Incidence Of Respiratory Diseases Research Articles

Perioperative analgesia in obese patients

Obesity in general and morbid obesity (MO) in particular are becoming more common around the world. MO is associated with altered physiology of the body and increased number of comorbidities, which can make perioperative pain control particularly difficult in such patients. Given the higher incidence of respiratory disorders, traditional opioid-oriented treatment of pain in patients with MO can often lead to ventilation disorders and increased morbidity and/or mortality. Multimodal analgesia strategies based on a step-by-step, according to the pain severity, opioid-sparing approach can improve patient safety and treatment outcomes. Further progress in understanding the mechanisms of acute pain forces doctors to actively detect and treat both its nociceptive and pro-nociceptive components (hyperalgesia, etc.). Such multimodal analgesia protocols should be standardized and implemented in perioperative care of patients with MO. In addition to standardizing the treatment of postoperative pain, regardless of used regimen of anesthesia and analgesia, some patients with MO require enhanced respiratory monitoring to prevent possible airway side effects. This review briefly describes the physiological changes in obese patients, the pathophysiology of pain, and the evidence-based clinical updates for pain management in MO. Also, the role of opioid-sparing pharmacological adjuvants is discussed and future directions of research in the field of perioperative pain management in patients with MO are highlighted.

Insecticide Exposure and Risk of Asthmatic Symptoms: A Systematic Review and Meta-Analysis.

The incidence of respiratory disease is increasing. In relation to this, in addition to infection, factors associated with working with chemical insecticides are a cause for concern. Some of the chemicals involved have been shown to affect the respiratory system, and consequentially workers are at increased risk of conditions such as asthma. However, medical opinion around this area is still controversial; therefore, the objective of this study is to investigate the association between exposure to insecticides and asthma by means of a systematic review of the relevant literature. Relevant literature was identified, and a systematic review was conducted to investigate the association between exposure to insecticides and asthma. A total of five studies (three cross sectional and two cohort) including 45,435 subjects were identified as relevant. The summary odds ratios related to the impact of exposure to specific insecticides on asthma were organophosphates 1.31 (95%CI = 1.17–1.48, I2 = 27%, p = 0.172), carbamates 1.44 (95%CI 1.08–1.92, I2 = 56.7%, p = 0.031) and organochlorines 1.31 (95%CI 1.19–1.64, I2 = 37.3%, p = 0.131). Farmers exposed to certain insecticides may have an increased risk of asthma and asthmatic symptoms, but further research on that issue is urgently needed.

Особливості перебігу бронхообструктивного синдрому у дітей раннього віку залежно від рівня забезпеченості вітаміном D

Актуальність. Захворювання органів дихання, і в тому числі бронхообструктивний синдром (БОС), є досить частою патологією дитячого віку. Відомо, що частота і тяжкість респіраторних захворювань корелюють із рівнем забезпеченості вітаміном D (VD), дефіцит якого може сприяти розвитку повторних епізодів БОС у дітей раннього віку поряд з іншими факторами ризику, такими як еозинофілія, обтяжений сімейний та індивідуальний алергоанамнез. Мета. Вивчення рівня забезпеченості VD і прогностичних критеріїв розвитку повторних епізодів БОС у дітей раннього віку. Матеріали та методи. Обстежено 120 дітей віком від 6 місяців до 3 років зі встановленим діагнозом «гострий обструктивний бронхіт» (1-ша група — 60 дітей з епізодичним БОС, 2-га група — 60 дітей із повторним БОС). Усім дітям проводили оцінку анамнестичних даних, загальне клінічне обстеження з визначенням ступеня тяжкості БОС за шкалою The Seattle Children’s respiratory scoring tool. Лабораторні дослідження включали визначення концентрації 25-гідроксивітаміну D (25(OH)D) в сироватці крові електрохемілюмінесцентним методом на аналізаторі Cobas e411 (серійний номер 1041-24, виробник Roche Diagnostics GmbH, Німеччина) та сироваткової концентрації загального кальцію (Са) за загальнопри­йнятою методикою. При аналізі отриманих даних використовували непараметричні статистичні критерії. Різниця між показниками, що порівнювались, вважалась вірогідною при р < 0,05. Результати. У дітей із повторним БОС на відміну від дітей з епізодичним БОС був значно нижчий рівень саплементації VD (р < 0,01). Перебіг БОС у дітей 2-ї групи вірогідно частіше супроводжувався розвитком синдрому дихальної недостатності порівняно з 1-ю групою (p < 0,01). За наявності повторних епізодів БОС в анамнезі захворювання характеризувалось більш тяжким перебігом. Середній показник 25(OH)D в сироватці крові у дітей 1-ї групи становив 33 (28,1; 41,9) нг/мл, 2-ї групи — 13,68 (7,96; 19,51) нг/мл (U = 152,0; p < 0,01). Достатній рівень забезпеченості VD частіше реєструвався у дітей 1-ї групи, тоді як у 2-й групі переважали діти, які мали дефіцит VD. Виявлено зворотну залежність між рівнем VD і частотою БОС. Рівень Са в сироватці крові в обох групах знаходився в межах нормальних величин. Висновки. Розвиток повторних епізодів БОС асоційований із більш низькими показники 25(OH)D у сироватці крові. Тяжкий перебіг БОС частіше зустрічається у дітей із повторними епізодами та на тлі дефіциту VD, який, однак, не супроводжується порушеннями кальцієвого обміну. Адекватний рівень забезпеченості VD найбільшою мірою забезпечується за рахунок достатнього рівня його саплементації, особливо на першому році життя. Таким чином, перебіг та частота епізодів БОС у дітей раннього віку залежать від рівня забезпеченості VD.

Epidemiological manifestations of respiratory system diseases among military personnel of central military region

Objective. To assess the epidemiological manifestations of the incidence of respiratory system diseases (RSD) among the military personnel of the military units of the Central Military Region.
 Materials and methods. The morbidity analysis was carried out according to official statistics for 20032019 with an assessment of long-term dynamics, structure and spatial characteristics.
 Results. Despite the preventive measures taken, the incidence of respiratory diseases in the troops remains high and continues to grow. The conscript servicemen are at risk. In the structure of RSD incidence, acute respiratory viral infections (ARVI) take the leading place, tonsillitis and bronchitis are in the second place, and community-acquired pneumonia (CAP) is in the third place. Differences in the trends of long-term dynamics of morbidity in various clinical forms of RSD were revealed. The Siberian Federal Region is the most favorable regarding RSD incidence.
 Conclusions. The incidence of respiratory diseases among conscripts is higher than that in contract servicemen, with downward trend for CAP and growth for ARVI and bronchitis.

Supplementation of Live Yeast, Mannan Oligosaccharide, and Organic Selenium during the Adaptation Phase of Newly Arrived Beef Cattle: Effects on Health Status, Immune Functionality, and Growth Performance

The effect of a nutraceutical mixture, based on live yeast (LY), mannan oligosaccharides (MOS) and organic selenium (Se) on health status, as well as immune functionality and growth performance in the fattening of newly received beef cattle, was evaluated. A total of 1036 Charolaise heifers were allocated into two experimental groups: (i) control group, without any nutraceutical support (n = 487; initial weight = 325 ± 21 kg); and (ii) treatment group, supplementation during the first 30 days, with LY (5 g/head/day), organic Se (3 mg/head/day), and MOS (10 g/head/day) (n = 549; initial weight = 323 ± 23 kg). The incidence of bovine respiratory disease (BRD) and other health issues was monitored, as well as the mortality rate. Blood samples were taken at d0 and d30 to evaluate the immune functionality and the inflammatory status. Growth performances, feces chemical composition, and carcass characteristics were recorded. The BRD occurrence tended to be reduced (p = 0.06) in the Treatment group. The BHV-1 antibody production after vaccination was significantly improved (p = 0.031), as well as the bactericidal activity (p = 0.0012) in the Treatment group. No differences were found in the inflammatory status parameters. The final weight (p = 0.006) and the average daily gain at d30 (p < 0.0001) were significantly improved by the treatment. No differences were found in terms of carcass characteristics, while the fecal content of NDF (p < 0.0001), ADF (p = 0.0003), and starch (p < 0.0001) were significantly reduced by the treatment. The result of the present study suggests that the nutraceutical mixture used can support the animal’s immune systems, improving its ability to react against pathogens, as well as feed efficiency and growth performances during the whole fattening period.

Helcococcus ovis associated with septic arthritis and bursitis in calves \u2013 a case report

BackgroundSeptic arthritis often occurs in young calves when the passive transfer of maternal immunoglobulins has failed, which results in hypogammaglobulinaemia in the calf. Another important cause is suboptimal herd health management which often leads to general health impairment and, subsequently, to septic arthritis.Case presentationA dairy farmer consulted the Herd Health Service of the University Clinic reporting general herd health impairment, a high incidence of respiratory diseases, unsatisfactory weight gain and arthritis in calves, as well as mastitis and high milk cell counts. Clinical examinations were performed, and diagnostic measures were taken. A transtracheal lavage (TTL) was performed, and synovial swab samples were taken from the carpal joint and the subcutaneous tarsal bursae of two calves. Microbiological examinations of synovial swabs revealed co-infections of Trueperella pyogenes and Helcococcus ovis in one calf and Helcococcus ovis in pure culture in the other. The TTLs confirmed the presence of Mycoplasma spp. associated with respiratory diseases.ConclusionsHelcococcus ovis is currently regarded as a co-infective bacterial agent. However, it seems to play a significant role as the primary pathogen in this case.

Naringenin Regulates Lipopolysaccharide-Induced Abnormal Airway Surface Liquid Secretion

Airway surface liquid (ASL) is one of the key factors affecting the respiratory system's physiological function. Abnormal ASL secretion can increase the incidence of various respiratory diseases. Lipopolysaccharide (LPS) stimulation can damage the airway epithelial barrier, affect the concentration of ASL contents, and down-regulate ion channel expression, which in turn causes abnormal ASL secretion. Naringenin, which exists in many Citrus foods, has the ability to promote airway surface liquid secretion. This work is designed to investigate the regulatory mechanism of naringenin on LPS-induced abnormal ASL secretion. The effects of naringenin and LPS on the viability of Calu-3 cells were measured by CellTiter 96® AQueous One Solution Cell Proliferation Assay (MTS). ASL secretion volume was measured by a micropipette on air–liquid interface cultured cells. The concentration of Cl−, Na+, lysozyme, and total protein in ASL were respectively measured by assay kits. The mRNA expressions were determined by quantitative real-time polymerase chain reaction, and proteins were measured by enzyme-linked immunosorbent assay. The results indicated that LPS could affect ASL secretion and regulate cystic fibrosis transmembrane conductance regulator (CFTR), aquaporin 1 (AQP1) and aquaporin 5 (AQP5) expression. Naringenin had the ability to regulate the ASL secretion by increasing secretion volume, and Cl− and Na+ concentrations, reducing lysozyme and total protein content, and regulating CFTR, AQP1, and AQP5 expression. This study indicated that naringenin had regulating effects to attenuate LPS-induced abnormal ASL secretion.

Analysis of spatial-temporal distribution of notifiable respiratory infectious diseases in Shandong Province, China during 2005\u20132014

BackgroundLittle comprehensive information on overall epidemic trend of notifiable respiratory infectious diseases is available in Shandong Province, China. This study aimed to determine the spatiotemporal distribution and epidemic characteristics of notifiable respiratory infectious diseases.MethodsTime series was firstly performed to describe the temporal distribution feature of notifiable respiratory infectious diseases during 2005–2014 in Shandong Province. GIS Natural Breaks (Jenks) was applied to divide the average annual incidence of notifiable respiratory infectious diseases into five grades. Spatial empirical Bayesian smoothed risk maps and excess risk maps were further used to investigate spatial patterns of notifiable respiratory infectious diseases. Global and local Moran’s I statistics were used to measure the spatial autocorrelation. Spatial-temporal scanning was used to detect spatiotemporal clusters and identify high-risk locations.ResultsA total of 537,506 cases of notifiable respiratory infectious diseases were reported in Shandong Province during 2005–2014. The morbidity of notifiable respiratory infectious diseases had obvious seasonality with high morbidity in winter and spring. Local Moran’s I analysis showed that there were 5, 23, 24, 4, 20, 8, 14, 10 and 7 high-risk counties determined for influenza A (H1N1), measles, tuberculosis, meningococcal meningitis, pertussis, scarlet fever, influenza, mumps and rubella, respectively. The spatial-temporal clustering analysis determined that the most likely cluster of influenza A (H1N1), measles, tuberculosis, meningococcal meningitis, pertussis, scarlet fever, influenza, mumps and rubella included 74, 66, 58, 56, 22, 64, 2, 75 and 56 counties, and the time frame was November 2009, March 2008, January 2007, February 2005, July 2007, December 2011, November 2009, June 2012 and May 2005, respectively.ConclusionsThere were obvious spatiotemporal clusters of notifiable respiratory infectious diseases in Shandong during 2005–2014. More attention should be paid to the epidemiological and spatiotemporal characteristics of notifiable respiratory infectious diseases to establish new strategies for its control.

Wildfire exposure {in utero} and use of respiratory medications in early childhood

BACKGROUND AND AIM: Wildfire smoke exposure is a growing concern as wildfires escalate in the western U.S. and abroad (bushfires in Australia). While gestational particulate matter exposure has been linked to increased incidence of childhood respiratory diseases, this association has not been examined with respect to wildfire smoke. Here, we use prescription claims data to investigate the relationship of childhood respiratory illness and in utero exposure to wildfire smoke. METHODS: The cohort consisted of infants (N182,000), born (2010-16) in one of the Metropolitan Statistical Areas (MSAs) of California, Oregon, Washington, Idaho, Nevada, or Montana and followed up to 8 years. We required had continuous prescription coverage and estimable birthdates via claims data in IBM’s MarketScan Commercial Claims Database. Our two outcomes were filled prescriptions of ‘upper respiratory’ and ‘lower respiratory’ medications. Using prescription claims, pediatric respiratory drugs (e.g., fluticasone, albuterol) were classified as ‘upper respiratory’ or ‘lower respiratory’ based on active ingredients, mode of administration, and drug class. Wildfire exposure, classified as number of smoke days during each trimester, for each MSA was determined from National Oceanic Atmospheric Association's Hazard Mapping System. First, second, and third trimesters were defined as 280-197, 196-99, and 1-98 days before estimated birthdate, respectively. We used proportional hazards models to assess the relationship of trimester-specific in utero wildfire smoke exposure and first use of respiratory medication. Models are adjusted for sex, birth season, birthyear, meteorological variables, and seasonality. RESULTS:Preliminary results suggest that gestational wildfire smoke is associated with both upper and lower respiratory medication usage during childhood. These associations are modified by season of birth and may differ by birthyear. Sensitivity analyses will account for preterm birth. CONCLUSIONS:Our results suggest that incidence of childhood respiratory illness, as indicated by respiratory medication usage, is impacted by in utero exposure to wildfire smoke. This abstract does not necessarily represent EPA policy. KEYWORDS: Air pollution, Wildfires, Children's environmental health, Respiratory outcomes, Natural disasters, Climate

Climate, Carbon Dioxide, and Plant-Based Aero-Allergens: A Deeper Botanical Perspective.

There is global evidence of a general increase in the incidence and prevalence of respiratory diseases including allergic rhinitis and associated asthma. This increase in turn, has been related, in part, to concurrent increases in carbon dioxide (CO2) and temperature on pollen production and allergic disease generated from plant-based sources of pollen. Such links to anthropogenic climate change has suggested three significant and interrelated consequences associated with respiratory allergies or disease. First, warmer temperatures and a longer frost-free growing season can influence pollen season length and temporal exposure to airborne aeroallergens. Second, both warmer temperatures and additional CO2 can increase the amount of pollen, the seasonal intensity, from spring through fall. Thirdly, there is evidence from oak and ragweed that rising levels of CO2 could increase the allergen concentration of the pollen and symptom severity. However, while these outcomes are of obvious consequence, they do not fully encompass all of the plant derived changes that could, directly or indirectly, influence aeroallergen production, exposure, and consequences for public health. In this overview, I will delve deeper into other plant-based links to climate/CO2 that are consequential either directly or indirectly to allergic rhinitis and associated disease. Such interactions range from pollen morphology to fire occurrence, from volatile organic compounds to potential changes in pesticide usage. The goal in doing so is to provide a broader context and appreciation for the interactions between plant biology and climate that can also affect allergen production and human impact but which, to date, have received little recognition or research.

СУРФАКТАНТНАЯ СИСТЕМА ЛЁГКИХ. ОБЗОРНАЯ СТАТЬЯ

This article contains the information about the structure, functioning, and regeneration of type 2 pneumocytes. The composition of the surfactant, the processes of its synthesis, formation, secretion, distribution and redistribution of its components, as well as the biological role of the surfactant in the functioning of the lungs are described in detail. The information about the development of the surfactant system of the lungs during embryogenesis is also included. Objectives. To review modern literature on the structure and functions of the surfactant system of the lungs, the organization and structure of the surfactant, the mechanism of surfactant formation, the embryogenesis of the respiratory section, to characterize the structure and processes of the functioning of type 2 pneumocytes, as well as the processes of synthesis and secretion of the surfactant, its biological role in the functioning of the lungs. The relevance of the chosen topic is connected with a high level of the respiratory system pathology including a high incidence of respiratory system organs diseases in early childhood, associated with an insufficient level of the surfactant maturity. The problem of pulmonary pathology in newborns, including premature babies, largely determines the level of infant morbidity and mortality.

Evolución de los casos de tosferina tras la vacunación de la embarazada y la pandemia COVID-19

BackgroundWhooping cough has had an increased incidence and severity specially in infants and maternal immunization has been implemented as a prevention strategy. COVID-19 pandemic seems to decrease the incidence of other respiratory diseases. MethodsRetrospective study from 2012 to 2021 to assess the influence of pertussis maternal immunizations and the first year of COVID-19 pandemic in the cases of whooping cough. Results960 suspected cases from primary care and hospital, with 130 cases (104 children and 26 adults) being diagnosed of whooping cough. In the post-vaccination period, a reduction in the cases and severity in infants up to 6 months old was observed as well as in the pertussis diagnosis in adult women. There were no whooping cough cases during the COVID-19 period. ConclusionsBoth the pertussis vaccination in pregnancy and the first year of the COVID-19 pandemic have decreased the number of pertussis cases.

Regional Differences in Epidemiological and Clinical Characteristics, Treatment, and Clinical Outcomes of COVID-19 in Wuhan and Remote Areas of Hubei Province.

Background: The Coronavirus disease 2019 (COVID-19) pandemic has been a major threat to global health. Regional differences in epidemiological and clinical characteristics, treatment and outcomes of patients have not yet been investigated. This study was conducted to investigate these differences amongCOVID-19 patients in Hubei Province, China.Methods: This retrospective cross-sectional study analyzed data on 289 COVID-19 patients from designated hospitals in three regions:Urban (Wuhan Union West Hospital), Suburban areas of Wuhan (Hannan Hospital) and Enshi city, between February 8 and 20, 2020. The final date of follow-up was December 14th, 2020. The outcomes were case fatality rate and epidemiological and clinical data.Results: Urban Wuhan experienced a significantly higher case fatality rate (21.5%) than suburban Wuhan (5.23%) and rural area of Enshi (3.51%). Urban Wuhan had a higher proportion of patients on mechanical ventilation (24.05%) than suburban Wuhan (0%) and rural Enshi (3.57%). Treatment with glucocorticoids was equivalent in urban and suburban Wuhan (46.84 and 45.75%, respectively) and higher than Enshi (25.00%). Urban Wuhan had a higher proportion of patients with abnormal tests including liver function and serum electrolytes and a higher rate of pneumonia (p < 0.01 for all). Urban Wuhan also had a higher incidence of respiratory failure, heart disease, liver disease and shock, compared with the other two regions (all p < 0.05).Conclusions: Our findings revealed that there are regional differences in COVID-19. These findings provide novel insights into the distribution of appropriate resources for the prevention, control and treatment of COVID-19 for the global community.

Letter to the Editor: Impact of COVID-19 Prevention Methods on Influenza and Other Respiratory Infections in Taiwan

Population Health ManagementVol. 24, No. 5 Letters to the EditorFree AccessLetter to the Editor: Impact of COVID-19 Prevention Methods on Influenza and Other Respiratory Infections in TaiwanDaniel L. Clinciu, Cheng-Hsien Chen, Jong-Yi Wang, and Garry HuangDaniel L. Clinciuhttps://orcid.org/0000-0001-5272-1414Department of Basic Medical Science, Graduate Institute of Biomedical Sciences, China Medical University, Taichung City, Taiwan.Search for more papers by this author, Cheng-Hsien ChenDepartment of Optics and Photonics, National Central University, Taoyuan City, Taiwan.*Correction added on August 3, 2021 after first online publication of July 14, 2021: The second author name has been corrected from Cheng-Shien Chen to Cheng-Hsien Chen.Search for more papers by this author, Jong-Yi WangDepartment of Health Services Administration, China Medical University, Taichung City, Taiwan.Search for more papers by this author, and Garry HuangAddress correspondence to: Garry Huang, PhD, Department of Health Care Administration, College of Management, Taipei Medical University, No. 250, Wuxing St., Xinyi District, Taipei City 110, Taiwan E-mail Address: garryhuang@tmu.edu.twhttps://orcid.org/0000-0002-1328-5055Department of Health Care Administration, College of Management, Taipei Medical University, Taipei City, Taiwan.Search for more papers by this authorPublished Online:18 Oct 2021https://doi.org/10.1089/pop.2021.0140AboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail The mandatory wearing of face masks, hand sanitizing, and technology-aided quarantines have been in Taiwan since January 2020 to protect against spreading COVID-19.1,2 It is highly likely that COVID-19 prevention methods lowered the number of infections from various common respiratory infections. Therefore, we investigated the effect of the COVID-19 prevention methods on the incidence of other common respiratory infections.Using the Taiwan National Infectious Disease Statistics System, we analyzed the incidence of respiratory infectious diseases (eg, influenza season before and during the COVID-19 pandemic, December 2019–February 2021). We looked at trends of influenza, meningitis, and gastroenteritis in Taiwan before and during the COVID-19 pandemic to determine if Taiwan's efficient COVID-19 mandates (eg, wearing face masks in public places; hand sanitizing at the entrance of public transportation systems, supermarkets, schools, and other facilities; technology-aided quarantines) changed the trends of these common infectious diseases.3In week 52 of year 2020, almost a year after nationwide mandates for face masks, hand sanitation, and quarantines began, there were no confirmed cases of severe influenza in Taiwan. Notably, on week 2 of 2020, before COVID-19 mandates went into effect, there were 109 confirmed severe cases at the height of the influenza season. There also were 5 cases of confirmed severe viral gastroenteritis, as opposed to only 1 confirmed severe case after preventive measures were implemented. Additionally, there were 2 cases of confirmed severe meningococcal meningitis before February 2020 compared to 0 cases from February 2020 through March 2021.The Taiwan National Infectious Disease Statistics System only records severe/complicated cases of infectious diseases; thus, many cases of mild influenza and/or other unrecorded infectious diseases that likely were prevented by mandatory face masks, hand sanitation, and quarantines were not recorded. Some countries may have experienced similar trends for common respiratory infections as Taiwan. Arguably, in other countries, reduced cases of common infections also could be attributed to more people staying home because of lockdowns, and fear of COVID-19. However, Taiwan implemented no lockdowns and there was no indication that more people in Taiwan stayed home during the pandemic, as trains and buses often operated at maximum capacity and people are seen outdoors in large numbers. The reduced number of influenza infections and other infectious diseases meant decreasing health care costs and reducing the burden on the health care system.Taiwan's example could influence and benefit other nations that, prior to the COVID-19 pandemic, did not value the benefits of face masks during influenza season, with many places and people even now stigmatized or showing skepticism over wearing face masks in public.4 Although it seems reasonable that poorer nations initially could not afford to provide masks for everyone in the country, it is clear that the cost of face masks is lower by far than the costs of providing ventilators and other medical technologies as a result of COVID-19, influenza, and other infectious diseases. Overall, the COVID-19 pandemic may have uncovered many important aspects for health care systems worldwide and population health management, especially influenza infections and other common respiratory infections.Author Disclosure StatementThe authors declare that there are no conflicts of interest.Funding InformationNo funding was received for this letter.

Assessment of Duration of Adaptation to Conditions of Learning in Cadets of Military Educational Institutions

Introduction. It is relevant to determine periods of adaptation of local and non-resident students coming from other Russian regions to learning conditions. The objective of our study was to measure duration of cadets’ adaptation to the learning environment as assessed by the incidence of respiratory diseases in view of synergistic effects of health risk factors in the Kaliningrad enclave. Materials and methods. We conducted a retrospective analysis of the incidence of respiratory diseases in cadets of two military universities (n = 3,381, n = 2,013) by cohorts (local and non-resident students) for five academic years in general and by year. Results. The proportion of respiratory diseases in university cadets was as high as 70.9 ± 2.0 and 52.1 ± 1.1 % in Universities 1 and 2, respectively. The share of respiratory diseases in the first and fifth-year students was 72.3 and 59.9 % in University 1,and 60.3 and 38.1 % in University 2, respectively. The respiratory disease incidence in non-resident cadets was 1.8 and 1.2 times higher than that in locals: 1,102.6 ± 6.2 versus 617.7 ± 24.5 ‰ and 477.6 ± 14.1 versus 388.2 ± 16.1 ‰ (p = 0.001) in Universities 1 and 2, respectively. We found differences in the rates of acute sinusitis, acute tonsillitis, upper respiratory tract infections and influenza, community-acquired pneumonia, and lower respiratory tract infections between local and non-resident cadets. In the second university, differences in the incidence of acute sinusitis and upper respiratory tract infections were still observed in third-year students while in the first university they were still pronounced in cadets during the fourth year of study. We suppose that they might be attributed to learning conditions, ratios of local to non-resident cadets, differences in living conditions and nutrition between the students. Conclusion. Duration of the period of adaptation of military university cadets to conditions of learning is influenced by a synergistic effect of adverse environmental factors. Adaptation of non-resident cadets lasts longer due to acclimatization to weather and climate conditions of the enclave. The incidence of respiratory diseases proves the differences in learning conditions between the universities.

GEOGRAPHICAL RESEARCH OF ECOLOGICALLY DEPENDENT DISEASE IN THE TERRITORIES OF OLD AGRICULTURAL DEVELOPMENT (CHERKASY REGION)

The dependence of morbidity on the environment has always been part of the subject area of geographical science. But recently, especially against the backdrop of the corona virus pandemic, this problem is gradually moving into the interests of Earth sciences, as it clearly marks the "relationship and interaction of terrestrial geospheres." The problem of the spread of ecologically dependent diseases of the population has long been in the interests of not only scientists and medical workers, but also geographers. The latter focused on establishing links between the quality of the natural environment of human life and the types of morbidity. V.O. Shevchenko, V.M. Gutsulyak, O. Y. Romaniv, I.M. Dudnyk, M. Petrovska, K.P. Mukha, N.I. Mezentseva, К.В. Mezentseva, T. Shovkun, D. Shiyan and others dealt with these issues.&#x0D; In geographical science, traditionally more attention has been paid to the study of morbidity in either industrialized or urban regions. The development of ecologically dependent pathology in rural areas is no less urgent, both due to the long history of agricultural development of Ukraine and due to the significant intensification (using pathogenic agrochemicals) of agriculture in market conditions. At the same time, economic development of soils in the study area, as a result of long-term agricultural activity, in fact, was aimed at their destruction. The last 70-80 years have been carried out by deep plowing, application of mineral fertilizers and pesticides. In Cherkasy region in all areas there is an excess, compared to the natural background, the content of certain chemicals in the natural environment, which are manifested through the content of heavy metals in soils, natural waters, bottom sediments of reservoirs.&#x0D; Against the background of more widespread data on the state of health of the population in industrialized regions, the situation with environmentally caused diseases in rural areas is insufficiently studied. Given the intensification of agricultural technologies in recent years, the risk of environmentally dependent disease in the regions of old agricultural development is becoming quite significant.&#x0D; Among the areas of development of such technologies are the use of heavy tillage equipment, which leads to the development of planar soil erosion (deflation), which in turn causes dusting of the air. However, the natural biodiversity of agroecosystems is significantly depleted, making them less resistant to external influences and, consequently, increasing the risks of adverse natural and anthropogenic factors affecting human health.&#x0D; To a large extent, the degree of disturbance of natural ecosystems by certain branches of agriculture depends on its specialization, which with different levels of intensity affects the environment, which provokes an overall increase in the incidence of respiratory diseases in Cherkasy region with negative dynamics.&#x0D; The main task of the article was to analyze the theoretical features of the study of medical and geographical problems and morbidity in geography, including coverage of the health of the rural population of Cherkasy region and the relationship of respiratory diseases with the development of intensive technologies in agriculture. deterioration of the ecological state of the environment.&#x0D; And the aim of the article is to identify the main spatial trends in the spread of environmentally dependent diseases (including respiratory diseases) in the regions of old agricultural development (on the example of Cherkasy region).&#x0D; Mapping the main indicators of morbidity and further comparing them with different levels of intensity of agriculture will establish a general relationship between the deterioration of the incidence of respiratory diseases and the state of agricultural landscapes affected by long-term agricultural activities.&#x0D; Establishing closer links between the occurrence of respiratory diseases and the state of the environment of Cherkasy region requires the use of special research methods (monitoring and medical-statistical direction).&#x0D; Key words: morbidity, ecological, specialization, agriculture, spatial, Cherkasy region.

Working with Respiratory Illness: Presenteeism Among Healthcare Personnel at Tertiary-Care Hospitals in Bangladesh, 2008–2016

Background: Healthcare personnel (HCP) in crowded and resource-poor countries (eg Bangladesh), might be at risk of exposure to and transmission of respiratory illnesses to coworkers, patients, and caregivers. The infection control practices in public hospitals are inadequate in Bangladesh. We estimated the incidence of respiratory illness episodes among HCP, and proportion of HCP who worked during respiratory illnesses, including influenza virus infection, at 2 tertiary-care public hospitals in Bangladesh. Methods: From May 2008 to February 2016, HCP (defined as physicians, nurses, interns, patient care assistant, cleaners, and administrative staff working in adult and pediatric medicine wards) were asked to self-report to study physicians when they experienced new onset of cough, rhinorrhea, difficulty breathing, or fever during the April–September influenza epidemic period each year. Study physicians followed HCP throughout their respiratory illness episodes and recorded respiratory symptoms, onset dates, duration of illness, and days of presenteeism and absenteeism during illness. Nasopharyngeal and oropharyngeal swabs were collected after informed written consent and were tested for influenza by rRT-PCR. We used hospital records to enumerate total HCP working in the study wards during influenza season and multiplied by 6-months follow-up per year to calculate person-time contribution for estimating respiratory illness incidence. Results: HCP self-reported 107 episodes of respiratory illness during 656 person years of follow-up, for an estimated incidence of 16.3 per 100 person years (95% CI, 13–20). Of 107 episodes, 33 (31%) included fever and cough. The mean illness length was 3.9 days (SD, ±1.8). HCP worked an average of 3.4 days (SD, ±1.4) while ill. HCP missed work for a median of 1 day (IQR, 1–2) during 29 (27%) of 107 illness episodes. HCP consented to collect swabs during 56 (52%) episodes, and among them 8 (14%) of 56 tested positive for influenza (flu-A, n = 5; flu-B, n = 3). Also, 63% of HCP with influenza reported fever and cough. HCP experiencing either respiratory illness or influenza worked for similar periods of days while ill: mean, 4 (SD, ±2.2) versus mean, 3.3 (SD, ±1.4) (P = .257). HCP worked during 105 (98%) of 107 respiratory illness and 7 (88%) of 8 influenza episodes. Conclusions: Most HCP in Bangladesh, including those with influenza, worked during respiratory illnesses. The potential value of stay-at-home policies, compensation for sick days, and influenza vaccination in reducing HCP-associated respiratory pathogen transmission could be assessed in Bangladesh and similar settings.Funding: NoDisclosures: None

The Role of Plant-Based Protein Functional Food in Preventing Acute Respiratory Disease: A Case Study.

The Kaliningrad region is known for its specific climate, which can negatively affect the adaptive potential of the body. This manifests in an increased incidence of respiratory diseases and skin conditions. To prevent high morbidity, a plant protein product was included in the diet of first-year university students. This study aimed to assess the effectiveness of this food intervention in preventing the most common diseases among Kaliningrad students. Two groups of university students took part in the food trial. In the control group, catabolic processes prevailed in nutrient metabolism. Disadaptation manifested itself in the metabolism of proteins, vitamins, minerals, hematopoiesis and humoral immunity. Inflammation was indicated by α1- and α2-globulins, a weak immune response, and IgM and IgG. High oxidative stress and low antioxidative ability of blood serum were observed. The plant-based protein product (FP) helped preserve testosterone level and prevent an increase in catabolic reactions. Moreover, it had a positive effect on both red blood cell hematopoiesis (a smaller increase in the average volume of erythrocytes, the same average concentration and content of hemoglobin, an increased relative red cell distribution width (RDW) and white blood cell hematopoiesis (a beneficial effect for the immune system: lymphocytes, the relative content of neutrophils, monocytes, basophils and eosinophils). The stimulation of humoral immunity was evidenced by beta- and gamma-globulins, an active immune response, the level of IgM and IgG, antioxidant protection, reduction of peroxides and an increase in antioxidant activity of blood serum. The 34-week observation showed a 1.7-fold decrease in the incidence of respiratory illnesses and a 5.7-fold decrease in skin and subcutaneous tissue diseases. Acute respiratory infections were reduced 1.8-fold. There were no cases of community-acquired pneumonia in the treatment group, compared with 55.1‰ in the control group. The incidence of respiratory diseases was 3.3–10.6 times lower in the treatment group than in the control group in weeks 6–19. The findings testify to the prophylactic effect of functional food during social adaptation and acclimatization of students.

PICU Chronic Lung Disease Mortality and Morbidity (PLUM)

Background: Children with Bronchopulmonary dysplasia (BPD) have increased incidence of respiratory illness, often necessitating Pediatric ICU admission. Little is known about the outcome of these admissions. Aim: This study aimed to determine clinical and demographic data of this cohort and determine factors affecting mortality and length of ICU stay. Oxygen requirement following a year after ICU admission was determined. Methods: Retrospective case-note review was performed. Patients with congenital cardiac abnormalities or chronic respiratory conditions like cystic fibrosis were excluded. Data were presented as descriptive statistics. Predictors of death and LOS were determined using Fisher’s exact test and univariate regression analyses. Results: Small numbers of deaths prohibited strong conclusions. Inotrope use (p&lt;0.001), blood transfusion (p&lt;0.001), use of inhaled nitric oxide (p=0.003) and a diagnosis of sepsis (p=0.004) were related to mortality. Age at admission, gestational age at birth, weight, oxygen requirement prior to admission or length of stay did not increase the odds of mortality. Inotrope usage (p=0.027), transfusion requirements (p=0.044) and a sepsis diagnosis (p=0.005) were significantly associated with length of ICU stay &gt;7 days. More than half the patients, who were followed up, had an oxygen requirement at 6-month and 12-month follow up. Conclusion: Patients admitted with chronic lung disease to PICU with pulmonary hypertension and sepsis has long ICU stay and more odds of dying. More than half of the children who survive to 6-month and 12-month follow up have ongoing oxygen requirement. Studies in larger populations of children with BPD will help in more accurate prognostication following PICU admission.

Relationship between air quality and incidence of respiratory diseases in communes 4, 6, 7 and 8 of the municipality of Cúcuta, Norte de Santander

Air pollution is one of the most significant environmental problems of public health in Colombia. The study aimed to carry out an analysis of the relationship between air quality and the incidence of respiratory diseases in communes 4, 6, 7 &amp; 8 of the municipality of Cúcuta. Thanks to the application of a quantitative and descriptive methodology with a correlational approach, a Citizen Perception Survey was designed. Also, concentrations of the particulate material (PM10) of El Salado and Atalaya areas were analyzed together with analysis of the burden of disease according to the records provided by (IMSALUD) &amp; (IDS). The results show a dependent association between the study variables. Additionally, it shows a significant trend for acute Rhinopharyngitis in vulnerable patients (children and older adults) and a favorable air quality status for the months evaluated (May – July / 2018).