Household Severe Acute Respiratory Syndrome Coronavirus 2 Transmission and Children: A Network Prospective Study.

BACKGROUND: The role of children in household transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains unclear. We describe the epidemiological and clinical characteristics of children with coronavirus disease 2019 (COVID-19) in Catalonia, Spain, and investigate the household transmission dynamics. METHODS: A prospective, observational, multicenter study was performed during summer and school periods (1 July 2020-31 October 2020) to analyze epidemiological and clinical features and viral household transmission dynamics in COVID-19 patients aged <16 years. A pediatric index case was established when a child was the first individual infected. Secondary cases were defined when another household member tested positive for SARS-CoV-2 before the child. The secondary attack rate (SAR) was calculated, and logistic regression was used to assess associations between transmission risk factors and SARS-CoV-2 infection. RESULTS: The study included 1040 COVID-19 patients. Almost half (47.2%) were asymptomatic, 10.8% had comorbidities, and 2.6% required hospitalization. No deaths were reported. Viral transmission was common among household members (62.3%). More than 70% (756/1040) of pediatric cases were secondary to an adult, whereas 7.7% (80/1040) were index cases. The SAR was significantly lower in households with COVID-19 pediatric index cases during the school period relative to summer (P = .02) and compared to adults (P = .006). No individual or environmental risk factors associated with the SAR. CONCLUSIONS: Children are unlikely to cause household COVID-19 clusters or be major drivers of the pandemic, even if attending school. Interventions aimed at children are expected to have a small impact on reducing SARS-CoV-2 transmission.

Prevalence, Clinical Characteristics and Risk Factors of Post-COVID-19 Condition in a Multicenter Pediatric Primary and Hospital Care Cohort.

The prevalence of post-COVID-19 condition is not well defined. We describe a cohort of 244 children diagnosed with COVID-19 and followed up for 6 months, in which 4.9% of patients had persistent symptoms at 12 weeks. Anosmia was the most frequent symptom. Being female and having more than 3 symptoms in acute infection were associated with an increased risk of post-COVID.

High-Throughput Flow Injection Analysis-Mass Spectrometry (FIA-MS) Fingerprinting for the Authentication of Tea Application to the Detection of Teas Adulterated with Chicory.

Tea is a broadly consumed beverage worldwide that is susceptible to fraudulent practices, including its adulteration with other plants such as chicory extracts. In the present work, a non-targeted high-throughput flow injection analysis-mass spectrometry (FIA-MS) fingerprinting methodology was employed to characterize and classify different varieties of tea (black, green, red, oolong, and white) and chicory extracts by principal component analysis (PCA) and partial least squares-discriminant analysis (PLS-DA). Detection and quantitation of frauds in black and green tea extracts adulterated with chicory were also evaluated as proofs of concept using partial least squares (PLS) regression. Overall, PLS-DA showed that FIA-MS fingerprints in both negative and positive ionization modes were excellent sample chemical descriptors to discriminate tea samples from chicory independently of the tea product variety as well as to classify and discriminate among some of the analyzed tea groups. The classification rate was 100% in all the paired cases-i.e., each tea product variety versus chicory-by PLS-DA calibration and prediction models showing their capability to assess tea authentication. The results obtained for chicory adulteration detection and quantitation using PLS were satisfactory in the two adulteration cases evaluated (green and black teas adulterated with chicory), with calibration, cross-validation, and prediction errors below 5.8%, 8.5%, and 16.4%, respectively. Thus, the non-targeted FIA-MS fingerprinting methodology demonstrated to be a high-throughput, cost-effective, simple, and reliable approach to assess tea authentication issues.

Symptom-Based Predictive Model of COVID-19 Disease in Children.

BACKGROUND: Testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is neither always accessible nor easy to perform in children. We aimed to propose a machine learning model to assess the need for a SARS-CoV-2 test in children (<16 years old), depending on their clinical symptoms. METHODS: Epidemiological and clinical data were obtained from the REDCap® registry. Overall, 4434 SARS-CoV-2 tests were performed in symptomatic children between 1 November 2020 and 31 March 2021, 784 were positive (17.68%). We pre-processed the data to be suitable for a machine learning (ML) algorithm, balancing the positive-negative rate and preparing subsets of data by age. We trained several models and chose those with the best performance for each subset. RESULTS: The use of ML demonstrated an AUROC of 0.65 to predict a COVID-19 diagnosis in children. The absence of high-grade fever was the major predictor of COVID-19 in younger children, whereas loss of taste or smell was the most determinant symptom in older children. CONCLUSIONS: Although the accuracy of the models was lower than expected, they can be used to provide a diagnosis when epidemiological data on the risk of exposure to COVID-19 is unknown.

Schools as a Framework for COVID-19 Epidemiological Surveillance of Children in Catalonia, Spain: A Population-Based Study.

Objective: We describe and analyze the childhood (<18 years) COVID-19 incidence in Catalonia, Spain, during the first 36 weeks of the 2020-2021 school-year and to compare it with the incidence in adults. Methods: Data on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) tests were obtained from the Catalan Agency for Quality and Health Assessment. Overall, 7,203,663 SARS-CoV-2 tests were performed, of which 491,819 were positive (6.8%). We collected epidemiological data including age-group incidence, diagnostic effort, and positivity rate per 100,000 population to analyze the relative results for these epidemiological characteristics. Results: Despite a great diagnostic effort among children, with a difference of 1,154 tests per 100,000 population in relation to adults, the relative incidence of SARS-CoV-2 for <18 years was slightly lower than for the general population, and it increased with the age of the children. Additionally, positivity of SARS-CoV-2 in children (5.7%) was lower than in adults (7.2%), especially outside vacation periods, when children were attending school (4.9%). Conclusions: A great diagnostic effort, including mass screening and systematic whole-group contact tracing when a positive was detected in the class group, was associated with childhood SARS-CoV-2 incidence and lower positivity rate in the 2020-2021 school year. Schools have been a key tool in epidemiological surveillance rather than being drivers of SARS-CoV-2 incidence in Catalonia, Spain.

The Importance of Rapid Influenza Testing in Pediatric Primary Care: Experience During Three Consecutive Influenza Seasons (2016-2019) in Barcelona (Catalonia, Spain).

Clinical diagnosis of influenza has low sensitivity in infants and children. Signs and symptoms are non-specific and similar to those of other respiratory viruses. Rapid influenza diagnostic tests (RIDTs) with adequate sensitivity and specificity used at the point of care can be useful for an etiologic diagnosis of influenza in primary care. This should have an impact on better management of these patients. We conducted a study during three consecutive influenza seasons (2016-2017, 2017-2018, and 2018-2019) in pediatric primary care settings collecting data from influenza point-of-care tests (POCTs)-confirmed ≤ 6-year-old patients. During the first two influenza seasons, antibiotic prescriptions and additional visits from influenza POCT-confirmed patients (Group_1) were compared to patients with influenza-like illness (ILI) (Group_2), or fever (2016 ICD-10 code R50) with no other signs of influenza (Group_3). Group_1 had 0.19 (2016-2017) and 0.23 (2017-2018) additional visits compared to 0.48 (2016-2017) and 0.49 (2017-2018) Group_2 p < 0.001 and 1.01 (2016-2017) and 0.80 (2017-2018) Group_3 p < 0.001. Antibiotic prescription was lower in Group_1 (10.2%) vs. Group_3 (17.2%) p < 0.002, difference statistically significant only for the 2017-2018 season. During the third season (2018-2019), RIDTs results were transmitted in real time to the reference laboratory ia the cloud, which strengthens the monitoring of circulating influenza viruses in the community. In our experience, the use of POCTs has a great potential in primary care specially in infants and young children in which the diagnosis maybe missed due to non-specific signs and symptoms.

First report of the simultaneous occurrence of choroid plexus papilloma and meningioma in a dog.

A 7-year-old spayed female English Cocker Spaniel was examined because of a 1-week history of lethargy, stumbling over objects and circling, and the presence of two tonic-clonic generalised seizures two days before presentation. The neurological signs suggested a lesion involving the right forebrain. Computed tomography revealed the presence of two intracranial masses, one located inside the right lateral ventricle and the other located in the right frontal lobe attached to the falx cerebri. Because of the poor prognosis, the owner refused to continue with the therapy and the dog was euthanised. On postmortem examination one mass was diagnosed histologically as a meningioma and the other as a papilloma of the choroid plexus. Information in the veterinary literature on multiple malignancies affecting the central nervous system is very limited. To the best of the authors' knowledge, the association of meningioma and choroid plexus papilloma has never been reported either in the human or in the veterinary medical literature.

Rapid Influenza Testing in Infants and Children Younger than 6 Years in Primary Care: Impact on Antibiotic Treatment and Use of Health Services.

Influenza is often misdiagnosed in children because of the low sensitivity of clinical diagnosis because of nonspecific signs and symptoms. This can be overcome by using digital immunoassays or rapid molecular diagnostic tests with adequate sensitivity and specificity. When using these tests at the patient care site, antibiotic consumption and number of healthcare consultations were reduced.

Congenital skeletal abnormalities in a tawny owl chick (Strix aluco).

In this case report, we describe a tawny owl chick (Strix aluco) coming from a Wild Fauna Recovery Center with multiple congenital malformations in the limbs. The animal was unable to fly and showed marked malnutrition and poor general appearance. Physical, radiologic, and anatomic examinations showed osseous malformations including dislocation of radius and carpometacarpus with abnormal nonfunctional fixation of ligamentum propatagialis, absence of most parts of the bones of the manus in both wings, and twisted nonfused left tarsometatarsus with marked griphosis of digits. Routine toxicologic and pathologic examinations did not reveal a specific etiology.

Diagnòstic ràpid de grip en lactants i infants menors de 6 anys a l'atenció primària / Diagnóstico rápido de gripe en lactantes y niños menores de 6 años en atención primaria / Rapid diagnosis of influenza in infants and children younger than 6 years of age in primary care

Fonament: La taxa d'incidència de la grip en l'edat pediàtrica és la més elevada de la població, i el diagnòstic és difícil els primers anys de vida perquè té una simptomatologia inespecífica. Els tests de diagnòstic ràpid (TDR) de grip podrien millorar el maneig dels pacients en atenció primària. Objectiu: Estudiar si el diagnòstic de grip amb un TDR objectiu en lactants i infants menors de 6 anys disminueix el consum d'antibiòtics i el nombre de consultes successives. Mètode: Estudi longitudinal prospectiu descriptiu realitzat durant la temporada epidèmica 2016-2017 en quatre centres d'atenció primària de Barcelona, a lactants i infants fins als 6 anys. Amb una mostra de frotis nasofaringi es van fer dos tipus de TDR i al cap de 10 dies s'efectuava un seguiment telefònic demanant l'evolució de la simptomatologia, l'antibioteràpia rebuda, les consultes fetes i el contagi familiar produït. Resultats: Es van diagnosticar 55 casos de grip A, amb una edat mitjana de 33 mesos. La durada de la febre abans del diagnòstic va ser de 2,1 dies i de 3,2 dies després del diagnòstic, amb una temperatura mitjana de 38,9ºC. La simptomatologia més freqüent va ser la respiratòria, amb una durada mitjana després del diagnòstic de 6-7 dies. Van rebre antibioteràpia dos pacients, es van efectuar 18 reconsultes i es va objectivar un contagi de 50 persones en 29 famílies. Conclusions: La baixa prescripció antibiòtica i de consultes successives semblen confirmar que fer el diagnòstic en la consulta mateix és útil per aconseguir aquest objectiu

Fundamento: La tasa de incidencia de gripe en edad pediátrica es la más elevada de la población y su diagnóstico es difícil en los primeros años de vida por su sintomatología inespecífica. Los tests de diagnóstico rápido (TDR) de gripe podrían mejorar el manejo de los pacientes en atención primaria. Objetivo: Estudiar si el diagnóstico de gripe con un TDR en lactantes y niños menores de 6 años disminuye el consumo de antibióticos y el número de consultas sucesivas. Método: Se realizó un estudio longitudinal prospectivo descriptivo durante la temporada epidémica de 2016-2017 en cuatro centros de atención primaria de Barcelona, a lactantes y niños hasta los 6 años. Con una muestra de frotis nasofaríngeo se realizaron dos tipos de TDR y a los 10 días se efectuaba el seguimiento telefónico, preguntando por la evolución de la sintomatología, la antibioterapia recibida, las consultas realizadas y el contagio familiar producido. Resultados: Se diagnosticaron 55 casos de gripe A, con una edad media de 33 meses. La duración media de la fiebre antes del diagnóstico fue de 2,1 días y de 3,2 días después del diagnóstico, con una temperatura media de 38,9ºC. La sintomatología más frecuente fue la respiratoria, con una duración media tras el diagnóstico de 6-7 días. Recibieron antibioterapia dos pacientes, se efectuaron 18 reconsultas y se objetivó un contagio de 50 pacientes en 29 familias. Conclusiones: La baja prescripción antibiótica y del número de consultas sucesivas parecen confirmar que realizar el diagnóstico en la propia consulta es útil para conseguir este objetivo

Background: The incidence of influenza in children is the highest among all age groups, and its diagnosis may be difficult in the first years of life due to the non-specific symptoms. Rapid diagnostic tests (RDT) of influenza could improve the management of patients in the primary care setting. Objective: To investigate if the diagnosis of influenza using RDT in infants and children under 6 years resulted in a decrease in the prescription of antibiotics and in the number of follow-up medical visits. Method: We conducted a descriptive prospective longitudinal study during the 2016-2017 epidemic season in four primary care centers of Barcelona, with infants and children up to 6 years of age. Two types of RDT using a nasopharyngeal swab sample were performed, with a follow-up telephone call 10 days later to inquire about symptoms, antibiotic treatment received, additional medical visits, and family contagion noted. Results: A total of 55 cases of influenza A were diagnosed, at a median age of 33 months. The median duration of fever before and after the diagnosis was 2.1 and 3.2 days, respectively, with a median temperature of 38.9ºC. The most frequent symptomatology was respiratory, with a median duration after diagnosis of 6-7 days. Two patients received antibiotic therapy, 18 additional medical visits were carried out, and 50 individuals were reported to be infected among 29 families. Conclusions: The low antibiotic prescription and number of following medical visits seem to confirm that a rapid diagnosis performed during the initial consultation is useful for achieving those goals

Titanium oxide as substrate for neural cell growth.

Titanium oxide has antiinflammatory activity and tunable electrochemical behavior that make it an attractive material for the fabrication of implantable devices. The most stable composition is TiO2 and occurs mainly in three polymorphs, namely, anatase, rutile, and brookite, which differ in its crystallochemical properties. Here, we report the preparation of rutile surfaces that permit good adherence and axonal growth of cultured rat cerebral cortex neurons. Rutile disks were obtained by sinterization of TiO2 powders of commercial origin or precipitated from hydrolysis of Ti(IV)-isopropoxide. Commercial powders sintered at 1300-1600 degrees C produced rutile surfaces with abnormal grain growth, probably because of impurities of the powders. Neurons cultured on those surfaces survived in variable numbers and showed fewer neurites than on control materials. On the other hand, rutile sintered from precipitated powders had less contaminants and more homogenous grain growth. By adjusting the thermal treatment it was possible to obtain surfaces performing well as substrate for neuron survival for at least 10 days. Some surfaces permitted normal axonal elongation, whereas dendrite growth was generally impaired. These findings support the potential use of titanium oxide in neuroprostheses and other devices demanding materials with enhanced properties in terms of biocompatibility and axon growth promotion.

Marcadores de la inflamación: lavado broncoalveolar y esputo inducido / No disponible

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