Frequency Of Acute Respiratory Infections Research Articles

The use of telemedicine after outpatient surgical treatment of varicose veins of the lower extremities

Introduction. Telemedicine is a new form of communication between a doctor and a patient. Of interest is the expediency of its use in the postoperative observation of patients. Aim. To analyze the possibility of optimizing the postoperative management of patients who underwent outpatient surgical treatment of VVLE using telemedicine. Materials and methods. The study was performed in two stages on patients with VVLE. At the first stage, a comparative prospective, randomized study of the main and comparison groups (50 patients C2 according to CEAP) in the early postoperative period was conducted. In the main group, telemedicine was used, in the comparison group – face-to-face examinations in the polyclinic. The frequency of complications associated with surgery, the frequency of acute respiratory infections and the time spent on a follow-up examination were compared. At the second stage, in 876 cases of telemedicine use in the postoperative period, the frequency and structure of complications requiring conversion to face-to-face examination were studied. Results. Significant differences between the compared groups were revealed by the frequency of acute respiratory infections and the time spent by the patient on a follow-up examination. The reasons for conversion from telemedicine to face-to-face examination: copious wetting of the bandage with blood, swelling and severe pain of the operated limb, hyperthermia are rare. Discussion. Most of the complications and side effects associated with surgical intervention registered in the study have characteristic specific manifestations: complaints and appearance, which allows them to be diagnosed through telemedicine. Conclusion. The use of telemedicine optimizes the postoperative period in patients with VVLE: the risk of infection with acute respiratory infections is reduced, the time of the doctor and the patient is saved, while there is no negative effect on the frequency associated with surgery.

The effect of vitamin D supplementation on the frequency and course of recurrent respiratory diseases in children

Background. Recurrent and prolonged course of respiratory infections leads to the formation of chronic foci of inflammation, the persistence of viruses, impaired physical and psychomotor development, and a decrease in the child’s immunity. Given the participation of vitamin D (VD) in the regulation of the body’s immune response, the study of its role in the development and course of recurrent respiratory diseases in children remains re­levant. The purpose is to study the effect of vitamin D supplementation on the frequency and course of recurrent respiratory diseases in children. Materials and methods. We examined 52 children with recurrent respiratory infections aged 4 to 10 years. Children were examined before and after VD supplementation according to the study criteria: the average frequency of acute respiratory infection (ARI) episodes per year, the severity of the clinical manifestations of ARI episode, its average duration, the frequency of antibiotic prescriptions and outpatient visits to the doctor. Results. It was found that at the beginning of the exa­mination, the level of 25(OH)D in the blood serum ranged from 11.1 to 29.9 ng/ml, 22 (42.3 %) children had VD deficiency. An analysis of the frequency of ARI episodes per year showed that children with VD deficiency were ill more often than children with a sufficient level of VD (p < 0.001). According to the results of the study, it was found that VD supplementation contributes to a decrease in the frequency of ARI episodes from 8.7 ± 1.7 to 6.8 ± 1.2 times a year (p < 0.001), a decrease in the average number of symptoms of an episode of acute respiratory infections per year from 5.5 ± 0.5 to 4.5 ± 0.5 and their manifestations from 9.2 to 7.41 points (p < 0.001), a decrease in the duration of ARI episode from 6.0 ± 1.7 to 5.7 ± 1.5 days (p = 0.003), as well as a decrease in the number of outpatient visits from 5 to 4 (p = 0.004) and antibiotic prescriptions from 61 to 38 (p < 0.001). Conclusions. VD supplementation improves the course of respiratory diseases in children. The study was carried out in accordance with the Declaration of Helsinki principles. The study protocol was adopted by the ethics committee of the institution indicated in the work. The informed consent of the children’s parents was obtained.

CATION COMPOSITION OF ORAL SECRETION IN PRIMARY SCHOOL-AGED CHILDREN

SUMMARY. Recurrent respiratory infections (RRIs) currently have the greatest medical and social burden among infectious diseases worldwide, with the highest prevalence and incidence rates of acute respiratory infections in children. Recent studies indicate the role of inadequate immune response and the development of recurrent acute respiratory infections (ARI) in children due to deficiencies in essential trace elements in the body, which are crucial for the proper functioning of physical barriers and the immune system. The hypothesis of our study assumed that, considering the recurrence of at least 6 episodes of ARI per year, children with RRIs may have changes in salivary ion levels, which could serve as a basis for local immune suppression of the upper respiratory mucosa. The aim – to investigate the levels of metals in the saliva of children of primary school age with recurrent respiratory infections in comparison with episodically ill peers and establish the relationship of these changes with the state of local immunity. Material and Methods. In the actual study, 40 children participated, with 30 of them (the main group) being children with recurrent respiratory infections and 10 other children who had episodic illnesses were assigned to the control group. The levels of metal cations in the saliva were examined using inductively coupled plasma atomic emission spectrometry, including essential metals such as copper, manganese, zinc, calcium, cobalt, potassium, magnesium, sodium, phosphorus, selenium, iron, chromium, and sulfur. Additionally, levels of conditionally essential metals like lithium, nickel, and boron were measured. The levels of secretory IgA and lysozyme in saliva were determined using the enzyme-linked immunosorbent assay method. Results. The main group was not homogeneous; therefore, we divided it into two clusters. Respondents in one cluster had significantly lower relative levels of essential ion content in saliva. Specifically, calcium was lower in 64 % (p=0.003), copper in 76.5 % (p=0.001), manganese in 41.1 % (p=0.008), magnesium in 64 % (p=0.02), and zinc in 58.8 % (p=0.027). This fact can be explained by their increased losses due to frequent inflammatory processes in the upper respiratory tract, resulting in higher daily replenishment needs compared to their peers. Correlation analysis revealed a connection between illness incidence and the levels of copper (p=0.008), sodium (p=0.00005), and phosphorus (p=0.028), indicating potential associations between saliva metal profiles and the frequency of ARI in children with RRIs. The presence of dental caries correlated with lithium (p=0.02), copper (p=0.032), and nickel levels (p=0.037). Integral indicators of local immunity, such as lysozyme and secretory IgA, exhibited correlations with metal levels in saliva (Li, Cu, Ni, Na, Co, P, Zn), confirming the hypothesis of their role in regulating immune reactions in the oral cavity. Conclusions. Cluster analysis of the metal profiles of the group of children with RRI shows its heterogeneity, 43 % of representatives of this cohort had significantly lower levels of calcium (p=0.003), copper (p=0.001), manganese (p=0.008), magnesium (p=0.02) and zinc (p=0.027) than the control group. Which may indicate the presence of deficient conditions in some children with PRI as a result of the increased need for their recovery. The presence of caries, the level of SIgA, lysozyme (clinical indicators of local immunity of the oral cavity) have certain relationships with the levels of essential and conditionally essential levels of salivary metals (Li, Cu, Ni, Na, Co, P, Zn), which indicates the benefit of the connection between the metal profile of saliva and the state of local immunity.

Clinical and immunological characteristic of children with recurrent episodes of acute laryngotracheitis, acute respiratory infections, otorhinolaryngological deseases

Introduction. Researching on pathogenesis and immunopathogenesis of acute respiratory infections in conjunction with recurrent episodes of acute laryngotracheitis and otorhinolaringological diseases (tonsillopharyngitis, rhinosinusitis, otitis) — is a high priority task for pediatrics, what is necessary to do to create an approach for preventing chronic illnesses.The aim of the present work. Researching on clinical and immunological characteristics and efficiency of treatment with prescription of bacterial lysate (OM-85) for children with recurrent episodes of acute laryngotracheitis, acute respiratory infections (ARI), otorhinolaringological diseases.Materials and methods. Fifty children 3-9 years old (32 children 3-6 years, 18 children 7-9 years old; 32 boys, 28 girls) in the initial period of monitoring, with recurrent episodes of acute laryngotracheitis (ALT), acute respiratory infections (ARI), otorhinolaryngological diseases were examined. The treatment in according with pediatric clinical practice guidelines, consultations with a pediatrician, otorhinolaryngologist, allergologist were provided to all children.Twenty five children (subgroup I b) received bacterial lysate (OM-85, 4 courses in 3 years ) in complex treatment. Subgroups I a, I b were similar in clinical symptoms, gender and age related. Follow up period continued three years. The results were evaluated a year and three years after treatment. Experimental group was composed of 30 children 3-9 years old, additionally examined. This group had such characteristics as: frequency of acute respiratory infections 3-5 times in a year, absence of chronic respiratory diseases, of recurrent episodes of acute laryngotracheitis. Immunological survey included some parameters of innate immunity, serum immunoglobulins, chemiluminescence, interferons (IFN-alfa, IFN-gamma).Results. In children with repeated episodes of ALT and ARI and otorhinolaryngological diseases the expression of TLR2 and TLR4 on CD14+ cells, receptors for IFN-γ (CD14+CD119+) is significantly higher than in children without ALT and with a frequency of ARI 3-5 times a year, which is accompanied by a decrease in the level of IFN-γ and IFN-α and is associated with the development of dysregulation of the immune system, which decreases with the administration of bacterial lysate (OM-86). Complex treatment of children within 3 years with the prescription of the drug significantly reduces the frequency of ARI — 2.6 times, tonsillopharyngitis — 1.8 times, rhinosinusitis — 2.2 times, the need for the prescription of antibiotics — 2.2 times. In the group treated by standards after 3 years, the need for antibiotics decreased by 1.6 times, the frequency of ARI exacerbations — by 1.2 times, tonsillopharyngitis — by 1.5 times, rhinosinusitis — by 1.8 times.

Бутстреп-аналіз імунного статусу в дітей дошкільного віку з рекурентними респіраторними інфекціями

Purpose - to carry out a systematic analysis of humoral and blood cellular immunity parameters in preschool children with a different frequency of acute respiratory infection (ARI) during the previous year using bootstrap analysis. Materials and methods. Twenty-six children (11 boys and 15 girls) aged 1 to 4 years old, undergoing inpatient treatment on ARI, were involved in the clinical study. Serum concentrations of immunoglobulins (Ig) of classes A, M, G, E and a number of blood cellular immunity parameters were studied. Also, two indicators of ARI recurrence were calculated, namely, the infectious index and the resistance index. The statistical processing of the primary digital material obtained was performed by IBM SPSS Statistics 28 licensed program. Results. A direct moderate bootstrap correlation between the resistance index and serum IgA concentration in the preschool children with the different frequency of ARI according to their anamnesis (Bρ=0.407; p<0.001 [0.397-0.418]) was established. A rank correlation analysis, a multiple linear and an ordinal logistic regression combined with bootstrapping showed no significant relationship between particular serum Ig, on the one hand, and particular blood cellular immunity parameters, on the other hand. A partial bootstrap correlation analysis revealed the significant influence of many covariates studied on the strength of relationship between the indicators in the selected pair combinations. Conclusions. Provided the initial quantitative limitation of the observation group of the preschool children suffering from recurrent respiratory infections, the bootstrapping procedure applied significantly expands the interpretive possibilities of the clinical and immunological study results. Besides the standard estimation of the asymptotic significance of partial correlation coefficients, the bootstrap definition of their 95% confidence interval is an additional and highly informative way to check the results’ statistical validity. The study was conducted in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the local ethics committees of the institutions mentioned in the paper. An informed parental consent was obtained for the study in children. No conflict of interests was declared by the authors.

Study of the Frequency and Outcome of Acute Respiratory Tract Infection in Exclusively Breastfed Infants

Introduction: Exclusive breast feeding is the fundamental component of child nutrition and survival. Exclusive breast feeding provides nutritional and immunological support for infant normal growth and development. Bangladesh is traditionally a breastfed community. The risks of acute respiratory infection (ARI) is higher in partially breastfed and formula-fed infants during the first 4 months of life. Objective: To see frequency and outcome of ARI in exclusively breastfed (EBF) infants. Materials and Methods: This cross sectional study was done at Department of Pediatrics, Rajshahi Medical College Hospital, from January 2013 to June 2013, a period of six months to find out the frequency and outcome of acute respiratory tract (ARI) infection in exclusively breastfed infants. 100 cases of infants suffering from ARI were selected who were exclusively breastfed. Data were analyzed through SPSS software. Results: Most of the EBF babies (M48+F28=) 76% came to hospital with a history of one or two attacks of ARI. Among 100 EBF babies, 96 babies were cured without complications and 02 babies develop complications and cured. There was 02 unfortunate death. Only 42% of EBF babies presented with moderate or less severe attack, 58% had mild attack. Hospital stays in EBF babies are shorter, only 64% of EBF patients had to stay more than 03 days. Conclusion: Frequency and severity of ARI attack is less and mild and hospital staying is short found in EBF babies, as well as better outcome with treatment. Medicine Today 2023 Vol.35(1): 16-19

The effect of combined therapy with calcium salts and vitamin D on the concentration of macro- and microelements in saliva in young children

Background. A balanced supply of macro- and microelements to various organs and systems is a prerequisite for maintaining human health. Deficiency or excess of macro- and microelements in saliva can be associated with both inflammation and oxidative damage to the oral tissues. Provision of calcium in the human body significantly affects the state of salivary ionome. However, currently there are few studies on the effect of Ca and vitamin D on the state of salivary ionome in healthy children. Purpose: to study the effect of combined use of prophylactic doses of Ca and vitamin D on the concentration of macro- and microelements in saliva of young children. Materials and methods. Under our supervision, there were 36 clinically healthy young children who received Calcicare 2.5 ml 3 times a day for 2 months. The study of the content of macro- and microelements in urine was carried out by optical emission spectrometry with an inductively coupled plasma. Statistical analysis of the results was performed using the application package Statistica 6.1 on a personal computer based on Intel Pentium processor. Results. The study showed that the combined use of calcium carbonate and vitamin D significantly changes the concentration of some macro- and microelements in saliva of young children. The level of some trace elements in saliva before the start of therapy with Calcicare correlated with the frequency of acute respiratory infections. Thus, a higher incidence of acute respiratory infections was observed in children with reduced salivary excretion of Ca and S. Young children had a low concentration of Ca and Mg in saliva before the course of Calcicare therapy. Treatment with Calcicare led to an activation of the metabolism of these macronutrients in saliva of young children, which was characterized by an increase in the level of Ca from 29.5 ± 4.4 mg/l to 60.1 ± 6.8 mg/l (p < 0.01), Mg from 4.9 ± 0.6 mg/l to 9.3 ± 0.8 mg/l (p < 0.01), S from 336.3 ± 3.8 mg/l to 2501.6 ± 275.4 mg/l (p < 0.01), and P from 5.6 ± 0.3 mg/l to 15.8 ± 0.7 mg/l (p < 0.01). An increase in the concentration of Ca and P in saliva after the treatment with Calcicare probably has an anti-caries effect. An increase in the level of Mg in saliva after the course of Calcicare may have anti-inflammatory and antitumor effect on the oral mucosa. Co-administration of calcium carbonate and vitamin D led to the disappearance of salivary excretion of some trace elements such as B, Cd, Li, Pb, which may relieve the oral mucosa and dental tissues from the toxic effects of these trace elements. Conclusions. The combined use of calcium carbonate and vitamin D (Calcicare) for 2 months in young children is accompanied by changes in salivary ionome, which are of anti-inflammatory and anti-caries nature. After taking calcium carbonate and vitamin D, there was a cessation of salivary excretion of some trace elements, which have a toxic effect on the oral tissues. The use of Calcicare in the recommended dose of 2.5 ml 3 times a day for 2 months is characterized by a high safety profile and can be recommended for young children, especially those at risk of developing calcium deficiency.

The role of vitamin D in the prevention and treatment of acute respiratory infections in children: A review

The highest frequency of acute respiratory infections occurs in children aged 37 years (preschoolers), when the child begins to meet with an increased infectious load in children's organized groups. Vitamin D deficiency or insufficiency is often detected in children with recurrent respiratory infections. At the same time, vitamin D is a complex regulator of innate and adaptive immunity, has an immunomodulatory and anti-inflammatory effect, and protects from a severe infection. The results of international and Russian studies demonstrate the feasibility of using vitamin D for the prevention and treatment of a number of respiratory infections in children and adults.

Study on acute respiratory infection in children aged 1 year to 5 years-A hospital-based cross-sectional study.

Acute respiratory infections (ARIs) are the single greatest cause of death among children throughout the world. They are responsible every year for the deaths of 4.3 million children under 5 years of age worldwide. Community- or hospital-based surveys for finding out the prevalence and various factors associated with ARI are very few, especially in urban areas. Also, surveys to study the use of vaccines in preventing ARIs are scarce. Hence, we studied ARI in children aged 1 year to 5 years in a tertiary care hospital in Kerala. The aim was to determine the frequency of ARIs in the last 1 year in children aged 1 year to 5 years, attending the immunization clinic at Lourdes Hospital, Kochi, and assess the selected epidemiological, socio-demographic, nutritional and immunization factors associated with ARIs in the study group. Children attending the immunization clinic at a tertiary care hospital, Kochi, in the age group of 1 year to 5 years were selected. A brief introduction was given to the mother/caregiver of the child regarding the purpose of the study and was asked to fill out the questionnaire. Informed consent was taken. For the study, ARI is defined as the presence of one or more of the following: cough, running nose, blocked nose, sore throat, difficulty breathing, or ear problems; with or without fever. Results were analyzed. Mother was the caregiver in 67% of the cases. When the caregiver was the mother, ARI is found to be less. Among those mothers who had no formal education, 100% of their children got ARI. Children whose caregivers were 30 years and older had lesser ARI. The proportion of children with ARIs was more with a history of respiratory infection among family members (parents/siblings) compared to those with no such history. The occurrence of ARI was more frequent in rural compared to urban areas. There is a significant proportion of ARI in non-exclusively breastfed infants, bottle feeding, and early initiation of complementary feeding. Children with a history of exposure to cigarette smoke had an increased occurrence of ARI. Similar results followed for exposure to biomass fuel and exposure to cold and rain. Children who were not immunized to vaccines-pneumococcal, Hib, measles, vitamin A, showed a higher occurrence of ARI compared to immunization. The studies regarding factors influencing ARI are relatively rare in an urban setting, thus this calls for more studies in urban areas. Health education can change the healthcare-seeking behavior and attitude of parents for preventing ARI-related deaths. Family physicians can play a significant role by educating caregivers of children and giving timely services. Promoting and ensuring exclusive breastfeeding practices, timely weaning after 6 months, and avoidance of bottle feeds can dramatically decrease the episodes of ARI.

Комплексний аналіз сироваткової концентрації матриксної металопротеїнази 1 та тканинного інгібітора металопротеїнази 1 у дітей дошкільного віку з рекурентними респіраторними інфекціями

Purpose - to systematically examine the state of interrelatedness between the serum concentration of matrix metalloproteinase 1 and the tissue inhibitor of metalloproteinase 1, the frequency of acute respiratory infections (ARIs), and a heterogeneous set of other clinical and laboratory parameters in preschool children. Materials and methods. Forty children (21 boy and 33 girls) aged 1 to 6 years old, undergoing inpatient treatment on acute respiratory infection, were involved in the clinical study. They were studied serum concentrations of MMP-1 and TIMP-1, C-reactive protein, certain blood leukocyte fractions, erythrocyte sedimentation rate, the content of several macro- and microbiological elements in their hair as well as a number of clinical signs. Also, two integral indicators of ARIs recurrence were calculated, namely, the infectious index (InI) and resistance index, as well as integral indices of inflammation and dolichostenomelia. The statistical processing of the primary digital material obtained was performed by IBM SPSS Statistics 27 licensed program. Results. The younger children had higher serum MMP-1 concentrations (p=0.007) and MMP-1/TIMP-1 ratio (p=0.008) compared to the older children. The girls showed higher values of MMP-1 (p=0.008) and MMP-1/TIMP-1 ratio (p=0.012) than the boys. The strong positive correlation between MMP-1 and InI in the children (ρ=0.514; p=0.001; 95% CI [0.232; 0.716]) was demonstrated. Using ordinal logistic regression method, a significant and simultaneously multidirectional dependence of InI categorical index on MMP-1 (B=1.078; p=0.013; 95% CI [0.223; 1.933]) and the age category of the examined children (B=-1.942; 95% CI [-3.757; -0.126]) was established. Conclusions. It is assumed that more frequent ARIs in children are accompanied by higher levels of serum MMP-1. It is not unlikely that there is differential «tuning» of MMP-1 activity in response to varying frequency of ARIs during the previous year. The degree of influence of the predictor, namely MMP-1, in ordinal regression models is determined by both the significance of this predictor and the variant of its combination with other studied covariates. The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the local ethics committees of the institutions mentioned in the paper. An informed parental consent was obtained for the study in children. No conflict of interests was declared by the authors.

Acute Respiratory Infections in Northern Pakistan: An Epidemiological Approach

Acute respiratory infections (ARIs) are mostly infections of the upper respiratory tract which consists upper airways. Common Acute Upper Respiratory Infections (AURIs) are common cold, acute inflammation of upper respiratory tract i.e., larynx, pharynx, mucus membranes, sinuses and middle ear. Most common bacteria are Streptococcus spp., Haemophillus spp. and Staphylococcus spp. etc. While, Parainfluenza virus, Rhinovirus, Coxsackievirus, Coronavirus, Respiratory Syncytial, Adenovirus and Influenza virus are the common AURIs causing viruses. They are leading cause of mortality and morbidity worldwide with 1.9 million deaths of children annually. In Pakistan, estimated 20-30% of the total childhood deaths >5 is caused by ARIs. The current study analyzed the epidemiology of ARIs in different facility types between Jan 2017- Dec 2019 of District Abbottabad. During the 3 years study period, 4,66,048 cases were reported with Primary health facilities having highest proportion of ARIs and prevalence was highest during 2018 (84.46%). Moreover, Highest (35%) frequency of ARIs occurred during winter with peak in December (12%). While, Tehsil Abbottabad showed high prevalence (68%) as compared to Havelian (32%). This fluctuation may be due to Risk factors that might be low humidity, indoor crowding, illiteracy and low-socioeconomic status. The current findings may help the government in making infrastructure for the health-care system development in future. Keywords: Acute respiratory infections (ARIs), Common Acute Upper Respiratory Infections (AURIs), Bacterial and Viral Etiology, Northern Pakistan

The role of exclusive breastfeeding on sIgA and lactoferrin levels in toddlers suffering from Acute Respiratory Infection: A cross-sectional study

Secretion of Immunoglobulin A (sIgA) and lactoferrin is a nutrient content in breast milk that can increase immunity in preventing infectious diseases such as Acute Respiratory Infection (ARI). This research aims to determine the role of exclusive breastfeeding (EBF) on sIgA and Lactoferrin levels in toddlers suffering from ARI. A cross-sectional study was conducted on 124 toddlers under five from January–July 2021. Toddlers were selected using a purposive technique sampling from three Community Health Centers in Central Jakarta. Data were analyzed using t-test and ANOVA. The history of immunization, EBF, and frequency of ARI was significantly associated with levels of sIgA and lactoferrin. Parity only correlated with sIgA but not with lactoferrin levels. Maternal and toddlers' age, gender, and nutritional status were not significantly related to sIgA and lactoferrin levels. There is a significant (p-value <0.001) difference in the mean protein sIgA and lactoferrin levels in toddlers who were given EBF with ARI frequency <2 times and toddlers who were given EBF with ARI frequency ≥2 times. Toddlers who were exclusively breastfed with ARI frequency <2 times had higher levels of sIgA and lactoferrin (188901.77 pg/ml and 262.32 ng/ml, respectively) compared to infants given EBF with ARI frequency ≥2 times (136683.47 pg/ml and 181.49 ng/ml, respectively). History of immunization was also significantly (p-value <0.05) associated with levels of sIgA and lactoferrin in infants with ARI. The content of sIgA and lactoferrin in breast milk and immunization can increase the body's immune system in toddlers suffering from ARI.

Incidence of Acute Respiratory Infections during Disasters in the Absence and Presence of COVID-19 Pandemic.

Japan recently experienced two major heavy rain disasters: the West Japan heavy rain disaster in July 2018 and the Kumamoto heavy rain disaster in July 2020. Between the occurrences of these two disasters, Japan began experiencing the wave of the coronavirus disease 2019 (COVID-19) pandemic, providing a unique opportunity to compare the incidence of acute respiratory infection (ARI) between the two disaster responses under distinct conditions. The data were collected by using the standard disaster medical reporting system used in Japan, so-called the Japan-Surveillance in Post-Extreme Emergencies and Disasters (J-SPEED), which reports number and types of patients treated by Emergency Medical Teams (EMTs). Data for ARI were extracted from daily aggregated data on the J-SPEED form and the frequency of ARI in two disasters was compared. Acute respiratory infection in the West Japan heavy rain that occurred in the absence of COVID-19 and in the Kumamoto heavy rain that occurred in the presence of COVID-19 were responsible for 5.4% and 1.2% of the total consultation, respectively (P <.001). Between the occurrence of these two disasters, Japan implemented COVID-19 preventive measures on a personal and organizational level, such as wearing masks, disinfecting hands, maintaining social distance, improving room ventilation, and screening people who entered evacuation centers by using hygiene management checklists. By following the basic prevention measures stated above, ARI can be significantly reduced during a disaster.

The place of combined mucoactive drugs in the treatment of acute respiratory infections in children

The problem of respiratory diseases and their therapy options still retains much of its urgency. Respiratory diseases in children are still super common. According to the data on infectious morbidity among children in the Russian Federation for the period 2018–2020, current trends have not changed, and the acute respiratory infections (ARI) are still ranked number one in terms of the frequency of registered diseases. According to the official records, the frequency of ARI in children among infectious diseases is 71,850.02 per 100,000 population, or 71%. Such well-known symptom as cough is one of the most frequent manifestations of respiratory diseases. It causes the greatest discomfort for both the little patients and their parents, the quality of life of the children and those around them worsens, many domestic and foreign authors mention this symptom in their works. And it is this problem that doctors of various specialties most often face. The cough is currently treated with drugs with different effects depending on the characteristics and manifestations of the disease. Systematic reviews and multicenter studies show that prescription of mucoactive drugs to treat cough in children with underlying ARI is substantiated and feasible. The authors substantiated the necessity of using combinations of various drugs aimed to reduce inflammation of the airways, improve mucociliary clearance, thin out and promote sputum discharge and, accordingly, reduce cough. The article briefly discusses the mechanisms of the development of cough in ARI, the action of drug substances included in the combination drugs used to treat cough in children, the possibility of using the combination of muco- and bronchoactive drugs of synthetic and plant origin.

Symptom Burden and Factors Associated with Acute Respiratory Infections in the First Two Years of Life-Results from the LoewenKIDS Cohort.

Acute respiratory infections (ARIs) are the most common childhood illnesses worldwide whereby the reported frequency varies widely, often depending on type of assessment. Symptom diaries are a powerful tool to counteract possible under-reporting, particularly of milder infections, and thus offer the possibility to assess the full burden of ARIs. The following analyses are based on symptom diaries from participants of the German birth cohort study LoewenKIDS. Primary analyses included frequencies of ARIs and specific symptoms. Factors, which might be associated with an increased number of ARIs, were identified using the Poisson regression. A subsample of two hundred eighty-eight participants were included. On average, 13.7 ARIs (SD: 5.2 median: 14.0 IQR: 10–17) were reported in the first two years of life with an average duration of 11 days per episode (SD: 5.8, median: 9.7, IQR: 7–14). The median age for the first ARI episode was 91 days (IQR: 57–128, mean: 107, SD: 84.5). Childcare attendance and having siblings were associated with an increased frequency of ARIs, while exclusive breastfeeding for the first three months was associated with less ARIs, compared to exclusive breastfeeding for a longer period. This study provides detailed insight into the symptom burden of ARIs in German infants.

Селективный дефицит иммуноглобулина А в отдаленном периоде после терапии ритуксимабом

Objective of the Paper: To demonstrate the possibility of developing late-onset hypoimmunoglobulinemia after a course of immunosuppressive therapy. Key points. A clinical observation is presented when a selective immunoglobulin A deficiency gradually developed in a patient with Sjögren's disease and MALT-lymphoma, who received rituximab for several years. It was associated with increased frequency of acute respiratory infections. The molecular mechanisms of secondary antibody deficiencies followed by immunisupressive therapy are virtually unknown and are likely to be heterogenous. It is necessary to carry out a differential diagnosis with primary immunodeficiencies. Conclusion. This clinical observation confirms that when choosing rituximab or other anti-B-cell drugs as basic therapy, one should be aware of the possible development of hypoimmunoglobulinemia both during treatment and in the long-term period. Before starting treatment with rituximab, one must determine the initial levels of serum immunoglobulins to assess the risk of infectious complications and identify primary immunodeficiencies and monitor them even after discontinuation of the drug, particularly in patients with infections. Keywords: rituximab, antibody deficiency, immunoglobulin A, Sjogren’s syndrome, lymphoma.

The absorptive and metabolic features of phagocytosis in children, depending on the frequency of acute respiratory infections

Purpose of the study. To improve of innate immune disorders diagnosis in preschool children with respiratory tract recurrent infectious diseases on the basis of new data of phagocytosis parameters by studying its absorption and prooxidant characteristics.&#x0D; Materials and methods. Under observation were 60 children aged 2 to 5 years. Two groups were formed: 1). children with respiratory tract acute infectious more than 6 times in year (n = 30); 2). children with respiratory tract acute infectious 6 or less times in year (n = 30).&#x0D; Results. Among children in 1 group, statistically significantly increased the registration quantity of low phagocytic counts (by 60,0%, p &lt; 0,05), phagocytic index (by 56,0%, p &lt; 0,05), index of phagocytosis completeness (70,0%, p &lt; 0,05), neutrophil phagocytic activity stimulated by staphylococcus (50,0%, p &lt; 0,05) and high rates of spontaneous neutrophil phagocytic activity (43,3%, p &lt; 0,05), high serum levels of lipid hydroperoxides (by 80,0%, p &lt; 0,05), diene conjugates (by 80,0%, p &lt; 0,05), malonic dialdehyde (76,7%, p &lt; 0.05), diene ketones (76,7%, p &lt; 0,05), Schiff bases (76,7%, p &lt; 0,05).&#x0D; Conclusion. In children 2–5 years with respiratory tract acute infectious more than 6 times in year the phagocytic dysfunction and increased lipid peroxidation were established. It is characterizing the failure and slowness of the early immune response.

THYMUS SONOMETRY AND RECURRENT RESPIRATORY INFECTIONS IN PRESCHOOL CHIKDREN

Introduction. The results of scientific research that have been received so far in terms of the relationship between health status of children of various age and thymus size are controversial. On the one hand, researchers mainly from the former Soviet Union note the presence of the clear association between thymomegaly and an increased tendency to recurrent respiratory infections among preschool children. On the other hand, according to current data of world medical science, a relatively larger thymus, on the contrary, is considered to be the sign of the optimal state of child's immune system. The study aimed at clarifying of the interdependence between the thymus physical parameters and the frequency of acute respiratory infections in children aged 1-6 years. Materials and Methods. Thirty-seven children (16 boys and 21 girls) aged from one to six years, undergoing inpatient treatment on acute respiratory infection, were involved in the clinical study. Two markers of acute respiratory infections recurrence (infections index, resistance index) were taken into account and several anthropometric parameters were calculated for each child. The participants also underwent ultrasound scan. The statistical processing of the obtained primary digital material was performed by IBM SPSS Statistics 26 licensed program. Results. The thymus size was within the reference values only in 14 (37.84%) examined children. In the majority of the patients (23 (62.16%)), it was below the mentioned values. The significant exceeding the thymic index values in the children of the younger age group as compared with the older children was found. There was no difference between the boys and girls in terms of thymus volume, mass and thymic index. Conclusions. There is а moderately pronounced inverse relationship between the age of the examined children and the thymic index, according to which this index values are decreased with increasing age. The integral indicators of acute respiratory infections recurrence among the preschool children are not correlated with the studied absolute and relative sonometric thymus parameters. The thymic index values are in the closest and inverse correlation with the body surface area among all the anthropometric parameters considered in the children.

Влияние применения пробиотического препарата, содержащего штамм Lactobacillus rhamnosus GG, на уровни HbD-2 и LL-37 в секрете верхних дыхательных путей и респираторную заболеваемость у детей, больных бронхиальной астмой и аллергическим ринитом

Актуальность. На сегодняшний день аллергические заболевания респираторного тракта, в частности бронхиальная астма и аллергический ринит, у детей являются актуальной медико-социальной проблемой, ассоциированной с высоким риском инвалидизации, существенным снижением качества жизни пациентов и их семей, а также значительной финансовой нагрузкой на пациентов и государство. Бронхиальная астма и аллергический ринит часто сосуществуют, обременяя течение друг друга. Дети, больные респираторными аллергическими заболеваниями, являются особенно уязвимыми к развитию острой респираторной вирусной инфекции (ОРВИ), а респираторные вирусы, в свою очередь, играют важную роль в патогенезе бронхиальной астмы и аллергического ринита, способствуя развитию заболеваний и выступая триггерами их обострений. Одной из возможных причин склонности к частым ОРВИ у детей с аллергической патологией дыхательной системы может быть недостаточность неспецифических факторов мукозального иммунитета респираторного тракта — эндогенных катионоактивных амфифильных антимикробных пептидов, в частности кателицидина (LL-37) и человеческих дефензинов. По данным ряда исследований, эти антимикробные пептиды проявляют противовирусное, антимикробное и иммуномодулирующее действие. При этом данных о состоянии продукции антимикробных пептидов и их влиянии на респираторную заболеваемость у детей с аллергическими заболеваниями в современной литературе недостаточно. В то же время в ряде литературных источников описано положительное влияние отдельных пробиотических штаммов, в частности Lactobacillus rhamnosus GG, на общую резистентность к респираторной вирусной инфекции и профилактику атопических заболеваний. Целью нашей работы стало изучение уровней антимикробных пептидов (человеческого β-дефензина 2 (HbD-2) и LL-37) в секрете слизистых оболочек верхних дыхательных путей у детей с бронхиальной астмой и аллергическим ринитом, выяснение их роли в защите от респираторной вирусной инфекции у данного контингента больных и оценка эффективности применения пробиотического препарата, содержащего Lactobacillus rhamnosus GG, с целью профилактики ОРВИ и снижения частоты вирус-индуцированных обострений аллергической патологии. Материалы и методы. Нами было проведено клинико-лабораторное обследование 76 детей в возрасте от 7 до 17 лет, из которых у 24 был диагностирован аллергический ринит, у 28 детей — бронхиальная астма, а у 24 — бронхиальная астма и аллергический ринит. Группу контроля составили 20 клинически здоровых детей соответствующего возраста и пола. Кроме общепринятых клинических, методы исследования включали анализ паттернов респираторной заболеваемости, определение уровней антимикробных пептидов LL-37, HbD-2 в секрете верхних дыхательных путей методами иммуноферментного и статистического анализа. Результаты. Установлено, что дети с аллергическими заболеваниями респираторного тракта характеризуются большей частотой ОРВИ (на 30 %) с более частым вовлечением в воспалительный процесс нижних дыхательных путей (на 72 %), что обусловливает более длительную продолжительность заболеваний (на 95 %) по сравнению со здоровыми детьми. У детей с аллергическим ринитом и бронхиальной астмой обнаружено существенное снижение уровней антимикробных пептидов в секрете верхних дыхательных путей по сравнению с группой контроля. На уровни антимикробных пептидов в секрете верхних дыхательных путей в наибольшей степени негативно влияет степень активности аллергического воспаления, сопровождающегося отсутствием контроля симптомов, а положительно — прием препаратов базисной терапии и отсутствие симптомов. Вместе с тем даже при наличии полного контроля симптомов аллергических заболеваний, то есть при минимальном уровне аллергического воспаления в дыхательных путях, уровни антимикробных пептидов были достоверно ниже, чем у детей контрольной группы. Установлено, что существует обратная связь между уровнями антимикробных пептидов и частотой и продолжительностью ОРВИ у детей с аллергическими заболеваниями, которая в наибольшей степени выражена при бронхиальной астме. Выводы. Прием пробиотического препарата, содержащего штамм Lactobacillus rhamnosus GG, в течение 1 месяца дополнительно к базисной терапии аллергического ринита и бронхиальной астмы способствовал достоверному повышению уровней HbD-2 (в среднем на 27 %) и LL-37 (в среднем на 60 %) в секрете верхних дыхательных путей, что сопровождалось снижением частоты ОРВИ в среднем на 26 % (в том числе и эпизодов с привлечением нижних дыхательных путей), уменьшением средней продолжительности ОРВИ на 22 % в течение следующего года и снижением вирус-индуцированных обострений на 25,7 %.

Analysis of factors influencing acute respiratory infection among under-five children in Sering Public Health Centre, Medan Tembung subdistrict

Nowadays, acute respiratory infection (ARI) is the most common cause of high morbidity and mortality rate in children. ARI is defined as an infection either in the upper or lower respiratory tract that lasts for 14 days and caused by either viruses or bacteria. The incidence of ARI in 2017 is 20.54%, with the most prominent characteristic in children aged 1 to 4 years. Factors thataffect ARI frequency are gender, birth weight, nutritional status, immunization status, vitamin A status, exclusive breastfeeding, smoke exposure, family income, and mother's formal education. This study aims to find out risk factors that potentiate ARI among children from age 1 to 5. This study used a descriptive-analytical method with a cross-sectional study approach. The data is taken by consecutive sampling method with a questionnaire as the tool. The bivariate analysis result using Fisher's exact test shows that there is no relation between sex (p=0.642), birth weight (p=0.683), completion of immunization (p=0.195), vitamin A supplementation (p=1.000), exclusive breastfeeding (p=0.157), crowding (p=1.000), family income (p=0.658), knowledge (p=1.000), attitude (p=0.156), and behavior (p=1.000) with the frequency of ARI. The bivariate analysis result using Kruskal-Wallis test shows that there is no significant difference between groups in each factor of smoke exposure (p=0.988) and mother's formal education (p=0.899) with the frequency of ARI. There is no relation between each factor with ARI frequency and there is no significant difference between groups in each factor with ARI frequency.