Respiratory Tract In Children Research Articles

Clinical Profile and Outcome of Bronchiolitis in Children With 1-24 Months of Age.

Introduction Bronchiolitis poses a significant challenge in pediatric critical care. It is an acute illness affecting the lower respiratory tract in children under the age of two. The most common cause of bronchiolitis is the seasonal respiratory syncytial virus, with influenza and adenovirus also notable contributors. It is characterized by various clinical symptoms and indicators, such as an upper respiratory prodrome, increased respiratory effort, and wheezing in younger children under two years old.This study primarily examines the clinical profile, risk factors, severity, and outcomes of bronchiolitis in children under two years, excluding the neonatal age group. Materials and methods Children under two years of age who presented with upper respiratory symptoms and their first episode of wheezing were evaluated. Those with pre-existing systemic conditions such as cardiac, respiratory, or immunodeficiency disorders were excluded. A detailed history was gathered using a questionnaire, and risk factors were analyzed. The severity of the condition was measured using the Wood-Downes-Ferres score. Data analysis was performed using IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp., Armonk, New York, United States). The relationship between risk factors, severity, and outcomes was examined using the chi-squared test. A two-sided probability of p<0.05 was considered statistically significant for all tests. Results Among 54 children aged 1-24 months with bronchiolitis, the average age was 10.18 months, with a standard deviation of 4.8 months. The severity of the condition was greater in younger children (1-12 months) and tended to decrease with age. Bronchiolitis was more common in males (33 cases) than females (21 cases). Approximately 50 children (92.6%) exhibited signs of respiratory distress, and 45 children (83.3%) showed cough as an initial symptom. Severity was notably higher in children with a history of irritability, which was statistically significant (chi-squared value: 8.169; p-value: 0.017). Only 16 children (29.65%) had a history of poor feeding. Bronchiolitis was more prevalent among infants with a birth weight under 1500 grams (63%). Non-exclusive breastfeeding and early bottle feeding were significant risk factors for bronchiolitis and its severity (chi-squared values: 18.794; p-value: 0.000 and 7.795; p-value: 0.020, respectively). Only two children (3.7%) had been exposed to passive smoke, and the severity was slightly higher in these cases. There was also a statistically significant association between socioeconomic status and bronchiolitis (chi-squared value: 11.917; p-value: 0.018). Conclusion This study aims to raise awareness among parents and clinicians about the high-risk age group for bronchiolitis, its typical presentations, and predictors of severity. It underscores the impact of both biological and environmental risk factors, such as bottle feeding, non-exclusive breastfeeding, and socioeconomic status, on the severity of the condition.

Epidemiological characteristics of common respiratory pathogens in children

Children's respiratory tract infection is a common disease affecting children's health, our purpose is to describe the epidemiological characteristics of common pathogens of children's respiratory tract infection in central Shandong, China, and compare them with those in other parts of world, so as to summarize the rules of children's respiratory tract infection in central Shandong, and provide scientific basis for health departments to prevent and treat local children's respiratory tract infection. Sputum, tracheal aspirate, alveolar lavage fluid and other samples of 4804 children admitted to wards of Zibo Maternal and Child Health Hospital for treatment of respiratory tract infection from June 2019 to December 2022 were collected, and 12 common respiratory tract pathogens were detected by PCR capillary electrophoresis fragment analysis, two bacteria (Streptococcus pneumoniae, Haemophilus influenzae), two atypical pathogens (Mycoplasma Pneumoniae, Chlamydia Pneumoniae) and eight viruses (Human rhinovirus, Respiratory Syncytial Virus, Influenza A Virus, Parainfluenza Virus, Human metapneumovirus, Human boca virus, Human coronavirus, Influenza B virus) were included, the positive detection rate of single pathogen, the proportion of each type of respiratory tract mixed infection and the positive detection rate of single pathogen in different ages and seasons were analyzed statistically. (1)Among 4804 children with respiratory tract infection, the total positive rate was 77.87% (3741/4804), the positive rate of single pathogen was 43.40% (1656/4804), Streptococcus pneumoniae, Rhinovirus and Respiratory syncytial virus were the highest, there were 2085 cases of mixed infection with two or more pathogens, the positive rate was 43.40%. (2) The positive rates of infection in infant group (0–1 years old), infant group (1–3 years old), preschool group and school age group (3 years old-) were roughly the same, the infection rates of Streptococcus pneumoniae, Respiratory syncytial virus and Parainfluenza virus in infant group, Rhinovirus in infant group, Influenza A virus, Chlamydia pneumoniae, Mycoplasma pneumoniae and Haemophilus influenzae in school age group were higher than those in other groups, the difference was statistically significant (P < 0.05). (3) The positive detection rates of spring, summer, autumn and winter groups were 43.58%, 38.64%, 33.73% and 29.27%, respectively, the positive rates of Streptococcus pneumoniae and Haemophilus influenzae in spring group, Mycoplasma pneumoniae in summer group, Rhinovirus, Respiratory syncytial virus and Influenza A virus in autumn group, Chlamydia pneumoniae, Boca virus and Influenza B virus in winter group were higher than those in other seasons, and the differences were statistically significant (P < 0.05). The pathogen detection rate of children varies with age and season, and the prevention and treatment of a certain respiratory pathogen infection must be combined with its raging season and age rule.

Characterization of bacterial and viral pathogens in the respiratory tract of children with HIV-associated chronic lung disease: a case–control study

IntroductionChronic lung disease is a major cause of morbidity in African children with HIV infection; however, the microbial determinants of HIV-associated chronic lung disease (HCLD) remain poorly understood. We conducted a case–control study to investigate the prevalence and densities of respiratory microbes among pneumococcal conjugate vaccine (PCV)-naive children with (HCLD +) and without HCLD (HCLD-) established on antiretroviral treatment (ART).MethodsNasopharyngeal swabs collected from HCLD + (defined as forced-expiratory-volume/second < -1.0 without reversibility postbronchodilation) and age-, site-, and duration-of-ART-matched HCLD- participants aged between 6–19 years enrolled in Zimbabwe and Malawi (BREATHE trial-NCT02426112) were tested for 94 pneumococcal serotypes together with twelve bacteria, including Streptococcus pneumoniae (SP), Staphylococcus aureus (SA), Haemophilus influenzae (HI), Moraxella catarrhalis (MC), and eight viruses, including human rhinovirus (HRV), respiratory syncytial virus A or B, and human metapneumovirus, using nanofluidic qPCR (Standard BioTools formerly known as Fluidigm). Fisher's exact test and logistic regression analysis were used for between-group comparisons and risk factors associated with common respiratory microbes, respectively.ResultsA total of 345 participants (287 HCLD + , 58 HCLD-; median age, 15.5 years [IQR = 12.8–18], females, 52%) were included in the final analysis. The prevalence of SP (40%[116/287] vs. 21%[12/58], p = 0.005) and HRV (7%[21/287] vs. 0%[0/58], p = 0.032) were higher in HCLD + participants compared to HCLD- participants. Of the participants positive for SP (116 HCLD + & 12 HCLD-), 66% [85/128] had non-PCV-13 serotypes detected. Overall, PCV-13 serotypes (4, 19A, 19F: 16% [7/43] each) and NVT 13 and 21 (9% [8/85] each) predominated. The densities of HI (2 × 104 genomic equivalents [GE/ml] vs. 3 × 102 GE/ml, p = 0.006) and MC (1 × 104 GE/ml vs. 1 × 103 GE/ml, p = 0.031) were higher in HCLD + compared to HCLD-. Bacterial codetection (≥ any 2 bacteria) was higher in the HCLD + group (36% [114/287] vs. (19% [11/58]), (p = 0.014), with SP and HI codetection (HCLD + : 30% [86/287] vs. HCLD-: 12% [7/58], p = 0.005) predominating. Viruses (predominantly HRV) were detected only in HCLD + participants. Lastly, participants with a history of previous tuberculosis treatment were more likely to carry SP (adjusted odds ratio (aOR): 1.9 [1.1 -3.2], p = 0.021) or HI (aOR: 2.0 [1.2 – 3.3], p = 0.011), while those who used ART for ≥ 2 years were less likely to carry HI (aOR: 0.3 [0.1 – 0.8], p = 0.005) and MC (aOR: 0.4 [0.1 – 0.9], p = 0.039).ConclusionChildren with HCLD + were more likely to be colonized by SP and HRV and had higher HI and MC bacterial loads in their nasopharynx. The role of SP, HI, and HRV in the pathogenesis of CLD, including how they influence the risk of acute exacerbations, should be studied further.Trial registrationThe BREATHE trial (ClinicalTrials.gov Identifier: NCT02426112, registered date: 24 April 2015).

Age-related features of the choice of inhalers in chilren and adolescents with bronchial asthma and other respiratory diseases

The inhalation way of drug delivery seems to be the most logical for respiratory diseases. However, the most important condition for the effectiveness of inhalation therapy in children and adolescents along with the correct choice of the active substance is the selection of the optimal device and adequate execution of the inspiratory maneuver. When prescribing therapy attention should be paid to the inhalation technique of a particular patient and also take into account the likelihood of side effects when using certain devices. The article provides data on factors affecting the pulmonary deposit of the drug, the internal resistance of various inhalers which have the greatest informativeness for choosing a device along with the assessment of the inspiratory flow rate developed by the patient. The most problematic aspects of drug delivery to the respiratory tract in children under 5 years of age and in patients with inadequate inhalation rate are analyzed. The principles of correct inhalation are discussed which are necessary to obtain an optimal respiratory fraction. It is known that the problem of synchronizing inhalation with the moment of receipt of the drug is the most important when using metered – dose aerosol inhalers. In children this problem can be solved by using a spacer or using nebulizers that convert the liquid form of the drug into an aerosol using compressor air. Individual selection of an inhaler depending on the abilities and preferences of the patient in some groups of patients can significantly increase the effectiveness of therapy without increasing the dose of medications. The article presents up-to-date data on digital inhaler systems and the possibilities of using electronic devices for monitoring and using the inhaler.

Application of bacteriophage therapy in the treatment of children with acute tonsillitis

Context In pediatrics, there is an increasing interest in the therapeutic efficacy of inhaled bacteriophages for treating infectious diseases of the upper respiratory tract in children. Aim To analyze the effectiveness of inhaled bacteriophage therapy in children with acute tonsillitis (AT). Settings and Design Clinical observation of patients was based on a randomized, controlled research method. Methods and Material A total of 212 sick children aged 4–15 years who had AT were examined. Bacteriophage therapy was carried out by nebulizer inhalation using the liquid polyvalent piobacteriophage. Patients were divided into two groups based on the treatment method. One group of patients received a course of bacteriophage therapy against the background of standard treatment. Results When patients sought medical help, during the general clinical examination, the following were noted: cervical lymphadenopathy (98.6%), hyperemia of the tonsils and hyperplasia (98.1%), against the background of hyperthermia. Bacteriological analysis of the pharynx mucus showed that the main causative agents of AT in children were the bacteria Streptococcus pyogenes, Staphylococcus aureus, Streptococcus pneumoniae, and Haemophilus influenzae. Patients who underwent inhaled bacteriophage therapy in the early stages of treatment experienced a 1.4-fold greater disappearance of objective signs of pathological processes in the tonsils against the backdrop of rapid improvement in the well-being of sick children. Moreover, the use of a combination of antibiotic therapy and bacteriophage therapy led to a decrease in the detection of pathogenic bacteria, and the effectiveness of drug treatment increased four times. Conclusion The use of bacteriophage therapy in the complex treatment of AT in children contributes to a more rapid relief of the acute period against the background of an improvement in the subjective assessment of well-being by up to 25%, and a decrease in the detection of pathogenic bacteria.

Molecular characteristics and biofilm formation capacity of nontypeable Haemophilus influenza strains isolated from lower respiratory tract in children

With the widespread introduction of the Hib conjugate vaccine, Nontypeable Haemophilus influenzae (NTHi) has emerged as the predominant strain globally. NTHi presents a significant challenge as a causative agent of chronic clinical infections due to its high rates of drug resistance and biofilm formation. While current research on NTHi biofilms in children has primarily focused on upper respiratory diseases, investigations into lower respiratory sources remain limited. In this study, we collected 54 clinical strains of lower respiratory tract origin from children. Molecular information and drug resistance features were obtained through whole gene sequencing and the disk diffusion method, respectively. Additionally, an in vitro biofilm model was established. All clinical strains were identified as NTHi and demonstrated the ability to form biofilms in vitro. Based on scanning electron microscopy and crystal violet staining, the strains were categorized into weak and strong biofilm-forming groups. We explored the correlation between biofilm formation ability and drug resistance patterns, as well as clinical characteristics. Stronger biofilm formation was associated with a longer cough duration and a higher proportion of abnormal lung imaging findings. Frequent intake of β-lactam antibiotics might be associated with strong biofilm formation. While a complementary relationship between biofilm-forming capacity and drug resistance may exist, further comprehensive studies are warranted. This study confirms the in vitro biofilm formation of clinical NTHi strains and establishes correlations with clinical characteristics, offering valuable insights for combating NTHi infections.

DEVELOPMENT OF ULTRASTRUCTURAL CHANGES IN DIAPHRAGM MUSCLE FIBERS DURING PARTIAL TRACHEAL STENOSIS IN YOUNG SEXUALLY IMMATURE RATS

Introduction. The study of congenital pathology of the respiratory tract in children is of great importance for theoretical and clinical pediatric otolaryngology. Currently, in the scientific literature there are single works concerning the study of the pathogenesis and clinic of laryngomalacia. First of all, this concerns the effect of acute and chronic hypoxia on the muscles of the respiratory system, in particular, the diaphragm. The aim of thіs work is to reveal the effect of hypoxia on the development of pronounced structural and functional changes in the diaphragm muscles of sexually immature animals when modeling partial tracheal occlusion. Materials and methods. Surgical partial occlusion of the trachea was performed on in sexually immature Wistar rats; we applied electron microscopy, morphometric and statistical research methods.&#x0D; Results. The obtained data demonstrated that the muscle fibers of the diaphragm are characterized by significant structural, functional and metabolic resistance to the development of acute or chronic hypoxia due to limited lung ventilation in rats. The density of muscle fibers did not change in any of the used terms of the experiment (7 and 21 days). On the 7th day of hypoxic exposure, a change in the state of the matrix of mitochondria of muscle fibers was observed, which was accompanied by partial ultrastructural rearrangements of the organization of these organelles. At the same time, no significant changes were observed during histological studies. Electrongrams demonstrated the ultrastructural damages were mainly limited to focal reduction of myofibrils and an increase in the mitochondria's diameter and found as especially pronounced on day 21 (a state of chronic hypoxia) on the muscular component of the respiratory system in rats. These changes are accompanied by the development of dystrophic disorders in the diaphragm myofibrils. On day 21 changes in the transendothelial transport of substance molecules were also detected. This was based on establishing the fact of a significant reduction in the number of pinocytosis vesicles in the cytoplasm of endothelial cells of diaphragm hemocapillaries in animals with partial tracheal occlusion. Disruption of the structural organization of actomyosin complexes was revealed in muscle fibers due to pathological changes in the mitochondria of myofibrils. It should be noted the development of destruction or complete loss of an important ultrastructural component of muscle fibers, Z-lines. These changes were completely absent on the 7th day following the influence of partial tracheal occlusion and the development of acute hypoxia. Moreover, on day 21, partial lysis of a significant amount of myofilaments of muscle fibers was observed. In addition, the development of the process of fiber swelling was detected against the background of which the above-mentioned ultrastructural destruction of the muscular component in the diaphragm was observed. These changes indicate the need for earlier treatment of laryngomalacia in children. The delay in surgical intervention leads to the development of severe or irreversible structural changes not only in the respiratory organs, but also in their muscular system.&#x0D; Conclusion. The muscular elements of the diaphragm have the pronounced and significant resistance to the state of hypoxia under conditions of limited ventilation of the respiratory tract. Ultrastructural and morphometric data, found on the 21st day after the modeling of partial tracheal stenosis, are not only of a compensatory and adaptive in nature, but also signs of pronounced disorders in the muscle fibers of the central part of the diaphragm in test animals.

Microbiota of the upper respiratory tract in children with chronic adenoiditis

Background. Routine application of the GC-MS method to assess the URT microbiota can potentially improve the efficacy and safety of treatment for chronic respiratory diseases.&#x0D; Aim. To perform a comparative analysis of the microbiota from the surface of the pharyngeal tonsil, from the deep parts of the nose, and saliva in children with chronic adenoiditis.&#x0D; Materials and methods. The study included 90 patients with chronic adenoiditis (CA) and/or pharyngeal tonsil hypertrophy (PTH). All study participants had swabs taken from the surface of the pharyngeal tonsil, from the deep parts of the nasal cavity, and saliva as a biological fluid of the oral cavity. Microorganisms were identified by specific fatty acids using GC-MS to assess the composition of the microbial community on the surface of the pharyngeal tonsil.&#x0D; Results. The study showed that the microbiota of the nasopharynx is identical in its qualitative composition to microorganisms from the deep parts of the nose. However, according to the results of the analysis of microbial markers of saliva, the oral microbiota showed significant differences in the quantitative and qualitative composition of microorganisms compared with the nasopharyngeal microbiota.&#x0D; Conclusion. The introduction of the GC-MS method for assessing the URT microbiota enables its monitoring in clinical practice for the treatment of chronic respiratory system diseases without disturbing the ecology of the mucous membranes and the whole body.

Клінічне значення деблокади носового дихання в дітей грудного і раннього віку на тлі гострих респіраторних вірусних інфекцій: переваги ізотонічного розчину морської води

Acute respiratory viral infections (ARVI) are an urgent problem in young children, which is due to their significant prevalence, they have a constant tendency to increase and occupy the first places in the structure of infectious diseases. Damage to the mucous membranes of the upper respiratory tract in children with ARVI lead to numerous problems that require adequate replacement of the main functions of the child’s body, which determined the relevance of our study. Purpose - to analyze the effectiveness of the use of isotonic dilution of sea water (Pshyk Mini medicine) for irrigation therapy in nasal congestion in infants and young children caused by acute respiratory infections. Materials and methods. A comprehensive examination of 100 infants and young children with influenza and other ARVI was conducted in the infectious diseases department of the Chernivtsi Regional Children’s Clinical Hospital. The children were randomly divided into 2 clinical groups: the Group I included 55 children (average age - 1.09±0.3 years, the proportion of boys - 58.1%), who, as part of complex standard therapy, received nasal irrigation using 2-3 drops of Pshyk mini medicine in each nostril 3 times/day. The Group II included 45 patients (average age - 1.15±0.2 years (p&gt;0.05), the proportion of boys - 59.1% (p&gt;0.05)), in whom isotonic sodium chloride solution was used for the purpose of the nasal sanitation. Results. The conducted studies showed that starting from the 3-4th day of hospitalization, a statistically significant decrease in catarrhal manifestations and the severity of nasal obstruction was noted in patients of the Group I who received Pshyk Mini in complex treatment. In particular, in relation to the results of the Group II, in the children of the Group I, on the 4th day of inpatient treatment, the chances of reducing the severity of catarrhal manifestations (estimated ≤2 points) increased: the absolute risk increase - 53.0%, the relative risk increase - 67.9% (95% CI: 57.8-76.9) with the minimum number of patients who need to be treated to obtain a positive result - 1.5. We also established that compared to the representatives of the Group II, children of the Group I had almost a 4-fold increase in the chances of restoring tolerance to feeding (estimation of feeding difficulties ≤2 points): attributive risk - 30.5%, relative risk - 1.6 (95% CI: 0.6-4.8), odds ratio - 3.9 (95% CI: 1.2-12.3). Conclusions. For the purpose of unblocking of nasal breathing in infants and children of early age at the background of acute respiratory viral infections, the use of an isotonic solution of sea water (Pshyk Mini medicine) has a number of significant advantages compared to the use of an isotonic solution of sodium chloride for this purpose. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Possibilities for increasing the effectiveness of treatment of respiratory infections of the upper respiratory tract in children of various age groups

The article discusses the experience of complex therapy of rhinitis and sinusitis in children of various age groups, confirming the effectiveness of the combined effects of local thermotherapy, pulsed red light and low-frequency magnetic field. This combination of physical factors has an anti-inflammatory, decongestant, stimulating local cellular activity effect and helps to increase the effectiveness and reduce the overall treatment time for these diseases. The purpose of the study is to evaluate the effectiveness of the combined use of heat, red spectrum phototherapy and magnetic field in the treatment of children with rhinitis and sinusitis. Materials and methods. The observation included 30 children with rhinitis and 40 children with sinusitis aged 2-18 years, receiving combined physiotherapy procedures as part of the main treatment. Results and its discussion. The positive effect of the combined effects of thermotherapy, pulsed light radiation in the red range and low-frequency magnetic field on clinical symptoms and functional indicators of nasal breathing in children with rhinitis and sinusitis has been confirmed. Conclusions. The use of a course of procedures combined with the effects of local thermotherapy, pulsed red light and low-frequency magnetic field against the background of the main treatment helps to increase the effectiveness of the treatment of respiratory infections of the upper respiratory tract in children of various age groups.

Ультразвуковое исследование легких при диагностике пневмоний у детей

Aim. To present current data on the characterization, methodology, and use of lung ultrasound (LUS) in the diagnosis of pneumonia in children. Key points. Respiratory pathology is most common in childhood due to the peculiarities of immunity and structure of the respiratory tract. Pneumonia is a not uncommon disease of the lower respiratory tract in children, requiring quick, accurate and easy to perform diagnosis, as well as correct and timely treatment. Recently, lung ultrasound examination has been gaining popularity as a tool for diagnosing diseases of the lower respiratory tract, including pneumonias. It was widely used during the COVID-19 pandemic, when there were a lot of patients. The advantages of this method are the ease of the procedure, the speed of obtaining results, the absence of ionizing radiation and the non-invasiveness of the study. Ultrasound allows for a real-time assessment of the lung tissue lesion pattern. Also, an ultrasound examination lets the child stay with their mother and keep calm during the diagnostic procedure, preventing stress. Numerous trials demonstrated high specificity and sensitivity of this diagnostic method. Results of the common and more time-consuming diagnostic methods, such as lung CT and lung X-ray, have been compared with ultrasonographic results. With lung ultrasound, the possibility of dynamic patient monitoring is opened up without the fear of receiving unnecessary radiation exposure. The review presents data on the gaining popularity of LUS, its sensitivity and specificity, the technique of the study, as well as characteristic signs of pulmonary lesions in pneumonia. Conclusion. Lung ultrasound as a tool for pneumonia diagnostics is widely used abroad and has been included in pneumonia management protocols. Ease-of-use and safety for patients facilitate the introduction and application of this diagnostic method in paediatric inpatientunits; later, it can be used in outpatient settings as well. Multidisciplinary approach to the diagnosis of pneumonia contributes to the acceleration of the correct diagnosis and the beginning of adequate therapy. Keywords: lung ultrasound, pneumonia in children, ultrasound signs of pulmonary lesions.

Острые респираторные вирусные инфекции: фокус на тяжесть течения. Блиц-обзор

This concise examination of international and domestic research on the impact of respiratory viruses and age-specific characteristics of the immune response in young children on the severity of influenza and other acute respiratory viral infections (ARVIs) is designed to highlight the importance of timely and effective therapy for these diseases. When selecting therapy for ARVIs in children, particularly those of a younger age, it is advisable to adopt a balanced approach that ensures adequate antiviral protection and rapid elimination of the virus, while also considering the necessity for effective and safe therapy to prevent an inadequate immune response. Furthermore, the review addresses the findings on a representative of the group of "Biological medicines produced using gradual processing technology" (State Pharmacopoeia of the Russian Federation, XV ed.), namely the domestic antiviral drug Anaferon® for children in drops for oral administration. The drug has been demonstrated to have antiviral activity, to provide a significant effect on reducing the duration of fever, and the severity of the disease course, and to have the favorable safety profile. Additionally, it is administered in a convenient, physiological manner, allowing for its wide application in the treatment of acute respiratory infections of the upper respiratory tract in children from 1 month to nearly 4 years (3 years, 11 months, and 29 days inclusive). KEYWORDS: ARVI, acute respiratory viral infection, acute respiratory infection of the upper respiratory tract, common cold, severity of course, treatment. FOR CITATION: Zaplatnikov A.L., Geppe N.A., Blokhin B.M., Kondyurina E.G. Acute respiratory viral infections: focus on severity. A brief overview. Russian Journal of Woman and Child Health. 2024;7(3):270–275 (in Russ.). DOI: 10.32364/2618-8430-2024-7-3-11.

Socio-economic burden of respiratory syncytial viral infection of the lower respiratory tract in children aged from birth to 5 years in the Russian Federation: modeling results

Background. Respiratory syncytial virus (RSV) is a common virus causing lower respiratory tract infections (LRTI), including acute bronchiolitis and pneumonia, in children in the first 5 years of life.Objective: to estimate the annual socio-economic burden for the Russian Federation (RF) due to RSV-LRTI in children aged under 5 years.Material and methods. Based on published results of meta-analysis of epidemiological data for RSV-induced infections, the annual number of RSV-LRTI cases, the number of hospitalizations, and associated lethal outcomes were calculated in the model for groups of children aged 0 – &lt;12 months, 12 – &lt;24 months, and 24 – 60 months. The costs of medical care were determined according to the current tariffs of the Compulsory Health Insurance system and published Russian data on the distribution of the number of RSV-LRTI cases by severity. The damage to gross domestic product (GDP) associated with fatalities was estimated taking into account life expectancy and employment.Results. According to the estimates, 397.2 thousand children aged under 5 years in the RF fall ill with RSV-LRTI during a year, including 44.6 thousand cases requiring hospitalization, and in 268 cases, the infection becomes lethal. Medical costs for treatment exceed 2.2 billion rubles, and the damage to GDP as a result of lethal outcomes reaches almost 10 billion rubles. The main damage is related to RSV-LRTI cases in children aged under 1 year, the share of which is over 50% among those hospitalized and over 70% among those who died.Conclusion. RSV significantly affects morbidity and mortality among children aged under 5 years. According to modeling data, it causes up to 3.5% of deaths in this age group, and the associated economic losses exceed 12.2 billion rubles, which justifies the need for RSV-LRTI immunoprophylaxis.

Integrated metabolome-microbiome analysis investigates the different regulations of Pudilan Xiaoyan oral liquid in young rats with acute pharyngitis compared to adult rats

BackgroundPudilan Xiaoyan Oral Liquid (PDL) is a famous traditional Chinese prescription recorded in the Chinese Pharmacopeia, which is widely used to treat inflammatory diseases of the respiratory tract in children and adults. However, the endogenous changes in children and adults with PDL in the treatment of acute pharyngitis remain unclear. PurposeThe differential regulatory roles of PDL in endogenous metabolism and gut microbes in young and adult rats were investigated with a view to providing a preclinical data reference for PDL in medication for children. MethodsAn acute pharyngitis model was established, and serum levels of inflammatory factors and histopathology were measured. This study simulated the growth and development of children in young rats and explored the endogenous metabolic characteristics and intestinal microbial composition after the intervention of PDL by using serum metabolomic technique and 16S rRNA high-throughput sequencing technique. ResultsThe results showed that PDL had therapeutic effects on young and adult rats with acute pharyngitis. Sixteen biomarkers were identified by metabolomics in the serum of young rats and 23 in adult rats. PDL can also affect intestinal microbial diversity and community richness in young and adult rats. Alloprevotella, Allobaculum, Alistipes, Bifidobacterium, and Enterorhabdus were prominent bacteria in young rats. Bacteria from the phylum Firmicutes of the adult rats changed more significantly under the treatment of PDL. In young rats, amino acid metabolism was the primary regulatory mode of PDL, whereas, in adult rats, glycerophospholipid metabolism was studied. ConclusionThe regulation of PDL on the serum metabolite group and intestinal microflora in young rats was different from that in adult rats, indicating the necessity of an independent study on children's medication. PDL may also exert therapeutic effects on young and adult rats by regulating gut microbial homeostasis. The results support the clinical application of PDL.

Retracted: Application of 64-Slice Spiral CT Imaging Technology Based on Smart Medical Augmented Reality in the Diagnosis of Foreign Bodies in the Respiratory Tract in Children.

[This retracts the article DOI: 10.1155/2021/9962997.].

Longitudinal anellome dynamics inthe upper respiratory tract ofchildren with acute respiratory tract infections.

Anelloviruses (AVs) are ubiquitous in humans and are the most abundant components of the commensal virome. Previous studies on the diversity, transmission, and persistence of AVs mainly focused on the blood or transplanted tissues from adults; however, the profile of the anellome in the respiratory tract in children are barely known. We investigated the anellome profile and their dynamics in the upper respiratory tract from a cohort of children with acute respiratory tract infections (ARTIs). Different to that in adult, betatorquevirus is the most abundant genus, followed by alphatorquevirus. We found that the relative abundance of betatorquevirus was higher in earlier time points, and in contrast, the abundance of alphatorquevirus was higher in later time points; these results might suggest that betatorquevirus decreased with age and alphatorquevirus increased with age in childhood. No difference regarding the diversity and abundance of anellome was found between single and multiple ARTIs, consistent with the idea that AV is not associated with certain disease. Most AVs are transient, and a small proportion (8 per cent) of them were found to be possibly persistent, with persistence time ranging from 1 month to as long as 56 months. Furthermore, the individual respiratory anellome appeared to be unique and dynamic, and the replacement of existing AVs with new ones are common over different time points. These findings demonstrate that betatorquevirus may be the early colonizer in children, and the individual respiratory anellome is unique, which are featured by both chronic infections and AV community replacement.

Effect of synthetic folic acid surplus on neurological symptoms in offspring

Background. It has long been known about the need for folic acid for the vital activity of both macro-and microorganisms. It is necessary for the processes of methylation, nucleotide synthesis and also the formation of methionine and reducing the toxic effect of homocysteine. The addition of synthetic folic acid to the diet of pregnant women, as well as at the stage of pre-pregnancy preparation, significantly reduces the risks of fetal neural tube defects, heart defects, and possibly other organs and systems of the body. In addition, folic acid can help improve fertility potential. However, there is evidence of adverse effects of folic acid proficite on the health of older adults (hiding B12-deficient status) and the offspring of mothers taking high doses prescribed by medical specialists like a risks of infectious-inflammatory and allergic diseases of the upper respiratory tract in children, eczema, also disorders of psychomotor development and insulin resistance. In 1980, the direct excitatory effect of folic acid on synaptic transmission in the central nervous system was proved. This is due to the molecular structure, it contains L-glutamate.&#x0D; Therefore, the aim of the work was trying to prove the existing correlation data on probable neuropathologies, including a reduced threshold of seizures, a high risk of epilepsy in a model of offspring of Wistar rats with an increased dosage of folate throughout gestation and including at the stage of pre-gravidar preparation.&#x0D; Methods. We have determined the ability to the first convulsive act by introducing a 20% solution of caffeine at the rate of 100 mg/kg of weight intraperitoneally.&#x0D; Results. In the control group, the average clonus time was 1779.6 seconds, in the experimental group with a 1 mg/kg folic acid per diet dosage of 797.3 seconds, and in the second group with a 5 mg/kg folic acid per diet 439.7 seconds (p 0,01).&#x0D; Conclusion. The obtained results of the difference in the convulsive threshold may be due to changes in synaptic density as a result of an excess of synthetic folic acid during the formation of NT and subsequently during the differentiation of nervous tissue in the central nervous system (in particular, in the 3rd trimester with a massive appearance of glutamatergic receptors), which can affect the processes of neurogenesis and the formation of neural networks.

Порушення носового дихання в дітей: причини, наслідки, сучасні погляди на корекцію та профілактику (огляд літератури)

Purpose - to analyze data from scientific sources on the causes, consequences, and current views on the correction and prevention of nasal breathing disorders. The authors have provided and systematized information on the peculiarities of the structure and functioning of the upper respiratory tract in children of various ages. The causes and consequences of nasal breathing disorders have been established. From the standpoint of modern international recommendations, the principles of correction of nasal breathing disorders and expanded views on the possibilities of prevention of diseases of the upper respiratory tract are evaluated. Conclusions. Nasal obstruction in childhood is the most common problem that can lead to negative consequences, and the nasal mucosa in young children needs regular care and hygienic cleaning. The use of the new medical product PSHIK MINI allows for high-quality, effective and safe moisturizing and cleansing of the nasal mucosa of children as a preventive and, if necessary, therapeutic procedure. No conflict of interests was declared by the authors.

The current state of diagnostics and management of foreign bodies in the respiratory tract in children

Introduction. Foreign body aspiration (FBA) into the respiratory tract is a severe, life-threatening condition in children which requires urgent medical and diagnostic measures. Purpose. To study outcomes after FBA diagnostics and treatment in children and to develop an algorithm for diagnosing foreign bodies in the respiratory tract in this group of patients. Material and methods. Outcomes in 86 children who were hospitalized with suspected foreign bodies in their respiratory tract to the Clinic of Pediatric Surgery in Marat Ospanov West Kazakhstan Medical University, Aktobe, Republic of Kazakhstan in 2018–2022. Results. In 73 children, out of 86, FBA was confirmed. Distribution of children with FBA by age was as follows: less than one year – 5 (6.8 %) children; 1–3 years – 46 (63.1 %); 3–5 years – 7 (9.6 %), over 5 years – 15 (20.5 %). Localization of foreign bodies in the respiratory tract was as follows: larynx –6; trachea – 10, right main bronchus –26, left main bronchus – 30, both lower lobe bronchi – 1. The revealed foreign bodied were : peanuts – 24 (32.8 %) cases, sunflower seed – 13 (17.8 %), fountain pen cap – 7 (9.6 %), plastic toy part – 5 (6.8 %), fish bone – 5 (6.8 %), stationery carnation – 4 (5.5 %), bone – 4 (5.5 %), small rock – 4 (5.5 %), carrot – 3 (4.2 %), tooth – 2 (2.7 %), bead – 1 (1.4 %), food masses –1 (1.4 %). In the diagnostics of foreign bodies, anamnesis, clinical examination, radiation and endoscopic diagnostic techniques were of great importance. On analyzing the obtained clinical material, the researchers developed their own algorithm for FBA diagnosis. Foreign bodies were removed with rigid bronchoscopy in 55 children, with fibrobronchoscopy in 9 children, direct laryngoscopy – in 6 cases, at thoracotomy and bronchotomy – in 3 children. There were no complications associated with the removal of foreign bodies. Conclusions. Foreign bodies in the respiratory tract are met most often in children , aged 1–3. In doubtful cases, MSCT was used in addition to traditional diagnostic methods. It allows to exclude or identify foreign bodies invisible at X-ray images. FBA removal should be performed at the third level medical institutions.

Acute Low Respiratory Infections in Children from 2 Months to 15 Years of Age in the Pediatric Department of the Commune II Reference Health Center in Bamako (Mali)

Introduction: Acute lower respiratory infections (ALRIs) in paediatrics include a heterogeneous group of conditions affecting the lower respiratory tract in children. They constitute a real public health problem, particularly in developing countries. Patient and Method: This was a retrospective, descriptive study from 1 January to 31 December 2018, i.e. 2 years. All children aged 2 months to 15 years hospitalized for ARFU were included. Results: In our study, the prevalence of ARBI was 14.47%. The sex ratio was 1.16 in favour of boys. The under-5s were the most represented 97.5%. The peaks of hospitalizations were found in October 18.2%, November 16.5% and August 14%. According to the Expanded Programme on Immunisation, 12.5% of the children were not correctly vaccinated. The reasons for consultation of our patients were respiratory distress with 25.6% followed by cough and cold 24.5%. Fever was associated with 70.2%. The clinical forms were dominated by: pneumonia 47.9% followed by superinfected bronchiolitis 33.1% and acute bronchitis 19%. The majority were treated with the combination of Ceftriaxone and gentamycin, i.e. 62.8% as first-line treatment. The evolution was favourable in 90.9% of cases with 5% death, 2.5% discharge against medical advice and 1.6% referral to higher level. Conclusion: Low-grade ARI is a public health problem in commune II of Bamako. Raising public awareness of the early signs of low-grade ARI, strict adherence to the expanded programme of immunisation, and upgrading of community and hospital health staff will help to reduce mortality from low-grade ARI.