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Objective To describe primary health care (consultation characteristics and management) for patients contacting their general practitioner (GP) with a respiratory tract infection (RTI) early on in the COVID-19 pandemic in contrasting European countries, with comparison to prepandemic findings.Setting Primary care in 16 countries (79 practices), when no routine SARS-CoV-2 testing was generally available.Design and participants Before (n=4376) and early in the pandemic (n=3301), patients with RTI symptoms were registered in this prospective audit study.Outcome measures Consultation characteristics (type of contact and use of PPE) and management characteristics (clinical assessments, diagnostic testing, prescribing, advice and referral) were registered. Differences in these characteristics between countries and between pandemic and prepandemic care are described.Results Care for patients with RTIs rapidly switched to telephone/video consultations (10% in Armenia, 91% in Denmark), and when consultations were face-to-face, GPs used PPE during 97% (95% CI 96% to 98%) of contacts. Laboratory testing for SARS-CoV-2 in primary care patients with RTIs was rapidly implemented in Denmark (59%) and Germany (31%), while overall testing for C reactive protein decreased. The proportion of patients prescribed antibiotics varied considerably between countries (3% in Belgium, 48% in UK) and was lower during the pandemic compared with the months before, except for Greece, Poland and UK. GPs provided frequent and varied COVID-related advice and more frequently scheduled a follow-up contact (50%, 95% CI 48% to 52%). GPs reported a slightly higher degree of confidence in the likely effectiveness of their management in face-to-face (73% (very) confident, 95% CI 71% to 76%) than in virtual consultations (69%, 95% CI 67% to 71%).Conclusions Despite between-country variation in consultation characteristics, access to SARS-CoV-2 laboratory testing and medication prescribing, GPs reported a high degree of confidence in managing their patients with RTIs in the emerging pandemic. Insight in the highly variable pandemic responses, as measured in this multicountry audit, can aid in fine-tuning national action and in coordinating a pan-European response during future pandemic threats.

One of the most frequent benign tumor pathology in children is represented by infantile hemangiomas (IHs). Although they are mostly cutaneous, sometimes they can develop at visceral level, the liver being the most common localization. Objectives. Estimating visceral hemangiomas (VHs) prevalence, and identification of risk factors for VHs in patients with infantile cutaneous hemangiomas (ICHs). Materials and methods. 6 years cross-sectional study (2012-2017) including children diagnosed with ICHs, admitted in I.N.S.M.C “Alfred-Rusescu“. All patients underwent an ultrasound screening for the detection of VHs. In order to identify possible risk factors, we collected demographic and perinatal data. Outcomes. 138 patients diagnosed with infantile cutaneous hemangiomas (ICHs) were included, with a slight predominance of girls (58%). The prevalence of the VHs in our study was 7,24% (10 patients). The liver was the most common visceral localization (7 patients). Conclusions. Female gender, preterm birth, low birth weight, and multiple gestations were described as potential risk factors for IHs. In our study, only multiple gestations tend to be associated with visceral hemangiomas, but without a significant statistical correlation.

Objectives. The aim of this study was to present and describe specific macroscopic and microscopic placental findings in patients with hypoxic-ischemic encephalopathy (HIE). Materials and methods. We conducted an observational prospective study which included 84 patients diagnosed with HIE and had available placental histopathological examination. HIE diagnosis was performed according to Sarnat Score. Both macroscopical and microscopical placental lesions were identified. Patients were divided into 2 groups according to the presence of placental lesions. Outcomes. Placental lesions were associated with HIE. Patients with both HIE and placental lesions had lower pH value (p

One of the affected organs in cystic fibrosis (CF) is the pancreas, mainly translated into exocrine pancreatic insufficiency. Although rare, acute pancreatitis (AP) has been described, mostly in pancreatic sufficient patients. Objectives. Estimating AP prevalence in CF pediatric population of the I.N.S.M.C. „Alessandrescu Rusescu” CF centre. Material and methods. 5 year retrospective study (2011-2016) including INSMC CF centre pediatric population aged 3-18 years. PA diagnosis was established on the presence of minimum 2 criteria between: characteristic abdominal pain, x3 normal value for age elevation of amylase/lipase, medical imaging evaluation suggestive for AP. Patients were evaluated with different criteria including PIP score of predicting AP risk. Outcomes. 48 patients were included with a slight female predominance (54%). 3 of them presented diagnostic criteria for AP (6,25%), all heaving pancreatic insufficiency and high PIP score (low risk of developing AP); 2 of them have low compliance with pancreatic enzymes substitution therapy; one of them presented recurrent episodes of AP. Conclusions. AP is a rare CF complication. It can be easily missed due to a large number of abdominal pain and emesis causes in CF patients. Although it is usually associated with pancreatic sufficiency, all our patients were pancreatic insufficient.

Malnutrition continues to be a major issue concerning pediatric cystic fibrosis patients’ medical care. Supplementary diagnostic association with food allergy in a cystic fibrosis patient leads to worse nutritional status decline. This particular association determines low quality of life and life expectance impairment. Low caloric intake, recurrent pulmonary infections, maldigestion and malabsorption, low treatment adherence, genetic susceptibility and chronic infections are all risk factors and/or causes of malnutrition in cystic fibrosis patients. The aim of our study was to evaluate the prevalence of IgE mediated food allergies in cystic fibrosis patients. A secondary objective was to assess nutritional status in cystic fibrosis patients with food allergies after exclusion diet. In order to accomplish our objectives, we conducted a descriptive, retrospective study on a 68 pediatric patient cohort with cystic fibrosis (CF). All children were diagnosed and followed in the Regional center for CF of INSMC “Alessandrescu-Rusescu”, Bucharest, between 2011 and 2016. After data collection and statistic analysis we observed a prevalence of 11.7% of food allergies in our cystic fibrosis patients cohort. Also, specific exclusion diet impact on nutritional status was evaluated.

With an incidence reaching almost 10%, infantile hemangiomas represent the most common tumors of infancy. Although the majority of hemangiomas develop on the skin, parenchymal tumor may occur in all organs. Parotid gland hemangiomas represent the most frequent vascular tumor of all salivary glands neoplasms. Ultrasound is a very helpfull tool in establishing the diagnosis of parotid gland infantile hemangioma as well as in the follow up of evolution durring treatment.

Infantile hemangiomas are the most frequent tumors of infancy, with an incidence reaching almost 10% (1). In children with more than 5 skin hemangiomas it has been noticed a highly association with visceral hemangiomas, the liver being the main site for their localization (2). Regarding therapeutic approach, if for skin hemangiomas the treatment is well established, for hepatic infantile hemangiomas clear guidelines are still necessary.