Risk Of Respiratory Infections Research Articles

Economic comparison between conventionally powered and electric cars

One of the most serious environmental problems of our time is air pollution, which has a profoundly damaging effect not only on the ecosystem but also on the human body. Increasing air pollution not only increases the risk of respiratory infections, but also increases the risk of asthma, chronic bronchitis and heart disease. In order to reduce these negative effects , the European Environment Agency supports the implementation of measures taken by EU decision-makers to reduce air pollution. At its meeting in Strasbourg on 14 February 2023, the European Parliament adopted an agreement to clean up the air by requiring all new cars and vans sold in the European Union from 2035 to be electrically powered. When this provision becomes definitive, there will be a gradual expansion of the market for electric vehicles, which already represents a steadily increasing proportion of the total number of cars on the road. This latter fact justifies an examination of the penetration, operational and financial consequences of vehicles with green plates. In the study an economic comparison between the most popular pure electric passenger car in the European Union in 2022, the Tesla Model Y with a green plate, and the Peugeot 208 with a conventional engine has been presented. Four economically developed EU Member States, Hungary, Denmark, Norway and France have been taken for consideration. The financial burden on owners of these car types in the year of purchase and in the following years of use has been investigated. The calculations are based on the legislation and market prices in 2023. Taking into account the average change in market prices, an increase of 10% per year in the costs shown in the table for both types of car has been calculated. The analysis shows that, although in the short term, owners of electric cars face much higher costs than their petrol-powered counterparts, in the long term they are an excellent investment in a cleaner vehicle. Conclusions are supported by the fact that the total expenditure on a Peugeot 208 passenger car in 2023 will exceed the total purchase price and maintenance costs of a Tesla Y model in 2023 in Hungary after approximately 10 years, 13 years in Norway, 10 years in Denmark and 12 years in France

Frequency and Outcome of Acute Respiratory Tract Infection in Exclusive, Partial, and Non-Breastfed Babies

Background: Exclusive breastfeeding provides nutritional and immunological support for the normal growth and development of the infant. Bangladesh is traditionally a breastfed community. The probability of having an acute respiratory infection (ARI) episode was higher for formula-fed infants than fully breastfed infants during the first four months of life. The risks for partially breastfed infants fell between those of formula-fed and fully breastfed infants, suggesting a dose-response effect of breastfeeding on the risk of respiratory infection.
 Objective: This study compares exclusive, partial, and non-breastfed groups regarding the frequency and outcome of acute respiratory infection. Materials and methods: This cross-sectional comparative study was done at the Department of Pediatrics, Rajshahi Medical College Hospital, from January 2013 to June 2013, a period of six months. A total of 300 cases of infants suffering from ARI were selected. Among them, 100 are each for exclusive breastfed (EBF) babies, partially breastfed babies (PBF), and non-breastfed (NBF) babies. In addition, demographic profile, frequency, severity of attacks, outcomes, and length of hospital stay were assessed.
 Results: Most EBF babies came to the hospital with a history of one or two attacks of ARI, but PBF and NBF babies had multiple attacks. i.e., two, three, or more attacks. Most of the NBF and PBF have presented with severe attacks (84% and 72%, respectively), whereas only 42% of EBF babies presented with severe attacks; nonetheless, a maximum of 58% of EBF babies present with mild attacks. The severe attack is more frequent in the PBF and NBF groups than in the EBF groups.
 Conclusion: Frequency, severity, and hospital staying of ARI attacks are found to be more in the PBF and NBF group of babies than in EBF babies. Better outcomes were found in EBF group babies.
 TAJ 2022; 36: No-1: 135-141

Gut Microbiota and Respiratory Infections: Insights from Mendelian Randomization.

The role of the gut microbiota in modulating the risk of respiratory infections has garnered increasing attention. However, conventional clinical trials have faced challenges in establishing the precise relationship between the two. In this study, we conducted a Mendelian randomization analysis with single nucleotide polymorphisms employed as instrumental variables to assess the causal links between the gut microbiota and respiratory infections. Two categories of bacteria, family Lactobacillaceae and genus Family XIII AD3011, were causally associated with the occurrence of upper respiratory tract infections (URTIs). Four categories of gut microbiota existed that were causally associated with lower respiratory tract infections (LRTIs), with order Bacillales and genus Paraprevotella showing a positive association and genus Alistipes and genus Ruminococcaceae UCG009 showing a negative association. The metabolites and metabolic pathways only played a role in the development of LRTIs, with the metabolite deoxycholine acting negatively and menaquinol 8 biosynthesis acting positively. The identification of specific bacterial populations, metabolites, and pathways may provide new clues for mechanism research concerning therapeutic interventions for respiratory infections. Future research should focus on elucidating the potential mechanisms regulating the gut microbiota and developing effective strategies to reduce the incidence of respiratory infections. These findings have the potential to significantly improve global respiratory health.

Impact of Kitchen Structure and Cookstove Technology on Respiratory Health of Rural Women Exposed to Indoor Air Pollution in Khyber Pakhtunkhwa, Pakistan

Incomplete combustion of polluting fuels (PF) is a major source of indoor pollution which poses severe risks of acute respiratory infections to women’s health such as cough, phlegm, and breathing difficulties. This article investigates the net impact of kitchen structural factors including the location of the kitchen and number of windows in the kitchen and cookstove technology on acute respiratory symptoms of rural women involved in cooking practices. A household survey was conducted to collect primary data from 250 rural households in Khyber Pakhtunkhwa province. Around 66 percent of rural households exclusively used polluted fuel for cooking which caused 4 respiratory symptoms among poor women. The results of the Poisson regression model revealed that the use of polluted energy in the enclosed kitchen was four times more responsible for respiratory symptoms than in the open kitchen; while an improved cookstove in the enclosed kitchen was three times more effective in controlling respiratory involvements . Concerted efforts are required to adopt short-term mitigation strategies such as improved stoves and efficient kitchen design.

COVID-19 Vaccination Among Patients Receiving Maintenance Renal Replacement Therapy: Immune Response, Real-World Effectiveness, and Implications for the Future.

Chronic kidney disease affects more than 800 million people worldwide and often progresses to end-stage renal disease, which requires maintenance dialysis. Patients receiving dialysis are at higher risk for severe respiratory infections, including SARS-CoV-2 (the causative agent of COVID-19). In addition, many patients who receive dialysis also receive immunosuppressive treatments for conditions such as systemic vasculitis, systemic lupus erythematosus, or malignancies. Many studies have shown that while mRNA COVID-19 vaccines induce some level of immune response in patients receiving dialysis, the magnitude of response is often lower than that of healthy individuals, and responses rapidly wane. Importantly, the risk of COVID-19-related hospitalization and mortality for patients receiving dialysis is 4- to 8-fold higher compared with the general population. In this article, we summarize recent immunogenicity and real-world outcomes of COVID-19 mRNA vaccination among patients receiving dialysis, with a focus on the 3-dose extended primary series and additional (fourth) doses.

10:20-10:30 Ultrasound-based monitoring of fetal lung development predicts the risk for respiratory infections in infants

10:20-10:30 Ultrasound-based monitoring of fetal lung development predicts the risk for respiratory infections in infants

The impact of respiratory infections and probiotic use on the nasal microbiota of frail residents in long-term care homes.

Residents in long-term care homes, who tend to be of advanced age and frail, are at increased risk of respiratory infections. The respiratory microbiota is known to change with age, but whether these changes contribute to the risk of infection is not known. Our goal was to determine how the nasal microbiota of frail older adults changes during symptoms of influenza-like illness (ILI) and how this may be impacted by enrolment in a placebo-controlled trial testing the feasibility of administering a Lactobacillus rhamnosus GG probiotic to prevent respiratory infection (2014-2017). The microbiome of the nasal (mid-turbinate) of 150 residents of long-term care homes was interrogated using 16S rRNA gene sequencing. We identified a diverse and individualised microbiota which could be separated into nine distinct clusters based on Bray-Curtis distances. Samples collected during symptoms of ILI differed statistically from those collected pre- and post-cold and influenza season, and we observed decreased temporal stability (as measured by movement between clusters) in individuals who experienced ILI compared to those who did not. The use of probiotics decreased ILI-induced changes to the microbiota; however, it is not clear whether this decrease is sufficient to prevent respiratory illness.

Safety, efficacy and pharmacokinetics of palivizumab in off-label neonates, infants, and young children at risk for serious respiratory syncytial virus infection: a multicenter phase II clinical trial

Pediatric patients with certain rare diseases are at increased risk of severe respiratory syncytial virus (RSV) infection. However, the prophylactic use of anti-RSV antibody (palivizumab) in these patients is not indicated at present in Japan. This first-in-the-world multicenter, uncontrolled, open-label, phase II clinical trial was carried out between 28 July 2019 and 24 September 2021at seven medical institutions in Japan to investigate the efficacy, safety, and pharmacokinetics of palivizumab in 23 subjects recruited from among neonates, infants, or children aged 24 months or younger who had any of the following conditions: pulmonary hypoplasia, airway stenosis, congenital esophageal atresia, inherited metabolic disease, or neuromuscular disease. At least four continuous doses of palivizumab were administered intramuscularly at 15mg/kg at intervals of 30 days. Twenty-three enrolled subjects completed the study. No subject required hospitalization for RSV. Adverse events (AE) did not notably differ from the event terms described in the latest interview form. Five severe AEs required unplanned hospitalization, but resolved without RSV infection. Therapeutically effective concentrations of palivizumab were maintained throughout the study period. Palivizumab might be well tolerated and effective in preventing serious respiratory symptoms and hospitalization due to severe RSV infection, indicating the prophylactic use in the pediatric patients included in this study. Japan Agency for Medical Research and Development (AMED), grant numbers 19lk0201097h0001 (to MM), 20lk0201097h0002 (to MM), 21lk0201097h0003 (to MM), and 22lk0201097h0004 (to MM). AMED did not have any role in the execution of this study, analysis and interpretation of the data, or the decision to submit the results.

Family-centered care for a patient with multiple organ dysfunction syndrome in the intensive care unit: A case report

Background: Patients with multiple organ dysfunction syndrome (MODS) require complex intensive care, and family involvement plays an essential role in achieving patient recovery. Family-centered care in the intensive care unit (ICU) benefits patients, families, and healthcare workers. Objective: This case study aimed to evaluate the family-centered care approach for patients with MODS in the ICU. Case: A 46-year-old male patient with MODS presented various problems, including the risk of respiratory infections, impaired renal perfusion, and pressure sores. An interview with the patient’s family revealed that they felt guilty, worried, and lacked sufficient information about the patient’s condition. The interventions provided to the family included giving them information about the patient’s condition, care plans, and evaluation results after procedures, providing spiritual guidance, offering family support, and involving them in the patient’s required procedures. Conclusion: After the patient had been admitted for two days, there was an improvement in the patient’s outcomes. Simultaneously, the patient’s family experienced a sense of calmness and increased satisfaction with the provided health services. To facilitate the implementation of family-centered care in the ICU, it is crucial to further develop hospital policies. Moreover, achieving successful family-centered care necessitates the support and cooperation of the medical staff.

P-Wave Axis of Schoolchildren Who Were Once Breastfed.

It has been known for decades that breastfeeding leads to a lower risk of asthma, respiratory infections, or metabolic syndrome at school age. In addition, evidence is now accumulating on the influence of breast milk on the shape, volume, or function of the heart and lungs. Within this field of research into the effects of breast milk on the structure of the heart and lungs, we have set out to analyze the differential electrocardiographic characteristics of schoolchildren who were once breastfed. This was an observational cross-sectional study, including 138 children aged 6 or 12 consecutively presenting to a well-child clinic between May and December 2022. The ability to perform reproducible ECG records, the feasibility of weighing and measuring patient, and breastfeeding data collected from birth were used as the inclusion criteria. Using the 40° cut-off value for the mean P-wave axis among schoolchildren, 76% of never-breastfed children in our sample have a P-wave axis in a more vertical position than the mean as compared to 58% of ever-breastfed children (OR: 2.25; 95% CI: 3.13-1.36); there was no other significant difference between infant feeding groups in somatometric characteristics or ECG parameters. We found a significant difference of the mean values of the P-wave axis between never- and ever-breastfed children. Although this report should be approached cautiously, these findings add to the renewed interest in discerning developmental interventions to improve cardiovascular health.

Mapping the risk of respiratory infections using suburban district areas in a large city in Colombia

BackgroundAcute respiratory infections (ARI) in Cúcuta -Colombia, have a comparatively high burden of disease associated with high public health costs. However, little is known about the epidemiology of these diseases in the city and its distribution within suburban areas. This study addresses this gap by estimating and mapping the risk of ARI in Cúcuta and identifying the most relevant risk factors.MethodsA spatial epidemiological analysis was designed to investigate the association of sociodemographic and environmental risk factors with the rate of ambulatory consultations of ARI in urban sections of Cúcuta, 2018. The ARI rate was calculated using a method for spatial estimation of disease rates. A Bayesian spatial model was implemented using the Integrated Nested Laplace Approximation approach and the Besag-York-Mollié specification. The risk of ARI per urban section and the hotspots of higher risk were also estimated and mapped.ResultsA higher risk of IRA was found in central, south, north and west areas of Cúcuta after adjusting for sociodemographic and environmental factors, and taking into consideration the spatial distribution of the city’s urban sections. An increase of one unit in the percentage of population younger than 15 years; the Index of Multidimensional Poverty and the rate of ARI in the migrant population was associated with a 1.08 (1.06—1.1); 1.04 (1.01—1.08) and 1.25 (1.22—1.27) increase of the ARI rate, respectively. Twenty-four urban sections were identified as hotspots of risk in central, south, north and west areas in Cucuta.ConclusionSociodemographic factors and their spatial patterns are determinants of acute respiratory infections in Cúcuta. Bayesian spatial hierarchical models can be used to estimate and map the risk of these infections in suburban areas of large cities in Colombia. The methods of this study can be used globally to identify suburban areas and or specific communities at risk to support the implementation of prevention strategies and decision-making in the public and private health sectors.

Inactivation of SARS-CoV-2 in Water by Chlorination.

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is present in both respiratory secretions and feces, creating its potential for transmission by swimming pools. Recreational water activity is known to be at increased risk of respiratory infections and respiratory viruses have caused been detected and have caused outbreaks in swimming pools. However, little is known regarding the chlorine inactivation of SARS-CoV-2 in water typical of swimming pools in the USA. In this study, the inactivation of SARS-CoV-2 Isolate hCoV-19/USA-WA1/2020 was observed in water by chlorination. All experiments were conducted within a BSL-3 laboratory at room temperature. Our results show that the virus was reduced by 3.5 log (> 99.9%) after 30s of 2.05-mg/L free chlorine contact and greater than 4.17 log (limit of detection) (> 99.99%) within 2min.

Infant Feeding Pattern Clusters Are Associated with Childhood Health Outcomes.

(1) Background: Feeding behavior habits have a pattern with a certain tendency during infancy. We aimed to identify the associations between feeding patterns in infancy and the subsequent 10-year childhood disease burden. (2) Methods: Data from 236,372 infants were obtained from the national health insurance and screening program records in South Korea. Parent-administered questionnaires during infancy provided details on the feeding type and types/frequency of complementary food for analyzing feeding patterns. The outcomes were all-cause hospitalization and the development of 15 representative childhood diseases until the age of 10 years. Anthropometric measurements obtained at 6 years of age were analyzed. To estimate outcome risks while considering multiple risk factors, we employed a Cox proportional hazard and modified Poisson regression. (3) Results: Three clusters were identified: high prevalence of breastfeeding with regular exposure to a variety of solid foods (n = 116,372, cluster 1), similar prevalence of breastfeeding and formula feeding with less exposure to solid foods (n = 108,189, cluster 2), and similar prevalence of breastfeeding and formula feeding with the least exposure to solid foods in infancy (n = 11,811, cluster 3). Compared with cluster 1, children in clusters 2 and 3 had increased risks of all-cause hospitalization (hazard ratio (HR), (95% confidence interval (CI)), 1.04 (1.03-1.06) and 1.08 (1.05-1.11), respectively). Children in clusters 2 and 3 had an increased risk of upper respiratory infection, pneumonia, and gastroenteritis, as well as neurobehavioral diseases. Overweight/obesity at the age of 6 years was associated with clusters 2 and 3. (4) Conclusions: Feeding patterns in infancy were associated with an increased risk of childhood disease burden.

Exposure to dust organophosphate and replacement brominated flame retardants during infancy and risk of subsequent adverse respiratory outcomes

BackgroundChildren are highly exposed to flame retardants in indoor environments, partly through inhalation. However, the associations of early life exposure to novel organophosphate (OPFRs) and replacement brominated flame retardants (RBFRs) with adverse respiratory outcomes during childhood are unclear. MethodsWe used a prospective birth cohort of 234 children recruited from the greater Cincinnati, Ohio metropolitan area between 2003 and 2006. OPFRs and RBFRs were analyzed in dust sampled from the homes' main activity room and the children's bedroom floor at child age 1 year. Caregivers reported subsequent respiratory symptoms every six months until child age 5 years and we measured forced expiratory volume in 1 s as well as peak expiratory flow (PEF) at child age 5 years. We performed generalized estimating equations and linear regression modeling adjusted for covariates to examine the exposure-outcome associations. ResultsGeometric means (GMs) (standard error [SE]) for dust concentrations were 10.27 (0.63) μg/g for total OPFRs (ΣOPFRs) and 0.48 (0.04) μg/g for total RBFRs (ΣRBFRs); GMs (SE) for dust loadings were 2.82 (0.26) μg/m2 for ΣOPFRs and 0.13 (0.01) μg/m2 for ΣRBFRs. Dust ∑OPFRs concentrations at age 1 year were associated with higher subsequent risks of wheezing (relative risk [RR]: 1.68, 95% confidence interval [CI]: 1.20–2.34), respiratory infections (RR: 4.01, 95% CI: 1.95–8.24), and hay fever/allergies (RR: 1.33, 95% CI: 1.10–1.60), whereas ∑OPFRs dust loadings at age 1 year were associated with higher risks of subsequent respiratory infections (RR: 1.87, 95% CI: 1.05–3.34) and hay fever/allergies (RR: 1.34, 95% CI: 1.19–1.51). PEF (mL/min) was lower with higher ∑OPFRs dust loadings (β: -12.10, 95% CI: -21.10, −3.10) and with the RBFR bis(2-ethylhexyl) tetrabromophthalate (β: -9.05, 95% CI: -17.67, −0.43). ConclusionsExposure to OPFRs and RBFRs during infancy may be a risk factor for adverse respiratory outcomes during childhood.

Early-Life Nutrition in Preterm Infants and Risk of Respiratory Infections and Wheezing: A Scoping Review.

Preterm birth is a common early-life event that can lead to long-term consequences. The incidence of wheezing, asthma, and respiratory tract infections is higher in children born prematurely than in the general population. The purpose of this review was to synthesize the existing literature on the role of early-life nutrition in the later risk of respiratory morbidities. A scoping review of the literature was performed by searching three online databases. Inclusion criteria were: infants born <37 GWk, comparing human milk versus any other type of milk feeding formulation. Our primary outcomes were wheezing or asthma or respiratory tract infections after discharge. Two authors independently screened the results and extracted study characteristics using a predefined charting form. Nine articles were included (eight cohort studies and one randomized trial). Four studies supported the protective effect of breastfeeding on wheezing or respiratory infections or both. Four studies did not confirm this association. One study confirmed the protective role of breastfeeding only on the subgroup of girls. There was a high heterogeneity among the included studies, in the type of milk feeding, outcomes, and age at follow-up. The current evidence is conflicting. The high heterogeneity and methodological flaws could have influenced the results of the studies. Carefully designed studies are required to define the role of early-life nutrition among preterm infants on their long-term respiratory outcomes.

Nutritional Status and Its Association with the Pattern and Risk of Acute Respiratory Infections among Infants in Rivers State, Nigeria: The Salient Factors and Way Out

Nutritional status measures a child’s health, in view of normal growth and development, physical activity and response to serious illness. Acute respiratory infections present diverse risks of clinical conditions among infants of varying nutritional status. The aim was to determine the extent and pattern of relationship between risk of acute respiratory infections (ARI) among infants and nutritional status. The study design was population-based case-control study of 1,100 randomly selected infants from 12 communities in 6 Local Government Areas of the 3 senatorial districts of Rivers State. The subjects were selected using multistage random sampling technique down to the community level. The characteristics of the subjects were represented using descriptive method whereas bivariate logistics regression at 5% level of significance was used to test the differences in ARI between normal nutritional status and some types of malnutritional status. Measures of size effect of ARI on nutritional status disparities were interpreted using odds ratio (OR). Pattern of ARI occurrence among infants with undernutrition status indicated by weight-for-age (15.4%) is higher in rural communities, than in urban communities (13.3%). While the difference in pattern of ARI occurrence among infants with undernutrition status indicated by weight-for-height (11.6%) is higher in urban communities, than in rural communities (9.1%). Overall, infants with underweight (weight at -2SD and below) malnutrition status from weight-for-age and wasting malnutrition status from weight-for-height had higher frequencies of occurrence of ARI, 22.9% and 26.2% respectively than their control subjects of same nutritional status of ARI, 8.7% and 15.6% respectively. Among infants of weight-for-age (≤ - 2SD) undernutrition, the odds for ARI (unadjusted) was 3.09 times higher in significance compared to infants with normal weight-for-age, OR- Unadjusted=3.09 (p&lt;0.0001,95%CI=0.227-0.478), whereas the odds for ARI (adjusted) was a significant risk lower among infants with normal weight-for-age by 70% (OR=0.31, p&lt; 0.0001, 95%CI = 0.201 – 0.475) against infants having underweight malnutrition, while infants of weight-for-height (wasting) malnutrition, the odds for ARI (unadjusted) was 1.89 times higher in significance compared to infants with normal weight-for-height, OR-Unadjusted=1.89, (p&lt;0.0001, 95% CI=0.406-0.786). These findings indicate trend of focus regarding rural and urban communities in the occurrence of ARI among infants based on under-nutritional status to effectively manage the condition, including renewed public health interventions from the prenatal period of life of the child.

Compositional shifts within the denture-associated bacteriome in pneumonia - an analytical cross-sectional study.

Introduction. Bacterial pneumonia is a common cause of morbidity and mortality in elderly individuals. While the incidence of edentulism is falling, approximately 19 % of the UK population wear a full or partial removable denture. Despite advances in denture biomaterials, the majority of dentures are fabricated using polymethyl-methacrylate. Growing evidence suggests that colonization of the oral cavity by putative respiratory pathogens predisposes individuals to respiratory infection, by translocation of these microorganisms along the respiratory tract.Hypothesis/Gap Statement. We hypothesized that denture surfaces provide a susceptible colonization site for putative respiratory pathogens, and thus could increase pneumonia risk in susceptible individuals.Aim. This study aimed to characterize the bacterial community composition of denture-wearers in respiratory health compared with individuals with a confirmed diagnosis of pneumonia.Methodology. This was an analytical cross-sectional study, comparing frail elderly individuals without respiratory infection (n=35) to hospitalized patients with pneumonia (n=26). The primary outcome was the relative abundance of putative respiratory pathogens identified by 16S rRNA metataxonomic sequencing, with quantitative PCR used to identified Streptococcus pneumoniae.Results. There was a statistically significant increase in the overall relative abundance of putative respiratory pathogens (P<0.0001), with a greater than 20-fold increase in the bioburden of these microorganisms. In keeping with these findings, there were significant shifts in bacterial community diversity (Chao index, P=0.0003) and richness (Inverse Simpson index P<0.0001) in the denture-associated microbiota of pneumonia patients compared with control subjects.Conclusion. Within the limitations of this study, our evidence supports the role of denture acrylic biomaterials as a potential colonization site for putative respiratory pathogens, which may lead to an increased risk of pneumonia in susceptible individuals. These findings support prior observational studies which have found denture-wearers to be at increased risk of respiratory infection. Further research is needed to confirm the sequence of colonization and translocation to examine potential causal relationships.

The Indian Epidemiological Evidences on Household Air Pollution and Respiratory Health Outcomes

Increasing number of evidence is linking household air pollution (HAP) with the respiratory and general health of people. In this context, this study tries to review and synthesize the Indian evidence on exposure to household air pollution and respiratory health outcomes from the epidemiological studies conducted in India. The literature is gathered by searching national and international databases and selected using PRISMA guidelines. Included 11 studies that suggested higher odds of developing respiratory illness in HAP-exposed individuals than the non-exposed ones. Most of the studies focused on respiratory health outcomes following exposure to HAP among women and children. Household air pollution was found to be associated with an increased risk of acute lower respiratory infections in children. Though Indian evidence is limited, household air pollution in combination with increasing ambient air pollution can have a significant health impact on the Indian population. Along with current legislative, administrative, and community efforts, higher individual and collective efforts are essential to reduce the overall impact of household air pollution in Indian settings.

Results of a regional immunoprophylaxis program for children at risk of a severe course of respiratory syncytial virus infection with palivizumab in the Republic of Bashkortostan

Background. Palivizumab has been successfully used in many countries worldwide to prevent respiratory syncytial infection in children at risk of severe infection. Despite the drug use experience in some regions of the Russian Federation, evidence on the outcomes of specific immunoprophylaxis in children from risk groups is scarce.&#x0D; Aim. To assess the results of the regional immunoprophylaxis program for children at high risk of severe respiratory syncytial virus infection (RSVI) with palivizumab in the Republic of Bashkortostan.&#x0D; Materials and methods. A single-center retrospective cohort study was conducted at the Catamnesis Cabinet of the Republican Clinical Perinatal Center, Ufa. A total of 516 preterm infants born before the full 35 weeks of gestation and who reached the age of 1 year of life between April 2020 and April 2022 were included in the study. Group 1 (palivizumab+) included 250 infants who received at least one immunization against RSVI at a dose of 15 mg/kg; Group 2 (palivizumab-) included 266 infants without immunization. In both groups, the percentage of children admitted to the clinic for acute respiratory infections and hospitalized for lower respiratory infections was determined.&#x0D; Results. It was found that children born at a gestational age of 32 weeks had immunoprophylaxis more often than children born at a gestational age of 3235 weeks (58.1% vs 37.2%; p0.001); also, they more often received 35 injections of palivizumab (32.9% vs 17.9%; p=0.018). The proportion of children who were admitted to the clinic for ARI was lower among those immunized than among those not immunized: 63.6% vs 82.0% (p0.001; relative risk RR 0.77, 95% confidence interval CI 0.690.86). Of children who received 12 injections of palivizumab, 70.2% sought medical care for acute respiratory infections versus 53.3% of children who received 35 injections (p0.001; RR 1.51, 95% CI 1.151.98). Among the immunized infants, the percentage of children admitted to the hospital for bronchitis was significantly lower: 24.0% vs 31.6% (p=0.045; RR 0.74, 95% CI 0.550.99). The most significant effect of palivizumab was demonstrated in children born at the gestational age of 32 weeks or less, who received 35 injections of the drug.&#x0D; Conclusion. The study demonstrated the effectiveness of the regional RSVI immunoprophylaxis program with palivizumab in children in the first year of life at risk for severe infection in the Republic of Bashkortostan.

Respiratory infection risk in positive airway pressure therapy users: a retrospective cohort study.

Concerns regarding the risk of positive airway pressure (PAP)-associated respiratory infection (RI) have shaped consumer views toward PAP device use and maintenance. However, data regarding temporal associations between PAP use and risk for RIs are limited. The purpose of the present study was to examine longitudinal associations between PAP use and risk of clinically significant RIs in a cohort of patients with obstructive sleep apnea. The frequency of clinically reported respiratory RIs pre- and post-PAP use were compared in a sample of 482 adult patients with obstructive sleep apnea who underwent PAP titration at a large academic sleep center between 2011 and 2014. RIs were identified by clinical record review beginning two years before and ending two years after the participants' PAP titration. Presence of longitudinal standard PAP data download reports identified PAP users from nonusers. PAP adherence was defined as at least 4 hours of use per day, five days per week for at least 70% of days. Poisson regression models, adjusted for age, sex, body mass index, and the number of pre-PAP use RIs were utilized to examine associations between PAP use and subsequent RIs. Poisson regression models adjusted for age, sex, body mass index, and the number of pre-PAP use RIs did not show associations between PAP therapy use and rate of post-PAP use RIs (rate ratio = 1.27, 95% confidence interval: 0.86-1.86). A sensitivity analysis that included only PAP users with difference in PAP adherence showed similar results (rate ratio = 0.65, 95% confidence interval: 0.32-1.30). Among adults with obstructive sleep apnea, we did not find evidence for association between PAP use/adherence and increased RI frequency. These data offer new information that could assuage patients with obstructive sleep apnea who are considering PAP deferral based on RI concerns. Gavidia R, Shieu MM, Dunietz GL, Braley TJ. Respiratory infection risk in positive airway pressure therapy users: a retrospective cohort study. J Clin Sleep Med. 2023;19(10):1769-1773.