Abstract
Background
It is known that SARS-CoV-2 antibodies from pregnant women with SARS-CoV-2 infection during pregnancy cross the placenta but the duration and the protective effect of these ...antibodies in infants is scarce.
Methods
This prospective study included mothers with SARS-COV-2 infection during pregnancy and their infants from April 2020 to March 2021. IgG antibodies to SARS-CoV-2 spike protein were performed on women and infants at birth and at two and six months during follow-up. Anthropometrical measures and physical and neurological examinations and a clinical history of symptoms and COVID-19 diagnosis were collected. Simple linear regression was performed to compare categorical and continuous variables. To compare the mother’s and infant’s antibody titers evolution, a mixed linear regression model was used. A predictive model of newborn antibody titers at birth has been established by means of simple stepwise linear regression.
Results
51 mother-infant couples were included. 45 (90%) of the mothers and 44 (86.3%) of the newborns had a positive serology al birth. These antibodies were progressively decreasing and were positive in 34 (66.7%) and 7 (13.7%) of infants at 2 and 6 months, respectively. IgG titers of newborns at birth were related to mothers’ titers, with a positive moderate correlation (Pearson’s correlation coefficient: 0.82, p < 0,001). Fetal/maternal antibodies placental transference rate was 1.3 (IQR: 0.7–2.2). The maternal IgG titers at delivery and the type of maternal infection (acute, recent, or past infection) was significantly related with infants’ antibody titers at birth. No other epidemiological or clinical factors were related to antibodies titers. Neurodevelopment, psychomotor development, and growth were normal in 94.2% of infants in the third follow-up visit. No infants had a COVID-19 diagnosis during the follow-up period.
Conclusions
Transplacental transfer of maternal antibodies is high in newborns from mothers with recent or past infection at delivery, but these antibodies decrease after the first months of life. Infant’s IgG titers were related to maternal IgG titers at delivery. Further studies are needed to learn about the protective role of maternal antibodies in infants.
Invasive fungal disease (IFD) is a significant cause of morbimortality in children under chemotherapy or hematopoietic stem cell transplant (HSCT). The purpose of this study is to describe the ...changes in the IFD epidemiology that occurred in a Pediatric Hematology-Oncology Unit (PHOU) with an increasing activity over time.
Retrospective revision of the medical records of children (from 6 months to 18 years old) diagnosed with IFD in the PHOU of a tertiary hospital in Madrid (Spain), between 2006 and 2019. IFD definitions were performed according to the EORTC revised criteria. Prevalence, epidemiological, diagnostic and therapeutic parameters were described. Comparative analyses were conducted using Chi-square, Mann-Whitney and Kruskal-Wallis tests, according to three time periods, the type of infection (yeast vs mold infections) and the outcome.
Twenty-eight episodes of IFD occurred in 27 out of 471 children at risk (50% males; median age of 9.8 years old, IQR 4.9-15.1), resulting in an overall global prevalence of 5.9%. Five episodes of candidemia and 23 bronchopulmonary mold diseases were registered. Six (21.4%), eight (28.6%) and 14 (50%) episodes met criteria for proven, probable and possible IFD, respectively. 71.4% of patients had a breakthrough infection, 28.6% required intensive care and 21.4% died during treatment. Over time, bronchopulmonary mold infections and breakthrough IFD increased (p=0.002 and p=0.012, respectively), occurring in children with more IFD host factors (p=0.028) and high-risk underlying disorders (p=0.012). A 64% increase in the number of admissions in the PHOU (p<0.001) and a 277% increase in the number of HSCT (p=0.008) were not followed by rising rates of mortality or IFD/1000 admissions (p=0.674).
In this study, we found that yeast infections decreased, while mold infections increased over time, being most of them breakthrough infections. These changes are probably related to the rising activity in our PHOU and an increase in the complexity of the baseline pathologies of patients. Fortunately, these facts were not followed by an increase in IFD prevalence or mortality rates.
We analyzed 136 children with tuberculosis disease or infection and a positive QuantiFERON-TB (QFT) assay, followed-up for a median of 21 months (0.4-11years). QFT reversed in 16.9% of cases, with ...significant decreases in TB1 (-1.72
. -0.03 IU/ml, p=0.001) and TB2 (-1.65
. -0.43 IU/ml, p=0.005) levels compared to non-reverters. We found a higher QFT reversion rate among children under 5 years (25.0%
11.9%, p=0.042), and those with TST induration <15mm (29%
13.3%, p=0.055). Our data reveal that, although QFT test remained positive in the majority of children, reversion occurred in 16% of cases in a progressive and stable pattern. Younger age and reduced TST induration were associated with QFT reversion.
SARS-CoV2 infection in pregnancy and exposed newborns is poorly known. We performed a longitudinal analysis of immune system and determined soluble cytokine levels in pregnant women infected with ...SARS-CoV2 and in their newborns. Women with confirmed SARS-CoV2 infection and their exposed uninfected newborns were recruited from Hospital General Universitario Gregorio Marañón. Peripheral blood mononuclear cells (PBMCs), cord cells and plasma were collected at birth and 6 months later. Immunophenotyping of natural killer (NK), monocytes and CD4/CD8 T-cells were studied in cryopreserved PBMCs and cord cells by multiparametric flow cytometry. Up to 4 soluble pro/anti-inflammatory cytokines were assessed in plasma/cord plasma by ELISA assay. SARS-CoV2-infected mothers and their newborns were compared to matched healthy non-SARS-CoV2-infected mothers and their newborns. The TNFα and IL-10 levels of infected mothers were higher at baseline than those of healthy controls. Infected mothers showed increased NK cells activation and reduced expression of maturation markers that reverted after 6 months. They also had high levels of Central Memory and low Effector Memory CD4-T cell subsets. Additionally, the increased CD4- and CD8-T cell activation (CD154 and CD38) and exhaustion (TIM3/TIGIT) levels at baseline compared to controls remained elevated after 6 months. Regarding Treg cells, the levels were lower at infected mothers at baseline but reverted after 6 months. No newborn was infected at birth. The lower levels of monocytes, NK and CD4-T cells observed at SARS-CoV2-exposed newborns compared to unexposed controls significantly increased 6 months later. In conclusion, SARS-CoV2 infection during pregnancy shows differences in immunological components that could lead newborns to future clinical implications after birth. However, SARS-CoV2 exposed 6-months-old newborns showed no immune misbalance, whereas the infected mothers maintain increased activation and exhaustion levels in T-cells after 6 months.
The considerable interest aroused in recent years by the unique properties and industrial applications of ionic liquids has given rise to the need for a detailed statement of the linkage between ...their molecular features and the observed macroscopic behavior. A combined experimental/computational approach to the study of ionic liquids is submitted here and applied to the relevant, nonhalogenated ionic liquids 1,3-dimethylimidazolium methylsulfate and 1-ethyl-3-methylimidazolium tosylate. To establish a reliable equation of state pertinent to these fluids, density data over wide pressure (0.1−60 MPa) and temperature (318.15−428.15 K) ranges, along with high pressure (1−70 MPa) viscosities and other selected ambient pressure properties were measured to assemble sufficient experimental information for the seek of predictive models for process design. A computational method based on ab initio and classical molecular dynamics yielded a deal of structural information, borne out by the experimental readings. Likewise, the predictive ability of the force field applied in molecular dynamics simulations was faced with the measured properties. The pictorial description of the selected ionic liquids reached this way may become widespread to other relevant examples in order to infer valuable structure/property relationships.
Tuberculosis in young refugees Ritz, Nicole; Brinkmann, Folke; Garcia, Begoña Santiago ...
Lancet,
12/2015, Volume:
386, Issue:
10012
Journal Article
Peer reviewed
Open access
The results showed that 86% of these countries had tuberculosis screening programmes for active tuberculosis and 55% of these countries had latent tuberculosis infection in refugees.3 The ptbnet--a ...clinical research network of more than 100 physicians in 24 European countries providing care for children with tuberculosis4,5--would like to express concerns that refugee children and adolescents are at risk of being neglected as a group if only symptom-based tuberculosis screening is used.
Severe bacterial infections (SBI) have become less frequent in children with sickle cell disease (SCD) in the last decades. However, because of their potential risk of SBI, they usually receive ...empirical therapy with broad-spectrum antibiotics when they develop fever and are hospitalized in many cases. We performed a prospective study including 79 SCD patients with fever median age 4.1 (1.7–7.5) years, 78.5% males; 17 of the episodes were diagnosed with SBI and 4 of them were confirmed and developed a risk score for the prediction of SBI. The optimal score included CRP > 3 mg/dl, IL-6 > 125 pg/ml and hypoxemia, with an AUC of 0.91 (0.83–0.96) for the prediction of confirmed SBI and 0.86 (0.77–0.93) for possible SBI. We classified the patients in 3 groups: low, intermediate and high risk of SBI. Our risk-score-based management proposal could help to safely minimize antibiotic treatments and hospital admissions in children with SCD at low risk of SBI.
This work reports on a theoretical and experimental study on the ionic liquid 1-butyl-3-methylimidazolium octylsulfate (BMIMOS). The halogen-free ionic liquid BMIMOS is a stable solvent regarding ...hydrolysis, whose availability, toxicologically favourable features and well documented biodegradability turns it into a suitable candidate for different multiton-scale industrial applications. The pressure-volume-temperature behaviour of this fluid has been evaluated accurately over wide ranges of temperature and pressure, and correlated successfully with the empirical TRIDEN equation. From the measured data the relevant derived coefficients, isothermal compressibility, isobaric expansibility and internal pressure have been calculated. Other valuable properties such as isobaric heat capacity, speed of sound and refractive index were measured at several temperatures and atmospheric pressure. The molecular structure was looked into by quantum computations at the B3LYP/6-31 + g(d) level and classical molecular dynamics simulations in the NPT ensemble with the OPLS-AA forcefield. Both macroscopic and microscopic studies concur in a complex structure involving microheterogenous polar and non-polar domains, brought about by the aggregation of the non-polar anionic chains.
Liquid structure for the green solvent ethyl lactate, pure or water mixed, was studied using microwave dielectric spectroscopy, solvatochromic Reichardt’s probe and thermophysical methods, inferring ...remarkable interactions through hydrogen bonding.
Ethyl lactate is a very important environmentally friendly solvent which liquid phase structure, pure or water mixed, is determined by its ability to develop intra and intermolecular association through hydrogen bonding. In this work, the molecular level features that control its behaviour are analyzed using a wide collection of experimental tools. Results for pure ethyl lactate show strong intermolecular association competing with intramolecular hydrogen bonding. For water containing mixtures, the addition of small quantities of ethyl lactate to liquid water has a strong effect on liquid structure reinforcing the water networks whereas for ethyl lactate rich fluids the addition of water has less remarkable effects.
Etiological diagnosis of fever in children with sickle cell disease (SCD) is often challenging. The aim of this study was to analyze the pattern of inflammatory biomarkers in SCD febrile children and ...controls, in order to determine predictors of severe bacterial infection (SBI).
A prospective, case-control study was carried out during 3 years, including patients younger than 18 years with SCD and fever (cases) and asymptomatic steady-state SCD children (controls). Clinical characteristics and laboratory parameters, including 10 serum proinflammatory cytokines (IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, IL-17a, IFN-γ and TNF-α) and comparisons among study subgroups were analyzed.
A total of 137 patients (79 cases and 58 controls) were included in the study; 78.5% males, median age 4.1 (1.7-7.5) years. Four cases were diagnosed with SBI, 41 viral infection (VI), 33 no proven infection (NPI) and 1 bacterial-viral coinfection (the latter excluded from the subanalyses). IL-6 was significantly higher in patients with SBI than in patients with VI or NPI (163 vs 0.7 vs 0.7 pg/ml, p < 0.001), and undetectable in all controls. The rest of the cytokines analyzed did not show any significant difference. The optimal cut-off value of IL-6 for the diagnosis of SBI was 125 pg/mL, with high PPV and NPV (PPV of 100% for a prevalence rate of 5, 10 and 15% and NPV of 98.7%, 97.3% and 95.8% for those prevalences rates, respectively).
We found that IL-6 (with a cut-off value of 125 pg/ml) was an optimal marker for SBI in this cohort of febrile SCD children, with high PPV and NPV. Therefore, given its rapid elevation, IL-6 may be useful to early discriminate SCD children at risk of SBI, in order to guide their management.
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