13 results on '"Zambruni M"'
Search Results
2. A single-center quality improvement project for gastroschisis care
- Author
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Kwiatkowski, L.M., primary, Law, M., additional, Dalal, L., additional, Pandey, R., additional, Li, W., additional, Domonoske, C., additional, Forbes, M., additional, Chang, M.L., additional, Zambruni, M., additional, and Aneji, C., additional
- Published
- 2023
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3. 676 - A single-center quality improvement project for gastroschisis care
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Howen, K, Kwiatkowski, LM, Law, M, Dalal, L, Pandey, R, Li, W, Domonoske, C, Forbes, M, Alvarez, J, Deckinga, M, Chang, ML, Austin, M, Speer, AL, Zambruni, M, Reynolds, EW, and Aneji, C
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- 2024
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4. 657 - A single-center quality improvement project for gastroschisis care
- Author
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Kwiatkowski, L.M., Law, M., Dalal, L., Pandey, R., Li, W., Domonoske, C., Forbes, M., Chang, M.L., Zambruni, M., and Aneji, C.
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- 2023
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5. Documento dei Giovani Pediatri per la Pediatria
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Buonuomo, P., Cecinati, V., Di Giorgio, A., Filocamo, G., Giuffrè, M., Insalaco, A., Schiavo, B., Rametta, V., Ros, M., Salata, M., Titomanlio, L., Zambruni, M., Buonuomo, PS, Cecinati, V, Di Giorgio, A, Filocamo, G, Giuffrè, M, Insalaco, A, Schiavo, B, Rametta, V, Ros, M, Salata, M, Titomanlio, L, and Zambruni, M
- Subjects
pediatria ,Settore MED/38 - Pediatria Generale E Specialistica ,giovani - Published
- 2010
6. Simulation training on respectful emergency obstetric and neonatal care in north-western Madagascar: a mixed-methods evaluation of an innovative training program.
- Author
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Guérin Benz J, Stancanelli G, Zambruni M, Paulin MR, Hantavololona H, Andrianarisoa VR, Rakotondrazanany H, de Tejada Weber BM, Mangeret FR, Reich MR, Guyer A, and Benski C
- Abstract
Background: The rates of maternal and neonatal deaths in Madagascar are among the highest in the world. In response to a request for additional training from obstetrical care providers at the Ambanja district hospital in north-eastern Madagascar, a partnership of institutions in Switzerland and Madagascar conducted innovative training on respectful emergency obstetric and newborn care using e-learning and simulation methodologies. The training focused on six topics: pre-eclampsia, physiological childbirth, obstetric maneuvers, postpartum hemorrhage, maternal sepsis, and newborn resuscitation. Cross-cutting themes were interprofessional communication and respectful patient care. Ten experienced trainers participated in an e-training-of-trainers course conducted by the Swiss partners. The newly-trained trainers and Swiss partners then jointly conducted the hybrid remote/in-person training for 11 obstetrical care providers in Ambanja., Methods: A mixed methods evaluation was conducted of the impact of the training on participants' knowledge and practices. Trainees' knowledge was tested before, immediately after, and 6 months after the training. Focus group discussions were conducted to elicit participants' opinions about the training, including the content and pedagogical methods., Results: Trainees' knowledge of the six topics was higher at 6 months (with an average of 71% correct answers) compared to before the training (62%), although it was even higher (83%) immediately after the training. During the focus group discussions, participants highlighted their positive impressions of the training, including its impact on their sense of professional effectiveness. They reported that their interprofessional relationships and focus on respectful care had improved. Simulation, which was a new methodology for the participants native to Madagascar, was appreciated for its engaging and active format, and they enjoyed the hybrid delivery of the training. Participants (including the trainers) expressed a desire for follow-up engagement, including additional training, and improved access to more equipment., Conclusion: The evaluation showed improvements in trainees' knowledge and capacity to provide respectful emergency care to pregnant women and newborns across all training topics. The hybrid simulation-based training method elicited strong enthusiasm. Significant opportunity exists to expand the use of hybrid onsite/remote simulation-based training to improve obstetrical care and health outcomes for women and newborns in Madagascar and elsewhere., (© 2024. The Author(s).)
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- 2024
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7. Lessons Learned From Building a Global Health Partnership on Obstetric Care in Madagascar.
- Author
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Benski C, Zambruni M, Stancanelli G, Landinarisoa T, Hantavololona A, Rachel Andrianarisoa V, Manjary PR, Capello C, de Tejada BM, Reich MR, and Guyer AL
- Subjects
- Humans, Madagascar, Global Health, Cooperative Behavior
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- 2023
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8. Stunting Is Preceded by Intestinal Mucosal Damage and Microbiome Changes and Is Associated with Systemic Inflammation in a Cohort of Peruvian Infants.
- Author
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Zambruni M, Ochoa TJ, Somasunderam A, Cabada MM, Morales ML, Mitreva M, Rosa BA, Acosta GJ, Vigo NI, Riveros M, Arango S, Durand D, Berends MN, Melby P, and Utay NS
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- Child Development, Cohort Studies, Cytokines genetics, Cytokines metabolism, Feces microbiology, Female, Gene Expression Regulation, Growth Disorders epidemiology, Humans, Infant, Intestinal Diseases epidemiology, Male, Nutritional Status, Peru, Pilot Projects, Gastrointestinal Microbiome, Growth Disorders etiology, Intestinal Diseases pathology, Intestinal Mucosa pathology
- Abstract
Stunting, defined as height-for-age Z score equal to or lower than -2, is associated with increased childhood mortality, cognitive impairment, and chronic diseases. The aim of the study was to investigate the relationship between linear growth, intestinal damage, and systemic inflammation in infants at risk of stunting. We followed up 78 infants aged 5-12 months living in rural areas of Peru for 6 months. Blood samples for biomarkers of intestinal damage (intestinal fatty-acid-binding protein [I-FABP] and zonulin) and systemic inflammation (interleukin-1β, interleukin-6, tumor necrosis factor α [TNF-α], soluble CD14, and lipopolysaccharide-binding protein [LBP]) and fecal samples for microbiome analysis were collected at baseline and closure of the study. The children's growth and health status were monitored through biweekly home visits by trained staff. Twenty-one percent of the children became stunted: compared with non-stunted children, they had worse nutritional parameters and higher levels of serum I-FABP at baseline. The likelihood of becoming stunted was strongly associated with an increase in sCD14 over time; LBP and TNF-α showed a trend toward increase in stunted children but not in controls. The fecal microbiota composition of stunted children had an increased beta diversity compared with that of healthy controls throughout the study. The relative abundance of Ruminococcus 1 and 2 , Clostridium sensu stricto , and Collinsella increased in children becoming stunted but not in controls, whereas Providencia abundance decreased. In conclusion, stunting in our population was preceded by an increase in markers of enterocyte turnover and differences in the fecal microbiota and was associated with increasing levels of systemic inflammation markers.
- Published
- 2019
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9. [Antimicrobial resistance of commensal Escherichia coli strains in children of two rural communities in Peru].
- Author
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Alzamora MC, Echevarría AC, Ferraro VM, Riveros MD, Zambruni M, and Ochoa TJ
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- Cohort Studies, Drug Resistance, Bacterial, Humans, Infant, Peru, Rural Health, Anti-Bacterial Agents pharmacology, Escherichia coli drug effects
- Abstract
Antibiotic resistance is a major global problem. The objective of this study was to determine antibiotic resistance in commensal strains isolated from healthy children from rural communities of Moyobamba and Urubamba in Peru. This cohort study identified 179 commensal E. coli strains from 93 children, followed for six months. Thirteen antibiotics were analyzed by diffusion disk. The highest rates of resistance were for cotrimoxazole (49.1%), ampicillin (48.0%), and nalidixic acid (31.8%). An 11.6% increase in resistance was found for nalidixic acid and 6.4% for cotrimoxazole in this period; while 34.0% of the isolates were multidrug-resistant. This study supports previous findings of multidrug resistance in commensal strains in rural communities and highlights the increased rates of resistance over time. We recommend studies in larger populations with a longer follow-up.
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- 2019
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10. Impact of Childhood Malnutrition on Host Defense and Infection.
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Ibrahim MK, Zambruni M, Melby CL, and Melby PC
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- Animals, Communicable Diseases epidemiology, Disease Susceptibility, Humans, Immune System immunology, Prospective Studies, Risk Factors, Communicable Diseases immunology, Malnutrition
- Abstract
The global impact of childhood malnutrition is staggering. The synergism between malnutrition and infection contributes substantially to childhood morbidity and mortality. Anthropometric indicators of malnutrition are associated with the increased risk and severity of infections caused by many pathogens, including viruses, bacteria, protozoa, and helminths. Since childhood malnutrition commonly involves the inadequate intake of protein and calories, with superimposed micronutrient deficiencies, the causal factors involved in impaired host defense are usually not defined. This review focuses on literature related to impaired host defense and the risk of infection in primary childhood malnutrition. Particular attention is given to longitudinal and prospective cohort human studies and studies of experimental animal models that address causal, mechanistic relationships between malnutrition and host defense. Protein and micronutrient deficiencies impact the hematopoietic and lymphoid organs and compromise both innate and adaptive immune functions. Malnutrition-related changes in intestinal microbiota contribute to growth faltering and dysregulated inflammation and immune function. Although substantial progress has been made in understanding the malnutrition-infection synergism, critical gaps in our understanding remain. We highlight the need for mechanistic studies that can lead to targeted interventions to improve host defense and reduce the morbidity and mortality of infectious diseases in this vulnerable population., (Copyright © 2017 American Society for Microbiology.)
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- 2017
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11. Maternal and pregnancy-related factors affecting human milk cytokines among Peruvian mothers bearing low-birth-weight neonates.
- Author
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Zambruni M, Villalobos A, Somasunderam A, Westergaard S, Nigalye M, Turin CG, Zegarra J, Bellomo S, Mercado E, Ochoa TJ, and Utay NS
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- Adult, Cohort Studies, Female, Humans, Immunity, Innate, Infant, Newborn, Lactation immunology, Maternal Age, Peru, Pregnancy, Pregnancy Complications, Cardiovascular immunology, Premature Birth immunology, Risk Factors, Transcriptome, Young Adult, Cytokines metabolism, Infant, Low Birth Weight, Milk, Human metabolism, Pregnancy Complications, Cardiovascular epidemiology, Premature Birth epidemiology
- Abstract
Several cytokines have been detected in human milk but their relative concentrations differ among women and vary over time in the same person. The drivers of such differences have been only partially identified, while the effect of luminal cytokines in the fine-regulation of the intestinal immune system is increasingly appreciated. The aim of this study was to investigate the associations between obstetrical complications and human milk cytokine profiles in a cohort of Peruvian women giving birth to Low Birth Weight (LBW) infants. Colostrum and mature human milk samples were collected from 301 Peruvian women bearing LBW infants. The concentration of twenty-three cytokines was measured using the Luminex platform. Ninety-nine percent of women had at least one identified obstetrical complication leading to intra-uterine growth restriction and/or preterm birth. Median weight at birth was 1,420g; median gestational age 31 weeks. A core of 12 cytokines, mainly involved in innate immunity and epithelial cell integrity, was detectable in most samples. Maternal age, maternal infection, hypertensive disorders, preterm labor, and premature rupture of membranes were associated with specific cytokine profiles both in colostrum and mature human milk. Mothers of Very LBW (VLBW) neonates had significantly higher concentrations of chemokines and growth factor cytokines both in their colostrum and mature milk compared with mothers of larger neonates. Thus, maternal conditions affecting pregnancy duration and in utero growth are also associated with specific human milk cytokine signatures., (Copyright © 2017. Published by Elsevier B.V.)
- Published
- 2017
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12. Diarrheagenic Escherichia coli: Prevalence and Pathotype Distribution in Children from Peruvian Rural Communities.
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Acosta GJ, Vigo NI, Durand D, Riveros M, Arango S, Zambruni M, and Ochoa TJ
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- Diarrhea etiology, Diarrhea microbiology, Escherichia coli Infections microbiology, Female, Humans, Infant, Male, Peru epidemiology, Prevalence, Rural Population statistics & numerical data, Diarrhea epidemiology, Enteropathogenic Escherichia coli, Escherichia coli Infections epidemiology
- Abstract
Diarrheagenic Escherichia coli (DEC) are common pathogens of childhood gastrointestinal infections worldwide. To date, research tracking DEC has mainly been completed in urban areas. This study aims to determine the prevalence and pathotype distribution of DEC strains in children from rural Peruvian communities and to establish their association with malnutrition. In this prospective cohort, 93 children aged 6-13 months from rural communities of Urubamba (Andes) and Moyobamba (jungle) were followed for 6 months. Diarrheal and control stool samples were analyzed using multiplex real-time polymerase chain reaction to identify the presence of virulence genes of DEC strains. The overall isolation rate of DEC was 43.0% (352/820). Enteroaggregative E. coli (EAEC, 20.4%), enteropathogenic E. coli (EPEC, 14.2%), and diffusely aggregative E. coli (DAEC, 11.0%) were the most prevalent pathotypes. EAEC was more frequently found in Moyobamba samples (P < 0.01). EPEC was the only strain significantly more frequent in diarrheal than asymptomatic control samples (P < 0.01). DEC strains were more prevalent among younger children (aged 6-12 months, P < 0.05). A decline in height-for-age Z-score (HAZ) was observed in 75.7% of children overall. EAEC was more frequently isolated among children who had a greater HAZ decline (P < 0.05). In conclusion, DEC strains were frequently found in stool samples from children in rural communities of the highlands and jungle of Peru. In addition, children with a greater decline in their growth rate had higher EAEC isolation rates, highlighting the importance of this pathogen in child malnutrition., (© The American Society of Tropical Medicine and Hygiene.)
- Published
- 2016
- Full Text
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13. High Prevalence and Increased Severity of Norovirus Mixed Infections Among Children 12-24 Months of Age Living in the Suburban Areas of Lima, Peru.
- Author
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Zambruni M, Luna G, Silva M, Bausch DG, Rivera FP, Velapatino G, Campos M, Chea-Woo E, Baiocchi N, Cleary TG, and Ochoa TJ
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- Diarrhea epidemiology, Diarrhea microbiology, Female, Humans, Male, Peru epidemiology, Prevalence, Bacterial Infections epidemiology, Caliciviridae Infections epidemiology, Coinfection epidemiology, Gastroenteritis epidemiology, Suburban Population statistics & numerical data
- Abstract
In an active diarrhea surveillance study of children aged 12-24 months in Lima, Peru, norovirus was the most common pathogen identified. The percentage of mixed (bacterial and noroviral) infections was significantly higher among norovirus-positive samples (53%) than among norovirus-negative samples (12%). The combination of norovirus with the most common bacterial pathogens was associated with increased clinical severity over that of either single-pathogen norovirus or single-pathogen bacterial infections., (© The Author 2015. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.)
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- 2016
- Full Text
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