Respiratory Track Infections Research Articles

The first report of iron-rich population of adapted medicinal spinach (Blitum virgatum L.) compared with cultivated spinach (Spinacia oleracea L.)

Folk medicine such as herbal and natural products have been used for centuries in every culture throughout the world. The Chenopodiaceae family with more than 1500 species is dispersed worldwide. The Iranian wild spinach (Blitum virgatum L.) is an important traditional medicinal plant used for antiviral diseases such as pneumonia and other respiratory track infections. This plant is a mountainous herb and is growing upper than 3000 m. We performed a mass selection plant breeding program on wild populations of this Iranian wild spinach during 2013–2020. Based on experimental and field characteristics this plant was identified as B. virgatum, |abbaricum|, and related characteristics were prepared with reference to the International Union for the Protection of New Varieties of Plants (UPOV). Mass selection program resulted from an adapted population named as medicinal spinach (MSP) population. To compare the mineral content of the mass-selected population with cultivated spinach (Spinacia oleracea L. |Varamin 88|), both plants were planted in pots and fields under similar conditions. In five leaves stage, plant samples were taken from both leaf and crown sections and used for experimental analysis. Atomic absorption spectroscopy was used to determine the mineral content including iron (Fe), zinc (Z), manganese (Mn), and copper (Cu). Our results showed the selected medicinal spinach population (MSP) with about 509 ppm iron was an important iron-rich population with about 3.5–4 times more than the amount of iron in cultivated spinach in the same conditions. Because iron is an important essential element for blood production, respiration process, energy metabolisms, synthesis of collagen, and some neurotransmitters are needed for proper immune function, so the supply of absorbable adequate iron is very important. The reasons such as the prevalence of the COVID-19 pandemic, which affects the amount of exchangeable oxygen in the lungs and historical local evidences of the use of this plant (MSP) for pneumonia, could open new horizons for focusing on studies related to the use of ancestral human experiences in addition to scientifically modern research.

Pattern of Respiratory Viruses among Pilgrims during 2019 Hajj Season Who Sought Healthcare Due to Severe Respiratory Symptoms.

The aim of our study was to define the spectrum of viral infections in pilgrims with acute respiratory tract illnesses presenting to healthcare facilities around the holy places in Makkah, Saudi Arabia during the 2019 Hajj pilgrimage. During the five days of Hajj, a total of 185 pilgrims were enrolled in the study. Nasopharyngeal swabs (NPSs) of 126/185 patients (68.11%) tested positive for one or more respiratory viruses by PCR. Among the 126 pilgrims whose NPS were PCR positive: (a) there were 93/126 (74%) with a single virus infection, (b) 33/126 (26%) with coinfection with more than one virus (up to four viruses): of these, 25/33 cases had coinfection with two viruses; 6/33 were infected with three viruses, while the remaining 2/33 patients had infection with four viruses. Human rhinovirus (HRV) was the most common detected viruses with 53 cases (42.06%), followed by 27 (21.43%) cases of influenza A (H1N1), and 23 (18.25%) cases of influenza A other than H1N1. Twenty-five cases of CoV-229E (19.84%) were detected more than other coronavirus members (5 CoV-OC43 (3.97%), 4 CoV-HKU1 (3.17%), and 1 CoV-NL63 (0.79%)). PIV-3 was detected in 8 cases (6.35%). A single case (0.79%) of PIV-1 and PIV-4 were found. HMPV represented 5 (3.97%), RSV and influenza B 4 (3.17%) for each, and Parechovirus 1 (0.79%). Enterovirus, Bocavirus, and M. pneumoniae were not detected. Whether identification of viral nucleic acid represents nasopharyngeal carriage or specific causal etiology of RTI remains to be defined. Large controlled cohort studies (pre-Hajj, during Hajj, and post-Hajj) are required to define the carriage rates and the specific etiology and causal roles of specific individual viruses or combination of viruses in the pathogenesis of respiratory tract infections in pilgrims participating in the annual Hajj. Studies of the specific microbial etiology of respiratory track infections (RTIs) at mass gathering religious events remain a priority, especially in light of the novel SARS-CoV-2 pandemic.

The Practical Impacts of Exercise-Intervention on COVID-19 Pandemic

PURPOSE: Coronavirus-19 (COVID-19) was first reported in China at the end of 2019. COVID-19 infected people increased and spreads COVID-19 rapidly across the globe. Finally, this outbreak turn into a pandemic and yields national crisis and finally to endemic. Most individual are exposed to stressful situation because of unknown duration of COVID-19. Most of all, smoking, obesity, metabolic syndromes, lowered immunity such as decreased natural killer (NK) cell, T cell activity were significantly correlated with the COVID19 incidence. However, all this variables were concerned with exercise habit and exercise-intervention, therefore, the present study aimed to assess the relationship between COVID-19 incidence and physical activity status.METHODS: PubMed database was searched from December 2019 to August 2020 using predefined search terms “COVID-19”, “exercise”, and “immunity”.Based on reference search, more than 65 articles were identified whereas 50 papers (36 references) met the inclusion criteria and were well connected with COVID-19 and physical exercise with immunity.We analyzed the connections between exercise and COVID-19 with many variables, and dealtabout COVID-19 prevention and exercise-intervention programs in the main text.RESULTS & CONCLUSIONS: Smoking, obesity, metabolic syndromes, reduced respiratory muscle mass, lowered immunity such as decreased natural killer cell and T cell activity were significantly correlated with the COVID-19 infection.However, all this variables were also concerned with exercise habit and exercise-intervention.Regular physical activity have shown to be an effective prescription for obesity, many metabolic syndromes and good immunity. However, physical inactivity and chronic metabolic syndromes were associated with reduced immunity such as reduced NK cell activity, uncontrolled T cell immunity, decreased respiratory immunity and even URTIs (upper respiratory track infection) for elite athletes. Multicomponent exercise program is considered especially for the elderly people, 5 days per week, 40-60% HRR (heart rate reserve) intensity, and 150-300 minutes aerobic and resistance training (200-400 minutes/week under the quarantine period) were recommended. Moreover, all form of psychological support also to increase immunity against COVID-19.More mechanism studies are urgently needed to determine which mode and which duration exercises are best most suited, and effective for prevention and treatment of COVID-19.

The risk of respiratory tract infections and symptoms in psoriasis patients treated with interleukin 17 pathway–inhibiting biologics: A meta-estimate of pivotal trials relevant to decision making during the COVID-19 pandemic

To the Editor: Biologic agents have revolutionized psoriasis treatment.1Menter A. Strober B.E. Kaplan D.H. et al.Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with biologics.J Am Acad Dermatol. 2019; 80: 1029-1072Abstract Full Text Full Text PDF PubMed Scopus (364) Google Scholar However, they are considered “immunosuppressive,” and thus, safety assessments focus on infection, particularly those that are serious or opportunistic, or both. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has focused attention on respiratory track infections (RTIs).2Lebwohl M. Rivera-Oyola R. Murrell D.F. Should biologics for psoriasis be interrupted in the era of COVID-19?.J Am Acad Dermatol. 2020; 82: 1217-1218Abstract Full Text Full Text PDF PubMed Scopus (120) Google Scholar The conceptual model of COVID-19 is that immunosuppression early in disease may be harmful, yet may be helpful in “late” severe COVID-19 illness; which may be mediated by a dysregulated hyperimmune response characterized by proinflammatory cytokines including interleukin 17 (IL-17).3Schett G. Sticherling M. Neurath M.F. COVID-19: risk for cytokine targeting in chronic inflammatory diseases?.Nat Rev Immunol. 2020; 20: 271-272Crossref PubMed Scopus (233) Google Scholar The effect of IL-17 inhibitors on COVID-19 is unknown, neither the risk of initial infection nor the risk of progression to worse disease. Current understanding of viral immunology suggests that IL-17 is not a dominant cytokine in viral immunity; however, IL-17 is important to mucosal immunity, raising the hypothesis that biologics targeting IL-17 could potentially increase RTI risk.4Das S. Khader S. Yin and yang of interleukin-17 in host immunity to infection.F1000Res. 2017; 6: 741Crossref PubMed Scopus (53) Google Scholar To test this hypothesis, we calculated a meta-estimate from the placebo-controlled period of phase 3 pivotal IL-17 trials of terms consistent with RTI of secukinumab, ixekizumab, and brodalumab abstracted from United States Food and Drug Administration prescribing information. RTI is a broad term classified by clinical judgment. The Medical Dictionary for Regulatory Activities (MedDRA), used to classify adverse events (AEs), has multiple terms for RTIs. To assess for RTIs, we summed the number of AEs that are associated with RTIs, divided by the total number of subjects in each study, and then calculated a meta-estimate. We found an increased risk of RTIs in the groups receiving IL-17 inhibitors compared with placebo (odds ratio, 1.56; 95% confidence interval, 1.04-2.33; Fig 1). Because prescribing information is not inclusive of all respiratory AEs from the pivotal trials that supported approval of IL-17 inhibitors, we conducted a summary risk estimate using data from the placebo-controlled period of these studies obtained from clinicaltrials.gov. This more detailed analysis yielded similar findings to our meta-estimate of prescribing information data (odds ratio, 1.31; 95% confidence interval, 1.05-1.62; Fig 2). Sensitivity analyses varying the terms analyzed yielded similar findings but with loss of statistical significance. Evaluating the risk of RTI in clinical trials is difficult because the diagnosis is made clinically without objective testing, and therefore, the etiology of these symptoms, be they viral, bacterial, fungal, or allergic, is unknown. Furthermore, there is substantial variation in the rates of RTIs in the placebo groups across the trials, demonstrating a lack of precision in measuring this outcome. For example, rates of “upper RTI” ranged from 0.0% to 7.44% in the placebo groups evaluated. In addition, owing to variation in reporting of MedDRA terms, the events were unevenly pooled because terms are reported inconsistently. It is also possible that patients may have had more than one RTI event, which could impact our estimates. These findings highlight the need for more meticulous evaluation of the impact of IL-17 inhibitors on RTIs in the setting of the novel coronavirus pandemic. Nevertheless, our meta-estimate demonstrates a potential safety signal for RTI associated with IL-17 inhibition and supports guidance issued by American Academy of Dermatology that clinicians should use their clinical judgment to continue or discontinue patients on these drugs in patients who have not tested positive or exhibited symptoms of COVID-19 and to discontinue these agents in patients who test positive for COVID-19 symptoms.5American Academy of Dermatology AssociationGuidance on the use of immunosuppressive agents.https://www.aad.org/member/practice/coronavirus/clinical-guidance/biologicsDate accessed: April 24, 2020Google Scholar Reply to research letterJournal of the American Academy of DermatologyVol. 83Issue 6PreviewTo the Editor: In light of the current coronavirus disease 2019 (COVID-19) pandemic, scientists have debated the safety of immunosuppressive biologic therapies. We read with interest the letter by Wan et al,1 “The risk of respiratory tract infections and symptoms in psoriasis patients treated with interleukin 17-pathway inhibiting biologics: A meta-estimate of pivotal trials relevant to decision-making during the COVID-19 pandemic.” We agree that caution should be used when exposing patients to systemic biologic agents in the setting of not only COVID-19 but also any acute or chronic infection, as Kaushik and Lebwohl2 have previously emphasized. Full-Text PDF

A Study to Evaluate the Safety of MEDI8897 for the Prevention of Medically Attended Respiratory Syncytial Virus(RSV) Lower Respiratory Track Infection (LRTI) in High-risk Children

A Study to Evaluate the Safety of MEDI8897 for the Prevention of Medically Attended Respiratory Syncytial Virus(RSV) Lower Respiratory Track Infection (LRTI) in High-risk Children

Vitamin D3 Supplementation on Immune Functions and Upper Respiratory Track Infection in Male Taekwondo Athletes

Vitamin D plays an important role for immune functions. Insufficient serum 25(OH)D concentration during winter season may be associated with increased risk of upper respiratory tract infection (URTI) in athletes. PURPOSE: This study was aimed to determine the effects of vitamin D3 supplementation on immune functions and URTI in male taekwondo athletes. METHODS: Twenty-five male taekwondo (TKD) athletes, aged 19-22 years with vitamin D deficiency (25(OH)D; 12.3±2.78 ng/ml), participated in this study. They were randomly assigned to receive 5,000 IU/day of vitamin D3 capsule (N=13) or placebo (N=12) during 4 weeks of winter training. Blood samples were collected two times (pre- and post-tests) to analyze serum 25(OH)D concentration. Saliva samples were collected three times (1st, 2nd, and 4th week) to analyze the salivary immunoglobulin A (SIgA) and lactoferrin concentrations. URTI symptoms were reported daily during 4 weeks of training. Repeated measures ANOVAs were performed and significant level was set at p<.05. RESULTS: The serum 25(OH)D concentration increased by 255.6% in supplementation group, but this level did not change in placebo group (F=247.50, p<.001). SIgA (F=23.00, p<.001) significantly increased in both groups during the study period, but salivary lactoferrin level (F=5.79, p=.011) increased only in placebo group at the 2nd week of training. URTI symptoms significantly decreased only in supplementation group (F=5.456, p=.005) throughout the study. CONCLUSIONS: The present study found that high dose of vitamin D3 supplementation (5,000 IU/day) increased the serum 25(OH)D concentration to sufficient level (40.1±6.79 ng/ml), and decreased URTI symptoms during winter training. Our findings suggest that vitamin D3 supplementation during winter training may provide potential benefits for preventing URTI in male taekwondo athletes with vitamin D deficient.

The Relationship Between Dust Quality and Home Ventilation with the Incidence of Upper Respiratory Tract Infection (URI) in The Ex-place of Final Processing (TPA) Keputih

Abstract: Upper Respiratory Track Infections (URI) is a kind of respiratory disease which is closely related to the quality of housing and the quality of ambient air. Ventilation is one component of a residential environmental health assessment. The dust may cause dryness of mucous in the respiratory tract so that a person may suffer or feel the symptoms of respiratory infection. This study aimed to analyze the relationship between ambient air dust and ventilation in the former place of fi nal processing (TPA) Keputih with URI (Upper Respiratory Tract Infection). This research is a cross sectional analytical and observational. The sample in this study is the ambient air concentration of dust particles and housewives from 77 families in RW VIII Keputih Area. To determine the relationship of ambient air dust and ventilation with respiratorydisease using Chi Square test. The results showed that respondents who had experienced respiratory infection as much as 89,6%. Levels of dust particles measured at the point I exceeded the quality standard that is equal to 0,3223 mg/Nm3. Home ventilation that do not appropiate the requirements of a healthy home is at 93.5%.There’s a relationship between the use of home ventilation with URI (p = 0.000) and the levels of ambient air dust particles with URI (p = 0.003). This study concludes that the two variables associated with the incidence of respiratory infection so the need for community empowerment and proactive attitude of the various instruments of government in the area of research on the prevention of URI and the presence of a good control of the quality of environmental health VIII RW Keputih Area.Keywords: dust quality, home ventilation, the ex-place of fi nal processing, URI

Changes in the etiology, incidence and prognosis of acute lower respiratory track infections in human immunodeficiency virus patients

AimTo describe the, incidence, the changes in the etiology and the prognosis of lower respiratory tract infection (LRTI) in HIV infected patients, presenting by the first time to the Emergency Department (ED), during years 2000-2010. Study designProspective collection of data. MetbodsData were collected on the first visit of HIV-infected patients at our ED due to a LRTI, (defined according to the criteria of the European Respiratory Society), between 1/1/2000 and 31/12/2010. A series of epidemiological and laboratory variables as well as the need for admission to the intensive care unit (ICU). LRTI etiology were also collected. The influence ofthe mentioned variables on 30-day mortality were analyzed. ResultsOne hundred thirty one patients were included. LRTI represented 27% of visits to the ED by HIV-infected patients. Mean age was 39±9 years. 72% of patients were males. 18% required admission to the ICU. The most frequent LRTI was pneumonia by P. jiroveci in 35 cases, bacterial penumonia in 27 and pulmonary tuberculosis in 20. LRTI incidence gradually reduced significantly over time from 6.13 × 1000 patients/year in year 2000 to 0.23 × 1000 patients/year in 2010 (p<0.05). Overall mortality was 14%. Logistic regression analysis showed that admission to ICU (p<0.004) and viral load (p<0.029) were independent variables predicting mortality. ConclusionLRTI is a pathology with a decreasing incidence, probably related to the widespread utilization increased of HAART regimens. lts etiology has also been changing, but with a non negligible mortality, mostly when ICU admission was required.

Prolonged Hypogammaglobulinemia After Rituximab Therapy for Post-Transplant EBV-Lymphoproliferative Disorder Following Hematopoietic Stem Cell Transplantation in Pediatric Patients

Abstract 4480Post-transplant lymphoproliferative disorder (PTLD) caused by Epstein Barr Virus (EBV) is a severe complication in allogeneic hematopoietic stem cell transplantation (HSCT). Rituximab is an effective treatment, now commonly used as early therapy against B-cell PTLD and preemptive treatment of EBV reactivation. In first trials, rituximab was considered to have little adverse events. As exposure to this therapy is increasing worldwide, special toxicities are recognized including prolonged hypogammaglobulinemia (PH). Few details are known about duration and severity of rituximab induced low serum immunoglobulin status, especially in pediatric population treated with this drug for PTLPD after HSCT.This retrospective study was conducted in one pediatric HSCT center (Robert Debré Hospital, Paris, France). Between December 2008 and June 2011, among 138 transplanted children, 39 children received rituximab (Mabthera®, Roche, Paris, France) for either EBV reactivation or B-cell PTLD. 28 children were then followed for immune status more than 12 months after rituximab based therapy. Median age at HSCT was 7 years (range 1 to 18). There were 17 males and 11 females. Indications for HSCT were hematological malignancy (n=17), sickle cell disease (n=3), B thalassemia (n=1), severe aplastic anemia (n=4) and inherited bone marrow failure (n=3). 23 children underwent 1 HSCT, 4 children received 2 while 1 received 3 HSCT. They received HSCT from either MSD (n=10), 9 to 10/10 HLA MUD (n=16), haploidentical familial donor (n=1) or unrelated 5/6 cord blood (n=1). PH was defined as serum Ig G level < 3.3g/l (1 year old), < 5g/l (1 to 5 year old), < 5.5 g/l (5 to 15 years old) and <6.5 g/l after 15 years old or serum IgM level < 0.5g/l, more than 12 months after HSCT. IV-Ig replacement therapy was used when serum immunoglobulin level was under the median range for age.Median duration of hypogammaglobulinemia was 13 months (range 0 to 38): 60% (17/28) of patients had PH that last in 3 cases more than 24 months (24, 27 and 38 months) after HSCT. 6 children still have a low immunoglobulin status. Among patients with PH, 6 underwent HSCT from 9/10 MUD, 1 from haploidentical family donor and 1 from unrelated cord blood. 3 patients received 2 HSCT and 1 patient 3 HSCT. 10 children with PH had abnormal levels of immunoglobulin before rituximab therapy. Regarding B-cell reconstitution, normalization of B cell count for age was obtained in every child, by a median time of 7.5 months (range 5 to 19) after HSCT in PH cases and 7 months (range 4 to 9) in non PH cases. Among patients with PH, 5 presented repeated lower or upper respiratory track infections (vs. 1 without PH). 2 had pancytopenia secondary to a Parvovirus B 19 infection, 1 presented an extensive VZV infection 17 month after HSCT, and 1 had Pneumocystis jirovecii pneumonia 9 month after HSCT. 1 child presented invasive aspergillosis 8 months after HSCT and 2 months after IV-Ig supplementation interruption.Although rituximab induces almost complete depletion of normal B lymphocytes in peripheral blood for an average of 6–9 months, prolonged serum immunoglobulin suppression is unusual. However, PH has been reported in patients treated with rituximab in association with chemotherapy, or after either autologous or allogeneic HSCT. In some of these studies, phenotypical analysis of B cell recovery help to find abnormalities in naïve B cell differentiation into memory B cells and plasma cells. It may help to explain that normalization of B-cell count is not systematically followed by a rapid increase in immunoglobulin. It seems that during the period of post HSCT immune reconstitution, rituximab could affect, in association with other immunosuppressive factors, not only B cell quantity but also B cell quality. PH may be then a frequent event as we report in our study. Consequences of PH on infection severity and frequency are controversial. Infectious complications secondary to rituximab-associated PH are rare but some are reported as a fatal invasive aspergillosis, frequent pulmonary infections, parvovirus or VZV infections. We also report such severe infections in our patients with PH. Thus, every EBV-PTLD patient treated with rituximab must be monitored closely with regard to serum Ig levels and probably have to receive IV-Ig supplementation, even if its interest remains unproved. B-cell sub-population monitoring may probably help to understand mechanism of PH and identify high-risk patients. Disclosures:No relevant conflicts of interest to declare.

Use of laryngeal mask airway in children with upper respiratory tract infection, compared with face mask: Randomized, single blind, clinical trial

Objective The incidence of postoperative cough (primary outcome) and adverse respiratory events (secondary outcome) in children who received anesthesia by laryngeal mask airway (LMA) with children who received anesthesia by face mask (FM) was compared in a blind randomized trial with uncomplicated upper respiratory track infection (URI) undergoing general anesthesia. Previous studies of pediatric patients with URI receiving anesthesia by endotracheal tube have reported a greater number of anesthetic complications; however reports concerning adverse effects in pediatric patients with URI receiving anesthesia by LMA or FM are scanty. Method For the present trial, 150 children with uncomplicated URI and requiring general anesthesia for ophthalmic procedures were enrolled. Once the severity of preoperative URI symptoms was stratified, the children were randomized to receive general anesthesia by FM or LMA. Anesthesia was induced with sevoflurane and nitrous oxide in oxygen (N 2O in O 2). Respiratory adverse events were evaluated peri- and post-operatively. Results The two groups did not differ in age, weight, American Society of Anesthesiologists (ASA) physical status, sex, duration of surgery or severity of URI symptoms. The incidences of cough (19% in LMA vs. 42% in FM), vomiting (4% in LMA vs. 12% in FM) and intervention to maintain the patency of the airway were statistically higher in the FM group ( p < 0.05). There were no differences between the two groups with respect to the incidences of apnea, laryngospasm, desaturation, bronchospasm, readmission and sore throat. Conclusion In children with uncomplicated URI, the administration of inhalation anesthetics in general anesthesia by LMA is likely to cause fewer adverse events than the use of FM.

SWIMMING POOL ATTENDANCE AND RESPIRATORY SYMPTOMS AT 1 YEAR: RESULTS FROM THE INMA BIRTH COHORT IN SPAIN

Background and Aims: Infant swimming pool attendance has been associated with increased respiratory diseases, but results are inconsistent. The aim was to assess the relationship between swimming pool attendance and several respiratory, atopic symptoms and infections during the first year of life. Methods: Four birth cohorts from different regions in Spain taking part of the INMA project were used. Data was collected by standard questionnaire at 12-14 months of age on frequency of swimming (indoor and outdoor swimming pools in winter and summer) and having had the following symptoms: bronchiolitis, bronchitis, low respiratory track infection (LRTI), cough, wheezing, atopic eczema, otitis. Birth season, small for gestational age, breastfeeding, day care attendance, maternal age, education, social class and atopy were considered as potential confounders. Odds ratios and 95% confidence interval (OR 95%CI) were calculated by logistic regression. Results: 2,644 children were included (855 from Valencia, 494 from Asturias, 638 from Guipuzcoa and 657 from Sabadell). Swimming pool attendance during the 1st year of age occurred among 42% of children, with a median cumulated duration of 720 minutes (Interquartile range = 210-1800). Swimming was more common among children in higher social classes with mid-aged mothers, day care attendants and those who breastfed or were born in autumn and winter. Prevalences of symptoms were 16% bronchiolitis, 14% bronchitis, 12% cough, 19% eczema, 33% LRTI, 32% wheezing and 31% otitis. Preliminary results showed no association between swimming pool attendance and symptoms. Compared to non-swimming pool attendants, children who attended swimming pools had the following adjusted OR (95%CI): bronchiolitis=1.04 (0.81-1.34), bronchitis=1.17 (0.91-1.51), wheezing=1.04 (0.86-1.25), respiratory infection=1.09 (0.91-1.32), cough=1.01 (0.78-1.31), eczema=1.03 (0.82-1.28), otitis=1.00 (0.83-1.21). Conclusions: Results showed lack of association between swimming pool attendance and respiratory symptoms during the first year of life in Spain. Further analyses considering the type of swimming pool are planned.

Cytoplasmic localized infected cell protein 0 (bICP0) encoded by bovine herpesvirus 1 inhibits β interferon promoter activity and reduces IRF3 (interferon response factor 3) protein levels

Bovine herpesvirus 1 (BHV-1), an alpha-herpesvirinae subfamily member, establishes a life-long latent infection in sensory neurons. Periodically, BHV-1 reactivates from latency, infectious virus is spread, and consequently virus transmission occurs. BHV-1 acute infection causes upper respiratory track infections and conjunctivitis in infected cattle. As a result of transient immune-suppression, BHV-1 infections can also lead to life-threatening secondary bacterial pneumonia that is referred to as bovine respiratory disease. The infected cell protein 0 (bICP0) encoded by BHV-1 reduces human β-interferon (IFN-β) promoter activity, in part, by inducing degradation of interferon response factor 3 (IRF3) and interacting with IRF7. In contrast to humans, cattle contain three IFN-β genes. All three bovine IFN-β proteins have anti-viral activity: but each IFN-β gene has a distinct transcriptional promoter. We have recently cloned and characterized the three bovine IFN-β promoters. Relative to the human IFN-β promoter, each of the three IFN-β promoters contain differences in the four positive regulatory domains that are required for virus-induced activity. In this study, we demonstrate that bICP0 effectively inhibits bovine IFN-β promoter activity following transfection of low passage bovine cells with interferon response factor 3 (IRF3) or IRF7. A bICP0 mutant that localizes to the cytoplasm inhibits bovine IFN-β promoter activity as efficiently as wt bICP0. The cytoplasmic localized bICP0 protein also induced IRF3 degradation with similar efficiency as wt bICP0. In summary, these studies suggested that cytoplasmic localized bICP0 plays a role in inhibiting the IFN-β response during productive infection.

The Job Demands–Resources model: Challenges for future research

Motivation: The motivation of this overview is to present the state of the art of Job Demands–Resources (JD–R) model whilst integrating the various contributions to the special issue.Research purpose: To provide an overview of the JD–R model, which incorporates many possible working conditions and focuses on both negative and positive indicators of employee well-being. Moreover, the studies of the special issue were introduced.Research design: Qualitative and quantitative studies on the JD–R model were reviewed to enlighten the health and motivational processes suggested by the model.Main findings: Next to the confirmation of the two suggested processes of the JD–R model, the studies of the special issue showed that the model can be used to predict work-place bullying, incidences of upper respiratory track infection, work-based identity, and early retirement intentions. Moreover, whilst psychological safety climate could be considered as a hypothetical precursor of job demands and resources, compassion satisfaction moderated the health process of the model.Contribution/value-add: The findings of previous studies and the studies of the special issue were integrated in the JD–R model that can be used to predict well-being and performance at work. New avenues for future research were suggested.Practical/managerial implications: The JD–R model is a framework that can be used for organisations to improve employee health and motivation, whilst simultaneously improving various organisational outcomes.

PP-212 Antitubercular agent mediated changes in rat type I collagen and spermatogenesis indices

pneumococcal polysaccharide vaccine (PPV) against invasive pneumococcal disease while studies examining pneumonia case-fatality rates are inclusive. Accordingly, the Centers for Disease Control (CDC) recommends that PPV be given to adults 65 and older and those with chronic diseases. The study aimed to explore if PPV was associated with a reduction in 30 and 60-day mortality among stroke patients, a portion of which was likely related to Streptococcus pneumoniae infection. Methods: Short-Stay records from the Medicare Provider Analysis and Review, 2007, were used to create a retrospective cohort. 382,959 unique in-patient admissions with a diagnosis of cerebrovascular disease International Classification of Disease Version (ICD-9 430 438.9) and without a diagnosis of pneumonia or lower respiratory track infections were identified for analysis. Vaccinated cases (n = 2023) were defined by the presence of ICD-9 codes V03.82 and 995.2. A multiple regression using a Cox proportional hazard model (adjusted for age, sex, race, influenza vaccination status, comorbidities, and a quality of care index) was used to assess mortality risk at 30 and 60 days after stroke admission. Results: A 21% reduction in mortality (HR = 0.79) was observed in the vaccinated group at 30 (p < 0.001, 99% CI: 0.68 0.92) and a 19% reduction in mortality (HR = 0.81) at 60 days (P< 0.001, 99% CI: 0.69 0.94). Conclusion: This study suggests that PPV might reduce pneumococcal-associated mortality among patients recently hospitalized for stroke.

Role of MUC1 Mucin During the Respiratory Track Infection and Inflammation

Role of MUC1 Mucin During the Respiratory Track Infection and Inflammation

Optimism, Self-Efficacy, and Perceived Stress as Predictors of Self-Reported Health Symptoms in College Students

Abstract. Studies provide support for the notion of increased vulnerability to upper respiratory track infections (URIs) with exposure to psychological stress, but only few have examined whether optimism and self-efficacy might moderate this relationship. The purpose of the present study was to examine (a) the influence of academic exam stress on susceptibility to URIs and (b) the extent to which these personality characteristics buffer against stress-related vulnerability to URIs. Using a repeated-measures design, URI infection status was measured in a sample of 80 college students with self-reports both during an exam period and outside such a period. Results suggested that optimism may protect from the adverse influence of heightened stress and that pessimistic, low self-efficacious participants may be at elevated risk for the development of URIs at times of increased stress.

Health needs in rural areas and the efficacy and cost‐effectiveness of doctors and nurses

Because of a lack of GPs in rural areas of Greece it is mandatory for junior doctors to offer medical service in those areas for a year. The aim of this study is to determine the possibility of replacement of internships with nurses and to suggest the most cost-effective way of covering health needs in remote areas. Regional survey. Patients of primary care offices in two remote areas of Crete, Greece within a year. Comparative analysis of the level of preventive medicine (estimated by questionnaires) and health needs in the two areas. The reasons for visiting medical offices, references rates, percentages of glucose and blood pressure regulation are also studied. Prescription of drugs for chronic diseases and blood pressure counting were the main reasons for office visits (2868/4594). Respiratory track infections (364/4594) follow. Apart from the high percentages of uncontrolled patients with blood pressure (34%) and diabetes mellitus (14%) there is a high percentage of ignorance or wrong opinions concerning preventive medicine, for example only 63% knew the value of a pap test. More than two-thirds of "medical" visits in rural areas were for acts that nurses could easily do. The easy access to a junior doctor did not promote preventive medicine. Replacement of junior doctors with properly trained nurses cooperating with GPs responsible for greater regions would be more cost-effective than junior doctors improving health in rural areas. Legislation should change, mainly with regard to repeat prescriptions, in order to reduce house visits.

Respiratory disease and cardiovascular morbidity

Background: Work related dust exposure is a risk factor for acute and chronic respiratory irritation and inflammation. Exposure to dust and cigarette smoke predisposes to exogenous viral and bacterial infections...

The Analysis of Exercise on the Immune Responses

The immune response to any stimulus is complex, requiring coordinated action by several types of cells in a tightly regulated sequence. Thus, a physical stress such as exercise may act at any number of points in the complex sequence of events collectively termed the immune response. Although exercise causes many propound changes in parameters of immune function, the nature and magnitude of such changes rely on several factors including the immune parameters of interest; type, intensity, and duration of exercise; fitness level or exercise history of the subject; environmental factors such as ambient temperature and humidity. Although regular moderate exercise appears to be important factor for increasing immunity, Athletes are susceptible to illness, in particular upper respiratory track infection, during periods of intense training and after competition. In addition, in elite athletes, frequent illness is associated with overtraining syndrome, a neuroendocrine disorder resulting from excessive training. Through this paper, we want to investigate the effects of exercise on the immunosuppression such as exercise induced lymphopenia, asthma, anaphylaxis, URT (upper respiratory track), and TB (tuberculosis) infection. and also, we want to suggest a direct mechanism, protection and therapy of exercise induced immunosuppression.

Right Aortic Arch With an Aberrant Left Subclavian Artery Causing Tracheoesophageal Compression

Right-sided aortic arch (RAA), a congenital malformation of the great vessels of the thorax, can cause symptoms from the compression of the trachea and/or esophagus. Most cases are diagnosed during childhood.1,2 There are a few reports in the literature about symptomatic RAA presented in adulthood. We report a case of a 19-year-old man with a RAA who presented with dyspnea on exertion, dysphagia, and a characteristic bronchoscopic image. CASE REPORT A 19-year-old man, nonsmoker, was admitted with gradually worsening dyspnea on exertion and dysphagia of 3 years’ duration. Physical examination was unremarkable. His chest x-ray revealed a right aortic knob without other abnormalities. The contrast-enhanced computed tomography (CT) scan of the chest demonstrated a RAA and the compression of the posterior wall of the lower part of the trachea and the right main bronchus, the latter from the right-sided descending aorta. The CT scan also revealed an anomalous origin and retroesophageal course of the left subclavian artery that caused compression of the middle part of the esophagus (Fig. 1).FIGURE 1.: Computed tomography scan of the chest, which shows the compression of the trachea by the right aortic arch and the coma-like appearance of its lumen as well as the compression of the esophagus by the left subclavian artery (arrow).Flexible bronchoscopy revealed a coma-shaped and stenosed lower third of the trachea, proximal to the origin of the right main bronchus, from an extrinsic pulsatile compression of its posterior wall (Fig. 2). Another site of stenosis was also observed at the orifice of the apical segmental bronchus of the right upper lobe by an extrinsic compression of its posterior wall. Single-contrast esophagography revealed stenosis at the middle third of the esophagus, from an extrinsic compression, with prestenotic dilatation.FIGURE 2.: Bronchoscopic image of the lower portion of the trachea reveals the characteristic coma-like appearance of its lumen by an extrinsic pulsatile compression.The patient’s symptoms were attributed to the RAA malformation, and a surgical correction of the anomaly was recommended. The patient refused therapeutic intervention, because he was informed of the benign nature of his disease. DISCUSSION Congenital malformations of the aortic arch arise from disorders in the formation of the primitive double aortic arch.3 A RAA with an aberrant origin of the left subclavian artery is 1 of these malformations that can cause symptoms during infancy as a result of the formation of a vascular “ring.” The usual symptoms and signs are stridor, apnea, dysphagia, recurrent respiratory track infections, and respiratory distress.4 When these appear in adulthood, they can mimic asthma or other obstructive airway diseases.5 In normal individuals, the left aortic arch passes in front and to the left of the trachea, and the ligamentum arteriosum connects the descending aorta to the pulmonary trunk. The left subclavian artery has a normal course at the left of the trachea. In our case, the aortic arch was cited posteriorly and on the right of the trachea. The left subclavian artery had an aberrant origin from the distal aortic arch and a retroesophageal course, passing between the esophagus and the thoracic vertebrae. The vascular “ring” was consisted by the right-sided aortic arch, the descending aorta, the left subclavian artery, the pulmonary trunk, and the ligamentum arteriosum. When the ligamentum arteriosum is sort or taut, compression of the trachea and esophagus can occur.1 In infants, the diagnoses of vascular abnormalities of the chest that cause airway obstruction can be made by using barium esophagography, bronchoscopy, CT scan, angiography, and magnetic resonance imaging (MRI).4,6 Backer et al. postulated that barium esophagography is the best diagnostic examination for infants with vascular “ring” anomalies.4 MRI is a noninvasive technique that can depict the anatomic abnormalities of the vessels of the chest and is also indicated in such cases.6 In our patient, the presence of RAA on the chest radiograph suggested that his symptoms were likely to be the result of this anomaly. It was confirmed by CT scan, single-contrast esophagography, and bronchoscopy. In patients with symptomatic RAA, bronchoscopy can assess the location and degree of the compression. During corrective surgery, bronchoscopy is essential to ensure that the correction of the airway compression has been achieved by operative manipulations.2 Chapotte and coworkers, in a retrospective study, also emphasized the importance of fiberoptic bronchoscopy in the assessment of airway compression in children resulting from vascular “rings” and concluded that bronchoscopy is a well-tolerated procedure, which optimizes the preoperative assessment of children with congenital heart disease.7