Publications by authors named "S Mertz"

44 Publications

RSV Specific Antibodies in Pregnant Women and Subsequent Risk of RSV Hospitalization in Young Infants.

J Infect Dis 2021 Jun 15. Epub 2021 Jun 15.

Helsinki University Hospital and University of Helsinki, Children's Hospital, Helsinki, Finland.

Background: The fusion (F) glycoprotein of respiratory syncytial virus (RSV) represents the major neutralizing antigen, and antibodies against the pre-F conformation have the most potent neutralizing activity. This study aimed to assess the correlation between maternal antibody (Ab) titers against the pre-F, post-F and G glycoproteins and the child's risk of developing severe RSV bronchiolitis early in infancy.

Methods: We identified previously healthy term infants less than 3 months of age hospitalized with RSV bronchiolitis from December 2015 to March 2016. We measured IgG Ab titers to pre-F, post-F, and G proteins in maternal sera obtained at 9-12 weeks of pregnancy of these hospitalized infants' mothers (n=94) and compared them with serum Ab titers of control pregnant mothers (n=130), whose children were not hospitalized.

Results: All maternal samples (n= 224) had detectable pre-F Abs. Pre-F Ab titers were significantly lower in mothers whose infants were hospitalized with RSV bronchiolitis compared with those mothers whose infants were not (23.9 [1.4-273.7] vs 30.6 [3.4-220.0] ug/l; p=0.0026). There were no significant differences in maternal post-F and G Ab titers between hospitalized versus non-hospitalized infants.

Conclusions: Our findings indicate that maternal pre-F antibodies are fundamental for providing immune protection to the infant.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/infdis/jiab315DOI Listing
June 2021

[Ventilation in Pediatric Anesthesia].

Authors:
Selinde Mertz

Anasthesiol Intensivmed Notfallmed Schmerzther 2021 May 26;56(5):342-354. Epub 2021 May 26.

About nine percent of all anesthesia procedures per year are performed in children. The risk for complications in pediatric anesthesia is higher in comparison with adults. There are significant differences in anatomy, physiology and pharmacology between pediatric and adult patients. Respiratory complications and circulations dysregulation occur more often in children. The most important consideration in the safe practice of pediatric anesthesia is to ensure a patent airway. Appropriate intraoperative management of newborns and infants needs a senior anesthetist with good knowledge and clinical experience including the management of possible complications.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1055/a-1189-8044DOI Listing
May 2021

Age-dependent Interactions Among Clinical Characteristics, Viral Loads and Disease Severity in Young Children With Respiratory Syncytial Virus Infection.

Pediatr Infect Dis J 2021 02;40(2):116-122

From the Center for Vaccines and Immunity.

Background: Age-dependent differences in clinical presentation and viral loads in infants and young children with respiratory syncytial virus (RSV) infection, and their correlation with disease severity are poorly defined.

Methods: Previously healthy children <2 years old with mild (outpatients) and severe (inpatients) RSV infection were enrolled and viral loads measured by polymerase chain reaction in nasopharyngeal swabs. Patients were stratified by age in 0-<3, 3-6 and >6-24 months, and multivariable analyses were performed to identify clinical and viral factors associated with severe disease.

Results: From 2014 to 2018, we enrolled 534 children with RSV infection, 130 outpatients with mild RSV infection and 404 inpatients with severe RSV disease. Median duration of illness was 4 days for both groups, yet viral loads were higher in outpatients than in inpatients (P < 0.001). In bivariate analyses, wheezing was more frequent in outpatients of older age (>3 months) than in inpatients (P < 0.01), while fever was more common in inpatients than outpatients (P < 0.01) and its frequency increased with age. Adjusted analyses confirmed that increased work of breathing and fever were consistently associated with hospitalization irrespective of age, while wheezing in infants >3 months, and higher RSV loads in children >6-24 months were independently associated with reduced disease severity.

Conclusions: Age had a significant impact defining the interactions among viral loads, specific clinical manifestations and disease severity in children with RSV infection. These observations highlight the importance of patient stratification when evaluating interventions against RSV.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/INF.0000000000002914DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7808270PMC
February 2021

Interviewer perceptions during the implementation of the multiple mini-interview model at a school of pharmacy.

Curr Pharm Teach Learn 2020 07 18;12(7):864-871. Epub 2020 Mar 18.

Legacy Health, 1919 NW Lovejoy St, Portland, OR, United States, 97209. Electronic address:

Introduction: Studies reveal positive interviewer perceptions of multiple mini-interview (MMI) upon MMI completion. No studies evaluate change in interviewer perceptions during MMI implementation. The objective was to evaluate the change in interviewer perceptions during the implementation of the MMI model at the University of Toledo College of Pharmacy and Pharmaceutical Sciences.

Methods: Interviewers (faculty volunteers, preceptors, student pharmacists) were eligible for inclusion in the prospective cohort. Consenting individuals (1) completed a pre-MMI training survey regarding perceptions of MMI, (2) participated in a 90-minute MMI training program (PowerPoint presentation and review of videos demonstrating MMI practices), (3) completed a post-MMI training survey, and (4) after interviews, completed a post-interview survey. The six Likert-scale MMI perception questions were independently analyzed for changes in the rank response across the three survey time points using Friedman's nonparametric repeated-measures analysis. Each question was evaluated for all respondents together, and for nine different respondent subgroups. The overall criteria for significance was α = 0.05 for each question, with Bonferroni correction for the ten overall comparisons made for each question.

Results: Thirty-two interviewers participated (20 faculty members, five preceptors, and seven student pharmacists). From the pre-MMI training survey through the post-interview survey, interviewers gained confidence in their ability to explain the rationale behind the MMI model, were more likely to agree that six minutes was adequate time to assess an applicant and believed MMI provides a fair assessment of an applicant's noncognitive attributes.

Conclusions: After interviewers received training and gained experience with MMI, perceptions of MMI improved.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cptl.2020.02.003DOI Listing
July 2020
-->