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Ortac Ersoy E, Er B, Ciftci F, Gulleroglu A, Suner K, Arpinar B, Aygencel G, Bacakoglu F, Akpinar S, Comert B, Sungurtekin H, Altıntas D, Rollas K, Turan S, Topeli A. Outcome of Patients Admitted to Intensive Care Units due to Influenza-Related Severe Acute Respiratory Illness in 2017-2018 Flu Season: A Multicenter Study from Turkey. Respiration 2020; 99:954-960. [PMID: 33271560 DOI: 10.1159/000511092] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 08/20/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Influenza can cause severe acute respiratory illness (SARI), which occurs as local outbreaks or seasonal epidemics with high intensive care unit (ICU) admission and mortality rates. Mortality is mainly due to SARI. OBJECTIVE The aim of this study was to evaluate the outcome of patients admitted to ICU due to influenza-related SARI in 2017-2018 flu season in Turkey. METHODS A retrospective multicenter study was conducted in 13 ICUs with a total of 216 beds from 6 cities in Turkey. All adult patients (over 18 years) admitted to the ICUs in 2017-2018 flu season (between September 1, 2017, and April 30, 2018) because of SARI and with a positive nasopharyngeal swab for influenza were included in the study. RESULTS A total of 123 cases were included in the study. The mean age of patients was 64.5 ± 17.5 years, and 66 (53.7%) patients were older than 65 years. The ICU mortality was 33.9%, and hospital mortality was 35.6%. Invasive mechanical ventilation (IMV), acute kidney injury (AKI), hematologic malignancy, and >65 years of age were the factors affecting mortality in influenza. CONCLUSION SARI due to influenza carries a high mortality rate, and IMV, AKI, presence of hematologic malignancy, and older age are independent risk factors for mortality.
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Affiliation(s)
- Ebru Ortac Ersoy
- Division of Intensive Care Medicine, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey,
| | - Berrin Er
- Division of Intensive Care Medicine, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Fatma Ciftci
- Department of Chest Diseases, Intensive Care Unit, Ankara University Faculty of Medicine, Ankara, Turkey
| | | | - Kezban Suner
- Intensive Care Unit, Sakarya University Education and Research Hospital, Sakarya, Turkey
| | - Burcu Arpinar
- Intensive Care Unit, Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, Istanbul, Turkey
| | - Gulbin Aygencel
- Medical Intensive Care Unit, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Feza Bacakoglu
- Division of Chest Diseases, Intensive Care Unit, Ege University Faculty of Medicine, İzmir, Turkey
| | - Serdar Akpinar
- Medical Intensive Care Unit, Dışkapı Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey
| | - Bilgin Comert
- Medical Intensive Care Unit, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Hulya Sungurtekin
- Intensive Care Unit, Pamukkale University Faculty of Medicine, Denizli, Turkey
| | - Defne Altıntas
- Medical Intensive Care Unit, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Kazim Rollas
- Intensive Care Unit, Tepecik Education Hospital, University of Health Sciences, Izmir, Turkey
| | - Sema Turan
- Intensive Care Unit, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Arzu Topeli
- Division of Intensive Care Medicine, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Abstract
OBJECTIVE The purpose of this article is to describe 3 patients each of whom developed a different form of tracheobronchial aspergillosis. METHODS We describe our clinical experience with 3 patients who developed significant respiratory symptoms secondary to Aspergillus infection. All patients were followed closely until there was resolution of pulmonary problems or they succumbed to respiratory insufficiency. RESULTS The first patient had asthma and her clinical and bronchoscopic findings were compatible with the diagnosis of mucoid impaction syndrome caused by Aspergillus. Response to therapy was excellent with complete recovery. The second and third patients had what we believe was tracheobronchial pseudomembranous aspergillosis. The precise reason for this complication in the second patient is unknown. The third patient was immunosuppressed and developed tracheobronchial aspergillosis. Despite aggressive therapy, both of these patients died. Diagnostic bronchoscopy was helpful in detecting the airway abnormalities and for obtaining respiratory specimens for culture. CONCLUSIONS These cases show the diverse tracheobronchial manifestations of Aspergillus species. Diagnostic bronchoscopy was helpful in the diagnosis of airway involvement by aspergillus.
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Yoo JK, Baker DP, Fish EN. Interferon-β modulates type 1 immunity during influenza virus infection. Antiviral Res 2010; 88:64-71. [DOI: 10.1016/j.antiviral.2010.07.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2010] [Revised: 07/09/2010] [Accepted: 07/20/2010] [Indexed: 01/12/2023]
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Yoo JK, Galligan CL, Virtanen C, Fish EN. Identification of a novel antigen-presenting cell population modulating antiinfluenza type 2 immunity. ACTA ACUST UNITED AC 2010; 207:1435-51. [PMID: 20547825 PMCID: PMC2901068 DOI: 10.1084/jem.20091373] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Antiinfluenza type 2 (T2) immunity contributes to both immunopathology and immunoprotection, yet the underlying mechanisms modulating T2 immunity remain ill defined. We describe a novel mouse antigen (Ag)-presenting cell (APC), designated late-activator APC (LAPC). After pulmonary influenza A (H1N1) virus infection, LAPCs enter the lungs, capture viral Ag, and subsequently migrate to the draining lymph node (DLN) and spleen, with delayed kinetics relative to dendritic cells (DCs). In the DLN, influenza virus–activated LAPCs present Ag and selectively induce T helper type 2 (Th2) effector cell polarization by cell–cell contact–mediated modulation of GATA-3 expression. In adoptive transfer experiments, influenza virus–activated LAPCs augmented Th2 effector T cell responses in the DLN, increased production of circulating antiinfluenza immunoglobulin, and increased levels of T2 cytokines in bronchoalveolar lavage fluid in recipient influenza virus–infected mice. LAPC-recipient mice exhibited exacerbated pulmonary pathology, with delayed viral clearance and enhanced pulmonary eosinophilia. Collectively, our results identify and highlight the importance of LAPCs as immunomodulators of T2 immunity during influenza A virus infection.
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Affiliation(s)
- Jae-Kwang Yoo
- Toronto General Research Institute, University Health Network, Toronto, Ontario M5G 2M1, Canada
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Bes C, Kılıçgün A, Talay F, Yılmaz F, Soy M. Bronchocentric granulomatosis in a patient with rheumatoid arthritis. Rheumatol Int 2010; 32:3261-3. [PMID: 20379817 DOI: 10.1007/s00296-010-1495-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2010] [Accepted: 03/27/2010] [Indexed: 10/19/2022]
Abstract
Bronchocentric granulomatosis is an uncommon entity which has no specific clinical, radiological and immunological features. It is usually diagnosed at morphological examination of biopsy or resected lung material. Aetiology of bronchocentric granulomatosis is unclear. A 49-year-old female patient, who was followed up with diagnosis rheumatoid arthritis in our outpatient clinic, presented with right lobe nodular lesion in chest radiography. Right thoracotomy and wedge resection was performed. Pathological examination revealed bronchocentric granulomatosis. Bronchocentric granulomatosis has been rarely reported in rheumatoid arthritis. This case might be a proof that bronchocentric granulomatosis may be one of the respiratory manifestations of rheumatoid arthritis.
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Affiliation(s)
- Cemal Bes
- Department of Rheumatology, Abant Izzet Baysal University Medical School, Bolu, Turkey.
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Abstract
Eosinophilic bronchopneumopathy (EBP) is a disease characterized by eosinophilic infiltration of the lung and bronchial mucosa, as demonstrated by examination of bronchoalveolar lavage fluid cytologic preparations or histologic examination of the bronchial mucosa. Although the precise cause of EBP is unknown, a hypersensitivity to aeroallergens is suspected. The diagnosis relies on typical history and clinical signs, demonstration of bronchopulmonary eosinophilia by cytology or histopathologic examination, and exclusion of known causes of lower airway eosinophilia. Most dogs display an excellent response to oral corticosteroid therapy; however, side effects of this treatment can be limiting. New therapeutic approaches are being studied, including the use of aerosol therapy, cyclosporine, or drugs interfering with T helper 2 immune response.
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Affiliation(s)
- Cécile Clercx
- Department of Veterinary Clinical Sciences, Small Animal Internal Medicine, University of Liège, 4000 Liège, Belgium.
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