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J Reina

Publications and source records attributed to J Reina.

At least 19 recordsLinked to original sources
PubMed2005

[New indications for the inactivated influenza vaccine in the pediatric population (2004-2005)].

Several epidemiological studies have indicated that, in all countries and in distinct epidemic years, the highest rates of influenza infection (between 15% and 42%) occur in the pediatric population, especially in school-aged children. Over various influenza seasons, the rates of annual outpatient visits attributable to influenza vary from 6-29% of children. Influenza and its complications have been reported to result in a 10-30% increase in the number of antibiotic courses prescribed to children during the influenza season. Current percentages of influenza vaccination in children are very low, although the hospitalization rates for infectious complications in children under 5 years are at least equal to those observed in individuals aged more than 65 years. The reasons for these low immunization rates are unknown, but many factors could be involved, especially the need for annual revaccination. In 2003 the Advisory Committee on Immunization Practices (ACIP) recommended influenza immunization only in children at high risk for influenza complications and in those living with someone in a high-risk group. However, they encouraged vaccination of all children aged 6-23 months old. After a review of various epidemiological studies, in 2004 both the ACIP and the American Academy of Pediatrics recommended systematic immunization of all healthy children within this age group. However, both institutions advise that before the routine introduction of influenza immunization in all children aged 6-23 months old, immunization programs in high-risk children need to be implemented.

Adolescent↗
PubMed2004

[Study of the clinical and epidemiological characteristics of respiratory infections caused by adenovirus in a pediatric population (1997-2003)].

INTRODUCTION: Infections due to adenoviruses are highly prevalent in pediatric patients. Because the clinical manifestations of the respiratory infections caused by adenoviruses are indistinguishable from those caused by other respiratory viruses, virological methods are required to establish their etiology. We present a retrospective study of the clinical and virological characteristics of patients with isolation of adenovirus in respiratory samples. MATERIAL AND METHODS: From 1997 to 2003 we analyzed 5,746 respiratory samples from pediatric patients (< 15 years old), of which 2,122 (36.9 %) were considered positive. The adenoviruses were isolated in the Hep-2 cell line culture by the shell vial method. RESULTS: Adenovirus was isolated in 100 clinical samples (4.7 % of all positive samples and 1.7 % of all samples studied) in a group of pediatric patients with a mean age of 14 months. The clinical diagnoses of patients were bronchiolitis (61 %), pneumonia (10 %), pertussis-like syndrome (16 %) and asthmatic crisis (11 %). Adenovirus infections mainly presented between December and March. Seventy-two percent of patients had a history of other viral respiratory tract infections and/or bronchial asthma. None of the patients had clinical conjunctivitis and only five patients had diarrhea due to adenoviruses. Seventy percent of the patients received artificial feeding and 30 % were breast-fed. Ninety percent of the patients were hospitalized and treatment mainly consisted of bronchodilator agents and antibiotics. CONCLUSIONS: Respiratory tract infections caused by adenoviruses mainly affected patients aged less than 14 months, in the first four months of the year, and with clinical manifestations of bronchiolitis or pneumonia without conjunctivitis. Clinically, these infections are difficult to differentiate from other viral respiratory infections.

Adenoviridae↗
PubMed2004

Prospective evaluation of a dot-blot enzyme immunoassay (Directigen RSV) for the antigenic detection of respiratory syncytial virus from nasopharyngeal aspirates of paediatric patients.

This study investigated the efficacy of a commercial enzyme immunoassay (Directigen RSV, ColorPAC) in comparison with the shell vial culture method (using Hep-2 cells) for the detection of respiratory syncytial virus (RSV) in nasopharyngeal aspirates from children with bronchiolitis. During the period 1995-2002, 4950 samples were examined. RSV was detected in 1660 (33.5%) samples, with a sensitivity of 80.9%, a specificity of 97.5%, a positive predictive value of 93.8%, a negative predictive value of 91.6%, and a testing efficiency value of 92.2% compared with shell vial culture. In 83 (5%) samples, the ColorPAC was positive and the shell vial assay was negative. Of these, 71 (85.6%) were false-negative by cell culture. The true false-positive results obtained by ColorPAC represented only 0.7% of all RSV-positive samples. In general, no statistically significant differences were detected between the different months and epidemic periods studied. Compared with ColorPAC, the shell vial culture method displayed a sensitivity of 95.8% and a specificity of 100%. Overall, the ColorPAC assay was an acceptable, simple and rapid method for the antigenic detection of RSV in paediatric respiratory samples.

Adolescent↗
PubMed2001

[Bronchiolitis caused by influenza type A virus. An emerging infectious disease].

OBJECTIVES: To prospectively study the emergence and diagnostic problems of bronchiolitis caused by influenza A virus among children durign the 1999-2000 influenza epidemic. MATERIALS AND METHODS: Negative respiratory syncitial virus (RSV) specimens (ELISA dot-blot) were seeded in the MDCK cell line for the isolation of influenza A virus, by the shell-vial technique. Vials were revealed by indirect immunofluorescence with antibodies directed against the influenza A virus nucleoprotein (Monofluookit IA, Pasteur Diagnostics). The clinical and epidemiologic features of patients with viral recovery were studied. A theoretical cost/benefit study was performed on the usefulness of the rapid antigenic detection of the influenza A virus. RESULTS: A total of 117 cases of respiratory infection caused by influenza A virus were detected. In 62 cases (52.9%) the diagnosis was bronchiolitis. Of them, 80.6% of cases were aged less than 6 years. Subtype H3N2 predominated in all respiratory infections, paticularly in bronchiolitis. During the 1999-2000 season, a significant emergence of bronchiolitis caused by influenza A virus was observed (week 3, 30% cases of influenza A versus 24% of RSV). The cost/benefit study disclosed that the antigenic detection of RSV and influenza A virus in all respiratory specimens would amount up to 30.83 Euros/specimen. CONCLUSIONS: During the last influenza epidemic, an emergence of bronchiolitis caused by influenza A virus among children was observed and confirmed. Based upon this observation, a dual strategy should be followed. On the one hand, a prophylactic approach (immunization of pregnant women); on the other hand, a diagnostic approach with a rapid antigenic detection of the influenza A virus.

Bronchiolitis↗
PubMed2001

Evaluation of different continuous cell lines in the isolation of mumps virus by the shell vial method from clinical samples.

AIMS: To compare prospectively the efficacy of the Vero, LLC-MK2, MDCK, Hep-2, and MRC-5 cell lines in the isolation of the mumps virus from clinical samples by means of the shell vial method. METHODS: During an epidemic outbreak of parotiditis 48 clinical samples (saliva swabs and CSF) were studied. Two vials of the Vero, LLC-MK2, MDCK, MRC-5, and Hep-2 cell lines were inoculated with 0.2 ml of the samples by the shell vial assay. The vials were incubated at 36 degrees C for two and five days. The vials were then fixed with acetone at -20 degrees C for 10 minutes and stained by a monoclonal antibody against mumps virus by means of an indirect immunofluorescence assay. RESULTS: The mumps virus was isolated from 36 samples. The Vero and LLC-MK2 cell lines showed a 100% isolation capacity, MDCK showed 77.7%, MRC-5 showed 44.4%, and Hep-2 showed 22.2%. The Vero and LLC-MK2 lines were significantly different to the other cell lines (p < 0.001). The sensitivity for the Vero and LLC-MK2 lines at two and five days of incubation was identical (100%). The values obtained in the study of the quantitative isolation capacity (positive isolation with > 5 infectious foci) were 94.4% for Vero, 97.2% for LLC-MK2, 5.5% for MDCK, 5.5% for Hep-2, and 0% for MRC-5. CONCLUSIONS: The Vero and LLC-MK2 cell lines are equally efficient at two and five days incubation for the isolation of the mumps virus from clinical samples, and the use of the shell vial method considerably shortens the time of aetiological diagnosis with higher specificity.

Animals↗
PubMed2000

Usefulness of pp65 antigenemia and viremia in the follow-up of renal transplant recipients with cytomegalovirus disease treated with ganciclovir.

We prospectively evaluated the usefulness of the pp65 antigenemia assay (AGA) and viremia (isolation) in the follow-up of 15 renal transplant recipients with a cytomegalovirus disease treated with ganciclovir. The AGA was performed with the extraction of PMNL with saline dextran, and the viremia detected by the inoculation of them in the MRC-5 cell line (shell-vial). Sixty-nine blood samples were studied, and 55 (79.7%) positive AGA and 42 (60.8%) positive viremia detected. The AGA needed a median of 9 days to negativize, and the viremia only 4 days. In eight patients (53%) the AGA and viremia were negative simultaneously. In seven patients (47%) the viremia was negative before the AGA (median 10.7 days). In this group, three patients (43%) presented a paradoxal rising of the AGA values after the negativization of the viremia. For the follow-up of renal transplant recipients treated with ganciclovir, the viremia was the most useful method of control. The viremia was negative before the AGA in many patients, demonstrating the therapeutic efficacy of ganciclovir.

Antiviral Agents↗
PubMed2000

[Evaluation of different clinical samples and cell lines in the isolation of enterovirus in pediatric patients].

BACKGROUND: To evaluate prospectively the efficacy of different clinical samples and cellular lines in the isolation of Enteroviruses from pediatric patients. METHODS: In the period july-1997 to july-1999 we analyze the samples of 102 pediatric patients (< 2 years old) with an unknown febrile etiology syndrome. After the process of decontamination the samples were inoculated in the MRC-5, Hep-2 and Vero cell lines by the shell-vial assay. After 2-3 days of incubation the monolayers were stained by a monoclonal antibody against VP1; then the strains were identified as Poliovirus, ECHO-virus or Coxsacke by specific antibodies. RESULTS: 96 clinical samples were studied (45 pharyngeal swabs, 28 feces, 13 cerebrospinal fluid, 5 bloods, 4 urines and one bronchoalveolar lavage). Enteroviruses were isolated in 48 patients (47%), corresponding to 60 clinical samples (62.5%). The enteroviruses were isolated in 75.5% of pharyngeal swabs, 71.4% of feces, 30.7% of cerebrospinal fluid, one blood (20%) and the bronchoalveolar lavage. 28 patients presented simultaneously both pharyngeal and rectal swabs; in this group the use of both samples permitted the isolation of Enteroviruses in 26 cases (92.8%). Of 60 Enteroviruses, 59 (98.3%) were isolated in the MRC-5 cell line, 23 (38.3%) in the Hep-2, and 14 (23.3%) in the Vero; the MRC-5 demonstrated a significant difference in the isolation of Enteroviruses compared with the other cell lines. The Enteroviruses were identified as 30 (50%) ECHO-virus, 15 (25%) as Poliovirus vaccine, 12 (20%) could not to be identified and in 3 cases (5%) no growth of virus was detected in the culture. The MRC-5 cell line was significatively superior to the other in the isolation of the different Enteroviruses. CONCLUSIONS: To obtain the maximum diagnostic efficacy in front a patient with a possible infection by Enteroviruses, is necessary to use different clinical samples, specially the more related to the infection focci (cerebrospinal fluid or blood). The MRC-5 cell line has been the most efficace in the isolation of Enteroviruses independently of the type of clinical sample or the viral genus. The shell-vial assay is a good method for the isolation and identification of Enteroviruses isolated from clinical samples.

Animals↗
PubMed2000

[Efficiency of the extraction method with saline dextran in the pp65 antigenemia assay against human cytomegalovirus].

BACKGROUND: To prospectively evaluate the efficacy of the saline dextran extraction method in the human cytomegalovirus (CMV) pp65 antigenemia assay (Ag-pp65). MATERIAL AND METHODS: In a 2 months period we studied all the blood samples from immunodepressed patients. The extraction of leukocytes polymorphonuclear (LPMN) was obtained with a 6% dextran solution in 0.9% saline. The total leukocytes population was counted and the percentage of LPMN obtained was established. Simultaneously the LPMN were cultivated into the MRC-5 cell line by the shell vial method (SVC). RESULTS: The 144 blood samples studied were divided in three groups depending of the positivity in the pp65-AG and/or in the SVC. The patients with both assays positive presented the lower overall leukocyte and LPMN counting, with a difference statistically significance with the pp65-Ag negative. No statistically difference was observed in the overall count of leukocytes in the pp65-Ag negative group. The overall percentage of LPMN obtained was 87%. The median value of pp65-Ag positive samples was 48/100,000 LPMN, this value would be 51/100,000 LPMN with the application of the real percentage of LPMN obtained (p > 0.05). CONCLUSIONS: The saline dextran extraction method presented a high efficacy in the majority of blood samples studied. The immunological status and the presence of a CMV infection or disease in the patient were the principal factors that influence the extraction method. In general there is no need to adjust the pp65-Ag value obtained with this method to the real one.

Cytomegalovirus↗
PubMed1999

[Comparison between centrifugation and sedimentation prior to cultures in the isolation of cytomegalovirus in the urine of renal transplant recipients].

BACKGROUND: To compare the capacity of conventional centrifugation and spontaneous sedimentation to detect the presence of cytomegalovirus (CMV) in urine samples. MATERIAL AND METHODS: We studied urine samples from 45 renal transplant recipients. After decontamination half of each sample was centrifuged (1,500 rpm for 10 minutes) and the other half was allowed to sediment at room temperature for 30 minutes. From the supernatant of each of these 250 microliters was inoculated in a shell-vial (MRC-5). Cultures were incubated for 48 hours at 37 degrees C and stained by an indirect immunofluorescence assay. The samples considered totally toxic were re-inoculated after dilution 1:1 with maintainance medium. RESULTS: Of 845 urine samples analyzed, 743 (88%) were negative and 102 (12%) positive. 66 (7.8%) were considered toxic: 35 (4.1%) partially toxic and 31 (3.6%) totally toxic. Of the centrifuged urine samples 86.2% were positive against 98% of the sedimented samples (p = 0.004). Of the 31 samples considered totally toxic, 17 (2.2%) corresponded with negative urine samples and 14 (13.7%) with positive samples. Off these, 12 (85.7%) were detected in centrifuged samples and 2 (14.3%) in sedimented samples (p = 0.001). CONCLUSIONS: The percentage of toxicity in the urine samples was low (7.8%) which does not seem to suggest the need for systematic dilution of all samples. The sedimentation process enabled us to detect a greater number of urine samples positive for CMV with a lower rate of toxicity of the monolayers. The use of this process would reduce the number of samples requiring reinoculation.

Centrifugation↗