Publications by authors named "Sandra Di Lalla"

7 Publications

  • Page 1 of 1

Blood neutrophils from children with COVID-19 exhibit both inflammatory and anti-inflammatory markers.

EBioMedicine 2021 May 9;67:103357. Epub 2021 May 9.

División Infectología, Hospital General de Agudos Dr. Juan A. Fernández, Av. Cerviño 3356, CABA C1425, Argentina.

Background: Perhaps reflecting that children with COVID-19 rarely exhibit severe respiratory symptoms and often remain asymptomatic, little attention has been paid to explore the immune response in pediatric COVID-19. Here, we analyzed the phenotype and function of circulating neutrophils from children with COVID-19.

Methods: An observational study including 182 children with COVID-19, 21 children with multisystem inflammatory syndrome (MIS-C), and 40 healthy children was performed in Buenos Aires, Argentina. Neutrophil phenotype was analyzed by flow cytometry in blood samples. Cytokine production, plasma levels of IgG antibodies directed to the spike protein of SARS-CoV-2 and citrullinated histone H3 were measured by ELISA. Cell-free DNA was quantified by fluorometry.

Findings: Compared with healthy controls, neutrophils from children with COVID-19 showed a lower expression of CD11b, CD66b, and L-selectin but a higher expression of the activation markers HLA-DR, CD64 and PECAM-1 and the inhibitory receptors LAIR-1 and PD-L1. No differences in the production of cytokines and NETs were observed. Interestingly, the expression of CD64 in neutrophils and the serum concentration of IgG antibodies directed to the spike protein of SARS-CoV-2 distinguished asymptomatic from mild and moderate COVID-19.

Interpretation: Acute lung injury is a prominent feature of severe COVID-19 in adults. A low expression of adhesion molecules together with a high expression of inhibitory receptors in neutrophils from children with COVID-19 might prevent tissue infiltration by neutrophils preserving lung function.

Funding: This study was supported by the Ministry of Science and Technology (National Agency for Scientific and Technological Promotion, IP-COVID-19-0277 and PMO BID PICT 2018-2548), and University of Buenos Aires from Argentina (20020170100573BA).
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http://dx.doi.org/10.1016/j.ebiom.2021.103357DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8153212PMC
May 2021

Patients assisted at the Department of Medicine of a pediatric hospital at the beginning of the COVID-19 pandemic in Buenos Aires, Argentina.

Arch Argent Pediatr 2020 12;118(6):418-426

Departamento de Medicina, Hospital General de Niños Pedro de Elizalde, Ciudad Autónoma de Buenos Aires, Argentina.

Introduction: Despite the magnitude of the COVID-19 pandemic, the information about its development in pediatrics is still limited. This report describes the characteristics of patients admitted to a children's hospital due to COVID-19 during the first three months of the pandemic.

Method: Descriptive study including all patients hospitalized due to COVID-19 between 4/1/2020 and 6/30/2020.

Results: A total of 191 patients were hospitalized due to COVID-19; their median age was 7.7 years; 89% had a history of close contact. Of them, 35.6 % were considered asymptomatic; 61.2 %, mild cases; and 3.2 %, moderate cases (no severe cases). None of them received a specific treatment for the disease. The most common symptoms were fever, sore throat, and cough. The median length of stay was 6 days.

Conclusion: A total of 191 cases of children and adolescents admitted due to COVID-19 are reported. Most were asymptomatic or presented with a mild disease.
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http://dx.doi.org/10.5546/aap.2020.eng.423DOI Listing
December 2020

Prevalence of deaf people who have a professional Argentine Sign Language interpreter during their children's medical consultations.

Arch Argent Pediatr 2018 10;116(5):310-315

Hospital General de Niños "Pedro de Elizalde", Ciudad Autónoma de Buenos Aires.

Introduction: In Argentina, hearing disability accounts for 18% of disabilities. Argentine Sign Language (ASL) is the communication system of choice used by deaf people (DP). An incorrect communication with physicians hampers the adequate provision of health care. DP require a professional ASL interpreter (PASLI) in the context of health care provided to their children. National Act no. 26378 stipulates the provision of a PASLI to facilitate access to public facilities. However, most DP neither have an interpreter nor know this right.

Objectives: To describe the prevalence of DP who have a PASLI present during their children's medical consultations and who know their right to access one at no charge.

Material And Method: Approved and registered, descriptive, cross-sectional study with a structured, self-administered survey. Participants: DP who knew ASL and had children aged 1 month to 18 years old. Outcome variables: to have a PASLI and to know the right to have one. Estimated sample size: 220. Convenience sampling selected from the Autonomous City of Buenos Aires and the province of Chaco. The prevalence and 95% confidence interval (95% CI) were estimated.

Results: Two hundred and twenty-two surveys were analyzed. Age: 34.9 ± 10.1 years old. Among all participants, 15.3% (95% CI: 11.1-20.6) sometimes had a PASLI during their children's medical consultations. Also, 48.6% (95% CI: 42.155.1) knew their right to have one.

Conclusion: The prevalence of DP who had a PASLI present during their children's medical consultations was low. Less than a half knew their right to have one.
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http://dx.doi.org/10.5546/aap.2018.eng.310DOI Listing
October 2018

[Using Objective Structured Clinical Examination (OSCE) across different levels of pediatric training].

Rev Fac Cien Med Univ Nac Cordoba 2014 ;71(2):94-7

Background: To evaluate professional competences is the main goal of every training program; the Objective Structured Clinical Examination (OSCE) is a useful tool for this task.

Objective: We describe OSCE administration across three different levels of pediatric training (postgraduate, internship and graduate medical education).

Methods: Regarding the most common pediatric scenarios, knowledge, clinical judgment and communicational skills were evaluated.

Results: In the postgraduate setting OSCE was used for the last 8 years, testing 330 students, and passing 60%-82% of them. In the internship setting OSCE was used for the last 2 years, testing 12 students, and passing 84% of them. In the medical school setting OSCE was used just once, testing 15 students, and passing 93.4% of them.

Conclusion: Despite logistic issues, OSCE could be administered across three different levels of pediatric training.
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April 2015

Assessment of the scientific output of Hospital de Niños Pedro de Elizalde, 2000-2011.

Arch Argent Pediatr 2014 Apr;112(2):147-52

Comité de Docencia e Investigación, Hospital General de Niños Pedro de Elizalde.

Introduction: Monitoring article submissions and publications developed by an institution is a suitable measure to assess its scientific output.

Objectives: To estimate the proportion of research projects that were completed and had results submitted/published by a pediatric hospital; to describe research project design and characteristics; to outline limitations on research development or dissemination.

Methods: Descriptive and analytical study including scientific studies approved to be developed between 2000 and 2011. Each investigator was contacted and asked to participate in a survey on research development, result dissemination and possible reasons for not completing or disseminating a study.

Results: The survey was completed by the authors of 197 projects (60.9% completed, 16.2% ongoing, 12.7% cancelled, and 10.2% put off). Drug trials were most likely not to be completed. Of all completed projects (n = 120), 45.8% were clinical research studies, 43.3% were epidemiological studies, and 10% were related to health services. When analyzed by design, 77.5% were observational studies while 22.5% were experimental ones. In terms of scope, 69.1% were restricted to the hospital, 16.6% were international multicenter studies, and 14.1% were national multicenter studies. Only 36.6% of projects received funding. Lack of time (20%) and insufficient sample size (10%) were the most commonly indicated reasons for non dissemination. A total of 78.3% of projects were presented in conferences and 37.5% were published. The presence of funding was the only independent predictor of publication.

Conclusions: Of all approved projects, 60.9% were completed; of them, 78.3% were presented in conferences and 37.5% were published. Drug trials were most likely not to be completed, and funded studies had more chances of being published.
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http://dx.doi.org/10.5546/aap.2014.147DOI Listing
April 2014

Impact of a brief intervention on the burnout levels of pediatric residents.

J Pediatr (Rio J) 2011 Nov-Dec;87(6):493-8

Hospital General de Niños Pedro de Elizalde, Buenos Aires, Argentina.

Objectives: To estimate burnout prevalence among pediatric residents and to evaluate the impact of a brief intervention aimed at controlling burnout.

Methods: A randomized controlled trial was conducted on 74 pediatric residents. The Maslach Burnout Inventory was administered to all subjects, and demographic information was gathered (age, gender, children, cohabitants, and residency year). The experimental group (n = 37) participated in self-care workshops over the course of 2 months, and the control group (n = 37) did not receive any intervention. After the intervention, the Maslach Burnout Inventory was administered again to all participants. All potential predictors of burnout were included in a logistic regression model. The efficacy of the intervention was evaluated by the chi-square test. P values < 0.05 were considered significant.

Results: The burnout prevalence among pediatric residents was 66%. After controlling for age, gender, children, and cohabitants, the prevalence of burnout was significantly higher among third-year residents (odds ratio = 11.8; 95% confidence interval 2.3-59.3; p = 0.003). There were no significant differences regarding burnout prevalence in the experimental group between the baseline and post-intervention periods (p = 0.8) or between the two groups after intervention (p = 0.8). The only difference observed was an improvement regarding "depersonalization" in the experimental group (p = 0.031).

Conclusions: The burnout prevalence among pediatric residents was 66% and was higher among third-year residents. A brief intervention was not effective in reducing burnout prevalence, despite the achievement of an improvement in "depersonalization."
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http://dx.doi.org/10.2223/JPED.2127DOI Listing
July 2012

[Assessing a test to evaluate clinical analytical thinking according to medical training level].

Rev Med Chil 2011 Apr 25;139(4):455-61. Epub 2011 Aug 25.

Docencia e Investigación, Hospital General de Niños Pedro de Elizalde Montes de Oca 40, Buenos Aires, Argentina.

Background: MATCH (Measuring Analytical Thinking in Clinical Health Care) is an instrument to evaluate clinical reasoning.

Aim: To assess MATCH performance in professionals and students with different training in pediatrics.

Material And Methods: MATCH was administered to medical students (S), first (R1) and third (R3) year residents and staff physicians (P). We evaluated the score and time required to achieve it, according to training level in pediatrics.

Results: Eighty five subjects were included (23 S, 28 R1, 17 R3 y 17 P), achieving 37.4 ± 6.0 points, in 25.2 ± 8.5 minutes. There were significant differences in score and time, according to training level. There was a positive correlation between training level and score (Rho = 0.515; p < 0.001), and a negative one between training level and time (Rho = -0.589; p < 0.001).

Conclusions: More experienced and trained professionals had a better performance in a clinical analytical thinking test.
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http://dx.doi.org//S0034-98872011000400006DOI Listing
April 2011