Maria Elina Serra - Academia.edu (original) (raw)
Papers by Maria Elina Serra
Archivos Argentinos De Pediatria, Dec 1, 2013
Archivos Argentinos De Pediatria, Feb 1, 2020
Archivos Argentinos de Pediatria, 2016
The continuing worldwide increase in the number of mothers working outside the home has led to th... more The continuing worldwide increase in the number of mothers working outside the home has led to the need to have child care facilities with different types of arrangements. Towards the end of the 20th century, the prevailing model was the public daycare center with qualified staff taking care of children from all social strata. In developing countries, early childhood care centers started in the 1970s as part of an effort to create a protective setting for young children in situations of social vulnerability. Since then, the demand for these services has grown progressively. 1 In Argentina, many children younger than 5 years old attend some type of child daycare center. Although available statistical information is not complete, the long waiting lists registered by official agencies indicate a significant demand. 2,3 The offer of early childhood care varies greatly and may be categorized into four basic modalities: state-run centers (public day care centers), private day care centers, municipal facilities targeted to the vulnerable population, and communitymanaged facilities for disadvantaged sectors. 4
Archivos Argentinos de Pediatria
Archivos Argentinos de Pediatria, 2021
Archivos Argentinos de Pediatria, 2020
The life-cycle of a manuscript from writing to publication is not usually taught during health ca... more The life-cycle of a manuscript from writing to publication is not usually taught during health care professionals' training. This article reviews the process that goes from from the authors' decision to communicate to its eventual publication, detailing practical aspects to be considered in each step. The responsibilities of the different roles involved are specified: author, editor, and reviewer. International guidelines supporting the writing of medical-scientific papers are also described.
American Journal of Respiratory and Critical Care Medicine, 2012
Rationale: Human rhinoviruses (HRV) are the leading cause of upper respiratory infections and hav... more Rationale: Human rhinoviruses (HRV) are the leading cause of upper respiratory infections and have been postulated to trigger asthma exacerbations. However, whether HRV are detected during crises because upper respiratory infections often accompany asthma attacks, or because they specifically elicit exacerbations, is unclear. Moreover, although several hypotheses have been advanced to explain virus-induced exacerbations, their mechanism remains unclear. Objectives: To determine the role of HRV in pediatric asthma exacerbations and the mechanisms mediating wheezing. Methods: We prospectively studied 409 children with asthma presenting with upper respiratory infection in the presence or absence of wheezing. Candidate viral and immune mediators of illness were compared among children with asthma with different degrees of severity of acute asthma. Measurements and Main Results: HRV infections specifically associated with asthma exacerbations, even after adjusting for relevant demographic and clinical variables defined a priori (odds ratio, 1.90; 95% confidence interval, 1.21-2.99; P ¼ 0.005). No difference in virus titers, HRV species, and inflammatory or allergic molecules was observed between wheezing and nonwheezing children infected with HRV. Type III IFN-l 1 levels were higher in wheezing children infected with HRV compared with nonwheezing (P , 0.001) and increased with worsening symptoms (P , 0.001). Moreover, after adjusting for IFN-l 1 , children with asthma infected with HRV were no longer more likely to wheeze than those who were HRV-negative (odds ratio, 1.18; 95% confidence interval, 0.57-2.46; P ¼ 0.66). Conclusions: Our findings suggest that HRV infections in children with asthma are specifically associated with acute wheezing, and that type III IFN-l 1 responses mediate exacerbations caused by HRV. Modulation of IFN-l 1 should be studied as a therapeutic target for exacerbations caused by HRV.
Pediatrics, 2008
OBJECTIVE. The protective role of breastfeeding against severe acute lung disease in infants is w... more OBJECTIVE. The protective role of breastfeeding against severe acute lung disease in infants is well established, but its mechanism is unclear. Most hypotheses assume that breastfeeding confers similar passive protection to every infant; however, a few observations have suggested that the benefits of breast milk against severe lung disease may differ according to gender. The objective of this study was to determine whether the effect of breastfeeding on susceptibility to severe acute lung disease among infants at high risk is different for girls and boys. METHODS. A cohort was analyzed prospectively by use of 2 different strategies: (1) predictors of first episode of rehospitalization by univariate and multivariate analyses using robust Poisson regression and (2) mean number of rehospitalizations between groups using multiple regression negative binomial models. RESULTS. A total of 119 high-risk, very low birth weight infants were enrolled. Breast milk protected girls but not boys a...
This article cites 48 articles, 29 of which can be accessed free
The Journal of Infectious Diseases, 2006
The FASEB Journal, 2014
Respiratory syncytial virus (RSV) is the primary cause of lower respiratory tract infection durin... more Respiratory syncytial virus (RSV) is the primary cause of lower respiratory tract infection during childhood and causes severe symptoms in some patients, which may cause hospitalization and death. Mechanisms for differential responses to RSV are unknown. Our objective was to develop an in vitro model of RSV infection to evaluate interindividual variation in response to RSV and identify susceptibility genes. Populations of human-derived HapMap lymphoblastoid cell lines (LCLs) were infected with RSV. Compared with controls, RSV-G mRNA expression varied from ϳ1to 400-fold between LCLs. Basal expression of a number of gene transcripts, including myxovirus (influenza virus) resistance 1 (MX1), significantly correlated with RSV-G expression in HapMap LCLs. Individuals in a case-control population of RSVinfected children who were homozygous (n)49؍ or heterozygous (n)271؍ for the predicted deleterious A allele in a missense G/A SNP in MX1 had significantly greater risk for developing severe RSV disease relative to those with the major allele (n)801؍ (2 ,503.5؍ P;120.0؍ OR: 1.750, 95% CI: 1.110, 2.758, P.)120.0؍ We conclude that genetically diverse human LCLs enable identification of susceptibility genes (e.g., MX1) for RSV disease severity in children, providing insight for disease risk.
Jornal de pediatria, Jan 22, 2017
This study aims to describe real world palivizumab use and effectiveness in high-risk Latin Ameri... more This study aims to describe real world palivizumab use and effectiveness in high-risk Latin American infants and young children. Prospective, multicenter observational study with infants at risk for severe RSV infection who received palivizumab according to routine clinical practice. Subjects were followed for one year with monthly visits after the first dose of palivizumab. An infant was considered adherent if receiving all the expected injections or five or fewer injections within appropriate inter-dose intervals. Annual incidence rates and risk factors of lower respiratory tract infection (LRTI) hospitalization were determined through Poisson regression models (α=0.05). The study enrolled 458 children from seven countries in Latin America, from February 2011 to September 2012. The majority (98%) were born <36 weeks gestation. Overall, patients received 83.7% of their expected injections and 86.7% completed one year of follow-up. Of the 61 LRTI hospitalizations, 12 episodes wer...
Archivos argentinos de pediatria, 2015
Day care center attendance is a risk factor for acquiring respiratory tract infections. There are... more Day care center attendance is a risk factor for acquiring respiratory tract infections. There are preventive measures which should be applied. To describe the availability of adequate supplies or building facilities, staff habits, behaviors and training, and the existence and enforcement of official guidelines or institutional standards regarding the prevention of respiratory tract infections in day care centers for infants in the city of Buenos Aires. Exploratory and cross sectional study carried out at systematically selected private day care centers for infants. The person responsible of the day care center was interviewed and a 3-hour observation session was held in a room of each of the day care centers. Information was collected on hand washing practices, clearance of nasal secretions, school exclusion guidance, immunization control, breastfeeding promotion and the existence of guidelines, standards and training on the prevention of respiratory tract infections. Twelve day car...
![Research paper thumbnail of [Newborn ventilation: comparison between a T-piece resuscitator and self-infating bags in a neonatal preterm simulator]](https://attachments.academia-assets.com/69579742/thumbnails/1.jpg)
](Archivos argentinos de pediatría, 2012
Although the provision of effective assisted ventilation is the most effective intervention in de... more Although the provision of effective assisted ventilation is the most effective intervention in delivery room resuscitation of depressed newborn infants, there is still limited evidence about which is the optimal device to deliver positive pressure ventilation (PPV). To compare the accuracy of pressures and ventilation rate (VR) delivered to a neonatal simulator with three devices: 240 ml and 450 ml self-infating bags (SIB) and a T-piece resuscitator, and to evaluate the variability in terms of providers' experience. 76 health care providers divided in two groups according to experience were asked to provide positive pressure ventilation to a neonatal simulator through a facial mask or an endotracheal tube with three ventilating devices: a T-piece resuscitator, a 240 ml and a 450 ml self-infating bags. Participants used each combination of device and interface randomly on 2 consecutive occasions. Mean and maximum PIP and respiratory rate were recorded. Statistical analyses were p...
Archivos argentinos de pediatría, 2013
Archivos Argentinos de Pediatria, 2012
Journal of Clinical Investigation, 2015
Archivos Argentinos de Pediatria, 2014
Introduction. Attending a day care center is a risk factor for respiratory infections. The object... more Introduction. Attending a day care center is a risk factor for respiratory infections. The objective of this study is to review which nonspecific prevention measures are recommended for day care centers and the evidence of their usefulness in this setting. Methods. Recommendations regarding nonspecific prevention at national level were searched using Google and the web sites of the Argentine Society of Pediatrics, the ministries of education and the ministries of health from different countries, both in English and Spanish. Recommendations regarding hand hygiene, clearance of secretions, cleaning the environment and elements, breastfeeding, and exclusion of symptomatic subjects were reviewed. A systematic search of the literature was conducted to find intervention studies at day care centers that evaluated the effectiveness of recommendations, published in Spanish and English. Results and the methodological quality of studies were analyzed. Results. Seven guidelines were found. Hand hygiene and environment cleaning were the only recommendations described in all guidelines. The exclusion of symptomatic subjects is mentioned in all, but criteria are heterogeneous. Clearance of nasal secretions and promotion of breastfeeding are outlined only in a few of the guidelines. Eight intervention studies on hand hygiene, cleaning of the environment, and clearance of secretions were found, whose results were heterogeneous and had major methodological limitations. Conclusion. A timely and adequate hand hygiene and an appropriate cleaning of the environment have been uniformly recommended by different guidelines as non-specific prevention measures against respiratory infections. The evidence on the usefulness of these measures in this setting is limited.
Journal of Allergy and Clinical Immunology, 2010
RATIONALE: Inflammation is known to underlie the pathogenesis of asthma. Nevertheless, diagnosis ... more RATIONALE: Inflammation is known to underlie the pathogenesis of asthma. Nevertheless, diagnosis is made by clinical history, reversible airway obstruction and bronchial hyperresponsiveness according to international guidelines. Exhaled nitric oxide is a non-invasive inflammatory marker. The aim of the study was to assess the sensitivity and specificity of FeNO in asthma diagnosis. METHODS: Sixty-four consecutive patients reporting asthma symptoms were included in the study. All of them underwent methacholine challenge test following the five-breath dosimeter protocol, after measurement of exhaled nitric oxide with a portable device. RESULTS: Twenty-three of the 64 patients were diagnosed with asthma. A positive MCh challenge was correlated with higher FeNO levels and with basal FEV1. No correlation was found between PC20 and FeNO levels. ROC curves were built for FeNO levels (AUC: 0.79). A cutoff point for FeNO level was calculated with maximal specificity and sensitivity for asthma diagnosis (39.5 ppb). CONCLUSIONS: FeNO as marker of inflammation is highly correlated with functional parameters (MCh) in asthmatic patients. A cutoff point of 39.5 ppb was calculated for asthma diagnosis in our population. The use of FeNO measurement may be a helpful tool for asthma diagnosis in patients not able of performing MCh challenges.
Jornal de pediatria, Jan 22, 2017
This study aims to describe real world palivizumab use and effectiveness in high-risk Latin Ameri... more This study aims to describe real world palivizumab use and effectiveness in high-risk Latin American infants and young children. Prospective, multicenter observational study with infants at risk for severe RSV infection who received palivizumab according to routine clinical practice. Subjects were followed for one year with monthly visits after the first dose of palivizumab. An infant was considered adherent if receiving all the expected injections or five or fewer injections within appropriate inter-dose intervals. Annual incidence rates and risk factors of lower respiratory tract infection (LRTI) hospitalization were determined through Poisson regression models (α=0.05). The study enrolled 458 children from seven countries in Latin America, from February 2011 to September 2012. The majority (98%) were born <36 weeks gestation. Overall, patients received 83.7% of their expected injections and 86.7% completed one year of follow-up. Of the 61 LRTI hospitalizations, 12 episodes wer...
Archivos Argentinos De Pediatria, Dec 1, 2013
Archivos Argentinos De Pediatria, Feb 1, 2020
Archivos Argentinos de Pediatria, 2016
The continuing worldwide increase in the number of mothers working outside the home has led to th... more The continuing worldwide increase in the number of mothers working outside the home has led to the need to have child care facilities with different types of arrangements. Towards the end of the 20th century, the prevailing model was the public daycare center with qualified staff taking care of children from all social strata. In developing countries, early childhood care centers started in the 1970s as part of an effort to create a protective setting for young children in situations of social vulnerability. Since then, the demand for these services has grown progressively. 1 In Argentina, many children younger than 5 years old attend some type of child daycare center. Although available statistical information is not complete, the long waiting lists registered by official agencies indicate a significant demand. 2,3 The offer of early childhood care varies greatly and may be categorized into four basic modalities: state-run centers (public day care centers), private day care centers, municipal facilities targeted to the vulnerable population, and communitymanaged facilities for disadvantaged sectors. 4
Archivos Argentinos de Pediatria
Archivos Argentinos de Pediatria, 2021
Archivos Argentinos de Pediatria, 2020
The life-cycle of a manuscript from writing to publication is not usually taught during health ca... more The life-cycle of a manuscript from writing to publication is not usually taught during health care professionals' training. This article reviews the process that goes from from the authors' decision to communicate to its eventual publication, detailing practical aspects to be considered in each step. The responsibilities of the different roles involved are specified: author, editor, and reviewer. International guidelines supporting the writing of medical-scientific papers are also described.
American Journal of Respiratory and Critical Care Medicine, 2012
Rationale: Human rhinoviruses (HRV) are the leading cause of upper respiratory infections and hav... more Rationale: Human rhinoviruses (HRV) are the leading cause of upper respiratory infections and have been postulated to trigger asthma exacerbations. However, whether HRV are detected during crises because upper respiratory infections often accompany asthma attacks, or because they specifically elicit exacerbations, is unclear. Moreover, although several hypotheses have been advanced to explain virus-induced exacerbations, their mechanism remains unclear. Objectives: To determine the role of HRV in pediatric asthma exacerbations and the mechanisms mediating wheezing. Methods: We prospectively studied 409 children with asthma presenting with upper respiratory infection in the presence or absence of wheezing. Candidate viral and immune mediators of illness were compared among children with asthma with different degrees of severity of acute asthma. Measurements and Main Results: HRV infections specifically associated with asthma exacerbations, even after adjusting for relevant demographic and clinical variables defined a priori (odds ratio, 1.90; 95% confidence interval, 1.21-2.99; P ¼ 0.005). No difference in virus titers, HRV species, and inflammatory or allergic molecules was observed between wheezing and nonwheezing children infected with HRV. Type III IFN-l 1 levels were higher in wheezing children infected with HRV compared with nonwheezing (P , 0.001) and increased with worsening symptoms (P , 0.001). Moreover, after adjusting for IFN-l 1 , children with asthma infected with HRV were no longer more likely to wheeze than those who were HRV-negative (odds ratio, 1.18; 95% confidence interval, 0.57-2.46; P ¼ 0.66). Conclusions: Our findings suggest that HRV infections in children with asthma are specifically associated with acute wheezing, and that type III IFN-l 1 responses mediate exacerbations caused by HRV. Modulation of IFN-l 1 should be studied as a therapeutic target for exacerbations caused by HRV.
Pediatrics, 2008
OBJECTIVE. The protective role of breastfeeding against severe acute lung disease in infants is w... more OBJECTIVE. The protective role of breastfeeding against severe acute lung disease in infants is well established, but its mechanism is unclear. Most hypotheses assume that breastfeeding confers similar passive protection to every infant; however, a few observations have suggested that the benefits of breast milk against severe lung disease may differ according to gender. The objective of this study was to determine whether the effect of breastfeeding on susceptibility to severe acute lung disease among infants at high risk is different for girls and boys. METHODS. A cohort was analyzed prospectively by use of 2 different strategies: (1) predictors of first episode of rehospitalization by univariate and multivariate analyses using robust Poisson regression and (2) mean number of rehospitalizations between groups using multiple regression negative binomial models. RESULTS. A total of 119 high-risk, very low birth weight infants were enrolled. Breast milk protected girls but not boys a...
This article cites 48 articles, 29 of which can be accessed free
The Journal of Infectious Diseases, 2006
The FASEB Journal, 2014
Respiratory syncytial virus (RSV) is the primary cause of lower respiratory tract infection durin... more Respiratory syncytial virus (RSV) is the primary cause of lower respiratory tract infection during childhood and causes severe symptoms in some patients, which may cause hospitalization and death. Mechanisms for differential responses to RSV are unknown. Our objective was to develop an in vitro model of RSV infection to evaluate interindividual variation in response to RSV and identify susceptibility genes. Populations of human-derived HapMap lymphoblastoid cell lines (LCLs) were infected with RSV. Compared with controls, RSV-G mRNA expression varied from ϳ1to 400-fold between LCLs. Basal expression of a number of gene transcripts, including myxovirus (influenza virus) resistance 1 (MX1), significantly correlated with RSV-G expression in HapMap LCLs. Individuals in a case-control population of RSVinfected children who were homozygous (n)49؍ or heterozygous (n)271؍ for the predicted deleterious A allele in a missense G/A SNP in MX1 had significantly greater risk for developing severe RSV disease relative to those with the major allele (n)801؍ (2 ,503.5؍ P;120.0؍ OR: 1.750, 95% CI: 1.110, 2.758, P.)120.0؍ We conclude that genetically diverse human LCLs enable identification of susceptibility genes (e.g., MX1) for RSV disease severity in children, providing insight for disease risk.
Jornal de pediatria, Jan 22, 2017
This study aims to describe real world palivizumab use and effectiveness in high-risk Latin Ameri... more This study aims to describe real world palivizumab use and effectiveness in high-risk Latin American infants and young children. Prospective, multicenter observational study with infants at risk for severe RSV infection who received palivizumab according to routine clinical practice. Subjects were followed for one year with monthly visits after the first dose of palivizumab. An infant was considered adherent if receiving all the expected injections or five or fewer injections within appropriate inter-dose intervals. Annual incidence rates and risk factors of lower respiratory tract infection (LRTI) hospitalization were determined through Poisson regression models (α=0.05). The study enrolled 458 children from seven countries in Latin America, from February 2011 to September 2012. The majority (98%) were born <36 weeks gestation. Overall, patients received 83.7% of their expected injections and 86.7% completed one year of follow-up. Of the 61 LRTI hospitalizations, 12 episodes wer...
Archivos argentinos de pediatria, 2015
Day care center attendance is a risk factor for acquiring respiratory tract infections. There are... more Day care center attendance is a risk factor for acquiring respiratory tract infections. There are preventive measures which should be applied. To describe the availability of adequate supplies or building facilities, staff habits, behaviors and training, and the existence and enforcement of official guidelines or institutional standards regarding the prevention of respiratory tract infections in day care centers for infants in the city of Buenos Aires. Exploratory and cross sectional study carried out at systematically selected private day care centers for infants. The person responsible of the day care center was interviewed and a 3-hour observation session was held in a room of each of the day care centers. Information was collected on hand washing practices, clearance of nasal secretions, school exclusion guidance, immunization control, breastfeeding promotion and the existence of guidelines, standards and training on the prevention of respiratory tract infections. Twelve day car...
Archivos argentinos de pediatría, 2012
Although the provision of effective assisted ventilation is the most effective intervention in de... more Although the provision of effective assisted ventilation is the most effective intervention in delivery room resuscitation of depressed newborn infants, there is still limited evidence about which is the optimal device to deliver positive pressure ventilation (PPV). To compare the accuracy of pressures and ventilation rate (VR) delivered to a neonatal simulator with three devices: 240 ml and 450 ml self-infating bags (SIB) and a T-piece resuscitator, and to evaluate the variability in terms of providers' experience. 76 health care providers divided in two groups according to experience were asked to provide positive pressure ventilation to a neonatal simulator through a facial mask or an endotracheal tube with three ventilating devices: a T-piece resuscitator, a 240 ml and a 450 ml self-infating bags. Participants used each combination of device and interface randomly on 2 consecutive occasions. Mean and maximum PIP and respiratory rate were recorded. Statistical analyses were p...
Archivos argentinos de pediatría, 2013
Archivos Argentinos de Pediatria, 2012
Journal of Clinical Investigation, 2015
Archivos Argentinos de Pediatria, 2014
Introduction. Attending a day care center is a risk factor for respiratory infections. The object... more Introduction. Attending a day care center is a risk factor for respiratory infections. The objective of this study is to review which nonspecific prevention measures are recommended for day care centers and the evidence of their usefulness in this setting. Methods. Recommendations regarding nonspecific prevention at national level were searched using Google and the web sites of the Argentine Society of Pediatrics, the ministries of education and the ministries of health from different countries, both in English and Spanish. Recommendations regarding hand hygiene, clearance of secretions, cleaning the environment and elements, breastfeeding, and exclusion of symptomatic subjects were reviewed. A systematic search of the literature was conducted to find intervention studies at day care centers that evaluated the effectiveness of recommendations, published in Spanish and English. Results and the methodological quality of studies were analyzed. Results. Seven guidelines were found. Hand hygiene and environment cleaning were the only recommendations described in all guidelines. The exclusion of symptomatic subjects is mentioned in all, but criteria are heterogeneous. Clearance of nasal secretions and promotion of breastfeeding are outlined only in a few of the guidelines. Eight intervention studies on hand hygiene, cleaning of the environment, and clearance of secretions were found, whose results were heterogeneous and had major methodological limitations. Conclusion. A timely and adequate hand hygiene and an appropriate cleaning of the environment have been uniformly recommended by different guidelines as non-specific prevention measures against respiratory infections. The evidence on the usefulness of these measures in this setting is limited.
Journal of Allergy and Clinical Immunology, 2010
RATIONALE: Inflammation is known to underlie the pathogenesis of asthma. Nevertheless, diagnosis ... more RATIONALE: Inflammation is known to underlie the pathogenesis of asthma. Nevertheless, diagnosis is made by clinical history, reversible airway obstruction and bronchial hyperresponsiveness according to international guidelines. Exhaled nitric oxide is a non-invasive inflammatory marker. The aim of the study was to assess the sensitivity and specificity of FeNO in asthma diagnosis. METHODS: Sixty-four consecutive patients reporting asthma symptoms were included in the study. All of them underwent methacholine challenge test following the five-breath dosimeter protocol, after measurement of exhaled nitric oxide with a portable device. RESULTS: Twenty-three of the 64 patients were diagnosed with asthma. A positive MCh challenge was correlated with higher FeNO levels and with basal FEV1. No correlation was found between PC20 and FeNO levels. ROC curves were built for FeNO levels (AUC: 0.79). A cutoff point for FeNO level was calculated with maximal specificity and sensitivity for asthma diagnosis (39.5 ppb). CONCLUSIONS: FeNO as marker of inflammation is highly correlated with functional parameters (MCh) in asthmatic patients. A cutoff point of 39.5 ppb was calculated for asthma diagnosis in our population. The use of FeNO measurement may be a helpful tool for asthma diagnosis in patients not able of performing MCh challenges.
Jornal de pediatria, Jan 22, 2017
This study aims to describe real world palivizumab use and effectiveness in high-risk Latin Ameri... more This study aims to describe real world palivizumab use and effectiveness in high-risk Latin American infants and young children. Prospective, multicenter observational study with infants at risk for severe RSV infection who received palivizumab according to routine clinical practice. Subjects were followed for one year with monthly visits after the first dose of palivizumab. An infant was considered adherent if receiving all the expected injections or five or fewer injections within appropriate inter-dose intervals. Annual incidence rates and risk factors of lower respiratory tract infection (LRTI) hospitalization were determined through Poisson regression models (α=0.05). The study enrolled 458 children from seven countries in Latin America, from February 2011 to September 2012. The majority (98%) were born <36 weeks gestation. Overall, patients received 83.7% of their expected injections and 86.7% completed one year of follow-up. Of the 61 LRTI hospitalizations, 12 episodes wer...