Measles is an extremely contagious viral disease. Even though a safe vaccine exists for this disease, it remains one of the leading causes of mortality and morbidity in infants and young children. We aimed to create a retrospective descriptive study in which to analyze the evolution of the measles epidemic at the European level. The documentation was carried out using European Centre for Disease Prevention and Control (ECDC) and World Health Organization (WHO) statistics. At the same time, we present the epidemic's evolution in Romania, using data provided by the Romanian National Institute of Public Health and Ministry of Health. European statistical data indicate a high number of patients diagnosed with measles both among children and adults. All European countries benefit from the measles vaccination in the form of the measles-mumps-rubella (MMR) trivaccine included in their National Vaccination Programme. The vaccination schedule varies from country to country. In the vaccination scheme, most European countries include two doses of the MMR vaccine among the pediatric population. Romania registered a limited number of cases of measles between 1980 and 2015 following the introduction of the measles vaccination in the National Vaccination Programme. Since 2005, the Romanian vaccination schedule includes two doses of MMR trivaccine, administered at 12 months and at 6-7 years. After 2015, as a result of a significant decrease in the number of vaccinated children, Romania is facing a major increase in the cases of measles. Consecutively, a measles epidemic was declared in 2016 and an additional dose of mandatory MMR trivaccine was introduced at the age of 9 months. After 4 years of this schedule of administration, starting with August 2020, the additional dose of MMR administered during infancy has been discontinued. We propose an analysis of the factors that influenced the downward evolution of the measles epidemic in Romania at the beginning of the third millennium. Issues related to the limitation of interpersonal contact in the context of the social distancing imposed by the Sars-CoV-2 virus pandemic are discussed. We consider necessary a detailed documentation of the percentage of new disease cases that will appear in the pediatric population in the near future, in the context of the resumption of daily activity after the reopening of nurseries, kindergartens and schools.
unavoidable. The positive identification of the aeroallergen that is responsible for allergic rhinitis symptoms is of great importance for choosing the right therapeutic approach.
Objectives and studyCow’s milk protein allergy (CMPA) has increased in prevalence in recent years. CMPA becomes a public health problem in terms of the impact it has on the child and family. Allergy to cow’s milk protein is characterised by clinical polymorphism, that is why it is sometimes difficult to diagnose, especially in primary care services. To facilitate this process, we intend to bring into clinical care some possible portraits of the patients with CMPA.We described a retrospective study, analysing the records of patients admitted to Children’s Hospital ’Dr. Victor Gomoiu ‘and diagnosed with APLV in the period January 2013 – December 2016.MethodsDuring the study were analysed the observation charts of patients hospitalised in the paediatric clinic who were diagnosed with CMPA. The parameters analysed were age, gender, reasons for hospitalisation, personal history, family history of allergies/atopy, type of nutrition in the postnatal period and time of diversification, anthropometric data of stature-weight development, laboratory tests. The study included 110 patients aged between 1–174 months (14 years 6 months), of which 56.4% are female and 43.6% male. 36.46% patients diagnosed with CMP are infants, 34.54% are preschoolers and 20% are schoolchildren.ResultsBy analysing the parameters mentioned we shaped patterns correlated with patients age: for example, infant with CMPA have digestive symptoms and unsatisfying weight curve, atopic dermatitis, they are artificially fed with a family history of atopy.ConclusionCMPA is a polymorphic entity, both by the symptoms and by the wide range of age of patients with this condition. Thus shaping clinical profiles could ease diagnosing CMPA and can become a useful tool especially in primary care.
Dietary side effects represent an increasingly prevalent public health issue worldwide. The proper illustration of the differences between food allergies, which involve immunological mechanisms, either IgE or non-IgE mediated, and food intolerances, which appear without immune involvement, is critical for establishing subsequent diagnostic and therapeutic options. Current medical research aims to study the pathogenesis of food allergies in order to develop new therapeutic tools.The existence of an abundance of modulating environmental factors, which act upon a genetic substrate entail a wide phenotypic variability of allergic reactions that leads to complex clinical manifestations. A comprehensive and correct diagnosis followed by prompt, adequate preventive measures, an adequate therapeutic approach, allow the maintaining of a proper nutritional status and psycho-behavioural development, the goal being to establish good quality of life for these patients.Food allergies are a major public health problem. Statistic data concerning the incidence and prevalence of food allergies in children vary. They depend on multiple parameters, such as age, sex, diet, existing comorbidities, genetic factor, socioeconomic factors, geographical area etc. In the general population, food allergies have a medically documented incidence of 10.8%, affecting around 8% of children and 3.7% of adults [1]. Approximately 6%–8% of children under the age of 2 will develop this disorder [2], which in 80% of cases will recede until school age [3]. The vast majority of proteic food allergies (60%) are IgE mediated. In most cases, these appear with exposure to a single type of food and in 35% of cases multiple food allergies are noted [1]. The most frequent type of food allergy in the first years of life is milk protein allergy, which affects 21.1% of children with documented food allergies [1].The trigger of the allergic reaction involves the interaction between food allergen, gastrointestinal barrier and immune system. Gastrointestinal tract is a complex ecosystem, its functions and components ensuring the absorption of nutrients from the ingested food. Furthermore, it is involved in the intestinal immune activity by averting pathogenic agents from entering the body. The intestinal immune components consist of gut-associated lymphoid tissue (GALT), mucosa associated lymphoid tissue (MALT), secretory IgA, effector immune cells (helper and suppressor T cells, macrophages, plasmocytes). Payer’s patches, the enterocytes and the intercellular junctions have the role of macromolecular passageway [6]. The non-immunologic barrier consists of: gastric pH, intestinal mucus, commensal microflora, lactoferrin etc. These components are underdeveloped in infants and toddlers. Therefore, enzymatic activity is reduced and the IgA secretion rate reaches normal values around the age of 4 years, features that determine a high prevalence of food allergies in these age groups [4]. The most significant risk factors involved in developing food allergies are immaturity...
Introduction. SARS-CoV-2 infection has put humanity to the test since December 2019, quickly becoming a global public health problem. There is a significant difference between the pediatric population versus the adult population in terms of infection rate, modes of transmission, clinical manifestations. The study aimed to identify some patterns of clinical presentation of SARS-CoV-2 infection in the pediatric population in “Dr. Victor Gomoiu“ Children’s Clinical Hospital in 2020, also following any possible variations between the first two waves of the pandemic. Materials and methods. The study was based on the descriptive observational analysis of two groups of SARS-CoV-2 positive patients, corresponding to the two pandemic waves. Patients were classified into some clinical patterns, using the definition of suspected / confirmed case established by the National Institute of Public Health (INSP) and transmitted through the National Center for Surveillance and Control of Communicable Diseases (CNSCBT), as well as the recommendations of the international guidelines and protocols. Results. There are found to be present some mild clinical forms of the disease secondary to SARS-CoV-2 virus infection, most children showing digestive symptoms. Starting with August (Group 2) there is a significant increase in the number of cases, as well as the appearance of a larger number of cases that associated respiratory symptoms. Conclusions. The study is showing the low impact of the SARS-CoV-2 virus infection in the pediatric population, compared to adults, especially in the first wave of the pandemic, the children having been considered “the hidden victims” of the pandemic, rather than its face. It is considered necessary the long-term monitoring of SARS-CoV-2 infected children, as the remote consciousness of the infection having been incompletely elucidated. Analyzing the epidemiological data obtained in the study, we are concluding the need for some sustained global efforts to define, more clearly, the variations in the patterns of the presentation of SARS-CoV-2 infection in children, in the context of the evolution of the pandemic.
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