Signs Of Acute Respiratory Infection Research Articles

Acute coronary syndrome as a current issue of pediatric cardiology. Outcomes and prognosis: Clinical case

Background. Acute coronary syndrome is widespread in the adult population and has clear diagnostic criteria. In pediatric practice, this pathology is rare, and often implies difficulties in diagnosis. Case description. A 16-year-old male with negative paternal history, hypercholesterolemia, dyslipidemia, and excessive body weight developed myocardial infarction on the background of acute tonsillitis. In the onset of the disease, the adolescent demonstrated clinical signs of acute respiratory infection and coronary spasm. Electrocardiogram revealed ST segment elevation above the baseline in leads I, II, III, aVF, V4–V6 and biochemical markers of myocardial necrosis. Echocardiography revealed signs of focal hypokinesis of the left ventricle, newly detected degree 2 mitral regurgitation. Percutaneous coronary angiography revealed no signs of coronary artery stenosis. The patient received conventional medical treatment of acute myocardial infarction as well as antibacterial therapy. He was discharged in satisfactory condition. After 1 year of follow-up after the myocardial infarction the patient showed no pathologic changes both on stress-echocardiography and electrocardiogram. Three-year catamnesis appeared to be favorable. Conclusion. The presented clinical case demonstrates the individual mechanism of acute coronary syndrome development in children. Pediatricians should be aware of the risk of developing acute coronary syndrome against the background of infectious pathology.

The role of gene polymorphism of some immune response molecules in the development of acute virus-induced bronchiolitis

The aim of research: To investigate the genetic polymorphism of immune response molecules (TNFα-308G> A (rs1800629), IL4-589C>T (rs2243250), IL10-592C> A (rs1800872), IL10-819C> T (rs1800871), IL10-1082G>A (rs1800896), IL-17A-197G> A (rs2275913), IL- 17F-161His> Arg (rs763780), TLR-2-753Arg>Gln (rs5743708), TLR-6-249Ser>Pro (rs5743810) and assess their prognostic value in the development of acute virus-induced bronchiolitis.Materials and methods. The study included children of the first year of life, whose average age was 4.2 ± 3.7 months. The main group consisted of 106 patients with moderate and severe acute viral bronchiolitis, more often associated with respiratory syncytial virus (56.6%). The control group consisted of 100 healthy children of the same age who had no signs of acute respiratory infection at the time of examination and did not receive passive immunoprophylaxis of respiratory syncytial infection. Genotyping was performed using the polymerase chain reaction method. The analysis of the results included the compliance with the Hardy-Weinberg law, the χ 2 test, the relative chance, and its 95% confidence interval. To assess the distribution of the claimed gene polymorphisms and their alleles, we used the general (χ2 test, df =2) and multiplicative (χ2 test, df =1) inheritance models.Results. It was revealed that the risk of developing acute viral bronchiolitis is increased compared to the healthy population in carriers of the following genotypes: CC, ST gene IL10-819C> T (rs1800871), GG, AA gene IL-17A-197G> A (rs2275913), HisHis gene IL-17F-161His> Arg (rs763780), SerSer, SerPro gene TLR-6-249Ser> Pro (rs5743810), GG gene TNF-α-308G>A (rs1800629). The TT genotype of the IL10-819C>T (rs1800871) gene is associated with a high risk of developing bacterial complications (pneumonia) in viral bronchiolitis. Carriers of genotypes AA, CC of the IL10-592C> A (rs1800872) gene have an increased likelihood of a severe course of viral bronchiolitis.Conclusion. Genetic analysis of gene polymorphism IL10-592C> A (rs1800872), IL10-819C> T (rs1800871), IL-17A-197G> A (rs2275913), IL-17F-161His> Arg (rs763780), TLR-6-249Ser> Pro (rs5743810), TNF-α-308 G>A (rs1800629) can be used as a personalized developmental criterion acute virus-induced bronchiolitis in children, determining the severity of its course and the likelihood of complications.

Dependence of thymic stromal lymphopoietin serum concentration from bronchial asthma control level and lung function results in patients of different age groups

Introduction. Bronchial asthma (BA) pathogenesis is settled by bronchial wall inflammation, which is the main treatment target.Aim. To study the dependence of thymic stromal lymphopoietin (TSLP) concentration in serum and nasal brush-biopsies from age, spirometry data deterioration and blood eosinophils in patients with uncontrolled BA.Materials and methods. Patients with uncontrolled BA of three age groups: children (6–11 y.o., n = 38), adolescents (14–17 y.o., n = 35) and adults (25–50 y.o., n = 31) were included in 1-year long open prospective study. Clinical history, АСТ/сАСТ questionnaires, lung function test (LFT), common blood count, serum and nasal material to evaluate TSLP were obtained during first visit, if there were no any signs of acute respiratory infection for not less than 14 days. Maintenance therapy was revised based on firstvisit findings. Patient were consequently examined twice with 6 months intervals, examination data, LFT readings, ACT results and eosinophil counts were collected. Statistical analyses included ANOVA (Kruskal-Wallis test) and Pearson’s correlation (r). Differences accepted significant with р < 0,05.Results. Serum TSLP levels did not differ between age groups. TSLP concentration correlate directly and significantly with duration of uncontrolled BA in previous 12 months (r = 0.74). In patients with atopic BA, maximum TSLP level was in dust mites sensitized group (792.6 ± 114.1 pg/ml). We have found greater serum TSLP concentration in patients who demonstrated FEV1 below normal even on optimal controller therapy at Visit 3. Eosinophil count randomly changed inside normal values and did not correlate with asthma control or TSLP level.Conclusion. Prognosis of future asthma exacerbations and LFT decrease is less favourable in patients with high serum TSLP level.

Атипові форми гострої Епштейна — Барр-вірусної інфекції в дітей

Актуальність. Сьогодні спостерігається тенденція до зростання захворюваності на Епштейна — Барр-вірусну інфекцію (ЕБВІ) у дітей. Мета дослідження: виявити частоту та особливості атипових форм гострої ЕБВІ в дітей. Матеріали та методи. Проаналізовано результати обстеження 28 дітей віком від 6 місяців до 18 років, які перенесли ЕБВІ та перебували під спостереженням у дитячій поліклініці. Визначали активність аланінамінотрансферази, аспартатамінотрансферази, лужної фосфатази, гаммаглутамілтранспептидази, рівень білірубіну, маркери вірусних гепатитів. Проводили ультразвукову діагностику, імуноферментний аналіз із визначенням у крові маркерів ЕБВ (IgM VCA, IgG EA, IgG VCA, ДНК-ЕБВ) методом полімеразної ланцюгової реакції. Дані оброблені методами статистичного аналізу з використанням прикладної програми Statistica 6. Результати. У 71,4 % випадків ЕБВІ перебігала в типовій формі із середнім ступенем тяжкості. Атиповий перебіг ЕБВІ спостерігався у 28,5 % випадків. Клінічно атипові форми розпочиналися переважно з ознак гострої респіраторної вірусної інфекції з наступним ураженням внутрішніх органів (печінки і серця), зокрема в дітей до 1 року, та змінами функціональних проб печінки. Висновки. Частота атипових форм гострої ЕБВІ становить 28,5 %. Атипові форми гострої ЕБВІ частіше трапляються в дітей грудного віку та підлітків і перебігають з ураженням внутрішніх органів (печінка та серце).

Association of molds and metrological parameters to frequency of severe asthma exacerbation

BackgroundSensitization to airborne molds may be a risk factor for severe asthma and direct cause of asthma exacerbation (AE).MethodsA prospective, 1-year (April 2016–March 2017) study, done in Kuwait Allergy Centre, investigated the link between AEs with exposure to outdoor molds and the role of meteorological parameters in mold sensitized patients and compared with non-allergic asthma patients who had asthma deterioration. The total of 676 adult asthmatics with moderate-severe AEs were included and divided into atopic (85.65%) and non-atopic group. Atopy was defined by positive skin prick test (SPT) to at least one inhalant allergen. Data regarding atopy and asthma severity were collected from patient’s records. Patients with symptoms and signs of acute respiratory infection and patient sensitized to indoor allergens only were excluded. Daily count of local pollens (Salsola kali, Bermuda grass) and molds (Aspergillus, Alternaria and Cladosporium) were obtained from the Aerobiology department. Daily metrological parameters (atmospheric pressure-AP, temperature-T and relative humidity-RH) were provided by Kuwait Environment Public Authority. Count of spores/m3 and weather variable are shown on weekly basis. The year circle was divided into 4 Seasons (1, 2, 3, 4) accordingly to typical desert climate.ResultsSensitization to molds was relatively high but significantly less (25.0%) if compared to the pollens sensitization. The highest number of AEs was in season 4 for both molds and pollens sensitized patients. Seasonal patterns for both allergens were significant and positively correlated with RH and AP. In season 1 only, mold sensitized patients showed higher rate of AEs. Non-atopic patients have been less sensitive to increased RH than atopic. Negative correlation with T was similar in both atopic and non-atopic patients.ConclusionDespite of high rate of sensitization to molds, their significant role in triggering AE was not found in desert environment. Typical desert climate and high allergencity of local weeds outweigh the influence of the molds.

SEASONAL FEATURES OF THE MICROBIAL LANDSCAPE OF PALATINE TONSILS IN HEALTHY STUDENTS

Aim.To find out microbial landscape characteristics of the palatine tonsils in healthy students, depending on the season. Materials and methods. It were examined 40 students without any oropharyngeal pathology aged 17-30 (23 ± 3.5). There were no signs of chronic tonsillitis at pha-ryngoscopy, no signs of acute respiratory infection; they did not take antibiotics for one last month prior to the study and had no tonsilitis for the last 5 years. Examination was made three times, once in a season: autumn from October 16 till November 2; winter from January 27 till March 6 ; spring from April 2 till April 19. Results. The normal microlandscape in healthy individuals aged 17-30 years permanently had Streptococcus viridans, Streptococcus pyogenes, Staphylococcus aureus, Staphylococcus epidermidis, Candida albicans, Neisseria, Micrococcus, Bacillus, and Pseudomonas aeruginosa. Presence of S. pyogenes andP. aeruginosa in the structure of microlandscape of the palatine tonsils did not cause any clinical symptoms in their carriers. We also revealed a seasonal dynamics expressed by the frequency of the increase of conditionally pathogenic flora on palatine tonsils in spring and the decrease in all microorganisms growth in winter.

INDUCTION OF EFFECTORS OF INNATE AND ADAPTIVE IMMUNITY IN THE PROCESS OF THERAPY OF TOPIC FORM OF RECOMBINANT INTERFERON-a2b DURING RESPIRATORY INFECTIONS IN PREGNANT

Study immunologic phenotype of lymphocytes in the process of therapy of topic form of recombinant interferon-α2b during respiratory infections in pregnant. 74 pregnant women from 14 weeks of gestation took part in the study, among them 55 - within 24 hours with symptoms of acute respiratory infection (ARI) of light and me- dium, severe course of infection, who do not need hospitalization. Group I - 34 pregnant womenwithARI receivingbasic therapywith human recombinant interferon-(α2b in gelform. Group II - 21 pregnant with ARI receiving only basic therapy. Control group had 19 pregnant women without signs of ARI. Relative content of principle lymphocyte subpopulations was studied by flow cytofluorimetry: CD3+, CD3+CD4+, CD3+CD8+, CD3-CD19+, CD3- CD16+56+, CD3-CD8+; immune regulatory indexwas calculated inblood within 24 hours from the onset of the disease and 8 - 10 days later. A disbalance of lymphocyte sub- populations was noted in pregnant women with light or medium severity course of acute respiratory infections, that was characterized by an increased content of CD3-CD16+56+ and CD3+CD8+, as well as a reduced content of CD3+ and CD3+CD8+. Inclusion of a topical form of recombinant interferon-α2b during the first days of development ofthe disease has a systemic effect on cell immunity and results in normalization of subpopulation compo- sition of blood lymphocytes that is characteristic for physiological course of pregnancy. Administration of topic form of recombinant interferon in pregnant with light or medium severity of ARI can be accompanied by activation of factors of innate and adaptive immunity.

Mapping the awareness levels of mothers about the danger signs of acute respiratory infections in children of the Southern States of India, its relation with treatment seeking behaviour

Mapping the awareness levels of mothers about the danger signs of acute respiratory infections in children of the Southern States of India, its relation with treatment seeking behaviour

Impact of Locally-Produced, Ceramic Cookstoves on Respiratory Disease in Children in Rural Western Kenya

Household air pollution is a risk factor for pneumonia, the leading cause of death among children < 5 years of age. From 2008 to 2010, a Kenyan organization sold ≈ 2,500 ceramic cookstoves (upesi jiko) that produce less visible household smoke than 3-stone firepits. During a year-long observational study, we made 25 biweekly visits to 200 homes to determine stove use and observe signs of acute respiratory infection in children < 3 years of age. Reported stove use included 3-stone firepit only (81.8%), upesi jiko only (15.7%), and both (2.3%). Lower, but not statistically significant, percentages of children in upesi jiko-using households than 3-stone firepit-using households had observed cough (1.3% versus 2.9%, rate ratio [RR] 0.48, 95% confidence interval [CI]: 0.22-1.03), pneumonia (0.9% versus 1.7%, RR 0.60, 95% CI: 0.24-1.48), and severe pneumonia (0.3% versus 0.6%, RR 0.66, 95% CI: 0.17-2.62). Upesi jiko use did not result in significantly lower pneumonia rates. Further research on the health impact of improved cookstoves is warranted.

Molecular epidemiology of human rhinovirus infections in Kilifi, coastal Kenya.

This study reports pediatric surveillance over 3 years for human rhinovirus (HRV) at the District Hospital of Kilifi, coastal Kenya. Nasopharyngeal samples were collected from children presenting at outpatient clinic with no signs of acute respiratory infection, or with signs of upper respiratory tract infection, and from children admitted to the hospital with lower respiratory tract infection. Samples were screened by real-time reverse transcriptase polymerase chain reaction (real-time RT-PCR) and classified further to species by nucleotide sequencing of the VP4/VP2 junction. Of 441 HRV positives by real-time RT-PCR, 332 were classified to species, with 47% (155) being HRV-A, 5% (18) HRV-B, and 48% (159) HRV-C. There was no clear seasonal pattern of occurrence for any species. The species were present in similar proportions in the inpatient and outpatient sample sets, and no significant association between species distribution and the severity of lower respiratory tract infection in the inpatients could be determined. HRV sequence analysis revealed multiple but separate clusters in circulation particularly for HRV-A and HRV-C. Most HRV-C clusters were distinct from reference sequences downloaded from GenBank. In contrast, most HRV-A and HRV-B sequences clustered with either known serotypes or strains from elsewhere within Africa and other regions of the world. This first molecular epidemiological study of HRV in the region defines species distribution in accord with reports from elsewhere in the world, shows considerable strain diversity and does not identify an association between any species and disease severity.

Prevalence of Human Bocavirus in Human Tonsils and Adenoids

Prevalence of Human Bocavirus in Human Tonsils and Adenoids

Respiratory disease caused by a species B2Adenovirus in a military camp in Turkey

In April 2004, two patients were admitted to hospital in Berlin, Germany, with clinical signs of acute respiratory infection after returning from a military exercise in their home country of Turkey. They were admitted to a high security infectious disease unit as epidemiological data pointed to an outbreak of unknown etiology. Samples taken at the time of admission proved to be strongly positive for Adenovirus by PCR, but negative for Influenza A/H1N1 virus, Influenza A/H3N2 virus, Influenza B virus, Respiratory syncytial virus, and SARS coronavirus. No evidence for bacterial infection was obtained by serological tests and blood cultures. The adenovirus detected was characterized further by genotyping and was identified as a species B2 virus with the highest similarity to adenovirus type 11a. J. Med. Virol. 77:232–237, 2005. © 2005 Wiley‐Liss, Inc.

The molecular biologist against infectious disease: Infectious diseases, in both the developing and the developed world, still pose considerable challenges to biomedical research. But science alone is clearly not sufficient to overcome the burden of disease in the world

The molecular biologist against infectious disease: Infectious diseases, in both the developing and the developed world, still pose considerable challenges to biomedical research. But science alone is clearly not sufficient to overcome the burden of disease in the world

Viruses and bacteria in bronchial samples from patients with primary hypogammaglobulinemia.

Viruses and bacteria in bronchoalveolar lavage fluids, protected specimen brush samples, and bronchial biopsies from 14 patients with primary hypogammaglobulinemia (11 patients with common variable immunodeficiency [CVID] and three patients with X-linked agammaglobulinemia [XLA]) were analyzed. At the time of the study, the patients had no signs of acute respiratory infections, and no antibiotics were administered. In addition to routine bacterial and viral cultures, polymerase chain reaction tests were used for the detection of adenovirus, cytomegalovirus (CMV), herpes simplex virus 1, enterovirus, rhinovirus, Borrelia burgdorferi, Chlamydia pneumoniae, Legionella spp., Mycoplasma pneumoniae, Pneumocystis carinii, and Ureaplasma urealyticum. Viruses (four adenoviruses, one CMV, and one rhinovirus) were detected in four of the 11 (36%) CVID patients. No viruses were found in the three patients with XLA or in 13 control patients. Bacteria from the lower respiratory tract were detected in nine of the 14 (64%) patients with hypogammaglobulinemia and three of the 13 (23%) control patients. Haemophilus influenzae was the most prevalent bacterium (43%) in the hypogammaglobulinemia patients. The study shows that patients with CVID harbor viral and bacterial infections in the lower respiratory tract, which may predispose to the development of changes in the respiratory tract.

About olfactory dysfunction in patients with neurotic disorders

In a specialized department of neuroses, the olfactory function was studied in 74 persons (68 women and 6 men from 21 to 63 years old) without a runny nose and other signs of acute respiratory infections. The control group consisted of 30 relatively healthy people. Attention was paid to anamnestic information about the originality of smell (dysesthesia, hyper- or hyposmia). A clinical experiment was conducted to recognize the smell of cologne, perfumes, deodorants and food products, taking into account the time and accuracy of the determination.