Recurrent respiratory infections (RRIs) are a common clinical condition in children, in fact about 25% of children under 1 year and 6% of children during the first 6 years of life have RRIs. In most cases, infections occur with mild clinical manifestations and the frequency of episodes tends to decrease over time with a complete resolution by 12 years of age. However, RRIs significantly reduce child and family quality of life and lead to significant medical and social costs.Despite the importance of this condition, there is currently no agreed definition of the term RRIs in the literature, especially concerning the frequency and type of infectious episodes to be considered. The aim of this consensus document is to propose an updated definition and provide recommendations with the intent of guiding the physician in the complex process of diagnosis, management and prevention of RRIs.
Rotavirus P[8]G9 was recognized as the most widespread genotype during a sentinel-based survey inItaly; phylogenetic analysis of the VP7 and VP4 genes showed that Italian isolates constituted a closely related genetic cluster distinct from the other G9 strains recently isolated in other European countries, America, and Asia.Rotavirus, the most common cause of gastroenteritis in infants and young children, presents an outer capsid composed of the VP4 and VP7 structural proteins, which expose the major antigen determinants capable of inducing neutralizing antibodies. The antigenic and molecular characteristics of VP4 and VP7 allow subdivision into two serogenotypes, P and G.The different approaches followed for the development of the two new rotavirus vaccines-a monovalent live attenuated vaccine containing a P1A[8]G1 strain (Rotarix; GlaxoSmithKline Biologicals) and a pentavalent bovine-human G1 to G4, P[8] reassortant vaccine (RotaTeq; Merck and Sanofi Pasteur MSD)-and the lack of clear data about the heterotypic protection both underline the importance of virological surveillance and strain characterization (11,18,22).Virological surveillance is spotty and largely incomplete, and in most regions of the world, including developed countries, the epidemiological picture is based mainly on specimens collected from hospitalized children (6,9,17,20,24). Data about genotype circulation in the general outpatient pediatric population are largely missing.In this article, the genotype distribution of rotavirus strains detected in stools collected from children ranging in age from newborn to 5 years during a large community surveillance is presented, and the molecular characterization of emerging types is shown in relation to the epidemiological aspects.In Italy, primary health care is provided by community pediatricians who monitor physical and psychosocial growth and development, promote age-appropriate screening, establish the first contact with the patient for diagnosis and treatment of acute and chronic disorders, and coordinate the management of health problems requiring multiple professional services. Each pediatrician surveys about 800 children ranging in age from newborn to 14 years.The sentinel-based network for rotavirus surveillance was organized in 2004 with 10 primary care pediatricians who surveyed globally 3,611 children, ranging in age from newborn to 5 years, living in Leghorn, Italy. Stratification by age range formed groups of 741, 747, 711, 708, and 705 children in the ranges of newborn to 11 months, 12 to 23 months, 24 to 35 months, 36 to 47 months, and 48 to 59 months, respectively. This sample corresponds to 24% of the entire population of newborns to 5-year-olds in the district. Pediatricians reported on a weekly basis the number of new cases of gastroenteritis, defined as the occurrence of three or more watery stools in a period of 24 h (22). The survey lasted for 12 months, from April 2005 to April 2006. Stool samples were collected from every child with gastroenteritis, stored at Ϫ20°C, and sent...
A community sentinel pediatrician-based epidemiological and virological surveillance study was conducted to estimate the incidence of gastroenteritis and laboratory-confirmed rotavirus-associated disease. The 1-year cumulative incidence of gastroenteritis in the cohort of children aged 0-5 years was 21%, with the highest rates in the 7-12-month and 13-18-month age groups (41.1% and 41.7%, respectively). Approximately one-third of gastroenteritis cases requiring an office visit or telephone consultation were attributable to rotavirus infection.
Background In 2019, a multidisciplinary panel of experts from eight Italian scientific paediatric societies developed a consensus document for the use of inhaled corticosteroids in the management and prevention of the most common paediatric airways disorders. The aim is to provide healthcare providers with a multidisciplinary document including indications useful in the clinical practice. The consensus document was intended to be addressed to paediatricians who work in the Paediatric Divisions, the Primary Care Services and the Emergency Departments, as well as to Residents or PhD students, paediatric nurses and specialists or consultants in paediatric pulmonology, allergy, infectious diseases, and ear, nose, and throat medicine. Methods Clinical questions identifying Population, Intervention(s), Comparison and Outcome(s) were addressed by methodologists and a general agreement on the topics and the strength of the recommendations (according to the GRADE system) was obtained following the Delphi method. The literature selection included secondary sources such as evidence-based guidelines and systematic reviews and was integrated with primary studies subsequently published. Results The expert panel provided a number of recommendations on the use of inhaled corticosteroids in preschool wheezing, bronchial asthma, allergic and non-allergic rhinitis, acute and chronic rhinosinusitis, adenoid hypertrophy, laryngitis and laryngospasm. Conclusions We provided a multidisciplinary update on the current recommendations for the management and prevention of the most common paediatric airways disorders requiring inhaled corticosteroids, in order to share useful indications, identify gaps in knowledge and drive future research.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.