History Of Upper Respiratory Infection Research Articles

Epidemiological Evidence for Upper Respiratory Infections as a Potential Risk Factor for Meniere's Disease: A Korean National Health Sample Cohort Study.

Meniere's disease (MD) is a chronic inner ear disorder characterized by tinnitus, ear fullness, episodic vertigo, and fluctuating hearing loss, which significantly impacts quality of life and poses management challenges. Recent evidence suggests that upper respiratory infections (URIs) may contribute to MD's onset. This study examines the potential link between URIs and MD using data from the Korean National Health Insurance Service-National Sample Cohort (2002-2019). We analyzed 19,721 individuals with MD and 78,884 matched controls, adjusting for demographic factors and comorbidities using propensity score matching. Our results showed that individuals with a URI within one year prior to the index date exhibited a 2.01-fold greater likelihood of developing MD (95% confidence interval [CI] = 1.91-2.11, p < 0.001), while those with URIs within two years demonstrated a 1.54-fold higher probability (95% CI = 1.50-1.59, p < 0.001). Furthermore, we found that even remote URIs occurring up to two years before the index date significantly increased the risk of developing MD, underscoring the need for long-term patient follow-up. Overall, our study suggests that individuals with a history of URI may have an elevated risk of developing MD over multiple time frames, regardless of demographic or health profiles.

VASCULAR PARKINSONISM WITH EARLY COGNITIVE IMPAIRMENT: A CASE REPORT AND LITERATURE REVIEW

Cerebral venous sinus thrombosis (CVST) is an uncommon condition of cerebral venous sinus thrombosis with a varied clinical presentation that can be diagnostically challenging. Intravenous heparin is the optimal immediate anticoagulant according to the European Academy of Neurology (EAN) guideline 2017. This report aims to describe highly suspicious CVST clinical features and suggest a diagnostic algorithm based on two cases of CVST found in our center. The first case is a 52-year-old man who presented with serial seizures preceded by subacute headache and diparesis. Non-contrast head CT (NCCT) showed multifocal haemorrhages and cord signs. The second case is a 19-year-old woman who presented with slowly decreased consciousness, headache, and a history of upper respiratory infection. Diffuse cerebral edema was revealed in NCCT. Both of these patients had thrombosis in superior sagittal sinus, right transverse, and sigmoid sinus. Heparinization was conducted and continued with rivaroxaban with a good response. CVST is rare case and often unrecognized; since it has serious complications, early diagnosis and treatment improve prognosis and survival.

Hubungan Faktor Risiko Eksternal terhadap Kejadian Otitis Media Akut pada Balita di RS Aminah Ciledug

This study examined the correlation of external risk factors to the incidence of AOM in toddlers and preschoolers. This research used an observational analytic design with a cross-sectional approach and data processing uses univariate, bivariate and multivariate analysis. Of the 61 research subjects, the majority of toddlers with AOM were 1-3 years old, 32 children (52.5%), 33 children (54.1%) were female, 37 children (60.7%) had perforation stage. 52 children (85.2%) received exclusive breastfeeding. The results showed that the four variables, including breastfeeding duration, use of pacifiers, PCV vaccinations, and history of ARI (Acute Respiratory Infection), correlated to incidences of acute otitis media. PCV vaccination and history of ARI are the most influencing variables with p-values of 0.024 and 0.006. There is a relationship between external risk factors and the incidence of AOM in toddlers, where the most influential variables are the administration of the PCV vaccine and a history of upper respiratory infection. The researcher of this study suggests at least three doses of PCV vaccination for children at the ages 2, 4, and 6 months, alongside the protection from triggers of ARI to prevent the occurrence of AOM.

Snoring, obstructive sleep apnea, and upper respiratory tract infection in elementary school children in Japan.

Both obstructivesleep apnea (OSA)and the common cold are disorders of the upper respiratory tract, and may be associated. However, studies on the association between OSA and upper respiratory tract infections (URTI) in children are scarce. The aim of this study was to investigate possible associations between snoring, the severity of OSA, and URTI in elementary school children. This was a cross-sectional study in a community cohort of elementary school children (first and second graders) in Japan. Information on sleep habits, history of URTI, and OSA risk was obtained from a parental questionnaire. Children underwent overnight tracheal sound recordings from which apnea-hypopnea index was estimated. Multivariable logistic analysis was employed to define the association between snoring, OSA, and URTI ≥ 3 episodes over six months. Of the 922 potential enrollees, 653 children and their parents (71%)agreed to participate in the study. Multivariable-adjusted ORs for URTI were 1.73 (95%CI: 1.16 to 2.59) in children who snored 1 to 4 nights per week and 2.82 (95%CI: 1.26 to 6.28) in snoring ≥ 5 nights per week compared with never snoring (reference). Likewise, subjectively reported louder snoring, as well as objectively defined louder sound levels, were significantly associated with URTI. In addition, OR for URTI in children with an estimated apnea-hypopnea index ≥ 2.0 events/hour was 2.65 (95%CI: 1.32 to 5.31) compared to children with apnea-hypopnea index less than 1.0 events/hour (reference). Snoring and severity of OSA as measured by nocturnal tracheal sound recordings were associated with increased susceptibility to URTI in elementary school children.

Effects of a Lactobacilli Probiotic on Reducing Duration of URTI and Fever, and Use of URTI-Associated Medicine: A Re-Analysis of a Randomized, Placebo-Controlled Study.

We previously reported on the effects of Lactoplantibacillus plantarum DR7 on reducing Upper Respiratory Tract Infections (URTI) symptoms’ score and frequency in 109 adults upon a 12-week consumption at 109 colony-forming units (CFU)/day, but several limitations were detected in the publication. Thus, the present study re-analyzed some data with the aim to address some of these weaknesses, and presents new data on duration of URTI and consumption of URTI-associated medication, as compared to the placebo. Our re-analyses found probiotic administration significantly reduced the proportion of patient days of URTI and of fever (all p < 0.05). Recent history of URTI was a prevalent co-factor in affecting duration of URTI symptoms and fever, while other demographic and clinical factors had no influence. Exploratory analyses suggested probiotic had an earlier benefit in patients without a recent history of URTI compared to those with a recent history of URTI. Therefore, recent history of infections could have a modulatory effect on probiotic efficacy. Average number of months with reported use of URTI-related medication was 3.4-times lower in the probiotic group as compared to placebo (p = 0.016) during the intervention. Taken together, our present new data further support previous findings that DR7 probiotic had a beneficial effect on URTI.

Surgical Management of Glaucoma Secondary to Bilateral Acute Iris Transillumination: A Role for Gonioscopy-assisted Transluminal Trabeculotomy.

PurposeWe report a case of bilateral acute iris transillumination (BAIT) in a young woman associated with ocular hypertension which eventually progressed to glaucoma that was treated with gonioscopy-assisted transluminal trabeculectomy (GATT).Case ReportA 37-year-old otherwise healthy female presented with intermittently red and inflamed eyes and blurred vision. She was treated with oral moxifloxacin months prior to presentation. Iris transillumination defects, a pigmented anterior chamber reaction, the absence of keratic precipitates, and a history of upper respiratory infection treated with an oral fluoroquinolone prompted the diagnosis of BAIT. Intraocular pressure (IOP) remained uncontrolled on multiple glaucoma medications. Following the development of new visual field defects, indicating progression to glaucoma, GATT with cataract extraction was performed.ConclusionAlthough surgical intervention is rare with BAIT, our case demonstrates that GATT may be used effectively in those patients needing better IOP control before considering incisional glaucoma surgery.

Clinical Presentation, Prognostic Factors, and Outcomes of Pediatric patients Diagnosed with Acute Myocarditis: A 10-Year Experience from the Emergency Department of a Tertiary Care Hospital.

Background: Myocarditis is a rare inflammatory disease of the myocardium with an annual incidence of 1 to 2 per 100,000 children. Patients with myocarditis present with variable signs and symptoms ranging from subclinical disease to arrhythmia, heart failure, and sudden cardiac arrest. This study is aimed to determine the clinical presentations and outcome of children diagnosed with acute myocarditis in the emergency department of a tertiary care hospital. Methods: This single center cross-sectional study was conducted in the emergency department of the Aga Khan University Hospital from January 2005 to December 2015. All children from six months to sixteen years of either gender admitted with a probable or definitive diagnosis of acute myocarditis from the emergency department were included. All the data were entered and analyzed on SPSS v20. The continuous variables were expressed as mean +/- SD and frequencies, and percentages were computed for categorical data. Univariate and multivariate analysis was done with a p-value of less than 0.05 was considered significant. Results: A total of 52 children were diagnosed with myocarditis during the study period. The mean age was 34.33 months with slightly higher preponderance of females (52%). More than half of the patients had a history of upper respiratory infection. The most common presenting symptoms were shortness of breath (46%), followed by irritability and drowsiness (38%). Forty-seven patients (90%) needed inotropic support and 33 patients (63%) required ventilatory support during hospital stay. Thirteen patients (25%) expired during hospital stay. Conclusion: Myocarditis in pediatric patients has higher mortality and may present with acute onset of symptoms that may be vague and overlapping. Early identification and prompt management by experienced pediatric emergency physicians may reduce morbidity and mortality.

Feline bilateral inflammatory aural polyps: a descriptive retrospective study

Feline inflammatory aural polyps (IP) have been reported as solitary growths, yet bilateral polyps may occur more commonly than described previously. To identify the prevalence and risk factors associated with bilateral feline IP within a population of cats evaluated at a veterinary teaching hospital over a 10year period. Twenty-five cats with histologically confirmed IP. A retrospective study was performed by searching computerized medical records of cats seen at The University of Tennessee Veterinary Teaching Hospital from 2005 to 2015. Keywords used for the search included "feline polyp", "ventral bulla osteotomy", "inflammatory polyp ear canal" and "nasopharyngeal polyp". Cats were separated into groups with unilateral or bilateral disease. Six of 25 (24%) cats had bilateral IP. Twelve cats had computed tomography performed (four of six with bilateral IP; eight of 19 with unilateral IP). Clinical signs, history of upper respiratory infection, post-treatment complications, and IP recurrence with and without local and systemic steroid administration were studied between groups and no differences were identified. In four of six cats with bilateral disease, the second polyp was identified with advanced imaging performed at the time of referral. These findings demonstrate that bilateral IP occur more frequently than reported previously and establish a prevalence for bilateral IP. These findings also highlight the value of advanced imaging techniques in diagnosing bilateral IP.

Anesthesia timing for children undergoing therapeutic cardiac catheterization after upper respiratory infection: a prospective observational study.

We aimed to analyze anesthesia timing and perioperative respiratory adverse event (PRAE) risk factors in children undergoing therapeutic cardiac catheterization after upper respiratory tract infection (URI). We prospectively included children for elective therapeutic cardiac catheterization. Parents or legal guardians were asked to complete a questionnaire on the child's demographics, tobacco exposure, and URI symptoms. PRAEs (laryngospasm, bronchospasm, coughing, airway secretion, airway obstruction, and oxygen desaturation) as well as details of anesthesia management were recorded. Of 332 children, 201 had a history of URI in the preceding eight weeks. The occurrence rate of PRAEs in children with URI≤two weeks reached the highest proportion, which was higher than that in children without URI (66.3% vs. 46.6%, P=0.007). The overall incidence of PRAEs in children with URI in 3-8 weeks was significantly lower than that in children with URI in the recent ≤two weeks (49.0% vs. 66.3%, P=0.007), and similar to that in the control group (49.0% vs. 46.6%). Multivariate analysis showed association between PRAEs and type of congenital heart disease (CHD) (P<0.001), anesthesia timing (P=0.007), and age (P=0.021). Delayed schedule (two weeks after URI) minimized the risk of PRAEs to the level comparable to that observed in children without URI (OR, 1.11; 95% CI: 0.64-1.91; P=0.707). If treatment is not urgent, a pediatric patient at a high risk of PRAEs will be benefit from the postponement of an interventional operation by at least two weeks after URI.

A descriptive study of aetiopathological evaluation of hoarseness: our experience

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;Hoarseness is a quality of voice that is rough, grating, harsh, more or less discordant and lower than normal in pitch for the individual. Besides affecting useful communication leading to tremendous alterations in daily living, voice problem may also signify the presence of more serious medical illnesses; such as malignancy or airway compromise. Hence this study is undertaken to determine the relative incidence of cases presented at a tertiary hospital, to analyse the hoarseness population based on age, sex, occupation etc, to find out the pathogenesis of hoarseness in the cases and to postulate the risk factors implicated in each. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;Descriptive cross sectional study was conducted on patients with hoarseness reported at Government Medical College, Trivandrum for a period of twelve months. Detailed history regarding duration, onset, nature of hoarseness, aggravating and relieving factors, voice fatiguability, diurnal variation, associated symptoms and history of upper respiratory infection were taken. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;Being the tertiary hospital, the incidence was noted to be 0.7%. Majority of patients are in 4&lt;sup&gt;th&lt;/sup&gt; to 7&lt;sup&gt;th&lt;/sup&gt; decades and the most commonly affected age group was 50-59 years. Male preponderance with 4:1 ratio was observed in which manual labourers constitute the single largest group. Smoking, alcohol intake and vocal abuse are found to be the major etiological factors. Majority of lesions were malignant in nature, commonest being Carcinoma Glottis. In benign lesions, majority was vocal cord polyp. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;Early detection of pathology and awareness is very important in the management of hoarseness.&lt;/span&gt;&lt;/p&gt;&lt;p&gt; &lt;/p&gt;

Prevalence of upper respiratory tract infections in habitually snoring and mouth breathing children

ObjectivesThe aim of the study was to investigate the prevalence of upper respiratory tract infections (URI) – as indicated by rhinosinusitis (RS), ear infections (EI), and antibiotic consumption – in a general pediatric population and evaluate the relationship between these conditions and habitual snoring and mouth breathing during sleep. MethodsA population-based cross-sectional study was performed in three medium-sized Polish cities from 2011 to 2015. Results4837/6963 questionnaires (69.5%) were completed, returned and analyzed. Mean age of studied group was 7.07 ± 0.72 and 7.14 ± 0.73 in girls and boys, respectively. Habitual mouth breathing during sleep (MB) was reported in 907 (18.7%) children and habitual snoring (HS) in 290 (6.0%). 230/290 (79.3%) of children with HS were also MB. Both HS and MB were more prevalent in boys than in girls (p = 0.027 and p < 0.0001, respectively) and neither was associated with BMI (p = 0.11 and p = 0.07, respectively).Habitual snoring and habitual mouth breathing were highly associated with more frequent bouts of rhinosinusitis, ear infections, and antibiotic use (p < 0.0001 for each parameter). ConclusionsHigher rates of rhinosinusitis, ear infections, and antibiotic consumption were similarly associated with HS and MB. MB is over three times more prevalent in the pediatric population relative to HS, therefore it might be considered as a risk factor for URI and may be included in history of URI.

Erythrocyturia and proteinuria conversion in post-streptococcal acute glomerulonephritis

Background Acute glomerulonephritis (AGN) is a sudden onsetof macroscopic hematuria and edema. The chronic post-strepto-coccal acute glomerulonephritis (PSAGN) can be predicted if mi-croscopic hematuria, proteinuria, and low serum complement C3level are present for a period exceeding six months after initial onsetof illness. It is prudent to follow the course of PSAGN until proteinurianormalizes and microhematuria disappears in urinalysis.Objective To acquire the time of erythrocyturia and proteinuriaconversion in post-streptococcal acute glomerulonephritis (PSAGN)among children.Methods A retrospective cohort study on children with PSAGNwas conducted in the Pediatric Outpatient Clinic and Ward atSanglah Hospital, Denpasar, Bali from January 2001-December2003. All subjects were recorded for clinical and laboratory signs,including initial symptoms, history of previous streptococcal infec-tions, blood pressure, complete blood count, serum albumin, ASTOtiter, complement C3 level, BUN, and serum creatinin. Erythrocyt-uria and proteinuria follow-ups were done by recording urinalysisfindings for a six-month period after initial onset.Results Thirty subjects 21 boys and 9 girls, mean age 8.7 (SD 2.5)years] with PSAGN were enrolled in the study, 16 had hematuria withedema. Twenty-one subjects had the history of upper respiratory tractinfections and 9 with skin infections. Mean systolic blood pressure was141.3 (SD 21.8) mmHg, mean diastolic blood pressure was 90.8 (SD16.3) mmHg, mean ASTO titer was 1103.3 (SD 686.1) IU/ml, and meancomplement C3 level was 42.2 (SD 15.5) mg/dl. Urinalysis monitoringshowed 2/30, 9/30, 12/30, 22/30, 27/30 subjects had conversion he-maturia at the first, second, third, fourth, and fifth month, respectively.Median duration of erythrocyturia conversion was 4.0 months (95% CI:3.53-4.47). There were 11/30, 18/30, 21/30, 23/30, 25/30, 26/30 sub-jects with proteinuria conversion at the first, second, third, fourth, fifth,and sixth month, respectively. Median duration of proteinuria conver-sion was 2.0 months (95% CI: 1.25-2.75).Conclusion Three out of 30 children remained with persistenthematuria and 4 of 30 remained with persistent proteinuria

First Case Report of Sinusitis with Lophomonas blattarum from Iran.

Introduction. Lophomonas blattarum is a rare cause of bronchopulmonary and sinus infection. This paper presents a rare case of Lophomonas sinusitis. Case Presentation. The patient was a 31-year-old woman who was admitted because of a history of upper respiratory infection and sinusitis. Direct microscopic examination of the sputum and nasal discharge showed large numbers of living Lophomonas blattarum with irregular movement of flagella. The patient was successfully treated by Metronidazole 750 mg t.i.d. for 30 days. Conclusions. This is the first case report of Lophomonas blattarum sinusitis from Iran.

A Case of Acute Rheumatic Fever With Henoch Schonlein Purpura.

Dear Editor, The relation of Henoch-Schonlein purpura (HSP) vasculitis with Acute rheumatic fever was defined by Gairdner firstly in 1948 (1). Both HSP and rheumatic fever can affect the joints and heart in a different way. In HSP artritis is usually non migratory and heart involvement is usually appear as myocarditis. In rheumatic fever artritis is usually migratory and heart involvement is manifest as valvulitis. Rheumatic fever may rarely develop during HSP. The role of group A beta-haemolytic streptococcus (GABHS) in the pathogenesis of rheumatic fever is well established. The presence of rheumatic fever, GABHS may sometimes have a pathogenic role in HSP (2). We present here a child admitted to our clinic as acute rheumatic carditis, who developed HSP vasculitis thereafter. A 12- year-old male presented to our clinic with initially right ankle,followed by left knee and left ankle, pain, sensitivity, redness. His complaints had started 4 days ago. We learned that he had an upper respiratory infection 15 days ago and used antibiotic. At the time of admission axillary body temperature was 36.7°C; blood pressure was 90/60 mmHg. Erythema marginatum-like eruptions appeared on his body and upper extremities, which regressed within 1 hour during follow-up (Figure 1). Figure 1. Marginatum-Like Eruptions on His Body A cardiac auscultation revealed a grade 2/6 systolic murmur over the mitral region. He had hyperemia and swelled on the left knee and right leg, a pronounced diameter difference between the two ankles. Laboratory investigation showed hemoglobin 11.2 g/dL, WBC count 7.6 × 109/L, platelet count 283 × 109/L, C-reactive protein was elevated 79.9 mg/dL, erythrocyte sedimentation rate was elevated, 80 mm/hour. Antistreptolysin (ASO) titer was 180 Todd Units on admission. ASO was elevated 320 Todd Units during follow-up. The throat culture was negative. Antinuclear antibody was absent, rheumatoid factor was negative. Electrocardiography revealed a PR interval of 0.20 seconds. Echocardiographic findings revealed minimal mitral, aortic, and tricuspid valve failure. The patient was diagnosed with ARF carditis, and treatment was started with 2 mg/kg/day prednisolone. Benzathine penicillin made intramuscular. During the second day of hospitalization patient developed purpuric rush on his lower ekstremities. Purpuric rush, did not become pale with pressure. The skin biopsy revealed leucocytoclastic vasculitis (Henoch-Schonlein purpura) (Figure 2). Figure 2. Skin Biopsy Image His serum immune globulin A (IgA) level was elevated 324 mg/dL. Therefore, the steroid treatment was continued. During follow-up the signs and symptoms of vasculitis and carditis regressed. Our patient had migratory artritis. According to the Jones criteria, our case had three major diagnostic symptoms of rheumatic fever; arthritis, carditis, and erythema marginatum; therefore, a diagnosis of acute rheumatic fever was made. ASO, which is a supporting parameter of diasease, was also high in our case. Ocal et al. (3) reported a case of HSP with rheumatic carditis with history of streptococcal infection 4 weeks ago. Our patient had history of upper respiratory infection before 2 weeks ago. Our case’s throat culture was negative for GABHS, but he used antibiotic. Elevated ASO titers suggested a recent streptococcus infection. Immunologic mechanism underlying HSP and rheumatic fever are quite different. Celluler immune mechanism mediated by T lymphocytes to streptococcal M-proteins cause destruction cardiac tissues (4). In these patients elevated IgA levels and immune complexes have been described (5). In previous reports during to HSP, developed acute rheumatic carditis thereafter (1, 3, 6). He is different from previous cases. In literature, the interval from onset of HSP to appearance of rheumatic fever was declared as 10 days to 12 weeks (2, 3, 6). Literatures are limited of HSP and acute rheumatic fever co-occurrence without time interval between these two diseases (6, 7). We presented this case due to that rheumatic fever appeared first, after 2 days purpuric rash occurred. Because of these two reasons our case is different from previous reports. We think that GABHS infections may trigger HSP as acute rheumatic fever.

Clinicopathologic analysis of 60 cases of pityriasis lichenoides et varioliformis acuta

Objective To explore the clinicopathologic features of pityriasis lichenoides et varioliformis acuta（PLEVA）. Methods A retrospective analysis was performed. Clinical and histological data were collected from 60 patients with PLEVA. The clinicopathologic features of PLEVA were analyzed. Results Among the 60 patients with PLEVA, 32（53.3%）were aged 2-18 years, and 28（46.7%）aged 19-49 years. Skin lesions were distributed in a diffuse pattern in 50（83.3%）patients, in a central pattern in 2（3.3%）patients, and in a peripheral pattern in 8（13.4%）patients. Nineteen（31.6%）patients had a history of upper respiratory infection. Histopathological examination revealed liquefactive degeneration of basal cells and perivasculitis in the dermis in all the 60 cases, neutrophil abscess formation in the stratum corneum in 26（43.3%）cases, keratinocyte necrosis in the epidermis in 41（68.3%）cases, generalized liquefactive degeneration in 30（50.0%）cases, migration of lymphocytes into the epidermis in 43（71.6%）cases, Pautrier's microabscess formation in 2 cases, varying degrees of extravasation of erythrocytes into the epidermis in 46（76.7%）cases, fibrinoid necrosis of blood vessel walls in the dermis in 3 cases. PLEVA progressed into granuloma fungoides in 1 patient. Twenty patients underwent immunohistochemical examination, and 3 of them showed monoclonal hyperplasia of T cells. Conclusions PLEVA has characteristic clinical manifestations, and the combination of pathological and clinical examination is the gold standard for its diagnosis. Key words: Pityriasis lichenoides, varioliformis acuta; Pathology

Human rhinovirus serotypes in the nasal washes and mucosa of patients with chronic rhinosinusitis.

Chronic rhinosinusitis (CRS) can be aggravated by viral upper respiratory infections. We aimed to investigate whether any specific human rhinovirus (HRV) serotype is more common in the mucosa of CRS patients, and to find any defining clinical characteristics, according to the various HRV serotypes. A prospective case-control study was conducted to determine HRV serotypes in 111 CRS patients and 51 non-CRS controls. No participant had a history of upper respiratory infection over a 4-week period. Nasal lavage fluids and turbinate epithelial cells were collected prospectively. When HRV was detected with multiplex polymerase chain reaction (PCR), strains were further characterized by sequencing the VP4/VP2 region of the HRV genome. HRV was detected in 40 CRS subjects (36%) and 11 non-CRS controls (21%). The overall detection rates of HRV in CRS patients were higher than in non-CRS controls (p < 0.05). Of the 8 serotypes detected in CRS patients, 5 belonged to HRV-A and 3 belonged to HRV-B; HRV-C was not detected. In non-CRS controls, only HRV-A was identified, with only 2 serotypes detected (HRV-A13 and HRV-A16). HRV-B and C were not detected. The high prevalence of HRV in CRS patients was confirmed in our study. However, we were unable to determine whether certain HRV serotypes are more predominant in CRS patients than non-CRS controls. HRV-A13 was the most common serotype in both CRS patients and non-CRS controls. We could not find any differences in the clinical characteristics according to the HRV serotypes in CRS patients.

Adverse events related to gastrointestinal endoscopic procedures in pediatric patients under anesthesia care and a predictive risk model (AEGEP Study)

BackgroundMultiple studies have analyzed perioperative factors related to adverse events (AEs) in children who require gastrointestinal endoscopic procedures (GEP) in settings where deep sedation is the preferred anesthetic technique over general anesthesia (GA) but not for the opposite case. MethodsWe reviewed our anesthesia institutional database, seeking children less than 12 years who underwent GEP over a 5-year period. A logistic regression was used to determine significant associations between preoperative conditions, characteristics of the procedure, airway management, anesthetic approaches and the presence of serious and non-serious AEs. ResultsGA was preferred over deep sedation [77.8% vs. 22.2% in 2178 GEP under anesthesia care (n=1742)]. We found 96 AEs reported in 77 patients, including hypoxemia (1.82%), bronchospasm (1.14%) and laryngospasm (0.91%) as the most frequent. There were 2 cases of severe bradycardia related to laryngospasm/hypoxemia and a case of aspiration resulting in unplanned hospitalization, but there were no cases of intra- or postoperative deaths. Final predictive model for perioperative AEs included age <1 year, upper respiratory tract infections (URTI) <1 week prior to the procedure and low weight for the age (LWA) as independent risk factors and ventilation by facial mask as a protector against these events (p<0.05). ConclusionsAEs are infrequent and severe ones are remote in a setting where AG is preferred over deep sedation. Ventilatory AEs are the most frequent and depend on biometrical and comorbid conditions more than anesthetic drugs chosen. Age <1 year, history of URTI in the week prior to the procedure and LWA work as independent risk factors for AEs in these patients.

Asthmatic Children Have Increased Specific Anti–Mycoplasma pneumoniae IgM but not IgG or IgE—Values Independent of History of Respiratory Tract Infection

Bronchial asthma is exacerbated by Mycoplasma pneumoniae-induced upper respiratory tract infections (URTIs) in children. Specific IgM and IgG isotypes are involved in the immune response to M. pneumoniae, but little is known about the role of specific IgE antibodies against M. pneumoniae in asthma. To investigate the role of IgM-, IgG- and IgE-specific antibody responses to M. pneumoniae in children with persistent asthma in relationship to history of URTI within the past 6 months. Total or specific anti-M. pneumoniae IgM, IgG and IgE antibody responses were studied in stable asthmatic pediatric patients (M. pneumoniae positive and negative) without current exacerbation and nonasthmatic controls (N = 23 and 13, respectively) (UniCAP total IgE Fluoroenzymeimmunoassay, enzyme-linked immunosorbent assay). Values of specific IgM correlated with specific IgG (Spearman correlation, rho = 0.61, P < 0.0001) but not with specific IgE anti-M. pneumoniae antibodies (AMA) in asthmatic subjects compared with nonasthmatic controls. However, concentrations of specific IgG correlated with specific IgE AMA (rho = 0.49, P = 0.0017). Asthmatic subjects had higher levels of specific IgM AMA levels compared with nonasthmatics (median [interquartile range]: 0.57 [1.00] versus 0.21 [0.19]; Kruskal-Wallis test, P = 0.0008). In addition, IgM positivity was significantly higher in asthmatic compared with nonasthmatic subjects (39.1% versus 0.0%; Fisher's exact test, P = 0.01). These results were independent of URTI history in the past 6 months, which was not associated with higher IgM, IgG or IgE AMA levels compared with no URTI history (P = 0.25-0.64). Increased specific IgM anti-M. pneumoniae responses may indicate an important role for M. pneumoniae infection in asthma.

Two cases of dural sinus thrombosis and review of the literature

Dural sinus thrombosis (DST) may occur due to infection, surgery, hypercoagulability or compression of the sinuses by tumors. DST in the cases of intracranial hematoma may also occur after head injury such that depressed skull fractures or skull fractures that cross the sinus obstruct the blood flow in the sinus. DST is rare with wide range of non-specific signs and symptoms, ranging in severity from mild headache to coma and death. We present two cases of DST in this report and review the literature for this condition which has high risk of morbidity and mortality. The first case was a 16 years old boy hospitalized because of history of headache, nausea and repeated vomiting for two day after a motorcycle traffic accident who died on the third day of his hospitalization. The second case was an 18 years old girl who had a history of upper respiratory infection and diarrhea for four days and died several hours after her admission to emergency service. In both cases, DST was diagnosed at medicolegal autopsy.

Hemophagocytic syndrome in a cat with multiple myeloma

An 11-year-old, castrated male, Domestic Medium Hair cat was presented to the University of Florida Small Animal Hospital with a 2-week history of upper respiratory infection and increased serum globulins, as reported by the referring veterinarian. Physical examination was unremarkable other than melanosis of the left iris, with no evidence of ocular, nasal, or respiratory disease. Laboratory abnormalities included moderate nonregenerative anemia, mild leukopenia, mild hyperfibrinogenemia, severe hyperglobulinemia, mild hypoalbuminemia, and hypocholesterolemia. Abdominal radiographs and ultrasonographic examination revealed mild splenomegaly with no other abnormalities. Thoracic radiographs revealed no abnormalities. Cytologic evaluation of fine-needle aspirates from the spleen, liver, and bone marrow revealed numerous plasma cells and many vacuolated macrophages exhibiting marked phagocytosis of mature erythrocytes and platelets, occasionally metarubricytes and leukocytes, and rarely plasma cells. The cytologic interpretation was multiple myeloma and associated hemophagocytic syndrome (HPS). Serum protein electrophoresis revealed a monoclonal gammopathy, providing further evidence for a multiple myeloma. To the authors' knowledge, this is the first report of HPS secondary to neoplasia in a cat.