Clinical Respiratory Symptoms Research Articles

Serum oxidant and antioxidant levels in diesel exposed toll collectors.

It has been suggested that exposure to diesel exhaust may lead to adverse effects due to the generation of oxidants. To evaluate the end products of oxidative stress in DE exposure, toll collectors who are considered a high risk group in regard to occupational toxins were compared to controls who had office-based occupations in the same company in this cross sectional study. A total of 38 toll collectors constituted the study group. All subjects were male. The toll collectors and 29 controls were similar regarding age, smoking status and duration of work. All subjects underwent a clinical examination and an interviewer-administrated questionnaire regarding respiratory symptoms, past medical and occupational history, and pulmonary function tests were performed in all subjects. Serum malondialdehyde (MDA), nitrite+nitrate and vitamin E levels were measured. Toll collectors showed higher serum MDA (5.76 +/- 2.15 micromol/L vs. 3.07 +/- 0.76 micromol/L, p=0.0001) and nitrite+nitrate levels (96.50 +/- 45.54 micromol/L vs. 19.32 +/- 11.77 micromol/L, p=0.0001) than controls. Vitamin E levels were similar in toll collectors and controls (10.57 +/- 3.44 mg/L and 9.72 +/- 2.44 mg/L, respectively, p=0.267). There was no difference between groups in terms of the findings of clinical examinations and respiratory symptoms. In pulmonary function parameters, only peak expiratory flow (PEF) in toll collectors was significantly lower than that of controls (88.9% predicted and 104.2% predicted, respectively, p=0.012). In conclusion, we suggest that serum MDA and nitrite+nitrate levels may be used as biological markers of oxidative stress related to DE exposure, but prospective controlled clinical studies are necessary to clarify the possible association between concentrations of MDA and nitrite+nitrate and pulmonary diseases related to DE exposure.

Polymorphisms of cytokine genes in atopic dermatitis

Rationale The clinical and immunological development of AD children may be associated with age-related changes in the genetic background of cytokine gene polymorphisms. Methods Fifty-two boys and 26 girls with severe AD, age 6 months to 5 years, were enrolled. Investigation included clinical (dermatologic allergy, food allergy, and respiratory allergy symptoms) assessments and evaluations of laboratory parameters (blood count, humoral immunity, IgE, specific IgE and IgG to food and respiratory allergens). Single nucleotide polymorphisms in the genes for IL-1, IL-1R, IL-2, IL-4, IL-6, IL-10, IL-12, TGFβ, TNFα and IFNγ were investigated by PCR with sequence specific primers. The genotypic frequencies and haplotypes were compared to 100 healthy donors. Results Significant differences in cytokine gene polymorphisms between AD and healthy population were found in the promoter sequence of IL-10 (the genotype frequency C/C at position −819, 63% versus 47%, p=0.04; frequency of A/G at position −1082, 48% versus 69%, p=0.001), while less significant differences appeared in other tested positions. Clinical and laboratory parameters, however, were independent of genetic background. Half of all severe AD children had elevated values of IgE, 40% had positive IgE to egg white, while low IgG occurred in 44%. Conclusions Within currently known cytokine gene polymorphisms, notable differences in AD children were only found in IL-10, an important regulatory cytokine, but these polymorphisms were independent of the clinical and immunological profiles of the investigated AD children.

Exposure time-dependent bactericidal activities of amoxicillin against Actinobacillus pleuropneumoniae; an in vitro and In vivo pharmacodynamic model.

The pharmacodynamic effects of amoxicillin against Actinobacillus pleuropneumoniae at exposure concentration above and below minimum inhibitory concentration (MIC) were evaluated in both in vitro and in vivo. In vitro, the growth and morphological change of A. pleuropneumoniae in culture medium was observed. In vivo, the efficacy of amoxicillin on experimentally induced A. pleuropneumoniae infection in disease-free pigs was evaluated. Fifteen pigs were divided into three groups (n = 5 per group). After the onset of clinical respiratory disease symptoms, 6 h post-infection, amoxicillin sustained-release injectable formulation was injected intramuscularly at 7.5 mg/kg/day (group I) and 15 mg/kg/day (group II). Then the serum concentration of amoxicillin was measured. An untreated infected group served as controls. In each amoxicillin administration group, if symptoms were not absent after 48 h, the pig was injected with the amoxicillin sustained-release injectable formulation again using the same dosage. In vitro, the growth of A. pleuropneumoniae inhibited by amoxicillin exposure at the concentration above the MIC (1.28 x MIC), and the inhibition time was in directly proportion to the time of amoxicillin exposure. Moreover, all the cells were lysed. Whereas the bacterial growth inhibition at the amoxicillin exposure concentration below the MIC (0.25 x MIC) was not done, and the shape of cells were normal or long filamentous. In vivo, the group I clinical and pathological score was higher than the group II, and the group I weight gain was significantly less than the group II. Performance with respect to weight gain corresponded with clinical signs. The infected control group was severely affected with an 80% (4/5) mortality rate 24-96 h post-challenge. The duration of time above MIC (T > MIC) of serum amoxicillin concentration in the group I was less than group II. The present studies suggest that amoxicillin has exposure time-dependent bactericidal activity against A. pleuropneumoniae.

Respiratory disease in kennelled dogs: serological responses to Bordetella bronchiseptica lipopolysaccharide do not correlate with bacterial isolation or clinical respiratory symptoms.

The role of Bordetella bronchiseptica in a natural outbreak of canine infectious respiratory disease was investigated both by culture and serological analysis. B. bronchiseptica was found in the lungs of a large proportion of clinically healthy dogs and in a greater proportion of dogs with respiratory disease. Using a lipopolysaccharide (LPS) antigen-based enzyme-linked immunosorbent assay, we analyzed the serological responses of a large number of dogs. Dogs with high antibody levels showed no protection from disease, and there was no correlation between the development of disease and rising antibody titer. Similarly, there was no difference in antibody levels in dogs with and without B. bronchiseptica in the lungs. Antibodies to LPS have no predictive value in determining which animals will contract respiratory disease, how severe the disease will be, or which dogs will have B. bronchiseptica colonizing the lungs.

Cough sensitivity in atopic dermatitis

The aim of study was to investigate the cough sensitivity (C2) to capsaicin (CAPS) in patients with atopic dermatitis without clinical respiratory symptoms. Cough sensitivity (C2) is defined as the lowest CAPS concentration, which evokes two or more coughs. Forty eight dermatological patients (21 M, 27 F; mean age 44 yr) and 24 healthy volunteers (14 M, 10 F; mean age 37 yr) inhaled deep breath (2 l) of CAPS aerosol in doubled concentrations (from 0.02 to 200 μmol/l) (Pari Provokationstest I, PARI WERK; mass median diameter 1.2 μm). Cough sensitivity (C2) expressed as geometric mean (95% CI) of CAPS concentration was 0.13 μmol/l (0.06–0.31) in 26 patients with atopic dermatitis (10 M, 16 F; mean age 41 yr), 5.51 μmol/l (1.33–22.90) in 22 patients with psoriasis (11 M, 11 F; mean age 46 yr) and 4.29 μmol/l (2.54–7.26) in 24 controls. There is significant difference of cough sensitivity (C2) between patients with atopic dermatitis and healthy volunteers ( p<0.001) and also between patients with atopic dermatitis and psoriasis ( p<0.001). Cough sensitivity (C2) in atopic dermatitis patients without clinical respiratory symptoms is significantly increased. In patients with psoriasis cough sensitivity (C2) is not significantly changed.

Prévalence des symptômes respiratoires, des troubles ventilatoires et des sensibilisations cutanées à différents allergènes chez les épiciers de Casablanca

The aim of this study was to determine the prevalence of respiratory symptoms, pulmonary function abnormality and allergic sensitization among grocers in Casablanca. This retrospective cross-sectional epidemiological inquiry among a cohort of 100 grocers and 100 control subjects who were not grocers included an analysis of working conditions and a medical workup (questionnaire, medical examination, spirometry and skin prick testing). Atopy was found in 22% of the grocers, in 18% of the controls. Sixty-seven percent of the grocers reported clinical respiratory symptoms compared to only 24% of the controls. Cough, expectoration, dyspnea, rhinitis, conjunctivitis, symptoms suggestive of asthma and chronic bronchitis were significantly more frequent in the grocers. Pulmonary function tests were abnormal in 39% of the grocers, more so in those who had worked longest. Skin tests were positive to at least one allergen in 53% of the grocers and in 22% of the controls. Sensitivity to common inhalant allergens was found in 6% of the grocers and 12% of the controls. Sensitivity to occupational allergens (such as storage mites, molds and cereal allergens) was 31% among the grocers and 4% among the controls. Among the grocers, 7% were sensitive to spices, 5% to coffee, 5% to tea, and 14% to wheat and rye flour. It is imperative to implement medical and technical prevention measures to reduce the risks related to these allergies.

Recurrent abdominal pain, food allergy and endoscopy

Gastrointestinal food allergy, a well-recognized clinical entity, has a wide spectrum of clinical features, including cutaneous, respiratory and gastrointestinal symptoms and objective abnormalities. The gastrointestinal alterations in food allergy have been described throughout the gastrointestinal tract. Recurrent abdominal pain (RAP) is a common complaint in school-age children. The findings among children with RAP of an underlying food allergy associated with mucosal pathology of the foregut may support a causal relationship between food allergy and RAP. Further studies are needed to elucidate whether well-documented food allergy (based on double-blind placebo-controlled food challenges) is a major cause of RAP.

DIAGNOSTIC RADIOLOGY

Thirty-four men with left ventricular mechanical dysfunction were admitted to an intensive care unit with either an acute myocardial infarction (Group 1, n = 18) or worsening of clinical respiratory signs and symptoms in the setting of a chronic congestive cardiomyopathy (Group 2, n = 16). On admission, all individuals had pulmonary venous hypertension classified as at least Grade 3 by standard radiographic criteria. In each subject, mean pulmonary capillary wedge pressure (mm Hg), extravascular lung water (EVLW) (ml/kg), and chest radiographs were serially evaluated. In the patients in whom pharmacologic therapy successfully returned left ventricular filling pressures to near normal levels (less than or equal to 15 mm Hg), the chest radiograph returned to its baseline level (defined by the discharge radiograph) later in the patients with chronic heart failure (5.1 +/- 1.0 days) than in the patients with acute myocardial infarctions (2.1 +/- 1.2 days, p less than 0.01). Radiographic changes in extravascular water (interstitial and alveolar edema) mirrored changes in EVLW, although EVLW was initially greater in Group 2 (16.3 +/- 1.8 ml/kg) than in Group 1 (10.7 +/- 1.3 ml/kg, p less than 0.01). In the patients in whom filling pressures either worsened or changed less than 3 mm Hg, EVLW and chest radiographs did not markedly change. It is concluded that changes in radiographic pulmonary edema mirror changes in indicator-dilution measurements of EVLW. Radiographic phase lag represents a slow decline in EVLW after therapy for heart failure, which is prolonged in patients with chronic failure and greater EVLW.

Interstitial Pneumonitis in Association with Polymyositis and Dermatomyositis

The clinical, roentgenologic, physiologic, and pathologic features of interstitial pulmonary fibrosis in association with polymyositis and dermatomyositis have been described from a retrospective analysis. Presenting complaints ranged from acute febrile pneumonitis without specific muscular symptoms to muscular symptoms with no clinical respiratory symptoms. All patients had diffuse abnormalities on thoracic roentgenograms. High-dosage corticosteroid therapy in those patients with acute febrile pneumonitis resulted in clinical, roentgenographic, and some physiologic improvement. Pulmonary involvement did not appear to progress in most patients with chronic disease who were receiving longterm corticosteroid therapy. The clinical, roentgenologic, physiologic, and pathologic features of interstitial pulmonary fibrosis in association with polymyositis and dermatomyositis have been described from a retrospective analysis. Presenting complaints ranged from acute febrile pneumonitis without specific muscular symptoms to muscular symptoms with no clinical respiratory symptoms. All patients had diffuse abnormalities on thoracic roentgenograms. High-dosage corticosteroid therapy in those patients with acute febrile pneumonitis resulted in clinical, roentgenographic, and some physiologic improvement. Pulmonary involvement did not appear to progress in most patients with chronic disease who were receiving longterm corticosteroid therapy.