalia R. Impact of robotic technologies on prostate cancer patient’s choice for radical treatment. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00963-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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17
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Esperto F, Prata F, Civitella A, Tuzzolo P, Romei L, Crimi V, Tedesco F, Bach T, Tanidir Y, Scarpa R, Papalia R. Ureteroscopy (URS) video consensus: a simple and effective way to improve awareness of patients undergoing URS. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00903-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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18
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Esperto F, Prata F, Civitella A, Tuzzolo P, Romei L, Crimi V, Cacciatore L, Taffon C, Crescenzi A, Scarpa R, Papalia R. Real time urethral and ureteral assessment during radical cystectomy using ex vivo optical imaging. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01199-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Esperto F, Civitella A, Tuzzolo P, Prata F, Cacciatore L, Crimi V, Scarpa R, Papalia R. ICG guided laparoscopic pelvic lymph node dissection for prostate cancer. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01629-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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20
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Esperto F, Prata F, Civitella A, Tuzzolo P, Romei L, Crimi V, Tedesco F, Bach T, Tanidir Y, Scarpa R, Papalia R. Ureteroscopy (URS) video consensus: A simple and effective way to improve awareness of patients undergoing URS. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00679-5] [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: 10/20/2022]
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21
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Picão de Carvalho C, Castro C, Sampaio Graça I, Lorenzo C, Barbosa Rodrigues A, Inácio R, Prata F, Mouzinho A, Pinto S, Marques JG. [Correction to the article "Case Series of 103 Children with SARS-CoV-2 Infection in Portugal", published on Acta Med Port 2020 Dec;33(12):795-802]. ACTA MEDICA PORT 2020; 33:861. [PMID: 33600746 DOI: 10.20344/amp.15256] [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] [Received: 11/06/2020] [Accepted: 11/06/2020] [Indexed: 11/20/2022]
Abstract
On page 801, fifth, where it reads: "No início da pandemia, teorizou-se que a vacina BCG pudesse ter um efeito protetor relativamente à COVID-19,27,28 mas não se encontrou até à data evidência para tal, não estando atualmente recomendada a vacinação BCG na prevenção da COVID-19.28,29 No nosso estudo, a maioria dos doentes (76%) tinha sido vacinada. Analisámos separadamente o subgrupo de crianças nascidas após janeiro de 2016, altura em que passaram a ser vacinadas apenas as crianças pertencentes a grupos de risco.30 A taxa de vacinação neste grupo foi de 51%, sendo superior à taxa de 30,1% estimada para crianças nascidas em Portugal com um ano de idade referido a 2019.31" It should read: "No início da pandemia, teorizou-se que a vacina BCG pudesse ter um efeito protetor relativamente à COVID-19,27,28 mas não se encontrou até à data evidência para tal, não estando atualmente recomendada a vacinação BCG na prevenção da COVID-19.28 No nosso estudo, a maioria dos doentes (76%) tinha sido vacinada. Analisámos separadamente o subgrupo de crianças nascidas após janeiro de 2016, altura em que passaram a ser vacinadas apenas as crianças pertencentes a grupos de risco.29 A taxa de vacinação neste grupo foi de 51%, sendo superior à taxa de 30,1% estimada para crianças nascidas em Portugal com um ano de idade referido a 2019.30" Paper published with errors: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/14537.
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Affiliation(s)
- Clara Picão de Carvalho
- Unidade de Infecciologia e Imunodeficiências. Departamento de Pediatria. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Portugal
| | - Carolina Castro
- Unidade de Infecciologia e Imunodeficiências. Departamento de Pediatria. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Portugal
| | - Isabel Sampaio Graça
- Unidade de Infecciologia e Imunodeficiências. Departamento de Pediatria. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Serviço de Cardiologia Pediátrica. Hospital de Santa Cruz. Centro Hospitalar Lisboa Ocidental. Oeiras. Portugal
| | - Cristina Lorenzo
- Unidade de Infecciologia e Imunodeficiências. Departamento de Pediatria. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Portugal
| | - Ana Barbosa Rodrigues
- Unidade de Infecciologia e Imunodeficiências. Departamento de Pediatria. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Portugal
| | - Rafael Inácio
- Unidade de Infecciologia e Imunodeficiências. Departamento de Pediatria. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Portugal
| | - Filipa Prata
- Unidade de Infecciologia e Imunodeficiências. Departamento de Pediatria. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Clínica Universitária de Pediatria. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal
| | - Ana Mouzinho
- Unidade de Infecciologia e Imunodeficiências. Departamento de Pediatria. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Clínica Universitária de Pediatria. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal
| | - Sara Pinto
- Unidade de Infecciologia e Imunodeficiências. Departamento de Pediatria. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Clínica Universitária de Pediatria. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal
| | - José Gonçalo Marques
- Unidade de Infecciologia e Imunodeficiências. Departamento de Pediatria. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Clínica Universitária de Pediatria. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Instituto de Medicina Molecular. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal
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22
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Picão de Carvalho C, Castro C, Sampaio Graça I, Lorenzo C, Barbosa Rodrigues A, Inácio R, Prata F, Mouzinho A, Pinto S, Marques JG. [Case Series of 103 Children with SARS-CoV-2 Infection in Portugal]. ACTA MEDICA PORT 2020; 33:795-802. [PMID: 32931727 DOI: 10.20344/amp.14537] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 07/30/2020] [Accepted: 07/31/2020] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The North Lisbon University Hospital Center was activated for referral of SARS-CoV-2 infected patients on the 11th March 2020. The aim of this study is to describe the experience at the Department of Pediatrics in the approach and the clinical outcomes of infected children. MATERIAL AND METHODS A descriptive observational study was performed. Children and adolescents (0 to 18 years) with SARS-CoV-2 infection, diagnosed in the emergency room or admitted to the Department of Pediatrics between March 11th and June 18th, were included. Hospital records and Trace COVID-19 platform were reviewed and patient caregivers were interviewed to assess follow up. RESULTS Among 103 diagnosed children, 83% had a known previous contact with an infected patient, 43% presented fever and 42% presented respiratory symptoms. Ten percent had risk factors and 21% were aged under one year old. Ten percent were hospitalised, one needing intensive care, with paediatric inflammatory multisystem syndrome. Blood tests were performed in 9% and chest radiograph in 7%. No children required ventilation, antiviral therapy or underwent thoracic computed tomography scan. Eight percent of children returned to the emergency room and one child was hospitalised. The clinical outcome is known in 101 patients and is favourable in all. DISCUSSION Most children had an epidemiological link and little clinical repercussion, even during the first year of life. The expected mild severity in children justified the use of established clinical criteria and recommendations for similar conditions, regarding tests and hospitalizations. No antiviral treatments were given due to lack of evidence of its benefits. CONCLUSION This strategy contributed to a low consumption of hospital resources and proved safe in this series.
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Affiliation(s)
- Clara Picão de Carvalho
- Unidade de Infecciologia e Imunodeficiências. Departamento de Pediatria. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Portugal
| | - Carolina Castro
- Unidade de Infecciologia e Imunodeficiências. Departamento de Pediatria. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Portugal
| | - Isabel Sampaio Graça
- Unidade de Infecciologia e Imunodeficiências. Departamento de Pediatria. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Serviço de Cardiologia Pediátrica. Hospital de Santa Cruz. Centro Hospitalar Lisboa Ocidental. Oeiras. Portugal
| | - Cristina Lorenzo
- Unidade de Infecciologia e Imunodeficiências. Departamento de Pediatria. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Portugal
| | - Ana Barbosa Rodrigues
- Unidade de Infecciologia e Imunodeficiências. Departamento de Pediatria. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Portugal
| | - Rafael Inácio
- Unidade de Infecciologia e Imunodeficiências. Departamento de Pediatria. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Portugal
| | - Filipa Prata
- Unidade de Infecciologia e Imunodeficiências. Departamento de Pediatria. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Clínica Universitária de Pediatria. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal
| | - Ana Mouzinho
- Unidade de Infecciologia e Imunodeficiências. Departamento de Pediatria. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Clínica Universitária de Pediatria. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal
| | - Sara Pinto
- Unidade de Infecciologia e Imunodeficiências. Departamento de Pediatria. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Clínica Universitária de Pediatria. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal
| | - José Gonçalo Marques
- Unidade de Infecciologia e Imunodeficiências. Departamento de Pediatria. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Clínica Universitária de Pediatria. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Instituto de Medicina Molecular. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal
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Romai L, Tuzzolo P, Civitella A, Prata F, Perini P, Crimi V, Esperto F, Muto G, Scarpa R, Papalia R. Bladder NIRS: a non-invasive method functional to distinguish between Detrusor Underactivity (DU) and Bladder Outlet Obstruction (BOO), in men with LUTS. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35639-1] [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: 11/25/2022] Open
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Papalia R, Panebianco V, Esperto F, Prata F, Civitella A, Tuzzolo P, Romai L, Perini P, Crimi V, Muto G, Scarpa R. Correlation of VI-RADS score 5 and pelvic lymph node involvement in bladder cancer using multiparametric MRI. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35636-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Prata F, Cordelli E, Esperto F, Civitella A, Tuzzolo P, Sicilia R, Merone M, Scarpa R, Soda P, Papalia R. Radiomic analysis of T2 and ADC mpMRI images in the diagnosis of clinical significant prostate cancer: An early experience. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)32888-3] [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: 11/25/2022] Open
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Slogrove AL, Schomaker M, Davies MA, Williams P, Balkan S, Ben-Farhat J, Calles N, Chokephaibulkit K, Duff C, Eboua TF, Kekitiinwa-Rukyalekere A, Maxwell N, Pinto J, Seage G, Teasdale CA, Wanless S, Warszawski J, Wools-Kaloustian K, Yotebieng M, Timmerman V, Collins IJ, Goodall R, Smith C, Patel K, Paul M, Gibb D, Vreeman R, Abrams EJ, Hazra R, Van Dyke R, Bekker LG, Mofenson L, Vicari M, Essajee S, Penazzato M, Anabwani G, Q. Mohapi E, N. Kazembe P, Hlatshwayo M, Lumumba M, Goetghebuer T, Thorne C, Galli L, van Rossum A, Giaquinto C, Marczynska M, Marques L, Prata F, Ene L, Okhonskaia L, Rojo P, Fortuny C, Naver L, Rudin C, Le Coeur S, Volokha A, Rouzier V, Succi R, Sohn A, Kariminia A, Edmonds A, Lelo P, Ayaya S, Ongwen P, Jefferys LF, Phiri S, Mubiana-Mbewe M, Sawry S, Renner L, Sylla M, Abzug MJ, Levin M, Oleske J, Chernoff M, Traite S, Purswani M, Chadwick EG, Judd A, Leroy V. The epidemiology of adolescents living with perinatally acquired HIV: A cross-region global cohort analysis. PLoS Med 2018; 15:e1002514. [PMID: 29494593 PMCID: PMC5832192 DOI: 10.1371/journal.pmed.1002514] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 01/24/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Globally, the population of adolescents living with perinatally acquired HIV (APHs) continues to expand. In this study, we pooled data from observational pediatric HIV cohorts and cohort networks, allowing comparisons of adolescents with perinatally acquired HIV in "real-life" settings across multiple regions. We describe the geographic and temporal characteristics and mortality outcomes of APHs across multiple regions, including South America and the Caribbean, North America, Europe, sub-Saharan Africa, and South and Southeast Asia. METHODS AND FINDINGS Through the Collaborative Initiative for Paediatric HIV Education and Research (CIPHER), individual retrospective longitudinal data from 12 cohort networks were pooled. All children infected with HIV who entered care before age 10 years, were not known to have horizontally acquired HIV, and were followed up beyond age 10 years were included in this analysis conducted from May 2016 to January 2017. Our primary analysis describes patient and treatment characteristics of APHs at key time points, including first HIV-associated clinic visit, antiretroviral therapy (ART) start, age 10 years, and last visit, and compares these characteristics by geographic region, country income group (CIG), and birth period. Our secondary analysis describes mortality, transfer out, and lost to follow-up (LTFU) as outcomes at age 15 years, using competing risk analysis. Among the 38,187 APHs included, 51% were female, 79% were from sub-Saharan Africa and 65% lived in low-income countries. APHs from 51 countries were included (Europe: 14 countries and 3,054 APHs; North America: 1 country and 1,032 APHs; South America and the Caribbean: 4 countries and 903 APHs; South and Southeast Asia: 7 countries and 2,902 APHs; sub-Saharan Africa, 25 countries and 30,296 APHs). Observation started as early as 1982 in Europe and 1996 in sub-Saharan Africa, and continued until at least 2014 in all regions. The median (interquartile range [IQR]) duration of adolescent follow-up was 3.1 (1.5-5.2) years for the total cohort and 6.4 (3.6-8.0) years in Europe, 3.7 (2.0-5.4) years in North America, 2.5 (1.2-4.4) years in South and Southeast Asia, 5.0 (2.7-7.5) years in South America and the Caribbean, and 2.1 (0.9-3.8) years in sub-Saharan Africa. Median (IQR) age at first visit differed substantially by region, ranging from 0.7 (0.3-2.1) years in North America to 7.1 (5.3-8.6) years in sub-Saharan Africa. The median age at ART start varied from 0.9 (0.4-2.6) years in North America to 7.9 (6.0-9.3) years in sub-Saharan Africa. The cumulative incidence estimates (95% confidence interval [CI]) at age 15 years for mortality, transfers out, and LTFU for all APHs were 2.6% (2.4%-2.8%), 15.6% (15.1%-16.0%), and 11.3% (10.9%-11.8%), respectively. Mortality was lowest in Europe (0.8% [0.5%-1.1%]) and highest in South America and the Caribbean (4.4% [3.1%-6.1%]). However, LTFU was lowest in South America and the Caribbean (4.8% [3.4%-6.7%]) and highest in sub-Saharan Africa (13.2% [12.6%-13.7%]). Study limitations include the high LTFU rate in sub-Saharan Africa, which could have affected the comparison of mortality across regions; inclusion of data only for APHs receiving ART from some countries; and unavailability of data from high-burden countries such as Nigeria. CONCLUSION To our knowledge, our study represents the largest multiregional epidemiological analysis of APHs. Despite probable under-ascertained mortality, mortality in APHs remains substantially higher in sub-Saharan Africa, South and Southeast Asia, and South America and the Caribbean than in Europe. Collaborations such as CIPHER enable us to monitor current global temporal trends in outcomes over time to inform appropriate policy responses.
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Affiliation(s)
| | - Amy L. Slogrove
- Center for Infectious Diseases Epidemiology and Research, University of Cape Town, Cape Town, South Africa
| | - Michael Schomaker
- Center for Infectious Diseases Epidemiology and Research, University of Cape Town, Cape Town, South Africa
| | - Mary-Ann Davies
- Center for Infectious Diseases Epidemiology and Research, University of Cape Town, Cape Town, South Africa
| | - Paige Williams
- Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Suna Balkan
- Epicentre, Médecins Sans Frontières, Paris, France
| | | | - Nancy Calles
- Baylor International Pediatric AIDS Initiative, Texas Children’s Hospital-USA, Houston, Texas, United States of America
| | | | - Charlotte Duff
- MRC Clinical Trials Unit at University College London, London, United Kingdom
| | - Tanoh François Eboua
- Yopougon University Hospital, University Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | | | - Nicola Maxwell
- Center for Infectious Diseases Epidemiology and Research, University of Cape Town, Cape Town, South Africa
| | - Jorge Pinto
- School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - George Seage
- Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Chloe A. Teasdale
- ICAP at Columbia University Mailman School of Public Health, New York, New York, United States of America
| | - Sebastian Wanless
- Baylor International Pediatric AIDS Initiative, Texas Children’s Hospital-USA, Houston, Texas, United States of America
| | - Josiane Warszawski
- Inserm (French Institute of Health and Medical Research), CESP UMR Villejuif, France
| | - Kara Wools-Kaloustian
- Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Marcel Yotebieng
- College of Public Health, Ohio State University, Columbus, Ohio, United States of America
| | - Venessa Timmerman
- Center for Infectious Diseases Epidemiology and Research, University of Cape Town, Cape Town, South Africa
| | - Intira J. Collins
- MRC Clinical Trials Unit at University College London, London, United Kingdom
| | - Ruth Goodall
- MRC Clinical Trials Unit at University College London, London, United Kingdom
| | - Colette Smith
- MRC Clinical Trials Unit at University College London, London, United Kingdom
| | - Kunjal Patel
- Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Mary Paul
- Baylor International Pediatric AIDS Initiative, Texas Children’s Hospital-USA, Houston, Texas, United States of America
| | - Diana Gibb
- MRC Clinical Trials Unit at University College London, London, United Kingdom
| | - Rachel Vreeman
- Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Elaine J. Abrams
- ICAP at Columbia University Mailman School of Public Health, New York, New York, United States of America
| | - Rohan Hazra
- National Institute of Child Health and Human Development (NICHD), US National Institutes of Health, Rockville, Maryland, United States of America
| | - Russell Van Dyke
- Tulane University, New Orleans, Louisiana, United States of America
| | - Linda-Gail Bekker
- Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa
| | - Lynne Mofenson
- Elizabeth Glaser Pediatric AIDS Foundation, Washington, DC, United States of America
| | | | | | | | - Gabriel Anabwani
- Baylor International Pediatric AIDS Initiative, Gaborone, Botswana
| | - Edith Q. Mohapi
- Baylor International Pediatric AIDS Initiative, Maseru, Lesotho
| | - Peter N. Kazembe
- Baylor International Pediatric AIDS Initiative, Lilongwe, Malawi
| | | | - Mwita Lumumba
- Baylor International Pediatric AIDS Initiative, Mbeya, Tanzania
| | | | - Claire Thorne
- Institute of Child Health, University College London, London, United Kingdom
| | - Luisa Galli
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Annemarie van Rossum
- Erasmus MC University Medical Center Rotterdam-Sophia Children’s Hospital, Rotterdam, the Netherlands
| | | | - Magdalena Marczynska
- Medical University of Warsaw, Hospital of Infectious Diseases in Warsaw, Warsaw, Poland
| | | | | | | | - Liubov Okhonskaia
- Republican Hospital of Infectious Diseases, St Petersburg, Russian Federation
| | | | - Claudia Fortuny
- Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
| | - Lars Naver
- Karolinska University Hospital, Stockholm, Sweden
| | | | - Sophie Le Coeur
- Institut de Recherche pour le Développement (IRD) 174/PHPT, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
- Institut National d'Etudes Démograhiques (Ined), F-75020 Paris, France
| | - Alla Volokha
- Shupyk National Medical Academy of Postgraduate Education, Kiev, Ukraine
| | | | - Regina Succi
- Universidade Federal de São Paulo, São Paulo, Brazil
| | | | | | - Andrew Edmonds
- Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Patricia Lelo
- Pediatric Hospital Kalembe Lembe, Lingwala, Kinshasa, Democratic Republic of Congo
| | - Samuel Ayaya
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
| | - Patricia Ongwen
- Family AIDS Care and Education Services, Kenya Medical Research Institute, Kisumu, Kenya
| | | | - Sam Phiri
- Lighthouse Trust Clinic, Lilongwe, Malawi
| | | | - Shobna Sawry
- Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Harriet Shezi Children’s Clinic, Chris Hani Baragwanath Hospital, Johannesburg, South Africa
| | - Lorna Renner
- University of Ghana School of Medicine and Dentistry, Accra, Ghana
| | | | - Mark J. Abzug
- University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, Colorado, United States of America
| | - Myron Levin
- University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, Colorado, United States of America
| | - James Oleske
- Rutgers New Jersey Medical School, Newark, New Jersey, United States of America
| | - Miriam Chernoff
- Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Shirley Traite
- Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Murli Purswani
- Bronx-Lebanon Hospital Center (Icahn School of Medicine at Mount Sinai), Bronx, New York, United States of America
| | - Ellen G. Chadwick
- Feinberg School of Medicine, Northwestern University, Evanston, Illinois, United States of America
| | - Ali Judd
- MRC Clinical Trials Unit at University College London, London, United Kingdom
- * E-mail: (AJ); (VL)
| | - Valériane Leroy
- Inserm (French Institute of Health and Medical Research), UMR 1027 Université Toulouse 3, Toulouse, France
- * E-mail: (AJ); (VL)
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Judd A, Chappell E, Turkova A, Le Coeur S, Noguera-Julian A, Goetghebuer T, Doerholt K, Galli L, Pajkrt D, Marques L, Collins IJ, Gibb DM, González Tome MI, Navarro M, Warszawski J, Königs C, Spoulou V, Prata F, Chiappini E, Naver L, Giaquinto C, Thorne C, Marczynska M, Okhonskaia L, Posfay-Barbe K, Ounchanum P, Techakunakorn P, Kiseleva G, Malyuta R, Volokha A, Ene L, Goodall R. Long-term trends in mortality and AIDS-defining events after combination ART initiation among children and adolescents with perinatal HIV infection in 17 middle- and high-income countries in Europe and Thailand: A cohort study. PLoS Med 2018; 15:e1002491. [PMID: 29381702 PMCID: PMC5790238 DOI: 10.1371/journal.pmed.1002491] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 12/13/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Published estimates of mortality and progression to AIDS as children with HIV approach adulthood are limited. We describe rates and risk factors for death and AIDS-defining events in children and adolescents after initiation of combination antiretroviral therapy (cART) in 17 middle- and high-income countries, including some in Western and Central Europe (W&CE), Eastern Europe (Russia and Ukraine), and Thailand. METHODS AND FINDINGS Children with perinatal HIV aged <18 years initiating cART were followed until their 21st birthday, transfer to adult care, death, loss to follow-up, or last visit up until 31 December 2013. Rates of death and first AIDS-defining events were calculated. Baseline and time-updated risk factors for early/late (≤/>6 months of cART) death and progression to AIDS were assessed. Of 3,526 children included, 32% were from the United Kingdom or Ireland, 30% from elsewhere in W&CE, 18% from Russia or Ukraine, and 20% from Thailand. At cART initiation, median age was 5.2 (IQR 1.4-9.3) years; 35% of children aged <5 years had a CD4 lymphocyte percentage <15% in 1997-2003, which fell to 15% of children in 2011 onwards (p < 0.001). Similarly, 53% and 18% of children ≥5 years had a CD4 count <200 cells/mm3 in 1997-2003 and in 2011 onwards, respectively (p < 0.001). Median follow-up was 5.6 (2.9-8.7) years. Of 94 deaths and 237 first AIDS-defining events, 43 (46%) and 100 (42%) were within 6 months of initiating cART, respectively. Multivariable predictors of early death were: being in the first year of life; residence in Russia, Ukraine, or Thailand; AIDS at cART start; initiating cART on a nonnucleoside reverse transcriptase inhibitor (NNRTI)-based regimen; severe immune suppression; and low BMI-for-age z-score. Current severe immune suppression, low current BMI-for-age z-score, and current viral load >400 c/mL predicted late death. Predictors of early and late progression to AIDS were similar. Study limitations include incomplete recording of US Centers for Disease Control (CDC) disease stage B events and serious adverse events in some countries; events that were distributed over a long time period, and that we lacked power to analyse trends in patterns and causes of death over time. CONCLUSIONS In our study, 3,526 children and adolescents with perinatal HIV infection initiated antiretroviral therapy (ART) in countries in Europe and Thailand. We observed that over 40% of deaths occurred ≤6 months after cART initiation. Greater early mortality risk in infants, as compared to older children, and in Russia, Ukraine, or Thailand as compared to W&CE, raises concern. Current severe immune suppression, being underweight, and unsuppressed viral load were associated with a higher risk of death at >6 months after initiation of cART.
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Affiliation(s)
| | - Ali Judd
- MRC Clinical Trials Unit, University College London (UCL), London, United Kingdom
- * E-mail:
| | - Elizabeth Chappell
- MRC Clinical Trials Unit, University College London (UCL), London, United Kingdom
| | - Anna Turkova
- MRC Clinical Trials Unit, University College London (UCL), London, United Kingdom
| | - Sophie Le Coeur
- Institut National d'Etude Demographique (INED), Mortality, Health and Epidemiology Unit, Paris, France
- Institut de Recherche pour le Developpement (IRD), UMI 174/PHPT, Chiang Mai, Thailand
| | - Antoni Noguera-Julian
- Unitat d’Infectologia, Servei de Pediatria, Hospital Sant Joan de Deu, Universitat de Barcelona, Barcelona, Spain
| | | | - Katja Doerholt
- St George’s Healthcare NHS Trust, London, United Kingdom
| | - Luisa Galli
- Department of Health Sciences, Pediatric Unit, University of Florence, Florence, Italy
| | - Dasja Pajkrt
- Department of Pediatric Infectious Diseases, Emma Children’s Hospital, Academic Medical Center, Amsterdam, the Netherlands
| | | | - Intira J. Collins
- MRC Clinical Trials Unit, University College London (UCL), London, United Kingdom
| | - Diana M. Gibb
- MRC Clinical Trials Unit, University College London (UCL), London, United Kingdom
| | | | - Marisa Navarro
- Hospital General Universitario "Gregorio Marañón", Madrid, Spain
| | - Josiane Warszawski
- Institut National de la Santé et de la Recherche (INSERM), Paris, France
| | - Christoph Königs
- University Hospital Frankfurt, Department of Paediatrics, Goethe University, Frankfurt, Germany
| | - Vana Spoulou
- University of Athens Medical School, Athens, Greece
| | | | - Elena Chiappini
- Department of Health Sciences, Pediatric Unit, University of Florence, Florence, Italy
| | - Lars Naver
- Karolinska University Hospital, Stockholm, Sweden
| | - Carlo Giaquinto
- Paediatric European Network for the Treatment of AIDS (PENTA), Padova, Italy
| | - Claire Thorne
- UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | | | | | | | | | | | - Galina Kiseleva
- Shupyk National Medical Academy of Postgraduate Education, Kiev, Ukraine
| | - Ruslan Malyuta
- Perinatal Prevention of AIDS Initiative, Odessa, Ukraine
| | - Alla Volokha
- Shupyk National Medical Academy of Postgraduate Education, Kiev, Ukraine
| | | | - Ruth Goodall
- MRC Clinical Trials Unit, University College London (UCL), London, United Kingdom
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Espí Rito Santo R, Salgado C, Prata F, Mouzinho A. Ptosis, miosis and cats. BMJ Case Rep 2017; 2017:bcr-2017-219673. [PMID: 28839109 DOI: 10.1136/bcr-2017-219673] [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] [Indexed: 11/04/2022] Open
Abstract
Horner's syndrome (HS) is caused by a disruption in the oculosympathetic pathway. Both congenital and acquired HS are unusual in children. Acquired HS can be caused by trauma, surgical intervention, tumours, vascular malformations or infection.We describe the case of a 6-year-old boy who was brought to our emergency department with ptosis, miosis, painful cervical lymphadenopathy and a cat scratch on a hand. The diagnosis of a cat scratch disease was confirmed by serology. A full recovery was observed on antibiotic treatment and cervical lymphadenomegaly reduction 3 weeks later.
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Affiliation(s)
- Rita Espí Rito Santo
- Departamento de Pediatria, Hospital Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
| | - Catarina Salgado
- Departamento de Pediatria, Hospital Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
| | - Filipa Prata
- Departamento de Pediatria, Hospital Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
| | - Ana Mouzinho
- Departamento de Pediatria, Hospital Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
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Oliveira L, Esteves IC, Prata F, Tapadinhas C, Guerreiro C, Marques JG. Newborn with unexpected skin lesions. JAMA Pediatr 2014; 168:91-2. [PMID: 24394977 DOI: 10.1001/jamapediatrics.2013.3440] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Lia Oliveira
- Pediatric Department, Hospital de Santa Maria, Lisbon, Portugal
| | - Isabel Castro Esteves
- Pediatric Infectious Diseases, Pediatric Department, Hospital de Santa Maria, Lisbon, Portugal
| | - Filipa Prata
- Pediatric Infectious Diseases, Pediatric Department, Hospital de Santa Maria, Lisbon, Portugal
| | | | - Cristina Guerreiro
- Gynecology-Obstetrics Department, Alfredo da Costa Maternity Hospital, Lisbon, Portugal
| | - José Gonçalo Marques
- Pediatric Infectious Diseases, Pediatric Department, Hospital de Santa Maria, Lisbon, Portugal
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Pinto S, Prata F, Moreno T. Acute bilateral ptosis as the sole manifestation of neurocysticercosis in a child. Pediatr Neurol 2013; 49:518-9. [PMID: 23958288 DOI: 10.1016/j.pediatrneurol.2013.06.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 06/10/2013] [Accepted: 06/27/2013] [Indexed: 11/26/2022]
Affiliation(s)
- Sara Pinto
- Department of Paediatrics, Hospital de Santa Maria, Lisbon, Portugal.
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Abstract
A newborn of 26 days, born in Lisbon, Portugal, presented with fever, anaemia and thrombocytopaenia. She was admitted considering neonatal sepsis, but Plasmodium vivax was identified in the second peripheral blood smear performed. Parenteral quinine was started with good evolution. Despite clinicians' unfamiliarity with congenital malaria in non-endemic areas, this diagnosis, although rare, should not be forgotten in the evaluation of newborns/infants born to women from endemic areas or with recent trip to these areas.
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Affiliation(s)
- Ana Rita Prior
- Department of Pediatrics, Hospital Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal.
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De Windt W, Boon N, Van den Bulcke J, Rubberecht L, Prata F, Mast J, Hennebel T, Verstraete W. Biological control of the size and reactivity of catalytic Pd(0) produced by Shewanella oneidensis. Antonie van Leeuwenhoek 2006; 90:377-89. [PMID: 17033880 DOI: 10.1007/s10482-006-9088-4] [Citation(s) in RCA: 107] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2006] [Accepted: 05/11/2006] [Indexed: 11/29/2022]
Abstract
The interaction between Shewanella oneidensis MR-1 and the soluble metal Pd(II) during the reductive precipitation of Pd(0) determined the size and properties of the precipitated Pd(0) nanoparticles. Assessment of cell viability indicated that the bioreduction of Pd(II) was a detoxification mechanism depending on the Pd(II) concentration and on the presence and properties of the electron donor. The addition of H(2) in the headspace allowed S. oneidensis to resist the toxic effects of Pd(II). Interestingly, 25 mM formate was a less effective electron donor for bioreductive detoxification of Pd(II), since there was a 2 log reduction of culturable cells and a 20% decrease of viable cells within 60 min, followed by a slow recovery. When the ratio of Pd:cell dry weight (CDW) was below 5:2 at a concentration of 50 mg l(-1) Pd(II), most of the cells remained viable. These viable cells precipitated Pd(0) crystals over a relatively larger bacterial surface area and had a particle area that was up to 100 times smaller when compared to Pd(0) crystals formed on non-viable biomass (Pd:CDW ratio of 5:2). The relatively large and densely covering Pd(0) crystals on non-viable biomass exhibited high catalytic reactivity towards hydrophobic molecules such as polychlorinated biphenyls, while the smaller and more dispersed nanocrystals on a viable bacterial carrier exhibited high catalytic reactivity towards the reductive degradation of the anionic pollutant perchlorate.
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Affiliation(s)
- Wim De Windt
- Laboratory of Microbial Ecology and Technology (LabMET), Ghent University, Coupure Links 653, B-9000, Gent, Belgium
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