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BackgroundThe COVID-19 pandemic affected Respiratory Syncytial Virus (RSV) circulation and surveillance, causing logistical complexity for health systems. Our objective was to describe changes in epidemiology and clinical severity of RSV cases in British Columbia, Canada. MethodsComparative analysis of RSV detections in children <36 months at BC Childrens Hospital (BCCH) between September 1 and August 31 of 2017-18, 2018-19, 2019-20, 2020-21 and 2021-22. ResultsAbout one-fifth of children tested RSV positive on average across all periods. The median age of RSV cases was 11.8 [IQR: 3.8-22.3] months in 2021-22 versus 6.3 [IQR: 1.9-16.7] months in 2017-20 (p<0.001). Increased testing in 2021-22 (n=3,120) compared to 2017-20 (average n=1,222/period) detected milder infections with lower proportion hospitalized in all age subgroups <6 (26.0%), 6-11 (12.3%), 12-23 (12.2%) and 24-35 (16.0%) months versus 2017-20 (49.3%, 53.5%, 62.6%, 57.5%, respectively) (all p<0.001). Children <6 months consistently comprised most hospitalizations and those born prematurely <29 weeks or with chronic respiratory co-morbidities remained at highest hospitalization risk in 2021-22. Among hospitalized cases, intensive care, respiratory support or supplemental oxygen use did not differ between the 2017-20 and 2021-22 periods. ConclusionsRSV circulation halted during the pandemic, but with the lifting of mitigation measures a subsequent resurgence in children <36 months of age was accompanied by shift toward older (24-35 month) cases in 2021-22, without increased severity. For the 2022-23 period, increased circulation and residual vulnerability in additional birth cohorts spared from RSV infection during the pandemic could have marked cumulative healthcare impact, even without increase in proportion hospitalized.
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<p><b>AIM</b>To study the protection of casein and protamine against degradation of insulin (INS) by proteolysis enzymes and the effect of these two kinds of protein on the hypoglycemic action of INS solution and enteric-microspheres after administrated orally to rats.</p><p><b>METHODS</b>HPLC was used to determine the remained INS in the solution of alpha-chymotrypsin and trypsin with or without casein or protamine; INS solution and enteric-microspheres were prepared and adiministrated orally to rats together with the absorption enhancer sodium N-[8-(2-hydroxybenzoyl) amino] caprylate (SNAC). At the same time, casein or protamine or both of these two kinds of protein were administrated together in order to study their influence on the hypoglycemic effect of INS and microspheres.</p><p><b>RESULTS</b>Casein had a good protection against degradation of INS by alpha-chymotrypsin, but protamine had no protection effect. However, the degradation of INS by trypsin is concerned, the protection effect of protamine on INS was better that of casein. Both of protamine and casein can increase the hypoglycemic effect of INS solution and enteric-microspheres. Co-administrated these two kinds of protein had a better effect. In addition, co-administrated with SNAC, casein and protamine, INS enteric-microspheres had a longer and more potent hypoglycemic effect than that of the solution.</p><p><b>CONCLUSION</b>Casein and protamine can increase the stability of INS in the intestinal fluid by the mechanism of competition and combine with proteolysis enzymes, which will benefit to INS oral administration.</p>
