Background Interventions to tackle the COVID-19 pandemic may affect the burden of other respiratory diseases. Considering the repercussion of these unique social experiences in infant’s health, this study aims to assess the early impact of social distancing due to the COVID-19 pandemic in hospital admissions for acute bronchiolitis. Methods Data from hospitalizations of acute bronchiolitis in infants under one year were obtained from the Department of Informatics of the Brazilian Public Health database (DATASUS) for the period between 2016 and 2020. These data were also analyzed by macro-regions of Brazil (North, Northeast, Southeast, South and Midwest). To evaluate the effect of social distancing strategy on the incidence of acute bronchiolitis, the absolute and relative reduction was calculated by analyzing the yearly subsets of 2016vs2020, 2017vs2020, 2018vs2020, and 2019vs2020. Results There was a significant reduction in all comparisons, ranging from -78% [IRR 0.22 (0.20 to 0.24)] in 2016vs2020 at -85% [IRR 0.15 (0.13 to 0.16)] in 2019vs2020, for the data from Brazil. For analyzes by macro-regions, the reduction varied from -58% [IRR 0.41 (0.37 to 0.45)] in the Midwest in 2016vs2020 to -93% [IRR 0.07 (0.06 to 0.08)] in the South in 2019vs2020. Conclusions There was a significant reduction in hospitalization for acute bronchiolitis in children under one year old, in Brazil, of the order of more than 70% for most analysis. Our data suggest an important impact of social distance on reducing the transmission of viruses related to acute bronchiolitis. Such knowledge may guide strategies for prevention of viruses spread.

Introduction Pertussis is an important public health problem worldwide, especially in infants. An increase in the incidence in many countries occurred after 2010, including Brazil. In 2013, dTpa vaccine was introduced in the Brazil national immunization schedule of pregnant women. The objective of this study was to evaluate the national trends in the incidence of pertussis in Brazil in children under 1 year old, and the impact of the introduction of dTpa vaccine during pregnancy. Methods The incidence of hospitalizations and non-hospitalized confirmed cases of pertussis in neonates (< 1 month age) and young infants (1 month-< 1 year age) were analyzed, comparing the incidence in pre maternal vaccination (2011-2013) with the post-vaccination (2015-2017). We used non-respiratory hospitalizations as comparison, during the same period. A database of the Brazilian Ministry of Health (DATASUS) was used to analyze cases from 2007 to 2017 and the subsets of 2011-2013 and 2015-2017, after Pertussis resurgence. The vaccination data was accessed through the link of the Information System of the National Immunization Program (pni.datasus.gov.br). Results Between 2007 and 2017, 17,818 children under one year of age were hospitalized due to pertussis in Brazil. In the pre maternal vaccination period 2011-2013, the mean annual incidence of non-hospitalized confirmed cases of pertussis in children under 1 month was 722.2 / 100,000 and in the period of 2015-2017 the average was 377.3 / 100,000, representing a decrease of 47.7% [IRR 0.52 (0.46-0.59)]. At those periods of time, the average incidence per year for children of one month-< 1 year aged was 64.9 / 100,000 (2011-2013) and 29.3 / 100,000 (2015-2017) [IRR 0.45 (CI 0.29-0.69)].

Asthma hospitalization rates significantly decreased in the three-year period after the provision of free medicines to treat asthma. Our findings suggest that the provision of free medications for asthma may have a particular public health impact by its own in developing countries.

OM-85 BV for primary prevention of recurrent airway infections: a pilot randomized, double-blind, placebo-controlled study OM-85 BV para prevenção primária de infecções recorrentes das vias aéreas: estudo piloto, randomizado, duplo-cego, placebo-controlado

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Severe therapy-resistant asthma (STRA) is closely associated with distinct clinical and inflammatory pheno-endotypes, which may contribute to the development of age-related comorbidities. Evidence has demonstrated a contribution of accelerated telomere shortening on the poor prognosis of respiratory diseases in adults. Eotaxin-1 (CCL11) is an important chemokine for eosinophilic recruitment and the progression of asthma. In the last years has also been proposed as an age-promoting factor. This study aimed to investigate the association of relative telomere length (rTL) and eotaxin-1 in asthmatic children. Children aged 8-14 years (n=267) were classified as healthy control (HC, n=126), mild asthma (MA, n=124) or severe therapy-resistant asthma (STRA, n=17). rTL was performed by qPCR from peripheral blood. Eotaxin-1 was quantified by ELISA from fresh-frozen plasma. STRA had shorter telomeres compared to HC ( p =0.02) and MA ( p =0.006). Eotaxin-1 levels were up-regulated in STRA [median; IQR25-75)] [(1,190 pg/mL; 108–2,510)] compared to MA [(638 pg/mL; 134–1,460)] ( p =0.03) or HC [(627 pg/mL; 108–1,750)] ( p <0.01). Additionally, shorter telomeres were inversely correlated with eotaxin-1 levels in STRA (r=-0.6, p =0.013). Our results suggest that short telomeres and up-regulated eotaxin-1, features of accelerated aging, could prematurely contribute to a senescent phenotype increasing the risk for early development of age-related diseases in asthma.

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Objetivos: verificar o número e as causas de hospitalizações por quedas em idosos brasileiros, além dos gastos federais do Sistema Único de Saúde (SUS), no período de 2000 a 2018.Métodos: trata-se de um estudo ecológico, utilizando informações disponíveis na base de dados do Departamento de Informática do SUS. Foram coletados dados de idosos (≥60 anos) que internaram no SUS devido às quedas no período de 2000 a 2018 no Brasil. Extraíram-se o número de hospitalizações no País e nas regiões (Norte, Nordeste, Sul, Sudeste e Centro-Oeste), as causas das quedas (Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde – 10) e o valor de gastos federais. Para fins estatísticos, utilizou-se análise descritiva.Resultados: totalizaram-se 1,48 milhões de hospitalizações por quedas em idosos no Brasil, com uma taxa de 38,6 a cada 10 mil. As principais causas desses registros no DATASUS foram as “quedas sem especificações”, as “outras quedas no mesmo nível” e as “quedas no mesmo nível por escorregão, tropeção ou passos em falsos”. Em relação às localidades, os idosos pertencentes às regiões Sudeste (47,1), Sul (44,1) e Centro-Oeste (40,4) foram aqueles que apresentaram maiores medianas das taxas de hospitalizações por quedas no período analisado. Entretanto, o Nordeste (variação%=0,4), o Sul (variação%=0,2) e o Centro-Oeste (variação%=0,2) demonstraram maiores elevações desse indicador ao longo dos 18 anos, enquanto apenas a região Norte apresentou redução (variação%=-0,5). A mediana de gastos hospitalares federais (milhões) foi de R$135,58, variando de R$112,89 até R$194,98.Conclusões: houve aumento das taxas de hospitalizações por quedas em idosos no SUS em quase todas as unidades federativas. As causas mais frequentes foram as “quedas sem especificações”, as “outras quedas no mesmo nível” e as “quedas no mesmo nível por escorregão, tropeção ou passos em falsos”. Além disso, ocorreu elevação dos gastos hospitalares federais ao longo do período no País.