- A viral-vectored RSV vaccine induces long-lived humoral immunity in cotton rats. [Journal Article]
- VVaccine 2018 May 17
- Human respiratory syncytial virus (RSV) is the leading cause of lower airway disease in infants worldwide and repeatedly infects immunocompetent individuals throughout life. Severe lower airway RSV i...
Human respiratory syncytial virus (RSV) is the leading cause of lower airway disease in infants worldwide and repeatedly infects immunocompetent individuals throughout life. Severe lower airway RSV infection during infancy can be life-threatening, but is also associated with important sequelae including development of asthma and recurrent wheezing in later childhood. The basis for the inadequate, short-lived adaptive immune response to RSV infection is poorly understood, but it is widely recognized that RSV actively antagonizes Type I interferon (IFN) production. In addition to the induction of the anti-viral state, IFN production during viral infection is critical for downstream development of robust, long-lived immunity. Based on the hypothesis that a vaccine that induced robust IFN production would be protective, we previously constructed a Newcastle disease virus-vectored vaccine that expresses the F glycoprotein of RSV (NDV-F) and demonstrated that vaccinated mice had reduced lung viral loads and an enhanced IFN-γ response after RSV challenge. Here we show that vaccination also protected cotton rats from RSV challenge and induced long-lived neutralizing antibody production, even in RSV immune animals. Finally, pulmonary eosinophilia induced by RSV infection of unvaccinated cotton rats was prevented by vaccination. Overall, these data demonstrate enhanced protective immunity to RSV F when this protein is presented in the context of an abortive NDV infection.
- Risk Factors for Prolonged Postoperative Ileus In Adult Patients Undergoing Elective Colorectal Surgery: An Observational Cohort Study. [Journal Article]
- RRRev Recent Clin Trials 2018 May 20
- Purpose Prolonged postoperative ileus (PPOI) after abdominal surgery may effect unfavourably the patient recovery. The aim of this study was to estimate the incidence of PPOI in patients elective for...
Purpose Prolonged postoperative ileus (PPOI) after abdominal surgery may effect unfavourably the patient recovery. The aim of this study was to estimate the incidence of PPOI in patients elective for colorectal resection and investigate perioperative variables associated with PPOI. Methods A consecutive series of 428 patients undergoing colorectal resection (median age 72, range 24-92, years; men/women ratio 1.14) were analyzed. Data were extracted retrospectively throughout a five-year period from an electronic prospectively maintained database. PPOI was defined as the need for postoperative insertion of naso-gastric tube in a patient experiencing nausea and two episodes of vomiting and further showing absence of adequate bowel function (absence of flatus/stool) with lack of bowel sounds and abdominal distension. Results Incidence of PPOI was 7% [95% confidence interval (95%CI), 4.8-9.9%]. Mean hospital stay was 8 days longer in patients with PPOI. Male gender, cancer, cardiac and respiratory co-morbidity, rectal resection, open/converted access, duration of operation, stoma formation and body mass index were associated with PPOI at univariate analysis (0.001<P<0.048). PPOI was independently associated with male gender [adjusted odds ratio (OR), 4.2; 95%CI, 1.5-11.5], stoma formation (OR, 2.8; 95%CI, 1.2-6.8) and obesity (OR of obese vs. normal weight patients, 3.8, 95%CI, 1.2-12.0). Conclusions After colorectal resection PPOI leads to prolonged hospital stay and slower patient's recovery. An international standardized definition of PPOI is strongly needed to make comparable results from researches and to reliably identify patients with increased risk, also to improve the therapeutic preventive policies in these patients.
- [The prevalence of allergy-related symptoms and their risk factorinvestigation in early life]. [Journal Article]
- LCLin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2016 Jun 20; 32(2):948-951
- Objective: The aim of this study is to investigate the incidence of allergy-related symptoms and the associated risk factors.Method:There were 205 children aged 3 to 4 years old recruited for this st...
Objective: The aim of this study is to investigate the incidence of allergy-related symptoms and the associated risk factors.Method:There were 205 children aged 3 to 4 years old recruited for this study.Questionnaires on skin,wheezing and rhinitis symptoms were answered,and total IgE and specific IgE in serum against house dust mite extracts were tested.Logistic regression analysis with which we calculated odds ratio(OR) and 95% confidence interval(95%CI) were used for risk factor analysis.Result:Questionnaire results show that the reported history of symptoms was 43%(88 cases) for lactation eczema and 25%(51 cases) for wheezing.The currently reported symptoms was 19%(38 cases) for frequent skin rashes,16% (33 cases) for frequent wheezing and 46%(95 cases) for rhinitis symptoms.There are 33% (68 cases) of the children reported with no symptoms currently.The lactation eczema history(OR［95%CI］:2.76［1.10-3.40］,P<0.05)and wheezing history(OR［95%CI］:2.40［1.22-4.73］,P<0.01)are both the risk factors for developing rhinitis symptoms.Serology test shows that house dust mite IgE prevalence is 24%,which is the risk factor developing rhinitis symptom(OR［95%CI］:2.10［1.09-4.07］,P<0.05).But it has nothing to do with wheezing symptom.Conclusion: Lactation eczema and house dust mite sensitization are the risk factors for developing respiratory diseases in early childhood.The house dust mite allergic respiratory symptom starts with rhinitis symptom.
- Changes of Peak Expiratory Flow Rate in Adult Asthmatic Patient. [Journal Article]
- MMMymensingh Med J 2018; 27(2):245-250
- Asthma is a common pulmonary disorder characterizerized by airway inflammation, airway- hyper reactivity, and reversible airflow obstruction. The classic triad of symptoms is wheezing, chronic episod...
Asthma is a common pulmonary disorder characterizerized by airway inflammation, airway- hyper reactivity, and reversible airflow obstruction. The classic triad of symptoms is wheezing, chronic episodic dyspnea and chronic cough. The prevalence of asthma increased steadily over the latter part of the last century, first in the developed and then in the developing world. The number of people with asthma in the world may be as high as 334 million. Asthma in Bangladesh appears to be a substantial public health problem: an estimated 11.6 million people including 4.1 million children suffer from asthma-related symptoms. A cross sectional study was conducted from January 1999 to August 1999 on 5642 Bangladeshi people and another same study carried out from November 2009 to April 2010 on 8088 subjects. In 1999 the prevalence of asthma was 6.9% whereas in 2010 it is 6.96%. Airway resistance is always increased during the asthmatic attack. Airways obstruction, such as that caused by asthma, results in a reduced and variable Peak Expiratory Flow Rate (PEFR). PEFR is classically reduced in asthma. Recent asthma guidelines recommended the assessment of severity levels based on the most severe symptoms and peak expiratory flow rate. This descriptive type of cross-sectional study was done to find the changes of Peak expiratory flow rate in adult asthmatic patients and carried out in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh from July 2014 to January 2016. Fifty (50) male and 50 (fifty) female adult asthmatic patients aged 18-60 years were included in the study group. They are enrolled from the Department of Medicine, Mymensingh Medical College, Mymensingh, Bangladesh and also from locality. For comparison age matched 50 male and 50 female apparently healthy persons were also studied as control. PEFR was estimated by Wright's Peak flow meter. For statistical analysis unpaired student's 't' test was used. Mean PEFR were significantly decreased in study group in comparison to control group and the result was statistically significant (p<0.001). From this study, it may be concluded that peak expiratory flow rate was decreased in asthmatic patient and there was a significant relation of decline lung function.
- Health-related quality of life by allergy symptoms in elementary school students. [Journal Article]
- HQHealth Qual Life Outcomes 2018 May 15; 16(1):93
- CONCLUSIONS: As expected, the presence of allergic symptoms is inversely correlated with the quality of life of children. The EQ-5D-Y instrument proved to be useful in terms of feasibility and construct validity in assessing the quality of life of Korean elementary school students.
- StatPearls [BOOK]
- BOOKStatPearls Publishing: Treasure Island (FL)
- Chest inspection, palpation, and auscultation are key components of the physical examination of patients with respiratory disease. Palpation ascertains the signs suggested by inspecting and assessing...
Chest inspection, palpation, and auscultation are key components of the physical examination of patients with respiratory disease. Palpation ascertains the signs suggested by inspecting and assessing the state of the pleura and lung parenchyma by studying the vocal fremitus. Vocal (tactile) fremitus is palpation of the chest wall to detect changes in the intensity of vibrations created with certain spoken words in a constant tone and voice indicating underlying lung pathology. Pathophysiology Sound vibrations produced in the larynx during phonation are transmitted to the bronchi and lungs and then communicated to the chest wall. Transmission of spoken tones depends on the state of the underlying lung parenchyma in the pleural space. Normal lung parenchyma is a mixture of air-filled spaces and solid lung parenchyma. Air is a poor conductor of low sound frequencies whereas a solid or dense medium increases the transmission of low sound frequencies. Vocal fremitus may be decreased in conditions affecting the lung parenchyma, pleura, or chest wall. Vocal fremitus is decreased in bronchial asthma, emphysema, or bronchial obstruction due to air trapping and decreased density of lung parenchyma. In case of pleural effusion and pneumothorax, air/fluid accumulates in the potential space between the chest wall and lung parenchyma, decreasing the transmission of lower frequency sound vibrations. Vocal fremitus also may be decreased in individuals with obesity. On the other hand, inflammation and consolidation create a dense medium which increases the transmission of lower frequency sounds and vocal fremitus. Vocal resonance is the auscultatory counterpart of vocal fremitus. The following changes in vocal resonance are seen. Bronchophony: A louder sound heard over an area of consolidation. Whispering pectoriloquy: While the examiner auscultates over the lung fields, the patient is asked to whisper "one, two, three." Whispered words are heard clearly in the presence of consolidation. Whispered pectoriloquy has the same significance as increased fremitus and adds no new information to those approaches. Egophony or an "E to A" change: A qualitative change in the voice that resembles the bleating of a goat. Select sound frequencies are able to pass through consolidation and tend to distort the sound of the vowel "E" so that it is perceived by the examiner as "A" or "AAAH." Other types of fremitus: Ronchial fremitus - palpable ronchi. Pleural fremitus - palpable pleural rub.
- Pregnancy Trimester-Specific Exposure to Ambient Air Pollution and Child Respiratory Health Outcomes in the First 2 Years of Life: Effect Modification by Maternal Pre-Pregnancy BMI. [Journal Article]
- IJInt J Environ Res Public Health 2018 May 15; 15(5)
- Prenatal exposure to air pollution is associated with childhood respiratory health; however, no previous studies have examined maternal pre-pregnancy body mass index (BMI) as a potential effect modif...
Prenatal exposure to air pollution is associated with childhood respiratory health; however, no previous studies have examined maternal pre-pregnancy body mass index (BMI) as a potential effect modifier. We investigated whether maternal pre-pregnancy BMI modified the association of trimester-specific air pollution divided into quartiles of exposure (Q1⁻4) on respiratory health in the Growing Up in Singapore towards healthy Outcomes (GUSTO) study (n = 953) in 2-year-old children. For episodes of wheezing, children of overweight/obese mothers and who were exposed to particulate matter less than 2.5 μm (PM2.5) in the first trimester had an adjusted incidence rate ratio (IRR) (95% confidence interval (CI)) of 1.85 (1.23⁻2.78), 1.76 (1.08⁻2.85) and 1.90 (1.10⁻3.27) in quartile (Q) 2⁻4, with reference to Q1. This association is seen in the second trimester for bronchiolitis/bronchitis. The risk of ear infection in the first year of life was associated with exposure to PM2.5 in the first trimester with adjusted Odds Ratio (adjOR) (95% CI) = 7.64 (1.18⁻49.37), 11.37 (1.47⁻87.97) and 8.26 (1.13⁻60.29) for Q2⁻4, and similarly in the second year with adjOR (95% CI) = 3.28 (1.00⁻10.73) and 4.15 (1.05⁻16.36) for Q2⁻3. Prenatal exposure to air pollution has an enhanced impact on childhood respiratory health, and differs according to maternal pre-pregnancy BMI.
- Association of a four-locus gene model including IL13, IL4, FCER1B, and ADRB2 with the Asthma Predictive Index and atopy in Chinese Han children. [Journal Article]
- JIJ Investig Allergol Clin Immunol 2018 May 11; :0
- CONCLUSIONS: Our results indicated that the four-locus gene model consisting of L13 rs20541, IL4 rs2243250, ADRB2 rs1042713 and FCER1B rs569108 was associated with the API and atopy. These findings provide an evidence of the gene model for determining a high risk of developing asthma and atopy in Chinese Han children.
- Diffuse endobronchial metastasis from sigmoid carcinoma presenting as wheezing and respiratory failure. [Journal Article]
- RCRespirol Case Rep 2018; 6(5):e00328
- A 66-year-old Thai man with underlying asthma, history of traumatic right haemothorax, and sigmoid carcinoma with bladder invasion developed productive cough, whitish sputum, dyspnoea, and wheezing f...
A 66-year-old Thai man with underlying asthma, history of traumatic right haemothorax, and sigmoid carcinoma with bladder invasion developed productive cough, whitish sputum, dyspnoea, and wheezing for 2 months. Physical examination showed generalized expiratory wheezing in both lungs. Computed tomography scan of the chest revealed diffuse thickening of bronchial wall, predominantly at lower lobes; several various sizes of pulmonary nodules; diffuse interlobular septal thickening; multiple enlarged mediastinal lymph nodes and hilar lymph nodes; and right pleural effusion. The patient was intubated for respiratory failure with persistent wheezing and, subsequently, with difficulty weaning from mechanical ventilation. Bronchoscopy was performed, which revealed diffuse multiple small mucosal nodules in both lungs. Pathology of the nodules showed foci of adenocarcinoma. Positive immunochemical staining with CDX2 confirmed the diagnosis of endobronchial metastasis of sigmoid carcinoma. This case highlighted a rare presentation of endobronchial metastasis from sigmoid carcinoma with persistent wheezing, respiratory failure, and difficulty in weaning from mechanical ventilation.
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- Multicenter Study of Albuterol Use Among Infants Hospitalized with Bronchiolitis. [Journal Article]
- WJWest J Emerg Med 2018; 19(3):475-483
- CONCLUSIONS: Variation in pre-admission albuterol use suggests that local practice had a strong influence on use, but that patient characteristics also influenced the decision. While we agree with current guidelines in recommending against albuterol for all infants with bronchiolitis, our understanding of possible subgroups of responders may improve through investigation of infants with the identified characteristics.