rosa feijoo - Academia.edu (original) (raw)
Papers by rosa feijoo
Clinical and Translational Allergy
Introduction: Incidence of anaphylaxis is increasing. Data regarding anaphylaxis mortality are li... more Introduction: Incidence of anaphylaxis is increasing. Data regarding anaphylaxis mortality are limited, but conflicting. Our objective was to document anaphylaxis mortality rate (deaths per million population), time trends and specificities according to triggers (iatrogenic, venom, food, unknown), age groups, sex and geographical regions (North and South) in France, between 1979 and 2011. Methods: Data were obtained (1) from database of the National Mortality Center (CEPIDC) to collect cases in which anaphylaxis was included as a cause of death, sex, age, and geographic region of death, (2) from the database of the National Institute for Economical and Statistical studies (INSEE) to define the referent populations. We used a multivariable log-linear Poisson regression model to assess the impact of time period, age, sex and geographic region on anaphylaxis deaths. Results: During the period study, 1603 deaths were collected: 1564 in adults and 39 in children (age <18 year). The overall prevalence of anaphylaxis fatalities was 0.84 per million population (95% IC 0.80-0.88), ranging from 0.08 per million (95% IC 0.05-0.10) in pediatric population to 1.12 per million (95% CI 1.06 to 1.17) in adult population. Annual percentage change for case fatality rate was −2.0% (95% CI −2.5 to −1.5; p < 10 −4) indicating a decrease in case fatality rate during the study period. Anaphylaxis fatality rate was higher in men (1.08 per million [95% IC 1.00 1.16] than women (0.86 per million [95% IC 0.80-0.92]) (p < 10 −4). Triggers of anaphylaxis fatalities were iatrogenic (63%), mostly drugs, venom (14%) and food (0.6%). Unspecified anaphylaxis was frequent (23%). The highest rate was in persons aged >70 years (3.50 per million population per year [95% IC 3.25-3.76]) and the lowest in the pediatric population (p < 10 −4). Only venom-induced mortality rate was higher in South of France (0.16 per million [95% IC 0.13-0.19]) compared with the North (0.11 per million [95% IC 0.09-0.13]) (p = 0.004). Only 8 food-induced fatalities were recorded (age <35 years in 7 cases). Conclusion: Overall anaphylaxis mortality rate is decreasing over the three last decades in France. We confirm that iatrogenic causes are the most frequent causes. Older age and male sex are risk factors of fatal anaphylaxis of any cause except for food-induced anaphylaxis.
Clinical and Translational Allergy, 2016
Introduction: Bullous lesions are common skin lesions particularly in childhood. Drug reactions, ... more Introduction: Bullous lesions are common skin lesions particularly in childhood. Drug reactions, burns, insect bites, mosquito bites, skin diseases, autoimmune bullous dermatoses and bacterial infections are the most common etiologies. Herein, we report two children who have solitary mastocytoma presented with variable bullous lesions. Case 1: A 3-year old boy admitted to our outpatient department suffering from red, periodically vesicular and bullous lesions on his back of neck since birth. His medical history revealed that he had four attacks characterized by flushing, perioral paleness, and hypotension. The lesion became swollen and itchy when it was rubbed vigorously (positive Darier's sign). Physical examination revealed a bullous lesion (2 × 3 cm) in his dorsal neck region. Laboratory investigations including CBC, liver and kidney function tests and serum electrolytes were within normal limits. Histopathologic examination of a punch biopsy specimen revealed solitary mastocytoma and the patient is under regular antihistamine treatment. Case 2: A 3-month old boy admitted with complaints of oval, erythematous and periodically changing bullous lesions in his proximal of right ankle since birth. His medical history revealed that the lesion became bullous and itchy when his mother rubbed it vigorously. Physical examination revealed a bullous lesion (1 × 1 cm) in his left foot. Laboratory investigations for possible etiologic factors were within normal limits. Histopathologic examination of a punch biopsy specimen revealed solitary mastocytoma. The patient is uneventfully under regular follow up. Conclusion: Solitary mastocytomas should be considered in the differential diagnosis of periodically varying bullous reactions in children. Consent to publish Written informed consent for publication of this clinical details and/or clinical images was obtained from the patient/parent/guardian/relative of the patient. A copy of the consent form is available for review by the Editor of this journal.
![Research paper thumbnail of Onset of Effect, Changes in Airflow Obstruction and Lung Volume, and Health-Related Quality of Life Improvements with Benralizumab for Patients with Severe Eosinophilic Asthma: Phase IIIb Randomized, Controlled Trial (SOLANA) [Corrigendum]](https://attachments.academia-assets.com/68376522/thumbnails/1.jpg)
](Journal of Asthma and Allergy
The Journal of Asthma and Allergy is an international, peer-reviewed open-access journal publishi... more The Journal of Asthma and Allergy is an international, peer-reviewed open-access journal publishing original research, reports, editorials and commentaries on the following topics: Asthma; Pulmonary physiology; Asthma related clinical health; Clinical immunology and the immunological basis of disease; Pharmacological interventions and new therapies. The manuscript management system is completely online and includes a very quick and fair peer-review system, which is all easy to use. Visit http://www.dovepress.com/testimonials.php to read real quotes from published authors.
Journal of Asthma and Allergy
In the SOLANA trial, we sought to physiologically characterize benralizumab's onset of effect and... more In the SOLANA trial, we sought to physiologically characterize benralizumab's onset of effect and maintenance of that effect for patients with severe eosinophilic asthma. Methods: SOLANA (NCT02869438) was a multicenter, randomized, double-blind, parallelgroup, placebo-controlled, Phase IIIb study conducted at 49 centers in six countries (Chile, Germany, Hungary, the Philippines, South Korea, and the United States). Eligible patients with baseline blood eosinophil counts ≥300 cells/µL were randomized to subcutaneous benralizumab (30 mg) or placebo administered at Days 0, 28, and 56. The primary endpoint was the average change from baseline in prebronchodilator forced expiratory volume in 1 s (pre-BD FEV 1) during the Day 28-Day 84 period for benralizumab vs placebo. Secondary endpoints included patientreported outcomes (PROs). A subset of patients participated in a whole-body plethysmography substudy. Safety was also assessed. Results: In total, 233 patients were randomized to benralizumab (n=118) or placebo (n=115). Improvement from baseline in pre-BD FEV 1 with benralizumab 30 mg was not statistically significant compared with placebo (least-squares mean change difference [95% confidence interval] 57 mL [−22 to 135]; p=0.16). Compared with placebo, benralizumab demonstrated early (Day 7) nonstatistically significant improvements in whole-body plethysmography assessments of hyperinflation and clinically meaningful improvements in PRO measures (Asthma Control Questionnaire 6 at Day 14 and St. George's Respiratory Questionnaire at Day 28), which were maintained over the treatment period. Benralizumab's safety profile was commensurate with previously reported studies. Conclusion: The observed early changes in lung volume despite relatively small improvements in airflow obstruction suggest that the anti-inflammatory effect of benralizumab may be manifested as deflation over time for patients with hyperinflation, who potentially have a greater degree of airway remodeling. This early effect could partially explain the rapid PRO improvements observed for certain patients.
Context. A study with 24 health directorates of the Peru MOH as units of experimentation and anal... more Context. A study with 24 health directorates of the Peru MOH as units of experimentation and analysis that was conducted in 2000-2001 showed that two-day provider training plus one-day retraining on the job aids-assisted Balanced Counseling Strategy resulted in significant enhancement of the quality of care, an increase of four minutes in session length, and improved client knowledge of the method chosen when this was an IUD or hormonal method. This study presents results of a one-year follow-up. Methodology. New-event family planning clients were recruited as they exited counseling sessions at treated and control clinics. The clients had chosen a contraceptive method and stated intentions to use contraception for at least one year. A questionnaire that included the calendar module of DHS was applied twice in home interviews to tap six and 12-month outcomes. Twelve-month data from 215 clients were analyzed in depth. Results. Knowledge of the method chosen when this was the IUD or a hormonal method was greater in the treated cohort (p < .05, one-tailed, df = 18) at the end of the follow-up period. Mean monthly (k = 12) family planning use rates over health-directorates (n = 12) were obtained for each cohort. The latter months showed less use of needed contraception (p < .01, df = 11,11) and the treated cohort greater use (.81) than the control cohort (.78, p < .01, df = 1,11) when contemporaneous perceptions of need were considered. Cumulative continuation rates from life tables did not differ significantly between cohorts according to the Wilcoxon (Gehan) statistic. Proportions of method shifting were similar in both cohorts. Attainment of contemporaneous reproductive goal was significantly greater in the treated cohort (.96) than the control cohort (.95, p < .01, df = 1,11). Conclusions and Recommendations. The intervention caused consistent, yet small, improvements in client outcomes. Correlational findings suggested that better impacts can be achieved in provincial primary health facilities than in larger settings like clinics or hospitals in capital cities. The results are important because: 1) other studies have failed to show significant impacts of controlled quality-of-care improvements on the use of contraception; and 2) the Balanced Counseling Strategy was not implemented to its full extent. Greater impacts can be expected when the Strategy's potential is fully realized.
Clinical and Translational Allergy
Annals of hematology, 2018
The aims of this study were to describe hepcidin levels and to assess their associations with iro... more The aims of this study were to describe hepcidin levels and to assess their associations with iron status and the main variants in the HFE gene in healthy and full-term newborns during the first year of life, as a longitudinal study conducted on 140 infants. Anthropometric and biochemical parameters, hepcidin, hemoglobin (Hb), serum ferritin (SF), transferrin saturation (TS), mean corpuscular volume (MCV), and C-reactive protein (CRP), were assessed in 6- and 12-month-olds. Infants were genotyped for the three main HFE variants: C282Y, H63D, and S65C. Hepcidin levels increased from 6 to 12 months of age (43.7 ± 1.5 to 52.0 ± 1.5 ng/mL; p < 0.001), showing higher levels in infants with better iron status compared to those with iron deficiency (ID) (44.8 ± 1.5 vs 37.9 ± 1.3 ng/mL, p < 0.018, and 54.3 ± 1.5 vs 44.0 ± 1.4 ng/mL, p < 0.038, in 6- and 12-month-olds, respectively). In multivariate linear regression models, iron status was found to be associated with hepcidin level...
International journal of pediatric otorhinolaryngology, 2017
To evaluate the impact of different types of nasal septum deformity (NSD) on nasal obstruction, r... more To evaluate the impact of different types of nasal septum deformity (NSD) on nasal obstruction, rhinitis severity and response to medical treatment among pediatric persistent allergic rhinitis (PER) patients. In a prospective, real-life study, 150 children and adolescents (mean age 13 ± 2.8 years, females 32.6%) diagnosed with PER according to ARIA guidelines were assessed by nasal endoscopy for NSD according to Mladina's classification, their response to medical treatment (intranasal steroids and antihistamines or antileucotriens), the presence of comorbidities, rhinitis severity (modified-ARIA criterion) and nasal obstruction visual analog scale score (VAS). Most patients (87%) had 1 of the 7 types of septal deformities. There was a high prevalence of bilateral (types 4 and 6; 46%) and anterior unilateral (types 1 and 2; 25%) NSD in patients not responding to medical treatment. Type 4 (OR = 6.4; p = 0.005) or type 6 (OR = 4.4; p = 0.03) NSD increased the risk of lack of improv...
Journal of Neuroimmunology, 2017
Few studies have investigated the relationship between post-natal inflammatory biomarkers at earl... more Few studies have investigated the relationship between post-natal inflammatory biomarkers at early age and child neurodevelopment outcomes. The main aim of this study was to examine the relationship between IL-6, IL-1β, IL-4 cytokines, as well as cortisol at 6 and 12months of age, and neurodevelopment and psychological problems at 30months of age. The study was conducted on a sample of 51 full-term newborns who were followed up at 6, 12, and 30months of age. Infant neurodevelopment was assessed using the Bayley Scales of Infant Development-II, psychological problems were assessed with the Child Behavior Checklist 1.5-5 (CBCL 1.5-5) and the mother&amp;amp;amp;amp;amp;#39;s emotional symptoms were assessed with the General Health Questionnaire-28. When the infants were 6 and 12months old, IL-6, IL-1β, IL-4 cytokines, and cortisol were measured in blood samples. The results showed that higher IL-6 at 12months predicted higher scores in internalizing (emotionally reactive, anxious/depressed, withdrawn and attention problems) and externalizing problems (aggressive behavior) at 30months. By contrast, high levels of IL-1β at 6months were related to worse motor skills. Inflammatory biomarkers were not related to mental performance. IL-6 and IL-1β could be early markers of later psychological problems and psychomotor disabilities.
Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology, 2016
Allergic rhinitis (AR) is the most common chronic disease among children. To characterize the dis... more Allergic rhinitis (AR) is the most common chronic disease among children. To characterize the disease, a modified classification of severity (m-ARIA) has recently been validated in AR children. When medical treatment fails, surgery for nasal obstructive disorders (NOD) may be a therapeutic option. Our objective was to assess the prevalence of NOD and their influence in medical treatment response among children with persistent AR (PER). In a prospective, real-life study, 130 pediatric PER patients (13.1±2.8 years, females 31.5%, severe rhinitis 49%) referred from Allergy to ENT department were assessed for their response (R, responders; NR, non-responders) to medical treatment (intranasal steroids and antihistamines or antileucotriens) by direct questioning and nasal symptoms VAS, the presence of NOD (septal deformity, turbinate enlargement and adenoidal hyperplasia), comorbidities, nasal symptoms, rhinitis severity (modified-ARIA criterion) and asthma control (International Consensu...
Wellbeing and Development in Peru, 2008
... components. Like CFA, SEM requires a theoretical grounding, but we again rely instead on qual... more ... components. Like CFA, SEM requires a theoretical grounding, but we again rely instead on qualita-tive evidence. Amos 5.0 software was used for CFA and SEM; other statistical analyses were conducted using SPSS 14.0. 3.4. ...
Http Www Libreriasaulamedica Com, 2002
2003 IEEE Bologna Power Tech Conference Proceedings,, 2003
During the recent past, the share of wind power in electricity generation in Europe grew rapidly.... more During the recent past, the share of wind power in electricity generation in Europe grew rapidly. As a consequence multi-MW wind power plants more and more have to participate actively in operation of transmission systems. Examples are voltage and reactive power control, exact power generation according to scheduled schemes and contribution to fault treatment. The paper describes ongoing work of a project that demonstrates the capabilities of state-of-the-art wind power technology to deliver the required services and to contribute to efficient and safe network operation. The project combines innovative wind turbine technology with new concepts in the field of system integration and control.
with the Escuela de Administración de Negocios para Graduados (ESAN). The opinions expressed here... more with the Escuela de Administración de Negocios para Graduados (ESAN). The opinions expressed herein are those of the authors and do not necessarily reflect the view of USAID. One-Year Impacts of Improved Quality of Care in PeruEXECUTIVE SUMMARY Context. A study with 24 health directorates of the Peru MOH as units of experimentation and analysis that was conducted in 2000-2001 showed that two-day provider training plus one-day re-training on the job aids-assisted Balanced Counseling Strategy resulted in significant enhancement of the quality of care, an increase of four minutes in session length, and improved client knowledge of the method chosen when this was an IUD or hormonal method. This study presents results of a one-year follow-up. Methodology. New-event family planning clients were recruited as they exited counseling sessions at treated and control clinics. The clients had chosen a contraceptive method and stated intentions to use contraception for at least one year. A questi...
The American journal of tropical medicine and hygiene, 2005
Platelet dysfunction was detected in six children with purpura and eosinophilia. We conducted cli... more Platelet dysfunction was detected in six children with purpura and eosinophilia. We conducted clinical evaluations, hematologic and platelet function tests, clotting studies (bleeding time, prothrombin time, partial thromboplastin time, thrombin time, factor XIII, factor VIII, and von Willebrand factor), assays for IgG and IgM antibodies to platelets, and a search for stool parasites. Mild bleeding phenomena (ecchymoses, petechiae, epistaxis, and gingival) were transient. All children showed intestinal parasites and marked eosinophilia (mean count = 2,615.2 cells/muL, 95% confidence interval = 1,259.6-5,429.8). Main abnormalities included prolonged bleeding times (50%) and defective aggregation with collagen (100%) adrenaline (66%), or ADP (66%). Antibodies to platelets were not detected. Anti-parasite therapy reversed the hemorrhagic manifestations and normalized eosinophil counts and platelet alterations. No relationship could be established between excess eosinophils, intensity o...
Clinical and Translational Allergy, 2013
Pascal et al.: Comparison of the sensitization profile between children and adults allergic to mu... more Pascal et al.: Comparison of the sensitization profile between children and adults allergic to multiple plant-foods. Clinical and Translational Allergy 2013 3(Suppl 3):O4.
Clinical and Translational Allergy
Introduction: Incidence of anaphylaxis is increasing. Data regarding anaphylaxis mortality are li... more Introduction: Incidence of anaphylaxis is increasing. Data regarding anaphylaxis mortality are limited, but conflicting. Our objective was to document anaphylaxis mortality rate (deaths per million population), time trends and specificities according to triggers (iatrogenic, venom, food, unknown), age groups, sex and geographical regions (North and South) in France, between 1979 and 2011. Methods: Data were obtained (1) from database of the National Mortality Center (CEPIDC) to collect cases in which anaphylaxis was included as a cause of death, sex, age, and geographic region of death, (2) from the database of the National Institute for Economical and Statistical studies (INSEE) to define the referent populations. We used a multivariable log-linear Poisson regression model to assess the impact of time period, age, sex and geographic region on anaphylaxis deaths. Results: During the period study, 1603 deaths were collected: 1564 in adults and 39 in children (age <18 year). The overall prevalence of anaphylaxis fatalities was 0.84 per million population (95% IC 0.80-0.88), ranging from 0.08 per million (95% IC 0.05-0.10) in pediatric population to 1.12 per million (95% CI 1.06 to 1.17) in adult population. Annual percentage change for case fatality rate was −2.0% (95% CI −2.5 to −1.5; p < 10 −4) indicating a decrease in case fatality rate during the study period. Anaphylaxis fatality rate was higher in men (1.08 per million [95% IC 1.00 1.16] than women (0.86 per million [95% IC 0.80-0.92]) (p < 10 −4). Triggers of anaphylaxis fatalities were iatrogenic (63%), mostly drugs, venom (14%) and food (0.6%). Unspecified anaphylaxis was frequent (23%). The highest rate was in persons aged >70 years (3.50 per million population per year [95% IC 3.25-3.76]) and the lowest in the pediatric population (p < 10 −4). Only venom-induced mortality rate was higher in South of France (0.16 per million [95% IC 0.13-0.19]) compared with the North (0.11 per million [95% IC 0.09-0.13]) (p = 0.004). Only 8 food-induced fatalities were recorded (age <35 years in 7 cases). Conclusion: Overall anaphylaxis mortality rate is decreasing over the three last decades in France. We confirm that iatrogenic causes are the most frequent causes. Older age and male sex are risk factors of fatal anaphylaxis of any cause except for food-induced anaphylaxis.
Clinical and Translational Allergy, 2016
Introduction: Bullous lesions are common skin lesions particularly in childhood. Drug reactions, ... more Introduction: Bullous lesions are common skin lesions particularly in childhood. Drug reactions, burns, insect bites, mosquito bites, skin diseases, autoimmune bullous dermatoses and bacterial infections are the most common etiologies. Herein, we report two children who have solitary mastocytoma presented with variable bullous lesions. Case 1: A 3-year old boy admitted to our outpatient department suffering from red, periodically vesicular and bullous lesions on his back of neck since birth. His medical history revealed that he had four attacks characterized by flushing, perioral paleness, and hypotension. The lesion became swollen and itchy when it was rubbed vigorously (positive Darier's sign). Physical examination revealed a bullous lesion (2 × 3 cm) in his dorsal neck region. Laboratory investigations including CBC, liver and kidney function tests and serum electrolytes were within normal limits. Histopathologic examination of a punch biopsy specimen revealed solitary mastocytoma and the patient is under regular antihistamine treatment. Case 2: A 3-month old boy admitted with complaints of oval, erythematous and periodically changing bullous lesions in his proximal of right ankle since birth. His medical history revealed that the lesion became bullous and itchy when his mother rubbed it vigorously. Physical examination revealed a bullous lesion (1 × 1 cm) in his left foot. Laboratory investigations for possible etiologic factors were within normal limits. Histopathologic examination of a punch biopsy specimen revealed solitary mastocytoma. The patient is uneventfully under regular follow up. Conclusion: Solitary mastocytomas should be considered in the differential diagnosis of periodically varying bullous reactions in children. Consent to publish Written informed consent for publication of this clinical details and/or clinical images was obtained from the patient/parent/guardian/relative of the patient. A copy of the consent form is available for review by the Editor of this journal.
Journal of Asthma and Allergy
The Journal of Asthma and Allergy is an international, peer-reviewed open-access journal publishi... more The Journal of Asthma and Allergy is an international, peer-reviewed open-access journal publishing original research, reports, editorials and commentaries on the following topics: Asthma; Pulmonary physiology; Asthma related clinical health; Clinical immunology and the immunological basis of disease; Pharmacological interventions and new therapies. The manuscript management system is completely online and includes a very quick and fair peer-review system, which is all easy to use. Visit http://www.dovepress.com/testimonials.php to read real quotes from published authors.
Journal of Asthma and Allergy
In the SOLANA trial, we sought to physiologically characterize benralizumab's onset of effect and... more In the SOLANA trial, we sought to physiologically characterize benralizumab's onset of effect and maintenance of that effect for patients with severe eosinophilic asthma. Methods: SOLANA (NCT02869438) was a multicenter, randomized, double-blind, parallelgroup, placebo-controlled, Phase IIIb study conducted at 49 centers in six countries (Chile, Germany, Hungary, the Philippines, South Korea, and the United States). Eligible patients with baseline blood eosinophil counts ≥300 cells/µL were randomized to subcutaneous benralizumab (30 mg) or placebo administered at Days 0, 28, and 56. The primary endpoint was the average change from baseline in prebronchodilator forced expiratory volume in 1 s (pre-BD FEV 1) during the Day 28-Day 84 period for benralizumab vs placebo. Secondary endpoints included patientreported outcomes (PROs). A subset of patients participated in a whole-body plethysmography substudy. Safety was also assessed. Results: In total, 233 patients were randomized to benralizumab (n=118) or placebo (n=115). Improvement from baseline in pre-BD FEV 1 with benralizumab 30 mg was not statistically significant compared with placebo (least-squares mean change difference [95% confidence interval] 57 mL [−22 to 135]; p=0.16). Compared with placebo, benralizumab demonstrated early (Day 7) nonstatistically significant improvements in whole-body plethysmography assessments of hyperinflation and clinically meaningful improvements in PRO measures (Asthma Control Questionnaire 6 at Day 14 and St. George's Respiratory Questionnaire at Day 28), which were maintained over the treatment period. Benralizumab's safety profile was commensurate with previously reported studies. Conclusion: The observed early changes in lung volume despite relatively small improvements in airflow obstruction suggest that the anti-inflammatory effect of benralizumab may be manifested as deflation over time for patients with hyperinflation, who potentially have a greater degree of airway remodeling. This early effect could partially explain the rapid PRO improvements observed for certain patients.
Context. A study with 24 health directorates of the Peru MOH as units of experimentation and anal... more Context. A study with 24 health directorates of the Peru MOH as units of experimentation and analysis that was conducted in 2000-2001 showed that two-day provider training plus one-day retraining on the job aids-assisted Balanced Counseling Strategy resulted in significant enhancement of the quality of care, an increase of four minutes in session length, and improved client knowledge of the method chosen when this was an IUD or hormonal method. This study presents results of a one-year follow-up. Methodology. New-event family planning clients were recruited as they exited counseling sessions at treated and control clinics. The clients had chosen a contraceptive method and stated intentions to use contraception for at least one year. A questionnaire that included the calendar module of DHS was applied twice in home interviews to tap six and 12-month outcomes. Twelve-month data from 215 clients were analyzed in depth. Results. Knowledge of the method chosen when this was the IUD or a hormonal method was greater in the treated cohort (p < .05, one-tailed, df = 18) at the end of the follow-up period. Mean monthly (k = 12) family planning use rates over health-directorates (n = 12) were obtained for each cohort. The latter months showed less use of needed contraception (p < .01, df = 11,11) and the treated cohort greater use (.81) than the control cohort (.78, p < .01, df = 1,11) when contemporaneous perceptions of need were considered. Cumulative continuation rates from life tables did not differ significantly between cohorts according to the Wilcoxon (Gehan) statistic. Proportions of method shifting were similar in both cohorts. Attainment of contemporaneous reproductive goal was significantly greater in the treated cohort (.96) than the control cohort (.95, p < .01, df = 1,11). Conclusions and Recommendations. The intervention caused consistent, yet small, improvements in client outcomes. Correlational findings suggested that better impacts can be achieved in provincial primary health facilities than in larger settings like clinics or hospitals in capital cities. The results are important because: 1) other studies have failed to show significant impacts of controlled quality-of-care improvements on the use of contraception; and 2) the Balanced Counseling Strategy was not implemented to its full extent. Greater impacts can be expected when the Strategy's potential is fully realized.
Clinical and Translational Allergy
Annals of hematology, 2018
The aims of this study were to describe hepcidin levels and to assess their associations with iro... more The aims of this study were to describe hepcidin levels and to assess their associations with iron status and the main variants in the HFE gene in healthy and full-term newborns during the first year of life, as a longitudinal study conducted on 140 infants. Anthropometric and biochemical parameters, hepcidin, hemoglobin (Hb), serum ferritin (SF), transferrin saturation (TS), mean corpuscular volume (MCV), and C-reactive protein (CRP), were assessed in 6- and 12-month-olds. Infants were genotyped for the three main HFE variants: C282Y, H63D, and S65C. Hepcidin levels increased from 6 to 12 months of age (43.7 ± 1.5 to 52.0 ± 1.5 ng/mL; p < 0.001), showing higher levels in infants with better iron status compared to those with iron deficiency (ID) (44.8 ± 1.5 vs 37.9 ± 1.3 ng/mL, p < 0.018, and 54.3 ± 1.5 vs 44.0 ± 1.4 ng/mL, p < 0.038, in 6- and 12-month-olds, respectively). In multivariate linear regression models, iron status was found to be associated with hepcidin level...
International journal of pediatric otorhinolaryngology, 2017
To evaluate the impact of different types of nasal septum deformity (NSD) on nasal obstruction, r... more To evaluate the impact of different types of nasal septum deformity (NSD) on nasal obstruction, rhinitis severity and response to medical treatment among pediatric persistent allergic rhinitis (PER) patients. In a prospective, real-life study, 150 children and adolescents (mean age 13 ± 2.8 years, females 32.6%) diagnosed with PER according to ARIA guidelines were assessed by nasal endoscopy for NSD according to Mladina's classification, their response to medical treatment (intranasal steroids and antihistamines or antileucotriens), the presence of comorbidities, rhinitis severity (modified-ARIA criterion) and nasal obstruction visual analog scale score (VAS). Most patients (87%) had 1 of the 7 types of septal deformities. There was a high prevalence of bilateral (types 4 and 6; 46%) and anterior unilateral (types 1 and 2; 25%) NSD in patients not responding to medical treatment. Type 4 (OR = 6.4; p = 0.005) or type 6 (OR = 4.4; p = 0.03) NSD increased the risk of lack of improv...
Journal of Neuroimmunology, 2017
Few studies have investigated the relationship between post-natal inflammatory biomarkers at earl... more Few studies have investigated the relationship between post-natal inflammatory biomarkers at early age and child neurodevelopment outcomes. The main aim of this study was to examine the relationship between IL-6, IL-1β, IL-4 cytokines, as well as cortisol at 6 and 12months of age, and neurodevelopment and psychological problems at 30months of age. The study was conducted on a sample of 51 full-term newborns who were followed up at 6, 12, and 30months of age. Infant neurodevelopment was assessed using the Bayley Scales of Infant Development-II, psychological problems were assessed with the Child Behavior Checklist 1.5-5 (CBCL 1.5-5) and the mother&amp;amp;amp;amp;amp;#39;s emotional symptoms were assessed with the General Health Questionnaire-28. When the infants were 6 and 12months old, IL-6, IL-1β, IL-4 cytokines, and cortisol were measured in blood samples. The results showed that higher IL-6 at 12months predicted higher scores in internalizing (emotionally reactive, anxious/depressed, withdrawn and attention problems) and externalizing problems (aggressive behavior) at 30months. By contrast, high levels of IL-1β at 6months were related to worse motor skills. Inflammatory biomarkers were not related to mental performance. IL-6 and IL-1β could be early markers of later psychological problems and psychomotor disabilities.
Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology, 2016
Allergic rhinitis (AR) is the most common chronic disease among children. To characterize the dis... more Allergic rhinitis (AR) is the most common chronic disease among children. To characterize the disease, a modified classification of severity (m-ARIA) has recently been validated in AR children. When medical treatment fails, surgery for nasal obstructive disorders (NOD) may be a therapeutic option. Our objective was to assess the prevalence of NOD and their influence in medical treatment response among children with persistent AR (PER). In a prospective, real-life study, 130 pediatric PER patients (13.1±2.8 years, females 31.5%, severe rhinitis 49%) referred from Allergy to ENT department were assessed for their response (R, responders; NR, non-responders) to medical treatment (intranasal steroids and antihistamines or antileucotriens) by direct questioning and nasal symptoms VAS, the presence of NOD (septal deformity, turbinate enlargement and adenoidal hyperplasia), comorbidities, nasal symptoms, rhinitis severity (modified-ARIA criterion) and asthma control (International Consensu...
Wellbeing and Development in Peru, 2008
... components. Like CFA, SEM requires a theoretical grounding, but we again rely instead on qual... more ... components. Like CFA, SEM requires a theoretical grounding, but we again rely instead on qualita-tive evidence. Amos 5.0 software was used for CFA and SEM; other statistical analyses were conducted using SPSS 14.0. 3.4. ...
Http Www Libreriasaulamedica Com, 2002
2003 IEEE Bologna Power Tech Conference Proceedings,, 2003
During the recent past, the share of wind power in electricity generation in Europe grew rapidly.... more During the recent past, the share of wind power in electricity generation in Europe grew rapidly. As a consequence multi-MW wind power plants more and more have to participate actively in operation of transmission systems. Examples are voltage and reactive power control, exact power generation according to scheduled schemes and contribution to fault treatment. The paper describes ongoing work of a project that demonstrates the capabilities of state-of-the-art wind power technology to deliver the required services and to contribute to efficient and safe network operation. The project combines innovative wind turbine technology with new concepts in the field of system integration and control.
with the Escuela de Administración de Negocios para Graduados (ESAN). The opinions expressed here... more with the Escuela de Administración de Negocios para Graduados (ESAN). The opinions expressed herein are those of the authors and do not necessarily reflect the view of USAID. One-Year Impacts of Improved Quality of Care in PeruEXECUTIVE SUMMARY Context. A study with 24 health directorates of the Peru MOH as units of experimentation and analysis that was conducted in 2000-2001 showed that two-day provider training plus one-day re-training on the job aids-assisted Balanced Counseling Strategy resulted in significant enhancement of the quality of care, an increase of four minutes in session length, and improved client knowledge of the method chosen when this was an IUD or hormonal method. This study presents results of a one-year follow-up. Methodology. New-event family planning clients were recruited as they exited counseling sessions at treated and control clinics. The clients had chosen a contraceptive method and stated intentions to use contraception for at least one year. A questi...
The American journal of tropical medicine and hygiene, 2005
Platelet dysfunction was detected in six children with purpura and eosinophilia. We conducted cli... more Platelet dysfunction was detected in six children with purpura and eosinophilia. We conducted clinical evaluations, hematologic and platelet function tests, clotting studies (bleeding time, prothrombin time, partial thromboplastin time, thrombin time, factor XIII, factor VIII, and von Willebrand factor), assays for IgG and IgM antibodies to platelets, and a search for stool parasites. Mild bleeding phenomena (ecchymoses, petechiae, epistaxis, and gingival) were transient. All children showed intestinal parasites and marked eosinophilia (mean count = 2,615.2 cells/muL, 95% confidence interval = 1,259.6-5,429.8). Main abnormalities included prolonged bleeding times (50%) and defective aggregation with collagen (100%) adrenaline (66%), or ADP (66%). Antibodies to platelets were not detected. Anti-parasite therapy reversed the hemorrhagic manifestations and normalized eosinophil counts and platelet alterations. No relationship could be established between excess eosinophils, intensity o...
Clinical and Translational Allergy, 2013
Pascal et al.: Comparison of the sensitization profile between children and adults allergic to mu... more Pascal et al.: Comparison of the sensitization profile between children and adults allergic to multiple plant-foods. Clinical and Translational Allergy 2013 3(Suppl 3):O4.