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Ojha T, Patel A, Sivapragasam K, Sharma R, Vosoughi T, Skidmore B, Pinto AD, Hosseini B. Exploring Machine Learning Applications in Pediatric Asthma Management: Scoping Review. JMIR AI 2024; 3:e57983. [PMID: 39190449 DOI: 10.2196/57983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 05/27/2024] [Accepted: 06/13/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND The integration of machine learning (ML) in predicting asthma-related outcomes in children presents a novel approach in pediatric health care. OBJECTIVE This scoping review aims to analyze studies published since 2019, focusing on ML algorithms, their applications, and predictive performances. METHODS We searched Ovid MEDLINE ALL and Embase on Ovid, the Cochrane Library (Wiley), CINAHL (EBSCO), and Web of Science (core collection). The search covered the period from January 1, 2019, to July 18, 2023. Studies applying ML models in predicting asthma-related outcomes in children aged <18 years were included. Covidence was used for citation management, and the risk of bias was assessed using the Prediction Model Risk of Bias Assessment Tool. RESULTS From 1231 initial articles, 15 met our inclusion criteria. The sample size ranged from 74 to 87,413 patients. Most studies used multiple ML techniques, with logistic regression (n=7, 47%) and random forests (n=6, 40%) being the most common. Key outcomes included predicting asthma exacerbations, classifying asthma phenotypes, predicting asthma diagnoses, and identifying potential risk factors. For predicting exacerbations, recurrent neural networks and XGBoost showed high performance, with XGBoost achieving an area under the receiver operating characteristic curve (AUROC) of 0.76. In classifying asthma phenotypes, support vector machines were highly effective, achieving an AUROC of 0.79. For diagnosis prediction, artificial neural networks outperformed logistic regression, with an AUROC of 0.63. To identify risk factors focused on symptom severity and lung function, random forests achieved an AUROC of 0.88. Sound-based studies distinguished wheezing from nonwheezing and asthmatic from normal coughs. The risk of bias assessment revealed that most studies (n=8, 53%) exhibited low to moderate risk, ensuring a reasonable level of confidence in the findings. Common limitations across studies included data quality issues, sample size constraints, and interpretability concerns. CONCLUSIONS This review highlights the diverse application of ML in predicting pediatric asthma outcomes, with each model offering unique strengths and challenges. Future research should address data quality, increase sample sizes, and enhance model interpretability to optimize ML utility in clinical settings for pediatric asthma management.
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Affiliation(s)
- Tanvi Ojha
- Upstream Lab, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Atushi Patel
- Upstream Lab, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Krishihan Sivapragasam
- Upstream Lab, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Radha Sharma
- Upstream Lab, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Tina Vosoughi
- Upstream Lab, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | | | - Andrew D Pinto
- Upstream Lab, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
- Department of Family and Community Medicine, St. Michael's Hospital, Toronto, ON, Canada
- Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Division of Clinical Public Health & Institute for Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Banafshe Hosseini
- Upstream Lab, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
- Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Division of Clinical Public Health & Institute for Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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Asharam K, Mitku AAA, Ramsay L, Jeena PM, Naidoo RN. Environmental exposures associated with early childhood recurrent wheezing in the mother and child in the environment birth cohort: a time-to-event study. Thorax 2024:thorax-2023-221150. [PMID: 38964859 DOI: 10.1136/thorax-2023-221150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 05/29/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND Antenatal factors and environmental exposures contribute to recurrent wheezing in early childhood. AIM To identify antenatal and environmental factors associated with recurrent wheezing in children from birth to 48 months in the mother and child in the environment cohort, using time-to-event analysis. METHOD Maternal interviews were administered during pregnancy and postnatally and children were followed up from birth to 48 months (May 2013-October 2019). Hybrid land-use regression and dispersion modelling described residential antenatal exposure to nitrogen dioxide (NO2) and particulate matter of 2.5 µm diameter (PM2.5). Wheezing status was assessed by a clinician. The Kaplan-Meier hazard function and Cox-proportional hazard models provided estimates of risk, adjusting for exposure to environmental tobacco smoke (ETS), maternal smoking, biomass fuel use and indoor environmental factors. RESULTS Among 520 mother-child pairs, 85 (16%) children, had a single wheeze episode and 57 (11%) had recurrent wheeze. Time to recurrent wheeze (42.9 months) and single wheeze (37.8 months) among children exposed to biomass cooking fuels was significantly shorter compared with children with mothers using electricity (45.9 and 38.9 months, respectively (p=0.03)). Children with mothers exposed to antenatal ETS were 3.8 times more likely to have had recurrent wheeze compared with those not exposed (adjusted HR 3.8, 95% CI 1.3 to 10.7). Mean birth month NO2 was significantly higher among the recurrent wheeze category compared with those without wheeze. NO2 and PM2.5 were associated with a 2%-4% adjusted increased wheezing risk. CONCLUSION Control of exposure to ETS and biomass fuels in the antenatal period is likely to delay the onset of recurrent wheeze in children from birth to 48 months.
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Affiliation(s)
- Kareshma Asharam
- Discipline of Occupational and Environmental Health, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Aweke A Abebaw Mitku
- Discipline of Occupational and Environmental Health, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
- Department of Statistics, College of Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Lisa Ramsay
- Discipline of Occupational and Environmental Health, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Prakash Mohan Jeena
- Discipline of Paediatric and Child Health, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Rajen N Naidoo
- Discipline of Occupational and Environmental Health, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Haji T, Lyzwinski L, Dhaliwal C, Leung G, Giangioppo S, Radhakrishnan D. A real-world evaluation of the effectiveness and Sufficiency of Current Emergency Department Preventative Strategies for Reducing Emergency Department revisits in a Canadian children's hospital: a retrospective cohort study. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2024; 20:37. [PMID: 38918807 PMCID: PMC11197375 DOI: 10.1186/s13223-024-00900-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 05/21/2024] [Indexed: 06/27/2024]
Abstract
BACKGROUND Despite asthma guidelines' recommended emergency department preventative strategies (EDPS), repeat asthma-related emergency department (ED) visits remain frequent. METHODS We performed a retrospective cohort study of children aged 1-17 years presenting with asthma to the Children's Hospital of Eastern Ontario (CHEO) ED between September 1, 2014 - August 31, 2015. EDPS was defined as provision of education on trigger avoidance and medication technique plus documentation of an asthma action plan, a prescription for an inhaled controller medication or referral to a specialist. Logistic regression was used to identify factors associated with receipt of EDPS. We further compared the odds of repeat presentation to the ED within the following year among children who had received EDPS versus those who had not. RESULTS 1301 patients were included, and the mean age of those who received EDPS was 5.0 years (SD = 3.7). Those with a moderate (OR = 3.67, 95% CI: 2.49, 5.52) to severe (OR = 3.69, 95% CI: 2.50, 5.45) asthma presentation were most likely to receive EDPS. Receiving EDPS did not significantly reduce the adjusted odds of repeat ED visits, (OR = 0.82, 95% CI: 0.56, 1.18, p = 0.28). CONCLUSIONS Patients with higher severity asthma presentations to the ED were more likely to receive EDPS, but this did not appear to significantly decrease the proportion with a repeat asthma ED visit. These findings suggest that receipt of EDPS in the ED may not be sufficient to prevent repeat asthma ED visits in all children.
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Affiliation(s)
- Tahereh Haji
- Children's Hospital of Eastern Ontario, Ontario, Canada
| | | | - Cara Dhaliwal
- Children's Hospital of Eastern Ontario, Ontario, Canada
| | - Garvin Leung
- Children's Hospital of Eastern Ontario, Ontario, Canada
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Bareille P, Forth R, Imber V, Bondarenko I, Michaud A, Majorek-Olechowska B. Once-daily fluticasone furoate/vilanterol vs once-daily fluticasone furoate in patients with asthma aged 5 to 17 years. Ann Allergy Asthma Immunol 2024:S1081-1206(24)00376-4. [PMID: 38936466 DOI: 10.1016/j.anai.2024.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 06/19/2024] [Accepted: 06/19/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND Limited data exist comparing inhaled corticosteroid (ICS) plus adjunctive therapy vs ICS alone in pediatric asthma patients. OBJECTIVE To evaluate the efficacy and safety of fluticasone furoate/vilanterol (FF/VI) vs FF in children and adolescents with asthma. METHODS This phase 3, randomized, double-blind, multicenter study (NCT03248128) included participants aged 5 to 17 years with six months or more asthma history uncontrolled on ICS monotherapy. Participants received 4-week open-label fluticasone propionate (100 µg) twice daily before 1:1 randomization to 24-week double-blind FF (50 µg:100 µg) or FF/VI (50/25 µg:100/25 µg) once daily. Two populations with different primary endpoints were analyzed to meet United States (week 12 weighted mean forced expiratory volume in 1 second [FEV1; 0-4 hours]; participants aged 5-17 years) and European (change from baseline predose morning peak expiratory flow [ΔAM PEF] averaged over weeks 1-12; participants aged 5-11 years) regulatory requirements. RESULTS Overall, 902 participants, including 673 children aged 5 to 11 years, were randomized and treated. In participants aged 5 to 17, week 12 weighted mean FEV1 (0-4 hours) was greater with FF/VI vs FF (difference: 0.083 L; P < .001). In participants aged 5 to 11, ΔAM PEF over weeks 1 to 12 showed numerical improvement with FF/VI vs FF but was not statistically significant (difference: 3.2 L/min; P = .228). No drug-related serious adverse events or deaths were reported. CONCLUSION FF/VI significantly improved weighted mean FEV1 (0-4 hours; participants aged 5-17 years), but not ΔAM PEF (participants aged 5-11 years) vs FF. No new safety concerns were apparent. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03248128.
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Affiliation(s)
- Philippe Bareille
- Respiratory Medicines Discovery & Development, GSK, Stevenage, United Kingdom.
| | | | - Varsha Imber
- Clinical Sciences Respiratory, Research & Development, GSK, Brentford, London, United Kingdom
| | | | - Arthur Michaud
- Clinical Operations, GSK, Brentford, London, United Kingdom
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Zhu Y, Choi D, Somanath PR, Zhang D. Lipid-Laden Macrophages in Pulmonary Diseases. Cells 2024; 13:889. [PMID: 38891022 PMCID: PMC11171561 DOI: 10.3390/cells13110889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 05/17/2024] [Accepted: 05/21/2024] [Indexed: 06/20/2024] Open
Abstract
Pulmonary surfactants play a crucial role in managing lung lipid metabolism, and dysregulation of this process is evident in various lung diseases. Alternations in lipid metabolism lead to pulmonary surfactant damage, resulting in hyperlipidemia in response to lung injury. Lung macrophages are responsible for recycling damaged lipid droplets to maintain lipid homeostasis. The inflammatory response triggered by external stimuli such as cigarette smoke, bleomycin, and bacteria can interfere with this process, resulting in the formation of lipid-laden macrophages (LLMs), also known as foamy macrophages. Recent studies have highlighted the potential significance of LLM formation in a range of pulmonary diseases. Furthermore, growing evidence suggests that LLMs are present in patients suffering from various pulmonary conditions. In this review, we summarize the essential metabolic and signaling pathways driving the LLM formation in chronic obstructive pulmonary disease, pulmonary fibrosis, tuberculosis, and acute lung injury.
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Affiliation(s)
- Yin Zhu
- Clinical and Experimental Therapeutics, College of Pharmacy, University of Georgia, Augusta, GA 30912, USA (D.C.)
- Charlie Norwood VA Medical Center, Augusta, GA 30912, USA
| | - Dooyoung Choi
- Clinical and Experimental Therapeutics, College of Pharmacy, University of Georgia, Augusta, GA 30912, USA (D.C.)
| | - Payaningal R. Somanath
- Clinical and Experimental Therapeutics, College of Pharmacy, University of Georgia, Augusta, GA 30912, USA (D.C.)
- Charlie Norwood VA Medical Center, Augusta, GA 30912, USA
- Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Duo Zhang
- Clinical and Experimental Therapeutics, College of Pharmacy, University of Georgia, Augusta, GA 30912, USA (D.C.)
- Charlie Norwood VA Medical Center, Augusta, GA 30912, USA
- Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
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Tian F, Zhong X, Ye Y, Liu X, He G, Wu C, Chen Z, Zhu Q, Yu S, Fan J, Yao H, Ma W, Dong X, Liu T. Mutual Associations of Exposure to Ambient Air Pollutants in the First 1000 Days of Life With Asthma/Wheezing in Children: Prospective Cohort Study in Guangzhou, China. JMIR Public Health Surveill 2024; 10:e52456. [PMID: 38631029 PMCID: PMC11063886 DOI: 10.2196/52456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 12/21/2023] [Accepted: 03/05/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND The first 1000 days of life, encompassing pregnancy and the first 2 years after birth, represent a critical period for human health development. Despite this significance, there has been limited research into the associations between mixed exposure to air pollutants during this period and the development of asthma/wheezing in children. Furthermore, the finer sensitivity window of exposure during this crucial developmental phase remains unclear. OBJECTIVE This study aims to assess the relationships between prenatal and postnatal exposures to various ambient air pollutants (particulate matter 2.5 [PM2.5], carbon monoxide [CO], sulfur dioxide [SO2], nitrogen dioxide [NO2], and ozone [O3]) and the incidence of childhood asthma/wheezing. In addition, we aimed to pinpoint the potential sensitivity window during which air pollution exerts its effects. METHODS We conducted a prospective birth cohort study wherein pregnant women were recruited during early pregnancy and followed up along with their children. Information regarding maternal and child characteristics was collected through questionnaires during each round of investigation. Diagnosis of asthma/wheezing was obtained from children's medical records. In addition, maternal and child exposures to air pollutants (PM2.5 CO, SO2, NO2, and O3) were evaluated using a spatiotemporal land use regression model. To estimate the mutual associations of exposure to mixed air pollutants with the risk of asthma/wheezing in children, we used the quantile g-computation model. RESULTS In our study cohort of 3725 children, 392 (10.52%) were diagnosed with asthma/wheezing. After the follow-up period, the mean age of the children was 3.2 (SD 0.8) years, and a total of 14,982 person-years were successfully followed up for all study participants. We found that each quartile increase in exposure to mixed air pollutants (PM2.5, CO, SO2, NO2, and O3) during the second trimester of pregnancy was associated with an adjusted hazard ratio (HR) of 1.24 (95% CI 1.04-1.47). Notably, CO made the largest positive contribution (64.28%) to the mutual effect. After categorizing the exposure according to the embryonic respiratory development stages, we observed that each additional quartile of mixed exposure to air pollutants during the pseudoglandular and canalicular stages was associated with HRs of 1.24 (95% CI 1.03-1.51) and 1.23 (95% CI 1.01-1.51), respectively. Moreover, for the first year and first 2 years after birth, each quartile increment of exposure to mixed air pollutants was associated with HRs of 1.65 (95% CI 1.30-2.10) and 2.53 (95% CI 2.16-2.97), respectively. Notably, SO2 made the largest positive contribution in both phases, accounting for 50.30% and 74.70% of the association, respectively. CONCLUSIONS Exposure to elevated levels of mixed air pollutants during the first 1000 days of life appears to elevate the risk of childhood asthma/wheezing. Specifically, the second trimester, especially during the pseudoglandular and canalicular stages, and the initial 2 years after birth emerge as crucial susceptibility windows. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR-ROC-17013496; https://tinyurl.com/2ctufw8n.
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Affiliation(s)
- Fenglin Tian
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, China
| | - Xinqi Zhong
- Department of Neonatology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yufeng Ye
- Guangzhou Panyu Central Hospital, Guangzhou, China
| | - Xiaohan Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, China
| | - Guanhao He
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, China
| | - Cuiling Wu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, China
| | - Zhiqing Chen
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, China
| | - Qijiong Zhu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, China
| | - Siwen Yu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, China
| | - Jingjie Fan
- Department of Prevention and Health Care, Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Huan Yao
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, China
| | - Wenjun Ma
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, China
| | - Xiaomei Dong
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, China
| | - Tao Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou, China
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Özde Ş, Kayapınar O, Doğru M, Aktüre G, Kaya A, Coşkun G, Keskin M, Özde C. Evaluation of the Early Effects of Childhood Asthma and Its Treatment on Cardiac Function as Revealed by Two-Dimensional Speckle-Tracking Echocardiography. Pediatr Cardiol 2024; 45:858-866. [PMID: 36038783 DOI: 10.1007/s00246-022-02941-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 05/16/2022] [Indexed: 11/24/2022]
Abstract
There is minimal information available regarding the early effects of bronchial asthma (BA) and its treatment on cardiac function in children. We used two-dimensional speckle-tracking echocardiography (2D-STE) to evaluate cardiac function before and after the treatment of childhood BA. We enrolled 44 children with moderate and severe BA who had not been treated over the preceding 3 months or who were newly diagnosed. All children received the same treatment (that recommended by the Global Initiative for Asthma [GINA] in 2017). All children also underwent transthoracic 2D-STE before treatment and 6 months later. Clinical data were compared before and after treatment. After treatment, significant increases were evident in right ventricular (RV) systolic and diastolic strain, as well as the systolic strain rate. Before and after treatment, the RV global longitudinal systolic strains were - 22.8 ± 3.6 and - 25.1 ± 4.5, respectively (p = 0.036); the RV global longitudinal diastolic strains were - 18.5 ± 6.0 and - 21.5 ± 5.2, respectively (p = 0.038); and the RV systolic strain rates were - 1.26 ± 0.4 and - 1.12 ± 0.3, respectively (p = 0.025). After treatment, significant increases were observed in the right atrial (RA) peak longitudinal strain and strain rate. Before and after treatment, the RA peak atrial longitudinal strains were 32.5 ± 10.8 and 44.7 ± 11.2, respectively (p = 0.042) and the RA longitudinal strain rates were - 1.6 ± 0.3 and - 2.0 ± 0.5, respectively (p = 0.041). RV and RA subclinical dysfunction may develop in children with early-stage BA. However, asthma treatment appears to improve such dysfunction. In children with BA, clinical and subclinical changes in cardiac functions can be easily detected via 2D-STE.
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Affiliation(s)
| | | | | | | | - Adnan Kaya
- Duzce Universitesi Tip Fakultesi, Duzce, Turkey
| | | | | | - Cem Özde
- Duzce Universitesi Tip Fakultesi, Duzce, Turkey
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Furukawa LH, Garcia LDCE, Pieta MP, Castro MÂD, Pinto LA, Pitrez PM. Diagnosis and treatment of asthma in childhood: an overview of guidelines. J Bras Pneumol 2024; 50:e20240051. [PMID: 38536970 PMCID: PMC11095921 DOI: 10.36416/1806-3756/e20240051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024] Open
Affiliation(s)
- Laissa Harumi Furukawa
- . Grupo de Pesquisa em Epidemiologia e Genética das Doenças Respiratórias da Infância, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil
| | - Laura de Castro E Garcia
- . Grupo de Pesquisa em Epidemiologia e Genética das Doenças Respiratórias da Infância, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil
| | - Marina Puerari Pieta
- . Grupo de Pesquisa em Epidemiologia e Genética das Doenças Respiratórias da Infância, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil
| | - Miguel Ângelo de Castro
- . Grupo de Pesquisa em Epidemiologia e Genética das Doenças Respiratórias da Infância, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil
| | - Leonardo Araújo Pinto
- . Grupo de Pesquisa em Epidemiologia e Genética das Doenças Respiratórias da Infância, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil
- . Programa de Pós-Graduação em Medicina: Pediatria, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil
| | - Paulo M Pitrez
- . Pavilhão Pereira Filho, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre (RS) Brasil
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Le HHTC, Ngo HKT, Hieu LS, Sly PD, Phung D, Le An P, Vinh NN, Dang TN, Thuong DTH, Thanh HN, Thai PK. Indoor air pollution is associated with respiratory symptoms in children in urban Vietnam. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 917:170556. [PMID: 38296088 DOI: 10.1016/j.scitotenv.2024.170556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/07/2024] [Accepted: 01/27/2024] [Indexed: 02/05/2024]
Abstract
Exposure to indoor air pollution (IAP) is a leading environmental risk for respiratory diseases. We investigated the relationship between respiratory symptoms and polluting indoor activities such as smoking, cooking and contact with pets among children in Ho Chi Minh City (HCMC), Vietnam. A cross-sectional survey applied a multistage sampling method in 24 randomly selected secondary schools across the city. Approximately 15,000 students completed self-administrated questionnaires on risk factors and respiratory health outcomes within the preceding 12 months. Data were analyzed using a multivariable logistic regression model with robust standard errors. Wheeze was the most common respiratory symptom (39.5 %) reported, followed by sneezing and runny nose (28.3 %). A small percentage of students self-reported asthma (8.6 %). Approximately 56 % of participants lived with family members who smoked. A positive association between exposure to indoor secondhand smoke and respiratory symptoms was observed, with adjusted odds ratios (aOR) of 1.41 (95 % CI: 1.25-1.60, p < 0.001) for wheezing and 1.64 (95 % CI: 1.43-1.87, p < 0.001) for sneezing and runny nose, respectively. Using an open stove fuelled by coal, wood, or kerosene for cooking was associated with wheeze (aOR: 1.36, CI 95 %: 1.10-1.68, p = 0.01) and sneezing and runny nose (aOR: 1.36, CI 95 %: 1.09-1.69, p = 0.01). In the present study, IAP was associated with adverse health outcomes, as evidenced by an increase in respiratory symptoms reported within the previous 12 months.
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Affiliation(s)
- Hong H T C Le
- Children's Health and Environment Program, Child Health Research Centre, The University of Queensland, Australia
| | - Hieu K T Ngo
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Viet Nam
| | - Le Sy Hieu
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Viet Nam
| | - Peter D Sly
- Children's Health and Environment Program, Child Health Research Centre, The University of Queensland, Australia
| | - Dung Phung
- School of Public Health, The University of Queensland, Australia
| | - Pham Le An
- Centre for the Training of Family Medicine, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam; Science and Technology Department, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam.
| | - Nguyen Nhu Vinh
- Centre for the Training of Family Medicine, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam
| | - Tran Ngoc Dang
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Viet Nam
| | - Do Thi Hoai Thuong
- Science and Technology Department, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam
| | - Huynh Ngoc Thanh
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Viet Nam
| | - Phong K Thai
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, Australia
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Huang Y, Chang Z, Gao Y, Ren C, Lin Y, Zhang X, Wu C, Pan X, Huang Z. Overcoming the Low-Stability Bottleneck in the Clinical Translation of Liposomal Pressurized Metered-Dose Inhalers: A Shell Stabilization Strategy Inspired by Biomineralization. Int J Mol Sci 2024; 25:3261. [PMID: 38542235 PMCID: PMC10970625 DOI: 10.3390/ijms25063261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/07/2024] [Accepted: 03/08/2024] [Indexed: 06/25/2024] Open
Abstract
Currently, several types of inhalable liposomes have been developed. Among them, liposomal pressurized metered-dose inhalers (pMDIs) have gained much attention due to their cost-effectiveness, patient compliance, and accurate dosages. However, the clinical application of liposomal pMDIs has been hindered by the low stability, i.e., the tendency of the aggregation of the liposome lipid bilayer in hydrophobic propellant medium and brittleness under high mechanical forces. Biomineralization is an evolutionary mechanism that organisms use to resist harsh external environments in nature, providing mechanical support and protection effects. Inspired by such a concept, this paper proposes a shell stabilization strategy (SSS) to solve the problem of the low stability of liposomal pMDIs. Depending on the shell material used, the SSS can be classified into biomineralization (biomineralized using calcium, silicon, manganese, titanium, gadolinium, etc.) biomineralization-like (composite with protein), and layer-by-layer (LbL) assembly (multiple shells structured with diverse materials). This work evaluated the potential of this strategy by reviewing studies on the formation of shells deposited on liposomes or similar structures. It also covered useful synthesis strategies and active molecules/functional groups for modification. We aimed to put forward new insights to promote the stability of liposomal pMDIs and shed some light on the clinical translation of relevant products.
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Affiliation(s)
- Yeqi Huang
- College of Pharmacy, Jinan University, Guangzhou 511443, China; (Y.H.); (Y.G.); (C.R.); (Y.L.); (C.W.)
| | - Ziyao Chang
- School of Pharmaceutical Sciences, Sun Yat-Sen University, Guangzhou 510006, China; (Z.C.); (X.P.)
| | - Yue Gao
- College of Pharmacy, Jinan University, Guangzhou 511443, China; (Y.H.); (Y.G.); (C.R.); (Y.L.); (C.W.)
| | - Chuanyu Ren
- College of Pharmacy, Jinan University, Guangzhou 511443, China; (Y.H.); (Y.G.); (C.R.); (Y.L.); (C.W.)
| | - Yuxin Lin
- College of Pharmacy, Jinan University, Guangzhou 511443, China; (Y.H.); (Y.G.); (C.R.); (Y.L.); (C.W.)
| | - Xuejuan Zhang
- College of Pharmacy, Jinan University, Guangzhou 511443, China; (Y.H.); (Y.G.); (C.R.); (Y.L.); (C.W.)
| | - Chuanbin Wu
- College of Pharmacy, Jinan University, Guangzhou 511443, China; (Y.H.); (Y.G.); (C.R.); (Y.L.); (C.W.)
| | - Xin Pan
- School of Pharmaceutical Sciences, Sun Yat-Sen University, Guangzhou 510006, China; (Z.C.); (X.P.)
| | - Zhengwei Huang
- College of Pharmacy, Jinan University, Guangzhou 511443, China; (Y.H.); (Y.G.); (C.R.); (Y.L.); (C.W.)
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11
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Boonjindasup W, Marchant JM, McElrea MS, Yerkovich ST, Newcombe PA, Chang AB. Clinical determinants for State-Trait Anxiety Inventory of the parents of children with respiratory problems. Pediatr Pulmonol 2024; 59:31-40. [PMID: 37750592 PMCID: PMC10952396 DOI: 10.1002/ppul.26702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 09/14/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUNDS Understanding factors associated with anxiety of parents/carers of children with respiratory problems is clinically important yet there is relative paucity of data. In 106 children seen in the respiratory clinic of a pediatric hospital, we evaluated (a) the determinants for parental anxiety and (b) whether the anxiety scores correlate with quality-of-life (QoL) scores in the subset with chronic cough. METHODS We opportunistically re-analyzed data of our main study that examined the benefits of using spirometry for pediatric respiratory consultation where parents completed an anxiety questionnaire (State-Trait Anxiety Inventory, STAI) pre- and postconsultation. A subset (children with chronic cough) also completed the parent-proxy quality-of-life (PC-QoL) tool. We computed the association between clinical characteristics and anxiety scores using multivariable regression and between the two patient-reported outcome measures using Spearman's correlation. RESULTS The majority of parents/carers were women (n = 89, 84%). Most children (mean age = 10.9 years, SD = 3.7 years) were previously seen at the clinic (n = 67, 63.2%). In multivariate regression, parental anxiety score was significantly associated with reported presence of cough [coefficient β = 17.31 (95% confidence interval 9.62, 25.1)] and lower forced expiratory volume in first second (FEV1 )/forced vital capacity (FVC) [-3.88 (-7.05, -0.71)] at preconsultation, but associated with cough only [coefficient β = 12.04 (5.24, 18.84)] at postconsultation, all p < .05. STAI strongly correlated with PC-QoL scores at pre- but only modestly at postconsultation (rs = -.63 and -.39, respectively, p < .05). CONCLUSION Parental anxiety levels of children attending respiratory clinics are influenced by the presence of cough and low FEV1 /FVC of their child and are associated with poorer QoL. These highlight the need for on-going research to reduce parental anxiety focusing on cough and lung function indices.
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Affiliation(s)
- Wicharn Boonjindasup
- Child Health Division, Menzies School of Health Research, NHMRC Centre for Research Excellence in Paediatric Bronchiectasis (AusBREATHE)Charles Darwin UniversityDarwinNorthern TerritoryAustralia
- Australian Centre for Health Services Innovation, Centre for Healthcare TransformationQueensland University of TechnologyBrisbaneQueenslandAustralia
- Department of Pediatrics, Faculty of MedicineChulalongkorn UniversityBangkokThailand
| | - Julie M. Marchant
- Australian Centre for Health Services Innovation, Centre for Healthcare TransformationQueensland University of TechnologyBrisbaneQueenslandAustralia
- Department of Respiratory & Sleep MedicineQueensland Children's HospitalBrisbaneQueenslandAustralia
| | - Margaret S. McElrea
- Australian Centre for Health Services Innovation, Centre for Healthcare TransformationQueensland University of TechnologyBrisbaneQueenslandAustralia
- Department of Respiratory & Sleep MedicineQueensland Children's HospitalBrisbaneQueenslandAustralia
| | - Stephanie T. Yerkovich
- Child Health Division, Menzies School of Health Research, NHMRC Centre for Research Excellence in Paediatric Bronchiectasis (AusBREATHE)Charles Darwin UniversityDarwinNorthern TerritoryAustralia
- Australian Centre for Health Services Innovation, Centre for Healthcare TransformationQueensland University of TechnologyBrisbaneQueenslandAustralia
| | - Peter A. Newcombe
- School of PsychologyUniversity of QueenslandBrisbaneQueenslandAustralia
| | - Anne B. Chang
- Child Health Division, Menzies School of Health Research, NHMRC Centre for Research Excellence in Paediatric Bronchiectasis (AusBREATHE)Charles Darwin UniversityDarwinNorthern TerritoryAustralia
- Australian Centre for Health Services Innovation, Centre for Healthcare TransformationQueensland University of TechnologyBrisbaneQueenslandAustralia
- Department of Respiratory & Sleep MedicineQueensland Children's HospitalBrisbaneQueenslandAustralia
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12
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Lyu X, Liu J, Liu Z, Wu Y, Zhu P, Liu C. Anti-inflammatory effects of reticuline on the JAK2/STAT3/SOCS3 and p38 MAPK/NF-κB signaling pathway in a mouse model of obesity-associated asthma. THE CLINICAL RESPIRATORY JOURNAL 2024; 18:e13729. [PMID: 38286741 PMCID: PMC10799233 DOI: 10.1111/crj.13729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 12/05/2023] [Accepted: 12/18/2023] [Indexed: 01/31/2024]
Abstract
BACKGROUND Asthma associated with obesity is a chronic disease characterized by earlier airway remodeling, severe wheezing, and increased insensitivity to hormone therapy. Reticuline, a bioactive compound of Magnoliae Flos, exerts anti-inflammatory activity and can inhibit neutrophil recruitment. Thus, this study investigated the role of reticuline in obesity-related asthma. METHODS The BALB/c mice fed a low-fat diet (LFD) and high-fat diet (HFD) were intranasally challenged with house dust mites (HDMs) or ovalbumin (OVA). Reticuline (0.25 mg/kg) was administrated into mice by intragastrical gavage. Airway hyper-responsiveness was examined after the final challenge. Body weight was measured, and bronchoalveolar lavage fluid (BALF) and lung tissues were collected. The number of inflammatory cells in BALF was estimated. Histological changes were assessed by performing hematoxylin-eosin staining, and production of proinflammatory cytokines and IgE was examined by ELISA kits. Related pathways were studied with western blotting. RESULTS Reticuline suppressed airway resistance and inflammatory infiltration in lung tissue and reduced inflammatory cell recruitment in BALF in obesity mice with asthma. Additionally, the levels of IL-17A, IL-1β, IL-5, macrophage inflammatory protein 2, and regulated on activation, normal T cell expressed and secreted in the lung were reduced by reticuline. Mechanistically, reticuline inactivated the JAK2/STAT3/SOCS3 and p38 MAPK/NF-κB signaling pathways in obesity-related asthma. CONCLUSION Reticuline alleviates airway inflammation in obesity-related asthma by inactivating the JAK2/STAT3/SOCS3 and p38 MAPK/NF-κB signaling pathways.
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Affiliation(s)
- Xiaojiang Lyu
- Department of PediatricsAffiliated Hospital of North Sichuan Medical CollegeNanchongChina
| | - Jiaojiao Liu
- Department of PediatricsAffiliated Hospital of North Sichuan Medical CollegeNanchongChina
| | - Zengrong Liu
- Department of PediatricsAffiliated Hospital of North Sichuan Medical CollegeNanchongChina
| | - Ying Wu
- Department of PediatricsAffiliated Hospital of North Sichuan Medical CollegeNanchongChina
| | - Ping Zhu
- Department of PediatricsAffiliated Hospital of North Sichuan Medical CollegeNanchongChina
| | - Chonghai Liu
- Department of PediatricsAffiliated Hospital of North Sichuan Medical CollegeNanchongChina
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13
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Zhou W, Yu L, Zhang M, Xiao W. A low power respiratory sound diagnosis processing unit based on LSTM for wearable health monitoring. BIOMED ENG-BIOMED TE 2023; 68:469-480. [PMID: 37080905 DOI: 10.1515/bmt-2022-0421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 04/05/2023] [Indexed: 04/22/2023]
Abstract
Early prevention and detection of respiratory disease have attracted extensive attention due to the significant increase in people with respiratory issues. Restraining the spread and relieving the symptom of this disease is essential. However, the traditional auscultation technique demands a high-level medical skill, and computational respiratory sound analysis approaches have limits in constrained locations. A wearable auscultation device is required to real-time monitor respiratory system health and provides consumers with ease. In this work, we developed a Respiratory Sound Diagnosis Processor Unit (RSDPU) based on Long Short-Term Memory (LSTM). The experiments and analyses were conducted on feature extraction and abnormality diagnosis algorithm of respiratory sound, and Dynamic Normalization Mapping (DNM) was proposed to better utilize quantization bits and lessen overfitting. Furthermore, we developed the hardware implementation of RSDPU including a corrector to filter diagnosis noise. We presented the FPGA prototyping verification and layout of the RSDPU for power and area evaluation. Experimental results demonstrated that RSDPU achieved an abnormality diagnosis accuracy of 81.4 %, an area of 1.57 × 1.76 mm under the SMIC 130 nm process, and power consumption of 381.8 μW, which met the requirements of high accuracy, low power consumption, and small area.
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Affiliation(s)
- Weixin Zhou
- Chinese Academy of Sciences, Institute of Semiconductors, Beijing, China
| | - Lina Yu
- Chinese Academy of Sciences, Institute of Semiconductors, Beijing, China
| | - Ming Zhang
- Chinese Academy of Sciences, Institute of Semiconductors, Beijing, China
| | - Wan'ang Xiao
- Chinese Academy of Sciences, Institute of Semiconductors, Beijing, China
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14
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Sapouna V, Dimitriadis Z, Douros K, Kapreli E, Kortianou EA. Technical Factors That May Influence mHealth Adherence in Children With Chronic Pulmonary Diseases: Scoping Review. Pediatr Phys Ther 2023; 35:468-477. [PMID: 37656982 DOI: 10.1097/pep.0000000000001039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/03/2023]
Abstract
PURPOSE To synthesize the technical factors influencing adherence to nonpharmacological treatment (NPhT) in children with chronic pulmonary diseases (CPDs), using mobile health (mHealth) technology. METHODS Five electronic databases were searched from inception to October 12, 2022, with terms related to pediatrics, CPDs, adherence, NPhT, and mHealth. The methodological quality was assessed using the Critical Appraisal Skills Programme and the Mixed Methods Appraisal Tool checklist. RESULTS Eleven articles were included. Six major technical themes were supported by the evidence that may influence adherence to NPhT: design and context, technical support/business model, connectivity, free availability, privacy and security, and cultural readiness. CONCLUSIONS The design of mHealth applications (apps) should be done according to the needs of pediatric patients. This may mitigate any barriers and potentially foster adherence to the use of the apps. WHAT THIS ADDS TO THE EVIDENCE Six major technical themes may influence adherence to NPhT in children with chronic respiratory diseases.Video Abstract: Supplemental digital content available at http://links.lww.com/PPT/A487 .
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Affiliation(s)
- Vaia Sapouna
- Clinical Exercise Physiology and Rehabilitation Laboratory (Ms Sapouna and Drs Kapreli and Kortianou) and Health Assessment and Quality of Life Laboratory (Dr Dimitriadis), Physiotherapy Department, University of Thessaly, Lamia, Greece; Pediatric Allergy and Pulmonology Unit (Dr Douros), 3rd Department of Pediatrics, National and Kapodistrian University, Athens, Greece
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15
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Wang D, Wang Y, Liu Q, Sun W, Wei L, Ye C, Zhu R. Association of Air Pollution with the Number of Common Respiratory Visits in Children in a Heavily Polluted Central City, China. TOXICS 2023; 11:815. [PMID: 37888666 PMCID: PMC10610878 DOI: 10.3390/toxics11100815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/23/2023] [Accepted: 09/26/2023] [Indexed: 10/28/2023]
Abstract
Children's respiratory health is vulnerable to air pollution. Based on data collected from June 2019 to June 2022 at a children's hospital in Zhengzhou, China, this study utilized Spearman correlation analysis and a generalized additive model (GAM) to examine the relationship between daily visits for common respiratory issues in children and air pollutant concentrations. Results show that the number of upper respiratory tract infection (URTI), pneumonia (PNMN), bronchitis (BCT), and bronchiolitis (BCLT) visits in children showed a positive correlation with PM2.5, PM10, NO2, SO2, and CO while exhibiting a negative correlation with temperature and relative humidity. The highest increases in PNMN visits in children were observed at lag 07 for NO2, SO2, and CO. A rise of 10 μg/m3 in NO2, 1 μg/m3 in SO2, and 0.1 mg/m3 in CO corresponded to an increase of 9.7%, 2.91%, and 5.16% in PNMN visits, respectively. The effects of air pollutants on the number of BCT and BCLT visits were more pronounced in boys compared to girls, whereas no significant differences were observed in the number of URTI and PNMN visits based on sex. Overall, air pollutants significantly affect the prevalence of respiratory diseases in children, and it is crucial to improve air quality to protect the children's respiratory health.
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Affiliation(s)
- Dan Wang
- Emergency Department, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450014, China; (D.W.); (Q.L.); (C.Y.)
- Emergency Department, Maternal and Child Care Service Centre of Henan, Zhengzhou 450014, China
| | - Yanan Wang
- School of Ecology and Environment, Zhengzhou University, Zhengzhou 450001, China; (Y.W.); (W.S.)
| | - Qianqian Liu
- Emergency Department, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450014, China; (D.W.); (Q.L.); (C.Y.)
- Emergency Department, Maternal and Child Care Service Centre of Henan, Zhengzhou 450014, China
| | - Wenxin Sun
- School of Ecology and Environment, Zhengzhou University, Zhengzhou 450001, China; (Y.W.); (W.S.)
| | - Liangkui Wei
- Emergency Department, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450014, China; (D.W.); (Q.L.); (C.Y.)
- Emergency Department, Maternal and Child Care Service Centre of Henan, Zhengzhou 450014, China
| | - Chengxin Ye
- Emergency Department, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450014, China; (D.W.); (Q.L.); (C.Y.)
- Emergency Department, Maternal and Child Care Service Centre of Henan, Zhengzhou 450014, China
| | - Rencheng Zhu
- School of Ecology and Environment, Zhengzhou University, Zhengzhou 450001, China; (Y.W.); (W.S.)
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16
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Valente BCHG, Melo MDCBD, Liu PMF, Gonçalves BAR, Gomes RADS, Martins IG, Oliveira ACPLD, Ferreira ALDCM, Bothrel RG, de Lima Belizário Facury Lasmar LM. High and low-fidelity simulation for respiratory diseases pediatric training: a prospective and randomized study. J Pediatr (Rio J) 2023; 99:521-528. [PMID: 37244290 PMCID: PMC10492141 DOI: 10.1016/j.jped.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 05/29/2023] Open
Abstract
OBJECTIVE To compare high and low-fidelity simulations for the recognition of respiratory distress and failure in urgency and emergency pediatric scenarios. METHODS 70 fourth-year medical students were randomly distributed in high and low-fidelity groups and simulated different types of respiratory problems. Theory tests, performance checklists, and satisfaction and self-confidence questionnaires were used in the assessment. Face-to-face simulation and memory retention was applied. The statistics were evaluated by averages and quartiles, Kappa, and generalized estimating equations. The p-value was considered 0.05. RESULTS In the theory test there was an increase in scores in both methodologies (p < 0.001); in memory retention (p = 0.043) and at the end of the process the high-fidelity group had better results. The performance in the practical checklists was better after the second simulation (p > 0,05). The high-fidelity group felt more challenged in both phases (p = 0.042; p = 0.018) and showed greater self-confidence to recognize changes in clinical conditions and in memory retention (p = 0.050). The same group, in relation to the hypothetical real patient to be treated in the future, felt better confident to recognize respiratory distress and failure (p = 0.008; p = 0.004), and better prepared to make a systematic clinical evaluation of the patient in memory retention (p = 0.016). CONCLUSION The two levels of simulations enhance diagnostic skills. High fidelity improves knowledge, leads the student to feel more challenged and more self-confident in recognizing the severity of the clinical case, including memory retention, and showed benefits regarding self-confidence in recognizing respiratory distress and failure in pediatric cases.
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Affiliation(s)
| | - Maria do Carmo Barros de Melo
- Faculdade de Medicina da Universidade Federal de Minas Gerais, Departamento de Pediatria, Belo Horizonte, Minas Gerais, Brazil
| | - Priscila Menezes Ferri Liu
- Faculdade de Medicina da Universidade Federal de Minas Gerais, Departamento de Pediatria, Belo Horizonte, Minas Gerais, Brazil
| | | | | | - Isadora Guimarães Martins
- Faculdade de Medicina da Universidade Federal de Minas Gerais, Estudante de Medicina Belo Horizonte, Minas Gerais, Brazil
| | | | | | - Rafaella Garcia Bothrel
- Faculdade de Medicina da Universidade Federal de Minas Gerais, Estudante de Medicina Belo Horizonte, Minas Gerais, Brazil
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17
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Shi T, Wang J, Dong J, Hu P, Guo Q. Periodontopathogens Porphyromonas gingivalis and Fusobacterium nucleatum and Their Roles in the Progression of Respiratory Diseases. Pathogens 2023; 12:1110. [PMID: 37764918 PMCID: PMC10535846 DOI: 10.3390/pathogens12091110] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/18/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023] Open
Abstract
The intricate interplay between oral microbiota and the human host extends beyond the confines of the oral cavity, profoundly impacting the general health status. Both periodontal diseases and respiratory diseases show high prevalence worldwide and have a marked influence on the quality of life for the patients. Accumulating studies are establishing a compelling association between periodontal diseases and respiratory diseases. Here, in this review, we specifically focus on the key periodontal pathogenic bacteria Porphyromonas gingivalis and Fusobacterium nucleatum and dissect their roles in the onset and course of respiratory diseases, mainly pneumonia, chronic obstructive pulmonary disease, lung cancer, and asthma. The mechanistic underpinnings and molecular processes on how P. gingivalis and F. nucleatum contribute to the progression of related respiratory diseases are further summarized and analyzed, including: induction of mucus hypersecretion and chronic airway inflammation; cytotoxic effects to disrupt the morphology and function of respiratory epithelial cells; synergistic pathogenic effects with respiratory pathogens like Streptococcus pneumoniae and Pseudomonas aeruginosa. By delving into the complex relationship to periodontal diseases and periodontopathogens, this review helps unearth novel insights into the etiopathogenesis of respiratory diseases and inspires the development of potential therapeutic avenues and preventive strategies.
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Affiliation(s)
- Tao Shi
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Jiale Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Jiajia Dong
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
- State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Pingyue Hu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Qiang Guo
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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18
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Yu M, Wang R, Pei L, Zhang X, Wei J, Wen Y, Liu H, Ye H, Wang J, Wang L. The relationship between the use of GLP-1 receptor agonists and the incidence of respiratory illness: a meta-analysis of randomized controlled trials. Diabetol Metab Syndr 2023; 15:164. [PMID: 37491292 PMCID: PMC10369734 DOI: 10.1186/s13098-023-01118-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/19/2023] [Indexed: 07/27/2023] Open
Abstract
AIM We aimed to assess the association between the use of Glucagon-like peptide-1 receptor agonists and the risk of 12 respiratory diseases in patients with type 2 diabetes, obesity, or overweight. METHOD The PubMed (MEDLINE), EMBASE, Cochrane Library, and ClinicalTrials.gov databases were searched from the establishment of the database to December 24, 2022. Dichotomous outcomes were analyzed using RR and 95% CI calculated from fixed-effects models. RESULTS Twenty-eight RCTs were ultimately included for analysis, involving a total of 77,485 participants. Compared to controls, patients with GLP-1RAs have a 14% lower risk of respiratory disease (RR 0.86, 95% CI 0.81-0.93 p < 0.0001), with Semaglutid (RR 0.82, 95% CI 0.68-0.97, p = 0.02), Liraglutide (RR 0.86. 95% CI 0.75-0.98, p = 0.03), Dulaglutide (RR 0.82, 95% CI 0.70-0.96, p = 0.02), Albiglutide (RR 0.93,95% CI 0.79-1.10, p = 0.40), Exenatide (RR 0.93, 95% CI 0.74-1.18, p = 0.55), Lixisenatide (RR 0.83, 95% CI 0.62-1.12, p = 0.22), and Efpeglenatide (RR 0.76, 95% CI 0.46-1.24, p = 0.27). Semaglutide, Liraglutide and Dulaglutide reduce the risk of respiratory diseases by 18%, 14% and 18%, respectively.Trial duration, control type, and indication were not associated with the impact of GLP-1 receptor agonists on overall respiratory disease. Among secondary outcomes, the risk of Pulmonary edema (RR 0.66, 95% CI 0.44-0.98, p = 0.04), and Bronchitis (RR 0.86, 95% CI 0.74-1.00, p = 0.04) was reduced. CONCLUSION In conclusion, GLP-1RAs were linked to a lower risk of overall respiratory diseases, especially Pulmonary edema and Bronchitis. In the future, physicians should pay attention to the relationship between GLP-1 RA and the risk of respiratory diseases and evaluate the efficacy of GLP-1RAs in the primary and secondary prevention of respiratory diseases. Trial registration CRD42023396138.
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Affiliation(s)
- Meixin Yu
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Jinan University, No. 613, Huang pu Avenue West, Guangzhou, Guangdong, China
| | - Ruxin Wang
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Jinan University, No. 613, Huang pu Avenue West, Guangzhou, Guangdong, China
| | - Ling Pei
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Jinan University, No. 613, Huang pu Avenue West, Guangzhou, Guangdong, China
| | - Xiaofang Zhang
- Clinical Experimental Center, The First Affiliated Hospital of Jinan University, No. 613, Huang pu Avenue West, Guangzhou, Guangdong, China
| | - Jinjing Wei
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Jinan University, No. 613, Huang pu Avenue West, Guangzhou, Guangdong, China
| | - Yun Wen
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Jinan University, No. 613, Huang pu Avenue West, Guangzhou, Guangdong, China
| | - Han Liu
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Jinan University, No. 613, Huang pu Avenue West, Guangzhou, Guangdong, China
| | - Haowen Ye
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Jinan University, No. 613, Huang pu Avenue West, Guangzhou, Guangdong, China
| | - Jinghao Wang
- Department of Pharmacy, The First Affiliated Hospital of Jinan University, No. 613, Huang pu Avenue West, Guangzhou, Guangdong, China.
| | - Lihong Wang
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Jinan University, No. 613, Huang pu Avenue West, Guangzhou, Guangdong, China.
- The Guangzhou Key Laboratory of Basic and Translational Research on Chronic Diseases, The First Affiliated Hospital, Jinan University, Guangzhou, China.
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Tu WC, McManamen AM, Su X, Jeacopello I, Takezawa MG, Hieber DL, Hassan GW, Lee UN, Anana EV, Locknane MP, Stephenson MW, Shinkawa VAM, Wald ER, DeMuri GP, Adams KN, Berthier E, Thongpang S, Theberge AB. At-Home Saliva Sampling in Healthy Adults Using CandyCollect, a Lollipop-Inspired Device. Anal Chem 2023; 95:10211-10220. [PMID: 37364037 DOI: 10.1021/acs.analchem.3c00462] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
Respiratory infections are common in children, and there is a need for user-friendly collection methods. Here, we performed the first human subjects study using the CandyCollect device, a lollipop-inspired saliva collection device .We showed that the CandyCollect device can be used to collect salivary bacteria from healthy adults using Streptococcus mutans and Staphylococcus aureus as proof-of-concept commensal bacteria. We enrolled healthy adults in a nationwide (USA) remote study in which participants were sent study packages containing CandyCollect devices and traditional commercially available oral swabs and spit tubes. Participants sampled themselves at home, completed usability and user preference surveys, and mailed the samples back to our laboratory for analysis by qPCR. Our results showed that for participants in which a given bacterium (S. mutans or S. aureus) was detected in one or both of the commercially available methods (oral swab and/or spit tubes), CandyCollect devices had a 100% concordance with the positive result (n = 14 participants). Furthermore, the CandyCollect device was ranked the highest preference sampling method among the three sampling methods by 26 participants surveyed (combining survey results across two enrollment groups). We also showed that the CandyCollect device has a shelf life of up to 1 year at room temperature, a storage period that is convenient for clinics or patients to keep the CandyCollect device and use it any time. Taken together, we have demonstrated that the CandyCollect is a user-friendly saliva collection tool that has the potential to be incorporated into diagnostic assays in clinic visits and telemedicine.
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Affiliation(s)
- Wan-Chen Tu
- Department of Chemistry, University of Washington, Seattle, Washington 98195, United States
| | - Anika M McManamen
- Department of Chemistry, University of Washington, Seattle, Washington 98195, United States
| | - Xiaojing Su
- Department of Chemistry, University of Washington, Seattle, Washington 98195, United States
| | - Ingrid Jeacopello
- Department of Chemistry, University of Washington, Seattle, Washington 98195, United States
| | - Meg G Takezawa
- Department of Chemistry, University of Washington, Seattle, Washington 98195, United States
| | - Damielle L Hieber
- Department of Chemistry, University of Washington, Seattle, Washington 98195, United States
| | - Grant W Hassan
- Department of Chemistry, University of Washington, Seattle, Washington 98195, United States
| | - Ulri N Lee
- Department of Chemistry, University of Washington, Seattle, Washington 98195, United States
| | - Eden V Anana
- Department of Chemistry, University of Washington, Seattle, Washington 98195, United States
| | - Mason P Locknane
- Department of Chemistry, University of Washington, Seattle, Washington 98195, United States
| | - Molly W Stephenson
- Department of Chemistry, University of Washington, Seattle, Washington 98195, United States
| | - Victoria A M Shinkawa
- Department of Chemistry, University of Washington, Seattle, Washington 98195, United States
| | - Ellen R Wald
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, United States
| | - Gregory P DeMuri
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, United States
| | - Karen N Adams
- Institute of Translational Health Sciences, School of Medicine, University of Washington, Seattle, Washington 98109, United States
| | - Erwin Berthier
- Department of Chemistry, University of Washington, Seattle, Washington 98195, United States
| | - Sanitta Thongpang
- Department of Chemistry, University of Washington, Seattle, Washington 98195, United States
- Department of Biomedical Engineering, Faculty of Engineering, Mahidol University, Nakorn Pathom 73170, Thailand
| | - Ashleigh B Theberge
- Department of Chemistry, University of Washington, Seattle, Washington 98195, United States
- Department of Urology, School of Medicine, University of Washington, Seattle, Washington 98195, United States
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20
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El Kholy S, Al Naggar Y. Insights into the mechanism of histamine synthesis and recycling disruption induced by exposure to CdO NPs in the fruit fly (Drosophila melanogaster). ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:83376-83387. [PMID: 37340164 DOI: 10.1007/s11356-023-28211-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 06/07/2023] [Indexed: 06/22/2023]
Abstract
Exposure to a sublethal concentration of CdO nanoparticles impairs the vision of the fruit fly (Drosophila melanogaster) by disrupting histamine (HA) synthesis and recycling mechanisms. To gain more insights, we measured HA titer using HPLC in CdO NP-treated vs. non-treated adults in the current study and found that CdO NPs caused an increase in the level of HA in the head and the decapitated body. We asked whether HA accumulation (increase) is a response of photoreceptors or CNS histaminergic neurons, and whether there is any difference in the expression levels of HA recycling and transport encoding genes (Lovit, CarT, Ebony, Tan, BalaT) between the adult fly head and decapitated body that could explain this HA accumulation. We used GAL4/UAS system tool with three GAL4 drivers: ubiquitous tubP-GAL4, nervous system driver (elav Gal4), and compound eye drivers (sev Gal4 and GMR Gal4) to silence HA synthesis in site specific manner followed by detecting the expression level of genes involved in HA recycling and transport in both the heads and the decapitated bodies of CdO treated and non-treated flies. We found an increase in Lovit expression in the heads of treated adults, which is responsible for HA loading into synaptic vesicles and release from photoreceptors, as well as a decrease in catalytic enzymes involved in HA recycling, which leads to HA accumulation without increasing the real signal. To conclude, both photoreceptors and CNS histaminergic neurons are responsible for the increase in HA in CdO NP-treated flies, but through different mechanisms. Our results provide more insights on the underlying molecular mechanism of vision impairment because of nano-sized cadmium particles exposure.
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Affiliation(s)
- Samar El Kholy
- Zoology Department, Faculty of Science, Tanta University, Tanta, 31527, Egypt
| | - Yahya Al Naggar
- Zoology Department, Faculty of Science, Tanta University, Tanta, 31527, Egypt.
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21
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Banzon TM, Greco KF, Li L, Mukharesh L, Vieira CLZ, Steiner MK, Hauptman M, Ratchataswan T, Koutrakis P, Phipatanakul W, Gaffin JM. Effect of radon exposure on asthma morbidity in the School Inner-City Asthma study. Pediatr Pulmonol 2023; 58:2042-2049. [PMID: 37083192 PMCID: PMC10330665 DOI: 10.1002/ppul.26429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 03/06/2023] [Accepted: 03/31/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND Radon may have a role in obstructive lung disease outside its known carcinogenicity. Little is known about radon's effects on asthma morbidity. OBJECTIVE To determine the effect of radon on fractional exhaled nitric oxide (FE NO), asthma symptom-days, and lung function in inner-city asthmatic school children. METHODS Two hundred ninety-nine school-aged asthmatic children enrolled in the School Inner-City Asthma Study (SICAS-1) were followed. One and two-month averaged radon was assessed using a spatiotemporal model predicting zip code-specific monthly exposures. FE NO and spirometry were measured twice during the academic year. Asthma symptoms were assessed four times during the academic year. The interaction between indoor radon exposure (Bq/m3 ) and seasonality predicting log-transformed FE NO, forced expiratory volume in 1 s (FEV1 ) % predicted, forced vital capacity (FVC) % predicted, FEV1 /FVC, and asthma symptom-days was evaluated. RESULTS Participants with high radon exposure had greater change in FE NO from warm to cold periods compared to low radon exposure (interaction p = 0.0013). Participants with >50th percentile radon exposure experience significant FE NO increase from warm to cold weather (β $\beta $ = 0.29 [95% confidence interval [CI]: 0.04-0.54], p = 0.0240). We report a positive association between radon 1-month moving average (incidence rate ratio [IRR] = 1.01, p = 0.0273) and 2-month moving average (IRR = 1.01, p = 0.0286) with maximum asthma symptom-days (n = 299, obs = 1167). CONCLUSIONS In asthmatic children, radon may be associated with increased asthma morbidity, suggesting radon may be a modifiable environmental risk factor for airway inflammation.
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Affiliation(s)
- Tina M. Banzon
- Division of Allergy and Immunology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Kimberly F. Greco
- Institutional Centers for Clinical and Translational Research, Boston Children’s Hospital, Boston, MA, USA
| | - Longxiang Li
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Lana Mukharesh
- Division of Pulmonary Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | | | - M. Kathryn Steiner
- Department of Allergy and Immunology, Boston Children’s Hospital, Boston, MA, USA
| | - Marissa Hauptman
- Pediatric Environmental Health Center, Division of General Pediatrics, Boston Children’s Hospital
| | | | - Petros Koutrakis
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Wanda Phipatanakul
- Division of Allergy and Immunology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Jonathan M. Gaffin
- Division of Pulmonary Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
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22
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Prince N, Kelly RS, Chu SH, Kachroo P, Chen Y, Mendez KM, Begum S, Bisgaard H, Bønnelykke K, Kim M, Levy O, Litonjua AA, Wheelock CE, Weiss ST, Chawes BL, Lasky-Su JA. Elevated third trimester corticosteroid levels are associated with fewer offspring infections. Sci Rep 2023; 13:10461. [PMID: 37380711 PMCID: PMC10307773 DOI: 10.1038/s41598-023-36535-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 06/06/2023] [Indexed: 06/30/2023] Open
Abstract
Respiratory infections are a leading cause of morbidity and mortality in early life, and recurrent infections increase the risk of developing chronic diseases. The maternal environment during pregnancy can impact offspring health, but the factors leading to increased infection proneness have not been well characterized during this period. Steroids have been implicated in respiratory health outcomes and may similarly influence infection susceptibility. Our objective was to describe relationships between maternal steroid levels and offspring infection proneness. Using adjusted Poisson regression models, we evaluated associations between sixteen androgenic and corticosteroid metabolites during pregnancy and offspring respiratory infection incidence across two pre-birth cohorts (N = 774 in VDAART and N = 729 in COPSAC). Steroid metabolites were measured in plasma samples from pregnant mothers across all trimesters of pregnancy by ultrahigh-performance-liquid-chromatography/mass-spectrometry. We conducted further inquiry into associations of steroids with related respiratory outcomes: asthma and lung function spirometry. Higher plasma corticosteroid levels in the third trimester of pregnancy were associated with lower incidence of offspring respiratory infections (P = 4.45 × 10-7 to 0.002) and improved lung function metrics (P = 0.020-0.036). Elevated maternal androgens were generally associated with increased offspring respiratory infections and worse lung function, with some associations demonstrating nominal significance at P < 0.05, but these trends were inconsistent across individual androgens. Increased maternal plasma corticosteroid levels in the late second and third trimesters were associated with lower infections and better lung function in offspring, which may represent a potential avenue for intervention through corticosteroid supplementation in late pregnancy to reduce offspring respiratory infection susceptibility in early life.Clinical Trial Registry information: VDAART and COPSAC were originally conducted as clinical trials; VDAART: ClinicalTrials.gov identifier NCT00920621; COPSAC: ClinicalTrials.gov identifier NCT00798226.
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Affiliation(s)
- Nicole Prince
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
| | - Rachel S Kelly
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
| | - Su H Chu
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
| | - Priyadarshini Kachroo
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
| | - Yulu Chen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
| | - Kevin M Mendez
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
| | - Sofina Begum
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
| | - Hans Bisgaard
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, 2820, Gentofte, Denmark
| | - Klaus Bønnelykke
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, 2820, Gentofte, Denmark
| | - Min Kim
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, 2820, Gentofte, Denmark
| | - Ofer Levy
- Precision Vaccines Program, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Augusto A Litonjua
- Division of Pediatric Pulmonary Medicine, Department of Pediatrics, Golisano Children's Hospital and University of Rochester Medical Center, Rochester, NY, USA
| | - Craig E Wheelock
- Unit of Integrative Metabolomics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Stockholm, Sweden
- Gunma University Initiative for Advanced Research (GIAR), Gunma University, Maebashi, Japan
| | - Scott T Weiss
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
| | - Bo L Chawes
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, 2820, Gentofte, Denmark
| | - Jessica A Lasky-Su
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA.
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23
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Rodriguez-Martinez CE, Sossa-Briceño MP. Disparities in prevalence and outcomes of respiratory disease in low- and middle-income countries. Pediatr Pulmonol 2023. [PMID: 37378459 DOI: 10.1002/ppul.26573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/18/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023]
Abstract
OBJECTIVES To provide a comprehensive overview of disparities in prevalence and outcomes of respiratory diseases and notable challenges for providing optimal treatment to pediatric patients with respiratory diseases living in low- and middle-income countries (LMICs), as an input to help better understand the roots of respiratory health disparities. METHODS We conducted a narrative review of relevant literature published in electronic databases from inception to February 2023 that present data on disparities in prevalence and outcomes of respiratory disease in LMICs. Additionally, we included studies that describe and discuss challenges for providing optimal treatment to pediatric patients with respiratory diseases living in LMICs. RESULTS A number of early life exposures have been associated with adverse respiratory outcomes in later life. Several studies have shown marked geographical variations in the prevalence and burden of pediatric asthma, with consistently lower prevalence rates but significantly higher burdens and worse outcomes in LMICs. There is a wide range of challenges that adversely affect the efficient care of children with respiratory diseases that can be classified into three categories: patient-related factors, social/environmental factors, and factors related to healthcare providers or the healthcare system. CONCLUSIONS Respiratory health disparities in children living in LMICs represent a global public health issue mainly explained by an unequal distribution of preventable and modifiable risk factors for respiratory diseases across different demographic groups.
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Affiliation(s)
- Carlos E Rodriguez-Martinez
- Department of Pediatrics, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia
- Department of Pediatric Pulmonology, School of Medicine, Universidad El Bosque, Bogota, Colombia
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24
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Kandeel A, Fahim M, Deghedy O, Roshdy WH, Khalifa MK, Shesheny RE, Kandeil A, Naguib A, Afifi S, Mohsen A, Abdelghaffar K. Resurgence of influenza and respiratory syncytial virus in Egypt following two years of decline during the COVID-19 pandemic: outpatient clinic survey of infants and children, October 2022. BMC Public Health 2023; 23:1067. [PMID: 37277781 DOI: 10.1186/s12889-023-15880-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 05/11/2023] [Indexed: 06/07/2023] Open
Abstract
INTRODUCTION Two years after unprecedented low rates of circulation of most common respiratory viruses (SARS-CoV-2), the Egyptian ARI surveillance system detected an increase in acute respiratory infections (ARIs) with a reduced circulation of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), especially among school children. A national survey was conducted to estimate the burden and identify the viral causes of ARIs among children < 16 years of age. METHODS A one-day survey was carried out in 98 governmental outpatient clinics distributed all over Egypt 26 governorates. The four largest referral hospitals in each governorate where most influenza-like illness (ILI) patients seek care were selected. Using the WHO case definition, the first five patients < 16 years of age with ILI symptoms visiting the selected outpatient clinics on the survey day were enrolled. Basic demographic and clinical data of patients were collected using a linelist. Patients were swabbed and tested for SARS-CoV-2, influenza, and Respiratory Syncytial virus (RSV) by RT-PCR at the Central Laboratory in Cairo. RESULTS Overall, 530 patients enrolled, their mean age was 5.8 ± 4.2, 57.1% were males, and 70.2% reside in rural or semi-rural areas. Of all patients, 134 (25.3%) had influenza, 111 (20.9%) RSV, and 14 (2.8%) coinfections. Influenza-positive children were older compared to RSV, (7.2 ± 4.1, 4.3 ± 4.1, p < 0.001), with more than half of them (53.0%) being school students. Dyspnea was reported in RSV more than in influenza (62.2% vs. 49.3%, p < 0.05). Among RSV patients, children < 2 years had a higher rate of dyspnea than others (86.7% vs. 53.1%, < 0.001). CONCLUSIONS A resurgence of influenza and RSV was detected in Egypt in the 2022-2023 winter season. Influenza caused a higher rate of infection than RSV, while RSV caused more severe symptoms than influenza. Monitoring a broader range of respiratory pathogens is recommended to estimate the ARI burden and risky groups for severe disease in Egypt.
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Affiliation(s)
- Amr Kandeel
- Ministry of Health and Population, Cairo, Egypt
| | - Manal Fahim
- Ministry of Health and Population, Cairo, Egypt
| | - Ola Deghedy
- Ministry of Health and Population, Cairo, Egypt
| | - Wael H Roshdy
- Central Public Health Laboratory, Ministry of Health and Population, Cairo, Egypt
| | - Mohamed K Khalifa
- Centre of Scientific Excellence for Influenza Viruses, National Research Centre, 12622, Dokki, Giza, Egypt
| | - Rabeh El Shesheny
- Centre of Scientific Excellence for Influenza Viruses, National Research Centre, 12622, Dokki, Giza, Egypt
| | - Ahmed Kandeil
- Centre of Scientific Excellence for Influenza Viruses, National Research Centre, 12622, Dokki, Giza, Egypt
| | - Amel Naguib
- Central Public Health Laboratory, Ministry of Health and Population, Cairo, Egypt
| | - Salma Afifi
- Consultant Ministry of Health and Population, Cairo, Egypt
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25
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Bai S, Cui L, Du S, Zhao X, Lin S, Yang X, Zhang J, Liang Y, Wang Z. A life course approach to asthma and wheezing among young children caused by ozone: A prospective birth cohort in northern China. ENVIRONMENTAL RESEARCH 2023; 226:115687. [PMID: 36925033 DOI: 10.1016/j.envres.2023.115687] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/22/2023] [Accepted: 03/12/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Given differences in vulnerability of children in early life, a life course approach to asthma and wheezing (AW) in young children caused by ozone (O3) is not fully understood. METHODS We conducted a birth cohort in Jinan, China from 2018 to 2021 to elucidate the onset model of childhood AW due to O3 exposure. An inverse distance weighted model was used for individual exposure assessment. The time-dependent Cox proportional-hazard model and logistic model were used to investigate the effects of O3 exposure on AW. Principal component analysis, interaction analysis, and distributed lag model were used to analyze the life course approach. RESULTS The cumulative incidence rate for AW among 6501 children aged 2 was 1.4%. A high level of O3 was related to AW (HR: 2.10, 95% CI: 1.31, 3.37). Only O3 exposure after birth was associated with AW, with an OR of 1.82 (1.08, 3.12), after adjusting for the effect before birth. Furthermore, adjusting for other air pollutants, the HR for the individual effect of high O3 exposure on AW was 2.44 (1.53, 3.89). Interestingly, P values for interactions for O3 and the principal components of other pollutants, as well as the characteristic variable of open windows were less than 0.1. Moreover, an increase in the IQR of O3 exposure at the 31st to 37th weeks before birth and the 1st to 105th weeks after birth was associated with an increase in the HRs for AW. CONCLUSIONS High-level of O3 exposure after birth could lead to AW among young children. Importantly, the AW onset model may include the risk factors accumulation and the sensitive period model. Specifically, there are two sensitive windows in early life, and the correlated insults between the high level of O3 and other pollutants as well as open windows in the asthma-inducing effect.
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Affiliation(s)
- Shuoxin Bai
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China
| | - Liangliang Cui
- Jinan Municipal Center for Disease Control and Prevention, Jinan, Shandong, PR China
| | - Shuang Du
- Department of Occupational and Environmental Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China
| | - Xiaodong Zhao
- Jinan Municipal Center for Disease Control and Prevention, Jinan, Shandong, PR China
| | - Shaoqian Lin
- Jinan Municipal Center for Disease Control and Prevention, Jinan, Shandong, PR China
| | - Xiwei Yang
- Department of Occupational and Environmental Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China
| | - Jiatao Zhang
- Department of Occupational and Environmental Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China
| | - Yuxiu Liang
- Department of Occupational and Environmental Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China
| | - Zhiping Wang
- Department of Occupational and Environmental Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China.
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26
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Tu WC, McManamen AM, Su X, Jeacopello I, Takezawa MG, Hieber DL, Hassan GW, Lee UN, Anana EV, Locknane MP, Stephenson MW, Shinkawa VAM, Wald ER, DeMuri GP, Adams K, Berthier E, Thongpang S, Theberge AB. At-home saliva sampling in healthy adults using CandyCollect, a lollipop-inspired device. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.01.14.524039. [PMID: 36711895 PMCID: PMC9882111 DOI: 10.1101/2023.01.14.524039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Respiratory infections are common in children, and there is a need for user-friendly collection methods. Here, we performed the first human subjects study using the CandyCollect device, a lollipop inspired saliva collection device. 1 We showed the CandyCollect device can be used to collect salivary bacteria from healthy adults using Streptococcus mutans and Staphylococcus aureus as proof-of-concept commensal bacteria. We enrolled healthy adults in a nationwide (USA) remote study in which participants were sent study packages containing CandyCollect devices and traditional commercially available oral swabs and spit tubes. Participants sampled themselves at home, completed usability and user preference surveys, and mailed the samples back to our laboratory for analysis by qPCR. Our results showed that for participants in which a given bacterium ( S. mutans or S. aureus ) was detected in one or both of the commercially available methods (oral swab and/or spit tubes), CandyCollect devices had a 100% concordance with the positive result (n=14 participants). Furthermore, the CandyCollect device was ranked the highest preference sampling method among the three sampling methods by 26 participants surveyed (combining survey results across two enrollment groups). We also showed that the CandyCollect device has a shelf life of up to 1 year at room temperature, a storage period that is convenient for clinics or patients to keep the CandyCollect device and use it any time. Taken together, we have demonstrated that the CandyCollect is a user-friendly saliva collection tool that has the potential to be incorporated into diagnostic assays in clinic visits and telemedicine. For Table of Contents Only
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27
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Goyal JP, Kabra SK. Pediatric Pulmonology Training in India: Current Status and Future Directions. Indian J Pediatr 2023:10.1007/s12098-023-04590-0. [PMID: 37076652 PMCID: PMC10115596 DOI: 10.1007/s12098-023-04590-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 03/28/2023] [Indexed: 04/21/2023]
Abstract
Respiratory illnesses are common causes of morbidity and mortality in children. Postgraduates in Pediatrics spent significant time in learning to manage respiratory disorders. Improved survival of preterm neonates, improved diagnosis and survival of chronic respiratory problems, and advances in diagnosis and therapeutics have increased the need for specialists trained in managing these patients. Training programs in Pediatric Pulmonology are evolving over the past few decades. In India, super-specialty training in Pediatric Pulmonology has grown over the past few years. There is a need to modify the training structure used in industrialized countries due to differences in patient population, priorities, and limited available resources and expertise. Formal training courses have been started in a limited number of institutions. There is a large gap between the need for a trained workforce and the available specialists in the limited number of institutions. The Indian Academy of Pediatrics National Respiratory Chapter (IAPNRC) has initiated a fellowship program to bridge the gap. Comprehensive training involving academic and hands-on training may go a long way to improve the care of children with acute and chronic respiratory problems. For sustainable development of the super specialty, there is a need to work towards creating Pediatric Pulmonology service departments in various institutions that may be responsible for comprehensive training and research activities to answer common research questions.
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Affiliation(s)
- J P Goyal
- Department of Pediatrics, AIIMS, Jodhpur, India
| | - S K Kabra
- Department of Pediatrics, AIIMS, New Delhi, India.
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28
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Alshammari MK, Alotaibi MA, AlOtaibi AS, Alosaime HT, Aljuaid MA, Alshehri BM, AlOtaibi YB, Alasmari AA, Alasmari GA, Mohammed MH, Althobaiti SM, Almuhaya RA, Alkhoshi TA, Alosaimi AS, Alotaibi AA. Prevalence and Etiology of Community- and Hospital-Acquired Pneumonia in Saudi Arabia and Their Antimicrobial Susceptibility Patterns: A Systematic Review. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59040760. [PMID: 37109718 PMCID: PMC10143967 DOI: 10.3390/medicina59040760] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 03/30/2023] [Accepted: 04/10/2023] [Indexed: 04/29/2023]
Abstract
(1) Background and Objectives: Pneumonia is a major cause of morbidity and mortality worldwide, including in Saudi Arabia, and the prevalence and etiology of the disease varies depending on the setting. The development of effective strategies can help reduce the adverse impact of this disease. Therefore, this systematic review was conducted to explore the prevalence and etiology of community-acquired and hospital-acquired pneumonia in Saudi Arabia, as well as their antimicrobial susceptibility. (2) Materials and Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 recommendations were followed for this systematic review. Several databases were used to perform a thorough literature search, and papers were then assessed for eligibility by two independent reviewers. The Newcastle-Ottawa Scale (NOS) was used to extract the data from the relevant research and evaluate its quality. (3) Results: This systematic review included 28 studies that highlighted the fact that gram-negative bacteria, particularly Acinetobacter spp. and Pseudomonas aeruginosa, were the common cause of hospital-acquired pneumonia, while Staphylococcus aureus and Streptococcus spp. were responsible for community-acquired pneumonia in children. The study also found that bacterial isolates responsible for pneumonia showed high resistance rates against several antibiotics, including cephalosporins and carbapenems. (4) Conclusions: In conclusion, the study found that different bacteria are responsible for community- and hospital-acquired pneumonia in Saudi Arabia. Antibiotic resistance rates were high for several commonly used antibiotics, highlighting the need for rational antibiotic use to prevent further resistance. Moreover, there is a need to conduct more regular multicenter studies to assess etiology, resistance, and susceptibility patterns of pneumonia-causing pathogens in Saudi Arabia.
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Affiliation(s)
| | | | | | | | | | | | | | - Asma Ali Alasmari
- Clinical Pharmacy & Pharmacology Department, Ibn Sina National College for Medical Studies, Jeddah 22421, Saudi Arabia
| | - Ghadi Ali Alasmari
- Department of Ambulatory Care Pharmacy, International Medical Center, Jeddah 23214, Saudi Arabia
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Isaeva E, Bloch J, Poulsen A, Kurtzhals J, Reventlow S, Siersma V, Akylbekov A, Sooronbaev T, Munck Aabenhus R, Kjærgaard J. C reactive protein-guided prescription of antibiotics for children under 12 years with respiratory symptoms in Kyrgyzstan: protocol for a randomised controlled clinical trial with 14 days follow-up. BMJ Open 2023; 13:e066806. [PMID: 37041063 PMCID: PMC10106039 DOI: 10.1136/bmjopen-2022-066806] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/13/2023] Open
Abstract
INTRODUCTION While lower respiratory tract infections are the main cause of death for children under 5 globally, only a small proportion of children with respiratory tract infections need antibiotics. Overuse of antibiotics globally is leading to increasing rates of antibiotic resistance. In Kyrgyzstan, healthcare workers regularly prescribe antibiotics when clinical uncertainty is present to err on the side of caution. Targeting antibiotic use with biomarkers of inflammation such as C reactive protein (CRP) testing at the point-of-care test (POCT) has been shown to reduce antibiotic use in general, but only few studies have been done in children and no studies exist from Central Asia. This study aims to assess whether the use of a CRP POCT can safely decrease prescription of antibiotics for children with acute respiratory symptoms in primary level healthcare centres in Kyrgyzstan. METHODS AND ANALYSIS Multicentre, open-label, individually randomised, controlled clinical trial with 14 days follow-up (follow-up by phone on days 3, 7 and 14) in rural lowland Chui and highland Naryn regions of Kyrgyzstan. The population are children aged 6 months to 12 years attending the primary level healthcare centres during normal business hours with acute respiratory symptoms. CRP POCT equipment will be supplied to healthcare centres, along with a short training session in CRP use, including the interpretation of results to support the clinical evaluation of the child with acute respiratory infection. The primary outcomes are the proportion of patients prescribed an antibiotic within 14 days of index consultation (superiority analysis) and days to recovery (non-inferiority analysis). Secondary outcomes are antibiotics prescribed at index consultation, reconsultations, hospital admission and vital status within 14 days. Analysis of the first primary outcome, antibiotic use, will be intention to treat using a logistic regression model. Analysis of the second primary outcome, days to recovery, will be per protocol using a linear regression model and a non-inferiority margin of 1 day. ETHICS AND DISSEMINATION The study was approved on 18 June 2021 by the Ethics Committee (ref: no. 1) of the National Centre of Maternity and Childhood Care, Bishkek, Kyrgyzstan. The results of the study regardless of the conclusion will be presented at international conferences and published in peer-reviewed scientific medical journals along with policy briefs and technical reports. TRIAL REGISTRATION NUMBER NCT05195866.
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Affiliation(s)
- Elvira Isaeva
- Department of Allergology, National Centre of Maternity and Childhood Care, Bishkek, Kyrgyzstan
| | - Joakim Bloch
- Department of Clinical Microbiology, Rigshospitalet, Copenhagen, Denmark
- Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen, Denmark
| | - Anja Poulsen
- Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen, Denmark
| | - Jørgen Kurtzhals
- Department of Clinical Microbiology, Rigshospitalet, Copenhagen, Denmark
- Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Susanne Reventlow
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Volkert Siersma
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Azamat Akylbekov
- Department of Pulmonology, National Centre of Cardiology and Internal Medicine named after academician Mirsaid Mirrakhimov, Bishkek, Kyrgyzstan
| | - Talant Sooronbaev
- Department of Pulmonology, National Centre of Cardiology and Internal Medicine named after academician Mirsaid Mirrakhimov, Bishkek, Kyrgyzstan
| | - Rune Munck Aabenhus
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jesper Kjærgaard
- Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen, Denmark
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Sokan-Adeaga AA, Sokan-Adeaga MA, Sokan-Adeaga ED, Oparaji AN, Edris H, Tella EO, Balogun FA, Aledeh M, Amubieya OE. Environmental toxicants and health adversities: A review on interventions of phytochemicals. J Public Health Res 2023; 12:22799036231181226. [PMID: 37440795 PMCID: PMC10334012 DOI: 10.1177/22799036231181226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 04/28/2023] [Indexed: 07/15/2023] Open
Abstract
Toxicity arising from environmental contaminants has attracted global interest in the last few decades, due to the high morbidity and mortality associated with them. Efforts have been made to combat the consequential outcomes of environmental toxicity in humans through traditional remediation techniques and therapeutic measures which have been hampered by one or more limitations. Consequently, this scenario has triggered interest in the medicinal properties of phytochemicals. Thus, this review gives a succinct and in-depth elucidation of the various environmental contaminants and their toxicity effects on humans. It delves into the various classes of phytochemicals and their intervention roles. The study adopted a desk review of existing literatures from scientific reports and peer reviewed articles through triangulation of data sources. "Phytochemicals" are group of secondary metabolites obtained from plants with medicinal properties. These groups of compounds are included but not limited to flavonoids, tannins, saponins, alkaloids, cardenoloids, terpenoids, and phytosteroids. This review corroborates the prophylactic and therapeutics efficacy of these phytochemicals as anti-metastatic, anti-inflammatory, anti-aging, anti-oxidant, anti-microbial and live saving substances with empirical findings from several laboratory, clinical trials and epidemiologic studies. It conclude that given the wide range of medicinal properties of phytochemicals, there is an urgent need for its full optimization in the pharmaceutical industry and future studies should focus on identifying the bioactive molecules in these compounds and its effectiveness against mixer toxicity.
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Affiliation(s)
- Adewale Allen Sokan-Adeaga
- Department of Environmental Health
Science, Faculty of Public Health, College of Medicine, Lead City University,
Ibadan, Nigeria
| | - Micheal Ayodeji Sokan-Adeaga
- Department of Community Health and
Primary Health Care, Faculty of Clinical Sciences, College of Medicine, University
of Lagos, Lagos, Nigeria
| | - Eniola Deborah Sokan-Adeaga
- Department of Physiology, Faculty of
Basic Medical Sciences, College of Medicine, Ladoke Akintola University of
Technology (LAUTECH), Ogbomosho, Oyo State, Nigeria
| | | | - Hoseinzadeh Edris
- Incubation and Innovation Center, Saveh
University of Medical Sciences, Saveh, Iran
| | - Esther Oluwabukunola Tella
- Department of Environmental Health
Science, Faculty of Public Health, College of Medicine, Lead City University,
Ibadan, Nigeria
| | - Francis Adeniyi Balogun
- Department of Community Health, Faculty
of Public Health, College of Medicine, Lead City University, Ibadan, Nigeria
| | - Muhammad Aledeh
- College of Health, Psychology and
Social Care, University of Derby, Derby, United Kingdom
- Wiener Gesundheitsverbund, Psychiatric
Department, Klinik Donaustadt, Vienna, Austria
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O'Neil JA, Villasmil-Urdaneta LA. A path forward in the development of new aerosol drug delivery devices for pediatrics. Respir Med 2023; 211:107210. [PMID: 36907367 DOI: 10.1016/j.rmed.2023.107210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/24/2023] [Accepted: 03/09/2023] [Indexed: 03/14/2023]
Abstract
Inhaled medications are widely accepted as being the optimal route for treating pediatric respiratory diseases, a leading cause of hospitalization and death. Despite jet nebulizers being the preferred inhalation device for neonates and infants, current devices face performance issues with most of the drug never reaching the target lung location. Previous work has aimed to improve pulmonary drug deposition, yet nebulizer efficiency remains low. The development of an inhalant therapy that is efficacious and safe for pediatrics depends on a well-designed delivery system and formulation. To accomplish this, the field needs to rethink the current practice of basing pediatric treatments on adult studies. The rapidly evolving pediatric patient (i.e. neonates to eighteen) needs to be considered because they are different from adults with respect to airway anatomy, breathing patterns, and adherence. Previous research approaches to improve deposition efficiency have been limited due to the complexity of combining physics, which drives aerosol transport and deposition, and biology, especially within the area of pediatrics. To address these critical knowledge gaps, we need a better understanding of how patient age and disease state affect deposition of aerosolized drugs. The complexity of the multiscale respiratory system makes scientific investigation very challenging. The authors have simplified the complex problem into five components with these three areas as ones to address first: how the aerosol is (i) generated in a medical device, (ii) delivered to the patient, and (iii) deposited inside the lung. In this review, we discuss the technological advances and innovations made from experiments, simulations, and predictive models in each of these areas. In addition, we discuss the impact on patient treatment efficacy and recommend a clinical direction, with a focus on pediatrics. In each area, a series of research questions are posed and steps for future research to improve efficacy in aerosol drug delivery are outlined.
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Affiliation(s)
- Jennifer A O'Neil
- College of Engineering Technology, Department of Manufacturing and Mechanical Engineering Technology, Rochester Institute of Technology, 78 Lomb Memorial Drive, Golisano Hall 1361, Rochester, NY, USA.
| | - Larry A Villasmil-Urdaneta
- College of Engineering Technology, Department of Manufacturing and Mechanical Engineering Technology, Rochester Institute of Technology, Rochester, NY, USA
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Giorno EP, Foronda FK, De Paulis M, Bou Gohsn DN, Couto TB, Sa FV, Fraga AM, Farhat SC, Preto-Zamperlini M, Schvartsman C. Point-of-care lung ultrasound score for predicting escalated care in children with respiratory distress. Am J Emerg Med 2023; 68:112-118. [PMID: 36966586 DOI: 10.1016/j.ajem.2023.02.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 02/23/2023] [Accepted: 02/26/2023] [Indexed: 03/06/2023] Open
Abstract
PURPOSE Respiratory distress due to lower respiratory illnesses is a leading cause of death in children. Early recognition of high-risk populations is critical for the allocation of adequate resources. Our goal was to assess whether the lung ultrasound (US) score obtained at admission in children with respiratory distress predicts the need for escalated care. METHODS This prospective study included 0-18-year-old patients with respiratory distress admitted to three emergency departments in the state of Sao Paulo, Brazil, between July 2019 and September 2021. The enrolled patients underwent lung US performed by a pediatric emergency physician within two hours of arrival. Lung ultrasound scores ranging from 0 to 36 were computed. The primary outcome was the need for high-flow nasal cannula (HFNC), noninvasive ventilation (NIV), or mechanical ventilation within 24 h. RESULTS A total of 103 patients were included. The diagnoses included wheezing (33%), bronchiolitis (27%), pneumonia (16%), asthma (9%), and miscellaneous (16%). Thirty-five patients (34%) required escalated care and had a higher lung ultrasound score: median 13 (0-34) vs 2 (0-21), p < 0.0001; area under the curve (AUC): 0.81 (95% confidence interval [CI]: 0.71-0.90). The best cut-off score derived from Youden's index was seven (sensitivity: 71.4%; specificity: 79.4%; odds ratio (OR): 9.6 [95% CI: 3.8-24.7]). A lung US score above 12 was highly specific and had a positive likelihood ratio of 8.74 (95% CI:3.21-23.86). CONCLUSION An elevated lung US score measured in the first assessment of children with any type of respiratory distress was predictive of severity as defined by the need for escalated care with HFNC, NIV, or mechanical ventilation.
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Association of low physical activity with higher respiratory tract infections frequency among pre-school children. Pediatr Res 2023:10.1038/s41390-022-02436-7. [PMID: 36690745 DOI: 10.1038/s41390-022-02436-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 09/08/2022] [Accepted: 09/14/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND There is no consensus on the benefits of physical activity (PA) regarding upper respiratory tract infections (URTIs) among children. This study aimed to determine an association between the PA level and URTIs in preschoolers. METHODS In 4-7-year-old participants, URTI symptoms were monitored using the Polish version of the Wisconsin Upper Respiratory System Survey for Kids. The daily number of steps, PA intensity, and sleep duration were measured with a Garmin-vivofit pedometer. The lag effect between the initial level of daily PA and the frequency of infections was evaluated. RESULTS The average daily step count from healthy days was a significant determinant of the total number of days with the URTI symptoms, and it accounted for 44% (p < 0.001) of this variable variance. A low level of baseline PA (initial 14-day "run-in" observation period) was associated with an increased risk of URTI. In the non-sport group, the severity of the URTI symptoms depended on the number of daily steps. No significant correlation was found between sleep duration and the number of URTI days. CONCLUSION Low levels of PA in preschoolers result in increased susceptibility to respiratory infections. Parents should encourage children to engage in PA to prevent URTIs. IMPACT In pre-school children, higher physical activity (PA) is associated with fewer days of upper respiratory tract infection symptoms (URTIS). Children with a higher average daily step count have fewer days with URTIS over a long-term observation period. A change in the average number of steps per day by 1000 changed the number of days with symptoms of URTI by 4 days. The severity of URTIS was inversely related to the degree of PA. Children who participate in sports 3 or more hours per week have fewer URTIS than those who do not engage in sports regularly.
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Park JS, Kim K, Kim JH, Choi YJ, Kim K, Suh DI. A machine learning approach to the development and prospective evaluation of a pediatric lung sound classification model. Sci Rep 2023; 13:1289. [PMID: 36690658 PMCID: PMC9871007 DOI: 10.1038/s41598-023-27399-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 01/02/2023] [Indexed: 01/25/2023] Open
Abstract
Auscultation, a cost-effective and non-invasive part of physical examination, is essential to diagnose pediatric respiratory disorders. Electronic stethoscopes allow transmission, storage, and analysis of lung sounds. We aimed to develop a machine learning model to classify pediatric respiratory sounds. Lung sounds were digitally recorded during routine physical examinations at a pediatric pulmonology outpatient clinic from July to November 2019 and labeled as normal, crackles, or wheezing. Ensemble support vector machine models were trained and evaluated for four classification tasks (normal vs. abnormal, crackles vs. wheezing, normal vs. crackles, and normal vs. wheezing) using K-fold cross-validation (K = 10). Model performance on a prospective validation set (June to July 2021) was compared with those of pediatricians and non-pediatricians. Total 680 clips were used for training and internal validation. The model accuracies during internal validation for normal vs. abnormal, crackles vs. wheezing, normal vs. crackles, and normal vs. wheezing were 83.68%, 83.67%, 80.94%, and 90.42%, respectively. The prospective validation (n = 90) accuracies were 82.22%, 67.74%, 67.80%, and 81.36%, respectively, which were comparable to pediatrician and non-pediatrician performance. An automated classification model of pediatric lung sounds is feasible and maybe utilized as a screening tool for respiratory disorders in this pandemic era.
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Affiliation(s)
- Ji Soo Park
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea
| | - Kyungdo Kim
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Ji Hye Kim
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea
| | - Yun Jung Choi
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea
| | - Kwangsoo Kim
- Transdisciplinary Department of Medicine & Advanced Technology, Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, South Korea.
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea.
- Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, South Korea.
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Bhoite R, Satyavrat V, Premasudha Sadananda M. Clinical benefits of β-glucan supplementation in children: a review. DISCOVER FOOD 2022. [PMCID: PMC9793387 DOI: 10.1007/s44187-022-00038-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
AbstractMalnutrition is a global concern since it affects 130 million children under the age of 5 worldwide. The child’s immunity is brutally compromised, making them susceptible to various diseases and infections, leading to a high mortality rate. Multiple strategies have been implemented to strengthen immunity in children with compromised immunity, such as rendering a balanced diet, fortifying food, dietary supplements, and introducing potential natural dietary fibers to maintain good nutrition status, such as β-glucan. A class of biologically active polysaccharides, sourced from yeast, mushroom, bacteria, and cereals with versatile immunomodulatory benefits that potentially primes the host immune system, drives several metabolic health effects, increases infection resistance, shields against the damaging effects of stress, and maintains healthy energy levels. This review focuses on the capabilities, underlying mechanisms, immune-stimulating potency, and clinically meaningful shreds of evidence to substantiate the multiple health benefits of β-glucan in children. Although, more clinical studies are required, current findings confirms the various biological response modifying abilities of β-glucan that may notably aid in the development of a strong immune system in children for their overall health and wellbeing.
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Affiliation(s)
- Rachana Bhoite
- Dr Reddy’s Laboratories Pvt Ltd, Ameerpet, Hyderabad, India
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Hadian SA, Rezayatmand R. Economic impact of acute respiratory disease pandemics: A scoping review. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2022; 27:88. [PMID: 36685026 PMCID: PMC9854936 DOI: 10.4103/jrms.jrms_870_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 05/26/2022] [Accepted: 06/28/2022] [Indexed: 12/24/2022]
Abstract
Background The economic impact of acute respiratory disease pandemics has yet to be specifically systematically reviewed. The aim of this scoping review is to identify and classify the economic impacts and its values and ranges. Materials and Methods We conducted a literature search across three key databases using an extensive list of keywords. Then, we included studies which explored direct and indirect costs as well as broader economic impact associated with different nine acute respiratory diseases, i.e., pandemic and seasonal influenza, avian influenza, equine influenza, swine influenza, severe acute respiratory syndrome, coronavirus disease 2019, Middle East respiratory syndrome, H1N1, and H7N9. Results We included 62 studies in English language between 1987 and 2020, mostly from the countries of East Asia and Pacific pertinent. We classified the economic impact into 5 main categories and 18 subcategories. The main categories were macroeconomic impacts, impacts on health cost, industry, businesses and trade, and education. Conclusion Respiratory disease pandemics have widely impacted different sectors of economy such as the direct cost on macroeconomic, providing and receiving health services, disease management, industries, business and trade, education, and indirect costs due to productivity losses. However, lots of the reviewed studies were unable to quantify the actual economic cost of these impacts. This made it challenging to conduct any kind of quantitative comparison of the results. A key priority for future research is to develop standard methods to quantify the broader economic costs of respiratory disease pandemics. Understanding the total economic impact of respiratory disease pandemics is a key step to inform national and international priority setting for disease prevention and pandemic control interventions.
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Affiliation(s)
- Shirin Alsadat Hadian
- Student Research Committee, School of Management and Medical Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Reza Rezayatmand
- Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran,Address for correspondence: Dr. Reza Rezayatmand, Hezar Jerib St., Isfahan University of Medical Sciences, Health Management and Economics Research Center, Postal Code: 81746-73461, Isfahan, Iran. E-mail:
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Abstract
PURPOSE OF REVIEW To provide an update on the current understanding of the role of wingless/integrase-1 (Wnt) signaling in pediatric allergic asthma and other pediatric lung diseases. RECENT FINDINGS The Wnt signaling pathway is critical for normal lung development. Genetic and epigenetic human studies indicate a link between Wnt signaling and the development and severity of asthma in children. Mechanistic studies using animal models of allergic asthma demonstrate a key role for Wnt signaling in allergic airway inflammation and remodeling. More recently, data on bronchopulmonary dysplasia (BPD) pathogenesis points to the Wnt signaling pathway as an important regulator. SUMMARY Current data indicates that the Wnt signaling pathway is an important mediator in allergic asthma and BPD pathogenesis. Further studies are needed to characterize the roles of individual Wnt signals in childhood disease, and to identify potential novel therapeutic targets to slow or prevent disease processes.
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Affiliation(s)
- Nooralam Rai
- Department of Pediatrics, Columbia University Medical Center, New York, NY, USA
| | - Jeanine D’Armiento
- Department of Anesthesiology, Medicine, and Physiology and Cellular Biophysics, Columbia University Medical Center, New York, NY, USA
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Islam MA, Hasan MN, Ahammed T, Anjum A, Majumder A, Siddiqui MNEA, Mukharjee SK, Sultana KF, Sultana S, Jakariya M, Bhattacharya P, Sarkodie SA, Dhama K, Mumin J, Ahmed F. Association of household fuel with acute respiratory infection (ARI) under-five years children in Bangladesh. Front Public Health 2022; 10:985445. [PMID: 36530721 PMCID: PMC9752885 DOI: 10.3389/fpubh.2022.985445] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 10/17/2022] [Indexed: 12/04/2022] Open
Abstract
In developing countries, acute respiratory infections (ARIs) cause a significant number of deaths among children. According to Bangladesh Demographic and Health Survey (BDHS), about 25% of the deaths in children under-five years are caused by ARI in Bangladesh every year. Low-income families frequently rely on wood, coal, and animal excrement for cooking. However, it is unclear whether using alternative fuels offers a health benefit over solid fuels. To clear this doubt, we conducted a study to investigate the effects of fuel usage on ARI in children. In this study, we used the latest BDHS 2017-18 survey data collected by the Government of Bangladesh (GoB) and estimated the effects of fuel use on ARI by constructing multivariable logistic regression models. From the analysis, we found that the crude (the only type of fuel in the model) odds ratio (OR) for ARI is 1.69 [95% confidence interval (CI): 1.06-2.71]. This suggests that children in families using contaminated fuels are 69.3% more likely to experience an ARI episode than children in households using clean fuels. After adjusting for cooking fuel, type of roof material, child's age (months), and sex of the child-the effect of solid fuels is similar to the adjusted odds ratio (AOR) for ARI (OR: 1.69, 95% CI: 1.05-2.72). This implies that an ARI occurrence is 69.2% more likely when compared to the effect of clean fuel. This study found a statistically significant association between solid fuel consumption and the occurrence of ARI in children in households. The correlation between indoor air pollution and clinical parameters of ARI requires further investigation. Our findings will also help other researchers and policymakers to take comprehensive actions by considering fuel type as a risk factor as well as taking proper steps to solve this issue.
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Affiliation(s)
- Md. Aminul Islam
- COVID-19 Diagnostic Lab, Department of Microbiology, Noakhali Science and Technology University, Noakhali, Bangladesh
- Advanced Molecular Lab, Department of Microbiology, President Abdul Hamid Medical College, Karimganj, Bangladesh
| | - Mohammad Nayeem Hasan
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet, Bangladesh
- Joint Rohingya Response Program, Food for the Hungry, Cox's Bazar, Bangladesh
| | - Tanvir Ahammed
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Aniqua Anjum
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Ananya Majumder
- Department of Applied Chemistry and Chemical Engineering, Noakhali Science and Technology University, Noakhali, Bangladesh
| | - M. Noor-E-Alam Siddiqui
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Sanjoy Kumar Mukharjee
- COVID-19 Diagnostic Lab, Department of Microbiology, Noakhali Science and Technology University, Noakhali, Bangladesh
| | - Khandokar Fahmida Sultana
- COVID-19 Diagnostic Lab, Department of Microbiology, Noakhali Science and Technology University, Noakhali, Bangladesh
| | - Sabrin Sultana
- Department of Banking and Insurance, University of Chittagong, Chittagong, Bangladesh
| | - Md. Jakariya
- Department of Environmental Science and Management, North South University, Bashundhara, Dhaka, Bangladesh
| | - Prosun Bhattacharya
- COVID-19 Research, Department of Sustainable Development, Environmental Science and Engineering, KTH Royal Institute of Technology, Stockholm, Sweden
| | | | - Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Bareilly, Uttar Pradesh, India
| | - Jubayer Mumin
- Platform of Medical and Dental Society, Dhaka, Bangladesh
| | - Firoz Ahmed
- COVID-19 Diagnostic Lab, Department of Microbiology, Noakhali Science and Technology University, Noakhali, Bangladesh
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Chilot D, Belay DG, Shitu K, Mulat B, Alem AZ, Geberu DM. Prevalence and associated factors of common childhood illnesses in sub-Saharan Africa from 2010 to 2020: a cross-sectional study. BMJ Open 2022; 12:e065257. [PMID: 36379651 PMCID: PMC9668010 DOI: 10.1136/bmjopen-2022-065257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE This study aimed to assess the prevalence and determinants of common childhood illnesses in sub-Saharan Africa. DESIGN Cross-sectional study. SETTING Sub-Saharan Africa. PARTICIPANTS Under-5 children. PRIMARY OUTCOME Common childhood illnesses. METHODS Secondary data analysis was conducted using data from recent Demographic and Health Survey datasets from 33 sub-Saharan African countries. We used the Kids Record dataset file and we included only children under the age of 5 years. A total weighted sample size of 208 415 from the pooled (appended) data was analysed. STATA V.14.2 software was used to clean, recode and analyse the data. A multilevel binary logistic regression model was fitted, and adjusted OR with a 95% CI and p value of ≤0.05 were used to declare significantly associated factors. To check model fitness and model comparison, intracluster correlation coefficient, median OR, proportional change in variance and deviance (-2 log-likelihood ratio) were used. RESULT In this study, the prevalence of common childhood illnesses among under-5 children was 50.71% (95% CI: 44.18% to 57.24%) with a large variation between countries which ranged from Sierra Leone (23.26%) to Chad (87.24%). In the multilevel analysis, rural residents, mothers who are currently breast feeding, educated mothers, substandard floor material, high community women education and high community poverty were positively associated with common childhood illnesses in the sub-Saharan African countries. On the other hand, children from older age mothers, children from the richest household and children from large family sizes, and having media access, electricity, a refrigerator and improved toilets were negatively associated. CONCLUSIONS The prevalence of common illnesses among under-5 children was relatively high in sub-Saharan African countries. Individual-level and community-level factors were associated with the problem. Improving housing conditions, interventions to improve toilets and strengthening the economic status of the family and the communities are recommended to reduce common childhood diseases.
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Affiliation(s)
- Dagmawi Chilot
- Physiology, University of Gondar College of Medicine and Health Sciences, Gondar, Amara, Ethiopia
- CDT Africa, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia
| | - Daniel Gashaneh Belay
- Epidemiology, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
- Anatomy, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Kegnie Shitu
- Department of Health Education and Behavioral Sciences, University of Gondar, Gondar, Ethiopia
| | - Bezawit Mulat
- Physiology, University of Gondar College of Medicine and Health Sciences, Gondar, Amara, Ethiopia
| | - Adugnaw Zeleke Alem
- Epidemiology and Biostatistics, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Demiss Mulatu Geberu
- Health Systems and Policy, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
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Prince N, Kim M, Kelly RS, Diray-Arce J, Bønnelykke K, Chawes BL, Huang M, Levy O, Litonjua AA, Stokholm J, Wheelock CE, Bisgaard H, Weiss ST, Lasky-Su JA. Reduced Steroid Metabolites Identify Infection-Prone Children in Two Independent Pre-Birth Cohorts. Metabolites 2022; 12:metabo12111108. [PMID: 36422248 PMCID: PMC9692427 DOI: 10.3390/metabo12111108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/04/2022] [Accepted: 11/10/2022] [Indexed: 11/16/2022] Open
Abstract
Recurrent respiratory infections are a leading cause of morbidity and mortality in early life, but there is no broadly accepted means to identify infection-prone children during this highly vulnerable period. In this study, we investigated associations between steroid metabolites and incident respiratory infections in two pre-birth cohorts to identify novel metabolomic signatures of early infection proneness. Children from the Vitamin D Antenatal Asthma Reduction Trial and the Copenhagen Prospective Studies on Asthma in Childhood were included, and profiling was performed on plasma samples collected at ages 1 and 6 years. Both cohorts recorded incidence of lower respiratory infections, upper respiratory infections, ear infections, and colds. Poisson regression analysis assessed the associations between 18 steroid metabolites and the total number of respiratory infections that occurred in offspring during follow-up. We found that steroid metabolites across androgenic, corticosteroid, pregnenolone, and progestin classes were reduced in children that suffered more infections, and these patterns persisted at age 6 years, generally reflecting consistency in direction of effect and significance. Our analysis suggested steroid metabolite measurement may be useful in screening for infection proneness during this critical developmental period. Future studies should clinically evaluate their potential utility as a clinical screening tool.
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Affiliation(s)
- Nicole Prince
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Min Kim
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, 2820 Gentofte, Denmark
| | - Rachel S. Kelly
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Joann Diray-Arce
- Precision Vaccines Program, Division of Infectious Diseases, Boston Children’s Hospital, Boston, MA 02115, USA
| | - Klaus Bønnelykke
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, 2820 Gentofte, Denmark
| | - Bo L. Chawes
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, 2820 Gentofte, Denmark
| | - Mengna Huang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Ofer Levy
- Precision Vaccines Program, Division of Infectious Diseases, Boston Children’s Hospital, Boston, MA 02115, USA
| | - Augusto A. Litonjua
- Division of Pediatric Pulmonary Medicine, Department of Pediatrics, Golisano Children’s Hospital and University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Jakob Stokholm
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, 2820 Gentofte, Denmark
| | - Craig E. Wheelock
- Department of Medical Biochemistry and Biophysics, Division of Physiological Chemistry 2, Karolinska Institute, 17177 Stockholm, Sweden
| | - Hans Bisgaard
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, 2820 Gentofte, Denmark
| | - Scott T. Weiss
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Jessica A. Lasky-Su
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
- Correspondence: ; Tel.: +1-617-875-9992
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Yang Z, Lafata KJ, Chen X, Bowsher J, Chang Y, Wang C, Yin FF. Quantification of lung function on CT images based on pulmonary radiomic filtering. Med Phys 2022; 49:7278-7286. [PMID: 35770964 DOI: 10.1002/mp.15837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 06/06/2022] [Accepted: 06/08/2022] [Indexed: 12/13/2022] Open
Abstract
PURPOSE To develop a radiomics filtering technique for characterizing spatial-encoded regional pulmonary ventilation information on lung computed tomography (CT). METHODS The lung volume was segmented on 46 CT images, and a 3D sliding window kernel was implemented across the lung volume to capture the spatial-encoded image information. Fifty-three radiomic features were extracted within the kernel, resulting in a fourth-order tensor object. As such, each voxel coordinate of the original lung was represented as a 53-dimensional feature vector, such that radiomic features could be viewed as feature maps within the lungs. To test the technique as a potential pulmonary ventilation biomarker, the radiomic feature maps were compared to paired functional images (Galligas PET or DTPA-SPECT) based on the Spearman correlation (ρ) analysis. RESULTS The radiomic feature maps GLRLM-based Run-Length Non-Uniformity and GLCOM-based Sum Average are found to be highly correlated with the functional imaging. The achieved ρ (median [range]) for the two features are 0.46 [0.05, 0.67] and 0.45 [0.21, 0.65] across 46 patients and 2 functional imaging modalities, respectively. CONCLUSIONS The results provide evidence that local regions of sparsely encoded heterogeneous lung parenchyma on CT are associated with diminished radiotracer uptake and measured lung ventilation defects on PET/SPECT imaging. These findings demonstrate the potential of radiomics to serve as a complementary tool to the current lung quantification techniques and provide hypothesis-generating data for future studies.
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Affiliation(s)
- Zhenyu Yang
- Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina, USA
- Medical Physics Graduate Program, Duke Kunshan University, Kunshan, Jiangsu, China
| | - Kyle J Lafata
- Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina, USA
- Department of Radiology, Duke University, Durham, North Carolina, USA
- Department of Electrical and Computer Engineering, Duke University, Durham, North Carolina, USA
| | - Xinru Chen
- Medical Physics Graduate Program, Duke Kunshan University, Kunshan, Jiangsu, China
| | - James Bowsher
- Medical Physics Graduate Program, Duke Kunshan University, Kunshan, Jiangsu, China
| | - Yushi Chang
- Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina, USA
| | - Chunhao Wang
- Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina, USA
| | - Fang-Fang Yin
- Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina, USA
- Medical Physics Graduate Program, Duke Kunshan University, Kunshan, Jiangsu, China
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Chen D, Kong N, Wang H. Leading‐Edge Pulmonary Gene Therapy Approached by Barrier‐Permeable Delivery System: A Concise Review on Peptide System. ADVANCED NANOBIOMED RESEARCH 2022. [DOI: 10.1002/anbr.202200113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Dinghao Chen
- Key Laboratory of Precise Synthesis of Functional Molecules of Zhejiang Province School of Science Department of Chemistry Westlake University 18 Shilongshan Road Hangzhou Zhejiang Province 310024 China
- Institute of Natural Sciences Westlake Institute for Advanced Study 18 Shilongshan Road Hangzhou Zhejiang Province 310024 China
| | - Nan Kong
- Key Laboratory of Precise Synthesis of Functional Molecules of Zhejiang Province School of Science Department of Chemistry Westlake University 18 Shilongshan Road Hangzhou Zhejiang Province 310024 China
- Institute of Natural Sciences Westlake Institute for Advanced Study 18 Shilongshan Road Hangzhou Zhejiang Province 310024 China
| | - Huaimin Wang
- Key Laboratory of Precise Synthesis of Functional Molecules of Zhejiang Province School of Science Department of Chemistry Westlake University 18 Shilongshan Road Hangzhou Zhejiang Province 310024 China
- Institute of Natural Sciences Westlake Institute for Advanced Study 18 Shilongshan Road Hangzhou Zhejiang Province 310024 China
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Niranjan V, Tarantino G, Kumar J, Cassidy N, Galvin L, O’Dowd G, Barnes T, O’Neill F, Cullen M, O’Connor R, O’Regan A. Dancing for Health and Wellbeing: A Feasibility Study of Examining Health Impacts of Online Dancing among Pulmonary Fibrosis Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13510. [PMID: 36294090 PMCID: PMC9602927 DOI: 10.3390/ijerph192013510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 10/07/2022] [Accepted: 10/12/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Physical activity (PA) is recommended in the management of patients with pulmonary fibrosis (PF) to improve health outcomes. Dance is one such form of PA which is meaningful, valuable, enjoyable and has demonstrated positive physical and mental health effects. METHODS With pre-post design, 16 patients, members of the Irish Lung Fibrosis Association, were enrolled in this study. Once weekly, 75-min dance sessions were delivered for eight weeks via Zoom by an experienced choreographer. Participants completed Chronic Respiratory Questionnaire Self-Administered Standardised Format (CRQ-SAS) and European Quality of Life 5 Dimensions 3 Level Version (EQ-5D-3L) to assess self-rated quality of life. A paired-sample t-test was employed to assess the mean differences between the pre-and post-intervention scores. RESULTS Most patients (78.57%) were aged over 60 years; with 71.43% diagnosed with pulmonary fibrosis more than 3 years ago. We performed an analysis of 10/16 participants who completed the intervention (5 males, 5 females). On CRQ-SAS scale we found, (a) dyspnoea-small to moderate magnitude improvement of 0.5-1.0 among 50%, (b) fatigue-small to moderate magnitude improvement of 0.5-1.0 among 40%, (c) emotional function-small to high magnitude improvement of 0.5-2.0 among 50%, (d) mastery-small magnitude improvement of 0.5 among 20%. Participants reported their health moderate to best on Visual Analogue Scale of EQ-5D-3L which improved by 1-3 scale among 40%. Mental health improved as percentage of not feeling anxious or depressed rose post event from 42.86% to 72.73%. CONCLUSION Our findings demonstrate that a virtual dance intervention is acceptable, enjoyable and feasible for improving health outcomes among PF patients. More organised and continuous events in future may reveal cost-benefit ratio and impact on health outcomes.
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Affiliation(s)
- Vikram Niranjan
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, D04 V1W8 Dublin, Ireland
| | - Giampiero Tarantino
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, D04 V1W8 Dublin, Ireland
| | - Jaspal Kumar
- NUS Centre for Cancer Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore
| | - Nicola Cassidy
- Irish Lung Fibrosis Association, D01 V9Y4 Dublin, Ireland
| | - Liam Galvin
- Irish Lung Fibrosis Association, D01 V9Y4 Dublin, Ireland
| | - Gemma O’Dowd
- Irish Lung Fibrosis Association, D01 V9Y4 Dublin, Ireland
| | | | - Finola O’Neill
- Irish Lung Fibrosis Association, D01 V9Y4 Dublin, Ireland
| | - Matthew Cullen
- Irish Lung Fibrosis Association, D01 V9Y4 Dublin, Ireland
| | - Ray O’Connor
- School of Medicine, University of Limerick, V94 T9PX Limerick, Ireland
| | - Andrew O’Regan
- School of Medicine, University of Limerick, V94 T9PX Limerick, Ireland
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Chowdhury N, Turton B, Chher T, Hak S, Hondru G, Sokal-Gutierrez K. Relationship between Early Childhood Caries and Prolonged Coughing Episodes in a Cohort of Cambodian Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12842. [PMID: 36232141 PMCID: PMC9566348 DOI: 10.3390/ijerph191912842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
Studies have shown an association between Early Childhood Caries (ECC) and respiratory infections; however, most have been cross-sectional, and all have been in high-income countries. Inverse probability treatment weighting (IPTW) was applied to longitudinal data from the Cambodia Health and Nutrition Monitoring Study. An analytical sample of 1703 Cambodian children between 1- and 4-years old was used to examine the effect of caries incidence (ECC Activity) on the odds of a child subsequently experiencing an episode of prolonged coughing (>14 days) over the subsequent 18 m. ECC activity occurred among 523 children (30.7%) while prolonged coughing was observed among 235 children (13.8%). ECC activity increased the risk of prolonged coughing (RR 1.23; 95% CI 0.95, 1.58; Average treatment effect = 3%). Follow-up investigations are justified in order to examine whether ECC may be a modifiable risk factor for prevention of respiratory illness among young children.
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Affiliation(s)
- Noureen Chowdhury
- Faculty of Dentistry, University of Puthisastra, Phnom Penh 120211, Cambodia
| | - Bathsheba Turton
- Faculty of Dentistry, University of Puthisastra, Phnom Penh 120211, Cambodia
- Office of Global and Population Health, Henry M. Goldman School of Dental Medicine, Boston University, Bostson, MA 02118, USA
| | - Tepirou Chher
- Oral Health Bureau, Department of Preventive Medicine, Ministry of Health, Phnom Penh 12151, Cambodia
| | - Sithan Hak
- Oral Health Bureau, Department of Preventive Medicine, Ministry of Health, Phnom Penh 12151, Cambodia
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Wu C, Zhang Y, Wei J, Zhao Z, Norbäck D, Zhang X, Lu C, Yu W, Wang T, Zheng X, Zhang L. Associations of Early-Life Exposure to Submicron Particulate Matter With Childhood Asthma and Wheeze in China. JAMA Netw Open 2022; 5:e2236003. [PMID: 36219442 PMCID: PMC9554703 DOI: 10.1001/jamanetworkopen.2022.36003] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Exposure to particulate matter (PM) has been associated with childhood asthma and wheeze. However, the specific associations between asthma and PM with an aerodynamic equivalent diameter of 1 μm or less (ie, PM1), which is a contributor to PM2.5 and potentially more toxic than PM2.5, remain unclear. OBJECTIVE To investigate the association of early-life (prenatal and first year) exposure to size-segregated PM, including PM1, PM1-2.5, PM2.5, PM2.5-10, and PM10, with childhood asthma and wheeze. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study was based on a questionnaire administered between June 2019 and June 2020 to caregivers of children aged 3 to 6 years in 7 Chinese cities (Wuhan, Changsha, Taiyuan, Nanjing, Shanghai, Chongqing, and Urumqi) as the second phase of the China, Children, Homes, Health study. EXPOSURES Exposure to PM1, PM1-2.5, PM2.5, PM2.5-10, and PM10 during the prenatal period and first year of life. MAIN OUTCOMES AND MEASURES The main outcomes were caregiver-reported childhood asthma and wheeze. A machine learning-based space-time model was applied to estimate early-life PM1, PM2.5, and PM10 exposure at 1 × 1-km resolution. Concentrations of PM1-2.5 and PM2.5-10 were calculated by subtracting PM1 from PM2.5 and PM2.5 from PM10, respectively. Multilevel (city and child) logistic regression models were applied to assess associations. RESULTS Of 29 418 children whose caregivers completed the survey (15 320 boys [52.1%]; mean [SD] age, 4.9 [0.9] years), 2524 (8.6%) ever had wheeze and 1161 (3.9%) were diagnosed with asthma. Among all children, 18 514 (62.9%) were breastfed for more than 6 months and 787 (2.7%) had parental history of atopy. A total of 22 250 children (75.6%) had a mother with an educational level of university or above. Of the 25 422 children for whom information about cigarette smoking exposure was collected, 576 (2.3%) had a mother who was a current or former smoker during pregnancy and 7525 (29.7%) had passive household cigarette smoke exposure in early life. Early-life PM1, PM2.5, and PM10 exposure were significantly associated with increased risk of childhood asthma, with higher estimates per 10-μg/m3 increase in PM1 (OR, 1.55; 95% CI, 1.27-1.89) than in PM2.5 (OR, 1.14; 95% CI, 1.03-1.26) and PM10 (OR, 1.11; 95% CI, 1.02-1.20). No association was observed between asthma and PM1-2.5 exposure, suggesting that PM1 rather than PM1-2.5 contributed to the association between PM2.5 and childhood asthma. There were significant associations between childhood wheeze and early-life PM1 exposure (OR, 1.23; 95% CI, 1.07-1.41) and PM2.5 exposure (OR, 1.08; 95% CI, 1.01-1.16) per 10-μg/m3 increase in PM1 and PM2.5, respectively. CONCLUSIONS AND RELEVANCE In this cross-sectional study, higher estimates were observed for the association between PM with smaller particles, such as PM1, vs PM with larger particles and childhood asthma. The results suggest that the association between PM2.5 and childhood asthma was mainly attributable to PM1.
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Affiliation(s)
- Chuansha Wu
- Department of Environmental Hygiene and Occupational Medicine, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
| | - Yunquan Zhang
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, China
| | - Jing Wei
- Department of Chemical and Biochemical Engineering, Iowa Technology Institute, The University of Iowa, Iowa City
| | - Zhuohui Zhao
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
| | - Dan Norbäck
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Xin Zhang
- Research Centre for Environmental Science and Engineering, Shanxi University, Taiyuan, China
| | - Chan Lu
- Department of Occupational and Environmental Health, School of Public Health, Xiangya Medical College, Central South University, Changsha, China
| | - Wei Yu
- Joint International Research Laboratory of Green Buildings and Built Environments, Ministry of Education, Chongqing University, Chongqing, China
| | - Tingting Wang
- School of Nursing and Health Management, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Xiaohong Zheng
- School of Energy and Environment, Southeast University, Nanjing, China
| | - Ling Zhang
- Department of Environmental Hygiene and Occupational Medicine, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
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Fallahzadeh A, Sharifnejad Tehrani Y, Sheikhy A, Ghamari SH, Mohammadi E, Saeedi Moghaddam S, Esfahani Z, Nasserinejad M, Shobeiri P, Rashidi MM, Rezaei N, Heidari-Foroozan M, Rezaei N, Larijani B, Farzadfar F. The burden of chronic respiratory disease and attributable risk factors in North Africa and Middle East: findings from global burden of disease study (GBD) 2019. Respir Res 2022; 23:268. [PMID: 36175873 PMCID: PMC9521864 DOI: 10.1186/s12931-022-02187-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 09/19/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND North Africa and Middle East (NAME) has an increasing burden of chronic respiratory diseases (CRDs); however, a systematic understanding of the distribution and trends is not available. We aimed to report the trends of CRDs and attributable risk factors in this region between 1990 and 2019. METHODS Using data from the Global Burden of Diseases Study (GBD) 2019, cause specific mortality served as the basis for estimating incidence and disability-adjusted life years (DALYs). The burden attributable to risk factors was calculated by a comparative risk assessment and contribution of population ageing and growth was determined by decomposition analysis. RESULTS The number of deaths due to CRD in 2019 were 128,513 (110,781 to 114,351). In 2019, the age-standardized incidence rate (ASIR) of CRDs was 1052.8 (924.3 to 1209.4) per 100,000 population and had a 10.3% increase and the age-standardized death rate (ASDR) was 36.1 (30.9 to 40.3) with a 32.9% decrease compared to 1990. In 2019, United Arab Emirates had the highest ASIR (1412.7 [1237.3 to 1622.2]) and Afghanistan had the highest ASDR (67.8 [52.0 to 81.3]). CRDs were responsible for 2.91% of total DALYs in 2019 (1.69% due to chronic obstructive pulmonary disease [COPD] and 1.02% due to asthma). With regard to the components of DALYs, the age-standardized rate of years of life lost (YLL) had a - 39.0% (- 47.1 to - 30.3) decrease; while the age-standardized rate of years lived with disability (YLD) had a 13.4% (9.5 to 17.7) increase. Of total ASDRs of CRDs, 31.6% were attributable to smoking and 14.4% to ambient particulate matter pollution. CONCLUSION CRDs remain a leading cause of death and disability in NAME, with growth in absolute numbers. COPD and asthma were the most common CRDs and smoking was the leading risk factor especially in men. More attention is needed in order to reduce CRDs' burden through appropriate interventions and policies.
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Affiliation(s)
- Aida Fallahzadeh
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Yeganeh Sharifnejad Tehrani
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Sheikhy
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyyed-Hadi Ghamari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Esmaeil Mohammadi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Saeedi Moghaddam
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Esfahani
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Biostatistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Maryam Nasserinejad
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parnian Shobeiri
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad-Mahdi Rashidi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazila Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa Heidari-Foroozan
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Lee UN, Su X, Hieber DL, Tu WC, McManamen AM, Takezawa MG, Hassan GW, Chan TC, Adams KN, Wald ER, DeMuri GP, Berthier E, Theberge AB, Thongpang S. CandyCollect: at-home saliva sampling for capture of respiratory pathogens. LAB ON A CHIP 2022; 22:3555-3564. [PMID: 35983761 PMCID: PMC9931141 DOI: 10.1039/d1lc01132d] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Streptococcus pyogenes is a major human-specific bacterial pathogen and a common cause of a wide range of symptoms from mild infection such as pharyngitis (commonly called strep throat) to life-threatening invasive infection and post-infectious sequelae. Traditional methods for diagnosis include collecting a sample using a pharyngeal swab, which can cause discomfort and even discourage adults and children from seeking proper testing and treatment in the clinic. Saliva samples are an alternative to pharyngeal swabs. To improve the testing experience for strep throat, we developed a novel lollipop-inspired sampling platform (called CandyCollect) to capture bacteria in saliva. The device can be used in clinics or in the home and shipped back to a lab for analysis, integrating with telemedicine. CandyCollect is designed to capture bacteria on an oxygen plasma treated polystyrene surface embedded with flavoring substances to enhance the experience for children and inform the required time to complete the sampling process. In addition, the open channel structure prevents the tongue from scraping and removing the captured bacteria. The flavoring substances did not affect bacterial capture and the device has a shelf life of at least 2 months (with experiments ongoing to extend the shelf life). We performed a usability study with 17 participants who provided feedback on the device design and the dissolving time of the candy. This technology and advanced processing techniques, including polymerase chain reaction (PCR), will enable user-friendly and effective diagnosis of streptococcal pharyngitis.
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Affiliation(s)
- Ulri N Lee
- Department of Chemistry, University of Washington, Seattle, WA, USA.
| | - Xiaojing Su
- Department of Chemistry, University of Washington, Seattle, WA, USA.
| | - Damielle L Hieber
- Department of Chemistry, University of Washington, Seattle, WA, USA.
| | - Wan-Chen Tu
- Department of Chemistry, University of Washington, Seattle, WA, USA.
| | - Anika M McManamen
- Department of Chemistry, University of Washington, Seattle, WA, USA.
| | - Meg G Takezawa
- Department of Chemistry, University of Washington, Seattle, WA, USA.
| | - Grant W Hassan
- Department of Chemistry, University of Washington, Seattle, WA, USA.
| | - Tung Ching Chan
- Department of Chemistry, University of Washington, Seattle, WA, USA.
| | - Karen N Adams
- Institute of Translational Health Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Ellen R Wald
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Gregory P DeMuri
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Erwin Berthier
- Department of Chemistry, University of Washington, Seattle, WA, USA.
| | - Ashleigh B Theberge
- Department of Chemistry, University of Washington, Seattle, WA, USA.
- Department of Urology, School of Medicine, University of Washington, Seattle, WA, USA
| | - Sanitta Thongpang
- Department of Chemistry, University of Washington, Seattle, WA, USA.
- Department of Biomedical Engineering, Faculty of Engineering, Mahidol University, Nakorn Pathom, Thailand
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48
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Osei MM, Dayie NTKD, Azaglo GSK, Tettey EY, Nartey ET, Fenny AP, Manzi M, Kumar AMV, Labi AK, Opintan JA, Sampane-Donkor E. Alarming Levels of Multidrug Resistance in Aerobic Gram-Negative Bacilli Isolated from the Nasopharynx of Healthy Under-Five Children in Accra, Ghana. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10927. [PMID: 36078645 PMCID: PMC9518304 DOI: 10.3390/ijerph191710927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 08/25/2022] [Accepted: 08/29/2022] [Indexed: 06/15/2023]
Abstract
Nasopharyngeal carriage of aerobic Gram-negative bacilli (GNB) may precede the development of invasive respiratory infections. We assessed the prevalence of nasopharyngeal carriage of aerobic GNB and their antimicrobial resistance patterns among healthy under-five children attending seven selected day-care centres in the Accra metropolis of the Greater Accra region of Ghana from September to December 2016. This cross-sectional study analysed a total of 410 frozen nasopharyngeal samples for GNB and antimicrobial drug resistance. The GNB prevalence was 13.9% (95% CI: 10.8-17.6%). The most common GNB were Escherichia coli (26.3%), Klebsiella pneumoniae (24.6%), and Enterobacter cloacae (17.5%). Resistance was most frequent for cefuroxime (73.7%), ampicillin (64.9%), and amoxicillin/clavulanic acid (59.6%). The organisms were least resistant to gentamicin (7.0%), amikacin (8.8%), and meropenem (8.8%). Multidrug resistance (MDR, being resistant to ≥3 classes of antibiotics) was observed in 66.7% (95% CI: 53.3-77.8%). Extended-spectrum beta-lactamase (ESBL)-producing bacteria constituted 17.5% (95% CI: 9.5-29.9%), AmpC-producing bacteria constituted 42.1% (95% CI: 29.8-55.5%), and carbapenemase-producing bacteria constituted 10.5% (95% CI: 4.7-21.8%) of isolates. The high levels of MDR are of great concern. These findings are useful in informing the choice of antibiotics in empiric treatment of GNB infections and call for improved infection control in day-care centres to prevent further transmission.
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Affiliation(s)
- Mary-Magdalene Osei
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box GP 4236, Ghana
- FleRhoLife Research Consult, Accra P.O. Box TS 853, Ghana
| | - Nicholas T. K. D. Dayie
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box GP 4236, Ghana
| | - Godfred S. K. Azaglo
- Environmental Protection Agency, Starlet 91 Road, Ministries, Accra P.O. Box MB 326, Ghana
| | | | - Edmund T. Nartey
- Centre for Tropical Clinical Pharmacology & Therapeutics, University of Ghana Medical School, Accra P.O. Box GP 4236, Ghana
| | - Ama P. Fenny
- Institute of Statistical, Social and Economic Research (ISSER), University of Ghana, Accra P.O. Box LG 25, Ghana
| | - Marcel Manzi
- Department of Medical OCB, MSF-Belgium Headquarters, Rue de Bomel 65, 5000 Namur, Belgium
| | - Ajay M. V. Kumar
- International Union Against Tuberculosis and Lung Disease, 2 Rue Jean Lantier, 75001 Paris, France
- International Union Against Tuberculosis and Lung Disease, South-East Asia Office, C-6 Qutub Institutional Area, New Delhi 110016, India
- Yenepoya Medical College, Yenepoya (Deemed to Be University) University, University Road, Deralakatte, Mangalore 575018, India
| | - Appiah-Korang Labi
- World Health Organization Country Office, Roman Ridge, Accra P.O. Box MB 142, Ghana
| | - Japheth A. Opintan
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box GP 4236, Ghana
| | - Eric Sampane-Donkor
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box GP 4236, Ghana
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49
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Xu H, Wang X, Tian Y, Tian J, Zeng Y, Guo Y, Song F, Xu X, Ni X, Feng G. Short-term exposure to gaseous air pollutants and daily hospitalizations for acute upper and lower respiratory infections among children from 25 cities in China. ENVIRONMENTAL RESEARCH 2022; 212:113493. [PMID: 35618009 DOI: 10.1016/j.envres.2022.113493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/29/2022] [Accepted: 05/14/2022] [Indexed: 06/15/2023]
Abstract
To examine the short-term association between gaseous air pollutants (CO, NO2, SO2, and O3) and all-cause respiratory disease, acute upper respiratory infections (AURIs) as well as acute lower respiratory infections (ALRIs) among children, we conducted the study from 25 major cities in China. Hospitalization records of children aged 0-18 years due to all-cause respiratory diseases (889,926), AURIs (97,858), and ALRIs (642,154) from 2016 to 2019 were extracted. Concentrations of CO, NO2, SO2, and O3 were averaged across monitoring stations. Generalized additive models were used to estimate the associations between gaseous air pollutants and daily hospitalizations for all-cause respiratory disease, AURIs, and ALRIs. The meta-analysis was used to combine the city-specific estimates. A 10 mg/m3 increase in CO at lag01, and a 10 μg/m3 increase in NO2, SO2, and O3 at lag01 were associated with 1.65% (95%CI, 0.41-2.91), 0.54% (95%CI, 0.30-0.79), 0.60% (95%CI, 0.22-0.99), and 0.23% (95%CI, 0.06-0.39) increase of hospitalizations due to all-cause respiratory disease, respectively. For the disease subtype, O3 only had adverse effects on AURIs, CO and SO2 mainly on ALRIs, and NO2 on both AURIs and ALRIs. Children aged 4-6years were more vulnerable to the effects of CO and NO2, but those aged <1year were more susceptible to SO2 and O3. Besides, the O3 effect was stronger in the warm season than in the cold season. The study indicated that short-term exposure to CO, NO2, SO2, and O3 was associated with increased hospitalization for pediatric respiratory disease, and the association may vary by position of the respiratory tract, age, and season.
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Affiliation(s)
- Hui Xu
- Big Data Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xinyu Wang
- Big Data Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Yaohua Tian
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jian Tian
- Big Data Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Yueping Zeng
- Medical Record Management Office, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Yongli Guo
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Fei Song
- Medical Record Management Office, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xin Xu
- Big Data Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xin Ni
- Big Data Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China; Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beihang University & Capital Medical University, Beijing, China; Department of Otolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
| | - Guoshuang Feng
- Big Data Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China; Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beihang University & Capital Medical University, Beijing, China.
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50
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Aguilera R, Leibel S, Corringham T, Bialostozky M, Nguyen MB, Gershunov A, Benmarhnia T. Mediating Role of Fine Particles Abatement on Pediatric Respiratory Health During COVID-19 Stay-at-Home Order in San Diego County, California. GEOHEALTH 2022; 6:e2022GH000637. [PMID: 36545248 PMCID: PMC9756275 DOI: 10.1029/2022gh000637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/08/2022] [Accepted: 07/19/2022] [Indexed: 06/17/2023]
Abstract
Lower respiratory tract infections disproportionately affect children and are one of the main causes of hospital referral and admission. COVID-19 stay-at-home orders in early 2020 led to substantial reductions in hospital admissions, but the specific contribution of changes in air quality through this natural experiment has not been examined. Capitalizing on the timing of the stay-at-home order, we quantified the specific contribution of fine-scale changes in PM2.5 concentrations to reduced respiratory emergency department (ED) visits in the pediatric population of San Diego County, California. We analyzed data on pediatric ED visits (n = 72,333) at the ZIP-code level for respiratory complaints obtained from the ED at Rady Children's Hospital in San Diego County (2015-2020) and ZIP-code level PM2.5 from an ensemble model integrating multiple machine learning algorithms. We examined the decrease in respiratory visits in the pediatric population attributable to the stay-at-home order and quantified the contribution of changes in PM2.5 exposure using mediation analysis (inverse of odds ratio weighting). Pediatric respiratory ED visits dropped during the stay-at-home order (starting on 19 March 2020). Immediately after this period, PM2.5 concentrations, relative to the counterfactual values based in the 4-year baseline period, also decreased with important spatial variability across ZIP codes in San Diego County. Overall, we found that decreases in PM2.5 attributed to the stay-at-home order contributed to explain 4% of the decrease in pediatric respiratory ED visits. We identified important spatial inequalities in the decreased incidence of pediatric respiratory illness and found that brief decline in air pollution levels contributed to a decrease in respiratory ED visits.
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Affiliation(s)
- Rosana Aguilera
- Scripps Institution of OceanographyUniversity of California San DiegoLa JollaCAUSA
| | - Sydney Leibel
- Departments of Allergy and Immunology and Pediatric Allergy and ImmunologyUniversity of California San DiegoLa JollaCAUSA
- Herbert Wertheim School of Public Health and Human Longevity ScienceUniversity of California San DiegoLa JollaCAUSA
| | - Thomas Corringham
- Scripps Institution of OceanographyUniversity of California San DiegoLa JollaCAUSA
| | - Mario Bialostozky
- Department of Pediatrics Emergency MedicineUniversity of California San DiegoLa JollaCAUSA
| | - Margaret B. Nguyen
- Department of Pediatrics Emergency MedicineUniversity of California San DiegoLa JollaCAUSA
| | - Alexander Gershunov
- Scripps Institution of OceanographyUniversity of California San DiegoLa JollaCAUSA
| | - Tarik Benmarhnia
- Scripps Institution of OceanographyUniversity of California San DiegoLa JollaCAUSA
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