WorldWideScience

Sample records for allergic bronchopulmonary aspergillosis

  1. Eosinophilic pleural effusion complicating allergic bronchopulmonary aspergillosis.

    Science.gov (United States)

    Kirschner, Austin N; Kuhlmann, Erica; Kuzniar, Tomasz J

    2011-01-01

    Allergic bronchopulmonary aspergillosis (ABPA) is primarily a disease of patients with cystic fibrosis or asthma, who typically present with bronchial obstruction, fever, malaise, and expectoration of mucus plugs. We report a case of a young man with a history of asthma who presented with cough, left-sided pleuritic chest pain and was found to have lobar atelectasis and an eosinophilic, empyematous pleural effusion. Bronchoscopy and sputum cultures grew Aspergillus fumigatus, and testing confirmed strong allergic response to this mold, all consistent with a diagnosis of ABPA. This novel and unique presentation of ABPA expands on the differential diagnosis of eosinophilic pleural effusions. PMID:21311176

  2. Allergic Bronchopulmonary Aspergillosis: A Perplexing Clinical Entity.

    Science.gov (United States)

    Shah, Ashok; Panjabi, Chandramani

    2016-07-01

    In susceptible individuals, inhalation of Aspergillus spores can affect the respiratory tract in many ways. These spores get trapped in the viscid sputum of asthmatic subjects which triggers a cascade of inflammatory reactions that can result in Aspergillus-induced asthma, allergic bronchopulmonary aspergillosis (ABPA), and allergic Aspergillus sinusitis (AAS). An immunologically mediated disease, ABPA, occurs predominantly in patients with asthma and cystic fibrosis (CF). A set of criteria, which is still evolving, is required for diagnosis. Imaging plays a compelling role in the diagnosis and monitoring of the disease. Demonstration of central bronchiectasis with normal tapering bronchi is still considered pathognomonic in patients without CF. Elevated serum IgE levels and Aspergillus-specific IgE and/or IgG are also vital for the diagnosis. Mucoid impaction occurring in the paranasal sinuses results in AAS, which also requires a set of diagnostic criteria. Demonstration of fungal elements in sinus material is the hallmark of AAS. In spite of similar histopathologic features, co-existence of ABPA and AAS is still uncommon. Oral corticosteroids continue to be the mainstay of management of allergic aspergillosis. Antifungal agents play an adjunctive role in ABPA as they help reduce the fungal load. Saprophytic colonization in cavitary ABPA may lead to aspergilloma formation, which could increase the severity of the disease. The presence of ABPA, AAS, and aspergilloma in the same patient has also been documented. All patients with Aspergillus-sensitized asthma must be screened for ABPA, and AAS should always be looked for. PMID:27126721

  3. Immunopathology and Immunogenetics of Allergic Bronchopulmonary Aspergillosis

    Directory of Open Access Journals (Sweden)

    Alan P. Knutsen

    2011-01-01

    Full Text Available Allergic bronchopulmonary aspergillosis (ABPA is a Th2 hypersensitivity lung disease in response to Aspergillus fumigatus that affects asthmatic and cystic fibrosis (CF patients. Sensitization to A. fumigatus is common in both atopic asthmatic and CF patients, yet only 1%–2% of asthmatic and 7%–9% of CF patients develop ABPA. ABPA is characterized by wheezing and pulmonary infiltrates which may lead to pulmonary fibrosis and/or bronchiectasis. The inflammatory response is characterized by Th2 responses to Aspergillus allergens, increased serum IgE, and eosinophilia. A number of genetic risks have recently been identified in the development of ABPA. These include HLA-DR and HLA-DQ, IL-4 receptor alpha chain (IL-4RA polymorphisms, IL-10 −1082GA promoter polymorphisms, surfactant protein A2 (SP-A2 polymorphisms, and cystic fibrosis transmembrane conductance regulator gene (CFTR mutations. The studies indicate that ABPA patients are genetically at risk to develop skewed and heightened Th2 responses to A. fumigatus antigens. These genetic risk studies and their consequences of elevated biologic markers may aid in identifying asthmatic and CF patients who are at risk to the development of ABPA. Furthermore, these studies suggest that immune modulation with medications such as anti-IgE, anti-IL-4, and/or IL-13 monoclonal antibodies may be helpful in the treatment of ABPA.

  4. Diagnosis of allergic bronchopulmonary aspergillosis (ABPA) in cystic fibrosis

    DEFF Research Database (Denmark)

    Skov, M; Koch, C; Reimert, C M;

    2000-01-01

    The diagnosis of allergic bronchopulmonary aspergillosis (ABPA) in cystic fibrosis (CF) patients may be difficult to establish because ABPA shares many characteristics with coexisting atopy or other lung infections in these patients. This study aimed to evaluate the sensitivity and specificity...

  5. Allergic bronchopulmonary aspergillosis and bilateral fungal balls terminating in disseminated aspergillosis.

    Science.gov (United States)

    Anderson, C J; Craig, S; Bardana, E J

    1980-02-01

    A unique case of allergic bronchopulmonary aspergillosis associated with bilateral apical aspergillomas terminating in disseminated aspergillosis is presented. Postulated mechanisms of this combination are discussed with respect to the patient's clinical findings. The contribution of systemic and aerosolized corticosteroids are considered major contributing factors to dissemination of disease. PMID:7351446

  6. Childhood allergic bronchopulmonary aspergillosis presenting as a middle lobe syndrome

    OpenAIRE

    Shah, Ashok; Gera, Kamal; Panjabi, Chandramani

    2016-01-01

    Allergic bronchopulmonary aspergillosis (ABPA) is infrequently documented in children with asthma. Although collapse is not uncommon, middle lobe syndrome (MLS) as a presentation of ABPA is rather a rarity. A 9-year-old female child with asthma presented with increase in intensity of symptoms along with a right midzone patchy consolidation on a chest radiograph. In addition, an ill-defined opacity abutting the right cardiac border with loss of cardiac silhouette was noted. A right lateral vie...

  7. Allergic bronchopulmonary aspergillosis complicating cystic fibrosis in childhood.

    OpenAIRE

    Brueton, M. J.; Ormerod, L P; Shah, K J; Anderson, C. M.

    1980-01-01

    Allergic bronchopulmonary aspergillosis, known to be associated with cystic fibrosis in older patients, occurred in 7 young atopic children with cystic fibrosis. The diagnosis was suggested by the onset of, or the increase in, asthmatic symptoms accompanied by major chest x-ray changes ranging from total collapse of a lung or lobe to extensive but changing areas of consolidation. Each of the children had a blood eosinophilia, positive type I skin tests to Aspergillus fumigatus, and reversible...

  8. Bronchopulmonary allergic aspergillosis Aspergilosis broncopulmonar alérgica

    Directory of Open Access Journals (Sweden)

    Rodrigo Ramírez

    1990-03-01

    Full Text Available

    A series of well defined entitles associated with colonization or invasion by fungi of the genus Aspergillus are grouped under the term Aspergillosis; there are various modalities of pulmonary involvement, namely, extrinsec asthma, extrinsec allergic alveolitis, allergic bronchopulmonary aspergillosis, aspergilloma and an invasive form in debilitated terminal patients; besldes there exists a form of food poisoning. We report on the case of a 45 year-old asthmatic woman suffering from allerglc bronchopulmonary aspergillosis and sum. maryze the clinical and laboratory features of the different pulmonary forms of aspergillosis.

    El término Aspergllosis reúne una serle de entidades bien definidas, causadas por hongos del género Aspergillus. En este artículo se presenta el caso de una mujer de 45 años con aspergllosis broncopulmonar alérgica, atendida en el Hospital Universitario San Vicente de Paúl, de Medellín y se hace una somera revisión clínico-patológica de las diferentes formas de aspergllosis pulmonar.

  9. Allergic bronchopulmonary aspergillosis: a rare cause of pleural effusion.

    LENUS (Irish Health Repository)

    O'Connor, T M

    2012-02-03

    Aspergillus fumigatus is one of the most ubiquitous of the airborne saprophytic fungi. Allergic bronchopulmonary aspergillosis (ABPA) is a syndrome seen in patients with asthma and cystic fibrosis, and is characterized by hypersensitivity to chronic colonization of the airways with A. fumigatus. We report the case of a patient with ABPA presenting with pleural effusion. A 27-year-old male was referred with recurrent right pleural effusion. Past medical history was remarkable for asthma, allergic sinusitis, and recurrent pleurisy. Investigations revealed peripheral eosinophilia with elevated serum immunoglobulin E and bilateral pleural effusions with bilateral upper lobe proximal bronchiectasis. Precipitating serum antibodies to A. fumigatus were positive and the A. fumigatus immediate skin test yielded a positive reaction. A diagnosis of ABPA associated with bilateral pleural effusions was made and the patient was commenced on prednisolone. At review, the patient\\'s symptoms had considerably improved and his pleural effusions had resolved. ABPA may present with diverse atypical syndromes, including paratracheal and hilar adenopathy, obstructive lung collapse, pneumothorax and bronchopleural fistula, and allergic sinusitis. Allergic bronchopulmonary aspergillosis is a rare cause of pleural effusion and must be considered in the differential diagnosis of patients presenting with a pleural effusion, in particular those with a history of asthma.

  10. Allergic bronchopulmonary aspergillosis: a unique presentation in a pediatric patient

    Energy Technology Data Exchange (ETDEWEB)

    Huppmann, Michael V.; Monson, Matthew [Walter Reed Army Medical Center, Department of Radiology, Washington, DC (United States)

    2008-08-15

    Infection by the Aspergillus species of fungus can result in a variety of clinically and radiographically unique pulmonary diseases. The specific disease manifested is most dependent upon the immunocompetency of the infected individual. Allergic bronchopulmonary aspergillosis (ABPA) is most commonly seen in patients with asthma and cystic fibrosis. Since its original description in 1952, much has been published describing the radiographic manifestations of this disease. In this article, we present the unusual case of a 13-year-old whose initial radiographic presentation was that of a dense lobar consolidation. Additionally, we highlight the contributory role of the radiologist in guiding the appropriate clinical work-up and treatment of this disease. (orig.)

  11. Sinobronchial allergic aspergillosis with allergic bronchopulmonary aspergillosis: a less common co-existence

    Science.gov (United States)

    Upadhyay, Rashmi; Kant, Surya; Prakash, Ved; Saheer, S

    2014-01-01

    Allergic bronchopulmonary aspergillosis (ABPA) is an immunological pulmonary disorder that is characterised by a hyper-responsiveness of the airways to Aspergillus fumigatus. Although several other fungi may also present with similar clinical conditions, Aspergillus remains the most common fungal pathogen causing airway infections. Co-existence of ABPA with allergic Aspergillus sinusitis (AAS) is an uncommon presentation. The concept of one airway/one disease justifies the co-existence of ABPA with AAS, but it does not always hold true. We report a case of a 35-year-old woman who presented with symptoms suggestive of bronchial asthma. On further investigation, the radiological pattern showed fleeting shadows and CT scan showed central cystic bronchiectatic changes characteristic of ABPA. The nasal secretions were investigated for the presence of Aspergillus and were found to be positive. Hence a diagnosis of ABPA with AAS was established. The patient was treated with oral steroids and antifungal drugs. PMID:25371437

  12. Allergic bronchopulmonary aspergillosis treated successfully for one year with omalizumab

    Directory of Open Access Journals (Sweden)

    Collins J

    2012-11-01

    Full Text Available Jennifer Collins,1 Gabriele deVos,2 Golda Hudes,2 David Rosenstreich21New York Eye and Ear Infirmary, New York, NY, 2Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USABackground: Current therapy for allergic bronchopulmonary aspergillosis (ABPA uses oral corticosteroids, exposing patients to the adverse effects of these agents. There are reports of the steroid-sparing effect of anti-IgE therapy with omalizumab for ABPA in patients with cystic fibrosis (CF, but there is little information on its efficacy against ABPA in patients with bronchial asthma without CF.Objective: To examine the effects of omalizumab, measured by asthma control, blood eosinophilia, total serum immunoglobulin E (IgE, oral corticosteroid requirements, and forced expiratory volume spirometry in patients with ABPA and bronchial asthma.Methods: A retrospective review of charts from 2004–2006 of patients treated with omalizumab at an academic allergy and immunology practice in the Bronx, New York were examined for systemic steroid and rescue inhaler usage, serum immunoglobulin E levels, blood eosinophil counts, and asthma symptoms, as measured by the Asthma Control Test (ACT.Results: A total of 21 charts were screened for the diagnosis of ABPA and bronchial asthma. Four patients with ABPA were identified; two of these patients were male. The median monthly systemic corticosteroid use at 6 months and 12 months decreased from baseline usage. Total serum IgE decreased in all patients at 12 months of therapy. Pre-bronchodilator forced expiratory vital capacity at one second (FEV1 was variable at 1 year of treatment. There was an improvement in Asthma Control Test (ACT symptom scores for both daytime and nighttime symptoms.Conclusions: Treatment with omalizumab creates a steroid-sparing effect, reduces systemic inflammatory markers, and results in improvement in ACT scores in patients with ABPA.Keywords: allergic bronchopulmonary aspergillosis

  13. Childhood allergic bronchopulmonary aspergillosis presenting as a middle lobe syndrome.

    Science.gov (United States)

    Shah, Ashok; Gera, Kamal; Panjabi, Chandramani

    2016-01-01

    Allergic bronchopulmonary aspergillosis (ABPA) is infrequently documented in children with asthma. Although collapse is not uncommon, middle lobe syndrome (MLS) as a presentation of ABPA is rather a rarity. A 9-year-old female child with asthma presented with increase in intensity of symptoms along with a right midzone patchy consolidation on a chest radiograph. In addition, an ill-defined opacity abutting the right cardiac border with loss of cardiac silhouette was noted. A right lateral view confirmed a MLS, which was further corroborated by high resolution computed tomography. Central bronchiectasis was also observed, which prompted a work-up for ABPA. The child met 7/8 major diagnostic criteria for ABPA. She was then initiated on oral prednisolone that resulted in a marked clinical improvement within a fortnight. Radiological clearance occurred at 3 months with inflation of the middle lobe. ABPA presenting with MLS in a child is yet to be reported. A high index of suspicion is required to establish the diagnosis of ABPA in a child presenting with MLS. This would obviate the invasive investigations usually done to ascertain the cause of MLS.

  14. Childhood allergic bronchopulmonary aspergillosis presenting as a middle lobe syndrome.

    Science.gov (United States)

    Shah, Ashok; Gera, Kamal; Panjabi, Chandramani

    2016-01-01

    Allergic bronchopulmonary aspergillosis (ABPA) is infrequently documented in children with asthma. Although collapse is not uncommon, middle lobe syndrome (MLS) as a presentation of ABPA is rather a rarity. A 9-year-old female child with asthma presented with increase in intensity of symptoms along with a right midzone patchy consolidation on a chest radiograph. In addition, an ill-defined opacity abutting the right cardiac border with loss of cardiac silhouette was noted. A right lateral view confirmed a MLS, which was further corroborated by high resolution computed tomography. Central bronchiectasis was also observed, which prompted a work-up for ABPA. The child met 7/8 major diagnostic criteria for ABPA. She was then initiated on oral prednisolone that resulted in a marked clinical improvement within a fortnight. Radiological clearance occurred at 3 months with inflation of the middle lobe. ABPA presenting with MLS in a child is yet to be reported. A high index of suspicion is required to establish the diagnosis of ABPA in a child presenting with MLS. This would obviate the invasive investigations usually done to ascertain the cause of MLS. PMID:26844222

  15. Aspirin induced asthma accompanied with allergic bronchopulmonary aspergillosis: a case report

    Institute of Scientific and Technical Information of China (English)

    TANG Rui; ZHANG Hong-yu

    2010-01-01

    @@ In this paper, we describe a patient with a rather severe form of aspirin-induced asthma (AIA) and allergic bronchopulmonary aspergillosis (ABPA). The patient is a man born in 1948, who first presented with rhinorrhea,nasal congestion and chronic urticaria, and had an episode of asthma after ingestion of non-steroidal anti-inflammatory drugs (NSAIDs) for the further eight years.

  16. Human Immunodeficiency Virus and Allergic Bronchopulmonary Aspergillosis: Case Report and Review of Literature

    Science.gov (United States)

    Galiatsatos, Panagis; Melia, Michael T.; Silhan, Leann L.

    2016-01-01

    Allergic bronchopulmonary aspergillosis (ABPA) results from a hypersensitivity response to airways colonization with Aspergillus fumigatus, and it occurs most often in individuals with asthma or cystic fibrosis. Allergic bronchopulmonary aspergillosis is an indolent, but potentially progressive, disease in patients. In patients infected with human immunodeficiency virus (HIV), ABPA is rare, and its description in the literature is limited to case reports. We describe the occurrence of ABPA in a 37-year-old woman with well controlled HIV infection. This represents the first documented case of ABPA in an HIV-infected patient whose only pulmonary comorbidity included the ramifications of prior acute respiratory distress syndrome due to Pneumocystis jirovecii pneumonia. We also review prior case reports of ABPA in HIV-infected patients and consider risk factors for its development.

  17. Global burden of allergic bronchopulmonary aspergillosis with asthma and its complication chronic pulmonary aspergillosis in adults.

    Science.gov (United States)

    Denning, David W; Pleuvry, Alex; Cole, Donald C

    2013-05-01

    Allergic bronchopulmonary aspergillosis (ABPA) complicates asthma and may lead to chronic pulmonary aspergillosis (CPA) yet global burdens of each have never been estimated. Antifungal therapy has a place in the management of ABPA and is the cornerstone of treatment in CPA, reducing morbidity and probably mortality. We used the country-specific prevalence of asthma from the Global Initiative for Asthma (GINA) report applied to population estimates to calculate adult asthma cases. From five referral cohorts (China, Ireland, New Zealand, Saudi Arabia and South Africa), we estimated the prevalence of ABPA in adults with asthma at 2.5% (range 0.72-3.5%) (scoping review). From ABPA case series, pulmonary cavitation occurred in 10% (range 7-20%), allowing an estimate of CPA prevalence worldwide using a deterministic scenario-based model. Of 193 million adults with active asthma worldwide, we estimate that 4,837,000 patients (range 1,354,000-6,772,000) develop ABPA. By WHO region, the ABPA burden estimates are: Europe, 1,062,000; Americas, 1,461,000; Eastern Mediterranean, 351,000; Africa, 389,900; Western Pacific, 823,200; South East Asia, 720,400. We calculate a global case burden of CPA complicating ABPA of 411,100 (range 206,300-589,400) at a 10% rate with a 15% annual attrition. The global burden of ABPA potentially exceeds 4.8 million people and of CPA complicating ABPA ˜ 400,000, which is more common than previously appreciated. Both conditions respond to antifungal therapy justifying improved case detection. Prospective population and clinical cohort studies are warranted to more precisely ascertain the frequency of ABPA and CPA in different locations and ethnic groups and validate the model inputs.

  18. Cystic fibrosis transmembrane conductance regulator (CFTR) gene mutations in allergic bronchopulmonary aspergillosis.

    OpenAIRE

    Miller, P. W.; Hamosh, A.; Macek, M.; Greenberger, P. A.; MacLean, J; Walden, S M; Slavin, R G; Cutting, G R

    1996-01-01

    The etiology of allergic bronchopulmonary aspergillosis (ABPA) is not well understood. A clinical phenotype resembling the pulmonary disease seen in cystic fibrosis (CF) patients can occur in some individuals with ABPA. Reports of familial occurrence of ABPA and increased incidence in CF patients suggest a possible genetic basis for the disease. To test this possibility, the entire coding region of the cystic fibrosis transmembrane regulator (CFTR) gene was analyzed in 11 individuals who met ...

  19. Excellent outcome of Aspergillous endophthalmitis in a case of allergic bronchopulmonary aspergillosis

    Directory of Open Access Journals (Sweden)

    Balbir Khan

    2014-01-01

    Full Text Available While invasive aspergillosis occurs typically in severely immunocompromised patients, cases of surgical site infections have been reported in immunocompetent individuals. The purpose is to report an eye with post-operative Aspergillus endophthalmitis, which achieved a good visual outcome following early and aggressive treatment. A young patient, known case of allergic bronchopulmonary aspergillosis presented to us with post-cataract surgery endophthalmitis. He was treated with pars plana vitrectomy and intravitreal voriconazole and systemic itraconazole. The patient regained a vision of 20/30 with follow up of 2 years.

  20. Chest radiographic staging in allergic bronchopulmonary aspergillosis: relationship with immunological findings.

    LENUS (Irish Health Repository)

    Kiely, J L

    2012-02-03

    The question of whether a chest radiographic severity staging system could be correlated with standard blood\\/serum diagnostic indices in allergic bronchopulmonary aspergillosis (ABPA) was addressed in 41 patients. Asthma and positive Aspergillus fumigatus (AF) serology were considered essential diagnostic inclusion criteria. Eosinophil count, serum immunoglobulin (Ig)E and immediate skin hypersensitivity were also tested to grade patients as "definite" or "likely" ABPA. Definite cases had all five of these factors present, whereas likely cases had three or more. Chest radiographs were examined by experienced radiologists blinded to the clinical data. The six-stage radiographic score (0-5) was based on the severity and duration of changes seen: stage 0: normal; stage 1: transient hyperinflation; stage 2: transient minor changes; stage 3: transient major changes; stage 4: permanent minor changes; and stage 5: permanent major changes. Significant positive correlations (p<0.05) were observed between peak AF titres (expressed as an index), peak eosinophil count and radiographic severity stage. When considered as subgroups, these correlations approached, but did not reach, significance for the group with "likely" ABPA (n=28), but in the group with definite ABPA (n=13), there was a high correlation between radiographic score and peak AF index (r=0.59), as well as peak eosinophil count (r=0.62). This study suggests that the peak Aspergillus fumigatus index and eosinophil counts correlate best with the severity of radiographic stages in allergic bronchopulmonary aspergillosis. This chest radiographic staging system may be useful in the clinical assessment and management of patients with allergic bronchopulmonary aspergillosis, particularly in those patients with more severe radiographic stages.

  1. Voriconazole in the treatment of allergic bronchopulmonary aspergillosis in cystic fibrosis.

    LENUS (Irish Health Repository)

    Glackin, L

    2009-01-01

    Allergic bronchopulmonary aspergillosis (ABPA) can cause a significant clinical deterioration in patients with cystic fibrosis. There is very little research in the current literature with regard to alternatives for treatment, apart from long courses of steroids. We conducted a retrospective review of all our patients with ABPA treated with the antifungal voriconazole and found there was a significant drop in IgE levels post treatment as well as a decrease in steroid dosing. The improvement in FEV was not statistically significant; however there was a very wide variation in pre-treatment levels.

  2. Multiple bronchoceles in a non-asthmatic patient with allergic bronchopulmonary aspergillosis.

    Science.gov (United States)

    Amin, Muhammad Umar; Mahmood, Rabia

    2008-09-01

    Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity reaction due to a fungus, Aspergillus fumigatus. It is typically seen in patients with long-standing asthma. Our patient was a non-asthmatic 18 years old male who presented with chronic cough for 2 years. Peripheral blood eosinophilia and elevated scrum IgE were observed. His x-ray chest revealed v-shaped opacity in the left upper lobe close to the hilum. High resolution computed tomographic scan of the chest revealed multiple dilated bronchi filled with mucous (bronchoceles) and central bronchiectasis (CB) involving main segmental bronchi. Central bronchiectasis (CB) was typical of ABPA but bronchocele formation was a rare manifestation of the disease. The patient was managed with oral prednisolone and was relieved of his symptoms. Occurrence of ABPA in non-asthmatics is very rare and deserves reporting. PMID:18846804

  3. Allergic bronchopulmonary aspergillosis (ABPA): studies on the general and specific humoral response.

    Science.gov (United States)

    Sandhu, R S; Bardana, E J; Khan, Z U; Dordevich, D M

    1978-04-14

    Serum specimens from 138 patients suffering from chronic respiratory disorders including 63 with allergic bronchopulmonary aspergillosis (ABPA), 2o with suspected ABPA, 15 with pulmonary tuberculosis, 14 with bronchial asthma, 10 with chronic bronchitis and 6 with miscellaneous pulmonary conditions were studied for circulating antibodies to Aspergillus. The ammonium sulfate test was empolyed with an iodine-125 labeled mycelial component derived from Aspergillus fumigatus. When compared to normal controls from the same area, this test indicated that sera from 82 per cent of patients with ABPA had elevated binding titers to the radiolabeled antigenic component. Immunodiffusion using a culture filtrate antigen from A. fumigatus, revealed precipitating antibody to this fungus in 89 percent of sera from ABP patients. The majority of patients with ABPA demonstrated marked elevations of total serum IgE, moderate elevations of serum IgA and IgD and slightly increased levels of IgG and IgM. PMID:652026

  4. Use of Nebulized Amphotericin B in the Treatment of Allergic Bronchopulmonary Aspergillosis in Cystic Fibrosis

    Directory of Open Access Journals (Sweden)

    M. Proesmans

    2010-01-01

    Full Text Available Background. Systemic steroids and adjunctive antifungal therapy are the cornerstone in treating allergic bronchopulmonary aspergillosis (ABPA in the context of CF. Aim. Evaluate the use of inhaled amphotericin B (iAMB as antifungal agent in this context. Methods. Report of 7 CF patients with recurrent or difficult to treat ABPA and failure to taper systemic corticosteroids treated with AMB deoxycholate (AMB-d (Fungizone 25 mg 3× a week or AMB lipid complex (ABLC (Abelcet 50 mg twice weekly. Successful therapy was defined as steroid withdrawal without ABPA relapse within 12 months. Results. Therapy was successful in 6 of 7 patients treated with iAMB. In 5/6, lung function improved. The patient with treatment failure has concomitant MAC lung infection. Conclusion. Inhaled AMB may be an alternative to commonly used adjunctive antifungal therapy in the treatment of ABPA. More data are needed on safety and efficacy.

  5. 302 Screening for Allergic Bronchopulmonary Aspergillosis in Patients with Aspergillus + Asthma From 2000 to 2010

    OpenAIRE

    Greenberger, Paul

    2012-01-01

    Background Approximately 25% of patients with persistent asthma have immediate skin reactivity to Aspergillus species. The purpose of this study was to screen all patients with immediate hypersensitivity to Aspergillus for evidence of Allergic Bronchopulmonary Aspergillosis (ABPA). Methods All patients with asthma underwent immediate cutaneous testing including prick (epicutaneous) with a mix of Aspergillus species and if negative, intradermal at 1000 PNU/mL, Aspergillus fumigatus (Af). Sera ...

  6. Cystic fibrosis transmembrane conductance regulator (CFTR) gene mutations in allergic bronchopulmonary aspergillosis

    Energy Technology Data Exchange (ETDEWEB)

    Miller, P.W.; Hamosh, A.; Macek, M. Jr. [John Hopkins Univ. School of Medicine, Baltimore, MD (United States)] [and others

    1996-07-01

    The etiology of allergic bronchopulmonary aspergillosis (ABPA) is not well understood. A clinical phenotype resembling the pulmonary disease seen in cystic fibrosis (CF) patients can occur in some individuals with ABPA. Reports of familial occurrence of ABPA and increased incidence in CF patients suggest a possible genetic basis for the disease. To test this possibility, the entire coding region of the cystic fibrosis transmembrane regulator (CFTR) gene was analyzed in 11 individuals who met strict criteria for the diagnosis of ABPA and had normal sweat electrolytes ({le}40 mmol/liter). One patient carried two CF mutations ({Delta}F508/R347H), and five were found to carry one CF mutation (four {Delta}F508; one R117H). The frequency of the {Delta}F508 mutation in patients with ABPA was significantly higher than in 53 Caucasian patients with chronic bronchitis (P < .0003) and the general population (P < .003). These results suggest that CFTR plays an etiologic role in a subset of ABPA patients. 54 refs., 2 tabs.

  7. Allergic bronchopulmonary aspergillosis in Italian cystic fibrosis patients: Prevalence and percentage of positive tests in the employed diagnostic criteria

    International Nuclear Information System (INIS)

    The prevalence of allergic bronchopulmonary aspergillosis (ABPA) in cystic fibrosis (CF) patients is difficult to determine because the data in the literature are not homogeneous or comparable. ABPA and CF have similar clinical symptoms which make diagnosis difficult and underestimate the real dimensions of the problem. We conducted an epidemiological study on 3089 Italian CF patients to determine the prevalence of ABPA in Italy and verify the percentage of positive tests in the employed diagnostic criteria. Our results indicate that the prevalence of ABPA in Italian CF patients is 6.18%, mainly in adolescents and young adults. ABPA is diagnosed using clinical symptoms (presence of episodic bronchial obstructions or typical radiographic features) and on the basis of other criteria which can only be partially fulfilled in paediatric patients. Among the diagnostic tests the most sensitive are the total IgE (84.5%), specific IgE anti-Aspergillus fumigatus (81.6%) and the prick test (68.3%). In the absence of clinical symptoms and gold standard diagnostic tests, serological positivity and/or the skin test are not sufficient evidence to confirm the presence of ABPA

  8. Aspergilosis broncopulmonar alérgica. Complicaciones poco usuales de la afección ALLERGIC BRONCHOPULMONARY ASPERGILLOSIS. UNUSUAL COMPLICATIONS

    Directory of Open Access Journals (Sweden)

    EDGARDO CARRASCO C.

    2004-01-01

    Full Text Available Se revisa definición, etiología, etapas clínicas, tratamiento y complicaciones de la Aspergilosis Broncopulmonar Alérgica (ABPA. En el Instituto Nacional del Tórax se han seguido 35 casos de ABPA durante un promedio de 15 años. De esta serie se presentan dos pacientes de sexo femenino que corresponden a ABPA complicada por infección por Mycobacterium avium-intracellulare (MAI. Las pacientes que tenían 71 y 72 años de edad respectivamente, presentaron una infección pulmonar por MAI, 3 y diez años después de habérseles diagnosticado ABPA. El diagnóstico de ABPA se basó en sus características clínicas, radiológicas y en sus pruebas inmunológicas (prueba cutánea y Elisa IgG + para A. fumigatus. En ambos casos la infección pulmonar por MAI -confirmada por dos cultivos positivos- estuvo asociada a agravación clínica y radiológica. Las pacientes fueron tratadas exitosamente con claritromicina y etambutol durante 12 meses; este tratamiento estuvo asociado a estreptomicina y minociclina durante los primeros dos meses. La infección por MAI es una complicación poco frecuente de la ABPA. Esta asociación se debe sospechar si una TAC de alta resolución muestra nódulos asociados a bronquiectasias difusas ubicadas más allá de las bronquiectasias centrales (lesiones típicas de la ABPA no complicada. La infección pulmonar por MAI debe ser confirmada a través de cultivos de MAI en expectoración o en el líquido de lavado broncoalveolarDefinition, etiology, clinical stages, treatment and complications of Allergic Bronchopulmonary Aspergillosis (ABPA are reviewed. Thirty five cases of ABPA have been followed during an average of 15 years at Instituto Nacional del Tórax-Chile. From this series two female patients, corresponding to ABPA complicated by Mycobacterium avium-intracellulare (MAI infection are presented. The patients that were 71 and 72 years old respectively, presented a MAI pulmonary infection 3 and ten years after

  9. Elevated levels of manna-binding lectin (MBL) and eosinophilia in patients of bronchial asthma with allergic rhinitis and allergic bronchopulmonary aspergillosis associated with a novel intronic polymorphism in MBL

    DEFF Research Database (Denmark)

    Kaur, S.; Gupta, G.K.; Shah, A.;

    2006-01-01

    Mannan-binding lectin (MBL), an important component of innate immunity, binds to a range of foreign antigens and initiates the lectin complement pathway. Earlier studies have reported high plasma MBL levels in allergic patients in comparison to healthy controls. In view of varied plasma MBL levels...... being determined by genetic polymorphisms in its collagen region, we investigated the association of single nucleotide polymorphisms (SNPs) in the collagen region of human MBL with respiratory allergic diseases. The study groups comprised patients of bronchial asthma with allergic rhinitis (n = 49......) and allergic bronchopulmonary aspergillosis (APBA) (n = 11) and unrelated age-matched healthy controls of Indian origin (n = 84). A novel intronic SNP, G1011A of MBL, showed a significant association with both the patient groups in comparison to the controls (P

  10. HLA-DRB1 and HLA-DQB1 genes on susceptibility to and protection from allergic bronchopulmonary aspergillosis in patients with cystic fibrosis.

    Science.gov (United States)

    Muro, Manuel; Mondejar-López, Pedro; Moya-Quiles, María Rosa; Salgado, Gema; Pastor-Vivero, María Dolores; Lopez-Hernandez, Ruth; Boix, Francisco; Campillo, José Antonio; Minguela, Alfredo; Garcia-Alonso, Ana; Sánchez-Solís, Manuel; Álvarez-López, María Rocío

    2013-03-01

    Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity pulmonary disease that affects both patients with cystic fibrosis (CF) and those with asthma. HLA-DRB1 alleles have previously been associated with ABPA-CF susceptibility; however, HLA-DQB1 allele associations have not been clearly established. The aim of the present study was to investigate HLA class II associations in patients with ABPA-CF and determine their roles in susceptibility or protection. Patients with ABPA-CF, patients with CF without ABPA, patients with asthma without ABPA (AST), and healthy controls were included in this study. DNA was extracted by automatic extractor. HLA-DRB1 and -DQB1 genotyping was performed by the Luminex PCR-SSOP method (One Lambda, Canoga Park, CA, USA). Allele specific PCR-SSP was also performed by high-resolution analysis (One Lambda). Statistical analysis was performed with SSPS and Arlequin software. Both HLA-DRB1*5:01 and -DRB1*11:04 alleles occurred with greater frequency in patients with ABPA-CF than in those with AST and CF and control subjects, corroborating previously published data. On the other hand, analysis of haplotypes revealed that almost all patients with ABPA-CF lacking DRB1*15:01 or DRB1*11:04 carry either DRB1*04, DRB1*11:01, or DRB1*07:01 alleles. In the HLA-DQB1 region, the HLA-DQB1*06:02 allele occurred more frequently in patients with ABPA-CF than in those with AST and CF and healthy controls, whereas HLA-DQB1*02:01 occurred less frequently in patients with ABPA-CF. These data confirm that there is a correlation between HLA-DRB1*15:01, -DRB1*11:04, DRB1*11:01, -DRB1*04 and -DRB1*07:01 alleles and ABPA-CF susceptibility and suggest that HLA-DQB1*02:01 is an ABPA-CF resistance allele.

  11. 8例变态反应性支气管肺曲霉菌病的临床分析%Clinical Analysis of 8 Allergic Bronchopulmonary Aspergillosis

    Institute of Scientific and Technical Information of China (English)

    赵玉国

    2013-01-01

    目的:研究变态反应性支气管肺曲霉菌病(ABPA)的的诊断和治疗方法,并总结其临床特点。方法回顾性分析本人在省人民医院进修期间收集8例ABPA患者的临床表现,血清学结果,胸部放射学,病理检查结果,总结其临床特点,结果 ABPA的临床表现主要包括:哮鸣音、咳嗽、咳痰、咯血、呼吸困难和发热。所有病例血清IgE水平(3040±306) U/mL和外周血嗜酸性粒细胞计数(0.19±0.02)均升高。6例患者曲霉抗原皮肤测试阳性。CT可见中心支气管扩张,支气管壁增厚。、黏液或痰栓、游走性片状、结节状或肿块状肺浸润。所有患者均进行皮质类固醇与抗真菌治疗结合治疗。结论 ABPA的临床特征包括哮喘病史,血清总IgE水平升高,曲霉IgE抗体的存在,外周血嗜酸性粒细胞增高,特异性CT表现等。曲霉抗原皮肤测试、血清总IgE水平和胸部CT扫描对ABPA的诊断有重要意义。口服糖皮质激素和抗真菌的药物是有效的治疗方法。%Objective?To sdudy the diagnostic and treatment methods of allergic bronchopulmonary aspergillosis (ABPA), and summarizes its clinical features. Methods Retrospective analysis of 8 ABPA patients’ clinical manifestations, serological results, chest radiology, and pathology results, and summarize the clinical features. Results ABPA clinical manifestations include:wheeze, cough, sputum, hemoptysis, dyspnea, and fever. All cases serum IgE levels (3040±306)U/mL and peripheral blood eosinophilic granulocyte count (0.19±0.02) were increased. Six cases of patients with aspergillus antigen skin test positive. CT visible center of bronchiectasis, bronchial wall thickening. Mucus or sputum, migratory flake, nodular or mass-like pulmonary infiltration. All patients were corticosteroids and antifungal therapy combined treatment. Conclusion The clinical features of ABPA include a history of asthma, elevated total serum

  12. Allergic Broncho Pulmonary Aspergillosis Complicated by Nocardiosis

    Directory of Open Access Journals (Sweden)

    Brijesh Sharma

    2012-01-01

    Full Text Available We describe a 70-year-old male with a history of diabetes mellitus, hypertension, and asthma who presented with increasing breathlessness for 5 months. He was diagnosed to have allergic bronchopulmonary aspergillosis (ABPA by serological and radiographic criteria. He was treated with steroids and itraconazole. After initial improvement, he developed fever with cough and mucopurulent sputum. X-ray chest revealed multiple cavities with air fluid level. Patient was treated with antibiotics without any response. Sputum was negative for acid fast bacilli (AFB. Sputum culture for bacteria and fungus did not reveal any significant growth; however a delayed growth of Nocardia was noted on fungal plates. Modified Ziehl Nelsen stain was positive for AFB. Patient was treated with cotrimoxazole. We discuss the serological and radiological criteria of ABPA, presentation and treatment of nocardia pulmonary infection and other possible causes of necrotizing pneumonia in immunocompromised settings.

  13. Analysis of allergic bronchopulmonary aspergillosis in 8 children%儿童变应性支气管肺曲霉病8例

    Institute of Scientific and Technical Information of China (English)

    陈兰勤; 殷菊; 徐保平; 胡英惠; 申昆玲

    2015-01-01

    目的 总结儿童变应性支气管肺曲霉病(ABPA)病例的临床特点,提高对该病的认识,以期早期诊断及治疗.方法 以首都医科大学附属北京儿童医院2010年3月至2013年12月确诊的所有ABPA病例为研究对象,收集病例的临床资料、实验室检查、影像学检查及治疗预后等资料,并进行描述性分析.结果 确诊ABPA患儿8例,均为学龄期儿童,年龄为7岁2个月~13岁8个月.8例患儿中最显著的临床表现为咳嗽(8例)、咯痰(8例)、喘息(6例)、发热(4例)及咯血(3例).8例患儿中有6例外周血嗜酸性粒细胞计数明显升高,2例嗜酸性粒细胞计数正常;7例患儿血清总IgE水平显著升高(1.000 ~5.000 IU/L),1例患儿血清IgE水平轻度升高.血清变应原检测结果显示所有患儿对包括户尘螨、真菌等多种致敏原过敏,8例患儿对烟曲霉均有不同程度过敏,但仅有2例患儿痰和/或支气管灌洗液真菌培养烟曲霉阳性.影像学检查均有明显的肺部浸润表现,7例患儿具有典型中心型支气管扩张表现.肺功能表现有阻塞性通气功能障碍或混合性通气功能障碍.诊断ABPA后有7例患儿进行治疗,包括口服糖皮质激素、抗真菌治疗(伊曲康唑或伏立康唑口服)及其他对症治疗.治疗后患儿临床症状缓解,血清总IgE水平及嗜酸性粒细胞计数下降.结论 儿童ABPA相对少见,临床表现缺乏特异性,但血清总IgE水平显著升高、血嗜酸性粒细胞计数升高、烟曲霉特异性IgE/IgG抗体阳性及中心型支气管扩张等表现相对特异,是ABPA的主要诊断标准.ABPA对全身糖皮质激素及抗真菌药物治疗反应较好.%Objective To summarize the clinical features of the allergic bronchopulmonary aspergillosis (ABPA) in children,in order to improve the understanding for ABPA and make early diagnosis and treatment of the disease.Methods A retrospective study was performed on ABPA patients diagnosed in Department of

  14. Immunological Mechanism,Diagnosis and Treatment of Allergic Bronchopulmonary Aspergillosis%变应性支气管肺曲霉菌病的免疫机制与诊治

    Institute of Scientific and Technical Information of China (English)

    张鼎; 胡建; 廖纪萍; 迟春花

    2015-01-01

    Allergic bronchopulmonary aspergillosis(ABPA)is one kind of hypersensitivity pulmonary diseases in response to Aspergillus fumigatus that occurred smore often in patients with asthma and cystic fibrosis.ABPA develops in genetically susceptible patients related to human leukocyte antigen (HLA)-DR2 and DR5 restrictions,increased sensitivity to interleukin-4 stimulation,and increased Aspergillus fumigatus allergen-specific Th2CD4 + T-cell-mediated responses.Main symptoms of ABPA include cough,expectoration and wheeze.The new diagnostic criterion for ABPA was suggested by International Society for Human and Animal Mycology workgroup in 2013.Avoidance of fungi,steroids,antifungals and anti-IgE monoclonal antibody therapy play important roles in treatment of ABPA.%变应性支气管肺曲霉菌病(allergic bronchopulmonary aspergillosis,ABPA)是一种人体对曲霉菌发生变态反应所引起的疾病,好发于哮喘及囊性纤维化患者。发病机制复杂,与个体人类白细胞抗原(human leukocyte antigen,HLA)-DR2/DR5表达、对白细胞介素-4的易感性及由 CD4+辅助 T 细胞2介导的免疫反应相关。多表现为咳嗽、咯痰、喘息。2013年国际人和动物真菌学会工作组提出新的诊断标准。治疗包括避免变应原接触,可应用糖皮质激素、抗真菌药物及靶向治疗。

  15. Recent advance of the diagnosis and treatment of allergic bronchopulmonary aspergillosis%变应性支气管肺曲菌病的诊治最新进展

    Institute of Scientific and Technical Information of China (English)

    张永祥; 刘希芝; 王海英

    2012-01-01

    Allergic bronchopulmonary aspergillosis (ABPA) is an immunologic pulmonary disorder caused by hypersensitivity to Aspergillus fumigatus,most often occurring in a patient with asthma or cystic fibrosis.Diagnostic criteria include clinica manifestations of chronic asthma,recurrent pulmonary infiltrates with bronchiectasis,serum eosinophilia,elevated serum total IgE and Aspergillus fumigatus skin test positive,etc.Because many patients with ABPA may be minimally symptomatic or asymptomatic,a high index of suspicion for ABPA should be maintained while managing any patient with asthma,and further screening Aspergillus fumigatus by skin testing to prevent misdiagnosis.Early recognition allows treatment with corticosteroids,which are effective but may be required indefinitely,and combined hormone with newer antifungal azoles may be more effective.This review summarizes the advances in the diagnosis and management of ABPA.%变应性支气管肺曲菌病(allergic bronchopulmonary aspergillosis,ABPA)是机体对烟曲霉过敏引起的一种免疫性肺部疾病,最常见于哮喘和囊性纤维化患者.诊断标准包括慢性哮喘的临床表现、反复肺浸润与支气管扩张、血嗜酸粒细胞增高、血清总IgE增高及烟曲霉皮肤试验阳性等.由于许多ABPA患者症状轻微或无症状,对于哮喘患者一定要想到ABPA的可能,并进一步筛查皮肤试验,以防漏诊.早期诊断可早期给予糖皮质激素治疗,但激素可能要长期应用,激素联合较新的唑类抗真菌药可能更有效.本文对近几年来ABPA的流行病学、发病机制、诊断及处理进行综述.

  16. 儿童变应性支气管肺曲霉菌病四例报告并文献复习%Allergic bronchopulmonary aspergillosis:a report of four cases with literature review

    Institute of Scientific and Technical Information of China (English)

    徐慧; 赵宇红; 王维; 刘金荣; 赵顺英

    2015-01-01

    目的 分析儿童变应性支气管肺曲霉菌病(ABPA)的临床特点.方法 回顾性分析首都医科大学附属北京儿童医院呼吸二科病房2010年4月至2014年3月确诊的4例ABPA患儿的临床资料.分析近10年国内外数据库中报道的儿童ABPA检索资料.结果(1)4例ABPA患儿,2例确诊为囊性纤维化,1例同时诊断为哮喘.临床表现:咳嗽3例,胸闷(黏液栓堵塞)1例,反复喘息史2例;4例肺部影像学均表现有中心性支气管扩张,其中1例表现为游走性片状阴影;4例患儿血清总IgE升高,烟曲霉抗原速发皮试、血烟曲霉特异性IgE和IgG均为阳性.4例均使用糖皮质激素及抗真菌药物(伊曲康唑或伏立康唑)口服治疗,病情均得到不同程度的缓解.(2)在近10年国内外数据库中检索儿童ABPA,国外病例报告15篇,共报道22例,其中16例发生于囊性纤维化,3例发生于哮喘,16例囊性纤维化合并ABPA患儿中,仅1例以ABPA为首发症状.国内ABPA病例报告仅1例.结论 对于哮喘、过敏性疾病的患儿,如伴有IgE的异常增高、影像学出现支气管扩张、反复肺不张时需考虑ABPA的可能;对于临床确诊为ABPA的患儿,应注意除外囊性纤维化.%Objective To understand the clinical characteristics of allergic bronchopulmonary aspergillosis(ABPA) so as to diagnose and treat the disease earlier.Method A retrospective study was conducted on ABPA patients diagnosed in the Second Department of Respiratory Medicine,Beijing Children's Hospital Affiliated to Capital Medical University from April 2010 to March 2014.The literature of children's ABPA retrieved from the databases at home and abroad in recent 10 years were analyzed.Result (1)Among the 4 cases of ABPA,cystic fibrosis (CF) and asthma were diagnosed in 2 and 1 cases,respectively.Cough was present in 3 patients,recurrent wheezing in 2 and chest tightness in 1 case.CT scans showed central bronchiectasis in all 4 cases,while 1 patient had migratory

  17. Second-Hand Smoke Increases Bronchial Hyperreactivity and Eosinophilia in a Murine Model of Allergic Aspergillosis

    Directory of Open Access Journals (Sweden)

    Brian W. P. Seymour

    2003-01-01

    Full Text Available Involuntary inhalation of tobacco smoke has been shown to aggravate the allergic response. Antibodies to fungal antigens such as Aspergillus fumigatus (Af cause an allergic lung disease in humans. This study was carried out to determine the effect of environmental tobacco smoke (ETS on a murine model of allergic bronchopulmonary aspergillosis (ABPA. BALB/c mice were exposed to aged and diluted sidestream cigarette smoke to simulate 'second-hand smoke'. The concentration was consistent with that achieved in enclosed public areas or households where multiple people smoke. During exposure, mice were sensitized to Af antigen intranasally. Mice that were sensitized to Af antigen and exposed to ETS developed significantly greater airway hyperreactivity than did mice similarly sensitized to Af but housed in ambient air. The effective concentration of aerosolized acetylcholine needed to double pulmonary flow resistance was significantly lower in Af + ETS mice compared to the Af + AIR mice. Immunological data that supports this exacerbation of airway hyperresponsiveness being mediated by an enhanced type 1 hypersensitivity response include: eosinophilia in peripheral blood and lung sections. All Af sensitized mice produced elevated levels of IL4, IL5 and IL10 but no IFN-γ indicating a polarized Th2 response. Thus, ETS can cause exacerbation of asthma in ABPA as demonstrated by functional airway hyperresponsiveness and elevated levels of blood eosinophilia.

  18. CT findings of pulmonary aspergillosis

    Energy Technology Data Exchange (ETDEWEB)

    Cheon, Jung Eun; Im, Jung Gi; Goo, Jin Mo; Kim, Hong Dae; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1995-10-15

    The fungus aspergillus can cause a variety of pulmonary disorders. Aspergilloma is a noninvasive aspergillus colonization of virtually any type of preexisting pulmonary cavity or cystic space. Invasive pulmonary aspergillosis is serious, usually fatal infection in patients being treated with immunosuppressants or who have chronic debilitating disease. Allergic bronchopulmonary aspergillosis is characterized clinically by asthma, blood and sputum eosinophilia and positive immunologic reaction to aspergillus antigen. Awareness of the radiographic and CT findings of pulmonary aspergillosis is important in making the diagnosis of aspergillus-caused pulmonary disorders. In this pictorial essay, we illustrated various radiological findings of pulmonary aspergillosis focused on CT findings correlated with gross pathologic specimens.

  19. Aspergillosis

    Science.gov (United States)

    Aspergillus infection ... Aspergillosis is caused by a fungus called Aspergillus . The fungus is often found growing on dead leaves, stored grain, compost piles, or in other decaying vegetation. It can also be found ...

  20. Second-hand Smoke Increases Nitric Oxide and Alters the IgE Response in a Murine Model of Allergic Aspergillosis

    Directory of Open Access Journals (Sweden)

    Brian W. P. Seymour

    2005-01-01

    Full Text Available This study was performed to determine the effects of environmental tobacco smoke (ETS on nitric oxide (NO and immunoglobulin (Ig production in a murine model of allergic bronchopulmonary aspergillosis (ABPA. Adult BALB/c mice were exposed to aged and diluted sidestream cigarette smoke from day 0 through day 43 to simulate “second-hand smoke”. During exposure, mice were sensitized to soluble Aspergillus fumigatus (Af antigen intranasally between day 14 and 24. All Af sensitized mice in ambient air (Af + AIR made elevated levels of IgE, IgG1, IgM, IgG2a and IgA. Af sensitized mice housed in ETS (Af + ETS made similar levels of immunoglobulins except for IgE that was significantly reduced in the serum and bronchoalveolar lavage (BAL. However, immunohistochemical evaluation of the lung revealed a marked accumulation of IgE positive cells in the lung parenchyma of these Af + ETS mice. LPS stimulation of BAL cells revealed elevated levels of NO in the Af + AIR group, which was further enhanced in the Af+ETS group. In vitro restimulation of the BAL cells on day 45 showed a TH0 response with elevated levels of IL3, 4, 5, 10 and IFN-γ. However, by day 28 the response shifted such that TH2 cytokines increased while IFN-γ decreased. The Af + ETS group showed markedly reduced levels in all cytokines tested, including the inflammatory cytokine IL6, when compared to the Af+AIR group. These results demonstrate that ETS affects ABPA by further enhancing the NO production and reduces the TH2 and the inflammatory cytokines while altering the pattern of IgE responses.

  1. Prevalence of Allergic Broncho Pulmonary Aspergillosis in patients with Asthma attending allergy clinic in a North West Indian Tertiary Care Institute

    OpenAIRE

    Mathur, Navgeet; Mathur, Medha

    2016-01-01

    Context: Allergic Broncho Pulmonary Aspergillosis (ABPA) is an allergic disorder. Aspergillus fumigatus is the most common pathogen responsible for occurrence of ABPA. There can be serious consequences of ABPA including worsening of symptoms of asthma and more sinister complications like extensive fibrosis and bronchiectasis.Aims: To find out the prevalence of ABPA among asthma patients and association of former with factors like age, sex, occupation, family history of bronchial asthma, socio...

  2. Aspergilosis broncopulmonar alérgica. Complicaciones poco usuales de la afección ALLERGIC BRONCHOPULMONARY ASPERGILLOSIS. UNUSUAL COMPLICATIONS

    OpenAIRE

    EDGARDO CARRASCO C.

    2004-01-01

    Se revisa definición, etiología, etapas clínicas, tratamiento y complicaciones de la Aspergilosis Broncopulmonar Alérgica (ABPA). En el Instituto Nacional del Tórax se han seguido 35 casos de ABPA durante un promedio de 15 años. De esta serie se presentan dos pacientes de sexo femenino que corresponden a ABPA complicada por infección por Mycobacterium avium-intracellulare (MAI). Las pacientes que tenían 71 y 72 años de edad respectivamente, presentaron una infección pulmonar por MAI, 3 y diez...

  3. Evaluation of the Aspergillus Western blot IgG kit for diagnosis of chronic aspergillosis.

    Science.gov (United States)

    Oliva, A; Flori, P; Hennequin, C; Dubus, J-C; Reynaud-Gaubert, M; Charpin, D; Vergnon, J M; Gay, P; Colly, A; Piarroux, R; Pelloux, H; Ranque, S

    2015-01-01

    Immunoprecipitin detection (IPD) is the current reference confirmatory technique for anti-Aspergillus antibody detection; however, the lack of standardization is a critical drawback of this assay. In this study, we evaluated the performance of the Aspergillus Western blot (Asp-WB) IgG kit (LDBio Diagnostics, Lyon, France), a recently commercialized immunoblot assay for the diagnosis of various clinical presentations of chronic aspergillosis. Three hundred eight serum samples from 158 patients with aspergillosis sensu lato (s.l.) were analyzed. More specifically, 267 serum samples were derived from patients with Aspergillus disease, including 89 cases of chronic pulmonary aspergillosis, 10 of aspergilloma, and 32 of allergic bronchopulmonary aspergillosis, while 41 samples were from patients with Aspergillus colonization, including 15 cystic fibrosis (CF) and 12 non-CF patients. For blood donor controls, the Asp-WB specificity was 94%, while the kit displayed a sensitivity for the aspergillosis s.l. diagnosis of 88.6%, with a diagnostic odds ratio (DOR) of 119 (95% confidence interval [CI], 57 to 251). The DOR values were 185.22 (95% CI,78.79 to 435.45) and 43.74 (95% CI, 15.65 to 122.20) for the diagnosis of Aspergillus disease and Aspergillus colonization, respectively. Among the patients, the sensitivities of the Asp-WB in the diagnosis of Aspergillus colonization were 100% and 41.7% in CF and non-CF patients, respectively. The Asp-WB yielded fewer false-negative results than did IPD. In conclusion, the Asp-WB kit performed well for the diagnosis of various clinical presentations of aspergillosis in nonimmunocompromised patients, with an enhanced standardization and a higher sensitivity than with IPD, which is the current reference method.

  4. The potential impact of the pulmonary microbiome on immunopathogenesis of Aspergillus-related lung disease

    NARCIS (Netherlands)

    Kolwijck, E.; Veerdonk, F.L. van de

    2014-01-01

    Aspergillosis is an infection or allergic response caused by fungi of the genus Aspergillus. The most common forms of aspergillosis are allergic bronchopulmonary aspergillosis, chronic pulmonary aspergillosis, and invasive pulmonary aspergillosis. Aspergillus also plays an important role in fungal s

  5. Too Many Mouldy Joints – Marijuana and Chronic Pulmonary Aspergillosis

    OpenAIRE

    Gargani, Yousef; Bishop, Paul; Denning, David W.

    2011-01-01

    Chronic pulmonary aspergillosis is a progressive debilitating disease with multiple underlying pulmonary diseases described. Here we report the association of chronic pulmonary aspergillosis and long term marijuana smoking in 2 patients and review the literature related to invasive and allergic aspergillosis.

  6. Underlying conditions in chronic pulmonary aspergillosis including simple aspergilloma.

    Science.gov (United States)

    Smith, N L; Denning, D W

    2011-04-01

    Chronic pulmonary aspergillosis (CPA) is a condition caused by the ubiquitous fungus Aspergillus fumigatus in non-immunocompromised individuals. Numerous underlying conditions have been associated with CPA. Details of the underlying conditions of 126 CPA patients attending our tertiary referral clinic from all over the UK were extracted from the clinical notes, and the distribution of these underlying conditions was analysed. For those with several underlying pulmonary conditions, one was nominated as the primary condition. Many patients presented with multiple underlying conditions, and a total of 232 underlying conditions were identified for the 126 patients. Previous classical tuberculosis and non-tuberculous mycobacterial infection were the most common primary underlying conditions (15.3% and 14.9%, respectively). Others included allergic bronchopulmonary aspergillosis (ABPA), chronic obstructive pulmonary condition (COPD) and/or emphysema, pneumothorax and prior treated lung cancer. Some conditions were found more often as one of multiple underlying conditions, while others were found only as secondary underlying conditions. Tuberculosis, non-tuberculous mycobacterial infection and ABPA remain the predominant risk factors for development of CPA, with COPD, prior pneumothorax or treated lung cancer also relatively common among our referrals. Many patients have multiple underlying pulmonary conditions. CPA should be considered when upper lobe cavitary or fibrotic disease and systemic symptoms are present in those with lung disease. PMID:20595150

  7. Aspergilosis necrotizante crónica en un paciente con secuelas de tuberculosis pulmonar Chronic necrotizing aspergillosis in a patient with pulmonary tuberculosis sequelae

    Directory of Open Access Journals (Sweden)

    Alcides Zambrano F

    2007-03-01

    Full Text Available Aspergillus fumigatus puede causar diferentes patologías en el ser humano: aspergiloma, aspergilosis broncopulmonar alérgica, aspergilosis necrotizante crónica, aspergilosis invasora. En la aspergilosis necrotizante crónica hay invasión local del parénquima y destrucción. A diferencia de la aspergilosis invasora no invade vasos sanguíneos ni se disemina a otros órganos. La aspergilosis necrotizante crónica se presenta en pacientes de edad media o ancianos con patología pulmonar previa: EPOC, secuelas de tuberculosis, resección pulmonar, neumoconiosis, radioterapia, infarto pulmonar o sarcoidosis. La clínica es indolente e inespecífica, con fiebre, tos, expectoración y baja de peso. Se desconoce la incidencia de aspergilosis necrotizante crónica en nuestro medio. La aspergilosis necrotizante crónica es potencialmente fatal, por lo que requiere de un diagnóstico y tratamiento oportuno. Creemos que, debe considerarse esta entidad ante un cuadro consuntivo y febril prolongado, en pacientes con enfermedades predisponentes que producen una leve baja de la inmunidad. Describimos el caso de un paciente atendido en el Instituto Nacional del TóraxAspergillus fumigatus is the causative agent of differents pathologies in the human being: aspergilloma, allergic bronchopulmonary aspergillosis, chronic necrotizing aspergillosis and invasive aspergillosis. In chronic necrotizing aspergillosis there is local invasion of the lung tissue and parenchyma destruction. Chronic necrotizing aspergillosis is different from invasive aspergillosis, because the abscence of vascular invasion or dissemination. Chronic necrotizing aspergillosis is seen in middle-aged and elderly with underlying lung diseases: COPD, tuberculosis sequelae, lung resection, pneumoconiosis, radiotherapy, lung infarction or sarcoidosis. Clinical manifestations are non specific, being the most usual fever, cough, sputum production and weight loss. Incidence of chronic necrotizing

  8. The spectrum of allergic fungal diseases of the upper and lower airways.

    Science.gov (United States)

    Rodrigues, Jonathan; Caruthers, Carrie; Azmeh, Roua; Dykewicz, Mark S; Slavin, Raymond G; Knutsen, Alan P

    2016-01-01

    Fungi cause a wide spectrum of fungal diseases of the upper and lower airways. There are three main phyla involved in allergic fungal disease: (1) Ascomycota (2) Basidiomycota (3) Zygomycota. Allergic fungal rhinosinusitis (AFRS) causes chronic rhinosinusitis symptoms and is caused predominantly by Aspergillus fumigatus in India and Bipolaris in the United States. The recommended treatment approach for AFRS is surgical intervention and systemic steroids. Allergic bronchopulmonary aspergillosis (APBA) is most commonly diagnosed in patients with asthma or cystic fibrosis. Long term systemic steroids are the mainstay treatment option for ABPA with the addition of an antifungal medication. Fungal sensitization or exposure increases a patient's risk of developing severe asthma and has been termed severe asthma associated with fungal sensitivity (SAFS). Investigating for triggers and causes of a patient's asthma should be sought to decrease worsening progression of the disease. PMID:26776889

  9. Diagnosis and treatment of pulmonary aspergillosis%肺曲霉菌病的诊治分析

    Institute of Scientific and Technical Information of China (English)

    卢旭东; 陆益民

    2015-01-01

    目的:探讨肺曲霉菌病的临床特征、影像学特点、诊断和治疗方法,提高对该病的认识。方法回顾性分析2003—2013年昆山市第一人民医院收治的肺曲霉菌病患者58例的临床资料。结果58例患者中,仅28例初步诊断考虑有肺曲霉菌感染,19例误诊为肺癌或肺结核;26例经手术治疗,32例为内科保守治疗;53例治疗后好转,5例患者死亡。结论肺曲霉菌病诊断困难,且常需与支气管哮喘、支气管扩张、肺结核及肺癌等疾病相鉴别。肺曲霉菌球经手术切除及抗真菌药物治疗后预后较好;变应性支气管肺曲霉菌病需长期激素联合抗真菌治疗;而侵袭性肺曲霉菌病病死率较高,预后较差。%Objective To explore the clinical characteristic,imaging features,diagnosis and therapies of pulmonary aspergillosis,to improve the cognition of pulmonary aspergillosis. Methods The clinical data of 58 pulmonary aspergillosis pa-tients were retrospectively analyzed from 2003 to 2013 in the First People's Hospital of Kunshan. Results In the 58 patients, only 28 cases were primary diagnosed,19 cases were misdiagnosed as tuberculosis or lung cancer;26 cases were treated with operation,32 cases were treated with conservative treatmen;53 cases were improved after treatment,5 patients died. Conclu-sion Clinical diagnosis of pulmonary aspergillosis is difficult,needs to differentiate from bronchial asthma,bronchiectasis, pulmonary tuberculosis and lung cancer. The prognosis of aspergilloma patients is good after operation resection and antifungal therapy;allergic bronchopulmonary aspergillosis patients need long - term hormone combined with antifungal therapy;the mor-tality of invasive pulmonary aspergillosis patients is high,has a poor prognosis.

  10. Bronchopulmonary sequestration and dextrocardia.

    Science.gov (United States)

    Ivanovi-Herceg, Z; Majerić-Kogler, V; Mazuranić, I; Neralić-Meniga, I; Puljić, I

    1998-06-01

    Bronchopulmonary sequestration (BPS) is usually a rare congenital anomaly, which is most frequently extralobar or intralobar. The case of a patient with positional congenital anomaly--dextrocardia (situs thoracalis inversus) and intrapulmonary sequestration (IPS) is presented. Clinical and radiological characteristics of EPS and IPS are discussed, and new combinations of congenital anomalies with bronchopulmonary sequestration are described, dextrocardia and intrapulmonary sequestration. The importance of the algorithm of diagnostic examinations is emphasized, from detection of bronchopulmonary sequestration on the chest roentgenogram to establishing a definite diagnosis by means of angiography.

  11. Symptoms of Aspergillosis

    Science.gov (United States)

    ... Sporotrichosis Other pathogenic fungi Exserohilum Cladosporium Who Gets Fungal Infections? People living with HIV/AIDS Organ Transplant Patients ... C, Hekmat K, Cornely OA. Chronic pulmonary aspergillosis. Mycoses. 2014 May;57(5):257-70. Related Links ...

  12. Metastasizing Bronchopulmonary Leiomyosarcoma

    Directory of Open Access Journals (Sweden)

    Speros Livieratos MD

    2015-04-01

    Full Text Available An otherwise healthy 55-year-old female, nonsmoker, was seen in pulmonary consultation for progressively worsening shortness of breath. She had undergone a complete hysterectomy 7 years prior for bleeding leiomyomas. On presentation, her initial chest X-ray showed a large right-sided pleural effusion with multiple pulmonary nodules. Two thoracenteses failed to reveal any cytologic abnormalities. Bronchoscopy revealed smooth, round, endobronchial lesions. Histologic examination showed features consistent with leiomyosarcoma. We present a rare case of a patient that initially had possible leiomyomas of the uterus surgically removed and years later presented with bronchopulmonary leiomyosarcoma.

  13. Endosonography in bronchopulmonary disease

    DEFF Research Database (Denmark)

    Vilmann, Peter; Annema, Jouke; Clementsen, Paul

    2009-01-01

    via the esophagus, trachea and main bronchi. The concept of complete echo-endoscopic staging of lung cancer is postulated as virtually all mediastinal nodes as well as regions relevant to pulmonal medicine (liver and adrenal glands) can be reached by these two methods in combination....... a major impact of EUSFNA as well as EBUS-TBNA on management of patients with lung cancer as well as in patients with unknown lesions in the mediastinum. The aim of the present review is to discuss the current role of endosonography in bronchopulmonary diseases focusing on endosonographically guided biopsy...

  14. Displasia broncopulmonar Bronchopulmonary dysplasia

    Directory of Open Access Journals (Sweden)

    Luciana F. Velloso Monte

    2005-04-01

    Full Text Available OBJETIVO: Apresentar uma ampla revisão da literatura sobre displasia broncopulmonar, abordando novas definições, fisiopatologia, prevenção, tratamento, prognóstico e evolução. FONTE DOS DADOS: Foram selecionados os artigos mais relevantes sobre o tema, desde a sua descrição inicial, em 1967, pesquisados na MEDLINE. SÍNTESE DOS DADOS: A displasia broncopulmonar é considerada uma das principais causas de doença pulmonar crônica em lactentes. Está associada a hospitalizações freqüentes e prolongadas, especialmente por doenças pulmonares, altos índices de mortalidade e alterações no desenvolvimento neuropsicomotor e no crescimento pôndero-estatural. A patogênese é complexa e influenciada principalmente por prematuridade, infecção, oxigênio suplementar e ventilação mecânica. A prevenção envolve o acompanhamento pré-natal adequado, a prevenção do parto prematuro, o uso pré-natal do corticosteróide, a terapia de reposição de surfactante e o uso de estratégias ventilatórias "protetoras". O tratamento do paciente com displasia broncopulmonar demanda uma equipe multidisciplinar. Quando indicada, a suplementação de oxigênio é de extrema importância. Apesar de maior risco de morbimortalidade nos primeiros anos de vida, a evolução em longo prazo é favorável na maioria das vezes. CONCLUSÕES: A displasia broncopulmonar vem sendo profundamente estudada na tentativa de identificação das suas causas e possibilidades de prevenção e de tratamento. Ainda existem controvérsias quanto a esses assuntos e também em relação ao prognóstico desses pacientes, especialmente quando se trata da evolução tardia da "nova" displasia broncopulmonar.OBJECTIVE: To present a wide-ranging review of the literature on bronchopulmonary dysplasia, covering new definitions, pathophysiology, prevention, treatment, prognosis and progression. SOURCES OF DATA: The most relevant articles published on the subject since it was first

  15. Abdominal aspergillosis: CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Yeom, Suk Keu, E-mail: pagoda20@hanmail.net [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Kim, Hye Jin, E-mail: kimhyejin@amc.seoul.kr [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Byun, Jae Ho, E-mail: jhbyun@amc.seoul.kr [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Kim, Ah Young, E-mail: aykim@amc.seoul.kr [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Lee, Moon-Gyu, E-mail: mglee@amc.seoul.kr [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Ha, Hyun Kwon, E-mail: hkha@amc.seoul.kr [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of)

    2011-03-15

    Objective: In order to retrospectively evaluate the CT findings of abdominal aspergillosis in immunocompromised patients. Materials and methods: CT scans were reviewed with regard to the sites, number, morphologic appearance, attenuation, and the contrast enhancement patterns of the lesions in six patients (5 women, 1 man; mean age, 43.4 years; range, 23-59 years) with pathologically proved abdominal aspergillosis by two gastrointestinal radiologists in consensus. Medical records were also reviewed to determine each patient's clinical status and outcome. Results: All patients were immunocompromised state: 4 patients received immunosuppressive therapy for solid organ transplantation and 2 patients received chemotherapy for acute myeloid leukemia. Aspergillosis involved blood vessels (n = 3), liver (n = 2), spleen (n = 2), gastrointestinal tract (n = 2), native kidney (n = 1), transplanted kidney (n = 1), peritoneum (n = 1), and retroperitoneum (n = 1). CT demonstrated solid organ or bowel infarction or perforation secondary to vascular thrombosis or pseudoaneurysm, multiple low-attenuating lesions of solid organs presenting as abscesses, concentric bowel wall thickening mimicking typhlitis, or diffuse or nodular infiltration of the peritoneum and retroperitoneum. Conclusion: Familiarity with findings commonly presenting as angioinvasive features or abscesses on CT, may facilitate the diagnosis of rare and fatal abdominal aspergillosis.

  16. Abdominal aspergillosis: CT findings

    International Nuclear Information System (INIS)

    Objective: In order to retrospectively evaluate the CT findings of abdominal aspergillosis in immunocompromised patients. Materials and methods: CT scans were reviewed with regard to the sites, number, morphologic appearance, attenuation, and the contrast enhancement patterns of the lesions in six patients (5 women, 1 man; mean age, 43.4 years; range, 23-59 years) with pathologically proved abdominal aspergillosis by two gastrointestinal radiologists in consensus. Medical records were also reviewed to determine each patient's clinical status and outcome. Results: All patients were immunocompromised state: 4 patients received immunosuppressive therapy for solid organ transplantation and 2 patients received chemotherapy for acute myeloid leukemia. Aspergillosis involved blood vessels (n = 3), liver (n = 2), spleen (n = 2), gastrointestinal tract (n = 2), native kidney (n = 1), transplanted kidney (n = 1), peritoneum (n = 1), and retroperitoneum (n = 1). CT demonstrated solid organ or bowel infarction or perforation secondary to vascular thrombosis or pseudoaneurysm, multiple low-attenuating lesions of solid organs presenting as abscesses, concentric bowel wall thickening mimicking typhlitis, or diffuse or nodular infiltration of the peritoneum and retroperitoneum. Conclusion: Familiarity with findings commonly presenting as angioinvasive features or abscesses on CT, may facilitate the diagnosis of rare and fatal abdominal aspergillosis.

  17. Pediatric Invasive Aspergillosis

    Directory of Open Access Journals (Sweden)

    Rachel L. Wattier

    2016-06-01

    Full Text Available Invasive aspergillosis (IA is a disease of increasing importance in pediatrics due to growth of the immunocompromised populations at risk and improvements in long-term survival for many of these groups. While general principles of diagnosis and therapy apply similarly across the age spectrum, there are unique considerations for clinicians who care for children and adolescents with IA. This review will highlight important differences in the epidemiology, clinical manifestations, diagnosis, and therapy of pediatric IA.

  18. Chronic aspergillosis of the lungs: Unravelling the terminology and radiology

    Energy Technology Data Exchange (ETDEWEB)

    Desai, S.R.; Hedayati, V.; Patel, K. [King' s College Hospital NHS Foundation Trust, The Department of Radiology, King' s Health Partners, King' s College London, London (United Kingdom); Hansell, D.M. [The Royal Brompton and Harefield NHS Foundation Trust, Department of Radiology, London (United Kingdom)

    2015-10-15

    The propensity for Aspergillus spp. to cause lung disease has long been recognised but the satisfactory classification of these disorders is challenging. The problems caused by invasive disease in severely neutropenic patients, saprophytic infection of pre-existing fibrotic cavities and allergic reactions to Aspergillus are well documented. In contrast, a more chronic form of Aspergillus-related lung disease that has the potential to cause significant morbidity and mortality is under-reported. The symptoms of this form of Aspergillus infection may be non-specific and the radiologist may be the first to suspect a diagnosis of chronic pulmonary aspergillosis. The current review considers the classification conundrums in diseases caused by Aspergillus spp. and discusses the typical clinical and radiological profile of patients with chronic pulmonary aspergillosis. (orig.)

  19. Chronic necrotizing pulmonary aspergillosis

    Directory of Open Access Journals (Sweden)

    Lovrenski Aleksandra

    2011-01-01

    Full Text Available Introduction. Chronic necrotizing pulmonary aspergillosis (CNPA is a cavitary, infectious process of lung parenchyma with slow progressive course. Vascular invasion and dissemination to other organs are unusual. Case report. We presented a 25-year old man with bilineal acute leukaemia who developed pulmonary and systemic symptoms. Chest CT showed nodular consolidations and cavitary lesions in both lungs. Bronchial biopsy revealed necrotic hyphae but it was negative for Aspergillus by culture. Serum was positive for antibodies to Aspergillus, but it was negative for antigens. A thoracoscopic lung biopsy of the upper left lobe revealed necrosis of lung tissue, with acute and chronic inflammation of the cavity wall and the presence of hyphae consistent with Aspergillus species. Conclusion. Although confirmation of the diagnosis is difficult, a combination of characteristic clinical, radiological and histological findings and either serological results positive for Aspergillus or the isolation of Aspergillus from respiratory samples are highly indicative of CNPA.

  20. Mixed types of pulmonary aspergillosis%混合型肺曲霉病三例并文献复习

    Institute of Scientific and Technical Information of China (English)

    牟向东; 余进; 聂立功; 程渊; 王广发

    2014-01-01

    Objective To describe the clinical features of mixed types of pulmonary aspergillosis (MTPA),and therefore to improve the diagnosis and treatment of MTPA.Methods This study retrospectively analyzed 3 patients with MTPA in Peking University First Hospital from November 2010 to 2012." Invasive pulmonary aspergillosis (IPA),pulmonary aspergilloma,allergic bronchopulmonary aspergillosis (ABPA)" were used as the Chinese and English keywords,to search the literatures from Wanfang database and Pubmed database until to May 2014.Results There were 3 patients with MTPA,respectively with aspergilloma and IPA (patient 1),ABPA and IPA (patient 2),aspergilloma and IPA (patient 3).The cultures of respiratory secretions of the patients all yielded A.fumigatus.Patient 1 was treated by amphotericin B; Patient 2 was treated by intravenous itraconazole and glucocorticoid; Patient 3 was treated by oral voriconazole and inhaled corticosteroid,and the aspergilloma was surgically removed at the same time.Eventually,patients 1 and 2 died,while the symptoms of patient 3 were significantly improved.Drug sensitivity test of A.fumigatus showed resistance to amphotericin B or itraconazole.By far there was no concept of MTPA in the literatures and there were only 3 relevant case reports.Conclusion MTPA is a new subtype of pulmonary aspergillosis,which is more complicated and severe,and perhaps with drug resistance.MTPA should be treated by comprehensive therapies on the basis of sensitive and effective antifungal drugs.%目的 探讨混合型肺曲霉病(MTPA)的临床特点,提高对该病的诊治水平.方法 回顾性分析2010年11月至2012年11月北京大学第一医院收治的3例MTPA的临床特点.以“侵袭性肺曲霉病”、“肺曲霉球”及“变应性支气管肺曲霉病”两两组合为检索词,通过万方数据库和中国期刊全文数据库进行检索,以“混合型肺曲霉病”为检索词均未检索到相关文献;以“invasive pulmonaryaspergillosis

  1. Invasive aspergillosis in two patients with Pearson syndrome.

    NARCIS (Netherlands)

    Warris, A.; Verweij, P.E.; Barton, R.C.; Crabbe, D.C.G.; Evans, E.G.V.; Meis, J.F.G.M.

    1999-01-01

    Invasive aspergillosis is a serious opportunistic infection in the immunocompromised host. In the pediatric population invasive aspergillosis is seen predominantly in patients with hematologic malignancie, chronic granullamotous disease (CGD) and AIDS. Invasive aspergillosis carries a high case fata

  2. Bronchopulmonary lophomoniasis: emerging disease or unsubstantiated legend?

    OpenAIRE

    Martínez-Girón, Rafael; van Woerden, Hugo Cornelis

    2014-01-01

    The relationship between Lophomonas, a genus of multiflagellated protozoa, and respiratory pathology has recently received attention. Here, we summarize the origin, mode of transmission, pathogenic mechanism and relevant clinical data of bronchopulmonary lophomoniasis.

  3. Putative Bronchopulmonary Flagellated Protozoa in Immunosuppressed Patients

    OpenAIRE

    Ali Ahmet Kilimcioglu; Yavuz Havlucu; Nogay Girginkardesler; Pınar Çelik; Kor Yereli; Ahmet Özbilgin

    2014-01-01

    Flagellated protozoa that cause bronchopulmonary symptoms in humans are commonly neglected. These protozoal forms which were presumed to be “flagellated protozoa” have been previously identified in immunosuppressed patients in a number of studies, but have not been certainly classified so far. Since no human cases of bronchopulmonary flagellated protozoa were reported from Turkey, we aimed to investigate these putative protozoa in immunosuppressed patients who are particularly at risk of infe...

  4. Aspergilosis broncopulmonar alérgica, una complicación del paciente con fibrosis quística: reporte de dos casos y revisión de la literatura = Allergic bronchopulmonary aspergillosis, a complication of patients with cystic fibrosis: Report of two cases and review of the literature

    Directory of Open Access Journals (Sweden)

    Ballesteros Calderón, Alicia Lucía

    2012-01-01

    Full Text Available La aspergilosis broncopulmonar alérgica (ABPA es la enfermedad pulmonar resultante de hipersensibilidad a Aspergillus, que lleva a alteración de la depuración mucociliar, impactación mucosa con obstrucción de la vía aérea e infiltración pulmonar. Se caracteriza clínicamente por disnea, sibilancias, fiebre, malestar general y expectoración de color marrón o negro, y por la mala respuesta clínica al tratamiento habitual instaurado para las exacerbaciones en pacientes con enfermedad pulmonar crónica. En los pacientes con fibrosis quística (FQ puede ser difícil establecer el diagnóstico de ABPA debido a la superposición de las características clínicas, radiológicas e inmunológicas de las dos enfermedades y a la presencia frecuente de infecciones bacterianas pulmonares. Por ello, se recomienda que en el seguimiento de dichos pacientes se haga medición anual de la inmunoglobulina E (IgE sérica total y, según su resultado y el contexto clínico, se plantee el diagnóstico de ABPA y se haga el tratamiento oportuno con esteroides con el cual mejoran los síntomas, la función pulmonar, la calidad de vida y el pronóstico. Presentamos dos pacientes pediátricos con diagnóstico de FQ de difícil control, en quienes se hizo el diagnóstico de ABPA y cuya sintomatología pulmonar mejoró con el tratamiento esteroide.

  5. Communicating bronchopulmonary foregut malformation: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Chang Yeol; Goo Hyun Woo; Kim, Hyun Joo; Choi, Soo Jung; Cho, Yong Soo; Lee, Jean Hwa; Yoon, Chong Hyun; Lim, Tae Hwan [Asan Medical Center, College of Medicine, University of Ulsan, Seoul (Korea, Republic of)

    2000-07-01

    Communicating bronchopulmonary foregut malformations are rare tracheobronchial anomalies characterized by a fistula between an isolated portion of respiratory tissue and the esophagus or stomach. We describe a case of CBFM in which chest radiography revealed total haziness in the right lung field. The diagnosis was confirmed by esophagography. (author)

  6. Communicating bronchopulmonary foregut malformation: a case report

    International Nuclear Information System (INIS)

    Communicating bronchopulmonary foregut malformations are rare tracheobronchial anomalies characterized by a fistula between an isolated portion of respiratory tissue and the esophagus or stomach. We describe a case of CBFM in which chest radiography revealed total haziness in the right lung field. The diagnosis was confirmed by esophagography. (author)

  7. Invasive aspergillosis in developing countries.

    Science.gov (United States)

    Chakrabarti, Arunaloke; Chatterjee, Shiv Sekhar; Das, Ashim; Shivaprakash, M R

    2011-04-01

    To review invasive aspergillosis (IA) in developing countries, we included those countries, which are mentioned in the document of the International Monetary Fund (IMF), called the Emerging and Developing Economies List, 2009. A PubMed/Medline literature search was performed for studies concerning IA reported during 1970 through March 2010 from these countries. IA is an important cause of morbidity and mortality of hospitalized patients of developing countries, though the exact frequency of the disease is not known due to inadequate reporting and facilities to diagnose. Only a handful of centers from India, China, Thailand, Pakistan, Bangladesh, Sri Lanka, Malaysia, Iran, Iraq, Saudi Arabia, Egypt, Sudan, South Africa, Turkey, Hungary, Brazil, Chile, Colombia, and Argentina had reported case series of IA. As sub-optimum hospital care practice, hospital renovation work in the vicinity of immunocompromised patients, overuse or misuse of steroids and broad-spectrum antibiotics, use of contaminated infusion sets/fluid, and increase in intravenous drug abusers have been reported from those countries, it is expected to find a high rate of IA among patients with high risk, though hard data is missing in most situations. Besides classical risk factors for IA, liver failure, chronic obstructive pulmonary disease, diabetes, and tuberculosis are the newly recognized underlying diseases associated with IA. In Asia, Africa and Middle East sino-orbital or cerebral aspergillosis, and Aspergillus endophthalmitis are emerging diseases and Aspergillus flavus is the predominant species isolated from these infections. The high frequency of A. flavus isolation from these patients may be due to higher prevalence of the fungus in the environment. Cerebral aspergillosis cases are largely due to an extension of the lesion from invasive Aspergillus sinusitis. The majority of the centers rely on conventional techniques including direct microscopy, histopathology, and culture to diagnose IA

  8. Analysis of two cases with bronchopulmonary neurofibromatosis

    Directory of Open Access Journals (Sweden)

    Yuan Ting

    2012-07-01

    Full Text Available Abstract Neurogenic tumor of lung is very rare. Only few cases have been reported in the literature. We present here two cases of bronchopulmonary neurofibromatosis in two adults. In both cases, attempts at imaging failed to diagnose the case, and it was the histological study that ensured the diagnosis of neurofibromatosis. Biopsy specimens showed bundles of spindle-shaped cells mixed with collagen, and on immunohistochemistry some cells were positive for S-100 protein.

  9. Diagnosis and treatment of bronchopulmonary neuroendocrine tumours

    DEFF Research Database (Denmark)

    Tabaksblat, Elizaveta Mitkina; Langer, Seppo W; Knigge, Ulrich;

    2016-01-01

    Bronchopulmonary neuroendocrine tumours (BP-NET) are a heterogeneous population of neoplasms with different pathology, clinical behaviour and prognosis compared to the more common lung cancers. The management of BP-NET patients is largely based on studies with a low level of evidence and extrapol...... and extrapolation of data obtained from more common types of neuroendocrine tumours. This review reflects our view of the current state of the art of diagnosis and treatment of patients with BP-NET....

  10. Invasive aspergillosis in near drowning nonneutropenic patient

    Directory of Open Access Journals (Sweden)

    Kartik Munta

    2015-01-01

    Full Text Available Invasive aspergillosis in immunosuppressed people has been well documented, but to diagnose and treat in an immunocompetent individual after near drowning, it requires early suspicion and proper empirical treatment. We report a case diagnosed to have invasive aspergillosis with systemic dissemination of the infection to the brain, gluteal muscles, and kidneys after a fall in a chemical tank of a paper manufacturing company. He was ventilated for acute respiratory distress syndrome and managed with antibiotics and vasopressors. Due to nonresolving pneumonia and positive serum galactomannan, trans-tracheal biopsy was performed which confirmed invasive aspergillosis and was treated with antifungals. With the availability of galactomannan assay and better radiological investigative modalities, occurrence of such invasive fungal infections in cases of drowning patients should be considered early in such patients and treated with appropriate antifungals.

  11. Invasive aspergillosis in near drowning nonneutropenic patient.

    Science.gov (United States)

    Munta, Kartik; Gopal, Palepu B N; Vigg, Ajit

    2015-12-01

    Invasive aspergillosis in immunosuppressed people has been well documented, but to diagnose and treat in an immunocompetent individual after near drowning, it requires early suspicion and proper empirical treatment. We report a case diagnosed to have invasive aspergillosis with systemic dissemination of the infection to the brain, gluteal muscles, and kidneys after a fall in a chemical tank of a paper manufacturing company. He was ventilated for acute respiratory distress syndrome and managed with antibiotics and vasopressors. Due to nonresolving pneumonia and positive serum galactomannan, trans-tracheal biopsy was performed which confirmed invasive aspergillosis and was treated with antifungals. With the availability of galactomannan assay and better radiological investigative modalities, occurrence of such invasive fungal infections in cases of drowning patients should be considered early in such patients and treated with appropriate antifungals.

  12. Invasive aspergillosis: results of multicenter study

    Directory of Open Access Journals (Sweden)

    N. N. Klimko

    2014-01-01

    Full Text Available We present the results of a multicenter study of 445 patients with “proven” and “probable” invasive aspergillosis (EORTC/MSG, 2008. Invasive aspergillosis usually occurs in patients with hematological malignancies (88 %, main underlying diseases were acute myeloid and acute lymphoblastic leukemia. The risk factors: prolonged agranulocytosis (64 %, cytostatic chemotherapy (57 %, corticosteroid treatment (45 %, and allogeneic hematopoietic stem cells transplantation (29 %. The pathogens – A. fumigatus (42 %, A. niger (33 %, and A. flavus (21 %. The main site of infection were lungs (86 %. 12 week overall survival was 83 %. Bronchoscopy use for the early diagnosis (p = 0.01, adequatetherapy with voriconazole (p = 0.002 and secondary antifungal prophylaxis (p = 0.0003 were positive prognostic factors for survival of patients with invasive aspergillosis.

  13. Invasive aspergillosis: results of multicenter study

    Directory of Open Access Journals (Sweden)

    N. N. Klimko

    2014-09-01

    Full Text Available We present the results of a multicenter study of 445 patients with “proven” and “probable” invasive aspergillosis (EORTC/MSG, 2008. Invasive aspergillosis usually occurs in patients with hematological malignancies (88 %, main underlying diseases were acute myeloid and acute lymphoblastic leukemia. The risk factors: prolonged agranulocytosis (64 %, cytostatic chemotherapy (57 %, corticosteroid treatment (45 %, and allogeneic hematopoietic stem cells transplantation (29 %. The pathogens – A. fumigatus (42 %, A. niger (33 %, and A. flavus (21 %. The main site of infection were lungs (86 %. 12 week overall survival was 83 %. Bronchoscopy use for the early diagnosis (p = 0.01, adequatetherapy with voriconazole (p = 0.002 and secondary antifungal prophylaxis (p = 0.0003 were positive prognostic factors for survival of patients with invasive aspergillosis.

  14. Anaesthetic management of bilateral alveolar proteinosis for bronchopulmonary lavage.

    OpenAIRE

    Dixit R; Chaudhari L; Mahashur A

    1998-01-01

    The most hazardous manifestation of pulmonary alveolar proteinosis is progressive hypoxia for which bronchopulmonary lavage (BPL) is the single most effective treatment. Unfortunately this procedure under general anesthesia itself increases the risk of hypoxia due to the need for one lung ventilation. It was therefore considered interesting to report the successful anaesthetic management of a patient with pulmonary alveolar proteinosis for Bronchopulmonary lavage.

  15. Oxygen Saturation Targeting and Bronchopulmonary Dysplasia.

    Science.gov (United States)

    Darlow, Brian A; Morley, Colin J

    2015-12-01

    Oxygen saturation targeting is widely used in neonatal intensive care, but the optimal target range in very preterm infants has been uncertain and is the subject of recent debate and research. This review briefly discusses the technology of oxygen monitoring and the role of oxygen toxicity in preterm infants. The background to the recent trials of oxygen saturation targeting in acute and continuing care of very preterm infants is reviewed, and the findings and implications of the recent trials, particularly with respect to bronchopulmonary dysplasia, are discussed. PMID:26593080

  16. Chemoprophylaxis for pulmonary aspergillosis during intensive chemotherapy.

    OpenAIRE

    Cowie, F; Meller, S T; Cushing, P; Pinkerton, R.

    1994-01-01

    Three children who developed pulmonary aspergillosis while being treated for leukaemia or non-Hodgkin's lymphoma. Each child continued with intensive myelosuppressive chemotherapy regimens during the infection and each was successfully treated with antifungal prophylaxis based on itraconazole by mouth. Amphotericin B was also given during periods of severe neutropenia. No reactivation of the fungal infection was seen.

  17. Azole-Resistant Central Nervous System Aspergillosis

    NARCIS (Netherlands)

    J.W.M. van der Linden; R.R. Jansen; D. Bresters; C.E. Visser; S.E. Geerlings; E.J. Kuijper; W.J.G. Melchers; P.E. Verweij

    2009-01-01

    Three patients with central nervous system aspergillosis due to azole-resistant Aspergillus fumigatus (associated with a leucine substitution for histidine at codon 98 [L98H] and a 34-base pair repeat in tandem in the promoter region) are described. The patients were treated with combination therapy

  18. Azole-resistant central nervous system aspergillosis.

    NARCIS (Netherlands)

    Linden, J.W.M. van der; Jansen, R.R.; Bresters, D.; Visser, C.E.; Geerlings, S.E.; Kuijper, E.J.; Melchers, W.J.G.; Verweij, P.E.

    2009-01-01

    Three patients with central nervous system aspergillosis due to azole-resistant Aspergillus fumigatus (associated with a leucine substitution for histidine at codon 98 [L98H] and a 34-base pair repeat in tandem in the promoter region) are described. The patients were treated with combination therapy

  19. Orbital Aspergillosis: Voriconazole – The New Standard Treatment?

    OpenAIRE

    Ohlstein, Derek H.; Hooten, Claudia; Perez, Javier; Clark, Charles L.; Samy, Hazem

    2012-01-01

    Background/Aim To describe a case of invasive orbital aspergillosis and evaluate treatments and outcomes. Methods A case report and review of orbital aspergillosis treatment with voriconazole in the English language literature. Conclusion Amphotericin B with debridement is the current standard of care for orbital aspergillosis; however, its prognosis is unfavorable. When compared to amphotericin B, voriconazole demonstrates a survival benefit, has less systemic toxicity, and is better tolerat...

  20. Aspergillosis in HIV patients: a case series

    Directory of Open Access Journals (Sweden)

    F Laurent

    2012-11-01

    Full Text Available Purpose: Aspergillosis is uncommon in HIV patients and has been mostly reported in patients with CD4<50/µL. Data on risk factors and prognosis are scarce. We reviewed 19 cases of aspergillosis diagnosed in our HIV cohort. Methods: In the Brussels Saint-Pierre HIV cohort, 19 patients were diagnosed with aspergillosis between 1998 and 2012 (0.87/1000 patient/year of follow-up. We analyzed retrospectively and described localization and invasiveness of aspergillosis, risk factors, treatment and outcome of these patients. Results: Patients were mostly African (74% and mean age was 40 years (22–60. Clinical presentation were 10 invasive aspergillosis (IA (53%, 6 pulmonary aspergilloma (31% and 3 sinus fungal ball (16%. The global mortality was 42%. IA was proven for 3 patients, probable for 4 patients and possible for 3 patients according to IDSA definitions. Risk factors for IA included CD4<200/µL (70%; 40%<50 CD4/µL, corticotherapy (50%, neutropenia (20%, intravenous drug use (20%, cirrhosis (20%. IA arose in the time course of septic shock in 30% and opportunistic infections occurred concomitantly in 40%. Seven patients out of 10 with IA died including 3 patients before antifungal therapy. The 3 survivors recovered without relapse. Four patients were treated with voriconazole, 2 with itraconazole, 2 with liposomal amphotericine, 1 with caspofungine, and 2 with bitherapy. Among patients with aspergilloma (n=6, the major associated risk factor was tuberculosis sequelae (80%. Two patients were successfully treated with surgery and voriconazole, 1 died from massive hemoptysis, 2 were lost to follow-up, 1 is currently asymptomatic without treatment. Among patients with sinus fungal ball (n=3, all recovered without relapse with surgical treatment associated with voriconazole for one. Conclusion: Incidence of aspergillosis in HIV patients remains low but in accordance to previous reports, mortality of IA is high (70%. CD4<200 is the most common risk

  1. Manifestation of invasive pulmonary aspergillosis in the formation of mycetoma

    Energy Technology Data Exchange (ETDEWEB)

    Roos, N.; Peters, P.E.; Schellong, S.; Eiff, M. von

    1989-05-01

    Invasive pulmonary aspergillosis is characterized by radiological signs allowing a correct diagnosis, including differentiation from pulmonary candidiasis, when they are associated with appropriate clinical symptoms (neutropenia and fever persisting despite broad-spectrum antibiotics). In particular the formation of a pulmonary mycetoma in a previously normal lung is one of these signs. Unlike a simple fungus ball (the saprophytic form of aspergillosis), the rounded density of invasive pulmonary aspergillosis consists of sequestrum of devitalized lung tissue owing to blood vessel invasion by Aspergillus hyphae. This morphologic phenomenon is demonstrated in the present case report and is discussed together with the other roentgenological signs of the invasive aspergillosis.

  2. Manifestation of invasive pulmonary aspergillosis in the formation of mycetoma

    International Nuclear Information System (INIS)

    Invasive pulmonary aspergillosis is characterized by radiological signs allowing a correct diagnosis, including differentiation from pulmonary candidiasis, when they are associated with appropriate clinical symptoms (neutropenia and fever persisting despite broad-spectrum antibiotics). In particular the formation of a pulmonary mycetoma in a previously normal lung is one of these signs. Unlike a simple fungus ball (the saprophytic form of aspergillosis), the rounded density of invasive pulmonary aspergillosis consists of sequestrum of devitalized lung tissue owing to blood vessel invasion by Aspergillus hyphae. This morphologic phenomenon is demonstrated in the present case report and is discussed together with the other roentgenological signs of the invasive aspergillosis. (orig.)

  3. Chronic Pulmonary Aspergillosis Complicating Bronchial Atresia

    Directory of Open Access Journals (Sweden)

    Mazen O. Al-Qadi

    2014-01-01

    Full Text Available Bronchial atresia is a rare pulmonary developmental anomaly characterized by the presence of a focal obliteration of a segmental or lobar bronchial lumen. The lung distal to the atretic bronchus is typically emphysematous along with the presence of mucus filled ectatic bronchi (mucoceles. BA is usually asymptomatic but pulmonary infections can rarely develop in the emphysematous lung distal to the atretic bronchus. We present a unique case of chronic pulmonary aspergillosis (CPA in a patient with BA with no evidence of immune dysfunction. The patient was treated initially with voriconazole and subsequently underwent surgical excision of the involved area. On follow-up, she has done extremely well with no evidence for recurrence. In summary, we describe the first case of chronic pulmonary aspergillosis in an immunocompetent patient with bronchial atresia.

  4. Aspergillosis complicating a microwave ablation cavity.

    Science.gov (United States)

    Singh, Saurabh; Bandula, Steven; Brown, Jeremy; Whelan, Jeremy; Illing, Rowland

    2016-01-01

    We present a case of a patient who following chemotherapy developed semi-invasive pulmonary aspergillosis and an aspergilloma in a lung cavity previously formed by microwave ablation (MWA). A 55-year-old woman presented with cough and shortness of breath after finishing three cycles of chemotherapy for a metastatic nerve sheath tumour. She had been treated by MWA for pulmonary metastases 2 years previously which resulted in a residual right apical lung cavity. Postchemotherapy imaging showed that this cavity had enlarged, developed a thicker wall and contained lobulated soft tissue with a crescent sign on coronal reformats. In addition, the patient's Aspergillus-specific IgG was markedly raised. Treatment with itraconazole improved the symptoms and reduced the cavity size and wall thickness. This case shows that persisting lung cavities after MWA are a potential site for semi-invasive aspergillosis and has implications for the timing of chemotherapy in patient with metastatic lung disease. PMID:27624446

  5. Initial respiratory management in preterm infants and bronchopulmonary dysplasia

    Directory of Open Access Journals (Sweden)

    Ester Sanz López

    2011-01-01

    Full Text Available BACKGROUND: Ventilator injury has been implicated in the pathogenesis of bronchopulmonary dysplasia. Avoiding invasive ventilation could reduce lung injury, and early respiratory management may affect pulmonary outcomes. OBJECTIVE: To analyze the effect of initial respiratory support on survival without bronchopulmonary dysplasia at a gestational age of 36 weeks. DESIGN/METHODS: A prospective 3-year observational study. Preterm infants of 26 weeks (sensitivity =89.5% and specificity = 67%. The need for prolonged mechanical ventilation could be an early marker for the development of bronchopulmonary dysplasia. This finding could help identify a target population with a high risk of chronic lung disease. Future research is needed to determine other strategies to prevent bronchopulmonary dysplasia in this high-risk group of patients.

  6. Histological study of chronic pulmonary aspergillosis

    OpenAIRE

    Tochigi, Naobumi; Ishiwatari, Takao; Okubo, Yoichiro; Ando, Tsunehiro; Shinozaki, Minoru; Aki, Kyoko; GOCHO, KYOKO; Hata, Yoshinobu; Murayama, Somay Y.; Wakayama, Megumi; Nemoto, Tetsuo; Hori, Yasuhiro; SHIBUYA, KAZUTOSHI

    2015-01-01

    Background Chronic pulmonary aspergillosis (CPA) has been accepted the criteria for the diagnosis of pulmonary Aspergillus infection. Whereas, either pathophysiology or signs of CPA remains still controversial. Methods In this study, we histopathologically investigated 25 specimens of CPA, surgically resected. Results 21 (84 %) of that comprised male. There were 21 cases with mild impairment of the immune system and/or a scar mostly due to old tuberculosis. There is a tendency for a negative ...

  7. Anaesthetic management of bilateral alveolar proteinosis for bronchopulmonary lavage.

    Directory of Open Access Journals (Sweden)

    Dixit R

    1998-01-01

    Full Text Available The most hazardous manifestation of pulmonary alveolar proteinosis is progressive hypoxia for which bronchopulmonary lavage (BPL is the single most effective treatment. Unfortunately this procedure under general anesthesia itself increases the risk of hypoxia due to the need for one lung ventilation. It was therefore considered interesting to report the successful anaesthetic management of a patient with pulmonary alveolar proteinosis for Bronchopulmonary lavage.

  8. Cerebral Air Embolism from Angioinvasive Cavitary Aspergillosis

    Directory of Open Access Journals (Sweden)

    Chen Lin

    2014-01-01

    Full Text Available Background. Nontraumatic cerebral air embolism cases are rare. We report a case of an air embolism resulting in cerebral infarction related to angioinvasive cavitary aspergillosis. To our knowledge, there have been no previous reports associating these two conditions together. Case Presentation. A 32-year-old female was admitted for treatment of acute lymphoblastic leukemia (ALL. Her hospital course was complicated by pulmonary aspergillosis. On hospital day 55, she acutely developed severe global aphasia with right hemiplegia. A CT and CT-angiogram of her head and neck were obtained demonstrating intravascular air emboli within the left middle cerebral artery (MCA branches. She was emergently taken for hyperbaric oxygen therapy (HBOT. Evaluation for origin of the air embolus revealed an air focus along the left lower pulmonary vein. Over the course of 48 hours, her symptoms significantly improved. Conclusion. This unique case details an immunocompromised patient with pulmonary aspergillosis cavitary lesions that invaded into a pulmonary vein and caused a cerebral air embolism. With cerebral air embolisms, the acute treatment option differs from the typical ischemic stroke pathway and the provider should consider emergent HBOT. This case highlights the importance of considering atypical causes of acute ischemic stroke.

  9. Rhinitis: Allergic and Non-Allergic

    OpenAIRE

    Ogrady, M.J.

    1987-01-01

    Rhinitis, or the “stuffy nose”, can be allergic or non-allergic in nature. Accurate diagnosis depends on a well-taken history and physical examination. Non-allergic rhinitis is characterized by absent elevation in allergen-specific IgE. Treatment is based, if possible, on the etiology. Surgical procedures on the turbinates are often needed to allow improvement. Allergic rhinitis is characterized by an increase in allergen-specific IgE. Treatment may involve environmental control, pharmocologi...

  10. Disseminated aspergillosis in an adolescent with acute lymphoblastic leukemia.

    NARCIS (Netherlands)

    Zwitserloot, A.M.; Warris, A.; Hek, L.G.F.M. van 't; Die, LE van; Verweij, P.E.; Mavinkurve-Groothuis, A.M.C.

    2008-01-01

    Disseminated aspergillosis in immunocompromised patients has a mortality rate of almost 100%. Despite the development of new antifungal agents, the outcome of disseminated aspergillosis has only improved slightly, particular in patients with central nervous system (CNS) involvement. The use of combi

  11. Histiocytosis X and Bronchopulmonary Adenocarcinoma: A Rare Coexistence

    Directory of Open Access Journals (Sweden)

    Akýn Kaya

    2002-01-01

    Full Text Available There exists a rarely observed association between pulmonary histiocytosis X and bronchopulmonary cancer. However, the frequency of bronchopulmonary cancer in these patients is higher than in the general population. A 28-year-old patient who currently smokes ten packs of cigarettes a year came to our department of pneumology with complains of cough and hemoptysis. An x-ray of the thorax revealed bilateral cysts and a shadow in the upper part of the right pulmonary field. In addition, a chest tomography showed multiple cysts dispersed throughout the two pulmonary fields and an irregular mass with a diameter of four centimetres in the upper right lobe. Bronchopulmonary adenocarcinoma was diagnosed during a cytologic exam of the bronchial washing. We decided to perform a thoracotomy on the patient, since there was no far metastasis. An upper lobectomy and wedge resection of the upper segment of the lower right lobe, which had been invaded by the tumour, were performed. Histology confirmed the diagnosis of adenocarcinoma. A pulmonary biopsy was carried out on the tumour-free site and showed the presence of histiocytosis X. There is a hypothesis that a neoplasm developed on the pulmonary fibrosis could be an epiphenomenon of bronchopulmonary cancer in patients who smoke and have pulmonary histiocytosis X. It is interesting to note that histiocytosis X and bronchopulmonary cancer were diagnosed at the same time, since the bronchopulmonary cancer may have occurred within a few years following the diagnosis of histiocytosis X, even if she was a smoker. Hemoptysis, which is found in 5% of patients with histiocytosis X, may suggest cancer. This young patient, a smoker, who complained of hemoptysis, is a particularly rare case of the association between pulmonary histiocytosis X and bronchopulmonary cancer whose pathogenesis is not clear cut. It is thus important to note that smoking can have major consequences, even in young people.

  12. Invasive pulmonary aspergillosis in computed tomography

    International Nuclear Information System (INIS)

    We examined 65 patients with proved invasive aspergillosis. 35 out of these patients were HIV negative and were treated with immune depressive agents for different systemic diseases. The plain chest film usually only showed unspecific opacities in the lung. HRCT however made the diagnosis possible or at lest highly probable because of a number of characteristic findings: Multiple opacities of different size and character - the air crescent sign -the halo sign - the sponge sign - (sub)segmental infarction pneumonia - patent bronchus within consolidated infiltration - cavern with septal internal structure. (orig.)

  13. Invasive Aspergillosis Associated with a Foreign Body

    Directory of Open Access Journals (Sweden)

    Akifuddin Syed

    2015-01-01

    Full Text Available Invasive aspergillosis is a serious complication in immunocompromised individuals. It is associated with a high mortality rate, which demands a combined approach involving radical surgery and antifungal therapy. Here, we describe a patient who presented with nonspecific fever, refractory to antimicrobial agents. Though it primarily involved the nasal cavity and sinuses, it perforated into the oral cavity causing palatal changes. Surprisingly, a foreign body was found in the involved tissues that might have acted as a nidus of infection. A sufficient dose (3 mg/kg/day of liposomal amphotericin B was initiated soon after a thorough debridement procedure and the patient survived.

  14. Pediatric allergic conjunctivitis and allergic rhinitis

    Institute of Scientific and Technical Information of China (English)

    Tong Qiao; Yizhen Hu; Zhinan Wang

    2008-01-01

    Objective: To assess the relationship between allergic conjunctivitis(AC) and allergic rhinitis(AR) in pediatric ophthalmology and E.N.T outpatient clinic. Methods:Eight hundred and ninety two patients were enrolled in survey during Mar. 2005~Jan. 2007, 407 allergic conjunctivitis cases were placed in the ophthalmology clinic group and 485 allergic rhinitis cases were from the E.N.T clinic.The comorbid disorders, histories, symptoms, signs of patients were recorded. Type 1 allergy was tested in 479 cases by a specific IgE antibody blood test. Eosinophils were detected in superficial conjunctival scrapings of the superior tarsal conjunctiva and mucosa surface scrapings of middle nasal meatus in 88 cases with both diseases. Results:302(74%), 374(92%), 116(29%) in 407 cases with allergic conjunctivitis had concomitant eczema, rhinitis and asthma, respectively; 334(69%), 430(89%), 145(30%) in 485 cases with allergic rhinitis had concomitant eczema, allergic conjunctivitis and asthma, respectively. The prevalence of allergic conjunctivitis concomitant allergic rhinitis and allergic rhinitis concomitant allergic conjunctivitis had no significant difference(x2=2.6, P>0.05). The prevalence of allergic conjunctivitis and allergic rhinitis concomitant eczema and asthma also had no significant difference (x2=3.08; x2=0.21, P>0.05). The degree of severity of two kinds of disease symptoms is not parallel, in the patients with seasonal allergic conjuctivitis(SAC) and perennial allergic conjunctivitis(PAC), the clinical signs of AR were always severer(x2=258.2, P<0.05)than those of AC. However, the results coincided with the cases with vernal keratoconjuctivitis(VKC)(x2=66.5, P<0.05); Eosinophils were revealed in 50(57%) conjunctival scrapings and nasal mucosa scrapings(x2=1.5, P>0.05), 47(53%) cases had positive results in both scrapings. The main aeroallergens were house dust mites, house dust and fungi, and the main food-allergens were fish, crab and shrimp

  15. Pathogenesis of bronchopulmonary dysplasia: when inflammation meets organ development.

    Science.gov (United States)

    Shahzad, Tayyab; Radajewski, Sarah; Chao, Cho-Ming; Bellusci, Saverio; Ehrhardt, Harald

    2016-12-01

    Bronchopulmonary dysplasia is a chronic lung disease of preterm infants. It is caused by the disturbance of physiologic lung development mainly in the saccular stage with lifelong restrictions of pulmonary function and an increased risk of abnormal somatic and psychomotor development. The contributors to this disease's entity are multifactorial with pre- and postnatal origin. Central to the pathogenesis of bronchopulmonary is the induction of a massive pulmonary inflammatory response due to mechanical ventilation and oxygen toxicity. The extent of the pro-inflammatory reaction and the disturbance of further alveolar growth and vasculogenesis vary largely and can be modified by prenatal infections, antenatal steroids, and surfactant application.This minireview summarizes the important recent research findings on the pulmonary inflammatory reaction obtained in patient cohorts and in experimental models. Unfortunately, recent changes in clinical practice based on these findings had only limited impact on the incidence of bronchopulmonary dysplasia. PMID:27357257

  16. Invasive aspergillosis of the temporal bone

    Directory of Open Access Journals (Sweden)

    Renuka A Bradoo

    2012-01-01

    Full Text Available Invasive aspergillosis of temporal bone, an extremely rare yet potentially life-threatening disease entity, occurs mostly in immuno-compromised individuals. We report a case of a 65-year-old diabetic male who presented with bilateral ear discharge, bilateral subepithelial ear masses, and progressive left facial palsy of recent onset. The biopsy specimen taken from either side after surgical debridement revealed only nonspecific inflammatory granulation tissue, but the culture of the tissue was positive for Aspergillus flavus. Invasive aspergillosis was confirmed by demonstration of the fungi in the tissues with Gomori-Methanamine Silver staining. The patient was hence put on long-term Itraconazole therapy and is presently doing well. The possibility of invasive fungal otitis always needs to be considered as a differential diagnosis in immuno-compromised patients presenting with atypical otomastoiditis so as to diagnose this rare condition at an early stage to reduce the delay in the treatment and prevent its possible complications such as skull base osteomyelitis and progressive cranial nerve palsies.

  17. Bronchoplasty for Primary Broncho-Pulmonary Tumors

    International Nuclear Information System (INIS)

    Parenchyma-sparing procedures are widely used in patients with low-grade malignancies of the airway when anatomically suited lesions exist. This study was conducted to evaluate the short-term and the long-term results of bronchoplastic procedures for patients with centrally located primary bronchopulmonary tumors. Methods: Between 2000 and 2009, 36 patients with primary lung tumors required bronchoplasty were retrospectively analyzed. Preoperative assessment included computed tomography (CT) of the chest, bronchoscopy, and spirometry. Pre operative diagnosis was achieved by bronchoscopy for all patients, mediastinoscopy was done for patients with primary lung cancer. Neo adjuvant chemotherapy was given for 6 patients with non small cell lung cancer (NSCLC). Results: We had 15 males and 21 female, the mean age was 37 years and the mean hospital stay was 7.2 days. Operative procedures performed were:Sleeve lobectomy in 30 patients (13 right, 17 left), partial sleeve right pneumonectomy in 3 and bronchial resection with re-anastomosis in 3 (2 left, 1 right). Twelve patients (33.3%) suffered post-operative problems. There was one operative related mortality. Post operative pathology revealed: 27 patients with typical carcinoid, 2 with atypical carcinoid, 4 with squamous cell carcinoma, 2 with adenocarcifioma and one with hamartoma. Pathological TNM staging revealed: 17 patients with stage 1A, 11 with IB, 5 with IIA and 2 with stage IIIA. Follow-up data were available for all patients except two. Two patients died with disseminated disease 1.5 year and 2 years after surgery. The patient with hamartoma developed local recurrence 5 years later and re-excision was done. One patient with lung cancer developed bone metastases and was alive with disease, while the remaining 30 patient's were alive and disease free. The overall 5 years survival was 83.3%. Conclusion: Bronchoplastic resections achieve local control and long-term survival comparable to the standard resections in

  18. Renal aspergillosis secondary to renal intrumentation in immunocompetent patient

    OpenAIRE

    Paul, Sagorika; Singh, Viswajeet; Sankhwar, Satyanarayan; Garg, Manish

    2013-01-01

    Primary renal aspergillosis is a rare urological entity and immune-compromised persons are commonly prone to it. The clinical presentation resembles that of usual bacterial pyelonephritis. We report a case of localised unilateral renal aspergillosis with obstructive uropathy (hypoplastic contralateral kidney) in a young man, occurring after the endoscopic removal of impacted right upper ureteric calculus in a non-immunocompromised patient. In view of deranged renal function, he was initially ...

  19. Isolated Aspergillosis Myocardial Abscesses in a Liver-Transplant Patient

    Directory of Open Access Journals (Sweden)

    Kim-Diêp Dang-Tran

    2014-01-01

    Full Text Available Cardiac abscess is an uncommon and fatal complication after transplantation. We report a case of an initially isolated aspergillosis myocardial abscess diagnosed by cardiac magnetic resonance imaging (CMRI. At that time, there was no other biological evidence or other extracardiac manifestations. A three-month course of dual antifungal therapy followed by a single antifungal therapy was empirically given. Six month after admission, Aspergillus fumigatus was isolated for the first time and the patient deceased from a disseminated aspergillosis.

  20. Algorithm of rehabilitation examination of children with bronchopulmonary diseases

    Directory of Open Access Journals (Sweden)

    Nataliya Ivasyk

    2016-08-01

    Full Text Available Purpose: to develop the algorithm of rehabilitation examination for children with bronchopulmonary diseases. Material & Methods: analysis, generalization, systematization and comparison of data of scientific and methodical literature on problems of physical rehabilitation at bronchopulmonary diseases. Results: the offered algorithm of rehabilitation examination of children with bronchopulmonary diseases provides the consecutive application of such methods as: poll, physical examination, functional examination and method of indexes, which analysis allows defining the rehabilitation diagnosis, which is the basis of technology of the rehabilitation process. Conclusions: rehabilitation examination is the compound of physical rehabilitation which is carried out for the purpose of definition of the rehabilitation diagnosis and is based on subjective, objective assessments and data of supervision. The consecutive carrying out of the complex rehabilitation examination on the offered algorithm and the detailed analysis of its results will promote the determination of rehabilitation potential, the reasons of violations from various systems of organism and individualization of the rehabilitation process of children with bronchopulmonary diseases.

  1. Cerebral aspergillosis presenting as a mass lesion

    Directory of Open Access Journals (Sweden)

    Negar Azarpira

    2008-08-01

    Full Text Available Fungal infections of the central nervous system (CNS are almost always a surprising finding. Their presentation is usually subtle, often without any diagnostic characteristics, and they are frequently mistaken for pyogenic abscesses, or brain tumors. Aspergillosis of the central nervous system is an uncommon infection, mainly occurring in immunocompromised patients. It may present in several forms, including meningitis, mycotic aneurysms, infarcts and a tumoral form. We report an intracranial granuloma due to Aspergillus fumigatus involving the anterior cranial fossa and the frontal lobe. The clinical symptoms began one year before admission. Final diagnosis was made after craniotomy. The patient was treated with an extensive excision of the cerebral mass and medical antifungal therapy (intravenous amphotericin B, but she failed to respond to these treatments and died.

  2. An Economic Evaluation of Voriconazole versus Amphotericin B for the Treatment of Invasive Aspergillosis in Canada

    Directory of Open Access Journals (Sweden)

    Coleman Rotstein

    2004-01-01

    Full Text Available BACKGROUND: Invasive aspergillosis (IA is a serious fungal infection that affects immunocompromised patients. The Global Comparative Aspergillosis study demonstrated that voriconazole, a new broad-spectrum triazole, had better responses and improved survival compared with conventional amphotericin B deoxycholate (CAB and other licensed antifungal therapy (OLAT for the treatment of definite or probable aspergillosis.

  3. Spectrum of bronchopulmonary anomalies associated with tracheoesophageal malformations

    Energy Technology Data Exchange (ETDEWEB)

    Benson, J.E.; Fletcher, B.D.; Olsen, M.

    1985-09-01

    The combination of tracheoesophageal and pulmonary malformations is unusual and reportedly carries a high mortality. We have observed six patients with esophageal atresia and tracheoesophageal fistula and one with a bronchoesophageal fistula who had associated bronchopulmonary anomalies ranging from lobar hypoplasia and agenesis to unilateral pulmonary hypoplasia or agenesis. All of the pulmonary malformations were right-sided. Vertebral or rib anomalies were present in five patients, congenital heart disease in two, imperforate anus in one and one patient had radial aplasia and Pierre Robin syndrome. The bronchopulmonary anomalies complicated the surgical care of tracheoesophageal malformations and required radiologic differentiation from aspiration pneumonia and atelectasis. Six of the seven patients survived. Mortality and morbidity were related to complications and associated cardiac anomalies as well as severity of the lung anomaly.

  4. Two cases of broncho-pulmonary foregut malformations

    OpenAIRE

    Εleftherios D. Spartalis; Elias Lachanas; Dionisios Pavlopoulos; Othonas P. Michail; Anna Karakatsani; Perikles Tomos

    2009-01-01

    SUMMARY. Congenital broncho-pulmonary malformations are mostly asymptomatic. They are diagnosed during the investigation of a pulmonary infection or after a chest x-ray. Fetal ultrasound, chest x-ray, ventilation-perfusion scan, CT, MRI, barium meal, esophagoscopy, bronchoscopy and digital angiography can be used for further investigation. Surgical excision was our treatment of choice and had a significally good prognosis. Pneumon 2009; 22(2):178–185.

  5. Two cases of broncho-pulmonary foregut malformations

    Directory of Open Access Journals (Sweden)

    Εleftherios D. Spartalis

    2009-01-01

    Full Text Available SUMMARY. Congenital broncho-pulmonary malformations are mostly asymptomatic. They are diagnosed during the investigation of a pulmonary infection or after a chest x-ray. Fetal ultrasound, chest x-ray, ventilation-perfusion scan, CT, MRI, barium meal, esophagoscopy, bronchoscopy and digital angiography can be used for further investigation. Surgical excision was our treatment of choice and had a significally good prognosis. Pneumon 2009; 22(2:178–185.

  6. Bronchopulmonary Dysplasia from newborn disease to long-term sequelae

    OpenAIRE

    Broström, Eva Berggren

    2010-01-01

    Bronchopulmonary Dysplasia (BPD) is a complication of premature birth that is associated with increased mortality and morbidity in infancy and impaired lung function and obstructive lung disease from childhood to adulthood. The pathogenesis of BPD is multifactorial, and may involve one or more of the following: a deficiency in surfactant production in the immature lung, chronic inflammatory processes before and after birth, oxidative stress, and trauma due to mechanical vent...

  7. Alveolar proteinosis and nocardiosis: a patient treated by bronchopulmonary lavage.

    OpenAIRE

    Pascual, J.; Gómez Aguinaga, M. A.; Vidal, R; Maudes, A.; Sureda, A.; Gómez Mampaso, E.; Fogué, L.

    1989-01-01

    Alveolar proteinosis is a relatively rare disease of unclear pathogenesis associated with opportunistic-infections. Although nocardiosis is the most frequent one, only 22 cases have been reported previously and are reviewed here. We present a patient with alveolar proteinosis with nocardiosis treated as an emergency with bilateral bronchopulmonary lavage and antibiotics. No previous cases of this association have been successfully managed in this way.

  8. Reviewing the use of corticosteroids in bronchopulmonary dysplasia

    Directory of Open Access Journals (Sweden)

    Fernanda Aparecida de Oliveira Peixoto

    2016-04-01

    Full Text Available Abstract Objective: Review the risks and benefits of postnatal corticosteroid use for the treatment of bronchopulmonary dysplasia, considering that there is not a more effective therapy. Data sources: The literature review was carried out in the BIREME database, using the terms "bronchopulmonary dysplasia and corticosteroid" in the LILACS, IBECS, MEDLINE, Cochrane Library, and SciELO databases, selecting the most relevant articles on the subject, with emphasis on recent literature published in the last five years. Summary of the data: In preterm infants, bronchopulmonary dysplasia is still a common problem and remains without a specific therapy, despite knowledge of the several risk factors. The treatment essentially consists of supportive measures, but in the past, corticosteroids were widely used, as they are the only medications that have an impact on disease progression. However, the emergence of cerebral palsy associated with the indiscriminate use of corticosteroids has prevented the prescription of this drug in the last 15 years. Since then, no new measures have been taken, and the incidence of the disease tended to increase during this period, creating the need for a review of corticosteroid use and, possibly, more restricted indications. Conclusions: The association between risks and benefits of corticosteroid use in preterm infants needs to be considered due to the fact that some infant subpopulations may show more benefits than risks, such as those using mechanical ventilation with difficult weaning.

  9. Halting the allergic march.

    Science.gov (United States)

    Van Bever, Hugo P; Samuel, Sudesh T; Lee, Bee Wah

    2008-04-01

    The prevalence of childhood allergic diseases, such as allergic asthma, allergic rhinitis, and atopic dermatitis, has increased exponentially. In Singapore, the prevalence of asthma at all ages exceeds 20%, and around 50% of Singaporean children show features of an underlying allergy. The exact environmental causes for the increase of allergic diseases have not yet been identified, but most researchers agree that a decreased bacterial load in young children may be one of the reasons for the increase. However, the causes of allergy are multiple, and the development of an allergic disease is the result of complex interactions between genetic constitution and environmental factors. In this review article, different aspects of allergic sensitization are covered, including prenatal and postnatal sensitization. The phenomenon of the "allergic march" (switching from one clinical expression of allergy to another) and its underlying mechanisms are discussed. The last part of this review article is on prevention and treatment of allergic diseases, including the role of bacterial products (probiotics, prebiotics, and synbiotics) and the role of immunotherapy, including sublingual immunotherapy. PMID:23283392

  10. Metal densities in paranasal sinuses - reliable evidence of aspergillosis

    International Nuclear Information System (INIS)

    The significance of mycotic concretions of 'metal density' in the diagnosis of aspergillosis of the paranasal sinuses has been analysed in 47 patients with this diagnosis. The incidence, types, radiological appearances and chemical composition of these very dense calcifications are discussed. Demonstration of these concretions, if metal foreign bodies and displaced dental fillings are excluded, are evidence for a mycosis of the paranasal sinuses. Absence of these dense structures does not exclude aspergillosis and was present in our clinical material in only 50% of cases. (orig.)

  11. A novel case of canine disseminated aspergillosis following mating.

    Science.gov (United States)

    Walker, Jackson T; Frazho, Jean K; Randell, Susan C

    2012-02-01

    An intact bitch with a history of mating was presented with severe lameness and a vulvar discharge. A mixed lytic, proliferative tibial lesion and open pyometra were diagnosed. Bone biopsy and uterine culture revealed disseminated aspergillosis. This is the first report of Aspergillus pyometra with dissemination following mating in the dog. PMID:22851783

  12. A novel case of canine disseminated aspergillosis following mating

    OpenAIRE

    Walker, Jackson T.; Frazho, Jean K.; Randell, Susan C.

    2012-01-01

    An intact bitch with a history of mating was presented with severe lameness and a vulvar discharge. A mixed lytic, proliferative tibial lesion and open pyometra were diagnosed. Bone biopsy and uterine culture revealed disseminated aspergillosis. This is the first report of Aspergillus pyometra with dissemination following mating in the dog.

  13. Critical assessment of issues in the diagnosis of invasive aspergillosis.

    NARCIS (Netherlands)

    Klont, R.R.; Meis, J.F.G.M.; Verweij, P.E.

    2001-01-01

    Invasive aspergillosis remains a devastating disease, which is partly because of the inability to identify infected patients at an early stage of the disease. Recently, new diagnostic tests and procedures have been developed to help in identifying high-risk patients. High-resolution computed tomogra

  14. Allergic Rhinitis: Antihistamines

    Science.gov (United States)

    MENU Return to Web version Allergic Rhinitis | Antihistamines What are antihistamines? Antihistamines are medicines that help stop allergy symptoms, such as itchy eyes, sneezing and a runny nose. Sometimes, an antihistamine ...

  15. Allergic rhinitis during pregnancy.

    Science.gov (United States)

    2016-04-01

    During pregnancy, the first-choice drugs for allergic rhinitis are nasal or oral "non-sedating" antihistamines without antimuscarinic activity, in particular cetirizine, or loratadine after the first trimester. PMID:27186624

  16. A prospective survey of Aspergillus spp. in respiratory tract samples: prevalence, clinical impact and antifungal susceptibility

    DEFF Research Database (Denmark)

    Mortensen, K L; Johansen, H K; Fuursted, K;

    2011-01-01

    ) was evaluated using modified EORTC/MSG criteria. A total of 11,368 airway samples were received. Growth of Aspergillus spp. was found in 129 and 151 patients using routine and extended incubation, respectively. Three patients had proven IA (2%), 11 probable (7%), four had allergic bronchopulmonary aspergillosis...

  17. A complex communicating bronchopulmonary foregut malformation: diagnostic imaging and pathogenesis

    Energy Technology Data Exchange (ETDEWEB)

    Sumner, T.E.; Auringer, S.T.; Cox, T.D. [Department of Radiology, Bowman Gray School of Medicine, Wake Forest University, Medical Center Boulevard, Winston-Salem, NC 27157-1088 (United States)

    1997-10-01

    We report a newborn with an esophageal lung, a rare type of communicating bronchopulmonary foregut malformation (CBPFM). Associated findings included esophageal atresia, tracheoesophageal fistula (TEF) to the distal esophagus, duodenal stenosis with annular pancreas, imperforate anus, vertebral anomalies and ambiguous genitalia. Radiologic evaluation included chest radiographs, esophagrams, chest ultrasound and chest CT. After colostomy and surgical repair of duodenal stenosis and TEF, a right thoracotomy was performed to treat an esophageal lung. Radiologic features of this unusual variant of CBPFM are presented. Accurate preoperative imaging diagnosis is essential for planning surgical treatment of an esophageal lung. (orig.). With 1 fig.

  18. Esophageal lung – A rare bronchopulmonary foregut malformation

    Directory of Open Access Journals (Sweden)

    S.V. Parelkar

    2014-11-01

    Full Text Available Esophageal lung is a rare variety of communicating bronchopulmonary foregut malformation characterized by a fistula between an isolated portion of respiratory tissue and esophagus or stomach. It may involve the entire lung or one of the pulmonary lobes. Only 20 cases have been reviewed in 2011. Fifty percent of cases are associated with a tracheoesophageal fistula. We report a case of a 6 month old girl who was previously operated for TEF repair, with esophageal lobe which was successfully excised. The relevant literature is reviewed.

  19. [Therapy of allergic rhinitis].

    Science.gov (United States)

    Klimek, Ludger; Sperl, Annette

    2016-03-01

    If the avoidance of the provoking allergen is insufficient or not possible, medical treatment can be tried. Therapeutics of the first choice for the treatment of the seasonal and persistent allergic rhinitis are antihistamines and topical glucocorticoids. Chromones are less effective so they should only be used for adults with a special indication, for example during pregnancy. Beside the avoidance of the allergen the immunotherapy is the only causal treatment of allergic diseases. PMID:27120870

  20. Invasive central nervous system aspergillosis in bone marrow transplantation recipients: an overview

    International Nuclear Information System (INIS)

    Invasive central nervous system aspergillosis is being seen with an increased frequency, particularly due to the increased number of immunosuppressed patients. The major cause of invasive central nervous system aspergillosis is bone marrow transplantation. In most cases, aspergillosis develops in the paranasal sinuses and in the lungs, and secondarily spreads to the brain. Imaging of cerebral aspergillosis may present different patterns depending on the lesion's age and the immunologic status of the patient. Lesions of the spinal cord are far less common but has been encountered in our series. In this article we review the clinical and radiologic features of aspergillosis affecting the central nervous system in patients who underwent bone marrow transplantation. Different CT and MR patterns are presented, including pertinent clinical and pathologic material. Significant morbidity and mortality can be associated with this fungal infection, and it is therefore incumbent upon the radiologist to identify intracranial aspergillosis as early as possible so that appropriate therapy can be administered. (orig.)

  1. Aerosol and parenteral pneumocandins are effective in a rat model of pulmonary aspergillosis.

    OpenAIRE

    Kurtz, M B; Bernard, E M; Edwards, F F; Marrinan, J A; Dropinski, J; Douglas, C M; Armstrong, D

    1995-01-01

    The pneumocandins are semisynthetic analogs of echinocandin-like compounds that have shown efficacy in animal models of systemic candidiasis, disseminated aspergillosis, and pneumocystis pneumonia. However, the most common form of Aspergillus infection in susceptible patients is pulmonary aspergillosis, which was not directly tested in the mouse models used in the past. We have evaluated three pneumocandins, L-693,989, L-731,373, and L-733,560, in a rat model of pulmonary aspergillosis. Male ...

  2. Invasive aspergillosis in an immunocompetent patient with fever and a cardiac mass

    Directory of Open Access Journals (Sweden)

    Matthew LaBarbera

    2011-10-01

    Full Text Available Invasive aspergillosis is an often fatal disease that usually occurs in immunocompromised patients. We report a case of invasive aspergillosis presenting as a febrile respiratory infection with a cardiac mass in an immunocompetent patient. Invasive aspergillosis should be considered in the differential diagnosis of an otherwise undiagnosed febrile respiratory illness, even in immunocompetent patients. Echocardiography should be peformed to evaluate for endocarditis in such cases. Prompt initiation of appropriate antifungal therapy is warranted, even before the diagnosis of invasive aspergillosis is confirmed.

  3. Imaging features of gastric invasive aspergillosis: A report of two cases

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Dong Jin; Cho, Seung Hyun; Kim, Seong Hoon; Shin, Ji Yeol; Lee, Yil Gi [Daegu Fatima Hospital, Daegu (Korea, Republic of)

    2012-05-15

    Invasive aspergillosis is an opportunistic infection that usually occurs in immunocompromised patients. Although there are a few rare reports of isolated invasive aspergillosis affecting the small intestine, isolated or disseminated gastric invasive aspergillosis is extremely rare. Herein, we report 2 cases of gastric invasive aspergillosis in a 72 year old woman and a 43 year old man; the woman had been recovering from ruptured left posterior communicating artery aneurysm, which presented as emphysematous gastritis and the man from acute subdural haemorrhage in the intensive care unit, which presented as a pseudoaneurysm on CT imaging.

  4. Invasive pulmonary aspergillosis – case report and review of literature

    Directory of Open Access Journals (Sweden)

    Ashutossh Naaraayan

    2015-02-01

    Full Text Available Invasive pulmonary aspergillosis (IPA is a severe fungal infection with a high mortality rate. The incidence of IPA is on the rise due to an increase in the number of patients undergoing transplants and receiving chemotherapy and immunosuppressive therapy. Diagnosis is challenging due to the non-specific nature of symptoms. Voriconazole is the mainstay of therapy. We present a case of an elderly woman presenting with acute bronchitis and asthma exacerbation, who succumbed to overwhelming IPA. It is uncommon for IPA to develop in patients on short-term steroid therapy for asthma exacerbation. The possibility of aspergillosis in immunocompetent patients should be considered in those on systemic steroids and deteriorating pulmonary functions.

  5. Primary cutaneous aspergillosis due to Aspergillus flavus: a case report

    Institute of Scientific and Technical Information of China (English)

    ZHANG Qiang-qiang; LI Li; ZHU Min; ZHANG Chao-ying; WANG Jia-jun

    2005-01-01

    @@ Infections caused by opportunistic organisms which have been known as etiologic agents of disease become more and more frequent.Aspergillus spp. is one of the agents. Fungi of aspergillus genus are widely distributed in nature, particularly in the soil and in the decomposed vegetation. They are frequent opportunist pathogens in immunocompromised patients. The most frequent causative organisms that cause cutaneous aspergillosis are A.fumigatus and A.flavus.1-3 In this report, we present a case of primary cutaneous aspergillosis manifested by ulceration of the shank due to A. flavus. The patient had no deficiency of immunological status and severe disease associated with fungal infection. Excellent response was shown to anti-fungal therapy.

  6. Nasal Aspergillosis in a Dog: A Case Report

    Directory of Open Access Journals (Sweden)

    Camilo Padilla Peñuela

    2014-07-01

    Full Text Available Nasal aspergillosis is a major chronic disease affecting the nostrils in dogs. Clinical sinology is typical in every chronic nasal disease. Epistaxis and occasional pain occurs. Rhinoscopic assessment of the area evidences findings associated with the pathology and allows collecting samples for cytology and culture. Systemic therapy with oral antifungals has had variable utility, but now it has been replaced by direct topical medication to the affected area. This article describes the case of a 4-years-old male dog, submitted to consultation by unilateral muco-bloody nasal discharge with a week of evolution. The patient was treated by another vet center with cyclonamine and vitamin K for a possible clotting disorder. After a series of tests that included rhinoscopy and fungal culture, nasal aspergillosis was diagnosed. Intranasal clotrimazole was applied twice and it allowed the resolution of the clinical signs.

  7. Isavuconazole in the treatment of invasive aspergillosis and mucormycosis infections

    Science.gov (United States)

    Donnelley, Monica A; Zhu, Elizabeth S; Thompson, George R

    2016-01-01

    We have a limited arsenal with which to treat invasive fungal infections caused by Aspergillus and Mucorales. The morbidity and mortality for both pathogens remains high. A triazole antifungal, isavuconazole, was recently granted approval by the US Food and Drug Administration and the European Medicines Agency for the treatment of invasive aspergillosis and mucormycosis. A randomized double-blind comparison trial for the treatment of invasive aspergillosis found isavuconazole noninferior to voriconazole. A separate, open-label study evaluating the efficacy of isavuconazole in the treatment of mucormycosis found comparable response rates to amphotericin B and posaconazole treated historical controls. The prodrug isavuconazonium sulfate is commercially available in both an oral and intravenous formulation and is generally well tolerated. Isavuconazole’s broad spectrum of activity, limited side effect profile, and favorable pharmacokinetics will likely solidify its place in therapy. PMID:27330318

  8. Aspergillosis and proventricular impaction in an ostrich (Struthio camelus

    Directory of Open Access Journals (Sweden)

    Shahrzad Azizi

    2014-08-01

    Full Text Available Aspergillosis is the most common mycotic infection in a wide variety of bird and causes significant economic losses. The present study described concurrent occurrence of aspergillosis and proventricular impaction in a 4-year-old male ostrich. The bird had respiratory problems, coughing and anorexia. Postmortem examination revealed numerous greenish-white caseous foci, 0.5 to 1 cm in diameter distributed on the surfaces of the air sacs and throughout the lungs. In histopathological study, multifocal areas of caseous necrosis that surrounded by inflammatory cells including heterophils, lymphocytes and macrophages were present. Long branching septated hyphae were visible in the necrotic areas with hematoxylin and eosin and Periodic acid-Schiff staining. Thrombi were present in the blood vessels. The proventriculus was full of gravel.

  9. Invasive nosocomial pulmonary aspergillosis: risk factors and hospital building works.

    OpenAIRE

    Perraud, M; Piens, M A; Nicoloyannis, N.; Girard, P.; Sepetjan, M; Garin, J. P.

    1987-01-01

    A retrospective epidemiological study of 22 observations of invasive pulmonary aspergillosis, of which 18 were fatal, occurring over a period of 30 months, implicated certain building sites within the hospital. The building works were responsible for the diffusion into the atmosphere of fungal spores from normally closed reservoirs, notably false ceilings, fibrous thermal and/or acoustic insulation materials and roller-blind casings. The results of our study permit us to suggest that protecti...

  10. Histopathological identification of aspergillosis in animals at Dhaka Zoo

    OpenAIRE

    Ahasan, S.A.; Chowdhury, E.H.; Rahman, M M; Rahman, M. A.

    2013-01-01

    Dhaka Zoo with 2000 animal heads of 184 species from significant genetic diversity and five million visitors’ influx round the year is placing it a public health important spot. This study was conducted to investigate aspergillosis in animals at Dhaka Zoo to ascertain animal health, welfare and public health safety standard. One hundred and two necropsied tissue samples preserved in 10% neutral buffered formalin at necropsy from 36 animals of 25 different species were collected from Dhaka Zoo...

  11. Beware of the devastating pulmonary aspergillosis syndromes In certain environments

    LENUS (Irish Health Repository)

    Kooblall, M

    2016-02-01

    Nowadays with more stem cell transplants and immunosuppressive therapies there has been a rise in pulmonary aspergillosis syndromes. The following illustrates such a case. A 49 year old man had a past history of ankylosing spondylitis with a bilateral hip replacement. He was also on surveillance for a superficial bladder tumour since 2007. His chest x-ray in 2008 was normal. In 2010 his CXR showed patchy opacification in the right apex. CT thorax confirm fibrotic changes.

  12. Primary cutaneous aspergillosis and idiopathic bone marrow aplasia*

    Science.gov (United States)

    Furlan, Karina Colossi; Pires, Mario Cezar; Kakizaki, Priscila; Chartuni, Juliana Cabral Nunes; Valente, Neusa Yuriko Sakai

    2016-01-01

    We describe the case of a 9-year-old boy with idiopathic bone marrow aplasia and severe neutropenia, who developed skin ulcers under cardiac monitoring electrodes. The diagnosis of primary cutaneous aspergillosis was made after the second biopsy and culture. Imaging investigation did not reveal internal fungal infection. The child was treated, but did not improve and died 3 months after admission. The report highlights and discusses the preventable risk of aspergillus skin infection in immunocompromised patients. PMID:27438213

  13. Genetics Home Reference: allergic asthma

    Science.gov (United States)

    ... another allergic disorder, such as hay fever (allergic rhinitis) or food allergies. Asthma is sometimes part of ... the Symptoms of an Allergy? Centers for Disease Control and Prevention Disease InfoSearch: Asthma Johns Hopkins Medicine: ...

  14. Allergic reactions in anaesthesia

    DEFF Research Database (Denmark)

    Krøigaard, M; Garvey, L H; Menné, T;

    2005-01-01

    BACKGROUND: The aim of this retrospective survey of possible allergic reactions during anaesthesia was to investigate whether the cause suspected by anaesthetists involved corresponded with the cause found on subsequent investigation in the Danish Anaesthesia Allergy Centre (DAAC). METHODS: Case...... notes and anaesthetic charts from 111 reactions in 107 patients investigated in the DAAC were scrutinized for either suspicions of or warnings against specific substances stated to be the cause of the supposed allergic reaction. RESULTS: In 67 cases, one or more substances were suspected. In 49...... match, the right substance being suspected, but investigations showed an additional allergen or several substances, including the right substance being suspected. CONCLUSIONS: An informed guess is not a reliable way of determining the cause of a supposed allergic reaction during anaesthesia and may put...

  15. Refractory invasive aspergillosis controlled with posaconazole and pulmonary surgery in a patient with chronic granulomatous disease: case report

    OpenAIRE

    Kepenekli, Eda; Soysal, Ahmet; Kuzdan, Canan; Ermerak, Nezih Onur; Yüksel, Mustafa; Bakır, Mustafa

    2014-01-01

    Invasive aspergillosis is an important cause of morbidity and mortality in immunocompromised patients. Among primary immunodefiencies, chronic granulomatous disease (CGD) has the highest prevalence of invasive fungal diseases. Voriconazole is recommended for the primary treatment of invasive aspergillosis in most patients. In patients whose aspergillosis is refractory to voriconazole, therapeutic options include changing class of antifungal, for example using an amphotericin B formulation, an...

  16. Pseudomembranous necrotizing tracheobronchial aspergillosis:an analysis of 16 cases

    Institute of Scientific and Technical Information of China (English)

    HUANG Hai-dong; LI Qiang; HUANG Yi; BAI Chong; WU Ning; WANG Qing; YAO Xiao-peng; CHEN Bin

    2012-01-01

    Background In our clinical practice we have been attracted by a group of patients with airway aspergillosis who have airway obstruction; we termed the condition as pseudomembranous necrotizing tracheobronchial aspergillosis (PNTA).In this study we analyzed the clinical data from patients with PNTA,so as to guide the diagnosis and treatment of the disease.@@Methods A total of 16 PNTA patients were treated in Changhai Hospital from January 2000 to January 2009.Their clinical data,including the demographic information,clinical symptoms,imaging findings,bronchoscopy findings,treatment strategies and efficacy,and prognosis,were retrospectively analyzed.@@Results All 16 patients were found to have primary systemic immunodeficiency diseases and/or damage of the focal airways.Nine patients (9/16,56.3%) had pulmonary and tracheobronchial tumors,5/16 (31.3%) had tracheobronchial involvement secondary to non-pulmonary tumors,and 2/16 (12.5%) had lung transplantation.The most common causes of PNTA included local radiotherapy (10/16,62.5%),repeated chemotherapy (7/16,43.8%) and recurrent intervention therapy by bronchoscope (4/16,25.0%).Aspergillus fumigatus was the most frequent pathogen (62.5%,10/16).The main clinical manifestations included progressive dyspnea (14/16,87.5%) and irritable cough (12/16,75.0%).The trachea was involved in 9/16 patients (56.3%),right main bronchus in 10/16 (62.5%).All 16 patients were treated with systemic anti-aspergillosis agents,local anti-aspergillosis agents with amphotedcin B inhalation and direct perfusion of amphotericin B by bronchoscope,and interventional treatment by bronchoscope to ensure an unobstructed airway.The total efficiency was 31.3%.@@Conclusions PNTA is an infectious disease caused by aspergillus and it mainly involves the trachea,primary bronchus and segmental bronchus.A.fumigatus is the most common pathogen.PNTA can pose a severe clinical threat and often occurs after systemic immunodeficiency and

  17. Characteristics of lung function in pretermin fants with varying degress of bronchopulmonary dysplasia

    Institute of Scientific and Technical Information of China (English)

    卫敏超

    2013-01-01

    Objective To explore the characteristics of lung function in preterm infants with varying degrees of bronchopulmonary dysplasia (BPD) .Methods There were407 infants (278 males and 129 females) were recruited from Shenzhen Children’Hospital between January 2011

  18. Ultrasound diagnosis of pulmonary hypertension in children with chronic bronchopulmonary diseases

    International Nuclear Information System (INIS)

    Ultrasound criteria of diagnosis of pulmonary hypertension and study this complication frequency in children with chronic bronchopulmonary diseases was determined. As diagnostic criteria of pulmonary hypertension Doppler echocardiographic indices of circulation in the pulmonary arteries are suggested

  19. Surfactant phosphatidylcholine half-life and pool size measurements in premature baboons developing bronchopulmonary dysplasia

    NARCIS (Netherlands)

    D.J. Janssen; V.P. Carnielli (Virgilio); P.E. Cogo (Paola); S.R. Seidner; I.H.I. Luijendijk; J.L.D. Wattimena (Josias); A.H. Jobe (Alan); L.J.I. Zimmermann (Luc)

    2002-01-01

    textabstractBecause minimal information is available about surfactant metabolism in bronchopulmonary dysplasia, we measured half-lives and pool sizes of surfactant phosphatidylcholine in very preterm baboons recovering from respiratory distress syndrome and developing bronchopulmon

  20. Course of bronchopulmonary dysplasia. A radiographic follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Mortensson, W.; Lindroth, M.

    Forty-one low weight premature infants treated with intermittent positive pressure ventilation in infancy were followed clinically and with chest radiography for 4 to 6 years. One child died during the period (sudden infantile death) and 2 others were not available for follow-up examination. The abnormal chest pattern of bronchopulmonary dysplasia (BPD) resolved completely or improved during the period; residual changes were found in 34 per cent of the cases. The main part of the resolution occurred during the first 2 years. Mild BPD was more prone to heal. The persisting parenchymal changes - interstitial fibrosis or areas of hyperinflation or both - were generally slight. The frequency of infection of the lower respiratory tract was increased during the first 2 years of life and was positively correlated to the severity of the pulmonary abnormalities. The frequency of infection dramatically decreased during the subsequent 2 years.

  1. Chronic invasive aspergillosis of paranasal sinuses: A case report with review of literature

    Directory of Open Access Journals (Sweden)

    Avinash P Tamgadge

    2012-01-01

    Full Text Available Aspergillosis of the nasal and paranasal sinuses is recognized as being second to candidiasis, among opportunistic fungal infections in immunocompromised patients. However, invasive variant in normal and mildly immunocompromised hosts is a very rare occurrence. We report one such case of aspergillosis involving paranasal sinuses in mildly immunocompromised patient.

  2. Disseminated aspergillosis as the herald manifestation of chronic granulomatous disease in an adult patient.

    Directory of Open Access Journals (Sweden)

    Ilad Alavi Darazam

    2014-02-01

    Full Text Available Chronic granulomatous disease is an inherited defect in intracellular killing of ingested microorganisms characterized by recurrent life threatening bacterial and fungal infections including invasive aspergillosis in early childhood. We report a disseminated aspergillosis as the representative of adult onset chronic granulomatous disease without previous infection, with dramatic response to combination of antifungal and interferon therapy.

  3. [Esophageal aspergillosis in a patient with acute myelogenous leukemia and febrile neutropenia].

    Science.gov (United States)

    Besa, Santiago; Kattan, Eduardo; Cid, Ximena; Claro, Juan C

    2014-04-01

    Aspergillosis usually compromises the respiratory system, but can also affect others. We report a 46 yo female with acute myeloid leukemia, developed febrile neutropenia and dysphagia. Endoscopy revealed esophageal cytomegalovirus-like ulcers, but biopsies showed Aspergillus spp. It's important to consider aspergillosis in the differential diagnosis of esophageal lesions in high-risk patients.

  4. Surfactant phosphatidylcholine half-life and pool size measurements in premature baboons developing bronchopulmonary dysplasia

    OpenAIRE

    Janssen, D.J.; Carnielli, Virgilio; Cogo, Paola; Seidner, S.R.; Luijendijk, I.H.I.; Wattimena, Josias; Jobe, Alan; Zimmermann, Luc

    2002-01-01

    textabstractBecause minimal information is available about surfactant metabolism in bronchopulmonary dysplasia, we measured half-lives and pool sizes of surfactant phosphatidylcholine in very preterm baboons recovering from respiratory distress syndrome and developing bronchopulmonary dysplasia, using stable isotopes, radioactive isotopes, and direct pool size measurements. Eight ventilated premature baboons received (2)H-DPPC (dipalmitoyl phosphatidylcholine) on d 5 of life, and radioactive ...

  5. Regional Variation on Rates of Bronchopulmonary Dysplasia and Associated Risk Factors

    OpenAIRE

    María Ximena Rojas; Mario Augusto Rojas; Juan Manuel Lozano; Martín Alonso Rondón; Laura Patricia Charry

    2012-01-01

    Background. An abnormally high incidence (44%) of bronchopulmonary dysplasia with variations in rates among cities was observed in Colombia among premature infants. Objective. To identify risk factors that could explain the observed high incidence and regional variations of bronchopulmonary dysplasia. Study Design. A case-control study was designed for testing the hypothesis that differences in the disease rates were not explained by differences in city-of-birth specific population characteri...

  6. Periostin in Allergic Inflammation

    Directory of Open Access Journals (Sweden)

    Kenji Izuhara

    2014-01-01

    Full Text Available Periostin, an extracellular matrix protein belonging to the fasciclin family, has been shown to play a critical role in the process of remodeling during tissue/organ development or repair. Periostin functions as a matricellular protein in cell activation by binding to their receptors on cell surface, thereby exerting its biological activities. After we found that periostin is a downstream molecule of interleukin (IL-4 and IL-13, signature cytokines of type 2 immune responses, we showed that periostin is a component of subepithelial fibrosis in bronchial asthma, the first formal proof that periostin is involved in allergic inflammation. Subsequently, a great deal of evidence has accumulated demonstrating the significance of periostin in allergic inflammation. It is of note that in skin tissues, periostin is critical for amplification and persistence of allergic inflammation by communicating between fibroblasts and keratinocytes. Furthermore, periostin has been applied to development of novel diagnostics or therapeutic agents for allergic diseases. Serum periostin can reflect local production of periostin in inflamed lesions induced by Th2-type immune responses and also can predict the efficacy of Th2 antagonists against bronchial asthma. Blocking the interaction between periostin and its receptor, αv integrin, or down-regulating the periostin expression shows improvement of periostin-induced inflammation in mouse models or in in vitro systems. It is hoped that diagnostics or therapeutic agents targeting periostin will be of practical use in the near future.

  7. ALLERGIC CONTACT DERMATITIS

    Directory of Open Access Journals (Sweden)

    Trisna Yuliharti Tersinanda

    2013-07-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE Allergic contact dermatitis is an immunologic reaction that tends to involve the surrounding skin and may even spread beyond affected sites. This skin disease is one of the more frequent, and costly dermatologic problems. Recent data from United Kingdom and United States suggest that the percentage of occupational contact dermatitis due to allergy may be much higher, thus raising the economic impact of occupational allergic contact dermatitis. There is not enough data about the epidemiology of allergic contact dermatitis in Indonesia, however based on research that include beautician in Denpasar, about 27,6 percent had side effect of cosmetics, which is 25,4 percent of it manifested as allergic contact dermatitis. Diagnosis of allergic contact dermatitis is based on anamnesis, physical examination, patch test, and this disease should be distinguished from other eczematous skin disease. The management is prevention of allergen exposure, symptomatic treatment, and physicochemical barrier /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  8. Sibship Characteristics and Risk of Allergic Rhinitis and Asthma

    DEFF Research Database (Denmark)

    Westergaard, Tine; Rostgaard, Klaus; Wohlfahrt, Jan;

    2005-01-01

    asthma; birth order; hypersensitivity; rhinitis; allergic; perennial; rhinitis; allergic; seasonal; risk factors; siblings......asthma; birth order; hypersensitivity; rhinitis; allergic; perennial; rhinitis; allergic; seasonal; risk factors; siblings...

  9. Shoe allergic contact dermatitis.

    Science.gov (United States)

    Matthys, Erin; Zahir, Amir; Ehrlich, Alison

    2014-01-01

    Foot dermatitis is a widespread condition, affecting men and women of all ages. Because of the location, this condition may present as a debilitating problem to those who have it. Allergic contact dermatitis involving the feet is frequently due to shoes or socks. The allergens that cause shoe dermatitis can be found in any constituent of footwear, including rubber, adhesives, leather, dyes, metals, and medicaments. The goal of treatment is to identify and minimize contact with the offending allergen(s). The lack of product information released from shoe manufacturers and the continually changing trends in footwear present a challenge in treating this condition. The aim of this study is to review the current literature on allergic contact shoe dermatitis; clinical presentation, allergens, patch testing, and management will be discussed. PubMed and MEDLINE databases were used for the search, with a focus on literature updates from the last 15 years. PMID:25000234

  10. Pleural aspergillosis complicated by recurrent pneumothorax: a case report

    Directory of Open Access Journals (Sweden)

    Gao Jie

    2010-06-01

    Full Text Available Abstract Introduction Pneumothorax as the first symptom of pleural aspergillosis is rare. Case presentation A 31-year-old asthmatic Chinese man presented with recurrent spontaneous pneumothorax and underwent lobectomy due to persistent air leakage. Aspergillus was detected histopathologically in the visceral pleural cavity. He was treated with itraconazole at 200 mg a day, and nine months later he had no recurrent pneumothorax or aspergillus infection. Conclusion Recurrent pneumothorax may be a rare manifestation of aspergillus infection. Aspergillus species infection should be considered in the differential diagnosis of recurrent pneumothorax patients, particularly those with chronic lung disease.

  11. Allergic granulomatous angiitis

    OpenAIRE

    Trifunović Gordana; Plavec Goran; Tomić Ilija; Popović Lidija; Stefanović Dušan

    2004-01-01

    Allergic granulomatous angiitis (AGA) - Churg-Strauss syndrome, is a rare autoimmune disease characterized by three distinct clinical phases prodromal, eosinophilic, and vasculitic, and most of respiratory symptoms and signs begin in the first two phases of the disease. Two female patients of different age, who fulfilled the diagnostic criteria for AGA, and were in different phases and with the different duration of the disease are presented. The first patient (24 years of age) was admitted t...

  12. Prediction of exacerbation chronic bronchopulmonary diseases in children with influenza

    Directory of Open Access Journals (Sweden)

    O. I. Afanaseva

    2015-01-01

    Full Text Available The objective: To develop a method for predicting exacerbation of chronic illness in children with asthma and cystic fibrosis, patients with influenza, based on the study of the dynamics of cytokines. Materials and methods: Were examined 52 patients with bronchial asthma and 45 children with cystic fibrosis at the age from 1 year to 12 years, located in infectious pulmonary Department at the planned treatment of underlying pathology, in which influenza was in-hospital infection. Control group observations included 40 patients with the flu, without concomitant pulmonary disease. The etiology of viral infection was established by detection of viral RNA in nasopharyngeal swabs by PCR. Among the influenza viruses were identified influenza АH1N1, АH3N2, influenza B, and in 2009–2010 the predominant antigen was the pandemic influenza virus АH1N1pdm09. Determination of the concentration of serum interleukins IL-1β, IL-4, IL-8, IL-10, ТNF-α, IFN-γ was performed in the 1st and 3rd day of hospitalization cytokines by the solid-phase immune-enzyme assay. Analysis of the results performed using statistical package SPSS 17.0 EN for Windows. Results: The flu caused the aggravation associated bronchopulmonary pathology in 2/3 of children, as MV patients, and patients with BA (65,4%-66,7%, respectively. With an increase of the ratio of IL-4 / IFN-γ and IL-10/IFN-γ, at least 5-6 times, influenza can be considered a trigger of exacerbation of chronic bronchopulmonary pathologies that require amplification of the therapy of bronchial asthma and of сystic fibrosis. The growth of prognostic coefficients in 2-3 times allows using for treatment of influenza in these patients only antiviral agents. Conclusion: The study has shown a method for predicting exacerbation of bronchial asthma and cystic fibrosis in children at an early stage of influenza by calculating the ratio of IL-4/IFN-γ and IL-10/IFN-γ in children aged from 1 year to 12 years. 

  13. Reliability of CXR for the diagnosis of bronchopulmonary dysplasia

    International Nuclear Information System (INIS)

    Background. Bronchopulmonary dysplasia (BPD) continues to be prevalent, despite new treatment, in part because of increased survival in less mature infants. Investigations of new treatments have been hampered by a lack of universally accepted diagnostic criteria. Radiographic scoring systems have been developed to provide objective assessment of lung injury and risk for chronic lung disease. Objective. We sought to test the reliability of a recently reported system using chest radiography as the main tool for diagnosis of BPD. Materials and methods. One hundred chest radiographs, half demonstrating BPD and the other half without BPD, were analyzed by pediatric radiologists and by a neonatologist, using the Weinstein score (1-6, depending on increasing radiographic severity). The reliability of this scoring system was tested by kappa (k) statistics. Results. Reliability at the lowest threshold (dividing score 1 from score ≥ 2) was unacceptably low in this population. Reliability increased with inclusion of higher BPD scores in the comparison groups: 1-3 versus 4-6. Conclusion. Using the chest radiograph for the prediction of BPD is not reliable between different observers except at the two extremes of the disease. (orig.)

  14. Nutrition of preterm infants in relation to bronchopulmonary dysplasia

    Directory of Open Access Journals (Sweden)

    Tschirch Edda

    2011-02-01

    Full Text Available Background The pathogenesis of bronchopulmonary dysplasia (BPD is multifactorial. In addition to prenatal inflammation, postnatal malnutrition also affects lung development. Methods A retrospective study was performed to analyse during the first two weeks of life the total, enteral and parenteral nutrition of premature infants ( Results Ninety-five premature infants were analysed: 26 with BPD (27 ± 1 weeks and 69 without BPD (28 ± 1 weeks. There was no statistical significant difference in the total intake of fluids, calories, glucose or protein and weight gain per day in both groups. The risk of developing BPD was slightly increased in infants with cumulative caloric intake below the minimal requirement of 1230 kcal/kg and a cumulative protein intake below 43.5 g/kg. Furthermore, the risk of developing BPD was significantly higher when infants had a cumulative fluid intake above the recommended 1840 ml/kg. In infants who developed BPD, the enteral nutrition was significantly lower than in non-BPD infants [456 ml/kg (IQR 744, 235 vs. 685 (IQR 987, 511]. Infants who did not develop BPD reached 50% of total enteral feeding significantly faster [9.6 days vs. 11.5]. Conclusions Preterm infants developing BPD received less enteral feeding, even though it was well compensated by the parenteral nutrient supply. Data suggest that a critical minimal amount of enteral feeding is required to prevent development of BPD; however, a large prospective clinical study is needed to prove this assumption.

  15. "Aspergillosis following Cytomegalovirus disease in a kidney transplant patient "

    Directory of Open Access Journals (Sweden)

    "Ameri Sh

    2003-06-01

    Full Text Available A 32-year-old end stage renal disease (ESRD woman was scheduled for transplantation. Also, she has had fever of unknown origin (FUO, rise of ESR and PPD>22 mm. Therefore treatment with isoniazid and rifampin was started three months prior to transplantation. She developed allograft dysfunction on week after transplantation. She received a few course pulse therapy (methyl prednisolone, antilymphocyte globulin (ALG, hemodialysis and because of low blood level of cyclosporine, isoniazid and rifampin were stopped. She was seen because of unilateral decreased vision, fever, cough and in physical examination, chorioretinitis and bilateral infiltration in both lungs were seen three weeks later. Severe cytomegalovirus (CMV antigenemia was detected and she responded rapidly to gancyclovir. One month later, she complained of fever and productive cough again. In chest X-ray (CXR, cavitary lesions were shown and with transthoracic biopsy, invasive aspergillosis was detected. In spite of amphotericin B therapy, she developed CNs involvement. Unfortunately she expired six months post transplantation. This is an interesting case of aspergillosis following CMV infection most likely because of an excess of immunosuppression.

  16. Mycological and serological study of pulmonary aspergillosis in central India

    Directory of Open Access Journals (Sweden)

    Kurhade A

    2002-01-01

    Full Text Available PURPOSE: To study the prevalence and predisposing factors of Aspergillus infection and correlate microscopic, culture and serological findings along with drug sensitivity. METHODS: Sputum samples from 123 patients of pulmonary disease with clinical suspicion of having fungal, especially Aspergillus infections, were examined microscopically and for culture. Minimum inhibitory concentration (MIC of itraconazole was tested against the isolates. Serum samples from these patients were tested for precipitin against Aspergillus antigen using immunodiffusion (ID technique. RESULTS: Aspergillus species were isolated in 20 (16.26% cases and Aspergillus fumigatus was the predominant species isolated in 16 (80% cases. Precipitins were detected in 29 (23.58% cases. Serum samples collected from 50 healthy individuals to serve as controls showed no precipitin against Aspergillus antigen galactomannan. This fungus was found to be sensitive to itraconazole with MIC range 0.125-1µg/mL. CONCLUSIONS: Serological tests have an edge over routine smear and culture methods for the diagnosis of pulmonary aspergillosis. Itraconazole is more effective than amphotericin B and fluconazole in the treatment of aspergillosis.

  17. Isavuconazole in the treatment of invasive aspergillosis and mucormycosis infections

    Directory of Open Access Journals (Sweden)

    Donnelley MA

    2016-06-01

    Full Text Available Monica A Donnelley,1,2 Elizabeth S Zhu,1 George R Thompson 3rd3 1Department of Inpatient Pharmacy, University of California – Davis, Sacramento, 2Department of Clinical Sciences, Touro University College of Pharmacy, Vallejo, 3Department of Medicine, Division of Infectious Diseases, University of California – Davis, Davis, CA, USAAbstract: We have a limited arsenal with which to treat invasive fungal infections caused by Aspergillus and Mucorales. The morbidity and mortality for both pathogens remains high. A triazole antifungal, isavuconazole, was recently granted approval by the US Food and Drug Administration and the European Medicines Agency for the treatment of invasive aspergillosis and mucormycosis. A randomized double-blind comparison trial for the treatment of invasive aspergillosis found isavuconazole noninferior to voriconazole. A separate, open-label study evaluating the efficacy of isavuconazole in the treatment of mucormycosis found comparable response rates to amphotericin B and posaconazole treated historical controls. The prodrug isavuconazonium sulfate is commercially available in both an oral and intravenous formulation and is generally well tolerated. Isavuconazole’s broad spectrum of activity, limited side effect profile, and favorable pharmacokinetics will likely solidify its place in therapy. Keywords: isavuconazonium, antifungal, zygomycosis, mucor, mould infection, pharmacokinetics, pharmacodynamics, clinical efficacy, therapy, new agent

  18. [Advice for allergic travellers].

    Science.gov (United States)

    Sonneville, A

    1999-09-01

    Business and tourist journeys by air contribute to exposure of the body to multiple environments. The allergic patient, considered rightly to be a sentry of the environment, has many reasons to care about his journeys and to take precautions that are adapted to his case under the impetus of advice and information from his physician and his specialist. Some advice falls within a simple logic that is enough to remember when planning the journey while the others measures must follow a correct preventative strategy for allergy risks as much as those that concern the modalities before leaving as a drive taken on the ground. It is important therefore to know how to give advice and information on the different risks linked to the allergic condition and to the field of allergy and help the patient to orientate his choice of place of the journey, the methods of lodging, of transport and the programme of the journey. The advice should also include the preventative measures as a function of the known pathology under the form of medical equipment before, during the stay and on return. Finally some advice relative to medical equipment for prevention and cure would appear to be judicious. PMID:10524269

  19. [Improving system of prevention and rehabilitation for asbestos-related broncho-pulmonary diseases in workers].

    Science.gov (United States)

    2011-01-01

    To improve a system of prevention and rehabilitation for broncho-pulmonary diseases among workers engaged into extraction and utilization of chrysotile asbestos, the authors specified major criteria for diagnosis of asbestos-related pulmonary diseases and signs of exposure to asbestos-containing dust, with definition of risk groups for broncho-pulmonary diseases. The authors formulated main concepts of prevention and rehabilitation for asbestos-related pulmonary diseases in workers engaged into asbestos industry. Special attention was paid to harmonization of all medical and technical measures aimed to prevention and liquidation of asbestos-related diseases. PMID:21789804

  20. Nutrition of preterm infants with bronchopulmonary dysplasia after hospital discharge – Part II

    Directory of Open Access Journals (Sweden)

    Hercília Guimarães

    2014-01-01

    Full Text Available Preterm infants with bronchopulmonary dysplasia often present with severe growth failure at discharge from the neonatal intensive care unit. Catch-up growth accelerates after hospital discharge, nevertheless, feeding problems may need a specialized approach. Following the revision of the scientific literature on the most relevant aspects on nutrition of patients with bronchopulmonary dysplasia after hospital discharge in Part I, in this article the Authors present and discuss important issues such as catch up growth, swallow dysfunction, gastroesophageal reflux, and how to improve feeding competences.

  1. Impact of bronchopulmonary dysplasia on brain and retina

    Directory of Open Access Journals (Sweden)

    Annie Wing Hoi Poon

    2016-04-01

    Full Text Available Many premature newborns develop bronchopulmonary dysplasia (BPD, a chronic lung disease resulting from prolonged mechanical ventilation and hyperoxia. BPD survivors typically suffer long-term injuries not only to the lungs, but also to the brain and retina. However, currently it is not clear whether the brain and retinal injuries in these newborns are related only to their prematurity, or also to BPD. We investigated whether the hyperoxia known to cause histologic changes in the lungs similar to BPD in an animal model also causes brain and retinal injuries. Sprague Dawley rat pups were exposed to hyperoxia (95% O2, ‘BPD’ group or room air (21% O2, ‘control’ group from postnatal day 4–14 (P4–14; the rat pups were housed in room air between P14 and P28. At P28, they were sacrificed, and their lungs, brain, and eyes were extracted. Hematoxylin and eosin staining was performed on lung and brain sections; retinas were stained with Toluidine Blue. Hyperoxia exposure resulted in an increased mean linear intercept in the lungs (P<0.0001. This increase was associated with a decrease in some brain structures [especially the whole-brain surface (P=0.02], as well as a decrease in the thickness of the retinal layers [especially the total retina (P=0.0008], compared to the room air control group. In addition, a significant negative relationship was observed between the lung structures and the brain (r=−0.49, P=0.02 and retina (r=−0.70, P=0.0008 structures. In conclusion, hyperoxia exposure impaired lung, brain, and retina structures. More severe lung injuries correlated with more severe brain and retinal injuries. This result suggests that the same animal model of chronic neonatal hyperoxia can be used to simultaneously study lung, brain and retinal injuries related to hyperoxia.

  2. Bronchopulmonary dysplasia: correlation of radiographic and clinical findings

    Energy Technology Data Exchange (ETDEWEB)

    Breysem, L. [Department of Radiology, University Hospitals, K. U. Leuven, Herestraat 49, B-3000 Leuven (Belgium); Smet, M.H. [Department of Radiology, University Hospitals, K. U. Leuven, Herestraat 49, B-3000 Leuven (Belgium); Lierde, S. van [Department of Pediatrics, University Hospitals of Leuven, Leuven (Belgium); Devlieger, H. [Department of Pediatrics, University Hospitals of Leuven, Leuven (Belgium); Boeck, K. de [Department of Pediatrics, University Hospitals of Leuven, Leuven (Belgium); Marchal, G. [Department of Radiology, University Hospitals, K. U. Leuven, Herestraat 49, B-3000 Leuven (Belgium)

    1997-08-01

    Background and purpose. Abnormalities of the chest wall have been described in bronchopulmonary dysplasia (BPD). Clinical, radiographic and pulmonary function variables were evaluated in 1-year-old children ventilated because of neonatal lung disease in order to quantify these thoracic changes and to evaluate the lung disease. Methods. The pulmonary status of 51 infants with neonatal lung disease requiring artificial ventilation was reevaluated clinically and radiographically at the age of 1 year. Twenty-two of these infants had developed BPD. Thoracic depth and width were measured clinically and on chest X-ray. The Toce score evaluated the presence of cardiomegaly, hyperinflation, emphysema and interstitial lung disease. Lung function was measured after sedation using previously reported methods. In BPD patients, Toce score and lung function were determined and compared at 1 month and at 1 year of age. Results. In BPD patients, chest depth was significantly smaller when measured clinically as well as on chest radiograph (P < 0.05; Mann-Whitney U-test). There was a statistically significant correlation between chest depth measured clinically and on chest X-ray. Toce score was significantly higher in BPD patients (P < 0.05). In BPD patients intersitial abnormalities and decreased lung compliance were more frequent at the age of 1 month than at the age of 1 year. At the age of 1 year, hyperinflation was more frequent and at that time increased airway resistance was still noted. Thus the type of X-ray abnormality reflects the type of lung function disturbance. Conclusion. The flatness of the chest is most likely a consequence of the long-standing lung function abnormalities. (orig.). With 3 figs., 6 tabs.

  3. Circulating Fibrocytes Are Increased in Neonates with Bronchopulmonary Dysplasia.

    Directory of Open Access Journals (Sweden)

    Chun Li

    Full Text Available Bronchopulmonary dysplasia (BPD is characterized by the aberrant remodeling of the lung parenchyma, resulting from accumulation of fibroblasts or myofibroblasts. Circulating fibrocytes are implied in pulmonary fibrosis, but whether these cells are associated with the development of BPD or the progressive fibrosis is unknown. The aim of the present study was to investigate the occurrence of fibrocytes in peripheral venous blood and explore whether these cells might be associated with severity of BPD.We investigated circulating fibrocytes in 66 patients with BPD, 23 patients with acute respiratory distress syndrome(ARDS and 11 normal subjects. Circulating fibrocytes were defined and quantified as cells positive for CD45 andcollagen-1 by flow cytometry. Furthermore, serum SDF-1/CXCL12 and TGF-β1 were evaluated using ELISA methods. We also investigated the clinical value of fibrocyte counts by comparison with standard clinical parameters.The patients with BPD had significantly increased numbers of fibrocytes compared to the controls (p < 0.01. Patients with ARDS were not different from healthy control subjects. There was a correlation between the number of fibrocytes and pulmonary hypertension or oxygen saturation (p < 0.05. Fibrocyte numbers were not correlated with other clinical or functional variables or radiologic severity scores. The fibrocyte attractant chemokine CXCL12 increased in plasma (p < 0.05 and was detectable in the bronchoalveolar lavage fluid of 40% of the patients but not in controls.These findings indicate that circulating fibrocytes are increased in patients with BPD and may contribute to pulmonary fibrosis in BPD. Circulating fibrocytes, likely recruited through the CXCR4/CXCL12 axis, might contribute to the production of TGF-β1 for the expansion of fibroblast/myofibroblast population in BPD.

  4. Histone deacetylase inhibition as an alternative strategy against invasive aspergillosis

    Directory of Open Access Journals (Sweden)

    Frederic eLamoth

    2015-02-01

    Full Text Available Invasive aspergillosis (IA is a life-threatening infection due to Aspergillus fumigatus and other Aspergillus spp. Drugs targeting the fungal cell membrane (triazoles, amphotericin B or cell wall (echinocandins are currently the sole therapeutic options against IA. Their limited efficacy and the emergence of resistance warrant the identification of new antifungal targets. Histone deacetylases (HDACs are enzymes responsible of the deacetylation of lysine residues of core histones, thus controlling chromatin remodeling and transcriptional activation. HDACs also control the acetylation and activation status of multiple non-histone proteins, including the heat shock protein 90 (Hsp90, an essential molecular chaperone for fungal virulence and antifungal resistance. This review provides an overview of the different HDACs in Aspergillus spp. as well as their respective contribution to total HDAC activity, fungal growth, stress responses, and virulence. The potential of HDAC inhibitors, currently under development for cancer therapy, as novel alternative antifungal agents against IA is discussed.

  5. CT of invasive pulmonary aspergillosis in children with cancer

    International Nuclear Information System (INIS)

    In treating cases of malignancy, the use of chemotherapy carries a high risk of lower respiratory tract infections, especially fungal pneumonopathy. This complication is a major cause of mortality and is often difficult to diagnose because of non-specific clinical or radiological changes, but the early recognition of invasive fungal disease is imperative. CT is an important non-invasive method for the detection and evaluation of opportunistic fungal infections. In these patients am improved survival rate can be achieved when early detection by CT leads to the prompt institution of high-dose antifungal therapy. We illustrate the spectrum of CT findings of invasive pulmonary aspergillosis encountered in children with cancer. These patients had previously been treated with high-dose chemotherapy with or without bone marrow rescue, and underwent radiological examinations because of clinical evidence of pneumonopathy. Representative cases demonstrate the clinical applications of CT in the evaluation and management of invasive fungal disease. (orig.)

  6. Opportunistic filamentous mycoses: aspergillosis, mucormycosis, phaeohyphomycosis and hyalohyphomycosis.

    Science.gov (United States)

    Perusquía-Ortiz, Ana María; Vázquez-González, Denisse; Bonifaz, Alexandro

    2012-09-01

    Opportunistic filamentous mycoses are widely distributed all over the world. They are rarely observed in Europe but are common in developing countries. The most common are the aspergilloses (due to Aspergillus spp.) mostly in neutropenia and immunosuppression; the mucormycoses characterized by rapid progression in patients with diabetic ketoacidosis; the phaeohyphomycoses due to pigmented fungi causing either a mild superficial or a very serious deep disease and the hyalohyphomycoses due to hyaline filamentous fungi (Fusarium spp., Pseudallescheria spp., Scopulariopsis spp.). Cutaneous manifestations are usually secondary to dissemination from pulmonary or visceral disease; primary cases are less frequent and due to direct inoculation into the skin. We review epidemiological, clinical, diagnostic, and therapeutic data on the four most important opportunistic filamentous mycoses: aspergillosis, mucormycosis, phaeohyphomycosis and hyalohyphomycosis.

  7. CT of invasive pulmonary aspergillosis in children with cancer

    Energy Technology Data Exchange (ETDEWEB)

    Taccone, A. (Dept. of Radiology, Gaslini Children' s Hospital, Genoa (Italy)); Occhi, M. (Dept. of Radiology, Gaslini Children' s Hospital, Genoa (Italy)); Garaventa, A. (Div. of Hematology and Oncology, Gaslini Children' s Hospital, Genoa (Italy)); Manfredini, L. (Div. of Hematology and Oncology, Gaslini Children' s Hospital, Genoa (Italy)); Viscoli, C. (Dept. of Infectious Diseases, Gaslini Children' s Hospital, Genoa (Italy))

    1993-06-01

    In treating cases of malignancy, the use of chemotherapy carries a high risk of lower respiratory tract infections, especially fungal pneumonopathy. This complication is a major cause of mortality and is often difficult to diagnose because of non-specific clinical or radiological changes, but the early recognition of invasive fungal disease is imperative. CT is an important non-invasive method for the detection and evaluation of opportunistic fungal infections. In these patients am improved survival rate can be achieved when early detection by CT leads to the prompt institution of high-dose antifungal therapy. We illustrate the spectrum of CT findings of invasive pulmonary aspergillosis encountered in children with cancer. These patients had previously been treated with high-dose chemotherapy with or without bone marrow rescue, and underwent radiological examinations because of clinical evidence of pneumonopathy. Representative cases demonstrate the clinical applications of CT in the evaluation and management of invasive fungal disease. (orig.)

  8. Allergic granulomatous angiitis

    Directory of Open Access Journals (Sweden)

    Trifunović Gordana

    2004-01-01

    Full Text Available Allergic granulomatous angiitis (AGA - Churg-Strauss syndrome, is a rare autoimmune disease characterized by three distinct clinical phases prodromal, eosinophilic, and vasculitic, and most of respiratory symptoms and signs begin in the first two phases of the disease. Two female patients of different age, who fulfilled the diagnostic criteria for AGA, and were in different phases and with the different duration of the disease are presented. The first patient (24 years of age was admitted to the hospital due to aggravation of asthma, heart failure, and polyneuropathy. The second one (45 years of age was also hospitalized due to the worsening of asthma polyneuropathy, and fever. Both were treated continuously with glucocorticoids. The older patient also received a total of six pulse doses of cyclophosphamide. Satisfactory response to such a treatment was achieved in both cases.

  9. Aspergillus-Related Lung Disease

    Directory of Open Access Journals (Sweden)

    Alia Al-Alawi

    2005-01-01

    Full Text Available Aspergillus is a ubiquitous dimorphic fungus that causes a variety of human diseases ranging in severity from trivial to life-threatening, depending on the host response. An intact host defence is important to prevent disease, but individuals with pre-existing structural lung disease, atopy, occupational exposure or impaired immunity are susceptible. Three distinctive patterns of aspergillus-related lung disease are recognized: saprophytic infestation of airways, cavities and necrotic tissue; allergic disease including extrinsic allergic alveolitis, asthma, allergic bronchopulmonary aspergillosis, bronchocentric granulomatosis and chronic eosinophilic pneumonia; and airway and tissue invasive disease -- pseudomembranous tracheobronchitis, acute bronchopneumonia, angioinvasive aspergillosis, chronic necrotizing aspergillosis and invasive pleural disease. A broad knowledge of these clinical presentations and a high index of suspicion are required to ensure timely diagnosis and treatment of the potentially lethal manifestations of aspergillus-related pulmonary disease. In the present report, the clinical, radiographic and pathological aspects of the various aspergillus-related lung diseases are briefly reviewed.

  10. Allergic rhinitis: evidence for impact on asthma

    OpenAIRE

    Thomas, Mike

    2006-01-01

    Background This paper reviews the current evidence indicating that comorbid allergic rhinitis may have clinically relevant effects on asthma. Discussion Allergic rhinitis is very common in patients with asthma, with a reported prevalence of up to 100% in those with allergic asthma. While the temporal relation of allergic rhinitis and asthma diagnoses can be variable, the diagnosis of allergic rhinitis often precedes that of asthma. Rhinitis is an independent risk factor for the subsequent dev...

  11. Extracellular matrix metabolism in bronchopulmonary dysplasia : Focus on lysyl hydroxylases and transglutaminases

    OpenAIRE

    Witsch, Jörn Thilo

    2013-01-01

    Bronchopulmonary dysplasia is a complication of premature birth characterized by impaired alveolar development. Remodeling of the ECM is a driving force for alveolarization and, if pertubated, may impair septation, suggesting dysregulation of ECM remodeling enzymes that drive collagen fiber formation and maturation: the procollagen-lysine, 2-oxoglutarate 5-dioxygenases (Plod) family, also known as lysyl hydroxylases (which catalyzes glycosylation and hydroxylation of collagen),...

  12. Neutrophil and monocyte adhesion molecules in bronchopulmonary dysplasia, and effects of corticosteroids

    OpenAIRE

    Ballabh, P; Simm, M; Kumari, J; Krauss, A; Jain, A.; Califano, C; Lesser, M.; Cunningham-Rundle..., S

    2004-01-01

    Aims: To study a longitudinal change in the expression of adhesion molecules CD11b, CD18, and CD62L on neutrophils and monocytes in very low birth weight babies who develop respiratory distress syndrome, to compare these levels between bronchopulmonary dysplasia (BPD) and non-BPD infants, and to assess the effect of corticosteroid treatment on these adhesion molecules.

  13. Mixed form of congenital cystic adenomatoid malformation and extralobar bronchopulmonary sequestration : a case report

    International Nuclear Information System (INIS)

    Bronchopulmonary sequestration (BPS) and congenital cystic adenomatoid malformation (CCAM) are rare, but both should be included in the differential diagnosis of fetal lung mass. We experienced a mixed form of Stocker type-III CCAM and extralobar BPS, and present this case, together with a review of the related literature. (author)

  14. Long-term results of PRRT in advanced bronchopulmonary carcinoid

    Energy Technology Data Exchange (ETDEWEB)

    Mariniello, Annapaola; Bodei, Lisa; Baio, Silvia Melania; Gilardi, Laura; Colandrea, Marzia; Papi, Stefano; Grana, Chiara Maria [European Institute of Oncology, Division of Nuclear Medicine, Milan (Italy); Tinelli, Carmine [IRCCS Foundation Policlinico San Matteo, Epidemiology and Biometric Unit, Pavia (Italy); Valmadre, Giuseppe [Presidio Ospedaliero E. Morelli AOVV, Sondalo (Italy); Fazio, Nicola [European Institute of Oncology, Unit of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, Milan (Italy); Galetta, Domenico [European Institute of Oncology, Thoracic Surgery Division, Milan (Italy); Paganelli, Giovanni [Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Nuclear Medicine and Radiometabolic Units, Meldola (Italy)

    2016-03-15

    Peptide receptor radionuclide therapy (PRRT) for the treatment of neuroendocrine tumours (NET) has been explored for almost two decades, but there are still few trials that have exclusively investigated well-differentiated and moderately differentiated NET arising from the respiratory tree. Thus, the aim of this study was to explore the outcome in patients affected by bronchopulmonary carcinoid (BPC) following PRRT. We retrospectively analysed 114 patients with advanced stage BPC consecutively treated with PRRT at the European Institute of Oncology, Milan, from 1997 to 2012 and followed until October 2014. The objective responses, overall survival (OS) and progression-free survival (PFS) were rated, and three different PRRT protocols ({sup 90}Y-DOTATOC vs. {sup 177}Lu-DOTATATE vs. {sup 90}Y-DOTATOC + {sup 177}Lu-DOTATATE) were compared with regard to their efficacy and tolerability. The median OS (evaluated in 94 of the 114 patients) was 58.8 months. The median PFS was 28.0 months. The {sup 177}Lu-DOTATATE protocol resulted in the highest 5-year OS (61.4 %). Morphological responses (partial responses + minor responses) were obtained in 26.5 % of the cohort and were associated with longer OS and PFS. The {sup 90}Y-DOTATOC + {sup 177}Lu-DOTATATE protocol provided the highest response rate (38.1 %). Adverse events were mild in the majority of patients. However, haematological toxicity negatively affected survival. No severe (grade 3/4) serum creatinine increase was observed. Patients treated with {sup 90}Y-DOTATOC alone more frequently showed a mild/moderate decrease in renal function. In patients treated with chemotherapy before PRRT had a shorter OS and PFS, and a higher risk of developing nephrotoxicity. In a large cohort of patients with advanced BPC treated in a ''real-world'' scenario and followed up for a median of 45.1 months (range 2 - 191 months), PRRT proved to be promising in prolonging survival and delaying disease progression. Despite

  15. Hyperostosis of the maxillary sinus wall in aspergillosis: is it a characteristic finding

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ji Young; Cho, Woo Ho; Kim, Joung Sook; Kim, Myung Gyu; Kim, Young Hoon; Woo, Hoon Young [College of Medicine, Inje Univ., Kimhae (Korea, Republic of)

    2002-03-01

    To determine whether the wall thickening of the maxillary sinus is a characteristic finding in aspergillosis. In 103 patients, including 26 with aspergillosis, 21 with inverted papilloma (IP), and 56 with unilateral chronic sinusitis, the thickness of the maxillary sinus wall was determined by CT scanning. All cases were proven pathologically, and patients with a history of previous surgery of bone destruction were excluded. Two neuroradiologists retrospectively reviewed the CT scans using bone window settings for sinus wall hyperostosis and the presence of intrasinus calcification. Thickening of the maxillary sinus wall was assessed visually in a semiquantitative manner, and graded as 'none' (absence of thickening), 'mild' (thickening of up to 1.5 times), or moderate ot severe(over 1.5 times thicker than normal contralateral sinus wall at its thickest point). Moderate to severe wall thickening was found only in patients with aspergillosis (21/26, 80.8%). Mild wall thickening was seen in two patients with aspergillosis (2/26, 7.7%), in 12 of 21 with IP (57.1%), and in 5 of 56 with chronic maxillary sinusitis (8.9%). Most cases of chronic maxillary sinusits( 51/56,91.1%), 9/21 IP cases (42.9%), and 3/26 cases of aspergillosis (11.5%) showed no thickening of the maxillary sinus wall. Calcifications were found in 18 patients with aspergillosis (69.2%), in no patient with IP (0%), and in one with chronic maxillary sinusitis (1.8%). We suggest that 'moderate to severe' wall thickening of the maxillary sinus is the characteristic finding of aspergillosis. Although various sinonasal diseases can cause bone change, CT findings of hyperostosis of the maxillary sinus and intrasinus calcification are very helpful in differentiating fungal sinusitis from other types of chronic inflammatory lesions.

  16. How to Treat Allergic Rhinitis

    Institute of Scientific and Technical Information of China (English)

    孙浩

    2004-01-01

    @@ Characterized by paroxysmal rhinocnesmus and frequent sneezing, allergic rhinitis is often accompanied by itching in the throat and eyes, stuffy nose, anosmia and rhinorrhea, and the condition is aggravated when the patient catches cold.

  17. Allergic Rhinitis in Childhood - Review

    Directory of Open Access Journals (Sweden)

    Arzu Babayiğit

    2010-12-01

    Full Text Available Allergic rhinitis, an immunoglobulin E mediated disease, is the most common chronic allergic childhood disease. The disease is characterized by nasal sneezing, rhinorrhea, palate and eye itchiness, and congestion and it can significantly impact children’s health. It causes uncomfortable symptoms, impairs quality of life and can predispose to the development of comorbidities such as asthma. Etiological diagnosis is based on cutaneous prick tests, which have a high sensitivity and specificity rate and which can be easily applied to young children. Treatment initially involves avoidance measures and, when necessary, pharmacotherapy or immunotherapy. Pharmacotherapy generally involves antihistamines and/or nasal corticosteroids, but leukotriene antagonists have also demonstrated effectiveness in treating allergic rhinitis symptoms. In this article, the symptoms, diagnosis and treatment of allergic rhinitis in childhood are discussed. (Journal of Current Pediatrics 2010; 8: 105-12

  18. INCIDENCE DENSITY, PROPORTIONATE MORTALITY, AND RISK FACTORS OF ASPERGILLOSIS IN MAGELLANIC PENGUINS IN A REHABILITATION CENTER FROM BRAZIL.

    Science.gov (United States)

    Silva Filho, Rodolfo Pinho da; Xavier, Melissa Orzechowski; Martins, Aryse Moreira; Ruoppolo, Valéria; Mendoza-Sassi, Raúl Andrés; Adornes, Andréa Corrado; Cabana, Ângela Leitzke; Meireles, Mário Carlos Araújo

    2015-12-01

    Aspergillosis, an opportunistic mycosis caused by the Aspergillus genus, affects mainly the respiratory system and is considered one of the most significant causes of mortality in captive penguins. This study aimed to examine a 6-yr period of cases of aspergillosis in penguins at the Centro de Recuperação de Animais Marinhos (CRAM-FURG), Rio Grande, Brazil. A retrospective cohort study was conducted using the institution's records of penguins received from January 2004 to December 2009. Animals were categorized according to the outcome "aspergillosis," and analyzed by age group, sex, oil fouling, origin, prophylactic administration of itraconazole, period in captivity, body mass, hematocrit, and total plasma proteins. A total of 327 Magellanic penguins (Spheniscus magellanicus) was studied, 66 of which died of aspergillosis. Proportionate mortality by aspergillosis was 48.5%, and incidence density was 7.3 lethal aspergillosis cases per 100 penguins/mo. Approximately 75% of the aspergillosis cases occurred in penguins that had been transferred from other rehabilitation centers, and this was considered a significant risk factor for the disease. Significant differences were also observed between the groups in regard to the period of time spent in captivity until death, hematocrit and total plasma proteins upon admission to the center, and body mass gain during the period in captivity. The findings demonstrate the negative impacts of aspergillosis on the rehabilitation of Magellanic penguins, with a high incidence density and substantial mortality.

  19. INCIDENCE DENSITY, PROPORTIONATE MORTALITY, AND RISK FACTORS OF ASPERGILLOSIS IN MAGELLANIC PENGUINS IN A REHABILITATION CENTER FROM BRAZIL.

    Science.gov (United States)

    Silva Filho, Rodolfo Pinho da; Xavier, Melissa Orzechowski; Martins, Aryse Moreira; Ruoppolo, Valéria; Mendoza-Sassi, Raúl Andrés; Adornes, Andréa Corrado; Cabana, Ângela Leitzke; Meireles, Mário Carlos Araújo

    2015-12-01

    Aspergillosis, an opportunistic mycosis caused by the Aspergillus genus, affects mainly the respiratory system and is considered one of the most significant causes of mortality in captive penguins. This study aimed to examine a 6-yr period of cases of aspergillosis in penguins at the Centro de Recuperação de Animais Marinhos (CRAM-FURG), Rio Grande, Brazil. A retrospective cohort study was conducted using the institution's records of penguins received from January 2004 to December 2009. Animals were categorized according to the outcome "aspergillosis," and analyzed by age group, sex, oil fouling, origin, prophylactic administration of itraconazole, period in captivity, body mass, hematocrit, and total plasma proteins. A total of 327 Magellanic penguins (Spheniscus magellanicus) was studied, 66 of which died of aspergillosis. Proportionate mortality by aspergillosis was 48.5%, and incidence density was 7.3 lethal aspergillosis cases per 100 penguins/mo. Approximately 75% of the aspergillosis cases occurred in penguins that had been transferred from other rehabilitation centers, and this was considered a significant risk factor for the disease. Significant differences were also observed between the groups in regard to the period of time spent in captivity until death, hematocrit and total plasma proteins upon admission to the center, and body mass gain during the period in captivity. The findings demonstrate the negative impacts of aspergillosis on the rehabilitation of Magellanic penguins, with a high incidence density and substantial mortality. PMID:26667521

  20. Chronic necrotizing pulmonary aspergillosis presenting as bilateral pleural effusion: a case report

    Directory of Open Access Journals (Sweden)

    Rajalingham Sakthiswary

    2012-02-01

    Full Text Available Abstract Introduction Chronic necrotizing pulmonary aspergillosis is an uncommon subacute form of Aspergillus infection. It typically occurs in immunocompromised individuals and in those with underlying lung disease. This interesting case highlights the occurrence of this entity of aspergillosis in an immunocompetent middle-aged woman with atypical radiological findings. To the best of our knowledge this is the first case report of chronic necrotizing pulmonary aspergillosis presenting with pleural effusion. Case presentation Our patient was a 64-year-old Malay woman with a background history of epilepsy but no other comorbidities. She was a lifelong non-smoker. She presented to our facility with a six-month history of productive cough and three episodes of hemoptysis. An initial chest radiograph showed bilateral pleural effusion with bibasal consolidation. Bronchoscopy revealed a white-coated endobronchial tree and bronchoalveolar lavage culture grew Aspergillus niger. A diagnosis of chronic necrotizing pulmonary aspergillosis was made based on the clinical presentation and microbiological results. She responded well to treatment with oral itraconazole. Conclusions The radiological findings in chronic necrotizing pulmonary aspergillosis can be very diverse. This case illustrates that this condition can be a rare cause of bilateral pleural effusion.

  1. Economic considerations in the treatment of invasive aspergillosis: a review of voriconazole pharmacoeconomic studies

    Directory of Open Access Journals (Sweden)

    Kem P Krueger

    2009-08-01

    Full Text Available Kem P Krueger, A Christie NelsonSchool of Pharmacy, University of Wyoming, Laramie, WY, USAAbstract: Invasive aspergillosis is a life-threatening fungal infection predominately affecting immunocompromised individuals. The incidence of inpatient-treated aspergillosis cases in the US is estimated to be between 3.02 and 3.80 per 10,000 hospitalized patients. The estimated difference in hospital costs of patients with an aspergillosis infection is US$36,867 to US$59,356 higher than those of patients without the infection. Voriconazole is a synthetic, broad spectrum triazole antifungal agent, with FDA-approved indications for the treatment of invasive aspergillosis, esophageal candidiasis, candidemia in nonneutropenic patients, invasive candidiasis, and infections due to Scedosporium apiospermum and Fusarium species in patients refractory to or intolerant of other therapy. Eight cost-effectiveness analyses, one cost-minimization analysis, and one cost analysis were identified from a Medline search. The 10 pharmacoeconomic analyses were conducted in six different countries comparing voriconazole to conventional amphotericin B, liposomal amphotericin B, itraconazole, and caspofungin. All the cost-effectiveness and cost-minimization analyses identified voriconazole as the most cost-effective therapy. The cost analysis demonstrated voriconazole cost-savings. While the acquisition costs of voriconazole are higher than those of conventional amphotericin B, the toxicity profile and rate of treatment success associated with voriconazole result in lower total treatment costs per successfully treated patient.Keywords: voriconazole, antifungal agents, invasive aspergillosis, pharmacoeconomics 

  2. Guidelines for the management of gastroenteropancreatic neuroendocrine tumours (including bronchopulmonary and thymic neoplasms). Part II-specific NE tumour types

    DEFF Research Database (Denmark)

    Oberg, Kjell; Astrup, Lone Bording; Eriksson, Barbro;

    2004-01-01

    Part II of the guidelines contains a description of epidemiology, histopathology, clinical presentation, diagnostic procedure, treatment, and survival for each type of neuroendocrine tumour. We are not only including gastroenteropancreatic tumours but also bronchopulmonary and thymic neuroendocri...

  3. Васкground development questionnaire quality of life for school age children with broncho-pulmonary disease

    Directory of Open Access Journals (Sweden)

    Nataliya Ivasyk

    2015-08-01

    Full Text Available Purpose: to prove feasibility of developing a questionnaire to assess quality of life for school-age children with acute broncho-pulmonary diseases. Material and Methods: analysis of scientific and methodological literature on the study of quality of life. Results: to assess quality of life using both general and specific questionnaires. The most of special are questionnaires designed for adults, and all pulmonary questionnaires designed for chronic diseases. There are of survey questionnaire for children with acute broncho-pulmonary diseases. Conclusions: the proposed of us a questionnaire for children with broncho-pulmonary diseases include questions to determine the effect impact of symptoms of diseasea on motor activity and quality of life. In future we plans to cheak effectiveness of the application of this questionnaire for determine quality of life of children with acute broncho-pulmonary diseases with goal to determine the effectiveness of the rehabilitation process

  4. Role of serine proteases in the regulation of interleukin-877 during the development of bronchopulmonary dysplasia in preterm ventilated infants.

    Directory of Open Access Journals (Sweden)

    Mallinath Chakraborty

    Full Text Available The chemokine interleukin-8 is implicated in the development of bronchopulmonary dysplasia in preterm infants. The 77-amino acid isoform of interleukin-8 (interleukin-877 is a less potent chemoattractant than other shorter isoforms. Although interleukin-877 is abundant in the preterm circulation, its regulation in the preterm lung is unknown.To study expression and processing of pulmonary interleukin-877 in preterm infants who did and did not develop bronchopulmonary dysplasia.Total interleukin-8 and interleukin-877 were measured in bronchoalveolar lavage fluid from preterm infants by immunoassay. Neutrophil serine proteases were used to assess processing. Neutrophil chemotaxis assays and degranulation of neutrophil matrix metalloproteinase-9 were used to assess interleukin-8 function.Peak total interleukin-8 and interleukin-877 concentrations were increased in infants who developed bronchopulmonary dysplasia compared to those who did not. Shorter forms of interleukin-8 predominated in the preterm lung (96.3% No-bronchopulmonary dysplasia vs 97.1% bronchopulmonary dysplasia, p>0.05. Preterm bronchoalveolar lavage fluid significantly converted exogenously added interleukin-877 to shorter isoforms (p<0.001. Conversion was greater in bronchopulmonary dysplasia infants (p<0.05. This conversion was inhibited by α-1 antitrypsin and antithrombin III (p<0.01. Purified neutrophil serine proteases efficiently converted interleukin-877 to shorter isoforms in a time- and dose-dependent fashion; shorter interleukin-8 isoforms were primarily responsible for neutrophil chemotaxis (p<0.001. Conversion by proteinase-3 resulted in significantly increased interleukin-8 activity in vitro (p<0.01.Shorter, potent, isoforms interleukin-8 predominate in the preterm lung, and are increased in infants developing bronchopulmonary dysplasia, due to conversion of interleukin-877 by neutrophil serine proteases and thrombin. Processing of interleukin-8 provides an attractive

  5. Pathophysiological Implication of Computed Tomography Images of Chronic Pulmonary Aspergillosis.

    Science.gov (United States)

    Ando, Tsunehiro; Tochigi, Naobumi; Gocho, Kyoko; Moriya, Atsuko; Ikushima, Soichiro; Kumasaka, Toshio; Takemura, Tamiko; Shibuya, Kazutoshi

    2016-03-23

    Chronic pulmonary aspergillosis (CPA) is a refractory disorder that needs long-term antifungal treatment and occasionally results in fatal respiratory failure and hemoptysis. However, the pathological features of the disorder have not been thoroughly delineated. Thirty cases were therefore analyzed clinically and histologically to elucidate the pathophysiology of CPA. The subjects comprised 14 individuals who underwent surgical removal and 16 patients who died. No subject exhibited a severely immunocompromised state. The main symptoms included cough, hemosputum, and dyspnea. Chest computed tomography (CT) findings revealed a cavity, fungus ball, and consolidation and/or ground glass opacity (GGO); 27 serial CT scans showed enlarged consolidation and/or GGO (70%), dilatation of the cavity (26%), and extension to the opposite lung (22%). Histopathological findings revealed a cavity with ulceration, bronchitis, and various degrees of organizing pneumonia (OP) that were correlated with the area of consolidation and GGO on the CT scan. The essential pathophysiology of CPA can be understood as an active state of ulceration of the cavity and/or erosive bronchitis caused by contact with the fungus ball, which may play a significant role in the development of OP. Consequently, OP is thought to reflect respiratory failure that relates to the prognosis of CPA. PMID:26166500

  6. Visual loss due to paranasal sinus invasive aspergillosis in a diabetic patient.

    Science.gov (United States)

    Rallis, George; Gkinis, George; Dais, Panayotis; Stathopoulos, Panagiotis

    2014-01-01

    Aspergillus species are commonly found in the soil and decaying organic matter. The spores can be typically inhaled or ingested, yet disease due to tissue invasion is rarely seen in the immunocompetent host. In the immunocompromised patient, there has been an increased incidence of invasive aspergillosis in the last 20 years. Invasive aspergillosis of the maxillary sinus with orbital and cranial spread can be lethal, therefore, necessitates early diagnosis and prompt treatment. The predilection of Aspergillus for infiltration of blood vessels can result in serious ocular complications which can lead to loss of vision. We present the case of an uncontrolled diabetic patient with invasive maxillary sinus aspergillosis and extension to the orbital contents. Our purpose was to emphasize the need of early recognition and prompt initiation of combined antifungal treatment and surgical intervention with the intent to preserve the involved vital structures.

  7. Invasive aspergillosis in a user of inhaled cocaine: rhinosinusitis with bone and cartilage destruction

    Directory of Open Access Journals (Sweden)

    Luna Azulay-Abulafia

    2014-07-01

    Full Text Available Aspergillosis is an infection caused by saprophytic fungi of the genus Aspergillus, which typically occurs in immunosuppressed individuals, but has also been reported in immunocompetent patients. The main routes of entry are the respiratory tract, skin, cornea, and ear, and the infection may be localized or disseminated by contiguity or vascular invasion. We report a severe case of rhinosinusitis with cutaneous involvement, caused by invasive aspergillosis, in an immunocompetent user of inhaled cocaine. Invasive aspergillosis related to cocaine abuse has not yet been reported in the literature. After itraconazole treatment and surgical debridement, complete clinical remission was achieved. Nasal reconstruction with a skin graft over a silicone prosthesis resulted in a satisfactory esthetic outcome.

  8. Etiologic Agents and Diseases Found Associated with Clinical Aspergillosis in Falcons

    Directory of Open Access Journals (Sweden)

    Walter Tarello

    2011-01-01

    Full Text Available The aim of this study was to describe parasitological, microbiological, and pathological findings associated with the isolation of Aspergillus species in 94 clinically diseased captive falcons from Dubai. Concomitant agents and/or diseases were identified in 64 cases, causing either single (=36 or multiple coinfections (=28. Diagnoses found more often in association with aspergillosis were chronic fatigue and immune dysfunction syndrome (CFIDS (=29, Caryospora sp. (=16, Serratospiculum seurati infestation (=14, cestodiasis (=6, bumblefoot (=5, trematodosis due to Strigea falconispalumbi (=5, trichomoniasis (=4, Babesia shortti (=4, Mannheimia (Pastorella haemolytica (=4, interstitial hepatitis (=4, Escherichia coli (=3, and Clostridium perfringens enterotoxemia (=2. Compared with a control group of 2000 diseased falcons without evidence of aspergillosis, the prevalence of Babesia shortti, CFIDS, Mannheimia (Pastorella haemolytica, Escherichia coli, and falcon herpes virus infection was conspicuously higher in association with aspergillosis. These entities may be considered suitable candidates as predisposing factors for the mycosis.

  9. CLINICAL AND PATHOLOGICAL FINDINGS OF ASPERGILLOSIS IN MAGELLANIC PENGUINS (Spheniscus magellanicus

    Directory of Open Access Journals (Sweden)

    MELISSA ORZECHOWSKI XAVIER

    2011-09-01

    Full Text Available We studied a series of fifteen fatal cases of aspergillosis in penguins (Spheniscus magellanicus, seen over a 4-year period at a rehabilitation center in Southern Brazil. The clinical and pathological findings based on the lesions found at necropsy are described herein. The majority of animals (11/15 had sudden death without clinical signs. In 33.3% (5/15 of the cases, aspergillosis was restricted to the respiratory system and 66.6% showed disseminateddisease, with liver, kidney, adrenal gland and gastrointestinal tract involvement. Typical lesions were characterized as white-yellowish granulomatous nodules. To the best of our knowledge, this is the largest series of aspergillosis cases described in penguins in SouthAmerica.

  10. Disseminated Aspergillosis in the Immunocompetent Host: A Case Report and Literature Review.

    Science.gov (United States)

    Cheon, Shinhye; Yang, Min Kyu; Kim, Chung-Jong; Kim, Taek Soo; Song, Kyoung-Ho; Woo, Se Joon; Kim, Eu Suk; Park, Kyoung Un; Kim, Hong Bin

    2015-10-01

    Disseminated aspergillosis is very rare in immunocompetent hosts and is typically associated with a poor prognosis. We describe the case of a 66-year-old, immunocompetent man who developed pneumonia, endophthalmitis and probable spondylitis caused by Aspergillus species. The patient was successfully treated with antifungal drugs. We reviewed the English-language literature between 1980 and 2012 for disseminated aspergillosis cases in immunocompetent hosts, using the keywords "dissemin*" and "aspergillo*." Disseminated aspergillosis in immunocompetent hosts is very rare in the literature. However, awareness of possible dissemination of Aspergillus spp. is necessary in patients who have a probable lung lesion and in cases with unusual presentation of a disseminated infection, even if the patient has no risk factors. PMID:26016845

  11. Invasive pulmonary aspergillosis 10 years post bone marrow transplantation: a case report

    Directory of Open Access Journals (Sweden)

    Rashid Rifat

    2009-01-01

    Full Text Available Abstract Introduction Invasive pulmonary aspergillosis is a leading cause of mortality and morbidity in bone marrow transplant recipients. Establishing the diagnosis remains a challenge for clinicians working in acute care setting. However, prompt diagnosis and treatment can lead to favourable outcomes Case presentation We report a case of invasive aspergillosis occurring in a 39-year-old Caucasian female 10 years after an allogeneic haematopoietic bone marrow transplant, and 5 years after stopping all immunosuppression. Possible risk factors include bronchiolitis obliterans and exposure to building dust (for example, handling her husband's dusty overalls. There are no similar case reports in the literature at this time. Conclusion High clinical suspicion, especially in the setting of failure to respond to broad-spectrum antibiotics, should alert clinicians to the possibility of invasive pulmonary aspergillosis, which, in this case, responded to antifungal therapy.

  12. Component resolved testing for allergic sensitization

    DEFF Research Database (Denmark)

    Skamstrup Hansen, Kirsten; Poulsen, Lars K

    2010-01-01

    Component resolved diagnostics introduces new possibilities regarding diagnosis of allergic diseases and individualized, allergen-specific treatment. Furthermore, refinement of IgE-based testing may help elucidate the correlation or lack of correlation between allergenic sensitization and allergic...

  13. Imaging of Asthma.

    Science.gov (United States)

    Richards, John Caleb; Lynch, David; Koelsch, Tilman; Dyer, Debra

    2016-08-01

    Asthma is one of the most common diseases of the lung. Asthma manifests with common, although often subjective and nonspecific, imaging features at radiography and high-resolution computed tomography. The primary role of imaging is not to make a diagnosis of asthma but to identify complications, such as allergic bronchopulmonary aspergillosis, or mimics of asthma, such as hypersensitivity pneumonitis. This article reviews the imaging features of asthma as well as common complications and mimics. PMID:27401624

  14. MR imaging of cerebral aspergillosis in an infant with normal-immunity : a case report

    International Nuclear Information System (INIS)

    Cerebral aspergillosis is a rare condition, and like other opportunistic fungal infections, it most commonly occurs in immunocompromised patients. Because of the increasing use of chemotherapy in organ transplantation, cases involving neoplasms, corticosteroid therapy, and cases of lymphoma and leukemia, the incidence of fungal infections in the brain has recently increased. Cerebral aspergillosis in an infant with normal immunity is a very rare condition, and has not been reported in Korea. We report the MR findings of this condition in an infant with normal immunity. (author)

  15. MR imaging of cerebral aspergillosis in an infant with normal-immunity : a case report

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Ji Yeoun; Choi, Jin Ok; Lee, Kang Soo; Chae, Soo Hyun; Joo, Myung Jin [Presbyterian Medical Center, Chunju (Korea, Republic of)

    2000-04-01

    Cerebral aspergillosis is a rare condition, and like other opportunistic fungal infections, it most commonly occurs in immunocompromised patients. Because of the increasing use of chemotherapy in organ transplantation, cases involving neoplasms, corticosteroid therapy, and cases of lymphoma and leukemia, the incidence of fungal infections in the brain has recently increased. Cerebral aspergillosis in an infant with normal immunity is a very rare condition, and has not been reported in Korea. We report the MR findings of this condition in an infant with normal immunity. (author)

  16. Role of itraconazole in the management of aspergillosis in treated patients of pulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    Gupta P

    2005-01-01

    Full Text Available Sputum/ bronchial washings of 445 patients with residual tubercular cavitation were subjected to smear and culture examination to isolate fungi. Patients suffering from aspergillosis were put on oral itraconazole daily for 6 months and monitored clinicoradiologically during and after therapy. About half of the patients of aspergilloma and 85% of the patients of chronic necrotizing pulmonary aspergillosis improved by 3 months of therapy. Nausea and headache observed during therapy in 8 and 4 patients respectively were mild and self limiting. Relapses were seen in 8 out of the 37 patients who had completed 6 months therapy and available for follow-up.

  17. Eosinophilic inflammation in allergic asthma

    Directory of Open Access Journals (Sweden)

    Samantha Souza Possa

    2013-04-01

    Full Text Available Eosinophils are circulating granulocytes involved in pathogenesis of asthma. A cascade of processes directed by Th2 cytokine producing T-cells influence the recruitment of eosinophils into the lungs. Furthermore, multiple elements including interleukin (IL-5, IL-13, chemoattractants such as eotaxin, Clara cells, and CC chemokine receptor (CCR3 are already directly involved in recruiting eosinophils to the lung during allergic inflammation. Once recruited, eosinophils participate in the modulation of immune response, induction of airway hyperresponsiveness and remodeling, characteristic features of asthma. Various types of promising treatments for reducing asthmatic response are related to reduction in eosinophil counts both in human and experimental models of pulmonary allergic inflammation, showing that the recruitment of these cells really plays an important role in the pathophysiology of allergic diseases such asthma.

  18. Deregulation of the lysyl hydroxylase matrix cross-linking system in experimental and clinical bronchopulmonary dysplasia

    OpenAIRE

    Witsch, Thilo J.; Turowski, Paweł; Sakkas, Elpidoforos; Niess, Gero; Becker, Simone; Herold, Susanne; Mayer, Konstantin; Vadász, István; Roberts, Jesse D.; Seeger, Werner; Morty, Rory E.

    2013-01-01

    Bronchopulmonary dysplasia (BPD) is a common and serious complication of premature birth, characterized by a pronounced arrest of alveolar development. The underlying pathophysiological mechanisms are poorly understood although perturbations to the maturation and remodeling of the extracellular matrix (ECM) are emerging as candidate disease pathomechanisms. In this study, the expression and regulation of three members of the lysyl hydroxylase family of ECM remodeling enzymes (Plod1, Plod2, an...

  19. Understanding the Short- and Long-Term Respiratory Outcomes of Prematurity and Bronchopulmonary Dysplasia

    OpenAIRE

    Islam, Jessica Y; Keller, Roberta L; Aschner, Judy L.; Hartert, Tina V; Moore, Paul E

    2015-01-01

    Bronchopulmonary dysplasia (BPD) is a chronic respiratory disease associated with premature birth that primarily affects infants born at less than 28 weeks’ gestational age. BPD is the most common serious complication experienced by premature infants, with more than 8,000 newly diagnosed infants annually in the United States alone. In light of the increasing numbers of preterm survivors with BPD, improving the current state of knowledge of long-term respiratory morbidity for infants with BPD ...

  20. Partitioning of bronchopulmonary carcinoids in two different prognostic categories by Ki-67 score

    Directory of Open Access Journals (Sweden)

    Franco eGrimaldi

    2011-08-01

    Full Text Available Introduction: Histological distinction between typical and atypical bronchopulmonary carcinoids is based on mitotic activity and necrosis. Regardless of these two parameters, outcome after surgery is often unpredictable. In this study the prognostic value of different clinico-pathological factors was retrospectively analyzed in a large series of patients with bronchopulmonary carcinoid.Patients & Methods: The long-term postsurgical outcome of 106 radically treated patients affected by bronchopulmonary carcinoid from 2 Italian centers was correlated with tumor characteristics assessed by combining conventional histology with a panel of immunohistochemical markers of neuroendocrine differentiation (chromogranin-A, NSE and proliferation activity (Ki-67 score. Results: Carcinoids were assessed as typical (TC=75; 70.8% and atypical (AC=31; 29.2%. Mean follow-up was 8.3 years (range: 0-20; median: 8.0. All cases expressed neuroendocrine markers. At univariate analysis, tumor recurrence [14/75 TC (18.7%, 15/31 AC (48.4%] correlated with carcinoid histotype (P = 0.003, tumor size (P = 0.012, mitotic index (P = 0.044, Ki-67 score (P < 0.0001, and synchronous node metastasis (P = 0.037. Of these, Cox multivariate analysis confirmed only Ki-67 score as independent predictor of disease recurrence (P = 0.009. The best cut-off for Ki-67 score (calculated by ROC curves discriminating recurrent versus non recurrent disease was 4% (sensitivity 79.3%; specificity 83.8%; area under the curve 0.85. By stratifying patients according to this cut-off, a significantly different disease-free survival was found (log-rank test P < 0.0001.Conclusions: Ki-67 score accurately separates bronchopulmonary carcinoids in two well-distinct histo-prognostic categories. Ki-67 score predicts the patient’s outcome better than mitotic count, histotype and tumor stage and it is therefore helpful in establishing the appropriate follow-up.

  1. The role of patent ductus arteriosus and its treatments in the development of bronchopulmonary dysplasia

    OpenAIRE

    Clyman, Ronald I.

    2013-01-01

    A persistent left-to right shunt through a patent ductus arteriosus (PDA) increases the rate of hydrostatic fluid filtration into the lung’s interstitium, impairs pulmonary mechanics, and prolongs the need for mechanical ventilation. In preclinical trials, pharmacologic PDA closure leads to improved alveolarization and minimizes the impaired postnatal alveolar development that is the pathologic hallmark of the “new bronchopulmonary dysplasia (BPD)”. Although early pharmacologic closure of the...

  2. Bronchoconstriction following instillation of phenylephrine eye drops in premature infants with bronchopulmonary dysplasia: two cases report

    OpenAIRE

    Kim, Hyun Jee; Choi, Jin Guk; Kwak, Kyung-Hwa

    2015-01-01

    Premature infants requiring an ophthalmic examination or even surgery for retinopathy of prematurity (ROP) have a high prevalence of co-existing bronchopulmonary dysplasia (BPD). Reactive airway is one of the clinical presentations of BPD. We report two cases of bronchoconstriction following instillation of mydriatic eye drops. One occurred during induction of anesthesia for laser photocoagulation and the other before screening of ROP. The most likely cause in each case was phenylephrine eye ...

  3. A Clinical Scoring System to Predict the Development of Bronchopulmonary Dysplasia

    OpenAIRE

    Gürsoy, Tuğba; Hayran, Mutlu; Derin, Hatice; Ovalı, Fahri

    2015-01-01

    ObjectiveThis study aims to develop a scoring system for the prediction of bronchopulmonary dysplasia (BPD). MethodsMedical records of 652 infants whose gestational age and birth weight were below 32 weeks and 1,500g, respectively, and who survived beyond 28th postnatal day were reviewed retrospectively. Logistic regression methods were used to determine the clinical and demographic risk factors within the first 72 hours of life associated with BPD, as well as the weights of these factors on ...

  4. Nasal CPAP and surfactant for treatment of respiratory distress syndrome and prevention of bronchopulmonary dysplasia

    DEFF Research Database (Denmark)

    Verder, Henrik; Bohlin, Kajsa; Kamper, Jens;

    2009-01-01

    The Scandinavian approach is an effective combined treatment for respiratory distress syndrome (RDS) and prevention of bronchopulmonary dysplasia (BPD). It is composed of many individual parts. Of significant importance is the early treatment with nasal continuous positive airway pressure (nCPAP......-postnatal treatment with nCPAP and surfactant decreases the severity and mortality of RDS and BPD. This is mainly due to a diminished use of MV in the first days of life....

  5. Response to bronchodilators in very preterm infants with evolving bronchopulmonary dysplasia

    OpenAIRE

    Morrow DK; Schilling D; McEvoy CT

    2015-01-01

    Daniel K Morrow, Diane Schilling, Cindy T McEvoy Department of Pediatrics, Oregon Health and Science University, Portland, OR, USA Background: There are few effective and safe medications to treat very low birth weight (VLBW) infants with evolving bronchopulmonary dysplasia. Bronchodilators are often given to patients who have clinical signs of reactive airway disease, but there is not enough information regarding their effectiveness within this population. Objective: To quantify the pulmona...

  6. Severe bronchopulmonary dysplasia improved by noninvasive positive pressure ventilation: a case report

    Directory of Open Access Journals (Sweden)

    Mann Christian

    2011-09-01

    Full Text Available Abstract Introduction This is the first report to describe the feasibility and effectiveness of noninvasive positive pressure ventilation in the secondary treatment of bronchopulmonary dysplasia. Case presentation A former male preterm of Caucasian ethnicity delivered at 29 weeks gestation developed severe bronchopulmonary dysplasia. At the age of six months he was in permanent tachypnea and dyspnea and in need of 100% oxygen with a flow of 2.0 L/minute via a nasal cannula. Intermittent nocturnal noninvasive positive pressure ventilation was then administered for seven hours daily. The ventilator was set at a positive end-expiratory pressure of 6 cmH2O, with pressure support of 4 cmH2O, trigger at 1.4 mL/second, and a maximum inspiratory time of 0.7 seconds. Over the course of seven weeks, the patient's maximum daytime fraction of inspired oxygen via nasal cannula decreased from 1.0 to 0.75, his respiratory rate from 64 breaths/minute to 50 breaths/minute and carbon dioxide from 58 mmHg to 44 mmHg. Conclusion Noninvasive positive pressure ventilation may be a novel therapeutic option for established severe bronchopulmonary dysplasia. In the case presented, noninvasive positive pressure ventilation achieved sustained improvement in ventilation and thus prepared our patient for safe home oxygen therapy.

  7. Pulmonary aspergillosis and aflatoxins in chronic lung diseases.

    Science.gov (United States)

    Ali, Sana; Malik, Abida; Shahid, Mohd; Bhargava, Rakesh

    2013-10-01

    Fungal infections of lung have become increasingly common during the last few decades. Aspergillosis and the role of aflatoxins in various chronic lung diseases have not been extensively studied. Bronchoalveolar lavage (BAL) samples and sera from 40 patients of chronic lung diseases were analyzed for galactomannan antigen (GM) and aflatoxin by enzyme-linked immunosorbent assay. Direct microscopy and culture of BAL samples were also done to detect the Aspergillus species. Results revealed that 15 (37.5 %) of the 40 patients had growth of Aspergillus on BAL culture. Out of these culture-positive cases, 13 (86.7 %) patients were positive for galactomannan antigen also. About 62.5 % cases did not show growth of Aspergillus in BAL culture. However, galactomannan antigen could be detected in 20 % of these patients. Overall, 20 % patients were diagnosed as proven invasive fungal disease (IFD), 32.5 % were of probable IFD, 17.5 % of possible IFD. Aspergillus growth was observed in 100 % of proven and 53.8 % of probable IFD cases. Galactomannan antigen was found in 100 % cases of proven and 76.9 % of probable IFD. Ten (25 %) patients were found to be positive for aflatoxins. It was detected in 6 (40 %) of culture-positive cases. About 62.5 % of the cases with proven IFD and 46.1 % of probable IFD had aflatoxin in their samples. Aflatoxin positivity was found to be more in patients with proven IFD than in probable IFD, and higher level of aflatoxins was detected in cases with proven IFD. Significant difference was observed in aflatoxin positivity among food grain workers when compared to other occupations.

  8. Discrimination between invasive pulmonary aspergillosis and pulmonary lymphoma using CT

    Energy Technology Data Exchange (ETDEWEB)

    Kawel, Nadine, E-mail: nadine.kawel@gmx.de [Department of Radiology, Kantonsspital Graubuenden, Loestr. 170, 7000 Chur (Switzerland); Department of Radiology, University Hospital Basel, Petersgraben 4, 4031 Basel (Switzerland); Schorer, Georg M., E-mail: gmschorer@hotmail.com [Institute of Diagnostic Radiology, University Hospital of Zurich, Raemistr. 100, 8091 Zurich (Switzerland); Stiftung Zuercher Blutspendedienst SRK, Ruetistrasse 19, 8952 Schlieren (Switzerland); Desbiolles, Lotus, E-mail: lotus.desbiolles@usz.ch [Institute of Diagnostic Radiology, University Hospital of Zurich, Raemistr. 100, 8091 Zurich (Switzerland); Seifert, Burkhardt, E-mail: seifert@ifspm.uzh.ch [Biostatistics Unit ISPM, University of Zurich, Hirschengraben 84, 8001 Zurich (Switzerland); Marincek, Borut, E-mail: borut.marincek@usz.ch [Institute of Diagnostic Radiology, University Hospital of Zurich, Raemistr. 100, 8091 Zurich (Switzerland); Boehm, Thomas, E-mail: thomas_boehm@gmx.net [Department of Radiology, Kantonsspital Graubuenden, Loestr. 170, 7000 Chur (Switzerland); Institute of Diagnostic Radiology, University Hospital of Zurich, Raemistr. 100, 8091 Zurich (Switzerland)

    2011-03-15

    Objective: The purpose was to assess the characteristic CT features of invasive pulmonary aspergillosis (IPA) and pulmonary lymphoma (PL) and to analyze the potential to distinguish the two entities using CT. Methods: The CT images of 70 patients with either proven IPA (n = 35) or PL (n = 35) were evaluated retrospectively and independently by two radiologists (reader 1 [R1] and reader 2 [R2]), analyzing images for presence, number and characteristics of pulmonary nodules and masses, ground-glass opacities, consolidations and other interstitial changes. Results: Interreader agreement was moderate (4/33 CT features), good (9/33) or excellent (20/33). Pulmonary nodules (P = 0.045 [R1], P = 0.001 [R2]), nodules with spiculated outer contours (P < 0.001 [R1], P = 0.001 [R2]), nodules with a halo sign (P < 0.001 [R1+R2]), nodules with homogeneous (P = 0.030 [R1], P = 0.006 [R2]) and inhomogeneous (P = 0.001 [R1], P < 0.001 [R2]) attenuation patterns, nodules with cavitation (P = 0.006 [R1], P = 0.003 [R2]) and wedge-shaped, pleural-based consolidations (P < 0.001 [R1 + R2]) occurred significantly more often in patients with IPA, while masses without a halo sign (P = 0.03 [R1], P = 0.01 [R2]), lobar consolidations with bronchogram (P = 0.02 [R1 + R2]) and consolidations with homogeneous attenuation patterns (P < 0.001 [R1 + R2]) were found significantly more frequent in PL-patients. Conclusions: Those CT features can therefore be considered suggestive for either IPA or PL. However, in most cases the diagnosis cannot be made based on CT findings solely because no single feature gained a high sensitivity and specificity concomitantly. Furthermore, the logistic regression did not show a combination that was significantly better than the best univariate predictor.

  9. Fluid and electrolyte balance during the first week of life and risk of bronchopulmonary dysplasia in the preterm neonate

    Directory of Open Access Journals (Sweden)

    Gustavo Rocha

    2010-01-01

    Full Text Available BACKGROUND: Early fluid and electrolyte imbalances may be associated with an increased risk of bronchopulmonary dysplasia. OBJECTIVE: We sought to establish an association between fluid and electrolyte balance in the first week of life and the risk of bronchopulmonary dysplasia. METHODS: Clinical charts of 205 neonates <32 weeks gestational age and/or <1,250 g birth weight (admitted to our NICU between 1997 and 2008 were analyzed. Clinical features, fluid and electrolyte balance were analyzed for the first 7 days of life using multivariate models of generalized estimation equations. A p value <0.05 was considered significant in all of the hypothesis tests. RESULTS: The prevalence of bronchopulmonary dysplasia was 22%. Lower gestational age and birth weight, male gender, less frequent use of antenatal steroids, respiratory distress syndrome, use of surfactant, patent ductus arteriosus, duration of invasive ventilation and NICU stay were significantly associated with bronchopulmonary dysplasia. The variation in serum values of potassium, phosphorus and creatinine during the first week of life also revealed an association with bronchopulmonary dysplasia. Higher mean plasma calcium values were associated with spontaneous closure of the patent ductus arteriosus. The use of indomethacin to induce patent ductus arteriosus closure was significantly higher in bronchopulmonary dysplasia patients. CONCLUSIONS: Differences in renal function and tubular handling of potassium and phosphorus are present during the first week of life among preterm neonates who will develop bronchopulmonary dysplasia. The higher rate of patent ductus arteriosus and indomethacin use may influence these differences. Serum levels of calcium also appear to play a role in spontaneous ductus arteriosus closure.

  10. Anthropogenic Climate Change and Allergic Diseases

    Directory of Open Access Journals (Sweden)

    Hueiwang Anna Jeng

    2012-02-01

    Full Text Available Climate change is expected to have an impact on various aspects of health, including mucosal areas involved in allergic inflammatory disorders that include asthma, allergic rhinitis, allergic conjunctivitis and anaphylaxis. The evidence that links climate change to the exacerbation and the development of allergic disease is increasing and appears to be linked to changes in pollen seasons (duration, onset and intensity and changes in allergen content of plants and their pollen as it relates to increased sensitization, allergenicity and exacerbations of allergic airway disease. This has significant implications for air quality and for the global food supply.

  11. Asthma and Respiratory Allergic Disease

    Science.gov (United States)

    The pathogenesis of non-communicable diseases such as allergy is complex and poorly understood. The causes of chronic allergic diseases including asthma involve to a large extent, immunomodulation of the adaptive and particularly the innate immune systems and are markedly influen...

  12. Renal infarction secondary to invasive aspergillosis in a 5-year-old girl with acute lymphoblastic leukemia.

    Science.gov (United States)

    Lee, Ju Hyun; Im, Soo Ah; Cho, Bin

    2014-07-01

    Aspergillus species have angioinvasive properties and can involve extrapulmonary organs by hematogenous spread from the lungs. However, renal involvement by Aspergillus is uncommon and is usually associated with the formation of abscesses. We report an unusual case of invasive renal aspergillosis presenting with extensive renal infarction in a 5-year-old girl with acute lymphoblastic leukemia. This case emphasizes the fact that renal aspergillosis initially presents with only renal infarction, and metastatic-embolism by invasive aspergillosis should be considered in differential diagnosis for any focal lesion of kidney in a patient with leukemia.

  13. The radiological spectrum of invasive aspergillosis in children: a 10-year review

    Energy Technology Data Exchange (ETDEWEB)

    Thomas, Karen E. [Department of Diagnostic Radiology, Great Ormond Street Hospital for Children, Great Ormond Street, London (United Kingdom); Department of Diagnostic Radiology, The Hospital for Sick Children, 555 University Avenue, Toronto M5G 1X8 (Canada); Owens, Catherine M. [Department of Diagnostic Radiology, Great Ormond Street Hospital for Children, Great Ormond Street, London (United Kingdom); Veys, Paul A.; Novelli, Vas; Costoli, Vera [Host Defence Unit, Great Ormond Street Hospital for Children, London (United Kingdom)

    2003-07-01

    Invasive aspergillosis is an uncommon but life-threatening event in the immunocompromised child. Attempts at fungal isolation are often unrewarding and a high index of radiological suspicion is essential in the early diagnosis of infected children. To document the radiological spectrum of disease in invasive aspergillosis in the paediatric population. A retrospective review of the imaging performed in 27 consecutive patients (age 7 months to 18 years) with documented invasive Aspergillosis encountered over a 10-year period at a single institution. Radiographic findings of pulmonary disease (20 patients) included segmental and multilobar consolidation, perihilar infiltrates, multiple small nodules, peripheral nodular masses and pleural effusions. No cavitating lesions were seen on CXR. Small cavitating nodules were present on CT in two of eight children. Chest wall disease was particularly associated with underlying chronic granulomatous disease. Disseminated disease manifested as osteomyelitis (n=5), cerebral (n=3), oesophageal (n=1), hepatic (n=2), renal (n=2) and cutaneous (n=5) involvement. Imaging findings are discussed. Twelve patients (44%) subsequently died from Aspergillus-related complications. Invasive aspergillosis presents with a wide variety of radiographic findings involving multiple organ systems. Respiratory findings are varied but often non-specific, and a high index of suspicion is necessary in immunocompromised patients. In contrast to adult disease, the incidence of cavitation of pulmonary lesions appears low. (orig.)

  14. The radiological spectrum of invasive aspergillosis in children: a 10-year review

    International Nuclear Information System (INIS)

    Invasive aspergillosis is an uncommon but life-threatening event in the immunocompromised child. Attempts at fungal isolation are often unrewarding and a high index of radiological suspicion is essential in the early diagnosis of infected children. To document the radiological spectrum of disease in invasive aspergillosis in the paediatric population. A retrospective review of the imaging performed in 27 consecutive patients (age 7 months to 18 years) with documented invasive Aspergillosis encountered over a 10-year period at a single institution. Radiographic findings of pulmonary disease (20 patients) included segmental and multilobar consolidation, perihilar infiltrates, multiple small nodules, peripheral nodular masses and pleural effusions. No cavitating lesions were seen on CXR. Small cavitating nodules were present on CT in two of eight children. Chest wall disease was particularly associated with underlying chronic granulomatous disease. Disseminated disease manifested as osteomyelitis (n=5), cerebral (n=3), oesophageal (n=1), hepatic (n=2), renal (n=2) and cutaneous (n=5) involvement. Imaging findings are discussed. Twelve patients (44%) subsequently died from Aspergillus-related complications. Invasive aspergillosis presents with a wide variety of radiographic findings involving multiple organ systems. Respiratory findings are varied but often non-specific, and a high index of suspicion is necessary in immunocompromised patients. In contrast to adult disease, the incidence of cavitation of pulmonary lesions appears low. (orig.)

  15. Diagnostic and Therapeutic Challenges in a Liver Transplant Recipient with Central Nervous System Invasive Aspergillosis

    OpenAIRE

    Dionissios, Neofytos; Shmuel, Shoham; Kerry, Dierberg; Katharine, Le; Simon, Dufresne; Sean, Zhang X; Kieren, Marr A

    2012-01-01

    This is a case report of central nervous system (CNS) invasive aspergillosis (IA) in a liver transplant recipient, which illustrates the utility of enzyme-based diagnostic tools for the timely and accurate diagnosis of IA, the treatment challenges and poor outcomes associated with CNS IA in liver transplant recipients.

  16. Liposomal nystatin in patients with invasive aspergillosis refractory to or intolerant of amphotericin B.

    NARCIS (Netherlands)

    Offner, F.; Krcmery, V.; Boogaerts, M.; Doyen, C.; Engelhard, D.; Ribaud, P.; Cordonnier, C.; Pauw, B.E. de; Durrant, S.; Marie, J.P.; Moreau, P.; Guiot, H.F.L.; Samonis, G.; Sylvester, R.J.; Herbrecht, R.

    2004-01-01

    We assessed the activity and safety of liposomal nystatin, a broad-spectrum antifungal agent, for invasive aspergillosis in patients refractory to or intolerant of amphotericin B. Thirty-three patients were enrolled, received at least one dose of the study drug, and were evaluable for safety. Twenty

  17. CNS aspergillosis in a patient with Crohn’s disease on immunosuppressants: a case report

    OpenAIRE

    Shah, Shreyansh; Shirani, Peyman; Schmolck, Heike; Young, William C.; Schulz, Paul E.

    2009-01-01

    Fungal infections of the central nervous system are an uncommon cause of rapid decline in consciousness. We describe the case of central nervous system aspergillosis in a patient on immunosupressants whose clinical course highlights the need for an aggressive approach to diagnosis.

  18. Systemic dissemination of chronic necrotizing pulmonary aspergillosis in an elderly woman without comorbidity: a case report

    Directory of Open Access Journals (Sweden)

    Tokui Kotaro

    2012-08-01

    Full Text Available Abstract Introduction Chronic necrotizing pulmonary aspergillosis usually occurs in mildly immune-compromised hosts or those with underlying pulmonary disease. The radiographic pattern of chronic necrotizing pulmonary aspergillosis is typically a progressive upper lobe cavitary infiltrate with pleural thickening. We report here an atypical case of chronic necrotizing pulmonary aspergillosis mimicking lung cancer, which developed into a disseminated fatal disease in an older woman with no comorbidity. Case presentation An 80-year-old Japanese woman was referred to our hospital for a chest roentgenogram abnormality. Repeated fiber-optic bronchoscopy could not confirm any definite diagnosis, and she refused further examinations. Considering the roentgenogram findings and her age, she was followed-up as a suspected case of lung cancer without any treatment. Then, 10 months later, she complained of visual disturbance and was admitted to our department of ophthalmology. She was diagnosed as having endophthalmitis. After treatment with corticosteroids for 20 days, she developed acute encephalitis and died four weeks later. Autopsy revealed dissemination of Aspergillus hyphae throughout her body, including her brain. Conclusions In older patients, even if they do not have any comorbidity, chronic necrotizing pulmonary aspergillosis should be added to the differential diagnosis of solitary pulmonary lesions in a chest roentgenogram.

  19. Early serum galactomannan trend as a predictor of outcome of invasive aspergillosis

    NARCIS (Netherlands)

    L.Y.A. Chai (Louis); B.J. Kullberg (Bart Jan); E.M. Johnson (Elizabeth); S. Teerenstra (Steven); L.W. Khin (Lay Wai); A.G. Vonk (Alieke); J. Maertens (Johan); O. Lortholary (Olivier); P.J. Donnelly (Peter); H.T. Schlamm (Haran); P.F. Troke (Peter); M.G. Netea (Mihai); R. Herbrecht (Raoul)

    2012-01-01

    textabstractThe monitoring and prediction of treatment responses to invasive aspergillosis (IA) are difficult. We determined whether serum galactomannan index (GMI) trends early in the course of disease may be useful in predicting eventual clinical outcomes. For the subjects recruited into the multi

  20. Rapid diagnosis of azole-resistant aspergillosis by direct PCR using tissue specimens.

    NARCIS (Netherlands)

    Linden, J.W.M. van der; Snelders, E.; Arends, J.P.; Daenen, S.M.G.J.; Melchers, W.J.G.; Verweij, P.E.

    2010-01-01

    We report the use of PCR techniques on a formalin-fixed and paraffin-embedded tissue specimen for direct detection of one dominant azole resistance mechanism in a case of disseminated invasive aspergillosis. Rapid detection of mutations associated with azole resistance directly in tissue significant

  1. Rapid Diagnosis of Azole-Resistant Aspergillosis by Direct PCR Using Tissue Specimens

    NARCIS (Netherlands)

    van der Linden, Jan W. M.; Snelders, Eveline; Arends, Jan P.; Daenen, Simon M.; Melchers, Willem J. G.; Verweij, Paul E.

    2010-01-01

    We report the use of PCR techniques on a formalin-fixed and paraffin-embedded tissue specimen for direct detection of one dominant azole resistance mechanism in a case of disseminated invasive aspergillosis. Rapid detection of mutations associated with azole resistance directly in tissue significant

  2. Economic evaluation of voriconazole in the treatment of invasive aspergillosis in the Netherlands.

    NARCIS (Netherlands)

    Jansen, J.P.; Meis, J.F.G.M.; Blijlevens, N.M.A.; Wout, J.W. van 't

    2005-01-01

    OBJECTIVE: To asses the cost-effectiveness of voriconazole in comparison to conventional amphotericin B and itraconazole for the treatment of invasive aspergillosis in the Netherlands. METHODS: The cost-effectiveness of voriconazole in comparison to conventional amphotericin B or itraconazole was ev

  3. Investigation of dissemination of aspergillosis in poultry and possible control measures

    Directory of Open Access Journals (Sweden)

    Kapetanov Miloš C.

    2011-01-01

    Full Text Available Fungi belonging to genus Aspegillus are ubiquitous saprophytic microorganisms which are, in certain circumstances, responsible for clinical infections of respiratory tract in all poultry, particularly in young birds. In case of a lung form, Aspergillus fumigatus, A. niger and A. glaucus are the most frequently isolated fungi. In general, poultry is constantly exposed to these fungi in its environment. Predisposing factors, such as long exposition and highly contaminated environment and litter, high humidity in poultry houses, poor ventilation, malnutrition and stress, all contribute to clinical aspergillosis. Some geographic and seasonal regularities are observed in relation to the distribution of disease outbreaks. In this sense, cases of aspergillosis in our country were more frequently noted in wild areas located northern from the rivers Sava and Danube. Influence of some factors on the outbreak and spreading, as well as predominant clinical features of aspergillosis in poultry were investigated in this paper. Possible prophylactic and intervention measures were discussed. The occurrence of Aspergillus sp. in poultry was analyzed according to the clinical and laboratory investigations performed during the two selected years, 2000 and 2010. Widespread aspergillosis was noted in poultry flocks of different age, both in young and adult birds. During the years 2000 and 2010, acute aspergillosis was found in 12 and 16 commercial flocks of chickens and turkeys, respectively. Ocular infection with Aspergillus was determined in 10 day old broilers from two flocks. Aspergillus sp. was isolated from unhatched eggs (6.86%, litter (23.07%, environmental (36.17% and hatchery swabs (3.85%. Besides the appropriate antifungal therapy, enforcement of proper sanitary-hygiene measures on poultry farms and hatcheries, as well as microbiological control of feed are considered essential for an efficient control of infection and its spreading.

  4. Radiological and clinical findings of pulmonary aspergillosis following solid organ transplant

    Energy Technology Data Exchange (ETDEWEB)

    Park, Y.S. [Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center (Korea, Republic of); Seo, J.B. [Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center (Korea, Republic of)], E-mail: seojb@amc.seoul.kr; Lee, Y.K. [Department of Radiology, Bundang CHA Hospital, University of Pocheon Jungmoon College of Medicine (Korea, Republic of); Do, K.H.; Lee, J.S.; Song, J.-W.; Song, K.S. [Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center (Korea, Republic of)

    2008-06-15

    Aim: To evaluate the radiological and clinical findings in patients with pulmonary aspergillosis after solid organ transplantation. Materials and methods: This study included 13 consecutive patients (five liver, four kidney, and four heart transplant; 10 male and three female; median age 54 years; range 13-63 years) with histologically confirmed pulmonary aspergillosis after solid organ transplantation at a tertiary referral hospital. Chest radiographs and computed tomography (CT) examinations performed for diagnosis were available in all patients. Radiological findings, such as lesion characteristics, location, and associated findings, were assessed retrospectively by two radiologists. The changes in radiological findings and clinical response after treatment were also assessed. Clinical findings, such as time of onset, initial symptoms, clinical course, and laboratory findings, were reviewed. Results: The most common radiographic and CT findings were pulmonary nodules or masses (n = 12). The number of nodules or masses was less than 10 in eight patients. Associated findings were surrounding ground-glass opacity (n = 4), central low density (n = 8), central air cavity (n = 5), and air bronchogram (n = 3). Follow-up radiographs and/or CT after treatment showed improvement in eight patients, persistence in two, and deterioration in three. The onset time of pulmonary aspergillosis was a median of 32 days (range 15-165 days). The most common symptom at diagnosis was fever (n = 6). Ten of 13 patients did not have leucopaenia. There were two aspergillosis-associated deaths during the follow-up period. Conclusion: The most common radiological finding of pulmonary aspergillosis after solid organ transplantation is multiple nodules or masses, which commonly appear within 1 month following transplantation.

  5. Secretion of a fungal protease represents a complement evasion mechanism in cerebral aspergillosis.

    Science.gov (United States)

    Rambach, Günter; Dum, David; Mohsenipour, Iradj; Hagleitner, Magdalena; Würzner, Reinhard; Lass-Flörl, Cornelia; Speth, Cornelia

    2010-04-01

    Complement represents a central immune weapon in the brain, but the high lethality of cerebral aspergillosis indicates a low efficacy of the antifungal complement attack. Studies with cerebrospinal fluid (CSF) samples derived from a patient with cerebral aspergillosis showed a degradation of complement proteins, implying that Aspergillus might produce proteases to evade their antimicrobial potency. Further investigations of this hypothesis showed that Aspergillus, when cultured in CSF to simulate growth conditions in the brain, secreted a protease that can cleave various complement proteins. Aspergillus fumigatus, the most frequent cause of cerebral aspergillosis, destroyed complement activity more efficiently than other Aspergillus species. The degradation of complement in CSF resulted in a drastic reduction of the capacity to opsonize fungal hyphae. Furthermore, the Aspergillus-derived protease could diminish the amount of complement receptor CR3, a surface molecule to mediate eradication of opsonized pathogens, on granulocytes and microglia. The lack of these prerequisites caused a significant decrease in phagocytosis of primary microglia. Additional studies implied that the complement-degrading activity shares many characteristics with the previously described alkaline protease Alp1. To improve the current therapy for cerebral aspergillosis, we tried to regain the antifungal effects of complement by repressing the secretion of this degrading activity. Supplementation of CSF with nitrogen sources rescued the complement proteins and abolished any cleavage. Glutamine or arginine are of special interest for this purpose since they represent endogenous substances in the CNS and might be included in a future supportive therapy to reduce the high lethality of cerebral aspergillosis. PMID:20303595

  6. Allergic and non-allergic rhinitis: relationship with nasal polyposis, asthma and family history.

    Science.gov (United States)

    Gelardi, M; Iannuzzi, L; Tafuri, S; Passalacqua, G; Quaranta, N

    2014-02-01

    Rhinitis and rhinosinusitis (with/without polyposis), either allergic or non-allergic, represent a major medical problem. Their associated comorbidities and relationship with family history have so far been poorly investigated. We assessed these aspects in a large population of patients suffering from rhinosinusal diseases. Clinical history, nasal cytology, allergy testing and direct nasal examination were performed in all patients referred for rhinitis/rhinosinusitis. Fibre optic nasal endoscopy, CT scan and nasal challenge were used for diagnosis, when indicated. A total of 455 patients (60.7% male, age range 4-84 years) were studied; 108 (23.7%) had allergic rhinitis, 128 (28.1%) rhinosinusitis with polyposis, 107 (23.5%) non-allergic rhinitis (negative skin test); 112 patients had associated allergic and non-allergic rhinitis, the majority with eosinophilia. There was a significant association between non-allergic rhinitis and family history of nasal polyposis (OR = 4.45; 95%CI = 1.70-11.61; p = 0.0019), whereas this association was no longer present when allergic rhinitis was also included. Asthma was equally frequent in non-allergic and allergic rhinitis, but more frequent in patients with polyposis. Aspirin sensitivity was more frequent in nasal polyposis, independent of the allergic (p = 0.03) or non-allergic (p = 0.01) nature of rhinitis. Nasal polyposis is significantly associated with asthma and positive family history of asthma, partially independent of the allergic aetiology of rhinitis.

  7. Safe foods for allergic people

    DEFF Research Database (Denmark)

    Nørhede, Pia; Madsen, Charlotte Bernhard; Bennett, L.;

    food companies avoid being a part of such a tragic story? The EuroPrevall project has developed a new website on the management of food allergens, www.foodallergens.info, which is aimed at the food industry. Content on the new website about food allergy: • Basal knowledge about food allergy such as how...... allergy in 10 different European languages. Conclusion: If the company behind the pineapple & coconut fruit juice had asked an allergy expert for advice or had thought about allergic people themselves during the development of their product, the tragic story probably could have been avoided. An expert...... in allergy would ask if the milk really was necessary in the product. If the company insisted the expert would advice the company to warn allergic people about the content of milk by including it in the name or in the picture on the front of the carton....

  8. Allergen immunotherapy for allergic rhinoconjunctivitis

    DEFF Research Database (Denmark)

    Dhami, Sangeeta; Nurmatov, Ulugbek; Roberts, Graham;

    2016-01-01

    BACKGROUND: The European Academy of Allergy and Clinical Immunology (EAACI) is in the process of developing the EAACI Guidelines for Allergen Immunotherapy (AIT) for the Management of Allergic Rhinoconjunctivitis. We seek to critically assess the effectiveness, cost-effectiveness and safety of AIT...... in the management of allergic rhinoconjunctivitis. METHODS: We will undertake a systematic review, which will involve searching international biomedical databases for published, in progress and unpublished evidence. Studies will be independently screened against pre-defined eligibility criteria and critically...... appraised using established instruments. Data will be descriptively and, if possible and appropriate, quantitatively synthesised. CONCLUSION: The findings from this review will be used to inform the development of recommendations for EAACI's Guidelines on AIT....

  9. Eosinophilic inflammation in allergic asthma

    OpenAIRE

    IolandaFátima Lopes CalvoTibério; CarlaMáximoPrado

    2013-01-01

    Eosinophils are circulating granulocytes involved in pathogenesis of asthma. A cascade of processes directed by Th2 cytokine producing T-cells influence the recruitment of eosinophils into the lungs. Furthermore, multiple elements including interleukin (IL)-5, IL-13, chemoattractants such as eotaxin, Clara cells, and CC chemokine receptor (CCR)3 are already directly involved in recruiting eosinophils to the lung during allergic inflammation. Once recruited, eosinophils participate in the modu...

  10. Eosinophilic Inflammation in Allergic Asthma

    OpenAIRE

    Possa, Samantha S.; Leick, Edna A; Carla M. Prado; Martins, Mílton A.; Tibério, Iolanda F. L. C.

    2013-01-01

    Eosinophils are circulating granulocytes involved in pathogenesis of asthma. A cascade of processes directed by Th2 cytokine producing T-cells influence the recruitment of eosinophils into the lungs. Furthermore, multiple elements including interleukin (IL)-5, IL-13, chemoattractants such as eotaxin, Clara cells, and CC chemokine receptor (CCR)3 are already directly involved in recruiting eosinophils to the lung during allergic inflammation. Once recruited, eosinophils participate in the modu...

  11. Allergic contact dermatitis to Alstroemeria.

    Science.gov (United States)

    Marks, J G

    1988-06-01

    Two female florists developed dermatitis of the fingertips. Patch testing revealed allergic contact dermatitis to the flower, Alstroemeria, used in floral arrangements. They had positive patch tests to portions of Alstroemeria, and to tuliposide A, the allergen in this plant. Vinyl gloves were not helpful since tuliposide A readily penetrates through these gloves. Nitrile gloves may be protective since they prevented positive patch test to tuliposide A. PMID:2967676

  12. Optimal management of allergic rhinitis

    OpenAIRE

    Scadding, G K

    2015-01-01

    Allergic rhinitis (AR), the most common chronic disease in childhood is often ignored, misdiagnosed and/or mistreated. Undertreated AR impairs quality of life, exacerbates asthma and is a major factor in asthma development. It can involve the nose itself, as well as the organs connected with the nose manifesting a variety of symptoms. Evidence-based guidelines for AR therapy improve disease control. Recently, paediatric AR guidelines have been published by the European Academy of Allergy and ...

  13. Management of allergic Olympic athletes.

    Science.gov (United States)

    Fitch, K D

    1984-05-01

    Twenty percent of the recent Australian Olympic athletes have had an allergic disorder. Because of the ban on all sympathomimetic drugs except some beta 2-agonists. Olympic team physicians have a major responsibility to ensure that no competitor is disqualified for infringing on the antidoping rules of the Medical Commission of the International Olympic Committee. Inadvertent contravention of these regulations may occur because numerous banned sympathomimetics are available to athletes and their coaches without medical prescription and are frequently contained in combination preparations. The unbroken 24 yr in which asthmatics have won Olympic medals have been both before and after the introduction of drug tests. Currently a comprehensive range of preventive and therapeutic medications are available for asthmatics to compete with minimal respiratory disadvantage. It was, however, during a period of unnecessary restriction that an American swimmer forfeited his gold medal because of prerace ingestion of a banned sympathomimetic agent. Should adverse air quality be encountered during the Los Angeles Olympics, allergic competitors will be among the most inconvenienced . Athletes with allergic rhinitis and sinusitis will be the most disadvantaged because sympathomimetic vasoconstrictors remain banned. It is strongly recommended that the Medical Commission of the International Olympic Committee meet with an appropriate body of experts (i.e., the American Academy of Allergy and Immunology) to review this ban on vasoconstrictor agents. PMID:6715736

  14. Refractory invasive aspergillosis controlled with posaconazole and pulmonary surgery in a patient with chronic granulomatous disease: case report.

    Science.gov (United States)

    Kepenekli, Eda; Soysal, Ahmet; Kuzdan, Canan; Ermerak, Nezih Onur; Yüksel, Mustafa; Bakır, Mustafa

    2014-01-01

    Invasive aspergillosis is an important cause of morbidity and mortality in immunocompromised patients. Among primary immunodefiencies, chronic granulomatous disease (CGD) has the highest prevalence of invasive fungal diseases. Voriconazole is recommended for the primary treatment of invasive aspergillosis in most patients. In patients whose aspergillosis is refractory to voriconazole, therapeutic options include changing class of antifungal, for example using an amphotericin B formulation, an echinocandin, combination therapy, or further use of azoles. Posaconazole is a triazole derivative which is effective in Aspergillosis prophylaxis and treatment. Rarely, surgical therapy may be needed in some patients. Lesions those are contiguous with the great vessels or the pericardium, single cavitary lesion that cause hemoptysis, lesions invading the chest wall, aspergillosis that involves the skin and the bone are the indications for surgical therapy.Chronic granulomatous disease (CGD) is an inherited immundeficiency caused by defects in the phagocyte nicotinamide adenine dinucleotidephosphate (NADPH) oxidase complex which is mainstay of killing microorganisms. CGD is characterized by recurrent life-threatening bacterial and fungal infections and by abnormally exuberant inflammatory responses leading to granuloma formation, such as granulomatous enteritis, genitourinary obstruction, and wound dehiscence. The diagnosis is made by neutrophil function testing and the genotyping.Herein, we present a case with CGD who had invasive pulmonary aspergillosis refractory to voriconazole and liposomal amphotericine B combination therapy that was controlled with posaconazole treatment and pulmonary surgery. PMID:24401677

  15. Upper and lower airway pathology in young children with allergic- and non-allergic rhinitis

    DEFF Research Database (Denmark)

    Chawes, Bo Lk

    2011-01-01

    nasal eosinophilia albeit less than children with allergic rhinitis. These findings suggest different pathology in allergic- and non-allergic rhinitis which may have important clinical implications for early pharmacological treatment of rhinitis in young children. In paper II, we utilized the nasal...... with allergic rhinitis without asthma suggesting sub-clinical bronchial inflammation and supporting the allergic disease process to involve both upper and lower airways. In conclusion, these observations objectively show marked differences in nasal pathology in young children with allergic- and non...... resources. Unfortunately, diagnostic specificity is hampered by nonspecific symptom history and lack of reliable diagnostic tests which may explain why the pathology behind such diagnoses is poorly understood. Improved understanding of the pathophysiology of allergic- and non-allergic rhinitis in young...

  16. BRONCHOPULMONARY LESIONS AND QUALITY OF LIFE IN PATIENTS WITH RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    M. V. Sheyanov

    2011-01-01

    Full Text Available Aim – assessment of quality of life (QoL in patients with rheumatoid arthritis (RA with the presence and severity of bronchopulmonary lesions.Materials and methods. The study included 104 patients with RA and 100 patients not suffering from RA and verified chronic respiratory diseases. The analysis of the QOL of patients using questionnaires EQ-5D (EuroQoL Group, 1990 and SGRQ (St. George's Hospital questionnaire to assess respiratory function, performed spirometry, bodyplethysmography , pulse oximetry, the definition of lung diffusioncapacity, multispiral computed tomography of the lungs.Results. Performance of all scales and the resulting indices of questionnaires EQ-5D and SGRQ showed a significant decrease in QoL ofRA patients compared with those in control group and the general population. A correlation index of EQ-5D with vital capacity (r = 0.47;p < 0.001 and diffusion capacity (r = 0.67; p < 0.01 of the lungs is revealed. The main reason for the reduction of indices of the questionnaire SGRQ in patients with RA was the presence of shortness of breath. The multi-factorial origin of dyspnea in patients with RA with theessential role of bronchopulmonary lesions was established.Conclusion. Bronchopulmonary lesions in the underlying disease have an adverse impact on the QOL of patients with RA. Promising directions for improving the QOL of RA patients with bronchial lesions can be considered for activities for the conservation of respiratory lung function, exercise control RA activity, elimination of anemia correction of psycho-emotional disturbances of anxiety-depressive character.

  17. BRONCHOPULMONARY LESIONS AND QUALITY OF LIFE IN PATIENTS WITH RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    M. V. Sheyanov

    2014-07-01

    Full Text Available Aim – assessment of quality of life (QoL in patients with rheumatoid arthritis (RA with the presence and severity of bronchopulmonary lesions.Materials and methods. The study included 104 patients with RA and 100 patients not suffering from RA and verified chronic respiratory diseases. The analysis of the QOL of patients using questionnaires EQ-5D (EuroQoL Group, 1990 and SGRQ (St. George's Hospital questionnaire to assess respiratory function, performed spirometry, bodyplethysmography , pulse oximetry, the definition of lung diffusioncapacity, multispiral computed tomography of the lungs.Results. Performance of all scales and the resulting indices of questionnaires EQ-5D and SGRQ showed a significant decrease in QoL ofRA patients compared with those in control group and the general population. A correlation index of EQ-5D with vital capacity (r = 0.47;p < 0.001 and diffusion capacity (r = 0.67; p < 0.01 of the lungs is revealed. The main reason for the reduction of indices of the questionnaire SGRQ in patients with RA was the presence of shortness of breath. The multi-factorial origin of dyspnea in patients with RA with theessential role of bronchopulmonary lesions was established.Conclusion. Bronchopulmonary lesions in the underlying disease have an adverse impact on the QOL of patients with RA. Promising directions for improving the QOL of RA patients with bronchial lesions can be considered for activities for the conservation of respiratory lung function, exercise control RA activity, elimination of anemia correction of psycho-emotional disturbances of anxiety-depressive character.

  18. Bronchoconstriction following instillation of phenylephrine eye drops in premature infants with bronchopulmonary dysplasia: two cases report.

    Science.gov (United States)

    Kim, Hyun Jee; Choi, Jin Guk; Kwak, Kyung-Hwa

    2015-12-01

    Premature infants requiring an ophthalmic examination or even surgery for retinopathy of prematurity (ROP) have a high prevalence of co-existing bronchopulmonary dysplasia (BPD). Reactive airway is one of the clinical presentations of BPD. We report two cases of bronchoconstriction following instillation of mydriatic eye drops. One occurred during induction of anesthesia for laser photocoagulation and the other before screening of ROP. The most likely cause in each case was phenylephrine eye drops. We recommend that the minimal dosage of phenylephrine needed to attain proper mydriasis should be instilled to infant patients, and the possibility of bronchoconstriction occurrence kept in mind, especially for infants with low body weight with BPD. PMID:26634087

  19. VITAMIN C STATUS IN ALLERGIC CHILDREN

    OpenAIRE

    2000-01-01

    This study was undertaken to assess vitamin C status in allergic children. Twenty-six allergic patients and 46 apparently healthy controls aged 7-16 years of both sexes were introduced. All patients were diagnosed being allergic based on their histories, physical examinations and laboratory findings. Blood samples were obtained between 09.00-11.00 to determine total serum immunoglobulin E, histamine, plasma vitamin C and complete blood cell count. Stool examinations and urinealysis were also ...

  20. Contact-Allergic Reactions to Cosmetics

    OpenAIRE

    An Goossens

    2011-01-01

    Contact-allergic reactions to cosmetics may be delayed-type reactions such as allergic and photo-allergic contact dermatitis, and more exceptionally also immediate-type reactions, that is, contact urticaria. Fragrances and preservative agents are the most important contact allergens, but reactions also occur to category-specific products such as hair dyes and other hair-care products, nail cosmetics, sunscreens, as well as to antioxidants, vehicles, emulsifiers, and, in fact, any possible cos...

  1. Alternaria in Patients with Allergic Rhinitis

    OpenAIRE

    Monireh Mokhtari Amirmajdi; Nemat Allah Mokhtari Amirmajdi; Iman Eftekharzadeh Mashhadi; Farahzad Jabari Azad; Jalil Tavakol Afshari; Mohammad-Taghi Shakeri

    2011-01-01

    Inhalation of fungal spores is shown to participate in the development of allergic rhinitis symptoms. In this study, relation between presence of Alternaria in the human nasal cavity and allergic rhinitis is assessed.In a case-control study, 58 allergic rhinitis patients were compared with a well-matched control group of fifty healthy volunteers for sensitization to Alternaria (by skin prick test) and detection of Alternaria in their nasal mucous by conventional methods (microscopy with Methy...

  2. Allergic disease as an association of steroid sulphatase deficiency.

    Science.gov (United States)

    Sakura, N; Nishimura, S; Matsumoto, T; Ohsaki, M; Ogata, T

    1997-11-01

    Ten of 31 patients with steroid sulphatase (STS) deficiency were found to have an allergic disease (bronchial asthma, allergic rhinitis, or atopic dermatitis). STS deficiency may predispose patients to allergic disease.

  3. Cerebellar white matter inflammation and demyelination in chronic relapsing experimental allergic encephalomyelitis

    DEFF Research Database (Denmark)

    Wanscher, B.; Sørensen, P. S.; Juhler, M.;

    1993-01-01

    Experimental allergic encephalomyelitis, demyelination, inflammation, immunology, neuropathology......Experimental allergic encephalomyelitis, demyelination, inflammation, immunology, neuropathology...

  4. Invasive aspergillosis osteomyelitis in children - a case report and review of the literature

    International Nuclear Information System (INIS)

    Immunocompromised patients are at high risk of secondary infection associated with high morbidity. In children these complications include fungal osteomyelitis due to continuous infiltration or hematogenous spread. The case of a 4-year-old boy is presented who developed lumbalgia and thigh pain during ongoing chemotherapy for acute lymphatic leukemia. MRI revealed infarct-like lesions in the femur and L5 vertebra, which were biopsied. The histologic diagnosis was consistent with angioinvasive aspergillosis. A multifocal osseous presentation has rarely been described in children and an overview of the literature is presented. Invasive aspergillosis is a rare complication to be considered in children with MRI-detected bony lesions of infarct-like appearance. (orig.)

  5. Protective role of mannan-binding lectin in a murine model of invasive pulmonary aspergillosis

    DEFF Research Database (Denmark)

    Kaur, S; Gupta, VK; Thiel, Steffen;

    2007-01-01

    Innate immune molecules such as lung collectins and serum pentraxins have evolved as important host defence proteins against Aspergillus fumigatus, a medically important opportunistic fungal pathogen. Mannan-binding lectin (MBL), an opsonin and lectin complement pathway activator, constitutes...... of externally administered recombinant human (rh) MBL towards anti-fungal defence in invasive pulmonary aspergillosis (IPA) by in vivo and in vitro studies. In murine models of IPA with corticosteroid-induced immunosuppression, rhMBL-treated mice showed 80% survival compared to untreated IPA mice...... observed only when MBL was supplemented with MBL-deficient serum. The study suggests a therapeutic role of ex vivo-administered MBL in host defence against aspergillosis, possibly through MBL-mediated complement activation and other protective mechanisms aimed both directly at the pathogen, and indirectly...

  6. Invasive aspergillosis osteomyelitis in children - a case report and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Winterstein, Anton R.; Bohndorf, Klaus; Vollert, Kurt [Klinikum Augsburg, Department of Radiology, Augsburg (Germany); Wagner, Theodor [Klinikum Augsburg, Department of Pathology, Augsburg (Germany); Gnekow, Astrid [Klinikum Augsburg, Department of Pediatrics, Augsburg (Germany); Roemer, Frank W. [Klinikum Augsburg, Department of Radiology, Augsburg (Germany); Boston University School of Medicine, Department of Radiology, Boston, MA (United States)

    2010-08-15

    Immunocompromised patients are at high risk of secondary infection associated with high morbidity. In children these complications include fungal osteomyelitis due to continuous infiltration or hematogenous spread. The case of a 4-year-old boy is presented who developed lumbalgia and thigh pain during ongoing chemotherapy for acute lymphatic leukemia. MRI revealed infarct-like lesions in the femur and L5 vertebra, which were biopsied. The histologic diagnosis was consistent with angioinvasive aspergillosis. A multifocal osseous presentation has rarely been described in children and an overview of the literature is presented. Invasive aspergillosis is a rare complication to be considered in children with MRI-detected bony lesions of infarct-like appearance. (orig.)

  7. Aspergillosis of bilateral breast and chest wall in an immunocompetent male masquerading as breast cancer

    Directory of Open Access Journals (Sweden)

    Jitendra G Nasit

    2013-01-01

    Full Text Available Fungal species are not frequently encountered in an immunocompetent host. Invasive aspergillosis typically occurs in severely immunocompromised patient. Aspergillus infection of breast and chest wall are rarely encountered in an immunocompetent as well as in immunocompromised host. Till date only 13 cases of fungal infection of breast and chest wall have been reported in the literature. This report presents a case of aspergillosis of bilateral breast and chest wall in an immunocompetent male, clinically mimicking breast cancer. Diagnosis was achieved by fine-needle aspiration cytology and subsequently Aspergillus flavus was identified on fungal culture. The patient was successfully treated with voriconazole. Prompt diagnosis by cytology and appropriate treatment is necessary to prevent adverse outcome. Here, we present this rare case of fungal infection of breast and chest wall with relevant review of the literature.

  8. CYTOMORPHOLOGICAL EVALUATION AND PROGNOSIS OF BRONCHOPULMONARY COMPLICATIONS IN ACUTE AND EARLY PERIODS OF SPINAL CORD TRAUMA

    Directory of Open Access Journals (Sweden)

    I.A. Norkin

    2009-09-01

    Full Text Available There were investigated 50 cytological preparations after fibro-optic bronchoscopy of 10 patients with cervical spinal cord injuries. The dynamics of broncho-pulmonary complications of spinal cord injuries was estimated on the basis of cytological broncho-alveolar lavage fluid investigations. In the work there were used clinico-neurologic methods, radiological (computer tomography and magnetic resonance imaging, endoscopic (fibro-optic bronchoscopy and cytomorphological investigations. Cytomorphological investigations of broncho-alveolar lavage fluid were carried out on the 3-4, 7, 14, 30th days. Cellular composition of the broncho-alveolar wash-out (endopulmonary cytogramme was estimated by calculation of more than 100 cells in 3 fields of the immersion microscope coverage. Quantitative changes of cellular elements were taken into account with respect to normal cell amount. The results were analyzed according to the average out method. Quantitative changes of inflammatory elements in endopulmonary cytogramme were determined by the degree of endobronchitic manifestations and were corresponding to clinico-radiological picture of development of broncho-pulmonary complications in different periods of spinal cord injury

  9. Value and indications of liver scintigraphy in the initial assessment of bronchopulmonary cancers

    International Nuclear Information System (INIS)

    This retrospective study of 117 liver scintigraphs, carried out systematically in the initial examination of bronchopulmonary cancer patients, attempts to define the value and indications of the method in the diagnosis of liver metastases at the stage when the primary cancer is discovered. Its sensitivity and reliability were estimated by comparing the interpretation of the scan with the actual situation. Scintigraphic diagnosis meets with several difficulties. It is ruled by technology: in spite of many improvements it seems that the quality of conventional scintigraphy has reached its limits, through transverse axial tomodensitometry may be a future solution. Morever its interpretation depends on the experience and temperament of the observer, as shown by the results of double-blind readings. Finally the examination is not specific to the nature of the liver disease. It seems that without prejudice to the patient the indications of liver scintigraphy in the initial assessment of bronchopulmonary cancer may be limited to cases where some clinical or biological doubt on the integrity of the liver is present

  10. High-resolution CT findings in infants with bronchopulmonary dysplasia: preliminary report

    International Nuclear Information System (INIS)

    To evaluate high resolution CT(HRCT) findings in infants with bronchopulmonary dysplasia(BPD). In 13 infants(age range, 1-12 months;11 premature babies, two full-term babies; birth weight, 0.97-3.88kg;mean 2,03kg) with clinico-radiologically suggested BPD, HRCT findings of the lung were reviewed retrospectively. Spiral CT using ultra high bone algorithm, 1mm collimation with 5-8mm interval, and 0.7sec scan time was performed without regard to breathing-control of infants. Three radiologists each analysed the HRCT findings twice. HRCT findings of BPD were as follows:parenchymal bands(n=13), interlobular septal thickenings (n=12), multifocal hyperaeration involving lobar or segmental distribution(n=7), and involving lobular distribution or small cyst-like lesion(n=4), centrilobular nodules(n=7), consolidation and/or atelectasis(n=7), and bronchovascular bundle thickening(n=6). Parenchymal bands, interlobular septal thickenings, and multifocal hyperaerations were the major findings in cases of bronchopulmonary dysplasia whereas, centrilobular nodules, consolidation and/or atelectasis, and bronchovascular bundle thickenings were the minor findings. These findings may be used as basic data in the evaluation of BPD in future studies

  11. Stem cell experiments moves into clinic: new hope for children with bronchopulmonary dysplasia.

    Science.gov (United States)

    Pawelec, K; Gładysz, D; Demkow, U; Boruczkowski, D

    2015-01-01

    Bronchopulmonary dysplasia (BPD) is a chronic lung disease with long-term complications that affects mainly preterm born children with low birth weights, especially those treated with mechanical ventilation and oxygen therapy. Successful treatment of BPD could reduce the incidence of other diseases of prematurity such as periventricular leukomalacia and retinopathy. The effects of current therapies are unsatisfactory; thus, searching for novel therapeutic is underway. One promising approach seems administration of mesenchymal stem cells (MSC). Preclinical data strongly support the role of progenitor cells in the preservation of lung structure. MSC can be found more often in pre-term than term umbilical cord and its isolation from Wharton's jelly carries a potential in treating diseases of prematurity. Several questions concerning the use of MSC in BPD remain to be answered, including the amount of transferred cells, intervals between infusions, the best route for administration and the timing. MSC can be administered as a treatment or prophylaxis. However, having in mind that not all prematurely born children are at risk of developing bronchopulmonary dysplasia, a search for laboratory markers identifying potential patients should be conducted. This review summarizes the latest achievements in MSC therapy in the context of BPD. PMID:25252892

  12. Radiological diagnosis of immunologically mediated disorders of the bronchopulmonary system in children and adolescents

    International Nuclear Information System (INIS)

    After coverage of pathophysiological mechanisms, radiological symptoms and differential diagnosis of bacterial and opportunistic infections of the bronchopulmonary system are discussed as they occur in humoral, cellular and combined congenital and acquired immune deficiencies. The discussion is based on case reports. Humoral deficiences cause recurrent and chronic bacterial infections of the bronchopulmonary system, frequently with bronchiectasis. In the case of cellular and combined immune deficiencies, not only bacterial infections but also the very serious opportunistic infections occur. Opportunistic infections of the lung are predominantly caused by Pneumocystis carinii, by the cytomegaly virus, and by fungi such as Candida, Aspergillus and Mucor. Pneumocystis is also the most frequent cause of opportunistic infections of the lungs in children with AIDS. In contrast to the situation in adults, in children a relatively low-grade lymphocytic interstitial pneumonitis occasionally precedes the typical opportunistic infections. Lymphocytic interstitial pneumonitis and Pneumocystis pneumonia can be differentiated from each other easily in children because of their relatively characteristic appearances. Fungal infections, on the other hand, sometimes pose severe diagnostic problems. Radiological chest findings in autoimmune diseases are discussed. (orig.)

  13. Aspergilose pulmonar necrotizante crônica Chronic necrotizing pulmonary aspergillosis

    Directory of Open Access Journals (Sweden)

    Eduardo Felipe Barbosa Silva

    2009-01-01

    Full Text Available A aspergilose pulmonar necrotizante crônica é uma das formas de aspergilose pulmonar usualmente encontrada em pacientes com imunossupressão leve. Apresentamos o caso de uma paciente com queixas de tosse produtiva crônica, febre e astenia. Havia utilizado corticóides. A TC do tórax evidenciava consolidação com cavitação de permeio no lobo superior direito. A fibrobroncoscopia demonstrou secreção purulenta em árvore traqueobrônquica e lesão vegetante endobrônquica. Biópsias desta lesão e biópsia transbrônquica foram compatíveis com aspergilose. Diante do quadro clínico, radiológico e histopatológico, o diagnóstico de aspergilose pulmonar necrotizante crônica foi realizado. Tratada com itraconazol, a paciente apresentou boa evolução clínico-radiológica.Chronic necrotizing pulmonary aspergillosis is one of the forms of pulmonary aspergillosis typically found in mildly immunocompromised patients. We report the case of a female patient with complaints of chronic productive cough, fever and asthenia. She reported previous corticosteroid use. A CT scan of the chest revealed consolidation with interposed cavitation in the right upper lobe. Fiberoptic bronchoscopy revealed purulent fluid within the tracheobronchial tree and an endobronchial exophytic lesion. The results of the biopsy of that lesion and the transbronchial biopsy were consistent with aspergillosis. Based on the clinical, radiological and histopathological findings, the patient was diagnosed with chronic necrotizing pulmonary aspergillosis. Treated with itraconazole, the patient presented a favorable clinical-radiological evolution.

  14. Invasive aspergillosis in the aortic arch with infectious Aspergillus lesions in pulmonary bullae

    Directory of Open Access Journals (Sweden)

    Isao Watanabe

    2015-03-01

    Full Text Available A patient with pulmonary bullae died of massive hemoptysis. At autopsy a hole was observed in the aortic wall. A microscopic examination indicated small Aspergillus lesions in pulmonary bullae and extensive necrotic lesions with Aspergillus hyphae in the media of the thoracic aorta. These findings led to a diagnosis of invasive aspergillosis in the aortic arch. This is a rare case in which Aspergillus invaded the aorta in a patient without hematologic neoplasms or neutropenia.

  15. Pulmonary Aspergillosis in a Previously Healthy 13-Year-Old Boy

    Directory of Open Access Journals (Sweden)

    Jonathan H. Rayment

    2016-01-01

    Full Text Available Chronic granulomatous disease (CGD is a rare, polygenic primary immunodeficiency. In this case report, we describe a previously healthy 13-year-old boy who presented with multifocal pulmonary aspergillosis and was subsequently diagnosed with an autosomal recessive form of chronic granulomatous disease. CGD has a variable natural history and age of presentation and should be considered when investigating a patient with recurrent or severe infections with catalase-positive organisms.

  16. Invasive pulmonary aspergillosis caused by Aspergillus versicolor in a patient on mechanical ventilation

    OpenAIRE

    MV Pravin Charles; M Ravishankar; Easow, Joshy M; Noyal Mariya Joseph

    2011-01-01

    Aspergillus spp. often colonise the respiratory tract of critically ill patients in intensive care units and subsequently cause invasive disease. The risk of developing invasive disease is more in immunocompromised patients. Here we report a case of fatal invasive pulmonary aspergillosis caused by Aspergillus versicolor in a post-operative patient on mechanical ventilation, who did not respond to intravenous itraconazole. We then discuss the challenges involved in the accurate diagnosis of th...

  17. Invasive pulmonary aspergillosis complicating chronic obstructive pulmonary disease in an immunocompetent patient.

    Directory of Open Access Journals (Sweden)

    Ali Z

    2003-01-01

    Full Text Available Immunocompromised individuals are susceptible to pulmonary aspergillus infection, but invasive aspergillus infection is extremely rare in the presence of normal immunity. We report a case of invasive aspergillosis in an immunocompetent 63-year-old male with chronic obstructive pulmonary disease (COPD. Patients with COPD may be at risk for developing pulmonary aspergillus infection, which should be considered as a diagnostic possibility in patients with unresolving pulmonary infection.

  18. The Diagnosis of Invasive and Noninvasive Pulmonary Aspergillosis by Serum and Bronchoalveolar Lavage Fluid Galactomannan Assay

    Directory of Open Access Journals (Sweden)

    Shuzhen Zhang

    2015-01-01

    Full Text Available The incidence and mortality of invasive pulmonary aspergillosis (IPA are rising, particularly in critically ill patients and patients with severe chronic obstructive pulmonary disease (COPD. Noninvasive aspergillosis occurring in these patients requires special attention because of the possibility of developing subsequent IPA, given the poor health and worsened immune state of these patients. We compared the performance of the Platelia galactomannan (GM enzyme immunoassay in the bronchoalveolar lavage fluid (BALF and serum. The sensitivity, and specificity of BALF-GM were 85.4% and 62.4%, and those of serum-GM were 67.9% and 93.5% at the cutoff index of 0.5. As the cutoff index increased, the specificity of BALF-GM detection was increased with the detriment of sensitivity. The area under the ROC curves was 0.817 (95% CI: 0.718–0.916 for BALF-GM and 0.819 (95% CI: 0.712–0.926 for serum-GM. The optimal cutoff index was 1.19 for BALF-GM, and the sensitivity and specificity were 67.9% and 89.2%. The BALF-GM assay is more sensitive in detecting pulmonary aspergillosis than serum-GM assay and fungal cultures. However, BALF-GM assay has a high false-positive rate at the cutoff index of 0.5. Hence, the diagnostic cutoff index of the BALF-GM assay should be improved to avoid the overdiagnosis of pulmonary aspergillosis in clinic.

  19. Early diagnosis and treatment of invasive pulmonary aspergillosis in a patient with cystic fibrosis

    OpenAIRE

    Mosquera, Ricardo Alberto; Estrada, Lila; Clements, Roya Mohebpour; Jon, Cindy K

    2013-01-01

    Invasive pulmonary aspergillosis is a rare and fatal complication in patients with cystic fibrosis (CF) who lack concomitant risk factors. The few documented cases in children have all resulted in deaths during hospitalisation. We present the case of a 12-year-old boy with CF who was admitted for an exacerbation which was unresponsive to antibiotic therapy. The findings on imaging raised concerns about a possible fungal infection. As a result, voriconazole therapy was started prior to his res...

  20. Invasive aspergillosis causing small bowel infarction in a patient of carcinoma breast undergoing chemotherapy

    Directory of Open Access Journals (Sweden)

    Jain Vinod

    2006-01-01

    Full Text Available Abstract Background To report a 45 year old lady presenting with proximal jejunal gangrene due to invasive Aspergillosis. The patient was undergoing adjuvant chemotherapy for advance carcinoma of breast (Stage IV. Methods The patient was referred to our surgical emergency for acute abdominal symptoms for 6 hours. Histopathology revealed bowel wall necrosis and vascular invasion by Aspergillus Fumigatus. Postoperative recovery was uneventful and the patient received Amphotericin-B (1 mg/kg/day for invasive aspergillosis. Invasive pulmonary aspergillosis was confirmed by isolating Aspergillus Fumigatus from bronchoalveolar lavage and by a positive circulating galactomannan test (ELISA Assay. Results Detailed history revealed dry cough and two episodes of haemoptesis for 2 weeks. Haemogram and counts revealed anemia and neutropenia. Plain X – ray of the abdomen showed multiple air fluid levels and ultrasound of the abdomen revealed distended bowel loops. On exploration small bowel was found to be gangrenous. The patient was successfully managed by supportive treatment and conventional intravenous Amphotericin-B for 2 weeks. The lady was discharged one week after completion of antifungal therapy and one month later she underwent toilet mastectomy. The lady came to follow up for 1 year and she is currently under hormone therapy. Conclusion With the emergence of new and powerful immunosuppressive, anticancer drugs and potent antibiotics the survival of transplant and critically ill patients has remarkably increased but it has shown a significant rise in the incidence of invasive opportunistic fungal infections. We conclude hat the diagnosis of invasive gastrointestinal aspergillosis may be considered in a neutropenic patient with acute abdominal symptoms.

  1. Early molecular diagnosis of aspergillosis in a patient with acute myeloid leukaemia

    OpenAIRE

    Greco, R; Mancini, N.; Peccatori, J.; Cieri, N.; Vago, L.; F. Giglio; Morelli, M; Ghidoli, N; Carletti, S; Levati, G; Crucitti, L; E. Sala; Lupo Stanghellini, M T; Lorentino, F; Forcina, A

    2014-01-01

    Diagnosis of invasive fungal infection remains challenging. Here we report a case of early diagnosis of invasive aspergillosis in a neutropenic patient affected by acute myeloid leukaemia, achieved through the detection of Aspergillus fumigatus species-specific ribonucleic acid sequences by a sensitive multiplex real-time polymerase chain reaction-based molecular assay. Thanks to the early diagnosis, targeted therapy was promptly established and the severe fungal infection controlled, allowin...

  2. Aspergillosis in Intensive Care Unit (ICU patients: epidemiology and economic outcomes

    Directory of Open Access Journals (Sweden)

    Baddley John W

    2013-01-01

    Full Text Available Abstract Background Few data are available regarding the epidemiology of invasive aspergillosis (IA in ICU patients. The aim of this study was to examine epidemiology and economic outcomes (length of stay, hospital costs among ICU patients with IA who lack traditional risk factors for IA, such as cancer, transplants, neutropenia or HIV infection. Methods Retrospective cohort study using Premier Inc. Perspective™ US administrative hospital database (2005–2008. Adults with ICU stays and aspergillosis (ICD-9 117.3 plus 484.6 who received initial antifungal therapy (AF in the ICU were included. Patients with traditional risk factors (cancer, transplant, neutropenia, HIV/AIDS were excluded. The relationship of antifungal therapy and co-morbidities to economic outcomes were examined using Generalized linear models. Results From 6,424 aspergillosis patients in the database, 412 (6.4% ICU patients with IA were identified. Mean age was 63.9 years and 53% were male. Frequent co-morbidities included steroid use (77%, acute respiratory failure (76% and acute renal failure (41%. In-hospital mortality was 46%. The most frequently used AF was voriconazole (71% received at least once. Mean length of stay (LOS was 26.9 days and mean total hospital cost was $76,235. Each 1 day lag before initiating AF therapy was associated with 1.28 days longer hospital stay and 3.5% increase in costs (p  Conclusions Invasive aspergillosis in ICU patients is associated with high mortality and hospital costs. Antifungal timing impacts economic outcomes. These findings underscore the importance of timely diagnosis, appropriate treatment, and consideration of Aspergillus as a potential etiology in ICU patients.

  3. Immunohistochemical Analysis of Leucocyte Subsets in the Sinonasal Mucosa of Cats with Upper Respiratory Tract Aspergillosis.

    Science.gov (United States)

    Whitney, J L; Krockenberger, M B; Day, M J; Beatty, J A; Dhand, N K; Barrs, V R

    2016-01-01

    Leucocyte populations in the sinonasal mucosa of cats with and without upper respiratory tract aspergillosis were compared using immunohistochemistry and computer-aided morphometry. Inflammation was identified in the nasal mucosa of all affected cats, comprising predominantly of lymphoplasmacytic infiltration of the lamina propria associated with epithelial proliferation and degeneration. There was intense and diffuse expression of class II antigens of the major histocompatibility complex, associated with sites of hyphal invasion with hyperplasia and ulceration of the epithelium adjacent to fungal elements. Significantly more CD79b(+) cells, total lymphocytes, immunoglobulin (Ig)-expressing cells and MAC387(+) cells infiltrated the epithelium and more IgG(+) cells and total Ig-expressing cells infiltrated the lamina propria in affected cats compared with controls. Importantly, the inflammatory profile in affected cats was not consistent with the T helper (Th)1 and Th17 cell-mediated response that confers protective acquired immunity against invasive aspergillosis in dogs and people and in murine models of the infection. This finding may help to explain the development of invasive aspergillosis in systemically immunocompetent cats. PMID:27576043

  4. A case series of chronic necrotizing pulmonary aspergillosis and a new proposal.

    Science.gov (United States)

    Tashiro, Takayoshi; Izumikawa, Koichi; Tashiro, Masato; Morinaga, Yoshitomo; Nakamura, Shigeki; Imamura, Yoshifumi; Miyazaki, Taiga; Kakeya, Hiroshi; Yamamoto, Yoshihiro; Yanagihara, Katsunori; Hayashi, Tomayoshi; Nagayasu, Takeshi; Kohno, Shigeru

    2013-01-01

    Chronic necrotizing pulmonary aspergillosis (CNPA) is an indolent, cavitating process in the lungs resulting from invasion of lung tissue by Aspergillus spp. However, most previous reports have not found any clear evidence of parenchymal invasion, and clinical distinction between CNPA and chronic cavitary pulmonary aspergillosis (CCPA) is difficult. We performed a histopathological study of lung specimens obtained by autopsy, surgical resection, or biopsy to clarify the characteristic pathological and clinical features of CNPA. We present 4 cases of proven CNPA, diagnosed by histological demonstration of tissue invasion by the fungus, and present its clinical features. These 4 patients were male, and the mean age was 62 years (range, 51-75 years). Their underlying conditions were chronic obstructive pulmonary disease (n = 3), sequelae of pulmonary tuberculosis (n = 2), and diabetes mellitus (n = 1). Aspergillus precipitation tests were positive for 3; and Aspergillus antigen tests were positive for 2 on admission, and subsequently, for all 4. The isolated pathogens were Aspergillus niger for 1 and A. fumigatus for 1. Initial radiographic findings were infiltrates or nodular lesions, which slowly progressed and cavitated before the appearance of fungus balls. Although CNPA has characteristic pathological features, it is clinically difficult to distinguish CNPA from CCPA. We propose to use the term chronic progressive pulmonary aspergillosis for both CNPA and CCPA. PMID:23883842

  5. Invasive Aspergillosis in a Renal Transplant Recipient Successfully Treated with Interferon-Gamma

    Directory of Open Access Journals (Sweden)

    C. Estrada

    2012-01-01

    Full Text Available Invasive aspergillosis is a serious complication of solid organ transplantation. An early diagnosis is hampered by the lack of reliable serum markers and, even if appropriately diagnosed and treated with current antifungal agents, has a high mortality rate. We report a case of invasive pulmonary and cerebral aspergillosis in a renal transplant patient treated with IFN-γ in conjunction with combination anti-fungal therapy for six weeks in whom complete resolution of the fungal infection was achieved. Renal function remained intact throughout the treatment period. Surveillance CT scans of the chest and head showed resolution of prior disease but revealed a new left upper lobe mass four months after completion of treatment with IFN-γ. Biopsy of the lesion was positive for primary lung adenocarcinoma, for which she underwent left upper lobe resection. The pathology report confirmed clear surgical margins and lymph nodes and no evidence of fungal hyphae. IFN-γ should be considered early in the management of invasive aspergillosis in renal transplant patients. To date, allograft rejection has not been encountered.

  6. Erythropoietin combined with liposomal amphotericin b improves outcome during disseminated aspergillosis in mice

    Directory of Open Access Journals (Sweden)

    nathalie erousseau

    2014-10-01

    Full Text Available Disseminated aspergillosis is responsible for a high mortality rate despite the use of antifungal drugs. Adjuvant therapies are urgently needed to improve the outcome. The aim of this study was to demonstrate that the cytoprotective effect of erythropoietin combined to amphotericin b can reduce the mortality rate in a murine model of disseminated aspergillosis. After infection with Aspergillus fumigatus, neutropenic mice were randomized to receive vehicle or 7,5 mg/Kg of Liposomal Amphotericin B (LAmB or 7,5 mg/Kg of LAmB combined with 1000 IU/Kg of EPO (16 mice per group. Aspergillus galactomannan and organ cultures were performed to evaluate fungal burden at day 5. Cumulative long-term survival was analyzed at day 12 post-infection according to the Kaplan-Meier method. At day 5, fungal burden was similar between non-treated and treated groups. At day 12, mortality rates were 75 %, 62.5 % and 31 % in control group, LAmB group and EPO/LAmB group, respectively. We observed a significant decreased in mortality using EPO/LAmB combination compared to control group (p < 0.01. LAmB single treatment did not improve the survival rate compared to control group (p = 0.155.Our results provided the first evidence that erythropoietin improved the outcome of mice presenting disseminated aspergillosis when combined with amphotericin b.

  7. Aspergillus PCR in serum for the diagnosis, follow-up and prognosis of invasive aspergillosis in neutropenic and nonneutropenic patients.

    Science.gov (United States)

    Imbert, S; Gauthier, L; Joly, I; Brossas, J-Y; Uzunov, M; Touafek, F; Brun, S; Mazier, D; Datry, A; Gay, F; Fekkar, A

    2016-06-01

    We evaluated the usefulness of a serum Aspergillus PCR assay for the diagnosis and prognosis of invasive aspergillosis in a study involving 941 patients for a total of 5146 serum samples. Fifty-one patients had proven/probable aspergillosis. We compared galactomannan (GM), PCR and mycologic analysis of pulmonary samples in both neutropenic and nonneutropenic patients. PCR performed in serum yielded 66.7% sensitivity, 98.7% specificity, 75.6% positive predictive value and 98.0% negative predictive value, while the GM index yielded 78.4% sensitivity, 87.5% specificity, 27% positive predictive value and 98.6% negative predictive value. The inclusion of PCR in the European Organization for Research and Treatment of Cancer (EORTC) and the Mycosis Study Group (MSG) mycologic criteria permitted the reclassification of nine other cases from possible to probable aspergillosis and increased the sensitivity to 71.7%. Combining the GM index with serum PCR increased the detection rate of invasive aspergillosis with 88.2% sensitivity. PCR was systematically negative in 16 patients with noninvasive forms of aspergillosis (namely aspergilloma and chronic aspergillosis). Remaining PCR positive after a period of 14 to 20 days of treatment was related to poor outcome at 30 and 90 days. Our results also indicate that, unlike the determination of the GM index, the initial fungus load as determined by PCR was highly predictive of 90-day mortality, with the rate of the latter being 15.8% for patients with PCR appears to be a powerful and interesting tool for the identification of patients with invasive aspergillosis who might benefit from more intense care.

  8. Performance of serum biomarkers for the early detection of invasive aspergillosis in febrile, neutropenic patients: a multi-state model.

    Directory of Open Access Journals (Sweden)

    Michaël Schwarzinger

    Full Text Available BACKGROUND: The performance of serum biomarkers for the early detection of invasive aspergillosis expectedly depends on the timing of test results relative to the empirical administration of antifungal therapy during neutropenia, although a dynamic evaluation framework is lacking. METHODS: We developed a multi-state model describing simultaneously the likelihood of empirical antifungal therapy and the risk of invasive aspergillosis during neutropenia. We evaluated whether the first positive test result with a biomarker is an independent predictor of invasive aspergillosis when both diagnostic information used to treat and risk factors of developing invasive aspergillosis are taken into account over time. We applied the multi-state model to a homogeneous cohort of 185 high-risk patients with acute myeloid leukemia. Patients were prospectively screened for galactomannan antigenemia twice a week for immediate treatment decision; 2,214 serum samples were collected on the same days and blindly assessed for (1->3- β-D-glucan antigenemia and a quantitative PCR assay targeting a mitochondrial locus. RESULTS: The usual evaluation framework of biomarker performance was unable to distinguish clinical benefits of β-glucan or PCR assays. The multi-state model evidenced that the risk of invasive aspergillosis is a complex time function of neutropenia duration and risk management. The quantitative PCR assay accelerated the early detection of invasive aspergillosis (P = .010, independently of other diagnostic information used to treat, while β-glucan assay did not (P = .53. CONCLUSIONS: The performance of serum biomarkers for the early detection of invasive aspergillosis is better apprehended by the evaluation of time-varying predictors in a multi-state model. Our results provide strong rationale for prospective studies testing a preemptive antifungal therapy, guided by clinical, radiological, and bi-weekly blood screening with galactomannan

  9. Allergic Rhinitis: Mechanisms and Treatment.

    Science.gov (United States)

    Bernstein, David I; Schwartz, Gene; Bernstein, Jonathan A

    2016-05-01

    The prevalence of allergic rhinitis (AR) has been estimated at 10% to 40%, and its economic burden is substantial. AR patients develop specific immunoglobulin E (IgE) antibody responses to indoor and outdoor environmental allergens with exposure over time. These specific IgE antibodies bind to high-affinity IgE receptors on mast cells and basophils. Key outcome measures of therapeutic interventions include rhinitis symptom control, rescue medication requirements, and quality-of-life measures. A comprehensive multiple modality treatment plan customized to the individual patient can optimize outcomes. PMID:27083101

  10. INCIDENCE OF BRONCHOPULMONARY DYSPLASIA IN PRETERM NEWBORNS SUBMITTED TO MECHANICAL VENTILATION: A RETROSPECTIVE STUDY OF 1250 PRETERM NEWBORNS

    Directory of Open Access Journals (Sweden)

    Leilianna de Souza Vieira

    2014-03-01

    Full Text Available Objective: To determine the incidence of preterm newborn infants in mechanical ventilation who developed bronchopulmonary dysplasia in a public hospital at Fortaleza/CE. Method: Descriptive, retrospective and longitudinal quantitative analysis with 1250 preterm infants admitted to the Intensive Care Unit, Dr. César Cals General Hospital, at Fortaleza, from July 2006 to June 2007. Data collection occurred during two months, with visits to units twice a week, where the medical records were done. Were included in these sample newborns that were in mechanical ventilation and developed bronchopulmonary dysplasia. Then the gestational average was 28.6 weeks; the mean weight of infants was 1125.33 grams, born vaginally or cesarean section, of both sexes and with various primary diseases such as respiratory distress syndrome, jaundice and neonatal infection. Results: In the sample from the total admissions, 34.48% were for mechanical ventilation and 3.48% developed bronchopulmonary dysplasia. Conclusion: Despite the low prevalence, bronchopulmonary dysplasia is a important complication of prematurity, directly related to the duration of mechanical ventilation, thus the team must be committed on weaning and extubation of those as soon as possible, preferably within the first week of life.

  11. Anatomical Closure of Left-to-Right Shunts in Premature Infants with Bronchopulmonary Dysplasia and Pulmonary Hypertension: A Cautionary Tale

    Directory of Open Access Journals (Sweden)

    Narendra R. Dereddy

    2015-10-01

    Full Text Available Closure of a systemic to pulmonary shunt in premature infants with bronchopulmonary dysplasia may be beneficial, but in the presence of pulmonary hypertension is controversial. Here, we discuss two premature infants with pulmonary hypertension who developed acute pulmonary hypertensive crisis after closure of these shunts and hence advise caution.

  12. Anatomical Closure of Left-to-Right Shunts in Premature Infants with Bronchopulmonary Dysplasia and Pulmonary Hypertension: A Cautionary Tale

    OpenAIRE

    Dereddy, Narendra R.; Chilakala, Sandeep R.; Divya Rana

    2015-01-01

    Closure of a systemic to pulmonary shunt in premature infants with bronchopulmonary dysplasia may be beneficial, but in the presence of pulmonary hypertension is controversial. Here, we discuss two premature infants with pulmonary hypertension who developed acute pulmonary hypertensive crisis after closure of these shunts and hence advise caution.

  13. Current management of allergic rhinitis in children

    NARCIS (Netherlands)

    C. Georgalas; I. Terreehorst; W. Fokkens

    2010-01-01

    Over the last 20 years, there has been significant progress in our understanding of the pathophysiology of allergic rhinitis, including the discovery of new inflammatory mediators, the link between asthma and allergic rhinitis ('one airway-one disease' concept) and the introduction of novel therapeu

  14. Mold and human health: separating the wheat from the chaff.

    Science.gov (United States)

    Pettigrew, H David; Selmi, Carlo F; Teuber, Suzanne S; Gershwin, M Eric

    2010-04-01

    The term "mold" is utilized to define the ubiquitous fungal species commonly found in household dust and observed as visible multicellular filaments. Several well-defined human diseases are known to be caused or exacerbated by mold or by exposure to their byproducts. Among these, a solid connection has been established with infections, allergic bronchopulmonary aspergillosis, allergic fungal rhinosinusitis, hypersensitivity pneumonitis, and asthma. In the past decades, other less-defined and generally false conditions have also been ascribed to mold. We will herein review and critically discuss the available evidence on the influence of mold on human health. PMID:19714500

  15. Treating allergic rhinitis in pregnancy.

    Science.gov (United States)

    Piette, Vincent; Daures, Jean-Pierre; Demoly, Pascal

    2006-05-01

    Numerous pregnant women suffer from allergic rhinitis, and particular attention is required when prescribing drugs to these patients. In addition, physiologic changes associated with pregnancy could affect the upper airways. Evidence-based guidelines on the management of allergic rhinitis have been published. Medication can be prescribed during pregnancy when the apparent benefit of the drug is greater than the apparent risk. Usually, there is at least one "safe" drug from each major class used to control symptoms. All glucocorticosteroids are teratogenic in animals but, when the indication is clear (for diseases possibly associated, such as severe asthma exacerbation), the benefit of the drug is far greater than the risk. Inhaled glucocorticosteroids (eg, beclomethasone or budesonide) have not been incriminated as teratogens in humans and are used by pregnant women who have asthma. A few H1-antihistamines can safely be used as well. Most oral decongestants (except pseudoephedrine) are teratogenic in animals. There are no such data available for intranasal decongestants. Finally, pregnancy is not considered to be a contraindication for the continuation of immunotherapy.

  16. A new and clinically relevant murine model of solid-organ transplant aspergillosis

    Directory of Open Access Journals (Sweden)

    Susanne Herbst

    2013-05-01

    Invasive fungal infections (IFIs are a major cause of death in organ transplant patients. The murine hydrocortisone-mediated immunosuppression model of pulmonary aspergillosis is commonly used to characterise IFIs in these patients. However, this model does not take into account the effects of calcineurin inhibitors on transplant immunity to IFIs or the fungal calcineurin pathway, which is required for both virulence and antifungal drug resistance. To address these two issues, a new and clinically relevant transplant immunosuppression model of tacrolimus (FK506 and hydrocortisone-associated pulmonary aspergillosis was developed. We first characterised IFIs in 406 patients with a lung transplant. This showed that all of the patients with pulmonary aspergillosis were immunosuppressed with calcineurin inhibitors and steroids. Murine pharmacokinetic studies demonstrated that an ideal dose of 1 mg/kg/day of FK506 intraperitoneally produced blood trough levels in the human therapeutic range (5–12 ng/ml. There was increased mortality from pulmonary aspergillosis in a transplant-relevant immunosuppression model using both FK506 and hydrocortisone as compared with immunosuppression using hydrocortisone only. Lung histopathology showed neutrophil invasion and tracheobronchitis that was associated with reduced lung tumour necrosis factor-α (TNFα, JE (homologue of human MCP-1 and KC (homologue of human IL-8 at 24 hours, but increased lung TNFα, JE and KC at 48 hours when fungal burden was high. Furthermore, FK506 directly impaired fungal killing in alveolar macrophages in vitro, with FK506-mediated inhibition of the radial growth of Aspergillus fumigatus in vitro occurring at the low concentration of 5 ng/ml. Taken together, these findings show that the immunosuppressive activity of FK506 outweighs its antifungal activity in vivo. These observations demonstrate that FK506 impairs innate immune responses and leads to an incremental increase in susceptibility to IFIs when

  17. 38 CFR 3.380 - Diseases of allergic etiology.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Diseases of allergic... Specific Diseases § 3.380 Diseases of allergic etiology. Diseases of allergic etiology, including bronchial... progress nor as due to the inherent nature of the disease. Seasonal and other acute allergic...

  18. Systemic Hydrocortisone To Prevent Bronchopulmonary Dysplasia in preterm infants (the SToP-BPD study); a multicenter randomized placebo controlled trial

    NARCIS (Netherlands)

    W. Onland; M. Offringa; F. Cools; A.P.M.C. De Jaegere; K. Rademaker; H. Blom; E. Cavatorta; A. Debeer; P.H. Dijk; A.F. van Heijst; B.W. Kramer; A.A. Kroon; T. Mohns; H.L. van Straaten; A.B. te Pas; C. Theyskens; M.M. van Weissenbruch; A.H. van Kaam

    2011-01-01

    ABSTRACT: BACKGROUND: Randomized controlled trials have shown that treatment of chronically ventilated preterm infants after the first week of life with dexamethasone reduces the incidence of the combined outcome death or bronchopulmonary dysplasia (BPD). However, there are concerns that dexamethaso

  19. Nasal continuous positive airway pressure combined with surfactant and NO for treatment of respiratory distress syndrome, prevention of bronchopulmonary dysplasia, and brain protection

    Institute of Scientific and Technical Information of China (English)

    Henrik Verder

    2010-01-01

    @@ Respiratory distress syndrome (RDS) is the single most important cause of mortality and morbidity in preterm infants and bronchopulmonary dysplasia (BPD)is a leading cause of neuro-muscular disablement and decreased lung function in the most preterm infants.

  20. Understanding the Short- and Long-Term Respiratory Outcomes of Prematurity and Bronchopulmonary Dysplasia.

    Science.gov (United States)

    Islam, Jessica Y; Keller, Roberta L; Aschner, Judy L; Hartert, Tina V; Moore, Paul E

    2015-07-15

    Bronchopulmonary dysplasia (BPD) is a chronic respiratory disease associated with premature birth that primarily affects infants born at less than 28 weeks' gestational age. BPD is the most common serious complication experienced by premature infants, with more than 8,000 newly diagnosed infants annually in the United States alone. In light of the increasing numbers of preterm survivors with BPD, improving the current state of knowledge of long-term respiratory morbidity for infants with BPD is a priority. We undertook a comprehensive review of the published literature to analyze and consolidate current knowledge of the effects of BPD that are recognized at specific stages of life, including infancy, childhood, and adulthood. In this review, we discuss both the short-term and long-term respiratory outcomes of individuals diagnosed as infants with the disease and highlight the gaps in knowledge needed to improve early and lifelong management of these patients. PMID:26038806

  1. Mesenchymal stromal cells in the development and therapy of bronchopulmonary dysplasia.

    Science.gov (United States)

    Möbius, Marius A; Rüdiger, Mario

    2016-12-01

    Bronchopulmonary dysplasia (BPD), the chronic lung disease of prematurity, remains a major healthcare burden. Despite great progresses in perinatal medicine over the past decades, no cure for BPD has been found. The complex pathophysiology of the disease further hampers the development of effective treatment strategies, but recent insights into the biology of mesenchymal stem (MSCs) and progenitor cells in lung development and disease have ignited the hope of preventing or even treating BPD. The promising results of pre-clinical studies have lead to the first early phase clinical trials. However, these treatments are experimental and much more needs to be learned about the mechanism of action and manufacturing of MSCs. In this mini review, we briefly summarize the role of resident and exogenous MSCs in the development and treatment of BPD. PMID:27142639

  2. Air pollution and allergic diseases

    Energy Technology Data Exchange (ETDEWEB)

    Ring, J.

    1987-03-13

    In the discussion on possible adverse effects of air pollution upon human health one has to distinguish between out-door and in-door environment. The most frequent pollutants in out-door air over industrialized areas are particulate substances, sulfur dioxide, nitrous oxide, carbonmonoxide, ozone and lead. Most of these substances have direct irritating effects on mucous surfaces. Hypersensitivity reactions have been described against sulfur dioxide and sulfites occurring as asthma, urticaria or anaphylactoid reactions. In-door air pollution is of much greater practical importance for a variety of diseases. Apart from physio-chemical irritants and microbial organisms leading to infections, organic allergens (e.g. house dust mites, moulds, animal epithelia) can induce a variety of allergic diseases via different pathomechanisms.

  3. [Definition and clinic of the allergic rhinitis].

    Science.gov (United States)

    Spielhaupter, Magdalena

    2016-03-01

    The allergic rhinitis is the most common immune disorder with a lifetime prevalence of 24% and one of the most common chronic diseases at all--with tendency to rise. It occurs in childhood and influences the patients' social life, school performance and labour productivity. Furthermore the allergic rhinitis is accompanied by a lot of comorbidities, including conjunctivitis, asthma bronchiale, food allergy, neurodermatitis and sinusitis. For example the risk for asthma is 3.2-fold higher for adults with allergic rhinitis than for healthy people.

  4. Bronchopulmonary Dysplasia

    Science.gov (United States)

    ... RDS is a breathing disorder that mostly affects premature newborns. These infants' lungs aren't fully formed or aren't able to make enough surfactant (sur-FAK-tant). Surfactant is a liquid that ...

  5. Congenital bronchopulmonary malformations: A single-center experience and a review of literature

    Directory of Open Access Journals (Sweden)

    Kumar Basant

    2008-01-01

    Full Text Available Purpose: To present a single-center experience with 25 cases of bronchopulmonary malformations and the review the literature. Materials and Methods: We conducted a retrospective analysis of the medical records of patients with congenital bronchopulmonary malformations who were operated between July 1997 and July 2007 in our institute; we examined the modes of presentations, management, and outcome. Outcome of all patients was assessed over a short follow-up period (average 1.8 months. Results: Out of 25 patients, 18 (72% were male and 7 (28% were female. Age of patients ranged from 1 day to 11 years. The histopathological diagnosis was congenital cystic adenomatoid malformations [CCAM; n = 14 (56%], congenital lobar emphysema [CLE; n = 5 (20%], pulmonary sequestrations [PS; n = 3 (12%], and bronchogenic cysts [BC; n = 3 (12%]. Antenatal diagnosis was available in only 2 (8% patients. The common presenting symptoms were respiratory distress and chest infections. Lobectomy was the procedure of choice . Mortality was 16% (n = 4; M: F = 3: 1. Two patients died because of overwhelming sepsis, one from compromised cardiac function, and one from aspiration which might possibly have been prevented. Conclusion: Patients with progressive respiratory distress due to these anomalies may require urgent surgical intervention regardless of age. The surgical outcome is favorable, with manageable complications. Plain x-ray chest and CT of thorax are usually sufficient for diagnosis and planning of treatment. Pathological diagnosis may differ from the imaging diagnosis. Mortality is found to be more in neonates. Apart from initial stabilization, resection of lesion and careful postoperative care is necessary to reduce mortality and morbidity.

  6. Response to bronchodilators in very preterm infants with evolving bronchopulmonary dysplasia

    Directory of Open Access Journals (Sweden)

    Morrow DK

    2015-12-01

    Full Text Available Daniel K Morrow, Diane Schilling, Cindy T McEvoy Department of Pediatrics, Oregon Health and Science University, Portland, OR, USA Background: There are few effective and safe medications to treat very low birth weight (VLBW infants with evolving bronchopulmonary dysplasia. Bronchodilators are often given to patients who have clinical signs of reactive airway disease, but there is not enough information regarding their effectiveness within this population. Objective: To quantify the pulmonary function response to bronchodilator therapy in a population of VLBW infants with evolving bronchopulmonary dysplasia. Materials and methods: This is a retrospective analysis of an ongoing large database of pulmonary function tests (PFTs in premature infants. We reviewed the pre- and post-bronchodilator PFTs ordered by a physician due to concern for reactive airway disease. Inclusion criteria: Birth weight (BW <1,500 g; >14 days of age; admission diagnosis of respiratory distress syndrome; requiring ongoing oxygen, continuous positive airway pressure, or ventilator support at the time of PFT. PFTs were done prior to albuterol therapy and repeated 30 minutes after the therapy was given. PFTs included the measurement of passive respiratory mechanics with the single breath occlusion technique, including passive respiratory system compliance, resistance, and tidal volume. Results: Forty VLBW infants (mean gestation of 27.4 weeks; mean BW of 848 g were identified as having PFTs. Twenty-nine of these patients had a BW of ≤1,000 g. The patients were studied at a mean corrected gestational age of 34.9 weeks. Twenty-nine of 40 patients were extubated at the time of the PFT. Of these patients, 21 (52.5% had a decrease in respiratory system resistance of ≥10%. From the other 19 patients, five (12.5% had a decrease of 0% to <10% in respiratory system resistance, and 14(35% showed no response to therapy. There was no significant difference in respiratory system

  7. Allergic skin diseases : Studies on mechanisms in experimental atopic dermatitis and allergic contact dermatitis

    OpenAIRE

    LehtimÀki, Sari

    2012-01-01

    Atopic dermatitis (AD) is an allergic skin disease, characterized by relapsing eczema, dry skin and chronic skin inflammation. A large proportion of AD patients develop other allergies or asthma later in life. Allergic contact dermatitis (ACD) in turn, is one of the leading occupational diseases worldwide. Therefore, allergic skin diseases not only impair the quality of life of patients but also cause a great economical burden for the society. This thesis investigates some of the mechanisms b...

  8. [Allergic inflamation of the lower airways in patients with allergic rhinitis].

    Science.gov (United States)

    Stefanović, Lj; Balaban, J; Stosović, R; Mitrović, N; Djurasinović, M; Tanurdzić, S

    1994-01-01

    Reporting two of our cases we wanted to point to a great dilemma related to the final diagnosis. Recently, such cases have been more frewuently seen, since in all patients with allergic rhinitis conditions of the lower airways is examined before the administration of the specific immunotherapy. Therefore, we may see patients who are still free of pulmonary sings, despite of positive specific and/or non specific bronchoprovocative tests. The presented cases with evidenced allergic rhinitis are probably in the phase of development of allergic bronchial asthma, the phase of "allergic inflammation" of the lower airways, not clinically manifested yet. PMID:18173213

  9. Acute allergic angioedema of upper lip.

    Science.gov (United States)

    Mahendran, Kavitha; Padmini, Govindasway; Murugesan, Ramesh; Srikumar, Arthiseethalakshmi

    2016-01-01

    Mishaps can occur during dental procedures, some owing to inattention to detail and others are totally unpredictable. They usually include anaphylaxis or allergic reactions to materials used for restorative purposes or drugs such as local anesthetics. A patient reported to our department with moderate dental fluorosis, and the treatment was planned with indirect composite veneering. During the procedure while cementation acute allergic reaction occurred, the specific cause could not be identified after allergic testing. During the procedure while cementationacute allergic angioedema of upper lip. Anaphylaxis, urticaria, allergy, hereditary atopic eczema, cellulitis, cheilitis granulomatosa, and cheilitis glandularis. The patient was reassured and given prednisolone 10 mg and cetirizine 10 mg orally, once daily for 3 days after which the symptoms subsided. This paper will discuss the pathogenesis, classification, identification, and management of angioedema during dental procedures. PMID:27217646

  10. Acute allergic angioedema of upper lip

    Science.gov (United States)

    Mahendran, Kavitha; Padmini, Govindasway; Murugesan, Ramesh; Srikumar, Arthiseethalakshmi

    2016-01-01

    Mishaps can occur during dental procedures, some owing to inattention to detail and others are totally unpredictable. They usually include anaphylaxis or allergic reactions to materials used for restorative purposes or drugs such as local anesthetics. A patient reported to our department with moderate dental fluorosis, and the treatment was planned with indirect composite veneering. During the procedure while cementation acute allergic reaction occurred, the specific cause could not be identified after allergic testing. During the procedure while cementationacute allergic angioedema of upper lip. Anaphylaxis, urticaria, allergy, hereditary atopic eczema, cellulitis, cheilitis granulomatosa, and cheilitis glandularis. The patient was reassured and given prednisolone 10 mg and cetirizine 10 mg orally, once daily for 3 days after which the symptoms subsided. This paper will discuss the pathogenesis, classification, identification, and management of angioedema during dental procedures. PMID:27217646

  11. National prevalence of respiratory allergic disorders

    NARCIS (Netherlands)

    Dahl, R; Andersen, PS; Chivato, T; Valovirta, E; De Monchy, J

    2004-01-01

    Background: Many epidemiological studies have assessed the prevalence of respiratory allergic disorders in confined geographical locations. However, no study has yet established nationally prevalence data in a uniform manner representing whole countries and, thus, enabling cross-national comparisons

  12. Protective Effector Cells of the Recombinant Asp f3 Anti-Aspergillosis Vaccine

    Directory of Open Access Journals (Sweden)

    Diana eDiaz-Arevalo

    2012-08-01

    Full Text Available An Aspergillus fumigatus vaccine based on recombinant Asp f3 protein has the potential to prevent aspergillosis in humans, a devastating fungal disease that is the prime obstacle to the success of hematopoietic cell transplantation. This vaccine protects cortisone acetate (CA-immunosuppressed mice from invasive pulmonary aspergillosis via CD4+ T cell mediators. Aside from these mediators, the nature of downstream fungicidal effectors is not well understood. Neutrophils and macrophages protect immunocompetent individuals from invasive fungal infections, and selective neutrophil depletion rendered mice susceptible to aspergillosis whereas macrophage depletion failed to increase fungal susceptibility. We investigated the effect of neutrophil depletion on rAsp f3 vaccine protection, and explored differences in pathophysiology and susceptibility between CA-immunosuppression and neutrophil depletion. In addition to being protective under CA-immunosuppression, the vaccine also had a protective effect in neutrophil-depleted mice. However, in non-immunized mice, a ten-fold higher conidial dose was required to induce similar susceptibility to infection with neutrophil-depletion than with CA- immunosuppression. The lungs of non-immunized neutrophil-depleted mice became invaded by a patchy dense mycelium with highly branched hyphae, and the peribronchial inflammatory infiltrate consisted mainly of CD3+ T cells and largely lacked macrophages. In contrast, lungs of non-immunized CA-immunosuppressed mice were more evenly scattered with short hyphal elements. With rAsp f3-vaccination, the lungs were largely clear of fungal burden under either immunosuppressive condition. We conclude that neutrophils, although substantial for innate antifungal protection of immunocompetent hosts, are not the relevant effectors for rAsp f3-vaccine derived protection of immunosuppressed hosts. It is therefore more likely that macrophages represent the crucial effectors of the r

  13. Galactomannan and Real-Time PCR in the diagnosis of invasive Aspergillosis: preliminary data

    Directory of Open Access Journals (Sweden)

    Cristina Pedrotti

    2014-03-01

    Full Text Available The diagnosis of invasive aspergillosis is notoriously difficult. The standard culture-based methods have shown considerable limitations in performance. For this reason, non-culture methods have been increasingly employed for the diagnosis of invasive aspergillosis, and, among them, the methods based on Real-Time polymerase chain reaction (RT-PCR. In this study we assess the contribution in lowering diagnosis errors provided by the RT-PCR method when run alongside other methods. We analyzed 23 biological samples, 14 serum samples, and 9 bronchoalveolar lavage samples (BAL from 10 immunocompromised patients who were selected according to EORTC/MSG criteria (European Organization for Research and Treatment of Cancer/Mycoses Study Group. On the serum sample we searched the galactomannan (GM (Platelia Aspergillus® and the fungal genome (MycAssayTMAspergillus; the BAL samples were subjected also to the culture tests. In 11 serum samples the results showed concordance between GM and RT–PCR tests, while in 3 samples we report discordance: 2 results were GM positive and RT-PCR negative, and 1 results GM negative and RT-PCR indeterminate. In 5 BAL samples the results showed concordance between the two methods, while 4 were GM positive and RT-PCR negative. The data, although still preliminary, suggest an increased accuracy in the diagnosis of suspected invasive aspergillosis when employing both RT-PCR and GM tests given that the RT-PCR test eliminates the false positive results of the GM test. The PCR methods require, however, further applications of this type of diagnostic because of the severe limit given by the lack of standardization.

  14. Nasal hyperreactivity and inflammation in allergic rhinitis

    Directory of Open Access Journals (Sweden)

    I. M. Garrelds

    1996-01-01

    Full Text Available The history of allergic disease goes back to 1819, when Bostock described his own ‘periodical affection of the eyes and chest’, which he called ‘summer catarrh’. Since they thought it was produced by the effluvium of new hay, this condition was also called hay fever. Later, in 1873, Blackley established that pollen played an important role in the causation of hay fever. Nowadays, the definition of allergy is ‘An untoward physiologic event mediated by a variety of different immunologic reactions’. In this review, the term allergy will be restricted to the IgE-dependent reactions. The most important clinical manifestations of IgE-dependent reactions are allergic conjunctivitis, allergic rhinitis, allergic asthma and atopic dermatitis. However, this review will be restricted to allergic rhinitis. The histopathological features of allergic inflammation involve an increase in blood flow and vascular permeability, leading to plasma exudation and the formation of oedema. In addition, a cascade of events occurs which involves a variety of inflammatory cells. These inflammatory cells migrate under the influence of chemotactic agents to the site of injury and induce the process of repair. Several types of inflammatory cells have been implicated in the pathogenesis of allergic rhinitis. After specific or nonspecific stimuli, inflammatory mediators are generated from cells normally found in the nose, such as mast cells, antigen-presenting cells and epithelial cells (primary effector cells and from cells recruited into the nose, such as basophils, eosinophils, lymphocytes, platelets and neutrophils (secondary effector cells. This review describes the identification of each of the inflammatory cells and their mediators which play a role in the perennial allergic processes in the nose of rhinitis patients.

  15. Assessment of disease control in allergic rhinitis.

    OpenAIRE

    Demoly, Pascal; Calderon, Moises; Casale, Thomas; Scadding, Glenis; Annesi-Maesano, Isabella; Braun, Jean-Jacques; Delaisi, Bertrand; Haddad, Thierry; Malard, Olivier; Trébuchon, Florence; Serrano, Elie

    2013-01-01

    International audience The Allergic Rhinitis and its Impact on Asthma (ARIA) initiative has had a significant impact, by raising awareness of allergic rhinitis (AR) and improving the diagnosis and treatment of AR sufferers. ARIA classifies the severity of AR as "mild" or "moderate/severe" on the basis of "yes"/"no" answers to four questions. This two-point classification has been criticized as providing little guidance on patient management; patients with "mild" AR are unlikely to consult ...

  16. Occlusion of the syrinx as a manifestation of aspergillosis in Canada geese

    Science.gov (United States)

    Stroud, R.K.; Duncan, R.M.

    1982-01-01

    Aspergillosis has been described in many species of wild waterfowl, primarily as a disease of the respiratory tract. Typically, mycotic granulomas are found in the lungs. Air sacs may be thickened and contain discoid individual or coalescing greenish or bluish plaques resembling bread mold. Occasionally, there is systemic involvement, with granulomas in multiple organs. Carcasses often are emaciated, indicating a long-term course. In the present report, we describe a fatal acute manifestation of Aspergillus fumigatus infection that easily may be overlooked when examining wild waterfowl.

  17. Management of nasal aspergillosis in a dog with a single, noninvasive intranasal infusion of clotrimazole

    International Nuclear Information System (INIS)

    An 11-year-old, spayed female keeshond was presented for unilateral epistaxis and serous nasal discharge of four weeks duration. Initial nasal radiographs, rhinoscopy, and histopathology suggested severe, destructive lymphoplasmacytic rhinitis. The patient deteriorated while receiving an anti-inflammatory dose of prednisone. A computed tomographic scan of the nose demonstrated a soft-tissue density in both the right nasal cavity and frontal sinus. Samples for histopathology obtained at surgery were diagnostic for nasal aspergillosis. All clinical signs resolved with a single, noninvasive infusion of intranasal clotrimazole and a four-week course of oral itraconazole

  18. Common invasive fungal diseases: an overview of invasive candidiasis, aspergillosis, cryptococcosis, and Pneumocystis pneumonia.

    Science.gov (United States)

    Schmiedel, Yvonne; Zimmerli, Stephan

    2016-01-01

    Every year, Candida, Aspergillus, Cryptococcus and Pneumocystis infect an estimated two million individuals worldwide. Most are immunocompromised or critically ill. Candida is the most common fungal pathogen of the critically ill and of recipients of transplanted abdominal organs. In high-risk haemato-oncological patients, in contrast, the introduction of antifungal prophylaxis with fluconazole and later with mould-active posaconazole has led to a remarkable reduction of invasive candidiasis and is likely to have a similar effect on invasive aspergillosis. Invasive aspergillosis remains the dominant invasive fungal disease (IFD) of haemato-oncological patients and solid-organ transplant recipients and is increasingly found in individuals with exacerbated chronic obstructive pulmonary disease on corticosteroids. In the developed world, owing to antiretroviral therapy Pneumocystis pneumonia and cryptococcosis have become rare in patients with human immunodeficiency virus (HIV) and are mainly found in solid-organ transplant recipients or immunocompromised patients. In the developing world, cryptococcosis remains a common and highly lethal disease of HIV positive individuals. With invasive candidiasis and invasive aspergillosis, timely diagnosis is the principal challenge. The clinical presentation is nonspecific and current diagnostic tests lack sensitivity and specificity. The combination of several tests improves sensitivity, but not specificity. Standardised polymerase chain-reaction-based assays may be promising tools for more rapid and specific diagnosis of candidiasis and invasive aspergillosis. Nevertheless, initiation of treatment is often based solely on clinical suspicion. Empirical therapy, however, may lead to over-treatment of patients without IFD or it may miss its target in the case of resistance. Despite the success of antifungal prophylaxis in reducing the incidence of IFDs in haemato-oncological patients, there are a considerable number of

  19. Primary cutaneous aspergillosis due to Aspergillus niger in an immunocompetent patient

    Directory of Open Access Journals (Sweden)

    Mohapatra S

    2009-01-01

    Full Text Available Primary cutaneous aspergillosis is a rare entity, usually caused by A. fumigatus and A. flavus . Here, we present such a case, manifested by ulceration due to A. niger, which remained undiagnosed for a prolonged period. The immunological status was intact, although the patient had associated severe fungal infection. Recurrence of the lesion occurred despite repeated anti-fungal therapies. Anti fungal testing was done based on the broth dilution (M-38A, NCCLS, USA method. The culture isolate was found to be sensitive to fluconazole and amphotericin B. Continuation of antifungal therapy improved the symptoms, reducing the size of the lesion.

  20. Significant Differences in Markers of Oxidant Injury between Idiopathic and Bronchopulmonary-Dysplasia-Associated Pulmonary Hypertension in Children

    OpenAIRE

    Vera, Kimberly B.; Donald Moore; English Flack; Michael Liske; Marshall Summar

    2012-01-01

    While oxidant stress is elevated in adult forms of pulmonary hypertension (PH), levels of oxidant stress in pediatric PH are unknown. The objective of this study is to measure F2-isoprostanes, a marker of oxidant stress, in children with idiopathic pulmonary hypertension (IPH) and PH due to bronchopulmonary dysplasia (BPD). We hypothesized that F2-isoprostanes in pediatric IPH and PH associated with BPD will be higher than in controls. Plasma F2-isoprostanes were measured in pediatric PH pati...

  1. Surfactant and allergic airway inflammation.

    Science.gov (United States)

    Winkler, Carla; Hohlfeld, Jens M

    2013-01-01

    Pulmonary surfactant is a complex mixture of unique proteins and lipids that covers the airway lumen. Surfactant prevents alveolar collapse and maintains airway patency by reducing surface tension at the air-liquid interface. Furthermore, it provides a defence against antigen uptake by binding foreign particles and enhancing cellular immune responses. Allergic asthma is associated with chronic airway inflammation and presents with episodes of airway narrowing. The pulmonary inflammation and bronchoconstriction can be triggered by exposure to allergens or pathogens present in the inhaled air. Pulmonary surfactant has the potential to interact with various immune cells which orchestrate allergen- or pathogen-driven episodes of airway inflammation. The complex nature of surfactant allows multiple sites of interaction, but also makes it susceptible to external alterations, which potentially impair its function. This duality of modulating airway physiology and immunology during inflammatory conditions, while at the same time being prone to alterations accompanied by restricted function, has stimulated numerous studies in recent decades, which are reviewed in this article. PMID:23896983

  2. Upper and lower airway pathology in young children with allergic- and non-allergic rhinitis

    DEFF Research Database (Denmark)

    Chawes, Bo Lk

    2011-01-01

    Allergic- and non-allergic rhinitis are very common diseases in childhood in industrialized countries. Although these conditions are widely trivialized by both parents and physicians they induce a major impact on quality of life for the affected children and a substantial drainage of health care...... resources. Unfortunately, diagnostic specificity is hampered by nonspecific symptom history and lack of reliable diagnostic tests which may explain why the pathology behind such diagnoses is poorly understood. Improved understanding of the pathophysiology of allergic- and non-allergic rhinitis in young...... children may contribute to the discovery of new mechanisms involved in pathogenesis and help direct future research to develop correctly timed preventive measures as well as adequate monitoring and treatment of children with rhinitis. Asthma is a common comorbidity in subjects with allergic rhinitis...

  3. Case report - Bilateral renal aspergillosis in a patient with AIDS : A case report and review of reported cases

    NARCIS (Netherlands)

    Oosten, A.W.; Sprenger, H.G.; Van Leeuwen, J.T.M.; Meessen, N.E.L.; Van Assen, S.

    2008-01-01

    Renal aspergillosis is an extremely uncommon complication in HIV-infected patients. In general, prognosis is poor and the need for nephrectomy is emphasized. We report the case of a 37-year-old patient with AIDS since April 2003 (CD4 count 10 cells/mm(3), a high viral load, Candida esophagitis, bila

  4. Progressive increase in cavitation with the evolution of fungus ball: A clue to the diagnosis of chronic necrotizing pulmonary aspergillosis

    Directory of Open Access Journals (Sweden)

    Prasad R

    2009-01-01

    Full Text Available Chronic necrotizing pulmonary aspergillosis (CNPA is an uncommon pulmonary infection seen in the patients with chronic obstructive pulmonary disease, bronchiectasis, pneumoconiosis, diabetes mellitus, alcoholism, poor nutrition or low dose corticosteroid therapy. Here, we are presenting a case of CNPA with diabetes mellitus that was misdiagnosed as pulmonary tuberculosis.

  5. Eradication of Pulmonary Aspergillosis in an Adolescent Patient Undergoing Three Allogeneic Stem Cell Transplantations for Acute Lymphoblastic Leukemia

    Directory of Open Access Journals (Sweden)

    Michaela Döring

    2012-01-01

    Full Text Available Systemic fungal infections are a major cause of infection-related mortality in patients with hematologic malignancies. This report addresses the case of an adolescent patient with acute lymphoblastic leukemia who underwent three allogeneic hematopoietic stem cell transplantations and developed pulmonary aspergillosis. Combination therapy with liposomal amphotericin B (L-AmB, 3 mg/kg bw/day and caspofungin (CAS, 50 mg/day during the first allogeneic hematopoietic stem cell transplantation (HSCT improved the pulmonary situation. After shifting the antifungal combination therapy to oral voriconazole (2 × 200 mg/day and CAS, a new pulmonal lesion occurred alongside the improvements in the existing pulmonary aspergillosis. An antifungal combination during a second HSCT with L-AmB (3 mg/kg bw/day and CAS showed an improvement in the pulmonary aspergillosis. A combination therapy with CAS and L-AmB (1 mg/kg bw/day during the third HSCT led once again to progress the pulmonary aspergillosis, after increasing the L-AMB to 3 mg/kg bw/day for recovery. The presented case provides an example of how, despite severe immunosuppression, a combination of antifungal drugs administered intravenously at therapeutic dosages may be more efficient than either intravenous monotherapy or combinations of intravenous and oral antifungals in selecting pediatric and adolescent patients with proven fungal infections.

  6. Molecular identification of Emericella echinulata as a cause of Cerebral Aspergillosis in a patient following small bowel and liver transplantation

    Science.gov (United States)

    Molecular methods are now more commonly used for identification of the aspergilli and their teleomorphs and have led to reports of species not previously recognized as causing human disease. We report the first case of cerebral aspergillosis in a compromised patient caused by Emericella echinulata,...

  7. Immunochemical analysis of fumigaclavine mycotoxins in respiratory tissues and in blood serum of birds with confirmed aspergillosis.

    Science.gov (United States)

    Latif, Hadri; Gross, Madeleine; Fischer, Dominik; Lierz, Michael; Usleber, Ewald

    2015-11-01

    The ergoline alkaloid fumigaclavine A (FuA) is one of the major mycotoxins produced by Aspergillus fumigatus, the main causative fungal agent of avian aspergillosis. To study in situ production of FuA, post-mortem respiratory tissues of various avian species, as well as blood samples of falcons (Falco sp.), were analysed by enzyme immunoassay (EIA). At a detection limit of 1.5 ng/ml, FuA EIA positive results were obtained for tissue samples from seven (64%) out of 11 birds with confirmed aspergillosis, with a maximum concentration of 38 ng/g, while all controls (n = 7) were negative. No FuA could be detected in blood serum (detection limit 0.7 ng/ml) of 15 falcons, experimentally inoculated with A. fumigatus conidia. Fungal mycelium material from tissue of clinical aspergillosis cases, cultured on malt extract agar, was highly positive in the FuA EIA in milligrams per gram range. Chromatographic analysis of mycelium extracts revealed the co-presence of FuA and the structurally related fumigaclavine C (FuC). Alkaline hydrolysis of FuA and FuC yielded the corresponding deacetylation products, FuB and FuE. This is the first report showing that fumigaclavine alkaloids are produced by A. fumigatus in situ during the course of clinical aspergillosis in birds; however, the role of these compounds in the pathogenesis of this disease is still unknown.

  8. A 76-year-old man with a right lung adenocarcinoma and invasive Aspergillosis.

    Science.gov (United States)

    Dos Santos, Vitorino Modesto; da Trindade, Marcos Correa; de Souza, Diogo Wagner da Silva; de Menezes, Ana Isabel Costa; Oguma, Patricia Midori; Nascimento, Afonso Lucas Oliveira

    2013-08-01

    A 76-year-old male with adenocarcinoma on the right lung underwent five cycles of chemotherapy with pemetrexed disodium, cisplatin, and dexamethasone. Imaging studies of control showed a node in a cavitary lesion on the left lung, and the main hypothesis was Aspergillus infection. PCR was utilized and contributed to establish the early diagnosis in this patient with invasive aspergillosis. Furthermore, the species Aspergillus fumigatus was characterized by its growing at 50 °C but not at 10 °C, typical culture features, and presence of subclavate vesicles. Diagnosis criteria for Aspergillus pulmonary infection include characteristic clinical and imaging findings, elevated C-reactive protein and erythrocyte sedimentation rate, positive specific serological test, and isolation of Aspergillus from bronchoalveolar cultures. Molecular methods, as PCR, have been useful to complement the conventional microbiological investigations in immunocompromised people with invasive fungal infections. The patient was successfully treated with a schedule of voriconazole 4 mg/kg intravenous infusion every 12 h for 21 days and then switched to oral administration of 200 mg twice a day. He has been comfortable, maintaining normal vital signs, and the results of the periodical microbiologic tests of control are negative. Pathogenesis of invasive aspergillosis in patients with lung cancer is not completely understood. Case studies may contribute to a better knowledge about Aspergillus infection in this setting. PMID:23615821

  9. Chronic necrotizing pulmonary aspergillosis in pneumoconiosis - Clinical and radiologic findings in 10 patients

    Energy Technology Data Exchange (ETDEWEB)

    Kato, T.; Usami, I.; Morita, H.; Goto, M.; Hosoda, M.; Nakamura, A.; Shima, S. [Nagoya City University, Nagoya (Japan). School of Medicine, Dept. of Internal Medicine

    2002-01-01

    The authors studied 10 male patients with pneumoconiosis who were seen at Asahi Rosai Hospital and received a clinical diagnosis of chronic necrotizing pulmonary aspergillosis (CNPA) during a 15-year period, and detailed the long-term clinical and radiologic courses of four cases. Their occupational histories included pottery making and coal mining. Chest radiographic findings by the International Labor Organization profusion grading system were greater than category 2. All patients were symptomatic, with a productive cough, haemoptysis, and dyspnea. Serum findings were positive for the aspergillosis antibody in seven patients. The radiologic findings consisted of parenchymal infiltrates and cavities mostly containing mycetoma, which generally involved the upper lobes. The disease progressed slowly; in one patient, broad destruction of the lung was observed after > 10 years without antifungal administration. Most of the patients experienced clinical and radiologic improvement after receiving antifungal therapy, by oral, inhaled, or intracavitary administration. It was concluded that chronic persistent or progressive upper-lobe infiltrates and cavities in patients with pneumoconiosis should raise the possibility of CNPA. Early diagnosis and initiation of effective therapy are recommended to achieve a better outcome.

  10. Epidemiology and antifungal resistance in invasive aspergillosis according to primary disease - review of the literature

    Directory of Open Access Journals (Sweden)

    Mayr A

    2011-04-01

    Full Text Available Abstract Aspergilli, less susceptible to antifungals emerge and resistance to azoles have been found mainly in Aspergillus fumigatus; this has launched a new phase in handling aspergillosis. Resistant strains have currently been reported from Belgium, Canada, China, Denmark, France, Norway, Spain, Sweden, The Netherlands, UK and the USA. Centres in the UK (Manchester and The Netherlands (Nijmegen have described particularly high frequencies (15 and 10% respectively, and a significant increase in azole resistance in recent years. The reason of this high incidence may be due to long term azole therapy in patients with chronic aspergillosis in Manchester, and due to high use of agricultural azoles in Nijmegen. The primary underlying mechanism of resistance is as a result of alterations in the cyp51A target gene, with a variety of mutations found in clinical isolates and one genotype identified in the environmental (LH98. Reports on well documented in vitro and in vivo resistance to echinocandins are rare for Aspergillus species and resistance may be under-diagnosed as susceptibility testing is less frequently performed due to technical reasons.

  11. Invasive aspergillosis in hematopoietic stem cell transplant recipients: a retrospective analysis

    Directory of Open Access Journals (Sweden)

    Viviane Maria Hessel Carvalho-Dias

    2008-10-01

    Full Text Available Invasive aspergillosis (IA currently is an important cause of mortality in subjects undergoing hematopoietic stem cell transplants (HSCT and is also an important cause of opportunistic respiratory and disseminated infections in other types of immunocompromised patients. We examined the medical records of 24 cases of proven and probable invasive aspergillosis (IA at the Hospital de Clinicas of the Federal University of Parana, Brazil, from January 1996 to October 2006. During this period occurred a mean of 2.2 cases per year or 3.0 cases per 100 HSTC transplants. There was a significant relationship between structural changes in the bone marrow transplant (BMT Unit and the occurrence of IA cases (p=0.034, relative risk (RR = 2.47. Approximately 83% of the patients died due to invasive fungal infection within 60 days of follow up. Some factors tended to be associated with mortality, but these associations were not significant. These included corticosteroid use, neutropenia (<100 cells/mm³ at diagnosis, patients that needed to change antifungal therapy because of toxicity of the initial first-line regimen and disseminated disease. These factors should be monitored in BMT units to help prevent IA. Physicians should be aware of the risk factors for developing invasive fungal infections and try to reduce or eliminate them. However, once this invasive disease begins, appropriate diagnostic and treatment measures must be implemented as soon as possible in order to prevent the high mortality rates associated with this condition.

  12. Immunodiagnosis of systemic aspergillosis. I. Antigenemia detected by radioimmunoassay in experimental infection

    International Nuclear Information System (INIS)

    Because systemic aspergillosis is difficult to diagnose ante mortem, a study to improve immunodiagnosis was undertaken in a rabbit model of disseminated infection. We found that the predominant humoral response of infected animals was directed against four Aspergillus antigens identified by crossed immunoelectrophoresis. One of these antigens, a cell-wall carbohydrate, was purified by gel-filtration chromatography and was used to develop a radiommunoassay. The sensitivity of this assay was increased by testing for serum-bound antigen as well as for free antigen. When the sensitivity of the RIA was evaluated in the animal model, antigenemia was detected in 78% of 51 rabbits with disseminated infection and ante mortem in 86% of 42 rabbits with lethal infection. By contrast, with immunoprecipitin analysis only eight of 51 rabbits were positive for antigen, and six of 51 rabbits were positive for Aspergillus antibody. The specificity of the RIA was also tested. Negative controls for antigen included sera from 76 normal rabbits and sera from 25 rabbits with systemic candidiasis. The Candida control group is pertinent because 48% of these rabbits had specific Candida antigenemia detected by a mannan RIA. This study demonstrates that Aspergillus antigenemia occurs during the course of experimental disseminated aspergillosis and illustrates the potential of an Aspergillus antigen RIA for sensitive, specific immunodiagnosis of human infections

  13. Nationwide Surveillance of Azole Resistance in Aspergillus Diseases.

    Science.gov (United States)

    Vermeulen, Edith; Maertens, Johan; De Bel, Annelies; Nulens, Eric; Boelens, Jerina; Surmont, Ignace; Mertens, Anna; Boel, An; Lagrou, Katrien

    2015-08-01

    Aspergillus disease affects a broad patient population, from patients with asthma to immunocompromised patients. Azole resistance has been increasingly reported in both clinical and environmental Aspergillus strains. The prevalence and clinical impact of azole resistance in different patient populations are currently unclear. This 1-year prospective multicenter cohort study aimed to provide detailed epidemiological data on Aspergillus resistance among patients with Aspergillus disease in Belgium. Isolates were prospectively collected in 18 hospitals (April 2011 to April 2012) for susceptibility testing. Clinical and treatment data were collected with a questionnaire. The outcome was evaluated to 1 year after a patient's inclusion. A total of 220 Aspergillus isolates from 182 patients were included. The underlying conditions included invasive aspergillosis (n = 122 patients), allergic bronchopulmonary aspergillosis (APBA) (n = 39 patients), chronic pulmonary aspergillosis (n = 10 patients), Aspergillus bronchitis (n = 7 patients), and aspergilloma (n = 5 patients). The overall azole resistance prevalence was 5.5% (95% confidence interval [CI] 2.8 to 10.2%) and was 7.0% (4/57; 95% CI, 2.3 to 17.2%) in patients with APBA, bronchitis, aspergilloma, or chronic aspergillosis and 4.6% in patients with invasive aspergillosis (5/108; 95% CI, 1.7 to 10.7%). The 6-week survival in invasive aspergillosis was 52.5%, while susceptibility testing revealed azole resistance in only 2/58 of the deceased patients. The clinical impact of Aspergillus fumigatus resistance was limited in our patient population with Aspergillus diseases.

  14. Benzaldehyde suppresses murine allergic asthma and rhinitis.

    Science.gov (United States)

    Jang, Tae Young; Park, Chang-Shin; Kim, Kyu-Sung; Heo, Min-Jeong; Kim, Young Hyo

    2014-10-01

    To evaluate the antiallergic effects of oral benzaldehyde in a murine model of allergic asthma and rhinitis, we divided 20 female BALB/c mice aged 8-10 weeks into nonallergic (intraperitoneally sensitized and intranasally challenged to normal saline), allergic (intraperitoneally sensitized and intranasally challenged to ovalbumin), and 200- and 400-mg/kg benzaldehyde (allergic but treated) groups. The number of nose-scratching events in 10 min, levels of total and ovalbumin-specific IgE in serum, differential counts of inflammatory cells in bronchoalveolar lavage (BAL) fluid, titers of Th2 cytokines (IL-4, IL-5, IL-13) in BAL fluid, histopathologic findings of lung and nasal tissues, and expressions of proteins involved in apoptosis (Bcl-2, Bax, caspase-3), inflammation (COX-2), antioxidation (extracellular SOD, HO-1), and hypoxia (HIF-1α, VEGF) in lung tissue were evaluated. The treated mice had significantly fewer nose-scratching events, less inflammatory cell infiltration in lung and nasal tissues, and lower HIF-1α and VEGF expressions in lung tissue than the allergic group. The number of eosinophils and neutrophils and Th2 cytokine titers in BAL fluid significantly decreased after the treatment (Pbenzaldehyde exerts antiallergic effects in murine allergic asthma and rhinitis, possibly through inhibition of HIF-1α and VEGF.

  15. Preventing atopy and allergic disease.

    Science.gov (United States)

    Heine, Ralf G

    2014-01-01

    Due to the recent exponential increase in food allergies and atopic disorders, effective allergy prevention has become a public health priority in many developed regions. Important preventive strategies include the promotion of breastfeeding and vaginal deliveries, judicious use of perinatal antibiotics, as well as the avoidance of maternal tobacco smoking. Breastfeeding for at least 6 months and introduction of complementary solids from 4-6 months are generally recommended. Complex oligosaccharides in breast milk support the establishment of bifidobacteria in the neonatal gut which stimulate regulatory T lymphocyte responses and enhance tolerance development. Maternal elimination diets during pregnancy or lactation are not effective in preventing allergies. If exclusive breastfeeding is not possible, (supplemental) feeding with a partially hydrolyzed whey-based formula or extensively hydrolyzed casein-based formula may reduce the risk of cow's milk allergy and atopic dermatitis in infants with a family history of atopy. By contrast, asthma and allergic rhinitis at 4-6 years of age are not prevented by this approach. Soy formula and amino acid-based formula have no proven role in allergy prevention. Perinatal supplementation with probiotics and/or prebiotics may reduce the risk of atopic dermatitis, but no reliable effect on the prevention of food allergy or respiratory allergies has so far been found. A randomized trial on maternal fish oil supplementation during pregnancy found that atopic dermatitis and egg sensitization in the first year of life were significantly reduced, but no preventive effect for food allergies was demonstrated. The role of vitamin D deficiency or excess as a risk factor for food allergy and atopic disorders requires further study. PMID:24504215

  16. Preventing atopy and allergic disease.

    Science.gov (United States)

    Heine, Ralf G

    2014-01-01

    Due to the recent exponential increase in food allergies and atopic disorders, effective allergy prevention has become a public health priority in many developed regions. Important preventive strategies include the promotion of breastfeeding and vaginal deliveries, judicious use of perinatal antibiotics, as well as the avoidance of maternal tobacco smoking. Breastfeeding for at least 6 months and introduction of complementary solids from 4-6 months are generally recommended. Complex oligosaccharides in breast milk support the establishment of bifidobacteria in the neonatal gut which stimulate regulatory T lymphocyte responses and enhance tolerance development. Maternal elimination diets during pregnancy or lactation are not effective in preventing allergies. If exclusive breastfeeding is not possible, (supplemental) feeding with a partially hydrolyzed whey-based formula or extensively hydrolyzed casein-based formula may reduce the risk of cow's milk allergy and atopic dermatitis in infants with a family history of atopy. By contrast, asthma and allergic rhinitis at 4-6 years of age are not prevented by this approach. Soy formula and amino acid-based formula have no proven role in allergy prevention. Perinatal supplementation with probiotics and/or prebiotics may reduce the risk of atopic dermatitis, but no reliable effect on the prevention of food allergy or respiratory allergies has so far been found. A randomized trial on maternal fish oil supplementation during pregnancy found that atopic dermatitis and egg sensitization in the first year of life were significantly reduced, but no preventive effect for food allergies was demonstrated. The role of vitamin D deficiency or excess as a risk factor for food allergy and atopic disorders requires further study.

  17. Allergic rhinitis is associated with otitis media with effusion

    DEFF Research Database (Denmark)

    Kreiner-Møller, E; Chawes, B L K; Thomasen, Per Caye;

    2012-01-01

    Childhood otitis media with effusion is a common disease and a link to allergic diseases has been suggested.......Childhood otitis media with effusion is a common disease and a link to allergic diseases has been suggested....

  18. Increased levels of phthalates in very low birth weight infants with septicemia and bronchopulmonary dysplasia.

    Science.gov (United States)

    Strømmen, Kenneth; Lyche, Jan Ludvig; Blakstad, Elin Wahl; Moltu, Sissel Jennifer; Veierød, Marit Bragelien; Almaas, Astrid Nylander; Sakhi, Amrit Kaur; Thomsen, Cathrine; Nakstad, Britt; Brække, Kristin; Rønnestad, Arild Erlend; Drevon, Christian André; Iversen, Per Ole

    2016-01-01

    Very low birth weight infants (VLBW; birth weightphthalates from medical devices during their hospital stay. We measured urinary phthalate concentrations among hospitalized VLBW infants participating in a nutritional study. Possible associations between different phthalates and birth weight (BW), septicemia and bronchopulmonary dysplasia (BPD) were evaluated. Forty-six VLBW infants were enrolled in this randomized controlled nutritional study. The intervention group (n=24) received increased quantities of energy, protein, fat, essential fatty acids and vitamin A, as compared to the control group (n=22). The concentrations of 12 urinary phthalate metabolites were measured, using high-performance liquid chromatography coupled to tandem mass spectrometry, at 3 time points during the first 5weeks of life. During this study, the levels of di (2-ethylhexyl) phthalate (DEHP) metabolites decreased, whereas an increasing trend was seen regarding metabolites of di-iso-nonyl phthalate (DiNP). Significantly higher levels of phthalate metabolites were seen in infants with lower BW and those diagnosed with late onset septicemia or BPD. A significant positive correlation between the duration of respiratory support and DEHP metabolites was observed (p≤0.01) at 2.9weeks of age. Birth weight was negatively associated with urinary phthalate metabolite concentrations. Infants with lower BW and those diagnosed with septicemia or BPD experienced prolonged exposure from medical equipment containing phthalates, with subsequent higher levels of phthalate metabolites detected. Clinical Trial Registration no.: NCT01103219. PMID:26922148

  19. Interleukin-4 and 13 concentrations in infants at risk to develop Bronchopulmonary Dysplasia

    Directory of Open Access Journals (Sweden)

    Kruger Thomas E

    2003-08-01

    Full Text Available Abstract Background An exaggerated inflammatory response occurs in the first few days of life in infants who subsequently develop bronchopulmonary dysplasia (BPD. The increase of inflammatory cytokines in many disease processes is generally balanced by a rise in anti-inflammatory cytokines. Interleukin-4 (IL-4 and interleukin-13 (IL-13 have been shown to inhibit production of several inflammatory cytokines important in the development of BPD. Methods We sought to determine if a correlation exists between the presence or absence of IL-4 and IL-13 in tracheal aspirates (TA during the first 3 weeks of life and the development of BPD in premature infants. Serial TAs were prospectively obtained from 36 very low birth weight infants and IL-4 and IL-13 concentrations were determined by ELISA. Results Infants who developed BPD (n = 19 were less mature (25.3 ± 0.02 wks vs. 27.8 ± 0.05 wks; p Conclusions TA concentrations of IL-4 and IL-13 do not increase significantly during acute lung injury in premature infants.

  20. Pulmonary perfusion scintigraphy in the evaluation of the severity of bronchopulmonary dysplasia

    International Nuclear Information System (INIS)

    Objective. The objectives of this study were to analyze the changes in pulmonary perfusion in bronchopulmonary dysplasia (BPD) and to assess the advantages of this method in evaluating the severity of BPD. Patients and methods. The study group was made up of 10 children with BPD, matched with a control group of 12 children. The criteria for matching were birth weight, gestational age and need for ventilation for more than 3 days. Clinical and roentgenographic scoring systems were applied on the 21st day of life. At 6 months of corrected age, clinical evolutive severity was evaluated and a pulmonary perfusion scintigraphy using technetium-99 was performed in each child. The scintigraphic findings were classified in five categories ranging from normal to severely affected, depending on the degree and localization of perfusion abnormalities. Another score was obtained by assigning a value from 1 to 5 to each pulmonary lobe, depending on the concentration of the tracer. Results. The study of clinical, roentgenographic and evolutive scores always showed higher values in children with BPD, with good correlation between methods (P < 0.001). In the BPD group, abnormal lung perfusion patterns were more frequent and more severe (P < 0.05), the lobe scoring was higher (P < 0.05), and a lower count rate was found (P < 0.01). Conclusion. Pulmonary scintigraphy is a useful technique in evaluating the severity of BPD. (orig.). With 1 fig., 3 tabs

  1. Association of a FGFR-4 Gene Polymorphism with Bronchopulmonary Dysplasia and Neonatal Respiratory Distress

    Directory of Open Access Journals (Sweden)

    Milad Rezvani

    2013-01-01

    Full Text Available Background. Bronchopulmonary dysplasia (BPD is the most common chronic lung disease of premature birth, characterized by impaired alveolar development and inflammation. Pathomechanisms contributing to BPD are poorly understood. However, it is assumed that genetic factors predispose to BPD and other pulmonary diseases of preterm neonates, such as neonatal respiratory distress syndrome (RDS. For association studies, genes upregulated during alveolarization are major candidates for genetic analysis, for example, matrix metalloproteinases (MMPs and fibroblast growth factors (FGFs and their receptors (FGFR. Objective. Determining genetic risk variants in a Caucasian population of premature neonates with BPD and RDS. Methods. We genotyped 27 polymorphisms within 14 candidate genes via restriction fragment length polymorphism (RFLP: MMP-1, -2, -9, and -12, -16, FGF receptors 2 and 4, FGF-2, -3, -4, -7, and -18, Signal-Regulatory Protein α (SIRPA and Thyroid Transcription Factor-1 (TTF-1. Results. Five single nucleotide polymorphisms (SNPs in MMP-9, MMP-12, FGFR-4, FGF-3, and FGF-7 are associated ( with RDS, defined as surfactant application within the first 24 hours after birth. One of them, in FGFR-4 (rs1966265, is associated with both RDS ( and BPD (. Conclusion. rs1966265 in FGF receptor 4 is a possible genetic key variant in alveolar diseases of preterm newborns.

  2. Differential expression of long non-coding RNAs in hyperoxia-induced bronchopulmonary dysplasia.

    Science.gov (United States)

    Bao, Tian-Ping; Wu, Rong; Cheng, Huai-Ping; Cui, Xian-Wei; Tian, Zhao-Fang

    2016-07-01

    Bronchopulmonary dysplasia (BPD) is a common complication of premature birth that seriously affects the survival rate and quality of life among preterm neonates. Long non-coding RNAs (lncRNAs) have been implicated in many human diseases. However, the role of lncRNAs in the pathogenesis of BPD remains poorly understood. Here, we exposed neonatal C57BL/6J mice to 95% concentrations of ambient oxygen and established a mouse lung injury model that mimicked human BPD. Next, we compared lncRNA and messenger RNA (mRNA) expression profiles between BPD and normal lung tissues using a high-throughput mouse lncRNA + mRNA array system. Compared with the control group, 882 lncRNAs were upregulated, and 887 lncRNAs were downregulated in BPD lung tissues. We validated some candidate BPD-associated lncRNAs by real-time quantitative reverse-transcription polymerase chain reaction analysis in eight pairs of BPD and normal lung tissues. Gene ontology, pathway and bioinformatics analyses revealed that a downregulated lncRNA, namely AK033210, associated with tenascin C may be involved in the pathogenesis of BPD. To the best of our knowledge, our study is the first to reveal differential lncRNA expression in BPD, which provides a foundation for further understanding of the molecular mechanism of BPD development. Copyright © 2016 John Wiley & Sons, Ltd. PMID:27137150

  3. Hydrogen-rich water ameliorates bronchopulmonary dysplasia (BPD) in newborn rats.

    Science.gov (United States)

    Muramatsu, Yukako; Ito, Mikako; Oshima, Takahiro; Kojima, Seiji; Ohno, Kinji

    2016-09-01

    Bronchopulmonary dysplasia (BPD) is characterized by developmental arrest of the alveolar tissue. Oxidative stress is causally associated with development of BPD. The effects of hydrogen have been reported in a wide range of disease models and human diseases especially caused by oxidative stress. We made a rat model of BPD by injecting lipopolysaccharide (LPS) into the amniotic fluid at E16.5. The mother started drinking hydrogen-rich water from E9.5 and also while feeding milk. Hydrogen normalized LPS-induced abnormal enlargement of alveoli at P7 and P14. LPS increased staining for nitrotyrosine and 8-OHdG of the lungs, and hydrogen attenuated the staining. At P1, LPS treatment decreased expressions of genes for FGFR4, VEGFR2, and HO-1 in the lungs, and hydrogen increased expressions of these genes. In contrast, LPS treatment and hydrogen treatment had no essential effect on the expression of SOD1. Inflammatory marker proteins of TNFα and IL-6 were increased by LPS treatment, and hydrogen suppressed them. Treatment of A549 human lung adenocarcinoma epithelial cells with 10% hydrogen gas for 24 hr decreased production of reactive oxygen species in both LPS-treated and untreated cells. Lack of any known adverse effects of hydrogen makes hydrogen a promising therapeutic modality for BPD. Pediatr Pulmonol. 2016; 51:928-935. © 2016 Wiley Periodicals, Inc. PMID:26845501

  4. Intraerythrocyte Non-Protein-Bound Iron in Children with Bronchopulmonary Pathology

    Directory of Open Access Journals (Sweden)

    E.M. Vasilyeva

    2014-12-01

    Full Text Available A total of 230 children having bronchopulmonary pathology (BPP were examined. Patients were divided into 4 groups according to their intraerythrocyte non-protein- bound iron (IE-NPBI levels. We investigated the relationship of the IE-NPBI level with parameters of respiratory function (RF tests, the severity of comorbidities, and level of other free intracellular ions, such as copper, zinc, and magnesium. The pronounced increase in IE-NPBI level was typical for patients with the connective tissue dysplasia, often accompanied by mitral valve prolapse, osteopenia, and mineral metabolism violation. The severe comorbid diagnoses were typical for patients with reduced levels of IE-NPBI (chronic cor pulmonale, tuberculosis infection. The largest number of comorbidities, aggravating the underlying disease, took place in the group of patients with a significant reduction in IE-NPBI level. A significant increase in IE-NPBI level, as well as a marked reduction of IE-NPBI level, was an unfavorable factor for the underlying disease. We found a correlation between IE-NPBI level and parameters of RF-test in patients with moderate increase in IE-NPBI level.

  5. Mechanisms of cough provocation and cough resolution in neonates with bronchopulmonary dysplasia

    Science.gov (United States)

    Jadcherla, Sudarshan R.; Hasenstab, Kathryn A.; Shaker, Reza; Castile, Robert G.

    2016-01-01

    Background Cough and deglutition are protective mechanisms that defend against aspiration. We identified mechanisms associated with cough provocation as well as those associated with cough resolution in infants with bronchopulmonary dysplasia (BPD). Methods Manometry signatures of cough were recognized in 16 premature infants with BPD undergoing concurrent esophageal manometry, respiratory inductance plethysmography, and nasal air flow measurements. Pretussive and posttussive pharyngo-esophageal motility changes were analyzed. Mechanisms associated with cough and mechanisms that restored respiratory and esophageal normalcy were analyzed. Results We analyzed 312 cough events during 88 cough clusters; 97% were associated with recognizable manometric patterns. Initial mechanisms related with coughing included nonpropagating swallow (59%), upper esophageal sphincter (UES) reflex contraction (18%), and lower esophageal sphincter (LES) relaxation (14%). UES and LES dysfunction was present in 69% of nonpropagating swallow-associated cough clusters. Mechanisms restoring post-tussive normalcy included primary peristalsis (84%), secondary peristalsis (8%), and none recognized (8%). UES contraction reflex was associated with cough clusters more frequently in infants on nasal continuous positive airway pressure (NCPAP) (OR = 9.13, 95% CI = 1.88–44.24). Conclusion Cough clusters in infants with BPD had identifiable etiologies associated with esophageal events; common initial mechanisms were of upper aerodigestive origin, while common clearing mechanisms were peristaltic reflexes. PMID:26151491

  6. Development of a proxy-reported pulmonary outcome scale for preterm infants with bronchopulmonary dysplasia

    Directory of Open Access Journals (Sweden)

    Laughon Matthew M

    2011-07-01

    Full Text Available Abstract Background To develop an accurate, proxy-reported bedside measurement tool for assessment of the severity of bronchopulmonary dysplasia (also called chronic lung disease in preterm infants to supplement providers' current biometric measurements of the disease. Methods We adapted Patient-Reported Outcomes Measurement Information System (PROMIS methodology to develop the Proxy-Reported Pulmonary Outcomes Scale (PRPOS. A multidisciplinary group of registered nurses, nurse practitioners, neonatologists, developmental specialists, and feeding specialists at five academic medical centers participated in the PRPOS development, which included five phases: (1 identification of domains, items, and responses; (2 item classification and selection using a modified Delphi process; (3 focus group exploration of items and response options; (4 cognitive interviews on a preliminary scale; and (5 final revision before field testing. Results Each phase of the process helped us to identify, classify, review, and revise possible domains, questions, and response options. The final items for field testing include 26 questions or observations that a nurse assesses before, during, and after routine care time and feeding. Conclusions We successfully created a prototype scale using modified PROMIS methodology. This process can serve as a model for the development of proxy-reported outcomes scales in other pediatric populations.

  7. Persistent pulmonary abnormalities in newborns: The changing picture of bronchopulmonary dysplasia

    International Nuclear Information System (INIS)

    Significant changes in the radiographic features of bronchopulmonary dysplasia (BPD) have accompanied recent advances in treatment of neonatal respiratory distress syndrome. Retrospective study of 709 newborns showed atypical radiographic findings in many patients with clinical BPD. While 12/20 infants with clinical BPD showed changes identical to Northway's stage 4 disease, the remaining 8 (40% of patients with significant respiratory dysfunction) had diffuse, fine infiltrates without emphysema. Radiographic progression from RDS through all Northway stages was observed in only 4 patients. Diagnosis of stage 2 BPD was complicated by the presence of PDA in 9/17 cases. Stage 3 BPD was identified with certainty in only 5 infants, but may have coexisted with PIE in as many as 22 cases. Nevertheless, there was close agreement between the radiographic findings and clinical severity of chronic lung disease. Mild (type 1) infiltrates following RDS may be distinguished from chronic pulmonary insufficiency of prematurity (CPIP) or ''immature lung''. In patients who require only short-term supplemental 02, type 1 changes may reflect delayed resolution of RDS in an undeveloped lung. These same findings in infants with prolonged 02 dependence usually indicate a mild form of BPD. Coarse infiltrates and emphysema (type 2) are almost always associated with severe respiratory impairment. (orig.)

  8. Ultrafast CT scoring system for assessing bronchopulmonary dysplasia. Reproducibility and clinical correlation

    International Nuclear Information System (INIS)

    To evaluate the reproducibility of the Ultrafast CT (UFCT) scoring system and assess its usefulness in monitoring clinical severity in infants with bronchopulmonary dysplasia (BPD). UFCT scoring was done in 22 infants (15 boys and 7 girls aged 1 to 37 months) with BPD. A total of 258 lung fields were evaluated for the presence of hyperaeration, linear opacities, triangular subpleural opacities, and bronchovascular bundle distortion or thickening, and UFCT scores were given. Intraobserver and interobserver agreement and reproducibility of UFCT scores were statistically analyzed. In 12 patients, UFCT scores were linearly correlated with clinical severity scores based on respiratory dysfunction and complexity of care. 'Hyperaeration,' which was the most frequent (18 of 22, 81.8%) finding, showed high concordance (κ=0.73, p<0.001, κ=0.59, p<0.001), and its UFCT scores significantly correlated with intraobserver and interobserver analyses (r=0.94, p<0.001, r=0.82, p<0.001, respectively). UFCT scores for hyperaeration significantly correlated with clinical scores (r=0.75, p<0.01), whereas those for the others did not. UFCT is useful for assessing BPD. Hyperaeration was the most common and reproducible finding, and its extent significantly correlated with clinical severity. (author)

  9. A Relationship between Epithelial Maturation, Bronchopulmonary Dysplasia, and Chronic Obstructive Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Abraham B. Roos

    2012-01-01

    Full Text Available Premature infants frequently develop bronchopulmonary dysplasia (BPD. Lung immaturity and impaired epithelial differentiation contribute together with invasive oxygen treatment to BPD onset and disease progression. Substantial evidence suggests that prematurity is associated with long term pulmonary consequences. Moreover, there is increasing concern that lung immaturity at birth may increase the risk of developing chronic obstructive pulmonary disease (COPD. The mechanisms contributing to this phenomenon remains unknown, largely as a consequence of inadequate experimental models and clinical follow-up studies. Recent evidence suggests that defective transcriptional regulation of epithelial differentiation and maturation may contribute to BPD pathogenesis as well as early onset of COPD. The transcriptional regulators CCAAT/enhancer-binding protein (C/EBPα and C/EBPβ, SMAD family member (Smad3, GATA binding protein (GATA6, and NK2 homeobox (NKX2-1 are reported to be involved in processes contributing to pathogenesis of both BPD and COPD. Increased knowledge of the mechanisms contributing to early onset COPD among BPD survivors could translate into improved treatment strategies and reduced frequency of respiratory disorders among adult survivors of BPD. In this paper, we introduce critical transcriptional regulators in epithelial differentiation and summarize the current knowledge on the contribution of impaired epithelial maturation to the pathogenesis of inflammatory lung disorders.

  10. Liposomal amphotericin B (AmBisome) reduces dissemination of infection as compared with amphotericin B deoxycholate (Fungizone) in a rate model of pulmonary aspergillosis

    NARCIS (Netherlands)

    A.C.A.P. Leenders (Alexander); S. de Marie (Siem); M.T. ten Kate (Marian); I.A.J.M. Bakker-Woudenberg (Irma); H.A. Verbrugh (Henri)

    1996-01-01

    textabstractThe efficacy of AmBisome, a liposomal formulation of amphotericin B, was compared with that of Fungizone (amphotericin B desoxycholate), in a rat model of unilateral, pulmonary aspergillosis. Repeated administration of cyclophosphamide resulted in persistent

  11. Bronchial stump aspergillosis after lobectomy for lung cancer as an unusual cause of false positive fluorodeoxyglucose positron emission tomography and computed tomography: a case report

    Directory of Open Access Journals (Sweden)

    Font Albert

    2011-02-01

    Full Text Available Abstract Introduction Bronchial stump aspergillosis is a rare entity characterized by cough and hemoptysis. Case presentation We report the case of a 58-year-old Caucasian woman who developed bronchial stump aspergillosis two years after a left upper lobe resection for lung cancer. Bronchial stump aspergillosis was diagnosed as a result of a focus of increased fluorodeoxyglucose activity in a follow-up positron emission tomography and computed tomography scan. She was treated with oral antifungal therapy and presented with good evolution after three months of treatment. Conclusion Bronchial stump aspergillosis is an unusual complication after pulmonary resection. Clinicians should be aware of it when a local recurrence of cancer around the bronchial stump is suspected based on a positive positron emission tomography and computed tomography finding.

  12. Prevention of allergic disease in childhood

    DEFF Research Database (Denmark)

    Halken, Susanne

    2004-01-01

    The development and phenotypic expression of atopic diseases depends on a complex interaction between genetic factors, environmental exposure to allergens,and non-specific adjuvant factors, such as tobacco smoke, air pollution and infections. Preventive measures may include both exposure...... for this review was to evaluate possible preventive measures as regards prevention of development of allergic disease in childhood--primary prevention--and also some aspects of the effect of specific allergy treatment as regards secondary prevention in children with allergic asthma and allergic...... manifestations e.g. CMA and atopic dermatitis can be reduced significantly by simple dietary measures for the first4 months of life. In all infants breastfeeding should beencouraged for at least 4-6 months, and exposure to tobacco smoke should be avoided during pregnancy and early childhood. In HR infants...

  13. Contact-Allergic Reactions to Cosmetics

    Directory of Open Access Journals (Sweden)

    An Goossens

    2011-01-01

    Full Text Available Contact-allergic reactions to cosmetics may be delayed-type reactions such as allergic and photo-allergic contact dermatitis, and more exceptionally also immediate-type reactions, that is, contact urticaria. Fragrances and preservative agents are the most important contact allergens, but reactions also occur to category-specific products such as hair dyes and other hair-care products, nail cosmetics, sunscreens, as well as to antioxidants, vehicles, emulsifiers, and, in fact, any possible cosmetic ingredient. Patch and prick testing to detect the respective culprits remains the golden standard for diagnosis, although additional tests might be useful as well. Once the specific allergens are identified, the patients should be informed of which products can be safely used in the future.

  14. Role of platelets in allergic airway inflammation.

    Science.gov (United States)

    Idzko, Marco; Pitchford, Simon; Page, Clive

    2015-06-01

    Increasing evidence suggests an important role for platelets and their products (e.g., platelet factor 4, β-thromboglobulin, RANTES, thromboxane, or serotonin) in the pathogenesis of allergic diseases. A variety of changes in platelet function have been observed in patients with asthma, such as alterations in platelet secretion, expression of surface molecules, aggregation, and adhesion. Moreover, platelets have been found to actively contribute to most of the characteristic features of asthma, including bronchial hyperresponsiveness, bronchoconstriction, airway inflammation, and airway remodeling. This review brings together the current available data from both experimental and clinical studies that have investigated the role of platelets in allergic airway inflammation and asthma. It is anticipated that a better understanding of the role of platelets in the pathogenesis of asthma might lead to novel promising therapeutic approaches in the treatment of allergic airway diseases. PMID:26051948

  15. Heart Rate Variability Analysis in Patients with Allergic Rhinitis

    OpenAIRE

    Ming-Ying Lan; Guo-She Lee; An-Suey Shiao; Jen-Hung Ko; Chih-Hung Shu

    2013-01-01

    Background. Very few studies investigate the role of the autonomic nervous system in allergic rhinitis. In this study, we evaluated the autonomic nervous system in allergic rhinitis patients using heart rate variability (HRV) analysis. Methods. Eleven patients with allergic rhinitis and 13 healthy controls, aged between 19 and 40 years old, were enrolled in the study. Diagnosis of allergic rhinitis was based on clinical history, symptoms, and positive Phadiatop test. Electrocardiographic reco...

  16. Alternaria in Patients with Allergic Rhinitis

    Directory of Open Access Journals (Sweden)

    Monireh Mokhtari Amirmajdi

    2011-09-01

    Full Text Available Inhalation of fungal spores is shown to participate in the development of allergic rhinitis symptoms. In this study, relation between presence of Alternaria in the human nasal cavity and allergic rhinitis is assessed.In a case-control study, 58 allergic rhinitis patients were compared with a well-matched control group of fifty healthy volunteers for sensitization to Alternaria (by skin prick test and detection of Alternaria in their nasal mucous by conventional methods (microscopy with Methylene Blue stain and culture in Sabourad dextrose agar. Severity of the disease was determined according to  the ARIA classification. Pearson chi-square test was applied to compare the proportional difference between the study groups for detection of Alternaria in the nasal cavity, and sensitization to Alternaria.Relation between detection of Alternaria and allergic rhinitis was significant [OR = 18.18 (4.02-82.50] In addition, sensitization to Alternaria showed a significant relation with the disease [OR  =  2.8 (2.1-3.8]. There  was a significant relation between the  presence  of Alternaria in the nasal cavity and sensitization to Alternaria [OR =  10.4 (3.8-28.3]. Both sensitization to  Alternaria and presence of Alternaria in the nasal cavity did not  have a significant relation with the severity of allergic rhinitis. This study suggests Alternaria as a major  allergen that  its  presence  in  the  nasal  cavity and  subsequent  development  of sensitization have significant role in the induction of allergic rhinitis.

  17. Successful Off-Label Use of Recombinant Factor VIIa and Coil Embolization in an Adolescent with Massive Hemoptysis Due to Invasive Pulmonary Aspergillosis

    Directory of Open Access Journals (Sweden)

    Dilek Gürlek Gökçebay

    2015-03-01

    Full Text Available Invasive fungal infections have turned out to be a significant cause of morbidity and mortality in pediatric patients with malignant disorders. Massive hemoptysis, a rare complication of invasive pulmonary aspergillosis, may threaten the lives of patients, usually during the resolution of neutropenia. In this report, we describe a patient with massive hemoptysis due to invasive pulmonary aspergillosis whose bleeding was controlled successfully with off-label use of recombinant factor VIIa and subsequent coil embolization of the right pulmonary artery.

  18. New aspects in allergic contact dermatitis

    DEFF Research Database (Denmark)

    Mørtz, Charlotte G; Andersen, Klaus Ejner

    2008-01-01

    PURPOSE OF REVIEW: To give selected new information on contact allergy and allergic contact dermatitis with focus on diagnostic procedures and pitfalls. RECENT FINDINGS: Recent studies dealing with common contact allergens have improved our understanding of the relationship between positive patch...... tests and the clinical interpretation and consequences for the patient. SUMMARY: Nickel allergy is still the most common contact allergy in Europe in spite of full implementation of the EU Nickel Directive in 2001. Contact allergens in cosmetics and topical drugs are another common cause of allergic...

  19. Allergic Reactions to Pine Nut: A Review.

    Science.gov (United States)

    Cabanillas, B; Novak, N

    2015-01-01

    Pine nut is a nutrient-rich food with a beneficial impact on human health. The many bioactive constituents of pine nut interact synergistically to affect human physiology in a favorable way. However, pine nut can trigger dangerous allergic reactions. Severe anaphylactic reactions to pine nut accounted for most of the 45 cases reported in the scientific literature. Pine nut allergy seems to be characterized by low IgE cross-reactivity with other commonly consumed nuts and a high monosensitization rate. The present review provides updated information on allergic reactions to pine nut, molecular characterization of its allergens, and potential homologies with other nut allergens.

  20. Aspergilosis: una patología a considerar Aspergillosis: a phatology to be considered

    Directory of Open Access Journals (Sweden)

    Héctor Guillermo Oxilia

    2008-03-01

    Full Text Available La aspergilosis pulmonar es una infección micótica causada por el Aspergillus fumigatus, saprófito del esputo humano normal. Se estudiaron cinco casos de pacientes con aspergilosis, cuatro de ellos adultos, tres del sexo femenino y uno masculino, todos de presentación no invasiva, y uno, pediátrico, sexo masculino, del tipo invasiva. Fueron estudiados con radiología convencional, tomografía computada (TC helicoidal, TC multislice y video cápsula endoscópica. Afecta 3:1 a los hombres en relación con las mujeres. Hay tres formas de presentación: a invasiva: en los pacientes neutropénicos, donde predomina la afectación pulmonar, con diseminación a cerebro, corazón, riñón, tracto gastrointestinal, hígado, tiroides y bazo; tiene mal pronóstico y la mortalidad es muy elevada; b semiinvasiva: compromete fundamentalmente a pacientes con patología pulmonar preexistente; c no invasiva: afecta cavidades preexistentes, cavernas TBC ( tuberculosis o quistes, donde coloniza el hongo, y se denomina aspergiloma o micetoma.Pulmonary aspergillosis is a mycotic infection caused by the Aspergillus fumigatus, saprophyte of the normal human sputum. Five patients with non invasive aspergillosis were studied, of whom 4 were adults (3 women, 1 man and one, pediatric, with invasive aspergillosis. All of them were studied by conventional X-ray, spiral CT, multislice CT and video capsule endoscopy. The presentation is predominant among men (3 to 1. There are three forms of presentation: a invasive: in neutropenic patients it prevails the lung affectation; the brain, heart, kidney gastrointestinal tract, liver, thyroid and spleen spreading has a bad prognosis and mortality rate is very high; b semiinvasive: it mainly compromises patients with pre-existing pulmonary pathology; c non invasive: affects pre-existing cavities, TBC caverns or cysts where the fungus establishes; it is called aspergilloma or mycetoma.

  1. DOSE-DEPENDENT ALLERGIC ASTHMA RESPONSES TO PENICILLIUM CHRYSOGENUM

    Science.gov (United States)

    ABSTRACT Indoor mold has been associated with development of allergic asthma. Penicillium chrysogenum, a common indoor mold, is known to have several allergens and its viable conidia can induce allergic responses in a mouse model of allergic penicilliosis. The hypothesis o...

  2. 553 Correlation between Severity of Allergic Rhinitis and Impairment of Quality of Life in Allergic Adolescents

    OpenAIRE

    Infante, Eric Martinez

    2012-01-01

    Background Determine severity of the disease and its correlation with the degree of impairment in quality of life in adolescent patients with allergic rhinitis. Methods Were captured 124 adolescents aged 10 to 17 years, attending the outpatient Allergy Service at Social Security Hospital in Mexico, diagnosed with Allergic Rhinitis (AR). Before the clinical evaluation to confirm the diagnosis, severity of Allergic Rhinitis were classified according to criteria of Allergic Rhinitis and its Impa...

  3. Cytokine serum profiles in allergic and non-allergic asthma. Increased production of IL-10 by non-allergic asthmatic patients.

    Science.gov (United States)

    Sánchez-Guerrero, I; Vegara, R P; Herrero, N; García-Alonso, A M; Luna, A; Alvarez, M R

    1997-01-01

    Studies were undertaken to determine whether differences in serum cytokine balances could be involved in the pathogenesis of allergic and in non-allergic asthma. At this propose, interferon-gamma, tumor necrosis factor-alpha, interleukin-2, interleukin-4, interleukin-6, and interleukin-10 were measured by enzimoimmunoassay. The analysis was performed on 24 allergic and 24 non-allergic asthmatic patients and 16 healthy subjects. IFN-gamma and TNF-alpha, included into the type 1 cytokines, appeared significantly increased in the allergic with respect to the non-allergic asthmatic patients (p = 0.01) and (p < 0.001) respectively, while IL-10, which belongs to the type 2 cytokines, was significantly increased in the non-allergic asthmatic (p < 0.001). The IL-6 analysis did not show any significant difference in either of the study group. The most interesting finding was the high serum IL-10 values detected in intrinsic asthmatic patients, which in turn, suggests that this cytokine could participate in the regulation of different immunological features that occurs in non-allergic asthma, and maybe it could indicate a higher stimulated state of cells in this type of asthma. The data presented in this report show a different cytokine profile in serum from allergic and non-allergic asthmatic patients and denote a stronger prevalence of type 2 cytokines in intrinsic asthma.

  4. Case Report Associated with Aspergillosis and Hepatitis E Virus Coinfection in Himalayan Griffons

    Directory of Open Access Journals (Sweden)

    Heng Li

    2015-01-01

    Full Text Available This study involved a death which occurred in four Himalayan griffons housed in Beijing zoo, China. Based on pathogen identification and the pathological changes observed, we did characterize the fungi and Hepatitis E virus (HEV in four dead Himalayan griffons. Pathological changes were severe. Membranous-like material was observed on the surface of the internal organs. Spleen was necrotic. Focal lymphocyte infiltration in the liver and many sunflower-like fungi nodules were evident in the tissues, especially in the kidney. PCR was used to identify the pathogen. Based on the 18SrRNA genomic sequence of known fungi, the results confirmed that all four dead Himalayan griffons were infected with Aspergillus. At the same time the detection of HEV also showed positive results. To the best of our knowledge, this work appears to be the first report of concurrent presence of Aspergillosis and Hepatitis E virus in rare avian species.

  5. Aspergillosis in a Patient Receiving Temozolomide for the Treatment of Glioblastoma

    Directory of Open Access Journals (Sweden)

    Rodrigo Ramella Munhoz

    2013-08-01

    Full Text Available Leukopenia and selective CD4+ lymphopenia represent major adverse events associated with the use of temozolomide (TMZ, an oral alkylating agent incorporated in the treatment of glioblastoma (GBM. The increased risk of opportunistic infections, including those caused by Pneumocystis jiroveci and cytomegalovirus, has been previously described in the literature. Here we report the case, the first to our knowledge, of a patient with pulmonary invasive aspergillosis immediately after the completion of chemoradiation with TMZ for GBM. Diagnosis was confirmed through a CT-guided lung biopsy, and the patient had excellent response to systemic voriconazole. This case illustrates that TMZ can be associated with severe opportunistic infections, presumably associated with T lymphocyte immune dysfunction, and patients exposed to this agent should be carefully monitored.

  6. Invasive pulmonary aspergillosis in acute leukemia: Contribution of CT to early diagnosis and aggressive management

    International Nuclear Information System (INIS)

    More than 80% of patients with invasive pulmonary aspergillosis (IPA) who received antileukemic chemotherapy survived the infection as a result of early diagnosis and aggressive therapy. CT helped to establish the early diagnosis of IPA in these patients. Since first describing the CT findings of IPA, the authors have added ten new cases, each subsequently confirmed. The CT ''halo sign,'' a zone of lower attenuation surrounding a pulmonary mass, was seen in eight of nine patients on early scans obtained during aplasia. A characteristic progression from multiple fluffy masses to cavitation suggested IPA in five of seven patients. CT findings affected patient management in seven of ten patients and were one criterion for increasing antifungal therapy. The CT appearance of healing IPA resembled that of resolving pulmonary infarcts, and was used to monitor disease activity in the long term

  7. Successful pneumonectomy for invasive pulmonary aspergillosis and advanced non-small cell-lung cancer.

    Science.gov (United States)

    Minesaki, Shohei; Koyama, Nobuyuki; Ishida, Hironori; Kobayashi, Kunihiko

    2013-01-01

    Aspergillus spp. is a pathogenic fungus in patients with malignancy, immunosuppression or respiratory diseases, and invasive pulmonary aspergillosis (IPA) caused by its infection is an aggressive and often lethal disorder. We report a case of non-small-cell lung cancer (NSCLC) where pneumonectomy concomitantly enabled radical cure of the underlying disease and IPA against which different antifungal drugs had been ineffective. In a patient with locally advanced NSCLC that progressed despite chemoradiation, radiation pneumonitis and subsequently cavitary disease developed following the administration of corticosteroids. Based upon the isolation of Aspergillus spp. from sputum, a diagnosis of IPA was made and since the latter was refractory to multiple antifungal drugs, pneumonectomy was undertaken which resulted in successful treatment of both NSCLC and IPA. Surgical intervention should be considered as a therapeutic option for IPA complicating NSCLC that is refractory to medical management. PMID:23505081

  8. Invasive Pulmonary Aspergillosis in a Sickle Cell Patient Transplant Recipient: A Successful Treatment

    Directory of Open Access Journals (Sweden)

    Katia Paciaroni

    2015-08-01

    Full Text Available Sickle Cell Anaemia (SCA is the most common inherited blood disorder and is associated with severe morbidity and decreased survival. Allogeneic Haematopoietic Stem Cell Transplantation (HSCT is the only curative approach. Nevertheless the decision to perform a marrow transplant includes the risk of major complications  and mortality transplant related. The infections represent the main cause of mortality for SCA patients undergoing transplant. Invasive Pulmonary Aspergillosis (IPA is a devastating opportunistic infection and remains a significant cause of morbidity and mortality in HSCT recipients. Data regarding IPA in the setting of SCA are lacking. In the present report,  we describe a patient with SCA who developed IPA after allogeneic bone marrow transplant. The fungal infection was treated by systemic antifungal therapy in addition to the surgery, despite  mild chronic GVHD and with continuing immunosuppression therapy. This case shows that IPA occurring in bone marrow recipient with SCA can be successful treated

  9. Complete heart block in a neutropenic patient with aspergillosis: An unusual adverse effect of caspofungins

    Directory of Open Access Journals (Sweden)

    Sasmita Biswal

    2012-01-01

    Full Text Available We present a case of complete heart block (CHB in a 58-year-old female patient with acute myeloid leukemia (AML with no past history of cardiac disease, who received caspofungin in the treatment of disseminated fungal infection. To our knowledge, this is the first case of CHB associated with caspofungins. Subsequent to induction chemotherapy the patient developed invasive pulmonary aspergillosis with sudden tachypnea, dyspnoea, fever, bilateral pulmonary infiltrates and acute respiratory insufficiency consequent to neutropenia with ANC<500. During the first dose of antifungal therapy with caspofungins, she developed complete atrioventricular block and cardiac arrest. Complete heart block is an unusual adverse effect of caspofungins which has not been reported previously. Caspofungins release histamine in peripheral blood cells, so possible histamine-mediated symptoms ranging from severe fatal anaphylaxis can occur. These data suggest that infusion-related reactions associated with caspofungin may be mediated by histamine release secondary to caspofungin therapy.

  10. Five-years surveillance of invasive aspergillosis in a university hospital

    Directory of Open Access Journals (Sweden)

    Gastmeier Petra

    2011-06-01

    Full Text Available Abstract Background As the most common invasive fungal infection, invasive aspergillosis (IA remains a serious complication in immunocompromised patients, leading to increased mortality. Antifungal therapy is expensive and may result in severe adverse effects. The aim of this study was to determine the incidence of invasive aspergillosis (IA cases in a tertiary care university hospital using a standardized surveillance method. Methods All inpatients at our facility were screened for presence of the following parameters: positive microbiological culture, pathologist's diagnosis and antifungal treatment as reported by the hospital pharmacy. Patients fulfilling one or more of these indicators were further reviewed and, if appropriate, classified according to international consensus criteria (EORTC. Results 704 patients were positive for at least one of the indicators mentioned above. Applying the EORTC criteria, 214 IA cases were detected, of which 56 were proven, 25 probable and 133 possible. 44 of the 81 (54% proven and probable cases were considered health-care associated. 37 of the proven/probable IA cases had received solid organ transplantation, an additional 8 had undergone stem cell transplantation, and 10 patients were suffering from some type of malignancy. All the other patients in this group were also suffering from severe organic diseases, required long treatment and experienced several clinical complications. 7 of the 56 proven cases would have been missed without autopsy. After the antimycotic prophylaxis regimen was altered, we noticed a significant decrease (p = 0.0004 of IA during the investigation period (2003-2007. Conclusion Solid organ and stem cell transplantation remain important risk factors for IA, but several other types of immunosuppression should also be kept in mind. Clinical diagnosis of IA may be difficult (in this study 13% of all proven cases were diagnosed by autopsy only. Thus, we confirm the importance of IA

  11. Nasal and bronchial airway reactivity in allergic and non allergic airway inflammation

    OpenAIRE

    Kölbeck, Karl-Gustav

    2003-01-01

    In allergic or asthmatic airways disease, upper and lower airways show a uniform eosinophilic inflammation of the mucosa, and bronchial hyperreactivity is a common finding. To study the co- variation of mucosal reactivity in upper and lower airways, histamine challenges of both sites were performed in a group of patients with allergic rhinitis during non-season. Upper airways were monitored during challenge by the use of rhinostereometry, an optical technique that non-invasi...

  12. Retrospective assessment of seasonal allergic symptoms

    DEFF Research Database (Denmark)

    Bodtger, U; Poulsen, Lars K.; Malling, H-J

    2003-01-01

    The history of the severity of seasonal allergic symptoms is often obtained post-seasonally as a retrospective assessment. Correct rating is essential when determining the efficacy of pharmaceutical treatment, indications for allergen-specific immunotherapy (SIT), or inclusion into controlled...

  13. Silibinin attenuates allergic airway inflammation in mice

    International Nuclear Information System (INIS)

    Highlights: ► Silibinin diminishes ovalbumin-induced inflammatory reactions in the mouse lung. ► Silibinin reduces the levels of various cytokines into the lung of allergic mice. ► Silibinin prevents the development of airway hyperresponsiveness in allergic mice. ► Silibinin suppresses NF-κB transcriptional activity. -- Abstract: Allergic asthma is a chronic inflammatory disease regulated by coordination of T-helper2 (Th2) type cytokines and inflammatory signal molecules. Silibinin is one of the main flavonoids produced by milk thistle, which is reported to inhibit the inflammatory response by suppressing the nuclear factor-kappa B (NF-κB) pathway. Because NF-κB activation plays a pivotal role in the pathogenesis of allergic inflammation, we have investigated the effect of silibinin on a mouse ovalbumin (OVA)-induced asthma model. Airway hyperresponsiveness, cytokines levels, and eosinophilic infiltration were analyzed in bronchoalveolar lavage fluid and lung tissue. Pretreatment of silibinin significantly inhibited airway inflammatory cell recruitment and peribronchiolar inflammation and reduced the production of various cytokines in bronchoalveolar fluid. In addition, silibinin prevented the development of airway hyperresponsiveness and attenuated the OVA challenge-induced NF-κB activation. These findings indicate that silibinin protects against OVA-induced airway inflammation, at least in part via downregulation of NF-κB activity. Our data support the utility of silibinin as a potential medicine for the treatment of asthma.

  14. Eosinophil: central mediator of allergic asthma?

    Institute of Scientific and Technical Information of China (English)

    SHEN Hua-hao

    2005-01-01

    @@ Allergic asthma is a chronic disorder characterized by chronic airway inflammation, airway hyperresponsiveness, reversible airway obstruction, airway remodelling and mucus hypersecretion. It has been widely recognized that the infiltration of the lung with increased number of eosinophils is a hallmark of this disease.1

  15. Steroids vs immunotherapy for allergic rhinitis

    DEFF Research Database (Denmark)

    Aasbjerg, Kristian; Backer, Vibeke

    2014-01-01

    Treatment for seasonal allergic rhinitis induced by airborne allergens can be divided into two major groups: symptom-dampening drugs, such as antihistamines and corticosteroids, and disease-modifying drugs in the form of immunotherapy. It has been speculated that depot-injection corticosteroids g...

  16. Silibinin attenuates allergic airway inflammation in mice

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Yun Ho [Department of Anatomy, Medical School, Institute for Medical Sciences, Chonbuk National University, Jeonju, Jeonbuk 561-756 (Korea, Republic of); Jin, Guang Yu [Department of Radiology, Yanbian University Hospital, YanJi 133002 (China); Guo, Hui Shu [Centralab, The First Affiliated Hospital of Dalian Medical University, Dalian 116011 (China); Piao, Hong Mei [Department of Respiratory Medicine, Yanbian University Hospital, YanJi 133000 (China); Li, Liang chang; Li, Guang Zhao [Department of Anatomy and Histology and Embryology, Yanbian University School of Basic Medical Sciences, 977 Gongyuan Road, YanJi 133002, Jilin (China); Lin, Zhen Hua [Department of Pathology, Yanbian University School of Basic Medical Sciences, YanJi 133000 (China); Yan, Guang Hai, E-mail: ghyan@ybu.edu.cn [Department of Anatomy and Histology and Embryology, Yanbian University School of Basic Medical Sciences, 977 Gongyuan Road, YanJi 133002, Jilin (China)

    2012-10-26

    Highlights: Black-Right-Pointing-Pointer Silibinin diminishes ovalbumin-induced inflammatory reactions in the mouse lung. Black-Right-Pointing-Pointer Silibinin reduces the levels of various cytokines into the lung of allergic mice. Black-Right-Pointing-Pointer Silibinin prevents the development of airway hyperresponsiveness in allergic mice. Black-Right-Pointing-Pointer Silibinin suppresses NF-{kappa}B transcriptional activity. -- Abstract: Allergic asthma is a chronic inflammatory disease regulated by coordination of T-helper2 (Th2) type cytokines and inflammatory signal molecules. Silibinin is one of the main flavonoids produced by milk thistle, which is reported to inhibit the inflammatory response by suppressing the nuclear factor-kappa B (NF-{kappa}B) pathway. Because NF-{kappa}B activation plays a pivotal role in the pathogenesis of allergic inflammation, we have investigated the effect of silibinin on a mouse ovalbumin (OVA)-induced asthma model. Airway hyperresponsiveness, cytokines levels, and eosinophilic infiltration were analyzed in bronchoalveolar lavage fluid and lung tissue. Pretreatment of silibinin significantly inhibited airway inflammatory cell recruitment and peribronchiolar inflammation and reduced the production of various cytokines in bronchoalveolar fluid. In addition, silibinin prevented the development of airway hyperresponsiveness and attenuated the OVA challenge-induced NF-{kappa}B activation. These findings indicate that silibinin protects against OVA-induced airway inflammation, at least in part via downregulation of NF-{kappa}B activity. Our data support the utility of silibinin as a potential medicine for the treatment of asthma.

  17. Treatment of allergic rhinitis during pregnancy.

    Science.gov (United States)

    Demoly, Pascal; Piette, Vincent; Daures, Jean-Pierre

    2003-01-01

    Allergic rhinitis is a frequent problem during pregnancy. In addition, physiological changes associated with pregnancy can affect the upper airways. Evidence-based guidelines on the management of allergic rhinitis have recently been published, the most recent being the Allergic Rhinitis and its Impact on Asthma (ARIA)--World Health Organization consensus. Many pregnant women experience allergic rhinitis and particular attention is required when prescribing drugs to these patients. Medication can be prescribed during pregnancy when the apparent benefit of the drug is greater than the apparent risk. Usually, there is at least one drug from each major class that can be safely utilised to control symptoms. All glucocorticosteroids are teratogenic in animals but, when the indication is clear (for diseases possibly associated, such as severe asthma exacerbation), the benefit of the drug is far greater than the risk. Inhaled glucocorticosteroids (e.g. beclomethasone or budesonide) have not been incriminated as teratogens in humans and are used by pregnant women who have asthma. A few histamine H(1)-receptor antagonists (H(1)-antihistamines) can safely be used as well. Most oral decongestants (except pseudoephedrine) are teratogenic in animals. There are no such data available for intra-nasal decongestants. Finally, pregnancy is not considered as a contraindication for the continuation of allergen specific immunotherapy.

  18. Occupational issues of allergic contact dermatitis

    DEFF Research Database (Denmark)

    Andersen, Klaus E

    2003-01-01

    -effect relationships to be established with increased certainty. For prevention of allergic contact dermatitis it was a major step forward, with mandatory ingredient labelling of cosmetic products. However, improved labelling of the presence of contact allergens in household and industrial products is needed...

  19. Novel delivery systems for anti-allergic agents: allergic disease and innovative treatments.

    Science.gov (United States)

    Lopes, Carla M; Coelho, Pedro B; Oliveira, Rita

    2015-01-01

    Anti-allergic agents are used to treat a great variety of diseases which usually involve an inflammation reaction. These compounds act by inhibiting the release and the effects of inflammatory mediators (e.g. histamine) in the target tissue. The purpose of anti-allergy therapy is to deliver the drug to its local of action in a therapeutic concentration, minimizing the undesired side effects. In order to solve some of the anti-allergic agents' physicochemical drawbacks and the limitations associated to conventional pharmaceutical formulations (e.g. poor solubility and absorption, skin permeation, stability), novel drug delivery systems, such as cyclodextrins, liposomes, micelles, microemulsions, nano and microparticles, have been developed. Depending on the allergic condition, several administration routes are used to deliver anti-allergic agents, each with its own disadvantages to overcome. In the literature, there are a vast number of papers concerning novel delivery systems for anti-allergic agents, making it difficult to evaluate the information and the promising outcomes. The aim of the present review article is to compile the recent (i.e. in the new millennium) improvements of novel drug delivery technology focusing on the achievement of anti-allergic therapeutic delivery. The potential intrinsic benefits of these systems will reflect an increased therapeutic adherence and better patients' life quality. A critical prospect of future clinical trial directions will also be discussed. PMID:25895551

  20. A Comparison of KL-6 and Clara Cell Protein as Markers for Predicting Bronchopulmonary Dysplasia in Preterm Infants

    OpenAIRE

    Keyi Wang; Xianmei Huang; Hui Lu; Zhiqun Zhang

    2014-01-01

    Objectives. To evaluate the predictive characteristics of KL-6 and CC16 for bronchopulmonary dysplasia (BPD) in preterm infants, either independently or in combination. Study Design. This prospective cohort study was performed from 2011 to 2013 with preterm neonates of gestational age ≤32 weeks and birth weight ≤1500 g. Serum KL-6 and CC16 levels were determined 7 and 14 days after birth. Results. Seventy-three preterm infants were studied. BPD was identified in 24 of these infants. After adj...

  1. Excessive gas exchange impairment during exercise in a subject with a history of bronchopulmonary dysplasia and high altitude pulmonary edema

    OpenAIRE

    Lovering, AT; Romer, LM; Haverkamp, HC; Hokanson, JS.; Eldridge, MW

    2007-01-01

    A 27-year-old male subject (V(O2 max)), 92% predicted) with a history of bronchopulmonary dysplasia (BPD) and a clinically documented case of high altitude pulmonary edema (HAPE) was examined at rest and during exercise. Pulmonary function testing revealed a normal forced vital capacity (FVC, 98.1% predicted) and diffusion capacity for carbon monoxide (D(L(CO)), 91.2% predicted), but significant airway obstruction at rest [forced expiratory volume in 1 sec (FEV(1)), 66.5% predicted; forced ex...

  2. Deregulation of the lysyl hydroxylase matrix cross-linking system in experimental and clinical bronchopulmonary dysplasia.

    Science.gov (United States)

    Witsch, Thilo J; Turowski, Pawel; Sakkas, Elpidoforos; Niess, Gero; Becker, Simone; Herold, Susanne; Mayer, Konstantin; Vadász, István; Roberts, Jesse D; Seeger, Werner; Morty, Rory E

    2014-02-01

    Bronchopulmonary dysplasia (BPD) is a common and serious complication of premature birth, characterized by a pronounced arrest of alveolar development. The underlying pathophysiological mechanisms are poorly understood although perturbations to the maturation and remodeling of the extracellular matrix (ECM) are emerging as candidate disease pathomechanisms. In this study, the expression and regulation of three members of the lysyl hydroxylase family of ECM remodeling enzymes (Plod1, Plod2, and Plod3) in clinical BPD, as well as in an experimental animal model of BPD, were addressed. All three enzymes were localized to the septal walls in developing mouse lungs, with Plod1 also expressed in the vessel walls of the developing lung and Plod3 expressed uniquely at the base of developing septa. The expression of plod1, plod2, and plod3 was upregulated in the lungs of mouse pups exposed to 85% O2, an experimental animal model of BPD. Transforming growth factor (TGF)-β increased plod2 mRNA levels and activated the plod2 promoter in vitro in lung epithelial cells and in lung fibroblasts. Using in vivo neutralization of TGF-β signaling in the experimental animal model of BPD, TGF-β was identified as the regulator of aberrant plod2 expression. PLOD2 mRNA expression was also elevated in human neonates who died with BPD or at risk for BPD, compared with neonates matched for gestational age at birth or chronological age at death. These data point to potential roles for lysyl hydroxylases in normal lung development, as well as in perturbed late lung development associated with BPD. PMID:24285264

  3. MicroRNA in late lung development and bronchopulmonary dysplasia: the need to demonstrate causality.

    Science.gov (United States)

    Nardiello, Claudio; Morty, Rory E

    2016-12-01

    MicroRNA are emerging as powerful regulators of cell differentiation and tissue and organ development. Several microRNA have been described to play a role in branching morphogenesis, a key step in early lung development. However, considerably less attention has been paid to microRNA as regulators of the process of secondary septation, which drives lung alveolarization during late lung development. Secondary septation is severely perturbed in bronchopulmonary dysplasia (BPD), a common complication of preterm birth characterized by blunted alveolarization. A number of studies to date have reported microRNA microarray screens in animal models of BPD; however, only two studies have attempted to demonstrate causality. Although the expression of miR-150 was altered in experimental BPD, a miR-150(-/-) knockout mouse did not exhibit appreciable protection in a BPD animal model. Similarly, while the expression of miR-489 in the lung was reduced in clinical and experimental BPD, antagomiR and over-expression approaches could not validate a role for miR-489 in the impaired alveolarization associated with experimental BPD. This mini-review aims to highlight microRNA that have been revealed by multiple microarray studies to be potential causal players in normal and pathological alveolarization. Additionally, the challenges faced in attempting to demonstrate a causal role for microRNA in lung alveolarization are discussed. These include the tremendous variability in the animal models employed, and the limitations and advantages offered by the available tools, including antagomiRs and approaches for the validation of a specific microRNA-mRNA interaction during lung alveolarization. PMID:27216745

  4. Protective effects of BMSCs in combination with erythropoietin in bronchopulmonary dysplasia-induced lung injury.

    Science.gov (United States)

    Zhang, Zhao-Hua; Pan, Yan-Yan; Jing, Rui-Sheng; Luan, Yun; Zhang, Luan; Sun, Chao; Kong, Feng; Li, Kai-Lin; Wang, Yi-Biao

    2016-08-01

    Bronchopulmonary dysplasia (BPD) is the most common type of chronic lung disease in infancy, for which no effective therapy is currently available. The aim of the present study was to investigate the effect of treatment with bone marrow mesenchymal stem cells (BMSCs) in combination with recombinant human erythropoietin (rHuEPO) on BPD‑induced mouse lung injury, and discuss the underlying mechanism. The BPD model was established by the exposure of neonatal mice to continuous high oxygen exposure for 14 days, following which 1x106 BMSCs and 5,000 U/kg rHuEPO were injected into the mice 1 h prior to and 7 days following exposure to hyperoxia. The animals received four treatments in total (n=10 in each group). After 14 days, the body weights, airway structure, and levels of matrix metalloproteinase‑9 (MMP‑9) and vascular endothelial growth factor (VEGF) were detected using histological and immunohistochemical analyses. The effect on cell differentiation was observed by examining the presence of platelet endothelial cell adhesion molecule (PECAM) and VEGF using immunofluorescence. Compared with the administration of BMSCs alone, the body weight, airway structure, and the levels of MMP‑9 and VEGF were significantly improved in the BMSCs/rHuEPO group. The results of the present study demonstrated that the intravenous injection of BMSCs significantly improved lung damage in the hyperoxia‑exposed neonatal mouse model. Furthermore, the injection of BMSCs in combination with intraperitoneal injection of rHuEPO had a more marked effect, compared with BMSCs alone, and the mechanism may be mediated by the promoting effects of BMSCs and EPO. The results of the present study provided information, which may assist in future clinical trials. PMID:27279073

  5. Correlation of radiographic thoracic area and oxygenation impairment in bronchopulmonary dysplasia.

    Science.gov (United States)

    Dassios, Theodore; Curley, Anna; Krokidis, Miltiadis; Morley, Colin; Ross-Russell, Robert

    2016-01-01

    We hypothesized that radiographically-assessed hyperinflation in bronchopulmonary dysplasia (BPD) is related to the degree of oxygenation impairment. Our objective was to explore the relation of chest radiographic thoracic area (CRTA) with right-to-left shunt, right shift of the oxyhemoglobin dissociation curve and ventilation/perfusion ratio (VA/Q) in infants with BPD. Twenty-two infants born at median (IQR) gestation of 26 (24-28) weeks with BPD were prospectively studied at 39 (30-69) days. Inspired oxygen (FiO2) was varied to obtain transcutaneous oxygen saturation (SpO2) values between 85 and 96%. Shunt, shift and VA/Q were derived by plotting and analysing pairs of SpO2 and FiO2. CRTA was measured by free hand-tracing the perimeter of the thoracic area in anterio-posterior chest radiographs. Median (IQR) shunt was 8 (1-14)%, shift was 13 (11-19)kPa and VA/Q 0.42 (0.30-0.48). Median (IQR) CRTA/kg was 2495 (1962-2838)mm(2) and was significantly related to shift (r=0.674, p<0.001), VA/Q (r=-0.633, p<0.001), weight at study (r=-0.457, p=0.003) and day of life (r=-0.406, p=0.009), but not to shunt. CRTA in BPD is significantly related to oxygenation impairment as quantified by shift and VA/Q. CRTA can be used as a simple radiographic test to quantify BPD severity. PMID:26410458

  6. MicroRNA-mRNA interactions in a murine model of hyperoxia-induced bronchopulmonary dysplasia

    Directory of Open Access Journals (Sweden)

    Dong Jie

    2012-05-01

    Full Text Available Abstract Background Bronchopulmonary dysplasia is a chronic lung disease of premature neonates characterized by arrested pulmonary alveolar development. There is increasing evidence that microRNAs (miRNAs regulate translation of messenger RNAs (mRNAs during lung organogenesis. The potential role of miRNAs in the pathogenesis of BPD is unclear. Results Following exposure of neonatal mice to 80% O2 or room air (RA for either 14 or 29 days, lungs of hyperoxic mice displayed histological changes consistent with BPD. Comprehensive miRNA and mRNA profiling was performed using lung tissue from both O2 and RA treated mice, identifying a number of dynamically regulated miRNAs and associated mRNA target genes. Gene ontology enrichment and pathway analysis revealed that hyperoxia modulated genes involved in a variety of lung developmental processes, including cell cycle, cell adhesion, mobility and taxis, inflammation, and angiogenesis. MiR-29 was prominently increased in the lungs of hyperoxic mice, and several predicted mRNA targets of miR-29 were validated with real-time PCR, western blotting and immunohistochemistry. Direct miR-29 targets were further validated in vitro using bronchoalveolar stem cells. Conclusion In newborn mice, prolonged hyperoxia induces an arrest of alveolar development similar to that seen in human neonates with BPD. This abnormal lung development is accompanied by significant increases in the levels of multiple miRNAs and corresponding decreases in the levels of predicted mRNA targets, many of which have known or suspected roles in pathways altered in BPD. These data support the hypothesis that dynamic regulation of miRNAs plays a prominent role in the pathophysiology of BPD.

  7. Persistently elevated right ventricular index of myocardial performance in preterm infants with incipient bronchopulmonary dysplasia.

    Directory of Open Access Journals (Sweden)

    Christoph Czernik

    Full Text Available OBJECTIVES: Elevated pulmonary vascular resistance occurs during the first days after birth in all newborn infants and persists in infants at risk for bronchopulmonary dysplasia (BPD. It is difficult to measure in a non-invasive fashion. We assessed the usefulness of the right ventricular index of myocardial performance (RIMP to estimate pulmonary vascular resistance in very low birth weight infants. STUDY DESIGN: Prospective echocardiography on day of life (DOL 2, 7, 14, and 28 in 121 preterm infants (median [quartiles] gestational age 28 [26]-[29] weeks, birth weight 998 [743-1225] g of whom 36 developed BPD (oxygen supplementation at 36 postmenstrual weeks. RESULTS: RIMP derived by conventional pulsed Doppler technique was unrelated to heart rate or mean blood pressure. RIMP on DOL 2 was similar in infants who subsequently did (0.39 [0.33-0.55] and did not develop BPD (0.39 [0.28-0.51], p = 0.467. RIMP declined steadily in non-BPD infants but not in BPD infants (DOL 7: 0.31[0.22-0.39] vs. 0.35[0.29-0.48], p = 0.014; DOL 14: 0.23[0.17-0.30] vs. 0.35[0.25-0.43], p<0.001; DOL 28: 0.21[0.15-0.28] vs. 0.31 [0.21-0.35], p = 0.015. CONCLUSIONS: In preterm infants, a decline in RIMP after birth was not observed in those with incipient BPD. The pattern of RIMP measured in preterm infants is commensurate with that of pulmonary vascular resistance.

  8. Fractal analysis of alveolarization in hyperoxia-induced rat models of bronchopulmonary dysplasia.

    Science.gov (United States)

    Porzionato, Andrea; Guidolin, Diego; Macchi, Veronica; Sarasin, Gloria; Grisafi, Davide; Tortorella, Cinzia; Dedja, Arben; Zaramella, Patrizia; De Caro, Raffaele

    2016-04-01

    No papers are available about potentiality of fractal analysis in quantitative assessment of alveolarization in bronchopulmonary dysplasia (BPD). Thus, we here performed a comparative analysis between fractal [fractal dimension (D) and lacunarity] and stereological [mean linear intercept (Lm), total volume of alveolar air spaces, total number of alveoli, mean alveolar volume, total volume and surface area of alveolar septa, and mean alveolar septal thickness] parameters in experimental hyperoxia-induced models of BPD. At birth, rats were distributed between the following groups: 1) rats raised in ambient air for 2 wk; 2) rats exposed to 60% oxygen for 2 wk; 3) rats raised in normoxia for 6 wk; and 4) rats exposed to 60% hyperoxia for 2 wk and to room air for further 4 wk. Normoxic 6-wk rats showed increased D and decreased lacunarity with respect to normoxic 2-wk rats, together with changes in all stereological parameters except for mean alveolar volume. Hyperoxia-exposed 2-wk rats showed significant changes only in total number of alveoli, mean alveolar volume, and lacunarity with respect to equal-in-age normoxic rats. In the comparison between 6-wk rats, the hyperoxia-exposed group showed decreased D and increased lacunarity, together with changes in all stereological parameters except for septal thickness. Analysis of receiver operating characteristic curves showed a comparable discriminatory power of D, lacunarity, and total number of alveoli; Lm and mean alveolar volume were less discriminative. D and lacunarity did not show significant changes when different segmentation thresholds were applied, suggesting that the fractal approach may be fit to automatic image analysis. PMID:26851258

  9. Strategies of mucosal immunotherapy for allergic diseases

    Institute of Scientific and Technical Information of China (English)

    Yi-Ling Ye; Ya-Hui Chuang; Bor-Luen Chiang

    2011-01-01

    Incidences of allergic disease have recently increased worldwide.Allergen-specific immunotherapy (SIT) has long been a controversial treatment for allergic diseases.Although beneficial effects on clinically relevant outcomes have been demonstrated in clinical trials by subcutaneous immunotherapy (SCIT),there remains a risk of severe and sometimes fatal anaphylaxis.Mucosal immunotherapy is one advantageous choice because of its non-injection routes of administration and lower side-effect profile.This study reviews recent progress in mucosal immunotherapy for allergic diseases.Administration routes,antigen quality and quantity,and adjuvants used are major considerations in this field.Also,direct uses of unique probiotics,or specific cytokines,have been discussed.Furthermore,some researchers have reported new therapeutic ideas that combine two or more strategies.The most important strategy for development of mucosal therapies for allergic diseases is the improvement of antigen formulation,which includes continuous searching for efficient adjuvants,collecting more information about dominant T-cell epitopes of allergens,and having the proper combination of each.In clinics,when compared to other mucosal routes,sublingual immunotherapy (SLIT) is a preferred choice for therapeutic administration,although local and systemic side effects have been reported.Additionally,not every allergen has the same beneficial effect.Further studies are needed to determine the benefits of mucosal immunotherapy for different allergic diseases after comparison of the different administration routes in children and adults.Data collected from large,well-designed,double-blind,placebo-controlled,and randomized trials,with post-treatment follow-up,can provide robust substantiation of current evidence.

  10. Role of Toll-like receptors in lung innate defense against invasive aspergillosis. Distinct impact in immunocompetent and immunocompromized hosts.

    Science.gov (United States)

    Chignard, Michel; Balloy, Viviane; Sallenave, Jean-Michel; Si-Tahar, Mustapha

    2007-09-01

    Toll-like receptors are key to pathogen recognition by a host and to the subsequent triggering of an innate immune response. Experimental and clinical evidence shows that defects in Toll-like receptors or in signaling pathways downstream from these receptors render hosts susceptible to various types of infection, including aspergillosis. Patients receiving an immunosuppressive regimen, including corticosteroid therapy or cytotoxic chemotherapy, are also susceptible to infections. Aspergillus fumigatus is an opportunistic pathogen that infects the lungs of immunosuppressed hosts. Here, we review the evidence that experimental inactivation of various Toll-like receptors and of their signaling pathways may worsen cases of invasive pulmonary aspergillosis. Moreover, the literature clearly indicates that the type of immunosuppression is very important, as it influences whether or not Toll-like receptors contribute to infection. The involvement of Toll-like receptors, based on the immunological status of the patient, should be considered if an immunosuppressive treatment must be administered. PMID:17604224

  11. Sinus aspergillosis.

    Science.gov (United States)

    De Foer, C; Fossion, E; Vaillant, J M

    1990-01-01

    The prevalence of Aspergillus sinusitis is often underestimated because the vast majority of cases are classified as "unspecified sinusitis". Two possible aetio-pathogenic mechanisms can be involved in the development of this fungal infection. Traditionally, the literature emphasised the "anglophone" hypothesis which is based on the inhalation of spores. More recently, the "french" model, based on oro-sinusal fistula and/or the perforation of the maxillary sinus by root canal-filling material, is believed to explain the majority of cases in our industrialised environments. Still, neither model explains the totality of cases and several remain beyond comprehension. The disease most commonly presents as a chronic bacterial sinusitis. The process can however become invasive, thus resembling malignancy, with eventually a fatal outcome. Doctors and dentists should know the possible danger, presented by zinc-oxide-eugenol-paste in the sinus. Radical surgery is the treatment of choice, since a prolonged conservative approach (antibiotics, corticosteroids) can only worsen the prognosis. This paper discusses different aspects of the disease, and presents 10 cases, observed at the University Hospitals of Paris (France) and Leuven (Belgium). PMID:2406288

  12. Prevalence and fungal profile of pulmonary aspergillosis in immunocompromised and immunocompetent patients of a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Prakash Ved, Mishra Prem P, Verma Shashi K, Sinha Shivani, Sharma Mahendra

    2014-03-01

    Full Text Available Background: Aspergillus is a fungus which may present an array of pulmonary manifestations, depending on the patient’s immunological and physiological state. Although the incidence of pulmonary aspergillosis occurs primarily in immunocompromised patients but the incidence is also rising in immunocompetent individuals, especially in developing countries. Aim: The objective of the study was to determine the prevalence and predisposing factors of pulmonary aspergillosis along with species identification. Materials and Methods: One hundred and three patients admitted to the Department of Chest and Tuberculosis and in the Department of Medicine from Jan 2012 to Jan 2013 were included in this study. The patients were epitomized on the basis of clinical signs and symptoms, physical examination, chest radiography, CT scans, histopathological examination, bronchoscopy and fungal examination including potassium hydroxide mount, fungal culture of sputum and bronchoalveolar lavage. Species identification was done by colony characteristics, slide culture and Lactophenol Cotton blue mount. Results: Out of the 103 patients, (63 males and 40 females Aspergillus species has been isolated from 17 (16.5% males and 07 (6.79% females. Various predisposing factors of pulmonary aspergillosis have been identified in which pulmonary tuberculosis, chronic smoking and environmental exposure to asbestos, cement its tops the list. Many of the patients had multiple predisposing factors. Aspergillus species were isolated in 24 (23.3% cases. Aspergillus fumigatus was the predominant species isolated in 13 (54.16% cases followed by Aspergillus flavus in 07 (29.16% cases, Aspergillus niger in 03 (12.5 % and Aspergillus terrus in 1 (4.16% cases. Conclusion: It is concluded that the prevalence of pulmonary Aspergillosis is quite high in immunocompromised individuals and low in immunocompetent individuals. An adequate and efficient evaluation of the etiological agents has a

  13. Role of Toll-like receptors in lung innate defense against invasive aspergillosis. Distinct impact in immunocompetent and immunocompromized hosts.

    OpenAIRE

    Chignard, Michel; Balloy, Viviane; Sallenave, Jean-Michel; Si-Tahar, Mustapha

    2007-01-01

    Toll-like receptors are key to pathogen recognition by a host and to the subsequent triggering of an innate immune response. Experimental and clinical evidence shows that defects in Toll-like receptors or in signaling pathways downstream from these receptors render hosts susceptible to various types of infection, including aspergillosis. Patients receiving an immunosuppressive regimen, including corticosteroid therapy or cytotoxic chemotherapy, are also susceptible to infections. Aspergillus ...

  14. Fatal Case of Probable Invasive Aspergillosis after Five Years of Heart Transplant: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Toufik Mahfood Haddad

    2015-01-01

    Full Text Available Invasive fungal infections are very common in solid organ transplants and occur most frequently in the first three months after transplant. A 49-year-old female with a history of two remote heart transplants with the most recent one occurring 5 years ago was admitted for increasing shortness of breath, cough, and fever. Computerized tomography (CT scan of the chest showed left lower lung ground-glass and tree-in-bud opacities. She was started on broad spectrum antibiotics along with ganciclovir and micafungin. Ganciclovir was added due to the patient’s past history of CMV infection and empiric fungal coverage with micafungin. Bronchoalveolar lavage (BAL was performed as her respiratory status worsened and voriconazole was added for possible aspergillosis in combination therapy with micafungin. BAL galactomannan returned positive which was suggestive of aspergillosis. Patient worsened clinically and subsequently succumbed to cardiorespiratory arrest despite our best efforts. It is important to have a high degree of clinical suspicion for invasive aspergillosis in transplant patients even many years after transplant and initiate aggressive therapy due to poor outcomes.

  15. Selection of the antifungal agent decides prognosis of invasive aspergillosis: case report of a successful outcome with voriconazole.

    Science.gov (United States)

    Arakawa, Hisaya; Suto, Chikako; Notani, Hiroko; Ishida, Takashi; Abe, Kayoko; Ookubo, Yasuo

    2014-02-01

    Invasive aspergillosis is a rare disease and is often misdiagnosed. The clinical course is quite aggressive and it is a potentially fatal disease. We report a case of invasive aspergillosis involving the dura mater and optic nerves which was successfully treated with voriconazole, even though the patient had residual monocular blindness. An 86-year-old Japanese man complained of developing loss of vision in his left eye while taking oral fluconazole prescribed by an otolaryngologist for mycosis of the left maxillary sinus. He was referred to our hospital. At the first visit, he already had no light perception in the left eye, with decreased ocular motility in all directions and orbital apex syndrome. His corrected distance visual acuity (CDVA) in the right eye was 20/25 with enlargement of Mariotte's blind spot. Magnetic resonance imaging revealed inflammation around both optic nerves that also involved the dura mater. His antifungal therapy was changed to intravenous voriconazole. Although his right CDVA temporarily declined to 20/50, it improved to 20/16 by 10 months after the initiation of treatment. Maxillary sinus biopsy detected Aspergillus. Invasive aspergillosis progresses rapidly and aggressively. The present case highlights the importance of early diagnosis and selection of an appropriate antifungal agent. PMID:23397120

  16. Oleanolic acid controls allergic and inflammatory responses in experimental allergic conjunctivitis.

    Directory of Open Access Journals (Sweden)

    Claudia Córdova

    Full Text Available Pollen is the most common aeroallergen to cause seasonal conjunctivitis. The result of allergen exposure is a strong Th2-mediated response along with conjunctival mast cell degranulation and eosinophilic infiltration. Oleanolic acid (OA is natural a triterpene that displays strong anti-inflammatory and immunomodulatory properties being an active anti-allergic molecule on hypersensitivity reaction models. However, its effect on inflammatory ocular disorders including conjunctivitis, has not yet been addressed. Hence, using a Ragweed pollen (RWP-specific allergic conjunctivitis (EAC mouse model we study here whether OA could modify responses associated to allergic processes. We found that OA treatment restricted mast cell degranulation and infiltration of eosinophils in conjunctival tissue and decreased allergen-specific Igs levels in EAC mice. Th2-type cytokines, secreted phospholipase A2 type-IIA (sPLA2-IIA, and chemokines levels were also significantly diminished in the conjunctiva and serum of OA-treated EAC mice. Moreover, OA treatment also suppressed RWP-specific T-cell proliferation. In vitro studies, on relevant cells of the allergic process, revealed that OA reduced the proliferative and migratory response, as well as the synthesis of proinflammatory mediators on EoL-1 eosinophils and RBL-2H3 mast cells exposed to allergic and/or crucial inflammatory stimuli such as RWP, sPLA2-IIA or eotaxin. Taken together, these findings demonstrate the beneficial activity of OA in ocular allergic processes and may provide a new intervention strategy and potential therapy for allergic diseases.

  17. Bronchopulmonary arterial anastomosis at the precapillary level in human lung. Visualization using CT angiography compared with microangiography of autopsied lung

    International Nuclear Information System (INIS)

    To investigate the interrelationships between the bronchial and pulmonary circulations including the existence of precapillary bronchopulmonary arterial anastomoses, CT of bronchial arteriography (BAG-CT) was performed in 10 patients and BAG-CT during a pulmonary artery block test (PA-block) in 5 patients with lung cancer. Bronchial and pulmonary circulations were evaluated in 5 autopsied normal lungs by injecting silicone rubber with different colors into the bronchial and pulmonary arteries. BAG-CT correlated well with the findings at silicone rubber injection into lung autopsy samples. BAG-CT demonstrated inflow of contrast medium into the pulmonary artery during PA-block in all cases, while no inflow was observed before and following reversal of PA-block. Mixed silicone rubber was observed in the lobar to subsubsegmental bronchial arteries in all cases and in the subsubsegmental pulmonary artery in one case. Precapillary bronchopulmonary arterial anastomoses may exist at the level of the lobar bronchi to the periphery. If either the pulmonary or bronchial circulation is disturbed, flow occurs inside the anastomoses to supplement the other flow, especially flow from the bronchial to the pulmonary arteries via the anastomoses, which occurs within 30 min

  18. Bronchopulmonary arterial anastomosis at the precapillary level in human lung. Visualization using CT angiography compared with microangiography of autopsied lung

    International Nuclear Information System (INIS)

    Purpose: To investigate the interrelationships between the bronchial and pulmonary circulations including the existence of precapillary bronchopulmonary arterial anastomoses. Material and Methods: CT of bronchial arteriography (BAG-CT) was performed in 10 patients and BAG-CT during a pulmonary artery block test (PA-block) in 5 patients with lung cancer. Bronchial and pulmonary circulations were evaluated in 5 autopsied normal lungs by injecting silicone rubber with different colors into the bronchial and pulmonary arteries. Results: BAG-CT correlated well with the findings at silicone rubber injection into lung autopsy samples. BAG-CT demonstrated inflow of contrast medium into the pulmonary artery during PA-block in all cases, while no inflow was observed before and following reversal of PA-block. Mixed silicone rubber was observed in the lobar to subsubsegmental bronchial arteries in all cases and in the subsubsegmental pulmonary artery in one case. Conclusion: Precapillary bronchopulmonary arterial anastomoses may exist at the level of the lobar bronchi to the periphery. If either the pulmonary or bronchial circulation is disturbed, flow occurs inside the anastomoses to supplement the other flow, especially flow from the bronchial to the pulmonary arteries via the anastomoses, which occurs within 30 min. (orig.)

  19. FcgammaRIIb inhibits allergic lung inflammation in a murine model of allergic asthma.

    Directory of Open Access Journals (Sweden)

    Nilesh Dharajiya

    Full Text Available Allergic asthma is characterized by airway eosinophilia, increased mucin production and allergen-specific IgE. Fc gamma receptor IIb (FcgammaRIIb, an inhibitory IgG receptor, has recently emerged as a negative regulator of allergic diseases like anaphylaxis and allergic rhinitis. However, no studies to date have evaluated its role in allergic asthma. Our main objective was to study the role of FcgammaRIIb in allergic lung inflammation. We used a murine model of allergic airway inflammation. Inflammation was quantified by BAL inflammatory cells and airway mucin production. FcgammaRIIb expression was measured by qPCR and flow cytometry and the cytokines were quantified by ELISA. Compared to wild type animals, FcgammaRIIb deficient mice mount a vigorous allergic lung inflammation characterized by increased bronchoalveolar lavage fluid cellularity, eosinophilia and mucin content upon ragweed extract (RWE challenge. RWE challenge in sensitized mice upregulated FcgammaRIIb in the lungs. Disruption of IFN-gamma gene abrogated this upregulation. Treatment of naïve mice with the Th1-inducing agent CpG DNA increased FcgammaRIIb expression in the lungs. Furthermore, treatment of sensitized mice with CpG DNA prior to RWE challenge induced greater upregulation of FcgammaRIIb than RWE challenge alone. These observations indicated that RWE challenge upregulated FcgammaRIIb in the lungs by IFN-gamma- and Th1-dependent mechanisms. RWE challenge upregulated FcgammaRIIb on pulmonary CD14+/MHC II+ mononuclear cells and CD11c+ cells. FcgammaRIIb deficient mice also exhibited an exaggerated RWE-specific IgE response upon sensitization when compared to wild type mice. We propose that FcgammaRIIb physiologically regulates allergic airway inflammation by two mechanisms: 1 allergen challenge mediates upregulation of FcgammaRIIb on pulmonary CD14+/MHC II+ mononuclear cells and CD11c+ cells by an IFN-gamma dependent mechanism; and 2 by attenuating the allergen specific Ig

  20. A Population-based Clinical Study of Allergic and Non-allergic Asthma

    DEFF Research Database (Denmark)

    Knudsen, T.B.; Thomsen, S.F.; Nolte, H.;

    2009-01-01

    Background. The aim of this study was to describe differences between allergic and non-allergic asthma in a large community-based sample of Danish adolescents and adults. Methods. A total of 1,186 subjects, 14 to 44 years of age, who in a screening questionnaire had reported a history of airway...... symptoms suggestive of asthma and/or allergy, or who were taking any medication for these conditions were clinically examined. All participants were interviewed about respiratory symptoms, and furthermore skin test reactivity, lung function, and airway responsiveness were measured. Results. A total of 489...... individuals had clinical asthma of whom 61% had allergic asthma, whereas 39% had non-allergic asthma. Subjects with non-allergic asthma were more likely to be females, OR = 2.24 (1.32-3.72), p = 0.003, and to have cough as the predominant symptom, OR = 1.96, (1.19-3.23), p = 0.008, but were less likely...

  1. Links between allergic rhinitis and asthma

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    @@ Allergic diseases of the airway, which include seasonal rhinitis, chronic perennial rhinitis and asthma, are recognized as inflammatory disorders of the airway mucosa,1-3 but differ in the location of the inflammatory reaction and clinical manifestations of the disease. Asthma and allergic rhinitis frequently coexist in the same patient and are thought to share common predisposing genetic factors which interact with the environmental influences. Both diseases have increased in prevalence over recent decades4,5 particularly in westernized countries. This increase has been largely attributed to environmental factors such as exposure to aerial pollutants,4,6 and early life events, including the degree of exposure to infectious agents which might affect IgE production,5,7 since there has been insufficient time for a significant change in the gene pool.

  2. Neurology of allergic inflammation and rhinitis.

    Science.gov (United States)

    Canning, Brendan J

    2002-05-01

    Afferent nerves, derived from the trigeminal ganglion, and postganglionic autonomic nerves, derived from sympathetic and parasympathetic ganglia expressing many different neurotransmitters, innervate the nose. Reflexes that serve to optimize the air-conditioning function of the nose by altering sinus blood flow, or serve to protect the nasal mucosal surface by mucus secretion, vasodilatation, and sneezing, can be initiated by a variety of stimuli, including allergen, cold air, and chemical irritation. Activation of nasal afferent nerves can also have profound effects on respiration, heart rate, blood pressure, and airway caliber (the diving response). Dysregulation of the nerves in the nose plays an integral role in the pathogenesis of allergic rhinitis. Axon reflexes can precipitate inflammatory responses in the nose, resulting in plasma extravasation and inflammatory cell recruitment, while allergic inflammation can produce neuronal hyper-responsiveness. Targeting the neuronal dysregulation in the nose may be beneficial in treating upper airway disease. PMID:11918862

  3. Allergic contact dermatitis: Patient diagnosis and evaluation.

    Science.gov (United States)

    Mowad, Christen M; Anderson, Bryan; Scheinman, Pamela; Pootongkam, Suwimon; Nedorost, Susan; Brod, Bruce

    2016-06-01

    Allergic contact dermatitis resulting from exposure to a chemical or chemicals is a common diagnosis in the dermatologist's office. We are exposed to hundreds of potential allergens daily. Patch testing is the criterion standard for diagnosing the causative allergens responsible for allergic contact dermatitis. Patch testing beyond standard trays is often needed to fully diagnose patients, but not all dermatology practices have access to this testing procedure or these allergens. In order to adequately evaluate patients, physicians must understand the pathophysiology of the disease process and be well versed in the proper evaluation of patients, indications for patch testing, proper testing procedure, and other diagnostic tools available and be aware of new and emerging allergens. PMID:27185421

  4. Severe chronic allergic (and related) diseases

    DEFF Research Database (Denmark)

    Bousquet, J; Anto, J M; Demoly, P;

    2012-01-01

    and associated factors such as comorbidities and risk factors. This uniform definition will allow a better definition of the phenotypes of severe allergic (and related) diseases for clinical practice, research (including epidemiology), public health purposes, education and the discovery of novel therapies.......-up. Control is the degree to which therapy goals are currently met. These concepts have evolved over time for asthma in guidelines, task forces or consensus meetings. The aim of this paper is to generalize the approach of the uniform definition of severe asthma presented to WHO for chronic allergic...... and associated diseases (rhinitis, chronic rhinosinusitis, chronic urticaria and atopic dermatitis) in order to have a uniform definition of severity, control and risk, usable in most situations. It is based on the appropriate diagnosis, availability and accessibility of treatments, treatment responsiveness...

  5. Component resolved testing for allergic sensitization

    DEFF Research Database (Denmark)

    Skamstrup Hansen, Kirsten; Poulsen, Lars K

    2010-01-01

    Component resolved diagnostics introduces new possibilities regarding diagnosis of allergic diseases and individualized, allergen-specific treatment. Furthermore, refinement of IgE-based testing may help elucidate the correlation or lack of correlation between allergenic sensitization and allergic...... disease. Novel tools to predict severe outcomes and to plan for allergen-specific treatment are necessary, and because only a small amount of blood is needed to test for a multitude of allergens and allergenic components, component resolved diagnostics is promising. A drawback is the risk of overdiagnosis...... and misinterpretation of the complex results of such tests. Also, the practical use and selection of allergenic components need to be evaluated in large studies including well-characterized patients and healthy, sensitized controls and with representation of different geographical regions....

  6. Retrospective assessment of seasonal allergic symptoms

    DEFF Research Database (Denmark)

    Bødtger, Uffe; Poulsen, L K; Malling, H-J

    2003-01-01

    in a double-blind study. Assessment of severity of symptoms from the nose, eyes and lungs were performed daily during the season 2000, and post-seasonally 6 months after the season in 1999 and 2000. A four-point verbal descriptor scale (VDS-4) was used at all occasions. A mean in-seasonal symptom rating......BACKGROUND: The history of the severity of seasonal allergic symptoms is often obtained post-seasonally as a retrospective assessment. Correct rating is essential when determining the efficacy of pharmaceutical treatment, indications for allergen-specific immunotherapy (SIT), or inclusion...... into controlled clinical studies. OBJECTIVES: To investigate the agreement between in- and post-seasonal ratings of seasonal symptoms, and to investigate whether the effect of SIT could be detected retrospectively. MATERIAL AND METHODS: Thirty-five birch pollen-allergic patients were allocated to SIT or placebo...

  7. [Clinical diagnosis and treatment of allergic pharyngitis].

    Science.gov (United States)

    Liu, Jinfeng; Yan, Zhanfeng; Zhang, Mingxia

    2015-08-01

    Although the concept of united airway disease has been widely accepted, most scholars emphasize only the effect of rhino-sinusitis while ignoring the pharyngeal factors to the lower airway, especially to the allergic pharyngitis (AP), which still lacks enough awareness. First of all, absence of unified diagnostic standard leads to the lack of epidemiological data, which, results in doctors' personal experience but no guideline in treatments. In addition, it is still not clear that the role of AP in the allergic airway diseases and its relationship with asthma. However, the number of patients with AP has been increasing obviously in daily clinic practice. Combined with the previous observation, this paper does a systematic review about the clinical problems of AP, expecting to give a hand to the clinical diagnosis and treatment of AP. PMID:26685417

  8. Dominant epitopes and allergic cross-reactivity

    DEFF Research Database (Denmark)

    Mirza, Osman Asghar; Henriksen, A; Ipsen, H;

    2000-01-01

    as defined by the Bet v 1 Ab interaction surface. Molecular interactions predicted to occur in the interface are likewise in agreement with earlier observations on Ag-Ab complexes. The epitope is formed by amino acids that are conserved among major allergens from related species within the Fagales order......The symptoms characteristic of allergic hypersensitivity are caused by the release of mediators, i.e., histamine, from effector cells such as basophils and mast cells. Allergens with more than one B cell epitope cross-link IgE Abs bound to high affinity FcepsilonRI receptors on mast cell surfaces...... leading to aggregation and subsequent mediator release. Thus, allergen-Ab complexes play a crucial role in the cascade leading to the allergic response. We here report the structure of a 1:1 complex between the major birch pollen allergen Bet v 1 and the Fab fragment from a murine monoclonal IgG1 Ab, BV16...

  9. Systemic Hydrocortisone To Prevent Bronchopulmonary Dysplasia in preterm infants (the SToP-BPD study); a multicenter randomized placebo controlled trial

    NARCIS (Netherlands)

    Onland, Wes; Offringa, Martin; Cools, Filip; De Jaegere, Anne P.; Rademaker, Karin; Blom, Henry; Cavatorta, Eric; Dijk, Peter H.; van Heijst, Arno F.; Kramer, Boris W.; Kroon, Andre A.; Mohns, Thilo; van Straaten, Henrica L.; te Pas, Arjan B.; Theyskens, Claire; van Weissenbruch, Mirjam M.; van Kaam, Anton H.; Beer de, A.

    2011-01-01

    Background: Randomized controlled trials have shown that treatment of chronically ventilated preterm infants after the first week of life with dexamethasone reduces the incidence of the combined outcome death or bronchopulmonary dysplasia (BPD). However, there are concerns that dexamethasone may inc

  10. [The biological kinetics of biofilms of clinical strains of Staphylococcus aureus and Pseudomonas aeruginosa separated from patients with bronchopulmonary complications under traumatic disease of spinal cord].

    Science.gov (United States)

    Ul'ianov, V Iu; Opredelentseva, S V; Shvidenko, I G; Norkin, I A; Korshunov, G V; Gladkova, E V

    2014-08-01

    The capacity and intensity of formation of microbial biofilms was analyzed in 24 strains of Staphylococcus aureus and Pseudomonas aeruginosa in static conditions of cultivation during 24, 48, 72 and 96 yours. The microorganisms were separated from patients with bronchopulmonary infectious complications in acute and early periods of traumatic disease of spinal cord.

  11. N-Terminal Pro-B Type Natriuretic Peptide as a Marker of Bronchopulmonary Dysplasia or Death in Very Preterm Neonates

    DEFF Research Database (Denmark)

    Sellmer, Anna; Hjortdal, Vibeke Elisabeth; Bjerre, Jesper Vandborg;

    2015-01-01

    BACKGROUND: Bronchopulmonary dysplasia (BPD) is a serious complication of preterm birth. Plasma N-terminal pro-B type natriuretic peptide (NT-proBNP) has been suggested as a marker that may predict BPD within a few days after birth. OBJECTIVES: To investigate the association between NT-proBNP day...

  12. Role of Cysteinyl Leukotrienes in Allergic Rhinitis.

    Science.gov (United States)

    Shirasaki, Hideaki; Himi, Tetsuo

    2016-01-01

    Cysteinyl leukotrienes (CysLTs) are lipid mediators that have been implicated in the pathogenesis of allergic rhinitis. Pharmacological studies using CysLTs indicate that two classes of receptor exist: CysLT1 receptor (CysLT1R) and CysLT2 receptor (CysLT2R). The CysLT1R is a high-affinity leukotriene D4 receptor with lower affinity for leukotriene C4 that is sensitive to the CysLT1R antagonist currently used to treat asthma and allergic rhinitis. Our previous immunohistochemical and autoradiographic studies have demonstrated the presence of anti-CysLT1R antibodies labeled in eosinophils, mast cells, macrophages, neutrophils and vascular endothelial cells in human nasal mucosa. Furthermore, we have revealed that the novel radioactive CysLT1R antagonist [3H]-pranlukast bound specifically to CysLT1R in human inferior turbinates and its binding sites were localized to vascular endothelium and the interstitial cells. These data suggest that the major targets of CysLT1R antagonists in allergic rhinitis are the vascular bed and infiltrated leukocytes such as mast cells, eosinophils and macrophages. Clinical trials have demonstrated that CysLT1R antagonists are as effective as antihistamines for the treatment of allergic rhinitis; however, they are less effective than intranasal steroids. The use of CysLT1R antagonists in combination with antihistamines has generally resulted in greater efficacy than when these agents were used alone. PMID:27115997

  13. MicroRNA expression profiling studies on bronchopulmonary dysplasia: a systematic review and meta-analysis.

    Science.gov (United States)

    Yang, Y; Qiu, J; Kan, Q; Zhou, X-G; Zhou, X-Y

    2013-01-01

    Over the past several years, several microRNA (miRNA) expression profiling studies have been carried out on bronchopulmonary dysplasia (BPD) in mammalian lung tissues. The most effective way to identify these important miRNAs is to systematically search for similar signatures identified in multiple independent studies. Accordingly, a meta-analysis was conducted to review published miRNA expression profiling studies that compared miRNA expression profiles between BPD lung tissues and normal lung tissues. A vote-counting strategy that considered the total number of studies and time points reporting differential expression was applied. Furthermore, cut-off criteria of statistically significant differentially expressed miRNAs as defined by the author and their predicted target genes, if available, as well as the list of up- and down-regulated miRNA features, were collected and recorded. Results of the meta-analysis revealed that four up-regulated miRNAs (miRNA-21, miRNA-34a, miRNA-431, and Let-7f) and one down-regulated miRNA (miRNA-335) were differentially expressed in BPD lung tissues compared with normal groups. In addition, eight miRNAs (miRNA-146b, miRNA-29a, miRNA-503, miRNA-411, miRNA-214, miRNA-130b, miRNA-382, and miRNA-181a-1*) were found to show differential expression not only in the process of normal lung development, but also during the progress of BPD. Finally, several meaningful target genes (such as the HPGD and NTRK genes) of common miRNAs (such as miRNA-21 and miRNA-141) were systematically predicted. These specific miRNAs may provide clues of the potential mechanisms involved in BPD. Further mechanistic and external validation studies are needed to confirm the clinical significance of these miRNAs in the development of BPD. PMID:24301780

  14. Functional state of the bronchopulmonary system in Mayak nuclear workers inhaled plutonium-239 aerosols

    Energy Technology Data Exchange (ETDEWEB)

    Belyaeva, Z.; Grigoryeva, E.; Khokhryakov, V. [Southern Urals Biophysics Institute, Ozyorsk (Russian Federation)

    2006-07-01

    Full text of publication follows: The current system of the individual and collective protection facilities for nuclear personnel permits decreasing the radiation dose from internal emitters at the most. At the same time, specific production conditions do not exclude possible inhalation of plutonium-239 aerosols. As the lung is the critical organ for this isotope, the study of respiratory function is aimed at detecting of pre-clinical lung pathology. Early detection of internal exposure effects on functional state of respiratory apparatus is difficult due to a number of confounding actors of non-radiation nature, one of which is smoking. Functional state of bronchopulmonary system was studied in 386 males, workers of the first Russian nuclear facility. 1198 examinations were carried out during medical inspection as well as hospitalization for routine preventive inspection. Most of males (39.4%) started working at the age of 21-26 years and 27.2% at the age of 20 years. The main factors of occupational exposure were exposure to plutonium-239 aerosols and the external gamma -rays. The absorbed dose to lungs from incorporated plutonium-239 was 0-435.8 c Gy. Whole-body external gamma dose varied from 0 to 382 c Gy at the examination. Individual dosimetry data were provided by the Mayak Radiation Safety Department and Internal Dosimetry Laboratory of the Southern Urals Biophysics Institute. While studying respiratory function, the most informative indices characterizing the state of lung tissue and tracheobronchial system such as vital capacity inspiration, forced expiratory volume, forced inspiratory volume, test Tiffno, diffusion capacity, characteristics of the flow vs. volume of the forced vital capacity inspiration curve, and resistance were used. Analysis was done separately for smokers and nonsmokers. Smoking index, i.e. product of number of smoked cigarettes per day and number of years of smoking was considered an integral value. The study did not reveal the

  15. Severe allergic reactions to guinea pig

    Directory of Open Access Journals (Sweden)

    Shaw Jeffrey L

    2005-10-01

    Full Text Available Abstract Background Allergic sensitization and reactions to guinea pig (Cavia porcellus have been well documented in laboratory animal handlers, primarily manifesting as rhinitis, conjunctivitis, and asthma. Severe allergic reactions, however, are rare. Methods We report two patients with severe allergic reactions following non-occupational exposure to guinea pigs. The first patient, an 11-year-old female, developed ocular, nasal, skin and laryngeal edema symptoms immediately after handling a guinea pig. The second patient, a 24-year-old female, developed symptoms of isolated laryngeal edema after cleaning a guinea pig cage. Percutaneous skin testing, RAST, ELISA and ELISA inhibition testing with guinea pig extract were performed. Results Both patients had IgE-mediated allergy to guinea pig confirmed by ELISA and either RAST or skin testing. ELISA inhibition studies confirmed the specificity of the IgE reactivity to guinea pig. Conclusion Severe IgE-mediated reactions can occur following non-occupational guinea pig exposure. Physicians should be aware of this possibility.

  16. Conflicting sensory relationships. Encounters with allergic people.

    Science.gov (United States)

    Raffaetà, Roberta

    2012-01-01

    Increasingly, people employ the term 'allergy' to define various pathological conditions, although the biomedical community lacks a consensus on a definition of the term. It has become a widespread and convenient label for diverse conditions, often going beyond biomedical diagnosis. The aim of this paper is to explore how allergic people narrate their illness experiences, focusing specifically on the relationship between words, senses and bodies. This paper is based on an ethnographic study in a medium-sized north Italian city conducted from 2004 to 2008, starting in a public hospital Allergy Unit, and then developing through snowball recruitment and referral methods. Interviews were conducted with 37 allergic people, four allergologists and four nurses. Allergic people's narratives constantly drew upon two main concepts: weakness and pollution. These are interpreted as sensorial dimensions expressing a conflicting relationship with the outside environment. It is argued that in times of marked individualism and social transformations, bodily states are of fundamental importance and the mobilisation of sensory concepts is an attempt to give order and meaning to a world that is perceived as constituted by threatening aspects, polluted and out of order.

  17. Acupuncture Treatment in Asthma and Allergic Diseases

    Directory of Open Access Journals (Sweden)

    Ozgur Kartal

    2011-02-01

    Full Text Available Acupuncture has an historical significance and currently its’ use and esteem are growing in modern medicine. Acupuncture points, or acu points are specific foci along lineer meridians or channels on skin surface. Recently, they are stimulated with needles, ultrasound, palpation, light and electric resistance. Acupuncture is based on influencing of acu points. However there is no standard definition or clinical approach to acupuncture. Needling techniques and forms of stimulation vary widely across patients and practitioners. During the last 50 years, acupuncture techniques have been put into practice in different regions of the world by most medical specialties, including allergic diseases. In this review, effects of acupuncture on immune system, and the possible mechanisms in allergic diseases are discussed. According to published data, effectiveness of acupuncture in allergic diseases seems to be related with the activation of hypothalamic-pituitary-adrenal axis, which is resulted in increased steroid production. Evidence from large randomised trials, including follow-up measurements of markers of inflammation, could be obtained to prove the immunologic effects of acupuncture. [TAF Prev Med Bull 2011; 10(1.000: 107-114

  18. Malassezia spp. overgrowth in allergic cats.

    Science.gov (United States)

    Ordeix, Laura; Galeotti, Franca; Scarampella, Fabia; Dedola, Carla; Bardagí, Mar; Romano, Erica; Fondati, Alessandra

    2007-10-01

    A series of 18 allergic cats with multifocal Malassezia spp. overgrowth is reported: atopic dermatitis was diagnosed in 16, an adverse food reaction in another and one was euthanized 2 months after diagnosis of Malassezia overgrowth. All the cats were otherwise healthy and those tested (16 out of 18) for feline leukaemia or feline immunodeficiency virus infections were all negative. At dermatological examination, multifocal alopecia, erythema, crusting and greasy adherent brownish scales were variably distributed on all cats. Cytological examination revealed Malassezia spp. overgrowth with/without bacterial infection in facial skin (n = 11), ventral neck (n = 6), abdomen (n = 6), ear canal (n = 4), chin (n = 2), ear pinnae (n = 2), interdigital (n = 1) and claw folds skin (n = 1). Moreover, in two cats Malassezia pachydermatis was isolated in fungal cultures from lesional skin. Azoles therapy alone was prescribed in seven, azoles and antibacterial therapy in eight and azoles with both antibacterial and anti-inflammatory therapy in three of the cats. After 3-4 weeks of treatment, substantial reduction of pruritus and skin lesions was observed in all 11 cats treated with a combined therapy and in five of seven treated solely with azoles. Malassezia spp. overgrowth may represent a secondary cutaneous problem in allergic cats particularly in those presented for dermatological examination displaying greasy adherent brownish scales. The favourable response to treatment with antifungal treatments alone suggests that, as in dogs, Malassezia spp. may be partly responsible for both pruritus and cutaneous lesions in allergic cats. PMID:17845619

  19. Proteomic demonstration of the recurrent presence of inter-alpha-inhibitor H4 heavy-chain during aspergillosis induced in an animal model.

    Science.gov (United States)

    Desoubeaux, Guillaume; Jourdan, Marie-Lise; Valera, Lionel; Jardin, Bénédicte; Hem, Sonia; Caille, Agnès; Cormier, Bénédicte; Marchand-Adam, Sylvain; Bailly, Éric; Diot, Patrice; Chandenier, Jacques

    2014-05-01

    Invasive pulmonary aspergillosis remains a matter of great concern in oncology/haematology, intensive care units and organ transplantation departments. Despite the availability of various diagnostic tools with attractive features, new markers of infection are required for better medical care. We therefore looked for potential pulmonary biomarkers of aspergillosis, by carrying out two-dimensional (2D) gel electrophoresis comparing the proteomes of bronchial-alveolar lavage fluids (BALF) from infected rats and from control rats presenting non-specific inflammation, both immunocompromised. A bioinformatic analysis of the 2D-maps revealed significant differences in the abundance of 20 protein spots (ANOVA P-value0.8). One of these proteins, identified by mass spectrometry, was considered of potential interest: inter-alpha-inhibitor H4 heavy-chain (ITIH4), characterised for the first time in this infectious context. Western blotting confirmed its overabundance in all infected BALF, particularly at early stages of murine aspergillosis. Further investigations were carried on rat serum, and confirmed that ITIH4 levels increased during experimental aspergillosis. Preliminary results in human samples strengthened this trend. To our knowledge, this is the first description of the involvement of ITIH4 in aspergillosis. PMID:24360996

  20. Management of invasive aspergillosis in patients with COPD: rational use of voriconazole

    Directory of Open Access Journals (Sweden)

    Florence Ader

    2009-07-01

    Full Text Available Florence Ader1, Anne-Lise Bienvenu2, Blandine Rammaert3, Saad Nseir41Service des Maladies Infectieuses et Tropicales; 2Service de Parasitologie et Mycologie Médicale, Université Claude Bernard Lyon 1, Hospices Civils de Lyon, Hôpital de La Croixrousse, Lyon, France; 3Service des Maladies Infectieuses et Tropicales, Université Paris Descartes, Hôpital Necker Enfants Malades, Centre d’infectiologie Necker-Pasteur, Paris, France; 4Service de Réanimation Médicale, Hôpital A. Calmette, Centre Hospitalier Régional Universitaire, Lille, FranceAbstract: Invasive pulmonary aspergillosis (IPA is an important cause of mortality in patients with hematologic malignancies. The reported incidence of IPA in the context of chronic obstructive pulmonary disease (COPD seems to increase. Approximately 1%–2% of overall fatal cases of IPA occur in COPD patients. The combination of factors such as lung immune imbalance, long-term corticosteroid use, increasing rate of bacterial exacerbations over time, and malnutrition are responsible for the emergence of IPA in these patients. The diagnosis of IPA is difficult to establish, which explains the delay in implementing accurate antifungal therapy and the high mortality rate. Persistent pneumonia nonresponsive to appropriate antibiotic treatment raises the concern of an invasive fungal infection. Definite diagnosis is obtained from tissue biopsy evidencing Aspergillus spp. on microscopic examination or in culture. Culture and microscopy of respiratory tract samples have a sensitivity and specificity of around 50%. Other diagnostic tools can be useful in documenting IPA: computed tomography (CT scan, nonculture-based tests in serum and/or in bronchoalveolar lavage such as antibody/antigen tests for Aspergillus spp. More recent tools such as polymerase chain reaction or [1→3]-β-D-glucan have predictive values that need to be further investigated in COPD patients. Antifungal monotherapy using azole

  1. New concept in allergy: Non-allergic rats becomes allergic after induced by Porphyromonas gingivalis lipopolysaccharide

    Directory of Open Access Journals (Sweden)

    Haryono Utomo

    2013-06-01

    Full Text Available Background: As a theory, seemingly it is impossible that allergic diseases, including asthma, are the result of exposure to a transmissible agent. The fact that nearly all children with asthma are allergic, but only a small proportion of allergic children have asthma, at least raises the possibility that other factors are involved. Interestingly, non-allergic children become allergic after their parents came from working in allergic people for several months. Recent research revealed that periodontal pathogens are also transmissible from mother and caregivers to infants.Therefore, it is logical that non-allergic children could become allergic after exposed to periodontopathic bacteria. However, the mechanism is still unclear. Purpose: The objective of this study is to verify a new concept that non-allergic rat may become allergic after exposed to Porphyromonas gingivalis lipopolysaccharide. Methods: Randomized control series design experimental study was conducted to 24 male Wistar rats, two experimental groups and one control group. One group was subjected to intrasulcular injection of PgLPS1435/1450. Tissue examination were done for allergy biomarkers with peroxidase immunohistochemistry for leukotriene C4 (LTC4 and eosinophilic cationic protein (ECP in bronchus tissue. Serum level examination of interleukin 4 (IL-4, and immunoglobulin E (IgE was done with ELISA. Data were analyzes using ANOVA. Results: after four days, LTC4 and ECP expression increased significantly (p=0.001; even insignificant, IL-4 and IgE serum level also increased. Conclusion: PgLPS is able to stimulate immunocompetent cells which changed the host immune response of non-allergic rats. Therefore, it is possible that they become allergic.Latar belakang: Menurut teori, penularan penyakit alergi termasuk asma merupakan hal yang mustahil. Fakta menunjukkn bahwa hampir semua anak penderita asma mempunyai alergi, tetapi tidak semua anak alergi menderita asma, sehingga mungkin

  2. Upper and lower airway pathology in young children with allergic- and non-allergic rhinitis

    DEFF Research Database (Denmark)

    Chawes, Bo

    2011-01-01

    resources. Unfortunately, diagnostic specificity is hampered by nonspecific symptom history and lack of reliable diagnostic tests which may explain why the pathology behind such diagnoses is poorly understood. Improved understanding of the pathophysiology of allergic- and non-allergic rhinitis in young...... children may contribute to the discovery of new mechanisms involved in pathogenesis and help direct future research to develop correctly timed preventive measures as well as adequate monitoring and treatment of children with rhinitis. Asthma is a common comorbidity in subjects with allergic rhinitis...... airway patencies were strongly associated and independent of body size, rhinitis and asthma. The association was consistent for both baseline values and for decongested nasal airway patency and post-β2 FEV1. Blood and nasal eosinophilia were also associated with nasal airway obstruction. This suggests...

  3. Allergic reactions in salmonellosis depends on the Serotype of pathogens

    DEFF Research Database (Denmark)

    Mkrtchyan, M.S.; Zakaryan, М. K.; Mnatsakanyan, А. А.;

    2013-01-01

    that bacterial infections in early life may help to inhibit excessive allergic Th2 reactions by angling the immune system towards Th1 responses. However, it is known that infections can also cause the exacerbation of allergic reactions. Skewing of response away from Treg cells may lead to the onset and....../or progression of autoimmune diseases in humans. It is also thought that there is a high probability that infectious gastroenteritis increases the risk of subsequent autoimmune and allergic diseases....

  4. Moxibustion with Chinese herbal has good effect on allergic rhinitis

    OpenAIRE

    Min, Cunyun; Peng, Congjian; Wei, Guojian; Huang, Xuhui; Fu, Tingting; Du, Yu; Wang, Changjun

    2015-01-01

    Allergic rhinitis (AR) is a chronic inflammatory disease of rhino-ocular mucosa, affecting up to 40% of population worldwide. Chinese herbal medicines and Acupuncture, adopted thousands of years in China, has good effect on allergic rhinitis. This study evaluates the effects of Moxibustion with Chinese herbal in treating patients with allergic rhinitis over a 1-year follow-up. A randomized controlled trial was conducted in a sample of 355 participants recruited from Guangdong general hospital...

  5. Epidemiologic studies of the risk factors of allergic rhinitis

    OpenAIRE

    Saulyte, Jurgita

    2016-01-01

    This work consists of two parts, with the aim to identify modifiable, lifestylerelated risk factors, such as smoking and diet habits, of allergic rhinitis. Part one is a systematic review and meta-analysis on active and passive exposure to tobacco smoking and allergic rhinitis. The objective of this metaanalysis was to examine the evidence for an association between active smoking and passive exposure to secondhand smoke and allergic rhinitis in children and adults. The resu...

  6. Environmental risk factors and allergic bronchial asthma.

    Science.gov (United States)

    D'Amato, G; Liccardi, G; D'Amato, M; Holgate, S

    2005-09-01

    The prevalence of allergic respiratory diseases such as bronchial asthma has increased in recent years, especially in industrialized countries. A change in the genetic predisposition is an unlikely cause of the increase in allergic diseases because genetic changes in a population require several generations. Consequently, this increase may be explained by changes in environmental factors, including indoor and outdoor air pollution. Over the past two decades, there has been increasing interest in studies of air pollution and its effects on human health. Although the role played by outdoor pollutants in allergic sensitization of the airways has yet to be clarified, a body of evidence suggests that urbanization, with its high levels of vehicle emissions, and a westernized lifestyle are linked to the rising frequency of respiratory allergic diseases observed in most industrialized countries, and there is considerable evidence that asthmatic persons are at increased risk of developing asthma exacerbations with exposure to ozone, nitrogen dioxide, sulphur dioxide and inhalable particulate matter. However, it is not easy to evaluate the impact of air pollution on the timing of asthma exacerbations and on the prevalence of asthma in general. As concentrations of airborne allergens and air pollutants are frequently increased contemporaneously, an enhanced IgE-mediated response to aeroallergens and enhanced airway inflammation could account for the increasing frequency of allergic respiratory allergy and bronchial asthma. Pollinosis is frequently used to study the interrelationship between air pollution and respiratory allergy. Climatic factors (temperature, wind speed, humidity, thunderstorms, etc) can affect both components (biological and chemical) of this interaction. By attaching to the surface of pollen grains and of plant-derived particles of paucimicronic size, pollutants could modify not only the morphology of these antigen-carrying agents but also their allergenic

  7. Combination therapy for chronic invasive rhinocerebral aspergillosis in a clinically immunocompetent patient

    Science.gov (United States)

    Lujber, László; Gerlinger, Imre; Kuncz, Ádám; Pytel, József

    2003-01-01

    Background: Adequate therapy for chronic invasive rhinocerebral aspergillosis in immunocompetent patients is controversial. The incidence of the disease is high in the Sudan and the Middle East. Misinterpretation of diagnostic criteria, failure to verify tissue invasion of fungi, and a lack of understanding of the pathophysiology of various forms of fungal rhinosinusitis lead to controversies in nomenclature, diagnosis, and therapy. Objective: The aim of this report was to detail the clinical presentation and the endoscopic and imaging study findings of a patient with invasive Aspergillus rhinosinusitis with endocranial and orbital extension. This patient was treated with surgical débridement and a combination of antifungal drugs and immunomodulatory therapy. Methods: Endoscopic débridement and high-dose liposomal amphotericin B, in combination with flucytosine and immunomodulators, were used to treat this patient. Results: After treatment, the patient experienced 3 years of disease-free follow-up. Conclusion: Surgical débridement and high-dose systemic combined antifungal therapy with immunomodulatory drugs produced an excellent long-term result for this apparently immunocompetent patient with extensive invasive fungal rhinosinusitis with cerebral and orbital involvement. PMID:24944397

  8. Successful non-standard approaches to massive hemoptysis in invasive pulmonary aspergillosis

    Directory of Open Access Journals (Sweden)

    Mitrović Mirjana

    2012-01-01

    Full Text Available Introduction. Invasive pulmonary aspergillosis (IA is the most frequent invasive fungal infection in patients with hematological malignancies. Massive hemoptysis (MH with blood loss more than 300- 600 ml in 24 hours is a rare (5-10% of IA patients but frequently fatal complication. Standard treatment of MH, such as oxygenation, a semi-sitting position with the bleeding site down, bronchoscopical suctioning, antifungal therapy, transfusion support and surgical resection might be either ineffective or not feasible in some cases. Outline of Cases. We report two patients with life threatening, non-controlled, massive hemoptysis who were successfully managed by non-standard measures. A 61-year-old male with acute myeloid leukemia developed pulmonary IA and massive hemoptysis after consolidation cure by chemotherapy. The bleeding site was localized in the VI lung segment by bronchoscopy. Local application of fibrinogen-thrombin concentrate (fibrin glue stopped the bleeding. A 22-year-old female patient with the diagnosis of severe aplastic anemia developed IA and massive hemoptysis early after application of immunosuppressive therapy (antilymphocyte globulin, cyclosporine and corticosteroids. Conventional transfusion therapy, desmopresine and antifibrinolytics were ineffective. This urgent condition was successfully treated with human activated recombinant factor VII (rFVIIa, NovoSeven®. Conclusion. Our experience together with data from the available literature suggests a potential benefit of fibrinogen-thrombin concentrate and rFVIIa in the treatment of refractory critical bleeding in hematooncological patients.

  9. Detection of urinary excreted fungal galactomannan-like antigens for diagnosis of invasive aspergillosis.

    Directory of Open Access Journals (Sweden)

    Simon F Dufresne

    Full Text Available Mortality associated with invasive aspergillosis (IA remains high, partly because of delayed diagnosis. Detection of microbial exoantigens, released in serum and other body fluids during infection, may help timely diagnosis. In course of IA, Aspergillus galactomannan (GM, a well established polysaccharide biomarker, is released in body fluids including urine. Urine is an abundant, safely collected specimen, well-suited for point-of-care (POC testing, which could play an increasing role in screening for early disease. Our main objective was to demonstrate GM antigenuria as a clinically relevant biological phenomenon in IA and establish proof-of-concept that it could be translated to POC diagnosis. Utilizing a novel IgM monoclonal antibody (MAb476 that recognizes GM-like antigens from Aspergillus and other molds, we demonstrated antigenuria in an experimental animal IA model (guinea pig, as well as in human patients. In addition, we investigated the chemical nature of the urinary excreted antigen in human samples, characterized antigen detection in urine by immunoassays, described a putative assay inhibitor in urine, and indicated means of alleviation of the inhibition. We also designed and used a lateral flow immunochromatographic assay to detect urinary excreted antigen in a limited number of IA patient urine samples. In this study, we establish that POC diagnosis of IA based on urinary GM detection is feasible. Prospective studies will be necessary to establish the performance characteristics of an optimized device and define its optimal clinical use.

  10. Successful voriconazole treatment of invasive pulmonary aspergillosis in a patient with acute biphenotypic leukemia

    Directory of Open Access Journals (Sweden)

    Hirano,Teiichi

    2009-08-01

    Full Text Available A 23-year old woman with acute biphenotypic leukemia (ABL complained of chest pain with cough, high fever and hemoptysis during induction chemotherapy, although she had been treated with anti-biotics and micafungin. We made a clinical diagnosis of invasive pulmonary aspergillosis (IPA based on a consolidation in the right upper lung field on a chest radiograph as well as a high level of serum beta-D-glucan (with no evidence of tuberculosis and candidiasis. We changed her treatment from micafungin to voriconazole. Later, we discovered an air-crescent sign by CT scan that supported the diagnosis of IPA. Following voriconazole treatment, clinical symptoms ceased and abnormal chest shadows improved gradually and concurrently with a recovery of neutrophils. IPA must be considered in immunocompromised patients with pulmonary infiltrates who do not respond to broad-spectrum antibiotics. Serological tests and CT findings can aid in early diagnosis of IPA, which, along with treatment for IPA, will improve clinical outcomes.

  11. First line of defense: Innate cell-mediated control of pulmonary Aspergillosis

    Directory of Open Access Journals (Sweden)

    Vanessa eEspinosa

    2016-03-01

    Full Text Available Mycotic infections and their effect on the human condition have been widely overlooked and poorly surveilled by many health organizations even though mortality rates have increased in recent years. The increased usage of immunosuppressive and myeloablative therapies for the treatment of malignant as well as non-malignant diseases has contributed significantly to the increased incidence of fungal infections. Invasive fungal infections have been found to be responsible for at least 1.5 million deaths worldwide. About 90% of these deaths can be attributed to Cryptococcus, Candida, Aspergillus, and Pneumocystis. A better understanding of how the host immune system contains fungal infection is likely to facilitate the development of much needed novel antifungal therapies. Innate cells are responsible for the rapid recognition and containment of fungal infections and have been found to play essential roles in defense against multiple fungal pathogens. In this review we summarize our current understanding of host-fungi interactions with a focus on mechanisms of innate cell-mediated recognition and control of pulmonary aspergillosis.

  12. Laboratory Diagnosis of Invasive Aspergillosis: From Diagnosis to Prediction of Outcome

    Directory of Open Access Journals (Sweden)

    Richard C. Barton

    2013-01-01

    Full Text Available Invasive aspergillosis (IA, an infection caused by fungi in the genus Aspergillus, is seen in patients with immunological deficits, particularly acute leukaemia and stem cell transplantation, and has been associated with high rates of mortality in previous years. Diagnosing IA has long been problematic owing to the inability to culture the main causal agent A. fumigatus from blood. Microscopic examination and culture of respiratory tract specimens have lacked sensitivity, and biopsy tissue for histopathological examination is rarely obtainable. Thus, for many years there has been a great interest in nonculture-based techniques such as the detection of galactomannan, β-D-glucan, and DNA by PCR-based methods. Recent meta-analyses suggest that these approaches have broadly similar performance parameters in terms of sensitivity and specificity to diagnose IA. Improvements have been made in our understanding of the limitations of antigen assays and the standardisation of PCR-based DNA detection. Thus, in more recent years, the debate has focussed on how these assays can be incorporated into diagnostic strategies to maximise improvements in outcome whilst limiting unnecessary use of antifungal therapy. Furthermore, there is a current interest in applying these tests to monitor the effectiveness of therapy after diagnosis and predict clinical outcomes. The search for improved markers for the early and sensitive diagnosis of IA continues to be a challenge.

  13. Paving the way for predictive diagnostics and personalized treatment of invasive aspergillosis

    Directory of Open Access Journals (Sweden)

    Ana eOliveira-Coelho

    2015-05-01

    Full Text Available Invasive aspergillosis (IA is a life-threatening fungal disease commonly diagnosed among individuals with immunological deficits, namely hematological patients undergoing chemotherapy or allogeneic hematopoietic stem cell transplantation. Vaccines are not available, and despite the improved diagnosis and antifungal therapy, the treatment of IA is associated with a poor outcome. Importantly, the risk of infection and its clinical outcome vary significantly even among patients with similar predisposing clinical factors and microbiological exposure. Recent insights into antifungal immunity have further highlighted the complexity of host-fungus interactions and the multiple pathogen-sensing systems activated to control infection. How to decode this information into clinical practice remains however a challenging issue in medical mycology. Here, we address recent advances in our understanding of the host-fungus interaction and discuss the application of this knowledge in potential strategies with the aim of moving towards personalized diagnostics and treatment (theragnostics in immunocompromised patients. Ultimately, the integration of individual traits into a clinically applicable process to predict the risk and progression of disease, and the efficacy of antifungal prophylaxis and therapy, holds the promise of a pioneering innovation benefiting patients at risk of IA.

  14. Initial computed tomography findings of invasive pulmonary aspergillosis in non-hematological patients

    Institute of Scientific and Technical Information of China (English)

    XU Si-cheng; QIU Li-hua; LIU Wen-ya; FENG Yu-lin

    2012-01-01

    Background The computed tomography (CT) findings of invasive pulmonary aspergillosis (IPA) are unclear in nonhematological patients.The present study was a retrospective evaluation of CT images in non-hematological patients with IPA.Methods All adult patients who met the 2008 European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) criteria for proven or probable IPA were included during a 5-year study at our institutions.Initial CT findings in our cohort were retrospectively reviewed by two independent thoracic radiologists blinded to patient demographics and clinical outcomes.The presence,pattern,and distribution of abnormalities were recorded.Results Twenty-three non-hematological patients with pathologically confirmed IPA were included in our study.Areas of ground-glass opacities were present in 14 patients (61%),which were bilateral in 10 patients and unilateral in four.This pattern mainly involved the middle and upper lung zones.Air-space consolidation was identified in 12 patients (52%),and the areas were distributed along the bronchus or subpleura in most cases.Other findings,including five small nodules (22%),three macronodules (13%),and one halo sign (4%),were less common.Conclusions CT findings of IPA in non-hematological patients frequently manifested as acute bronchopneumonia,and ground-glass opacities and air-space consolidations were the most common CT findings of IPA in these patients.

  15. Graft-Versus-Host Disease after Liver Transplantation Complicated by Systemic Aspergillosis with Pancarditis

    Directory of Open Access Journals (Sweden)

    Joseph Romagnuolo

    2000-01-01

    Full Text Available Acute graft-versus-host disease (GVHD is a common complication after bone marrow transplantation, with characteristic rash and diarrhea being the most common features. After liver transplantation, however, this phenomenon is very rare. Most transplant patients are on a variety of medications, including immunosuppressants; therefore, the differential diagnosis of skin rash or diarrhea is broad. A 37-year-old man who underwent liver transplantation for primary biliary cirrhosis, and developed a rash and watery diarrhea, is presented. Skin and colonic biopsies confirmed acute GVHD. A pulse of intravenous steroids was given. The skin rash improved, but he developed pancytopenia. His course was complicated by central line infection, jugular and subclavian vein thrombosis, pseudomembranous colitis, recurrent bacteremia, cholestasis on total parenteral nutrition and cytomegalovirus infection. After the onset of pleuritic chest pain and clinical sepsis, spiral computed tomography scan of his chest and abdomen revealed septic infarcts in multiple organs. Despite empirical treatment with amphotericin B, he died of multiorgan dysfunction syndrome within 72 h. Autopsy revealed systemic aspergillosis with pancarditis, endocardial vegetations, and septic pulmonary, splenic, hepatic and renal infarcts. The pathogenesis and experience with this rare, but often fatal, complication of liver transplantation are reviewed. In contrast to GVHD after bone marrow transplantation, pancytopenia is common and liver dysfunction is rare. One should have a high level of suspicion in the liver transplant recipient presenting with rash and/or diarrhea.

  16. [Assessing the impact of risk factors and polymorphisms GST genes on the development of bronchopulmonary dysplasia in premature infants].

    Science.gov (United States)

    2014-09-01

    An increasing incidence of bronchopulmonary dysplasia (BPD) in premature infants has been reported in recent years. In the present study we analyzed the risk factors for BPD. It was revealed that the most significant factors are the low gestational age and birth weight, as well as prolonged use of mechanical ventilation and late neonatal infection. Polymorphism of studied genes and various combinations of polymorphic variants did not affect the risk of BPD developing. The influence of genetic polymorphisms on the duration of mechanical ventilation, the occurrence of late neonatal infection. For proper evaluation of the contribution of genetic polymorphism is necessary to conduct a preliminary analysis of all possible clinical and laboratory parameters to identify strong independent predictors and then analyze the indirect effects of genetic factors. Further research and development of new approaches to ventilation mode in preterm infants, based on the genetic polymorphism, will create a set of preventive measures and reduce the incidence of BPD. PMID:25341249

  17. DHA-Rich Tuna Oil Effectively Suppresses Allergic Symptoms in Mice Allergic to Whey or Peanut

    NARCIS (Netherlands)

    van den Elsen, Lieke Wj; Bol-Schoenmakers, Marianne; van Esch, Betty Cam; Hofman, Gerard A; van de Heijning, Bert Jm; Pieters, Raymond H; Smit, Joost J; Garssen, Johan; Willemsen, Linette Em

    2014-01-01

    BACKGROUND: Supplementation with long-chain n-3 polyunsaturated fatty acids (LCPUFAs) has been found to reduce the development of allergic disease. OBJECTIVE: The aim of this study was to compare the effectiveness of fish oil diets rich in eicosapentaenoic acid (20:5n-3; EPA) or docosahexaenoic acid

  18. Inhalation or instillation of steroids for the prevention of bronchopulmonary dysplasia.

    Science.gov (United States)

    Bassler, Dirk

    2015-01-01

    Survival of extremely preterm infants has increased over recent years, but bronchopulmonary dysplasia (BPD) remains a major cause of morbidity. In the USA, BPD is the most common chronic respiratory disorder of infancy and affects the pulmonary and overall health of 10,000 preterm infants annually. Preclinical and clinical studies suggest a crucial role for lung inflammation and host immune response in the pathogenesis of BPD. Inflammation may result from, amongst others, chorioamnionitis, postnatal infection, ventilation, and the administration of oxygen. Infants with BPD have worse long-term outcomes than those without chronic lung disease. They are more than twice as likely to be readmitted to hospital in their first year of life and, having survived their primary hospitalizations, they are more likely to die than very preterm infants without chronic lung disease. Survivors with BPD have an increased risk of neurodevelopmental impairment and their respiratory function remains compromised well into adolescence. As the first generations of extremely low birth weight (ELBW) survivors have not yet reached retirement age, there are currently no reliable data addressing the association between BPD and pulmonary diseases of the elderly such as chronic obstructive pulmonary disease. Although BPD is quite common in ELBW infants, there are infants who do not develop BPD, which supports the argument that BPD is a preventable disease, emphasizing the need for high-quality safety and efficacy prevention studies. However, according to an Institute of Medicine statement regarding pediatric drug studies, the therapeutic area that has the fewest drugs indicated for neonates is BPD. As inflammation seems to be a primary mediator of injury in the pathogenesis of BPD, anti-inflammatory agents such as steroids have long been the focus of preventive research activities. However, systemic steroids, although reducing BPD, have frequently been linked to adverse neurodevelopmental

  19. P67-phox (NCF2 lacking exons 11 and 12 is functionally active and leads to an extremely late diagnosis of chronic granulomatous disease (CGD.

    Directory of Open Access Journals (Sweden)

    Joachim Roesler

    Full Text Available Two brothers in their fifties presented with a medical history of suspected fungal allergy, allergic bronchopulmonary aspergillosis, alveolitis, and invasive aspergillosis and pulmonary fistula, respectively. Eventually, after a delay of 50 years, chronic granulomatous disease (CGD was diagnosed in the index patient. We found a new splice mutation in the NCF2 (p67-phox gene, c.1000 + 2T → G, that led to several splice products one of which lacked exons 11 and 12. This deletion was in frame and allowed for remarkable residual NADPH oxidase activity as determined by transduction experiments using a retroviral vector. We conclude that p67-phox which lacks the 34 amino acids encoded by the two exons can still exert considerable functional activity. This activity can partially explain the long-term survival of the patients without adequate diagnosis and treatment, but could not prevent progressing lung damage.

  20. Oscar Wilde's skin disease: allergic contact dermatitis?

    Science.gov (United States)

    Nater, J P

    1992-07-01

    During the last years of his life, Oscar Wilde (1856-1900) suffered from a suppurating otitis media as well as from an unidentified skin disease. The eruption was localized to his face, arms, chest and back and itched severely. A new theory is suggested, based on the fact that Wilde almost certainly used a dye to conceal his rapidly graying hair. He sensitized himself to p-phenylenediamine and developed a stubborn allergic contact dermatitis. Patch testing, the only proof of such a diagnosis, had not yet been devised.

  1. Immune allergic response in Asperger syndrome.

    Science.gov (United States)

    Magalhães, Elizabeth S; Pinto-Mariz, Fernanda; Bastos-Pinto, Sandra; Pontes, Adailton T; Prado, Evandro A; deAzevedo, Leonardo C

    2009-11-30

    Asperger's syndrome is a subgroup of autism characterized by social deficits without language delay, and high cognitive performance. The biological nature of autism is still unknown but there are controversial evidence associating an immune imbalance and autism. Clinical findings, including atopic family history, serum IgE levels as well as cutaneous tests showed that incidence of atopy was higher in the Asperger group compared to the healthy controls. These findings suggest that atopy is frequent in this subgroup of autism implying that allergic inflammation might be an important feature in Asperger syndrome.

  2. Allergic sensitization to ornamental plants in patients with allergic rhinitis and asthma.

    Science.gov (United States)

    Aydin, Ömür; Erkekol, Ferda Öner; Misirloigil, Zeynep; Demirel, Yavuz Selim; Mungan, Dilşad

    2014-01-01

    Ornamental plants (OPs) can lead to immediate-type sensitization and even asthma and rhinitis symptoms in some cases. This study aimed to evaluate sensitization to OPs in patients with asthma and/or allergic rhinitis and to determine the factors affecting the rate of sensitization to OPs. A total of 150 patients with asthma and/or allergic rhinitis and 20 healthy controls were enrolled in the study. Demographics and disease characteristics were recorded. Skin-prick tests were performed with a standardized inhalant allergen panel. Skin tests by "prick-to-prick" method with the leaves of 15 Ops, which are known to lead to allergenic sensitization, were performed. Skin tests with OPs were positive in 80 patients (47.1%). There was no significant difference between OP sensitized and nonsensitized patients in terms of gender, age, number of exposed OPs, and duration of exposure. Skin test positivity rate for OPs was significantly high in atopic subjects, patients with allergic rhinitis, food sensitivity, and indoor OP exposure, but not in patients with pollen and latex allergy. Most sensitizing OPs were Yucca elephantipes (52.5%), Dieffenbachia picta (50.8%), and Euphorbia pulcherrima (47.5%). There was significant correlation between having Saintpaulia ionantha, Croton, Pelargonium, Y. elephantipes, and positive skin test to these plants. Sensitivity to OPs was significantly higher in atopic subjects and patients with allergic rhinitis, food allergy, and indoor OP exposure. Furthermore, atopy and food sensitivity were found as risk factors for developing sensitization to indoor plants. Additional trials on the relationship between sensitization to OPs and allergic symptoms are needed. PMID:24717779

  3. Expression of Pendrin Periostin in Allergic Rhinitis Chronic Rhinosinusitis

    Directory of Open Access Journals (Sweden)

    Akihiro Ishida

    2012-01-01

    Conclusions: : Production of pendrin and periostin is upregulated in allergic rhinitis, chronic rhinosinusitis with nasal polyps, and aspirin-induced asthma. These findings suggest that pendrin can induce mucus production and that periostin can induce tissue fibrosis and remodeling in the nasal mucosa. Therefore, these mediators may be therapeutic target candidates for allergic rhinitis, chronic rhinosinusitis with nasal polyps, and aspirin- induced asthma.

  4. Angioedema-like allergic contact dermatitis related to black henna

    OpenAIRE

    Gokalp, Hilal; Kaya, Kismet

    2014-01-01

    Allergic contact dermatitis related to para-phenylendiamine (PPD) from temporary black henna tattoos and hair dyes has become an epidemic in recent years. Several cases of adverse skin reactions to PPD have been reported in the literature. Herein, we present a case of angioedema-like allergic contact dermatitis related to hair coloring with henna.

  5. STUDY OF PREVALENCE OF EOSINOPHILIA IN ALLERGIC RHINITIS

    Directory of Open Access Journals (Sweden)

    Ravi Kumar

    2015-10-01

    Full Text Available BACKGROUND: Allergic rhinitis is a common condition, though not life threatening, causes significant morbidity in terms of quality of life. Confirmation of allergen as etiological agent is cumbersome. Hence need for a simple test is vital and eosinophil parameters were looked at to answer the quest. AIM: To find out the prevalence of e osinophilia in Allergic rhinitis . To assess the value of nasal cytogram as an alternative investigation in diagnosing allergic rhinitis . MATERIALS & METHODS: Prospective study of 200 cases divided into two groups of 100 each was done. One group clinically with allergic rhinitis and other without. All cases had clinical examination after history was taken, Blood Absolute eosinophil count, Nasal smear for eosinophils done and assessed. RESULTS: Of the 200 patients examined in two groups of 100 each, mean age of allergic rhinitis patients was 26.22 years . Allergic rhinitis was more common in males than females. Prevalence of nasal eosinophilia was 61%.and blood eosinophilia was 57% in allergic rhinitis patients. Nasal smear sensitivity was 61% and specificity w as 87% . CONCLUSION: Nasal smear eosinophilia is a valid test, can be quickly and easily performed and read. Being an in - expensive test can be used to screen the patients of allergic rhinitis

  6. Impact on allergic immune response after treatment with vitamin A

    DEFF Research Database (Denmark)

    Matheu, Victor; Berggård, Karin; Barrios, Yvelise;

    2009-01-01

    ABSTRACT: BACKGROUND: Vitamin A may have some influence on the immune system, but the role in allergy modulation is still unclear. OBJECTIVE: To clarify whether high levels of retinoic acid (RA) affects allergic response in vivo, we used a murine experimental model of airway allergic disease...

  7. [Invasive aspergillosis of sphenoidal sinus in a patient in Djibouti, revealed by palsy of cranial nerves: a case report].

    Science.gov (United States)

    Crambert, A; Gauthier, J; Vignal, R; Conessa, C; Lombard, B

    2013-05-01

    The authors report a case of invasive aspergillosis of a sphenoid sinus mucocele revealed in a patient with diabetes in Djibouti by homolateral palsy of the 3rd, 4th, 5th and 6th nerves. This rare condition occurs preferentially in immunodeficient subjects. Because of its clinical polymorphism, its diagnosis is difficult and is often not made until complications develop. Endonasal surgery with anatomopathological and mycological examination is both a diagnostic and therapeutic procedure. It must be performed early, to avoid functional or even life-threatening complications. PMID:23803589

  8. Initial CT manifestations of invasive pulmonary aspergillosis in 45 non-HIV immunocompromised patients: association with patient outcome?

    Energy Technology Data Exchange (ETDEWEB)

    Horger, Marius [Department of Diagnostic Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076 Tuebingen (Germany)]. E-mail: mshorger@med.uni-tuebingen.de; Hebart, Holger [Department of Internal Medicine-Oncology, Eberhard-Karls-University, Ottfried-Mueller-Str. 5, 72070 Tuebingen (Germany); Einsele, Hermann [Department of Internal Medicine-Oncology, Eberhard-Karls-University, Ottfried-Mueller-Str. 5, 72070 Tuebingen (Germany); Lengerke, Claudia [Department of Internal Medicine-Oncology, Eberhard-Karls-University, Ottfried-Mueller-Str. 5, 72070 Tuebingen (Germany); Claussen, C.D. [Department of Diagnostic Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076 Tuebingen (Germany); Vonthein, Reinhard [Department of Medical Biometry, Eberhard-Karls-University Tuebingen, Westbahnhofstrasse 55, 72070 Tuebingen (Germany); Pfannenberg, Christina [Department of Diagnostic Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076 Tuebingen (Germany)

    2005-09-01

    Purpose: To assess early high-resolution computer tomographic (CT) signs of invasive pulmonary aspergillosis (IPA) in non-HIV immunosuppressed patients and their potential association with patient's outcome, including frequency and severity of pulmonary hemorrhage, taking also in consideration the impact of other known risk factors contributory to IPA. Material and methods: A retrospective review of serial CT scans was performed in 45 immunocompromised patients with a total of 46 episodes of invasive pulmonary aspergillosis. All patients underwent CT beginning with the day they showed clinical or laboratory signs of infection. Serial follow-up CT included more than two, up to 12 CT examinations. Patient's outcome was judged by clinical and radiological follow-up and classified as survival, death by IPA, or death unrelated to IPA. The influence of patient's age, underlying disease, hematopoietic stem cell transplantation, neutropenia, graft versus host disease, and antifungal therapy onset was also statistically considered. Results: Three main CT findings were identified: small nodules (<1 cm) 43% (20/46), large nodules 21% (10/46) and consolidations, either in patchy {+-} segmental 26% (12/46), or peribronchial distribution {+-} tree in bud 9% (4/46). In 11 patients (24%) we found a combination of two or more of these signs: 9 (19%) patients presented concurrent small nodules accompanied by reticulation, tree in bud or peribronchial infiltrates, while 2 (4%) patients showed large pulmonary nodules accompanied by large consolidations. An accompanying 'halo' sign was observed in 38 patients (82%). Crescent sign followed by cavitation was encountered in 29 patients (63%). Two patients succumbed to massive pulmonary bleeding caused by IPA. Twenty-one patients (15/46) deceased in this series, 12 of them succumbed to IPA, 1 died from cerebral invasive aspergillosis, while in 9 patients the cause of death was not primarily IPA. Manifest pulmonary

  9. The T788G Mutation in the cyp51C Gene Confers Voriconazole Resistance in Aspergillus flavus Causing Aspergillosis

    OpenAIRE

    Liu, Wei; Sun, Yi; Chen, Wei; Liu, Weixia; Wan, Zhe; Bu, Dingfang; Li, Ruoyu

    2012-01-01

    With voriconazole (VRC) being approved as the first choice in treating invasive aspergillosis (IA) and its increasing use in treatment, a VRC-resistant strain of Aspergillus flavus, the second leading cause of IA after Aspergillus fumigatus, has emerged. The VRC-resistant strain of A. flavus was isolated for the first time from the surgical lung specimen of an IA patient with no response to VRC therapy. In order to ascertain the mechanism of VRC resistance, the azole target enzyme genes in th...

  10. Successful management of pulmonary hemorrhage and aspergillosis in a patient with acute myeloid leukemia (AML-M3

    Directory of Open Access Journals (Sweden)

    Hulya Gunbatar

    2015-01-01

    Full Text Available A 35-year-old man presented with a one month history of gingival bleeding. He was diagnosed with Acute Myeloid Leukemia (AML-M3. During treatment he developed alveolar hemorrhage for which he was treated with a steroid. After the steroid treatment he developed a nodule, a cavitary lesion and atelectasia in the left lung. He was treated with voriconazole. After therapy with voriconazole his lesion significantly decreased. This case illustrates the efficacy and safety of antifungal therapy with voriconazole for aspergillosis complicated by AML.

  11. Allergic and nonallergic asthma in children: are they distinct phenotypes?

    Directory of Open Access Journals (Sweden)

    Seyed Alireza Mahdaviani

    2014-10-01

    Full Text Available The aim of current study is to describe clinical similarities and differences between atopic and non-atopic asthma in children. In a cross-sectional study, 95 asthmatic children (75 allergics and 20 nonallergics were included in the study. Demographic, clinical, and familial history were compared between two groups. There was no significant differences between variables like sex, age of onset (p=0.75, severity (p=0.70, and family history among the two groups (p=0.42. Patients with allergic asthma were significantly older than those with non- allergic asthma (11.28 ± 3.19 and 9.75 ± 2.35 years, respectively, p=0.02. The controversy lingers over the presence of a completely distinct phenotype of non-atopic asthma in children. Our study suggested that phenotypes of allergic and non-allergic asthma in children were not entirely distinct.

  12. Is Allergic Rhinitis a Factor That Affects Success of Tympanoplasty?

    Directory of Open Access Journals (Sweden)

    Elif Ersoy Callioglu

    2016-04-01

    Full Text Available Objective: The aim of the present study was to investigate the effect of allergic rhinitis on the success of the operation in chronic otitis surgery by using score for allergic rhinitis (SFAR. Materials and Methods: In the present study; 121 patients, who underwent type 1 tympanoplasty were examined retrospectively. SFAR of all patients were recorded. The graft success rates of 26 patients with allergic rhinitis (AR and 95 patients with no allergic rhinitis group (NAR were compared. Results: While the graft success rate in NAR group was 89.5%, this rate was 80.8% in the AR group. However, the difference between groups was not statistically significant (p = 0.311. Conclusion: These findings suggest that allergic rhinitis decreases the graft success rate of the pathologies occurring in eustachian tube, middle ear and mastoid although statistically significant difference wasn’t found. Prospective studies with larger patient groups are required in order to evaluate this pathology.

  13. Methylisothiazolinone in rinse-off products causes allergic contact dermatitis

    DEFF Research Database (Denmark)

    Yazar, K; Lundov, Michael Dyrgaard; Faurschou, A;

    2015-01-01

    the potential to cause allergic contact dermatitis. METHODS: Nineteen MI-allergic subjects and 19 controls without MI allergy applied two liquid hand soaps five times per day on areas of 5 × 10 cm(2) on the ventral side of their forearms. One soap contained 100 ppm MI, the maximum allowed concentration...... in cosmetics, and was used by 10 allergic subjects and all controls. Another liquid soap with 50 ppm MI was used by nine allergic subjects. As the negative control, all subjects used a similar soap that did not contain MI. The repeated open applications proceeded until a positive reaction occurred or up to 21...... days. The study was conducted in a randomized and blinded fashion. RESULTS: Ten out of 10 MI-allergic subjects developed positive reactions to the soap with 100 ppm and seven out of nine reacted to the 50 ppm soap, while none of the 19 controls had a positive reaction during 21 days of application...

  14. Selective suppression of leukocyte recruitment in allergic inflammation

    Directory of Open Access Journals (Sweden)

    CL Weller

    2005-03-01

    Full Text Available Allergic diseases result in a considerable socioeconomic burden. The incidence of allergic diseases, notably allergic asthma, has risen to high levels for reasons that are not entirely understood. With an increasing knowledge of underlying mechanisms, there is now more potential to target the inflammatory process rather than the overt symptoms. This focuses attention on the role of leukocytes especially Th2 lymphocytes that regulate allergic inflammation and effector cells where eosinophils have received much attention. Eosinophils are thought to be important based on the high numbers that are recruited to sites of allergic inflammation and the potential of these cells to effect both tissue injury and remodelling. It is hoped that future therapy will be directed towards specific leukocyte types, without overtly compromising essential host defence responses. One obvious target is leukocyte recruitment. This necessitates a detailed understanding of underlying mechanisms, particularly those involving soluble che-moattractants signals and cell-cell adhesion molecules.

  15. Importins and Exportins Regulating Allergic Immune Responses

    Directory of Open Access Journals (Sweden)

    Ankita Aggarwal

    2014-01-01

    Full Text Available Nucleocytoplasmic shuttling of macromolecules is a well-controlled process involving importins and exportins. These karyopherins recognize and bind to receptor-mediated intracellular signals through specific signal sequences that are present on cargo proteins and transport into and out of the nucleus through nuclear pore complexes. Nuclear localization signals (NLS present on cargo molecules to be imported while nuclear export signals (NES on the molecules to be exported are recognized by importins and exportins, respectively. The classical NLS are found on many transcription factors and molecules that are involved in the pathogenesis of allergic diseases. In addition, several immune modulators, including corticosteroids and vitamin D, elicit their cellular responses by regulating the expression and activity of importin molecules. In this review article, we provide a comprehensive list of importin and exportin molecules and their specific cargo that shuttled between cytoplasm and the nucleus. We also critically review the role and regulation of specific importin and exportin involved in the transport of activated transcription factors in allergic diseases, the underlying molecular mechanisms, and the potential target sites for developing better therapeutic approaches.

  16. Toxocara canis and the allergic process.

    Science.gov (United States)

    Zaia, Mauricio Grecco; Oliveira, Sandra Regina Pereira de; Castro, Cynthia Aparecida de; Soares, Edson Garcia; Afonso, Ana; Monnazzi, Luis Gustavo S; Peitl Filho, Oscar; Faccioli, Lúcia Helena; Anibal, Fernanda de Freitas

    2015-09-01

    The protective effect of infectious agents against allergic reactions has been thoroughly investigated. Current studies have demonstrated the ability of some helminths to modulate the immune response of infected hosts. The objective of the present study was to investigate the relationship between Toxocara canis infection and the development of an allergic response in mice immunised with ovalbumin (OVA). We determined the total and differential blood and bronchoalveolar lavage fluid cells using BALB/c mice as a model. To this end, the levels of interleukin (IL)-4, IL-5 and IL-10 and anti-OVA-IgE were measured using an ELISA. The inflammatory process in the lungs was observed using histology slides stained with haematoxylin and eosin. The results showed an increase in the total number of leukocytes and eosinophils in the blood of infected and immunised animals at 18 days after infection. We observed a slight lymphocytic inflammatory infiltrate in the portal space in all infected mice. Anti-OVA-IgE levels were detected in smaller proportions in the plasma of immunised and infected mice compared with mice that were only infected. Therefore, we concluded that T. canis potentiates inflammation in the lungs in response to OVA, although anti-OVA-IgE levels suggest a potential reduction of the inflammatory process through this mechanism. PMID:26517650

  17. Number of siblings and allergic rhinitis in children

    Directory of Open Access Journals (Sweden)

    Soewira Sastra

    2016-05-01

    Full Text Available Background Allergic rhinitis is one of the most common chronic diseases of childhood. Recent studies have suggested that having fewer siblings was associated with allergic rhinitis and atopic diseases in children. Previous studies also indicated that older siblings was associated with higher incidence of allergic rhinitis.Objectives To assess for a possible association between number of siblings and allergic rhinitis and to assess for an effect of birth order on allergic rhinitis in children.Methods We performed a cross-sectional study among school children aged 7 to 15 years, in the West Medan District from July to August 2011. Children with moderate or high risk of allergy were included. Subjects were divided into two groups, those with <3 siblings or ≥3 siblings. Children with acute respiratory tract infections, septal deviation, choanal atresia, nasal polyps, nasal tumors, or nasal foreign body were excluded. Risk of allergy was determined using the Indonesian Pediatrics Allergy Immunology Working Group trace card scoring system. Identification of allergic rhinitis and evaluation of its severity were done by use of the International Study of Asthma and Allergies in Childhood (ISAAC core questionnaire. Allergic rhinitis was diagnosed based on history, physical examination, and anterior rhinoscopy.Results A total of 78 subjects were enrolled. Allergic rhinitis was significantly higher in children with <3 siblings than those with ≥3 siblings (OR 10.33; 95%CI 3.569 to 29.916. Furthermore, allergic rhinitis was significantly higher in first-born children than in their younger siblings (P=0.0001.Conclusion Larger number of siblings and non-first-born children are associated with lower incidence of allergic rhinitis in children.

  18. Number of siblings and allergic rhinitis in children

    Directory of Open Access Journals (Sweden)

    Soewira Sastra

    2016-01-01

    Full Text Available Background Allergic rhinitis is one of the most common chronic diseases of childhood. Recent studies have suggested that having fewer siblings was associated with allergic rhinitis and atopic diseases in children. Previous studies also indicated that older siblings was associated with higher incidence of allergic rhinitis. Objectives To assess for a possible association between number of siblings and allergic rhinitis and to assess for an effect of birth order on allergic rhinitis in children. Methods We performed a cross-sectional study among school children aged 7 to 15 years, in the West Medan District from July to August 2011. Children with moderate or high risk of allergy were included. Subjects were divided into two groups, those with <3 siblings or ≥3 siblings. Children with acute respiratory tract infections, septal deviation, choanal atresia, nasal polyps, nasal tumors, or nasal foreign body were excluded. Risk of allergy was determined using the Indonesian Pediatrics Allergy Immunology Working Group trace card scoring system. Identification of aller-allergic rhinitis and evaluation of its severity were done by use of the International Study of Asthma and Allergies in Childhood (ISAAC core questionnaire. Allergic rhinitis was diagnosed based on history, physical examination, and anterior rhinoscopy. Results A total of 78 subjects were enrolled. Allergic rhinitis was significantly higher in children with <3 siblings than those with ≥3 siblings (OR 10.33; 95%CI 3.569 to 29.916. Furthermore, allergic rhinitis was significantly higher in first-born children than in their younger siblings (P=0.0001. Conclusion Larger number of siblings and non-first-born children are associated with lower incidence of allergic rhinitis in children.

  19. Common Genetic Polymorphisms within NFκB-Related Genes and the Risk of Developing Invasive Aspergillosis

    Science.gov (United States)

    Lupiañez, Carmen B.; Villaescusa, María T.; Carvalho, Agostinho; Springer, Jan; Lackner, Michaela; Sánchez-Maldonado, José M.; Canet, Luz M.; Cunha, Cristina; Segura-Catena, Juana; Alcazar-Fuoli, Laura; Solano, Carlos; Fianchi, Luana; Pagano, Livio; Potenza, Leonardo; Aguado, José M.; Luppi, Mario; Cuenca-Estrella, Manuel; Lass-Flörl, Cornelia; Einsele, Hermann; Vázquez, Lourdes; Ríos-Tamayo, Rafael; Loeffler, Jurgen; Jurado, Manuel; Sainz, Juan

    2016-01-01

    Invasive Aspergillosis (IA) is an opportunistic infection caused by Aspergillus, a ubiquitously present airborne pathogenic mold. A growing number of studies suggest a major host genetic component in disease susceptibility. Here, we evaluated whether 14 single-nucleotide polymorphisms within NFκB1, NFκB2, RelA, RelB, Rel, and IRF4 genes influence the risk of IA in a population of 834 high-risk patients (157 IA and 677 non-IA) recruited through a collaborative effort involving the aspBIOmics consortium and four European clinical institutions. No significant overall associations between selected SNPs and the risk of IA were found in this large cohort. Although a hematopoietic stem cell transplantation (HSCT)-stratified analysis revealed that carriers of the IRF4rs12203592T/T genotype had a six-fold increased risk of developing the infection when compared with those carrying the C allele (ORREC = 6.24, 95%CI 1.25–31.2, P = 0.026), the association of this variant with IA risk did not reach significance at experiment-wide significant threshold. In addition, we found an association of the IRF4AATC and IRF4GGTC haplotypes (not including the IRF4rs12203592T risk allele) with a decreased risk of IA but the magnitude of the association was similar to the one observed in the single-SNP analysis, which indicated that the haplotypic effect on IA risk was likely due to the IRF4rs12203592 SNP. Finally, no evidence of significant interactions among the genetic markers tested and the risk of IA was found. These results suggest that the SNPs on the studied genes do not have a clinically relevant impact on the risk of developing IA.

  20. Genome-wide Expression Profiling Reveals S100B as Biomarker for Invasive Aspergillosis

    Directory of Open Access Journals (Sweden)

    Andreas eDix

    2016-03-01

    Full Text Available Invasive aspergillosis (IA is a devastating opportunistic infection and its treatment constitutes a considerable burden for the health care system. Immunocompromised patients are at an increased risk for IA, which is mainly caused by the species Aspergillus fumigatus. An early and reliable diagnosis is required to initiate the appropriate antifungal therapy. However, diagnostic sensitivity and accuracy still needs to be improved, which can be achieved at least partly by the definition of new biomarkers. Besides the direct detection of the pathogen by the current diagnostic methods, the analysis of the host response is a promising strategy towards this aim. Following this approach, we sought to identify new biomarkers for IA. For this purpose, we analyzed gene expression profiles of haematological patients and compared profiles of patients suffering from IA with non-IA patients. Based on microarray data, we applied a comprehensive feature selection using a random forest classifier. We identified the transcript coding for the S100 calcium-binding protein B (S100B as a potential new biomarker for the diagnosis of IA. Considering the expression of this gene, we were able to classify samples from patients with IA with 82.3% sensitivity and 74.6% specificity. Moreover, we validated the expression of S100B in a real-time reverse transcription polymerase chain reaction (RT-PCR assay and we also found a down-regulation of S100B in A. fumigatus stimulated DCs. An influence on the IL1B and CXCL1 downstream levels was demonstrated by this S100B knockdown. In conclusion, this study covers an effective feature selection revealing a key regulator of the human immune response during IA. S100B may represent an additional diagnostic marker that in combination with the established techniques may improve the accuracy of IA diagnosis.

  1. Genome-Wide Expression Profiling Reveals S100B as Biomarker for Invasive Aspergillosis.

    Science.gov (United States)

    Dix, Andreas; Czakai, Kristin; Springer, Jan; Fliesser, Mirjam; Bonin, Michael; Guthke, Reinhard; Schmitt, Anna L; Einsele, Hermann; Linde, Jörg; Löffler, Jürgen

    2016-01-01

    Invasive aspergillosis (IA) is a devastating opportunistic infection and its treatment constitutes a considerable burden for the health care system. Immunocompromised patients are at an increased risk for IA, which is mainly caused by the species Aspergillus fumigatus. An early and reliable diagnosis is required to initiate the appropriate antifungal therapy. However, diagnostic sensitivity and accuracy still needs to be improved, which can be achieved at least partly by the definition of new biomarkers. Besides the direct detection of the pathogen by the current diagnostic methods, the analysis of the host response is a promising strategy toward this aim. Following this approach, we sought to identify new biomarkers for IA. For this purpose, we analyzed gene expression profiles of hematological patients and compared profiles of patients suffering from IA with non-IA patients. Based on microarray data, we applied a comprehensive feature selection using a random forest classifier. We identified the transcript coding for the S100 calcium-binding protein B (S100B) as a potential new biomarker for the diagnosis of IA. Considering the expression of this gene, we were able to classify samples from patients with IA with 82.3% sensitivity and 74.6% specificity. Moreover, we validated the expression of S100B in a real-time reverse transcription polymerase chain reaction (RT-PCR) assay and we also found a down-regulation of S100B in A. fumigatus stimulated DCs. An influence on the IL1B and CXCL1 downstream levels was demonstrated by this S100B knockdown. In conclusion, this study covers an effective feature selection revealing a key regulator of the human immune response during IA. S100B may represent an additional diagnostic marker that in combination with the established techniques may improve the accuracy of IA diagnosis. PMID:27047454

  2. Impaired T cell responsiveness to interleukin-6 in hematological patients with invasive aspergillosis.

    Directory of Open Access Journals (Sweden)

    Jose F Camargo

    Full Text Available Invasive mold infections (IMI are among the most devastating complications following chemotherapy and hematopoietic stem cell transplantation (HSCT, with high mortality rates. Yet, the molecular basis for human susceptibility to invasive aspergillosis (IA and mucormycosis remain poorly understood. Herein, we aimed to characterize the immune profile of individuals with hematological malignancies (n = 18 who developed IMI during the course of chemotherapy or HSCT, and compared it to that of hematological patients who had no evidence of invasive fungal infection (n = 16. First, we measured the expression of the pattern recognition receptors pentraxin 3, dectin-1, and Toll-like receptors (TLR 2 and 4 in peripheral blood of chemotherapy and HSCT recipients with IMI. Compared to hematological controls, individuals with IA and mucormycosis had defective expression of dectin-1; in addition, patients with mucormycosis had decreased TLR2 and increased TLR4 expression. Since fungal recognition via dectin-1 favors T helper 17 responses and the latter are highly dependent on activation of the signal transducer and activator of transcription (STAT 3, we next used phospho-flow cytometry to measure the phosphorylation of the transcription factors STAT1 and STAT3 in response to interferon-gamma (IFN-γ and interleukin (IL-6, respectively. While IFN-γ/STAT1 signaling was similar between groups, naïve T cells from patients with IA, but not those with mucormycosis, exhibited reduced responsiveness to IL-6 as measured by STAT3 phosphorylation. Furthermore, IL-6 increased Aspergillus-induced IL-17 production in culture supernatants from healthy and hematological controls but not in patients with IA. Altogether, these observations suggest an important role for dectin-1 and the IL-6/STAT3 pathway in protective immunity against Aspergillus.

  3. Antigenic and anticorpal diagnosis of invasive aspergillosis and candidosis in immunocompromised host

    Directory of Open Access Journals (Sweden)

    Marco Machetti

    2009-03-01

    Full Text Available Invasive aspergillosis (IA and candidemia are an increasing cause of morbidity and mortality in immunocompromised patients, but diagnostic procedures are often hampered by critical patients conditions. In recent years, non-culture methods have reached a standardization level suitable to be marketed and widely employed. A method for a panfungal antigenic diagnosis, is the detection in serum of (1→3-ß-D-Glucan (BDG, a polisaccaridic component of fungal cell wall. Best results can be obtained in Aspergillus, Candida and Fusarium infections, while the test performs poorly with Cryptococcus and in zygomycosis. The use of this method are limited by the high costs and by the need of disposable materials certified as glucan-free, in order to avoid false positive results. Galactomannan (GM antigen detection is a method for non-invasive diagnosis of IA. The assay, in latex agglutination (LA and enzymeimmunoassay (EIA format, detect GM in serum, whose presence correlates with IA. Sensitivity and specificity strongly fluctuate (50-100% and 81-98% respectively depending on the time of sampling, the positivity cut-off employed, the concomitant administration of antifungal drugs and of some antibiotics. Nevertheless the method is a very useful and widely employed tool for the diagnosis of IA. For the diagnosis of candidemia, two Candida antigens may be detected in serum: the 56°C heat-labile antigen in LA format, and the mannan antigen, in LA and EIA format. Both the methods perform quite well, but sensitivities and specificities are not so good to allow a routinely and useful use in clinical practice.

  4. The Plasmair Decontamination System Is Protective Against Invasive Aspergillosis in Neutropenic Patients.

    Science.gov (United States)

    Fernandez-Gerlinger, Marie-Paule; Jannot, Anne-Sophie; Rigaudeau, Sophie; Lambert, Juliette; Eloy, Odile; Mignon, François; Farhat, Hassan; Castaigne, Sylvie; Merrer, Jacques; Rousselot, Philippe

    2016-07-01

    OBJECTIVE Invasive aspergillosis (IA) is a rare but severe infection caused by Aspergillus spp. that often develops in immunocompromised patients. Lethality remains high in this population. Therefore, preventive strategies are of key importance. The impact of a mobile air decontamination system (Plasmair, AirInSpace, Montigny-le-Bretonneux, France) on the incidence of IA in neutropenic patients was evaluated in this study. DESIGN Retrospective cohort study METHODS Patients with chemotherapy-induced neutropenia lasting 7 days or more were included over a 2-year period. Cases of IA were confirmed using the revised European Organization for Research and Treatment of Cancer (EORTC) criteria. We took advantage of a partial installation of Plasmair systems in the hematology intensive care unit during this period to compare patients treated in Plasmair-equipped versus non-equipped rooms. Patients were assigned to Plasmair-equipped or non-equipped rooms depending only on bed availability. Differences in IA incidence in both groups were compared using Fisher's exact test, and a multivariate analysis was performed to take into account potential confounding factors. RESULTS Data from 156 evaluable patients were available. Both groups were homogenous in terms of age, gender, hematological diagnosis, duration of neutropenia, and prophylaxis. A total of 11 cases of probable IA were diagnosed: 10 in patients in non-equipped rooms and only 1 patient in a Plasmair-equipped room. The odds of developing IA were much lower for patients hospitalized in Plasmair-equipped rooms than for patients in non-equipped rooms (P=.02; odds ratio [OR] =0.11; 95% confidence interval [CI], 0.00-0.84). CONCLUSION In this study, Plasmair demonstrated a major impact in reducing the incidence of IA in neutropenic patients with hematologic malignancies. Infect Control Hosp Epidemiol 2016;37:845-851. PMID:27340735

  5. Bone suppression increases the visibility of invasive pulmonary aspergillosis in chest radiographs.

    Directory of Open Access Journals (Sweden)

    Steven Schalekamp

    Full Text Available Chest radiographs (CXR are an important diagnostic tool for the detection of invasive pulmonary aspergillosis (IPA in critically ill patients, but their diagnostic value is limited by a poor sensitivity. By using advanced image processing, the aim of this study was to increase the value of chest radiographs in the diagnostic work up of neutropenic patients who are suspected of IPA.The frontal CXRs of 105 suspected cases of IPA were collected from four institutions. Radiographs could contain single or multiple sites of infection. CT was used as reference standard. Five radiologists and two residents participated in an observer study for the detection of IPA on CXRs with and without bone suppressed images (ClearRead BSI 3.2; Riverain Technologies. The evaluation was performed separately for the right and left lung, resulting in 78 diseased cases (or lungs and 132 normal cases (or lungs. For each image, observers scored the likelihood of focal infectious lesions being present on a continuous scale (0-100. The area under the receiver operating characteristics curve (AUC served as the performance measure. Sensitivity and specificity were calculated by considering only the lungs with a suspiciousness score of greater than 50 to be positive.The average AUC for only CXRs was 0.815. Performance significantly increased, to 0.853, when evaluation was aided with BSI (p = 0.01. Sensitivity increased from 49% to 66% with BSI, while specificity decreased from 95% to 90%.The detection of IPA in CXRs can be improved when their evaluation is aided by bone suppressed images. BSI improved the sensitivity of the CXR examination, outweighing a small loss in specificity.

  6. Clinical and economic analysis of voriconazole using for treatment of invasive aspergillosis in Russian Federation

    Directory of Open Access Journals (Sweden)

    V. I. Ignatieva

    2015-01-01

    Full Text Available Introduction. Based on clinical studies data voriconazole is recommended as the drug of choice for treatment of invasive aspergillosis (IA – a widespread infectious complications occurring in immunocompromised patients and is characterized by severe clinical course and high mortality.The aim of this study was to assess the cost-effectiveness of voriconazole compared to other preparations recommended in the Russian practice for the treatment of IA in adult patients.Materials and methods. The authors constructed a «decision tree» type of model, which compared the three treatment alternatives for the IA in adult patients, depending on the drug in first-line therapy: 1 voriconazole, 2, caspofungin, or 3 amphotericin B lipid complex (LC. Efficacy was assessed as the probability of patient survival within 14 weeks of starting treatment. We took into account the drugs cost and an increase in the hospitalization duration due to the development of serious adverse events. The model parameters were determined on the basis of the published results of clinical studies, the costs were calculated on the basis of medicines prices in the public procurement and the average bed-day cost in system of obligatory health insurance. Probabilistic sensitivity analysis was performed.Results. It has been shown that the use of voriconazole for treatment of IA is the dominant strategy compared to the use of caspofungin and amphotericin B LC, providing cost reduction while achieving maximum effect. Probabilistic sensitivity analysis (1000 simulations showed stability of the revealed pattern.Conclusion. The use of voriconazole in the treatment of IA allows to save the greatest number of lives at minimal cost compared to other preparations recommended in the Russian practice.

  7. Clinical and economic analysis of voriconazole using for treatment of invasive aspergillosis in Russian Federation

    Directory of Open Access Journals (Sweden)

    V. I. Ignatieva

    2015-06-01

    Full Text Available Introduction. Based on clinical studies data voriconazole is recommended as the drug of choice for treatment of invasive aspergillosis (IA – a widespread infectious complications occurring in immunocompromised patients and is characterized by severe clinical course and high mortality.The aim of this study was to assess the cost-effectiveness of voriconazole compared to other preparations recommended in the Russian practice for the treatment of IA in adult patients.Materials and methods. The authors constructed a «decision tree» type of model, which compared the three treatment alternatives for the IA in adult patients, depending on the drug in first-line therapy: 1 voriconazole, 2, caspofungin, or 3 amphotericin B lipid complex (LC. Efficacy was assessed as the probability of patient survival within 14 weeks of starting treatment. We took into account the drugs cost and an increase in the hospitalization duration due to the development of serious adverse events. The model parameters were determined on the basis of the published results of clinical studies, the costs were calculated on the basis of medicines prices in the public procurement and the average bed-day cost in system of obligatory health insurance. Probabilistic sensitivity analysis was performed.Results. It has been shown that the use of voriconazole for treatment of IA is the dominant strategy compared to the use of caspofungin and amphotericin B LC, providing cost reduction while achieving maximum effect. Probabilistic sensitivity analysis (1000 simulations showed stability of the revealed pattern.Conclusion. The use of voriconazole in the treatment of IA allows to save the greatest number of lives at minimal cost compared to other preparations recommended in the Russian practice.

  8. Implementation of different histochemical methods in diagnostics of brain Aspergillosis in turkey chicks

    Directory of Open Access Journals (Sweden)

    Kureljušić Branislav

    2011-01-01

    Full Text Available Aspergillosis is a frequent fungal disease in different species of birds and mammals caused by fungi of the genus Aspergillus. It is characterized by inflammatory changes primarily in the respiratory system, even though it sometimes takes on a generalized form when several organ systems are affected. Mucotic-granulomatous meningoencephalitis with a predominant localization in the cerebellum has been described in turkeys, ducks and geese. Within this paper, examinations have been performed on a flock of broiler turkeys aged 12 days who had sustained evident neurological disorders in the form of ataxy, torticollis, paresis, and paralysis of the hind extremities and wings. In three of the ten autopsied chicks the macroscopic findings indicated granulomatous encephalitis of the cerebellum. A white-coloured granuloma, around 3mm in diameter, was situated cranioventrally and was clearly visible on the sagital section of the cerebellum. Mucological examinations of the cerebellum lesion resulted in the isolation of the fungi Aspergillus fumigatus. Haematoxylin-eosin (HE, Grocott and PAS methods were used for the evaluation of histopathological changes and proving Aspergillus fumigatusa hyphae. The microscopic examination of brain tissue sections stained with the HE method revealed the existence of a granuloma with a centrally placed necrotic area. The necrotic area was infiltrated with heterophilic granulocytes and surrounded by macrophage, giant cells and lymphocytes. A connective tissue capsule was located on the periphery of the granuloma. The fungi hyphae, as integral parts of the granuloma, were difficult to observe, and in some samples stained using the HE method they could not be seen at all. On the other hand, sections stanied using the Grocott and PAS methods showed prominent septed and branched hyphae in different parts of the granuloma. With the objective of making an etiological diagnosis of mucotic diseases, it is necessary to apply several

  9. Transfer of the Active Form of Transforming Growth Factor-β1 Gene to Newborn Rat Lung Induces Changes Consistent with Bronchopulmonary Dysplasia

    OpenAIRE

    Gauldie, Jack; Galt, Tom; Bonniaud, Philippe; Robbins, Clinton; Kelly, Margaret; Warburton, David

    2003-01-01

    Bronchopulmonary dysplasia is a chronic lung disease of premature human infancy that shows pathological features comprising varying sized areas of interstitial fibrosis in association with distorted large alveolar spaces. We have previously shown that transfer of active transforming growth factor (TGF)-β1 (AdTGFβ1223/225) genes by adenovirus vector to embryonic lungs results in inhibition of branching morphogenesis and primitive peripheral lung development, whereas transfer to adult lungs res...

  10. Development of Model of Stage Health Care System for Patients with Bronchopulmonary Dysplasia. Stage I: Determining the Need for Regional Centers for Diagnosis and Treatment

    OpenAIRE

    Shypko, A. F.

    2016-01-01

    Graphical and polynomial (quantitative) regional model of bronchopulmonary dysplasia (BPD) prevalence, depending on the number of premature children, was substantiated, composed and proposed for use for the first time. This provides an opportunity to perform generalized comparative (at the state level) analysis of BPD diagnosis. BPD incidence rates in groups of prematurely born children with different levels of BW deficiency (BW) were determined by calculating the ratio between the number of ...

  11. Determination of the Need and Assessment Algorithms of the Scope of Activity of Regional Centers for Diagnosis and Treatment of Bronchopulmonary Dysplasia

    OpenAIRE

    Shypko, A. F.

    2016-01-01

    Graphical and polynomial (quantitative) regional model of bronchopulmonary dysplasia (BPD) prevalence, depending on the number of premature children, was substantiated, composed and proposed for use for the first time. This provides an opportunity to perform generalized comparative (at the state level) analysis of BPD diagnosis. BPD incidence rates in groups of prematurely born children with different levels of BW deficiency (BW) were determined by calculating the ratio between the number of ...

  12. Comparison of topical administration of clotrimazole through surgically placed versus nonsurgically placed catheters for treatment of nasal aspergillosis in dogs: 60 cases (1990-1996)

    International Nuclear Information System (INIS)

    To examine the clinical response to topical administration of clotrimazole in dogs with nasal aspergillosis, to compare effect of surgically placed versus nonsurgically placed catheters used for administration on outcome, and to examine whether subjective scoring of computed tomographic images can predict outcome. Retrospective case series. 60 dogs with nasal aspergillosis. Information including signalment, history, diagnostics, treatment method, and outcome was retrieved from medical records of dogs with nasal aspergillosis treated between 1990 and 1996 at the University of California School of Veterinary Medicine or cooperating referral practices. Final outcome was determined by telephone conversations with owners and referring veterinarians. Images obtained before treatment were subjectively assessed to develop an algorithm for predicting outcome. Clotrimazole solution (1%) was infused during a 1-hour period via catheters surgically placed in the frontal sinus and nose (27 dogs) and via nonsurgically placed catheters in the nose (18). An additional 15 dogs received 2 to 4 infusions by either route. Topical administration of clotrimazole resulted in resolution of clinical disease in 65% of dogs after 1 treatment and 87% of dogs after one or more treatments. The scoring system correctly classified dogs with unfavorable and favorable responses 71 to 78% and 79 to 93% of the time, respectively. Topical administration of clotrimazole, using either technique, was an effective treatment for nasal aspergillosis in dogs. Use of non-invasive intranasal infusion of clotrimazole eliminated the need for surgical trephination of frontal sinuses in many dogs and was associated with fewer complications

  13. Enhanced antifungal efficacy in experimental invasive pulmonary aspergillosis by combination of AmBisome with Fungizone as assessed by several parameters of antifungal response

    NARCIS (Netherlands)

    M.J. Becker (Martin); S. de Marie (Siem); M.H.A.M. Fens (Marcel); W.C.J. Hop (Wim); H.A. Verbrugh (Henri); I.A.J.M. Bakker-Woudenberg (Irma)

    2002-01-01

    textabstractIn common with a proportion of patients with invasive pulmonary aspergillosis (IPA), the efficacy of AmBisome treatment regimens in our rat model remains suboptimal. To investigate whether this might be the result of initially low antifungal activity of amphotericin B a

  14. Immunodiagnosis of systemic aspergillosis. I. Antigenemia detected by radioimmunoassay in experimental infection. [/sup 125/I tracer technique

    Energy Technology Data Exchange (ETDEWEB)

    Weiner, M.H.; Coats-Stephen, M.

    1979-01-01

    Because systemic aspergillosis is difficult to diagnose ante mortem, a study to improve immunodiagnosis was undertaken in a rabbit model of disseminated infection. We found that the predominant humoral response of infected animals was directed against four Aspergillus antigens identified by crossed immunoelectrophoresis. One of these antigens, a cell-wall carbohydrate, was purified by gel-filtration chromatography and was used to develop a radiommunoassay. The sensitivity of this assay was increased by testing for serum-bound antigen as well as for free antigen. When the sensitivity of the RIA was evaluated in the animal model, antigenemia was detected in 78% of 51 rabbits with disseminated infection and ante mortem in 86% of 42 rabbits with lethal infection. By contrast, with immunoprecipitin analysis only eight of 51 rabbits were positive for antigen, and six of 51 rabbits were positive for Aspergillus antibody. The specificity of the RIA was also tested. Negative controls for antigen included sera from 76 normal rabbits and sera from 25 rabbits with systemic candidiasis. The Candida control group is pertinent because 48% of these rabbits had specific Candida antigenemia detected by a mannan RIA. This study demonstrates that Aspergillus antigenemia occurs during the course of experimental disseminated aspergillosis and illustrates the potential of an Aspergillus antigen RIA for sensitive, specific immunodiagnosis of human infections.

  15. Mucosal exposure to cockroach extract induces allergic sensitization and allergic airway inflammation

    Directory of Open Access Journals (Sweden)

    Arizmendi Narcy G

    2011-12-01

    Full Text Available Abstract Background Allergic sensitization to aeroallergens develops in response to mucosal exposure to these allergens. Allergic sensitization may lead to the development of asthma, which is characterized by chronic airway inflammation. The objective of this study is to describe in detail a model of mucosal exposure to cockroach allergens in the absence of an exogenous adjuvant. Methods Cockroach extract (CE was administered to mice intranasally (i.n. daily for 5 days, and 5 days later mice were challenged with CE for 4 consecutive days. A second group received CE i.n. for 3 weeks. Airway hyperresponsiveness (AHR was assessed 24 h after the last allergen exposure. Allergic airway inflammation was assessed by BAL and lung histology 48 h after the last allergen exposure. Antigen-specific antibodies were assessed in serum. Lungs were excised from mice from measurement of cytokines and chemokines in whole lung lysate. Results Mucosal exposure of Balb/c mice to cockroach extract induced airway eosinophilic inflammation, AHR and cockroach-specific IgG1; however, AHR to methacholine was absent in the long term group. Lung histology showed patchy, multicentric damage with inflammatory infiltrates at the airways in both groups. Lungs from mice from the short term group showed increased IL-4, CCL11, CXCL1 and CCL2 protein levels. IL4 and CXCL1 were also increased in the BAL of cockroach-sensitized mice in the short-term protocol. Conclusions Mucosal exposure to cockroach extract in the absence of adjuvant induces allergic airway sensitization characterized by AHR, the presence of Th2 cytokines in the lung and eosinophils in the airways.

  16. Abietic acid attenuates allergic airway inflammation in a mouse allergic asthma model.

    Science.gov (United States)

    Gao, Yi; Zhaoyu, Liu; Xiangming, Fang; Chunyi, Lin; Jiayu, Pan; Lu, Shen; Jitao, Chen; Liangcai, Chen; Jifang, Liu

    2016-09-01

    Abietic acid (AA), one of the terpenoids isolated from Pimenta racemosa var. grissea, has been reported to have anti-inflammatory and immunomodulatory effects. However, the anti-allergic effects of AA remain unclear. The aim of this study was to investigate the anti-allergic effects of AA in an ovalbumin (OVA)-induced asthma murine model. The model of mouse asthma was established by induction of OVA. AA (10, 20, 40mg/kg) was administered by oral gavage 1h after the OVA treatment on days 21 to 23. At 24h after the last challenge, bronchoalveolar lavage fluid (BALF) and lung tissues were collected to assess pathological changes, cytokines production, and NF-κB expression. The results showed that AA attenuated lung histopathologic changes, inflammatory cells infiltration, and bronchial hyper-responsiveness. AA also inhibited OVA-induced the nitric oxide (NO), IL-4, IL-5, IL-13, and OVA-specific IgE production, as well as NF-κB activation. In conclusion, the current study demonstrated that AA exhibited protective effects against OVA-induced allergic asthma in mice and the possible mechanism was involved in inhibiting NF-κB activation. PMID:27318791

  17. Coin exposure may cause allergic nickel dermatitis

    DEFF Research Database (Denmark)

    Thyssen, Jacob P; Gawkrodger, David J; White, Ian R;

    2012-01-01

    Nickel is used in coins because the metal has beneficial properties, including price, colour, weight, and corrosion resistance, and also because it is easy to stamp. It has often been claimed that the duration of skin contact with coins is too short to cause nickel release and dermatitis. However......, it is well known by dermatologists specialized in occupational skin diseases, and by their nickel-allergic patients, that hand eczema in cashiers and other professionals who handle coins may be caused or aggravated by nickel release from coins. In this review, we present evidence from past studies showing...... that nickel-containing coins can indeed pose a risk for those who handle them. For protection of the health of consumers, cashiers, and other workers who handle coins, it is suggested that coins without nickel release should be used as a substitute for the high nickel-releasing coins currently in widespread...

  18. Allergic contact dermatitis in children and adolescents

    DEFF Research Database (Denmark)

    Mørtz, Charlotte G; Andersen, Klaus Ejner

    1999-01-01

    From a clinical point of view, the prevalence of allergic contact dermatitis (ACD) among children and adolescents seems to be low. However, many children have dermatitis, most often atopic dermatitis. In selected cases, ACD is suspected, and the child is tested. The question remains, whether...... the prevalence of ACD in children really is low or whether the possibility of ACD is not sufficiently considered. During the last decade, reports have appeared on series of children and adolescents with contact allergy and ACD. Few cases have been reported in infants, but the development of contact allergy...... and ACD increases with age. Most studies include selected groups of children and adolescents with suspected ACD. Few studies have examined unselected populations, and most consider only the prevalence of contact allergy without evaluating the clinical relevance, e.g., the prevalence of ACD. Furthermore...

  19. [Allergic contact eczema from epoxy resin].

    Science.gov (United States)

    Calzado, Leticia; Ortiz-de Frutos, Francisco J; del Prado Sánchez-Caminero, María; Galera, Carmen María; Valverde, Ricardo; Vanaclocha, Francisco

    2005-11-01

    Epoxy resins are plastics that are widely used as electrical insulation, in coatings, and as adhesives and paints. They have strong sensitizing power and are one of the main causes of allergic contact eczema, both in the workplace and elsewhere. We present the case of a worker at a plastics/chemical plant, who handled aeronautical components in the process of manufacturing fuselage parts. He consulted his physician because of eczematous lesions on his fingers, hands and forearms which had developed over a two-year period and were clearly related to his work. The standard battery of skin tests was performed, along with the plastics and adhesives series and tests using the products from his workplace. Positivity was shown to epoxy resins (standard battery) and to the products from his workplace, which included different fiberglass and carbon fiber sheets impregnated with epoxy resins and epoxy adhesives.

  20. Treatment of 67 Cases of Seasonal Allergic Rhinitis by Acupuncture

    Institute of Scientific and Technical Information of China (English)

    王旭; 张利; 王鹰雷; 黄国琪

    2010-01-01

    @@ Seasonal allergic rhinitis refers to a seasonal and regional allergic disease induced mainly by botanical pollen,also termed "Hay Fever" and "Pollinosis",clinically manifested by the main symptoms of itching sensation in the nose,nasal obstruction,sneezing,watery nasal discharge,conjunctival congestion,itching in the eyes,lacrimation,and asthma developed from an incessant cough in some people,or manifested by the gastrointestinal symptoms of nausea,vomiting,abdominal pain,and diarrhea,and skin eczema,urticaria,pruritus vulvae,vaginitis.The author treated 67 cases of seasonal allergic rhinitis by acupuncture from 2002 to 2004.Now,the result is summarized as follows.

  1. The Treatment of Allergic Respiratory Disease During Pregnancy.

    Science.gov (United States)

    Namazy, Jai; Schatz, M

    2016-01-01

    Pregnancy may be complicated by new-onset or preexisting asthma and allergic rhinitis.This article reviews the recognition and management of asthma and allergic rhinitis during pregnancy, paying close attention to the general principles of allergy and use of asthma medication during pregnancy. Both allergic rhinitis and asthma can adversely affect both maternal quality of life and, in the case of maternal asthma, perinatal outcomes. Optimal management is thus important for both mother and baby. This article reviews the safety of asthma and allergy medications commonly used during pregnancy.

  2. Assessment of disease control in allergic rhinitis.

    Science.gov (United States)

    Demoly, Pascal; Calderon, Moises A; Casale, Thomas; Scadding, Glenis; Annesi-Maesano, Isabella; Braun, Jean-Jacques; Delaisi, Bertrand; Haddad, Thierry; Malard, Olivier; Trébuchon, Florence; Serrano, Elie

    2013-01-01

    The Allergic Rhinitis and its Impact on Asthma (ARIA) initiative has had a significant impact, by raising awareness of allergic rhinitis (AR) and improving the diagnosis and treatment of AR sufferers. ARIA classifies the severity of AR as "mild" or "moderate/severe" on the basis of "yes"/"no" answers to four questions. This two-point classification has been criticized as providing little guidance on patient management; patients with "mild" AR are unlikely to consult a physician, whereas the group of patients with "moderate/severe" seen by specialists is heterogeneous. These perceived shortcomings have prompted attempts to improve the ARIA classification or, by analogy with the Global Initiative for Asthma (GINA), adopt approaches based on "disease control" in AR. Even though "disease severity", "disease control" and "responsiveness to treatment" are different (albeit related) metrics, they are not mutually exclusive. Currently, there is no single, accepted definition, but we propose that "disease control" in AR can combine (i) measurements of the severity and/or frequency of daily or nocturnal symptoms, (ii) impairments in social, physical, professional and educational activities, (iii) respiratory function monitoring and (iv) exacerbations (e.g. unscheduled medical consultations and rescue medication use). Although control-based classifications have a number of limitations (e.g. their dependence on treatment compliance and the patient's psychological status), these instruments could be used as an adjunct to the ARIA severity classification and regional practice parameters. Here, we assess the strengths and weaknesses of the current two-level ARIA classification, analyze published proposals for its modification and review the literature on instruments that measure AR control. We conclude that there is a need for research in which severity is compared with control in terms of their effects on patient management. PMID:23419058

  3. Semaphorin 3A controls allergic and inflammatory responses in experimental allergic conjunctivitis

    Institute of Scientific and Technical Information of China (English)

    Junmi; Tanaka; Hideo; Tanaka; Nobuhisa; Mizuki; Eiichi; Nomura; Norihiko; Ito; Naoko; Nomura; Masayuki; Yamane; Tomonobu; Hida; Yoshio; Goshima; Hiroshi; Hatano; Hisashi; Nakagawa

    2015-01-01

    AIM: To assess the efficacy of topical Semaphorin 3A(SEMA3A) in the treatment of allergic conjunctivitis.METHODS: Experimental allergic conjunctivitis(EAC)mice model induced by short ragweed pollen(SRW) in 4-week-old of BALB/c mice, mice were evaluated using haematoxylin and eosin(H&E) staining, immunofluor-escence and light microscope photographs. Early phase took the samples in 24 h after instillation and late phase took the samples between 4 to 14 d after the start of treatment. The study use of topical SEMA3A(10 U, 100 U,1000 U) eye drops and subconjunctival injection of SEMA3 A with same concentration. For comparison, five types of allergy eyedrops were quantified using clinical characteristics.· RESULTS: Clinical score of composite ocular symptoms of the mice treated with SEMA3 A were significantly decreased both in the immediate phase and the late phase compared to those treated with commercial ophthalmic formulations and non-treatment mice. SEMA3 A treatment attenuates infiltration of eosinophils entering into conjunctiva in EAC mice. The score of eosinophil infiltration in the conjunctiva of SEMA3 A 1000 U-treated group were significantly lower than low-concentration of SEMA3 A treated groups and non-treated group. SEMA3 A treatment also suppressed T-cell proliferation in vitro and decreased serum total Ig E levels in EAC mice. Moreover, treatment of SEMA3 A suppressed Th2-related cytokines(IL-5, IL-13 and IL-4)and pro-inflammatory cytokines(IFN-γ, IL-17 and TNF-α)release, but increased regulatory cytokine IL-10 concentration in the conjunctiva of EAC mice.CONCLUSION: SEMA3 A as a biological agent, showed the beneficial activity in ocular allergic processes with the less damage to the intraocular tissue. It is expected that SEMA3 A may be contributed in patients with a more severe spectrum of refractory ocular allergic diseases including allergic conjunctivitis in the near future.

  4. B-type natriuretic peptide is a biomarker for pulmonary hypertension in preterm infants with bronchopulmonary dysplasia

    Directory of Open Access Journals (Sweden)

    Cuna A

    2013-05-01

    Full Text Available Alain Cuna,1 Jegen Kandasamy,1 Naomi Fineberg,2 Brian Sims1 1Department of Pediatrics, Division of Neonatology, 2Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA Background: B-type natriuretic peptide (BNP is a cardiac biomarker useful in screening for pulmonary hypertension (PH in adults. It is possible that BNP may also be useful in detecting PH among preterm infants with bronchopulmonary dysplasia (BPD. Objective: To determine the utility of BNP for identification of PH among preterm infants with BPD. Methods: We retrospectively identified preterm infants with BPD who underwent screening echocardiography for suspected PH and had serum BNP levels measured within 10 days before or after echocardiography. Eligible infants were classified based on echocardiographic diagnosis of either PH or no PH. Median and interquartile ranges (IQR of BNP values were compared, and area under the curve (AUC of receiver operator characteristic (ROC analysis was used to determine the optimum threshold value for detection of PH. Results: Twenty-five preterm infants with BPD (mean gestational age 26.5 ± 1.7 weeks, mean birth weight 747 ± 248 g were identified. The median difference in days between echocardiography and BNP measurement was 1 day (IQR 0–3, range 0–10 days. Based on echocardiography, 16 were diagnosed with PH and nine without PH. No significant difference in terms of gestational age, birth weight, sex, race, or respiratory support was found between the two groups. Median (IQR BNP values of those with PH were higher than those without PH (413 [212–1178] pg/mL versus 55 [21–84] pg/mL, P < 0.001. AUC of ROC analysis showed that a BNP value of 117 pg/mL had 93.8% sensitivity and 100% specificity for detecting PH. Conclusion: BNP estimation may be useful for screening of PH in infants with BPD. Keywords: B-type natriuretic peptide, pulmonary hypertension, bronchopulmonary dysplasia, biological markers

  5. Vitamin D serum levels in allergic rhinitis: any difference from normal population?

    OpenAIRE

    Arshi, Saba; Ghalehbaghi, Babak; Kamrava, Seyyed-Kamran; Aminlou, Mina

    2012-01-01

    Background Recently it has been suggested that, the worldwide increase in allergic diseases such as asthma, allergic rhinitis and food allergy is associated with low vitamin D intake. Objective This study measured the vitamin D levels in patients with allergic rhinitis and compared the results with the general population. Methods Vitamin D levels were assessed in 50 patients with allergic rhinitis diagnosed clinically by Allergic Rhinitis and its Impact on Asthma 2008 criteria and the result ...

  6. mTOR信号通路与支气管肺发育不良%mTOR signaling pathway and bronchopulmonary dysplasia

    Institute of Scientific and Technical Information of China (English)

    邹冬梅(综述); 王少华(审校)

    2016-01-01

    mTOR信号通路是在进化上高度保守的细胞内信号通路,参与多条信号通路的传导,主要包括 PI3K/AKT/mTOR 通路、AKT/TSC1-TSC2/Rheb/mTOR 通路、LKB1-AMPK-TSC-mTOR 通路和 FGF-10-Spry2-mTORC1-STAT3/HIF-1α-VEGF-A通路。该信号通路从多个水平多个方面参与肺发育及肺部多种疾病的调控过程,可能与支气管肺发育不良( bronchopulmonary dysplasia,BPD)有关。 BPD是早产儿十分常见的一种慢性肺疾病( chronic lung disease,CLD),是各种理化因素对发育不成熟肺造成急性肺损伤及损伤后异常修复、肺纤维化的过程。该文总结了mTOR信号通路与肺发育、急性肺损伤及肺纤维化可能存在的关系,探索mTOR信号通路在BPD形成过程中的作用,以期为BPD的防治提供新的切入点。%mTOR signaling pathway is a highly conserved intracellular signaling pathway,which partici-pates in several signaling pathways, such as PI3K/AKT/mTOR, AKT/TSC1-TSC2/Rheb/mTOR, LKB1-AMPK-TSC-mTOR and FGF-10-Spry2-mTORC1-STAT3/HIF-1α-VEGF-A. mTOR signaling implicate in the regulation of the development of lung and many pulmonary diseases in many aspects,may be connected to bron-chopulmonary dysplasia. Bronchopulmonary dysplasia is one of the very common chronic lung diseases in pre-term,physical and chemical factors have been shown to induce acute lung injury, aberrant wound healing and lung fibrosis in the immature lung. This review summarizes relationship of mTOR signaling among lung develop-ment,acute lung injury and lung fibrosis,to explore the role of mTOR signaling in the development of bronchop-ulmonary dysplasia,in hope of providing novel method in the prevention and treatment of bronchopulmonary dysplasia.

  7. Correlation between Circulating Fungal Biomarkers and Clinical Outcome in Invasive Aspergillosis.

    Directory of Open Access Journals (Sweden)

    Dionysios Neofytos

    Full Text Available Objective means are needed to predict and assess clinical response in patients treated for invasive aspergillosis (IA. We examined whether early changes in serum galactomannan (GM and/or β-D-glucan (BDG can predict clinical outcomes. Patients with proven or probable IA were prospectively enrolled, and serial GM and BDG levels and GM optical density indices (GMI were calculated twice weekly for 6 weeks following initiation of standard-of-care antifungal therapy. Changes in these biomarkers during the first 2 and 6 weeks of treatment were analyzed for associations with clinical response and survival at weeks 6 and 12. Among 47 patients with IA, 53.2% (25/47 and 65.9% (27/41 had clinical response by weeks 6 and 12, respectively. Changes in biomarkers during the first 2 weeks were associated with clinical response at 6 weeks (GMI, P = 0.03 and 12 weeks (GM+BDG composite, P = 0.05; GM, P = 0.04; GMI, P = 0.02. Changes in biomarkers during the first 6 weeks were also associated with clinical response at 6 weeks (GM, P = 0.05; GMI, P = 0.03 and 12 weeks (BDG+GM, P = 0.02; GM, P = 0.02; GMI, P = 0.01. Overall survival rates at 6 weeks and 12 weeks were 87.2% (41/47 and 79.1% (34/43, respectively. Decreasing biomarkers in the first 2 weeks were associated with survival at 6 weeks (BDG+GM, P = 0.03; BDG, P = 0.01; GM, P = 0.03 and at 12 weeks (BDG+GM, P = 0.01; BDG, P = 0.03; GM, P = 0.01; GMI, P = 0.007. Similar correlations occurred for biomarkers measured over 6 weeks. Patients with negative baseline GMI and/or persistently negative GMI during the first 2 weeks were more likely to have CR and survival. These results suggest that changes of biomarkers may be informative to predict and/or assess response to therapy and survival in patients treated for IA.

  8. Aspergilose em avestruz (Struthio camelus no Brasil Aspergillosis in an ostrich (Struthio camelus in Brazil

    Directory of Open Access Journals (Sweden)

    Tatiane Alves da Paixão

    2004-04-01

    mycological findings, a severe mycotic pneumonia and air sacculitis caused by Aspergillus fumigatus was diagnosed. To the best of our knowledge, this is the first reported case of aspergillosis in an ostrich in Brazil.

  9. PREMEDICATION PROTOCOLS IN DENTAL PRACTICE IN NON-ALLERGIC PATIENTS.

    OpenAIRE

    Angelina Kisselova; Adriana Krasteva; Assya Krasteva

    2011-01-01

    The aim is to present some of the most prescribed premedication schemes prior to an upcoming dental analgesia in non-allergic patients. These schemes we would like to be proved as “standard protocols” in dental practice.

  10. Allergic rhinitis - what to ask your doctor - child

    Science.gov (United States)

    ... How do I find out when smog or pollution is worse in our area? What does my ... More Allergen Allergic rhinitis Allergies - overview Allergy testing - skin Asthma and allergy - resources Common cold Sneezing Patient ...

  11. Allergic rhinitis - what to ask your doctor - adult

    Science.gov (United States)

    ... How do I find out when smog or pollution is worse in my area? Am I taking ... More Allergen Allergic rhinitis Allergies - overview Allergy testing - skin Asthma and allergy - resources Common cold Sneezing Patient ...

  12. Dermatotoxicologic clinical solutions: hair dying in hair dye allergic patients?

    Science.gov (United States)

    Edwards, Ashley; Coman, Garrett; Blickenstaff, Nicholas; Maibach, Howard

    2015-03-01

    This article describes how to identify allergic contact dermatitis resulting from hair dye, and outlines interventions and prevention principles for those who wish to continue dyeing their hair despite being allergic. Hair dye chemicals thought to be the most frequent sensitizers are discussed with instructions for health care providers on how to counsel patients about techniques to minimize exposure to allergenic substances. This framework should allow many patients to continue dyeing their hair without experiencing adverse side effects. PMID:24754409

  13. Delayed Allergic Reaction to Secondary Administrated Epidural Hyaluronidase

    OpenAIRE

    Park, A Reum; Kim, Woong Mo; Heo, Bong Ha

    2015-01-01

    We are reporting a rare case of a delayed hypersensitivity reaction caused by hyaluronidase allergy following a lumbar transforaminal epidural block. Using an intradermal skin test, we have provided evidence that the systemic allergic reaction resulted from hypersensitivity to hyaluronidase. To our knowledge, this is a rare case of a delayed hypersensitivity reaction to epidural hyaluronidase, comprised of an initial exposure to hyaluronidase with no subsequent allergic response in prior bloc...

  14. Exposure to particulate hexavalent chromium exacerbates allergic asthma pathology

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, Brent C. [Department of Microbiology, Immunology and Tropical Medicine, The George Washington University, Washington, DC 20037 (United States); Department of Pharmacology and Physiology, The George Washington University, Washington, DC 20037 (United States); Constant, Stephanie L. [Department of Microbiology, Immunology and Tropical Medicine, The George Washington University, Washington, DC 20037 (United States); Patierno, Steven R. [Department of Pharmacology and Physiology, The George Washington University, Washington, DC 20037 (United States); GW Cancer Institute, The George Washington University, Washington, DC 20037 (United States); Jurjus, Rosalyn A. [Department of Anatomy and Regenerative Biology, The George Washington University, Washington, DC 20037 (United States); Ceryak, Susan M., E-mail: phmsmc@gwumc.edu [Department of Pharmacology and Physiology, The George Washington University, Washington, DC 20037 (United States)

    2012-02-15

    Airborne hexavalent chromate, Cr(VI), has been identified by the Environmental Protection Agency as a possible health threat in urban areas, due to the carcinogenic potential of some of its forms. Particulate chromates are produced in many different industrial settings, with high levels of aerosolized forms historically documented. Along with an increased risk of lung cancer, a high incidence of allergic asthma has been reported in workers exposed to certain inhaled particulate Cr(VI) compounds. However, a direct causal association between Cr(VI) and allergic asthma has not been established. We recently showed that inhaled particulate Cr(VI) induces an innate neutrophilic inflammatory response in BALB/c mice. In the current studies we investigated how the inflammation induced by inhaled particulate Cr(VI) might alter the pathology of an allergic asthmatic response. We used a well-established mouse model of allergic asthma. Groups of ovalbumin protein (OVA)-primed mice were challenged either with OVA alone, or with a combination of OVA and particulate zinc chromate, and various parameters associated with asthmatic responses were measured. Co-exposure to particulate Cr(VI) and OVA mediated a mixed form of asthma in which both eosinophils and neutrophils are present in airways, tissue pathology is markedly exacerbated, and airway hyperresponsiveness is significantly increased. Taken together these findings suggest that inhalation of particulate forms of Cr(VI) may augment the severity of ongoing allergic asthma, as well as alter its phenotype. Such findings may have implications for asthmatics in settings in which airborne particulate Cr(VI) compounds are present at high levels. -- Highlights: ► Allergic asthma correlated with exposure to certain inhaled particulate chromates. ► Direct causal association between Cr(VI) and allergic asthma not established. ► Cr exacerbated pathology and airway hyperresponsiveness in an OVA-challenged mouse. ► Particulate Cr

  15. Allergic Rhinitis and its Impact on Asthma (ARIA)

    DEFF Research Database (Denmark)

    Bousquet, J; Schünemann, H J; Samolinski, B;

    2012-01-01

    Allergic rhinitis (AR) and asthma represent global health problems for all age groups. Asthma and rhinitis frequently coexist in the same subjects. Allergic Rhinitis and its Impact on Asthma (ARIA) was initiated during a World Health Organization workshop in 1999 (published in 2001). ARIA has rec...... workshop report, it is important to make a summary of its achievements and identify the still unmet clinical, research, and implementation needs to strengthen the 2011 European Union Priority on allergy and asthma in children....

  16. Occupational Exposure to Urban Air Pollution and Allergic Diseases

    OpenAIRE

    Luigi Vimercati; Maria Franca Gatti; Antonio Baldassarre; Eustachio Nettis; Nicola Favia; Marco Palma; Gabriella Lucia Maria Martina; Elisabetta Di Leo; Marina Musti

    2015-01-01

    Exposure to air pollution is associated with increased morbidity from cardiovascular diseases, lung cancer, respiratory and allergic diseases. The aim of this study was to investigate allergic diseases in 111 traffic wardens compared to a control group of 101 administrative employees. All participating subjects underwent a physical examination, in which a complete medical history was taken and a dedicated allergological questionnaire administered. Spirometry, Specific IgE dosage (RAST) and sk...

  17. Regulatory T cells and regulation of allergic airway disease

    OpenAIRE

    Martin, Helen; Taube, Christian

    2012-01-01

    Diseases like asthma have dramatically increased in the last decades. The reasons for the rising prevalence are still controversially discussed. Besides the genetic predisposition a number of different causes are thought to affect the increase of allergies. These include the hygiene hypothesis as well as changes in intestinal microbiota. Allergic airway inflammation is driven by T cells but it has become clear that tolerance and also suppression of allergic inflammation are mediated by so cal...

  18. Platelets promote allergic asthma through the expression of CD154

    OpenAIRE

    Tian, Jun; ZHU, TIANYI; Liu, Juan; Guo, Zhenhong; Cao, Xuetao

    2014-01-01

    Platelet activation is associated with multiple immune responses and the pathogenesis of various immune-related diseases. However, the exact role and the underlying mechanism of platelets in the progression of allergic asthma remain largely unclear. In this study, we demonstrate that during antigen sensitization, platelets can be activated by ovalbumin (OVA) aerosol via the upregulation of CD154 (CD40L) expression. Platelet transfer promoted allergic asthma progression by inducing more severe...

  19. Efficacy of montelukast and desloratadine combination in allergic rhinitis

    OpenAIRE

    Cingi, Cemal; Oğhan, Fatih; Ünlü, Halis; Tekat, Atilla; Okuyucu, Şemsettin

    2011-01-01

    Allergic rhinitis represents a global health problem affecting 10 to 25% of the population worldwide. The complications i.e. sinusitis, nasal polyps, middle ear and lower respiratory tract infections increase the importance of allergic rhinitis. Besides treatment costs, due to wage loss and decrease in productive capacity it has a huge negative impact on community. It may also seriously affect quality of life. Despite recent developments in its treatment modalities, several studies have indic...

  20. Allergic Rhinitis and Pharmacological Management in Elite Athletes

    OpenAIRE

    Alaranta, A.; Alaranta, H.; Heliövaara, M.; Alha, P.; Palmu, P.; Helenius, I

    2005-01-01

    Introduction: Only a few studies have examined the occurrence of atopy and clinically apparent allergic disease and their pharmacological management in elite athletes. The aim of the study was to assess the frequency of allergic rhinitis and the use of antiallergic medication within the subgroups of elite athletes as compared with a representative sample of young adults of the same age. Methods: A cross-sectional survey was carried out in 2002. All the athletes (N = 494) financially suppo...

  1. Exposure to particulate hexavalent chromium exacerbates allergic asthma pathology

    International Nuclear Information System (INIS)

    Airborne hexavalent chromate, Cr(VI), has been identified by the Environmental Protection Agency as a possible health threat in urban areas, due to the carcinogenic potential of some of its forms. Particulate chromates are produced in many different industrial settings, with high levels of aerosolized forms historically documented. Along with an increased risk of lung cancer, a high incidence of allergic asthma has been reported in workers exposed to certain inhaled particulate Cr(VI) compounds. However, a direct causal association between Cr(VI) and allergic asthma has not been established. We recently showed that inhaled particulate Cr(VI) induces an innate neutrophilic inflammatory response in BALB/c mice. In the current studies we investigated how the inflammation induced by inhaled particulate Cr(VI) might alter the pathology of an allergic asthmatic response. We used a well-established mouse model of allergic asthma. Groups of ovalbumin protein (OVA)-primed mice were challenged either with OVA alone, or with a combination of OVA and particulate zinc chromate, and various parameters associated with asthmatic responses were measured. Co-exposure to particulate Cr(VI) and OVA mediated a mixed form of asthma in which both eosinophils and neutrophils are present in airways, tissue pathology is markedly exacerbated, and airway hyperresponsiveness is significantly increased. Taken together these findings suggest that inhalation of particulate forms of Cr(VI) may augment the severity of ongoing allergic asthma, as well as alter its phenotype. Such findings may have implications for asthmatics in settings in which airborne particulate Cr(VI) compounds are present at high levels. -- Highlights: ► Allergic asthma correlated with exposure to certain inhaled particulate chromates. ► Direct causal association between Cr(VI) and allergic asthma not established. ► Cr exacerbated pathology and airway hyperresponsiveness in an OVA-challenged mouse. ► Particulate Cr

  2. Pulmonary Function Tests and Work-Related Respiratory and Allergic

    OpenAIRE

    Boskabady Mohammad Hosein; Taheri Ehsan; Ahmadi Sina; Ebrahimi Kolsoumeh; Soudaneh Malihe; Mohammadi Fatemeh; Sabourhasanzadeh Alireza

    2009-01-01

    Bakers are frequently exposed to various irritant chemicals during work which can induce respiratory problems. In this study, pulmonary function tests and self-reported respiratory and allergic symptoms in bakers were compared with matched control subjects. The frequency of respiratory and allergic symptoms was evaluated in a sample of 58 Iranian bakers and 58 control subjects using a questionnaire. Pulmonary function tests (PFT) were also measured in all participants. All respiratory symptom...

  3. Treatment of Allergic Rhinitis Is Associated with Improved Attention Performance in Children: The Allergic Rhinitis Cohort Study for Kids (ARCO-Kids)

    OpenAIRE

    Dong-Kyu Kim; Chae Seo Rhee; Doo Hee Han; Tae-Bin Won; Dong-Young Kim; Jeong-Whun Kim

    2014-01-01

    BACKGROUND: It has been well known that pediatric allergic rhinitis was associated with poor performance at school due to attention deficit. However, there were no cohort studies for the effect of treatment of allergic rhinitis on attention performance in pediatric population. Thus, the aim of this study was to investigate whether attention performance was improved after treatment in children with allergic rhinitis. METHODS: In this ARCO-Kids (Allergic Rhinitis Cohort Study for Kids), consecu...

  4. Association between Hemoglobin Levels in the First 3 Days of Life and Bronchopulmonary Dysplasia in Preterm Infants.

    Science.gov (United States)

    Duan, Jun; Kong, Xiangyong; Li, Qiuping; Hua, Shaodong; Zhang, Sheng; Feng, Zhichun; Zhang, Xiaoying

    2016-08-01

    Objective The objective of this study was to determine the association between hemoglobin (Hb) levels in the first 3 days of life and bronchopulmonary dysplasia (BPD) in preterm infants. Study Design The study population comprises 147 neonates with a gestational age (GA) of less than 32 weeks who were admitted to BaYi Children's Hospital Affiliated to Beijing Military General Hospital from January 2014 to May 2015. Hb levels in the first 3 days of life, maternal and infant characteristics, were recorded and then analyzed. Results BPD patients had a lower GA and birth weight than non-BPD patients. Rates of surfactant use, use of early inhalation hormone, days of mechanical ventilation > 2 weeks, and patent ductus arteriosus in BPD patients were higher and have a significant difference. Number of transfusions was higher in BPD patients. Lower Hb levels in the first 3 days of life were also observed in BPD patients. A cutoff value of Hb levels was determined as 155.5 g/L. Hb ≤ 155 g/L in the first 3 days of life was a significant risk factor for BPD. Conclusion Our study demonstrated that lower Hb levels in the first 3 days of life may increase the risk of developing BPD in preterm infants. PMID:27120476

  5. High incidence of rickets in extremely low birth weight infants with severe parenteral nutrition-associated cholestasis and bronchopulmonary dysplasia.

    Science.gov (United States)

    Lee, Soon Min; Namgung, Ran; Park, Min Soo; Eun, Ho Sun; Park, Kook In; Lee, Chul

    2012-12-01

    Risk factors for rickets of prematurity have not been re-examined since introduction of high mineral formula, particularly in ELBW infants. We analyzed the incidence and the risk factors of rickets in extremely low birth weight (ELBW) infants. As a retrospective case-control study from 2004 to 2008, risk factors were analyzed in 24 patients with rickets versus 31 patients without. The frequency of rickets in ELBW infants was 24/55 (44%). Infants with rickets were diagnosed at 48.2 ± 16.1 days of age, and improved by 85.3 ± 25.3 days. By radiologic evaluation, 29% were grade 1 rickets, 58% grade 2 and 13% grade 3. In univariate analysis, infants with rickets had significantly higher incidence of patent ductus arteriosus, parenteral nutrition associated cholestasis (PNAC), severe PNAC and moderate/severe bronchopulmonary dysplasia (BPD). In multiple regression analysis, after adjustment for gestation and birth weight, rickets significantly correlated with severe PNAC and with moderate/severe BPD. Serum peak alkaline phosphatase levels were significantly elevated in rickets (P rickets of prematurity remains high and the incidence of severe PNAC and moderate/severe BPD was significantly increased 18 and 3 times, respectively.

  6. A Comparison of KL-6 and Clara Cell Protein as Markers for Predicting Bronchopulmonary Dysplasia in Preterm Infants

    Directory of Open Access Journals (Sweden)

    Keyi Wang

    2014-01-01

    Full Text Available Objectives. To evaluate the predictive characteristics of KL-6 and CC16 for bronchopulmonary dysplasia (BPD in preterm infants, either independently or in combination. Study Design. This prospective cohort study was performed from 2011 to 2013 with preterm neonates of gestational age ≤32 weeks and birth weight ≤1500 g. Serum KL-6 and CC16 levels were determined 7 and 14 days after birth. Results. Seventy-three preterm infants were studied. BPD was identified in 24 of these infants. After adjusting for potential confounders, serum KL-6 concentrations were found to be elevated in BPD infants at both time points relative to non-BPD infants, while serum CC16 concentrations were lower at 14 days. At both 7 d and 14 d of life the predictive power of KL-6 levels exceeded that of CC16 (area under receiver operating characteristic curve: at 7 d, 0.91 cf. 0.73, P=0.02; at 14 d, 0.95 cf. 0.85, P=0.05. The combination of these markers enhanced the sensitivity further. Conclusions. Serum KL-6 levels higher than 79.26 ng/mL at 14 days postpartum in preterm infants predict the occurrence of BPD. CC16 was less predictive than KL-6 at this time point, but KL-6 and CC16 together enhanced the prediction.

  7. Bronchopulmonary dysplasia: clinical grading in relation to ventilation/perfusion mismatch measured by single photon emission computed tomography.

    Science.gov (United States)

    Kjellberg, Malin; Björkman, Karin; Rohdin, Malin; Sanchez-Crespo, Alejandro; Jonsson, Baldvin

    2013-12-01

    Bronchopulmonary dysplasia (BPD) is a significant cause of morbidity in the preterm population. Clinical severity grading based on the need for supplemental oxygen and/or need for positive airway pressure at 36 weeks postmenstrual age does not yield reproducible predictive values for later pulmonary morbidity. Single photon emission computed tomography (SPECT) was used to measure the distribution of lung ventilation (V) and perfusion (Q) in 30 BPD preterm infants at a median age of 37 weeks postmenstrual age. The V and Q were traced with 5 MBq Technegas and Technetium-labeled albumin macro aggregates, respectively, and the V/Q match-mismatch was used to quantify the extent of lung function impairment. The latter was then compared with the clinical severity grading at 36 weeks, and time spent on mechanical ventilation, continuous positive airway pressure (CPAP) and supplemental oxygen. Of those with mild and moderate BPD 3/9 and 3/11 patients, respectively, showed significant V/Q mismatches. By contrast, 4/10 patients with severe BPD showed a satisfactory V/Q matching distribution. An unsatisfactory V/Q match was not correlated with time spent on supplemental oxygen or CPAP, but was significantly negatively correlated with time spent on mechanical ventilation. SPECT provides unique additional information about regional lung function. The results suggest that the current clinical severity grading can be improved and/or complemented with SPECT. PMID:23359534

  8. [Characteristics of temporary organization of the bronchopulmonary pattern in healthy persons and in patients with bronchial asthma].

    Science.gov (United States)

    Alekseev, M Iu; Gorbenko, P P; Dubinskaia, A V; Savich, A A; Sysuev, V M

    1989-01-01

    It has been shown by periodographic computer analysis that ultradian rhythms of all examined parameters (bronchial resistance, inhalation, exhalation and breathing cycle duration, inspiration activity index, pneumographic amplitude, inhalation rate) of bronchopulmonary pattern in asthmatics and normal subjects exhibit latent periodicity, with prevailing oscillations of about 60 sec. during spontaneous breathing or under exposures. changing bronchial potency. Slow-wave components form very complex poly-harmonical temporal structure with specific organization during air breathing and response to challenge tests. Bronchospasm provoked by inhalation of acetylcholine produced an abrupt decrease of the number of periodical ultradian components (or even total disappearance of oscillations) and the development of a rigid hypersynchronic temporal structure on the basis of the hypersynchronized ultradien fluctiations. The principal factors of this new system may be changes of airway resistance. Analysis of our data suggests that the phenomenon of bronchial hyper-reactivity may be associated with a disturbance in temporal organization of the cardiobronchopulmonary pattern. Development of temporal disorganization may have some pathogenetic stages such as hypersynchronization, disrhythmy, appearance of a rigid temporal structure and bronchospasm as a clinical result. PMID:2711745

  9. Irreversible Respiratory Failure in a Full-Term Infant with Features of Pulmonary Interstitial Glycogenosis as Well as Bronchopulmonary Dysplasia.

    Science.gov (United States)

    Jiskoot-Ermers, Maresa E C; Antonius, Tim A J; Looijen-Salamon, Monika G; Wijnen, Marc H W A; Loza, Bettina F; Heijst, Arno F J van

    2015-10-01

    Pulmonary interstitial glycogenosis (PIG) is a rare interstitial lung disease in the newborns. We report on the clinical presentation and pathological findings of a full-term male infant with pulmonary hypertension requiring extracorporeal membrane oxygenation (ECMO). An open lung biopsy demonstrated interstitial changes resembling pulmonary interstitial glycogenosis as well as bronchopulmonary dysplasia (BPD), without convincing evidence of maturational arrest, infection, alveolar proteinosis, or alveolar capillary dysplasia. The boy was treated with glucocorticoids and, after a few days, was weaned from ECMO. A few hours later, the patient died due to acute severe pulmonary hypertension with acute right ventricular failure. The etiology and underlying pathogenic mechanisms of PIG are unknown. The clinical outcomes are quite varied. Deaths have been reported when PIG exists with abnormal lung development and pulmonary vascular growth and congenital heart disease. No mortality has been reported in PIG together with BPD in full-term infants. In this article, we reported on a full-term infant with interstitial changes resembling PIG and BPD who expired despite no convincing evidence of an anatomical maturational arrest or congenital heart disease. PMID:26495172

  10. Acute toxicity of polyethylene glycol p-isooctylphenol ether in Syrian hamsters exposed by inhalation or bronchopulmonary lavage

    Energy Technology Data Exchange (ETDEWEB)

    Damon, E.G. (Inhalation Toxicology Research Inst., Albuquerque, NM); Halliwell, W.H.; Henderson, T.R.; Mokler, B.V.; Jones, R.K.

    1982-01-01

    Dose-response studies were conducted with Syrian hamsters exposed to polyethylene glycol p-isooctylphenyl ether (Triton X-100) via inhalation or bronchopulmonary lavage. Syrian hamsters were exposed to an aerosol of Triton X-100 with a mass median aerodynamic diameter of 1.5 ..mu..m and a concentration of 3.0 mg/liter. Estimated initial lung burdens of Triton X-100 ranged from 800 to 3100 ..mu..g. Hamsters were lavaged with concentrations of Triton X-100 ranging from 0.01 to 0.10% in isotonic saline resulting in initial lung burdens of Triton X-100 that ranged from 300 to 3200 ..mu..g. The LD50/7 values were 1700 ..mu..g (1300 to 2100 ..mu..g, 95% confidence limits) for the inhalation study and 2100 (1900 to 2700) ..mu..g for the lavage study. The difference between the LD50/7 values for the two methods of exposure was not significant. However, histopathological examination revealed differences in the nature and distribution of pathologic changes observed in animals exposed by the two routes of administration. Animals exposed by inhalation died as a result of ulcerative laryngitis and laryngeal edema with only minimal pulmonary pathologic alterations. Animals exposed by lavage, where the larynx was not exposed to Triton X-100, died from pulmonary edema and acute exudative pneumonia. These results demonstrate the need for careful selection of exposure methods to meet the specific objectives of a toxicology study.

  11. Significant Differences in Markers of Oxidant Injury between Idiopathic and Bronchopulmonary-Dysplasia-Associated Pulmonary Hypertension in Children

    Directory of Open Access Journals (Sweden)

    Kimberly B. Vera

    2012-01-01

    Full Text Available While oxidant stress is elevated in adult forms of pulmonary hypertension (PH, levels of oxidant stress in pediatric PH are unknown. The objective of this study is to measure F2-isoprostanes, a marker of oxidant stress, in children with idiopathic pulmonary hypertension (IPH and PH due to bronchopulmonary dysplasia (BPD. We hypothesized that F2-isoprostanes in pediatric IPH and PH associated with BPD will be higher than in controls. Plasma F2-isoprostanes were measured in pediatric PH patients during clinically indicated cardiac catheterization and compared with controls. F2-Isoprostane levels were compared between IPH, PH due to BD, and controls. Five patients with IPH, 12 with PH due to BPD, and 20 control subjects were studied. Patients with IPH had statistically higher isoprostanes than controls 62 pg/mL (37–210 versus 20 pg/mL (16–27, <0.01. The patients with PH and BPD had significantly lower isoprostanes than controls 15 pg/mL (8–17 versus 20 pg/ml (16–27, <0.02. F2-isoprostanes are elevated in children with IPH compared to both controls and patients with PH secondary to BPD. Furthermore, F2-isoprostanes in PH secondary to BPD are lower than control levels. These findings suggest that IPH and PH secondary to BPD have distinct mechanisms of disease pathogenesis.

  12. Irreversible Respiratory Failure in a Full-Term Infant with Features of Pulmonary Interstitial Glycogenosis as Well as Bronchopulmonary Dysplasia

    Directory of Open Access Journals (Sweden)

    Maresa E. C. Jiskoot-Ermers

    2015-10-01

    Full Text Available Pulmonary interstitial glycogenosis (PIG is a rare interstitial lung disease in the newborns. We report on the clinical presentation and pathological findings of a full-term male infant with pulmonary hypertension requiring extracorporeal membrane oxygenation (ECMO. An open lung biopsy demonstrated interstitial changes resembling pulmonary interstitial glycogenosis as well as bronchopulmonary dysplasia (BPD, without convincing evidence of maturational arrest, infection, alveolar proteinosis, or alveolar capillary dysplasia. The boy was treated with glucocorticoids and, after a few days, was weaned from ECMO. A few hours later, the patient died due to acute severe pulmonary hypertension with acute right ventricular failure. The etiology and underlying pathogenic mechanisms of PIG are unknown. The clinical outcomes are quite varied. Deaths have been reported when PIG exists with abnormal lung development and pulmonary vascular growth and congenital heart disease. No mortality has been reported in PIG together with BPD in full-term infants. In this article, we reported on a full-term infant with interstitial changes resembling PIG and BPD who expired despite no convincing evidence of an anatomical maturational arrest or congenital heart disease.

  13. The Prevalence of Allergic Rhinitis in Patients with Chronic Rhinosinusitis

    Directory of Open Access Journals (Sweden)

    Mehdi Bakhshaee

    2014-10-01

    Full Text Available Introduction: Chronic rhinosinusitis (CRS is a multifactorial disease. Allergies are considered a predisposing factor to CRS; however, this remains controversial. The objective of this research was to investigate the prevalence of co-morbidities and allergic reaction, and to specify the most common allergens in patients with confirmed CRS.   Materials and Methods: One hundred patients with signs and symptoms of CRS who met the diagnostic endoscopic and radiologic criteria of chronic rhinosinusitis were selected. They filled out a questionnaire and underwent a skin prick test for the common inhalant allergens. Allergic rhinitis was diagnosed according to the history and positive skin prick tests.   Results: The mean age of patients was 34. Males were slightly more involved (54%. The prevalence of polypoid and none-polypoid rhinosinusitis was 54% and 46% respectively. The patients’ most common symptoms were nasal discharge (95%, blockage (94%, smell disorders (63%, cough (45%, halitosis (41%, lethargy (37%, and aural fullness (36%. Allergy to at least one allergen was noted in 64% of the CRS patients which is higher than general population in Mashhad, Iran with allergic rhinitis (22.4%. Salsola was the most common allergen. There was no significant difference in allergic reactions between polypoid and non-polypoid CRS patients.   Conclusion:  Allergic reactions was found in Iranian CRS patients with or without polyposis to be much higher than general population in Mashhad with allergic rhinitis alone.

  14. Heart Rate Variability Analysis in Patients with Allergic Rhinitis

    Directory of Open Access Journals (Sweden)

    Ming-Ying Lan

    2013-01-01

    Full Text Available Background. Very few studies investigate the role of the autonomic nervous system in allergic rhinitis. In this study, we evaluated the autonomic nervous system in allergic rhinitis patients using heart rate variability (HRV analysis. Methods. Eleven patients with allergic rhinitis and 13 healthy controls, aged between 19 and 40 years old, were enrolled in the study. Diagnosis of allergic rhinitis was based on clinical history, symptoms, and positive Phadiatop test. Electrocardiographic recordings on the sitting and supine positions were obtained for HRV analysis. Results. In the supine position, there were no significant statistical differences in very-low-frequency power (VLF, ≤0.04 Hz, low-frequency power (LF, 0.04–0.15 Hz, high-frequency power (HF, 0.15–0.40 Hz, and the ratio of LF to HF (LF/HF between the patient and control groups. The mean RR intervals significantly increased, while LF% and LF/HF significantly decreased in the patient group in the sitting position. Moreover, mean RR intervals, LF, and LF/HF, which were significantly different between the two positions in the control group, did not show a significant change with the posture change in the patient group. Conclusion. These suggest that patients with allergic rhinitis may have poor sympathetic modulation in the sitting position. Autonomic dysfunction may therefore play a role in the pathophysiology of allergic rhinitis.

  15. The effects of pollutants on the allergic immune response.

    Science.gov (United States)

    Kemeny, D M

    2000-11-01

    An increase in the prevalence of allergy and allergic diseases has taken place in the industrialised countries. Allergic diseases represent a major health problem, and appear linked to affluence and modern lifestyle. In the 20th century air pollution from industrial sources largely has been replaced by diesel exhaust and other traffic pollution. Further, the indoor environment in which we spend most of our time has changed dramatically. In order to understand the contribution of pollution and other environmental changes to the development of allergy, we need to understand the biologic processes that underlie allergic immune responses. In the present paper, immune regulatory pathways that control the allergic immune response are delineated. Castor bean dust causes widespread allergic sensitisation. The investigations that made clear the importance of CD8 T cells for the regulation of IgE production were triggered by studies of castor bean allergy. A special focus is in this review placed on the regulatory role of CD8 T cells in the development of the allergic immune response.

  16. Histological distinction between early allergic and irritant patch test reactions: follicular spongiosis may be characteristic of early allergic contact dermatitis

    DEFF Research Database (Denmark)

    Vestergaard, L; Clemmensen, Ole; Sørensen, Flemming Brandt;

    1999-01-01

    Comparative light microscopic studies have revealed subtle differences between allergic and irritant reactions in the skin. In the search for specific differences, we focussed on the early inflammatory response. This pilot study was conducted to test the hypothesis that follicular spongiosis can...... differentiate between early allergic and irritant patch test reactions. 8 patients with known contact allergy to either colophony or quarternium-15 participated in the study. In each patient, allergic and irritant patch tests reactions were elicited, and 4-mm punch biopsies were taken after 6 8 h from...... clinically equipotent reactions. Paired sets of slides were assessed blindly by 2 pathologists. 1 patient showing a pityrosporum folliculitis was excluded from the study. All biopsies from allergic patch tests were characterized by follicular spongiosis, while biopsies from irritant patch tests showed...

  17. Combination antifungal therapy and surgery for the treatment of invasive pulmonary aspergillosis after hematopoietic stem cell transplantation

    Directory of Open Access Journals (Sweden)

    Tiziana Toffolutti

    2011-06-01

    Full Text Available An 8-year old boy, affected by severe aplastic anemia, developed a probable pulmonary invasive aspergillosis (IA early after a second unrelated allogeneic hematopoietic stem cell transplant (HSCT. He was treated promptly with the combination of liposomal amphotericin B and caspofungin. Despite the initial stabilization, the patient deteriorated and the antifungal therapy was switched to voriconazole and caspofungin. The patient gradually improved and was discharged home on day +29 post-HSCT on oral voriconazole. On day +119, a sudden episode of hemoptysis occurred and a right superior lobectomy was decided to remove the residual aspergilloma. The patient is now alive and well more than 24 months from HSCT. This case demonstrated that antifungal combination therapy and surgery are valid options to cure pulmonary IA even in patients at high-risk and severely immunosuppressed.

  18. The role of heparanase in pulmonary cell recruitment in response to an allergic but not non-allergic stimulus.

    Directory of Open Access Journals (Sweden)

    Abigail Morris

    Full Text Available Heparanase is an endo-β-glucuronidase that specifically cleaves heparan sulfate proteoglycans in the extracellular matrix. Expression of this enzyme is increased in several pathological conditions including inflammation. We have investigated the role of heparanase in pulmonary inflammation in the context of allergic and non-allergic pulmonary cell recruitment using heparanase knockout (Hpa-/- mice as a model. Following local delivery of LPS or zymosan, no significant difference was found in the recruitment of neutrophils to the lung between Hpa-/- and wild type (WT control. Similarly neutrophil recruitment was not inhibited in WT mice treated with a heparanase inhibitor. However, in allergic inflammatory models, Hpa-/- mice displayed a significantly reduced eosinophil (but not neutrophil recruitment to the airways and this was also associated with a reduction in allergen-induced bronchial hyperresponsiveness, indicating that heparanase expression is associated with allergic reactions. This was further demonstrated by pharmacological treatment with a heparanase inhibitor in the WT allergic mice. Examination of lung specimens from patients with different severity of chronic obstructive pulmonary disease (COPD found increased heparanase expression. Thus, it is established that heparanase contributes to allergen-induced eosinophil recruitment to the lung and could provide a novel therapeutic target for the development of anti-inflammatory drugs for the treatment of asthma and other allergic diseases.

  19. The role of heparanase in pulmonary cell recruitment in response to an allergic but not non-allergic stimulus.

    Science.gov (United States)

    Morris, Abigail; Wang, Bo; Waern, Ida; Venkatasamy, Radhakrishnan; Page, Clive; Schmidt, Eric P; Wernersson, Sara; Li, Jin-Ping; Spina, Domenico

    2015-01-01

    Heparanase is an endo-β-glucuronidase that specifically cleaves heparan sulfate proteoglycans in the extracellular matrix. Expression of this enzyme is increased in several pathological conditions including inflammation. We have investigated the role of heparanase in pulmonary inflammation in the context of allergic and non-allergic pulmonary cell recruitment using heparanase knockout (Hpa-/-) mice as a model. Following local delivery of LPS or zymosan, no significant difference was found in the recruitment of neutrophils to the lung between Hpa-/- and wild type (WT) control. Similarly neutrophil recruitment was not inhibited in WT mice treated with a heparanase inhibitor. However, in allergic inflammatory models, Hpa-/- mice displayed a significantly reduced eosinophil (but not neutrophil) recruitment to the airways and this was also associated with a reduction in allergen-induced bronchial hyperresponsiveness, indicating that heparanase expression is associated with allergic reactions. This was further demonstrated by pharmacological treatment with a heparanase inhibitor in the WT allergic mice. Examination of lung specimens from patients with different severity of chronic obstructive pulmonary disease (COPD) found increased heparanase expression. Thus, it is established that heparanase contributes to allergen-induced eosinophil recruitment to the lung and could provide a novel therapeutic target for the development of anti-inflammatory drugs for the treatment of asthma and other allergic diseases.

  20. Epidemiology of invasive fungal infections after liver transplantation and the risk factors of late-onset invasive aspergillosis.

    Science.gov (United States)

    Nagao, Miki; Fujimoto, Yasuhiro; Yamamoto, Masaki; Matsumura, Yasufumi; Kaido, Toshimi; Takakura, Shunji; Uemoto, Shinji; Ichiyama, Satoshi

    2016-02-01

    Invasive fungal infection (IFI) in liver transplant recipients is associated with poor outcomes. Targeted antifungal prophylaxis is recommended for high-risk populations; however, the epidemiology of IFI has changed, and the risk criteria remain unclear. In addition, the risk factors for late-onset invasive aspergillosis (IA) have not been fully characterized. We examined 279 recipients over 16 years of age to uncover their IFI epidemiology, clinical characteristics and outcomes. In addition, a case-control study was performed to identify the risk factors of late-onset IA. Of the 279 recipients, 96.1% underwent living donor liver transplantation. Antifungal prophylaxis was administered to 80.6% of the recipients. IFI occurred in 15 patients, among which 8 cases were early-onset (≤90 days after liver transplantation) and 7 cases were late-onset (>90 days after liver transplantation). Five of the late-onset cases were invasive pulmonary aspergillosis, and 2 were fungemia cases. The mortality rate of late-onset IA was 80.0%. According to a multivariate analysis, steroid use before liver transplantation, bloodstream infection within 90 days after liver transplantation and reoperation within 90 days after liver transplantation were significant risk factors for late-onset IA after liver transplantation. The prevalence of IFI was low in our population given that over 80% of liver recipients received antifungal prophylaxis. The prognosis of late-onset IA remains poor, and predictors associated with late-onset IA, such as steroid use before liver transplantation, bloodstream infection and reoperation after liver transplantation, may help clinicians to optimize prevention measures for these devastating infections. PMID:26683245