ABSTRACT
Growing evidence indicates that gut and respiratory microbiota have a potential key effect on bronchiolitis, mainly caused by respiratory syncytial virus (RSV). This was a prospective study of 96 infants comparing infants with bronchiolitis (n = 57, both RSV and non-RSV associated) to a control group (n = 39). Gut (feces) and respiratory [nasopharyngeal aspirate (NPA)] microbial profiles were analyzed by 16S rRNA amplicon sequencing, and respiratory viruses were identified by PCR. Clinical data of the acute episode and follow-up during the first year after infection were recorded. Pairwise comparisons showed significant differences in the gut (R2 = 0.0639, P = 0.006) and NPA (R2 = 0.0803, P = 0.006) microbiota between cases and controls. A significantly lower gut microbial richness and an increase in the NPA microbial diversity (mainly due to an increase in Haemophilus, Streptococcus, and Neisseria) were observed in the infants with bronchiolitis, in those with the most severe symptoms, and in those who subsequently developed recurrent wheezing episodes after discharge. In NPA, the higher microbial richness differed significantly between the control group and the non-RSV bronchiolitis group (P = 0.01) and between the control group and the RSV bronchiolitis group (P = 0.001). In the gut, the richness differed significantly between the control group and the non-RSV group (P = 0.01) and between the control group and the RSV bronchiolitis group (P = 0.001), with higher diversity in the RSV group. A distinct respiratory and intestinal microbial pattern was observed in infants with bronchiolitis compared with controls. The presence of RSV was a main factor for dysbiosis. Lower gut microbial richness and increased respiratory microbial diversity were associated with respiratory morbidity during follow-up. IMPORTANCE: Both the intestinal and respiratory microbiota of children with bronchiolitis, especially those with respiratory syncytial virus infection, are altered and differ from that of healthy children. The microbiota pattern in the acute episode could identify those children who will later have other respiratory episodes in the first year of life. Preventive measures could be adopted for this group of infants.
Subject(s)
Bronchiolitis , Gastrointestinal Microbiome , Respiratory Syncytial Virus Infections , Humans , Infant , Bronchiolitis/microbiology , Bronchiolitis/virology , Male , Female , Prospective Studies , Respiratory Syncytial Virus Infections/microbiology , Respiratory Syncytial Virus Infections/virology , RNA, Ribosomal, 16S/genetics , Bacteria/classification , Bacteria/isolation & purification , Bacteria/genetics , Infant, Newborn , Feces/microbiology , Feces/virology , Microbiota , Hospitalization , Respiratory System/microbiology , Respiratory System/virology , Nasopharynx/microbiology , Nasopharynx/virology , Severity of Illness IndexABSTRACT
AIM: We investigated prolonged symptoms in children after COVID-19, including the clinical characteristics and risk factors. METHODS: This multicentre retrospective study focused on 451 children under 18 years old who were diagnosed with symptomatic COVID-19 between 14 March and 31 December 2020. Persistent symptoms were analysed with a telephone questionnaire by the attending physicians from 1 August to 30 September 2021. A control group of 98 with no history of COVID-19, who were treated for other reasons, was also included. RESULTS: Most (82.0%) of the cases had mild infections that required outpatient care and 5.1% were admitted to the paediatric intensive care unit (PICU). We found that 18.4% had symptoms that lasted 4-12 weeks. There were also 14.6% who were symptomatic for longer than 12 weeks and the odds risks were higher for children aged 5 years or more (OR 3.0), hospitalised (OR 3.9), admitted to the PICU (OR 4.3) and with relatives who were symptomatic for 12 weeks or more (OR 2.8). The controls had similar percentages of prolonged symptoms, despite having no history of COVID-19, especially those who were older than 5 years. CONCLUSION: This study confirmed that a worrying percentage of children had prolonged symptoms after COVID-19.
Subject(s)
COVID-19 , Adolescent , COVID-19/epidemiology , Child , Hospitalization , Humans , Intensive Care Units, Pediatric , Retrospective Studies , SARS-CoV-2ABSTRACT
This paper analyzes the process of construction of the Argentine public health system, highlighting the limitations that occurred in the proposed nationalization of health policy in the postwar period and the central role played by subnational jurisdictions, making the provision of services rendered on a provincial basis. More precisely, in this respect it is seen how the expansion of health services in some provinces shows us how, in the second quarter of the twentieth century, it was primarily the result of the action of local rather than national departments. In order to better elucidate this process, the trajectory of public healthcare facilities in the province of Córdoba between 1930 and 1955 was studied.
Subject(s)
Health Policy/history , Health Services Administration/history , Argentina , Health Facility Administration/history , History, 20th Century , Politics , Public Health/historyABSTRACT
Este trabajo analiza el proceso de construcción del sistema público de salud argentino, poniendo en evidencia las limitaciones que se produjeron en el proyecto de nacionalización de las políticas sanitarias en la postguerra y el papel central que tuvieron las jurisdicciones subnacionales, provincializando la provisión de los servicios. Más precisamente se visibiliza cómo, en el segundo cuarto del siglo XX, la ampliación de los servicios de salud en algunas provincias fue principalmente el resultado de la acción de las reparticiones locales antes que nacionales. Con el propósito de dilucidar mejor ese proceso, estudiamos la trayectoria de los dispositivos sanitarios públicos en la provincia de Córdoba entre 1930 y 1955.
This paper analyzes the process of construction of the Argentine public health system, highlighting the limitations that occurred in the proposed nationalization of health policy in the postwar period and the central role played by subnational jurisdictions, making the provision of services rendered on a provincial basis. More precisely, in this respect it is seen how the expansion of health services in some provinces shows us how, in the second quarter of the twentieth century, it was primarily the result of the action of local rather than national departments. In order to better elucidate this process, the trajectory of public healthcare facilities in the province of Córdoba between 1930 and 1955 was studied.
Subject(s)
History, 20th Century , Health Policy/history , Health Services Administration/history , Argentina , Health Facility Administration/history , Politics , Public Health/historyABSTRACT
Este trabajo analiza el proceso de construcción del sistema público de salud argentino, poniendo en evidencia las limitaciones que se produjeron en el proyecto de nacionalización de las políticas sanitarias en la postguerra y el papel central que tuvieron las jurisdicciones subnacionales, provincializando la provisión de los servicios. Más precisamente se visibiliza cómo, en el segundo cuarto del siglo XX, la ampliación de los servicios de salud en algunas provincias fue principalmente el resultado de la acción de las reparticiones locales antes que nacionales. Con el propósito de dilucidar mejor ese proceso, estudiamos la trayectoria de los dispositivos sanitarios públicos en la provincia de Córdoba entre 1930 y 1955. (AU)
Subject(s)
History, 20th Century , Health Services , Politics , Health Systems , Public Health , Health Policy , ArgentinaABSTRACT
Esta investigación tiene como objetivo analizar los procesos de estructuración de políticas sanitarias en una provincia argentina a lo largo de los años treinta y comienzos de los cuarenta, poniendo en evidencia la importancia de este período en la generación de cambios en el tratamiento estatal de la salud en el interior del país. Para ello, el trabajo se dedica a estudiar la construcción de las políticas sanitarias y las nuevas capacidades estatales que se desplegaron alrededor del campo de la salud pública en la provincia de Córdoba(AU)
The objective of this research is to analyze the health policy structuring process in an Argentine an province during the thirties and the beginning of the forties, showing the importance of this period in the production of changes in state health management in the interior provinces of the country. In order to do so, this paper studies the construction of the health policies and the new state capabilities that were brought into action surrounding public health in the province of Córdoba(AU)
Subject(s)
Humans , Public Health/history , Health Policy/history , History of Medicine , Argentina , Health Planning GuidelinesABSTRACT
The purpose of this paper is to analyze changes produced in the public health system of Córdoba during the peronist government and the performance of the provincial state in the process. We study the increase of health services, public social spending, health agencies and bureaucracies of the state of Córdoba between 1943 and 1955.
La finalidad de este artículo es analizar los cambios producidos en los sistemas de salud públicos en Córdoba durante los gobiernos peronistas y la actuación del Estado provincial en el proceso. En la investigación se analiza el incremento de los servicios de salud, el gasto público social y las agencias y burocracias sanitarias del Estado cordobés entre 1943 y 1955.
Subject(s)
Health Policy/history , Argentina , Democracy , Federal Government , Government Programs , History, 20th CenturyABSTRACT
Esta investigación tiene como objetivo analizar los procesos de estructuración de políticas sanitarias en una provincia argentina a lo largo de los años treinta y comienzos de los cuarenta, poniendo en evidencia la importancia de este período en la generación de cambios en el tratamiento estatalde la salud en el interior del país. Para ello, el trabajo se dedica a estudiar la construcción de las políticas sanitarias y las nuevas capacidades estatales que se desplegaron alrededor del campo de la salud pública en la provincia de Córdoba. (AU)
Subject(s)
History, 20th Century , Public Health/history , Health Policy/history , Health Infrastructure , ArgentinaABSTRACT
Desde los años cuarenta en la Argentina se desplegó un intenso proceso de construcción estatal que generaría nuevas capacidades de elaboración de políticas públicas e intervención social. A su vez, este fenómeno fue acompañado por una creciente centralización del poder político estatalen el Ejecutivo nacional. En ese contexto, el trabajo se propone realizar una aproximación a la cuestión desde una mirada centrada en una jurisdicción provincial, construyendo una narración que sitúe la historia de estas entidades políticas dentro del relato más amplio sobre la estructuración del Estado intervencionista. Con esa finalidad se analiza la trayectoria de una repartición sanitaria provincial y la de sus relaciones con los organismos del Estado federal, buscando desentrañar las reacciones que los aparatos públicos provinciales esbozaron frente al proceso de centralización de las políticas sociales que acompañó a la emergencia del peronismo. (AU)
