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Sample records for bronchiolitis obliterans syndrome

  1. Bronchiolitis obliterans syndrome after lung transplantation: medical treatment.

    Science.gov (United States)

    Verleden, G M

    2000-04-01

    Obliterative bronchiolitis (OB) or the clinical correlate bronchiolitis obliterans syndrome (BOS) is the main cause of late morbidity and mortality after heart-lung and lung transplantation. Although several risk factors for the development of OB/BOS have already been identified, very effective preventive therapy remains Utopian, although there has been much improvement in recent years. This paper attempts to summarize current experience in the medical treatment of OB/BOS, either by tackling the known risk factors for the development of OB/BOS or by changing the immunosuppressive drug regimen for treating established OB/BOS. The current treatment options, however, are rather anecdotal and mostly single-centre experiences. Therefore, multicentre studies are definitely needed to try to identify the most appropriate drug regimen either to prevent and to treat obliterative bronchiolitis/bronchiolitis obliterans syndrome.

  2. Elevated peptides in lung lavage fluid associated with bronchiolitis obliterans syndrome.

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    Matthew D Stone

    Full Text Available OBJECTIVE: The objective of this discovery-level investigation was to use mass spectrometry to identify low mass compounds in bronchoalveolar lavage fluid from lung transplant recipients that associate with bronchiolitis obliterans syndrome. EXPERIMENTAL DESIGN: Bronchoalveolar lavage fluid samples from lung transplant recipients were evaluated for small molecules using ESI-TOF mass spectrometry and correlated to the development of bronchiolitis obliterans syndrome. Peptides associated with samples from persons with bronchiolitis obliterans syndrome and controls were identified separately by MS/MS analysis. RESULTS: The average bronchoalveolar lavage fluid MS spectrum profile of individuals that developed bronchiolitis obliterans syndrome differed greatly compared to controls. Controls demonstrated close inter-sample correlation (R = 0.97+/-0.02, average+/-SD while bronchiolitis obliterans syndrome showed greater heterogeneity (R = 0.86+/-0.09, average+/-SD. We identified 89 features that were predictive of developing BOS grade 1 and 66 features predictive of developing BOS grade 2 or higher. Fractions from MS analysis were pooled and evaluated for peptide content. Nearly 10-fold more peptides were found in bronchiolitis obliterans syndrome relative to controls. C-terminal residues suggested trypsin-like specificity among controls compared to elastase-type enzymes among those with bronchiolitis obliterans syndrome. CONCLUSIONS: Bronchoalveolar lavage fluid from individuals with bronchiolitis obliterans syndrome has an increase in low mass components detected by mass spectrometry. Many of these features were peptides that likely result from elevated neutrophil elastase activity.

  3. The effect of bronchiolitis obliterans syndrome on health related quality of life

    NARCIS (Netherlands)

    Vermeulen, KM; Groen, H; van der Bij, W; Erasmus, ME; Koeter, GH; TenVergert, EM

    2004-01-01

    Bronchiolitis obliterans syndrome (BOS) is the most important factor limiting long-term survival after lung transplantation, and has a substantial impact on patients' daily life in terms of disability and morbidity. Aim of our study was to examine the effects of BOS on health related quality of life

  4. Bronchiolitis obliterans syndrome after lung transplantation: biomarkers for inflammation and fibrogenesis

    NARCIS (Netherlands)

    Kastelijn, E.A.

    2012-01-01

    Lung transplantation is the treatment of choice for patients with end-stage lung disease. However, long-term survival is limited due to the development of chronic rejection in the donor lung of the transplant recipient, called bronchiolitis obliterans syndrome (BOS). BOS is diagnosed after lung tr

  5. Acute cellular rejection is a risk factor for bronchiolitis obliterans syndrome independent of post-transplant baseline FEV1

    DEFF Research Database (Denmark)

    Burton, C.M.; Iversen, M.; Carlsen, J.;

    2009-01-01

    BACKGROUND: Post-transplant baseline forced expiratory volume in 1 second (FEV(1)) constitutes a systematic bias in analyses of bronchiolitis obliterans syndrome (BOS). This retrospective study evaluates risk factors for BOS adjusting for the confounding of post-transplant baseline FEV(1). METHODS...

  6. Two cases of bronchiolitis obliterans organizing pneumonia syndrome after the radiation of breast-conserving therapy

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    Komuro, Youko; Nakagomi, Hiroshi; Akaike, Hidenori; Chiba, Shigehiro; Miyashita, Yoshihiro; Obu, S.; Yamaguchi, Motoshi; Oyama, Toshio [Yamanashi Prefectural Central Hospital, Kofu (Japan)

    2001-12-01

    Bronchiolitis obliterans organizing pneumonia (BOOP) syndrome is a recently reported complication of the adjuvant radiotherapy of breast-conserving surgery. We report two cases of BOOP syndrome in 100 patients who underwent breast-conserving therapy. A 75 year-old woman had a cough 3 months after radiation therapy for cancer of the left breast. Chest radiography and computed tomography showed consolidation with air bronchograms in the upper left lung. Transbronchial lung biopsy showed lymphocyte infiltration and fibrosis in the alveoli. A 45-year old woman with bilateral breast cancer had a cough and palpitations for 3 month after radiation therapy for cancer of the right breast. Chest radiography and computed tomography showed consolidation in upper and middle fields of the left lung. Transbronchial lung biopsy showed granulation formation in the alveolar duct, which is a typical feature of BOOP. The symptoms and radiographic findings improved with oral administration of prednisolone. BOOP syndrome may occur as a complication of breast-conserving therapy. (author)

  7. Identification of miRNAs Potentially Involved in Bronchiolitis Obliterans Syndrome: A Computational Study

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    Politano, Gianfranco; Inghilleri, Simona; Morbini, Patrizia; Calabrese, Fiorella; Benso, Alfredo; Savino, Alessandro; Cova, Emanuela; Zampieri, Davide; Meloni, Federica

    2016-01-01

    The pathogenesis of Bronchiolitis Obliterans Syndrome (BOS), the main clinical phenotype of chronic lung allograft dysfunction, is poorly understood. Recent studies suggest that epigenetic regulation of microRNAs might play a role in its development. In this paper we present the application of a complex computational pipeline to perform enrichment analysis of miRNAs in pathways applied to the study of BOS. The analysis considered the full set of miRNAs annotated in miRBase (version 21), and applied a sequence of filtering approaches and statistical analyses to reduce this set and to score the candidate miRNAs according to their potential involvement in BOS development. Dysregulation of two of the selected candidate miRNAs–miR-34a and miR-21 –was clearly shown in in-situ hybridization (ISH) on five explanted human BOS lungs and on a rat model of acute and chronic lung rejection, thus definitely identifying miR-34a and miR-21 as pathogenic factors in BOS and confirming the effectiveness of the computational pipeline. PMID:27564214

  8. Risk factors for bronchiolitis obliterans syndrome in allogeneic hematopoietic stem cell transplantation

    Institute of Scientific and Technical Information of China (English)

    MO Xiao-dong; XU Lan-ping; LIU Dai-hong; ZHANG Xiao-hui; CHEN Huan; CHEN Yu-hong; HAN Wei

    2013-01-01

    Background The occurrence of bronchiolitis obliterans syndrome (BOS) after allogeneic hematopoietic stem cell transplantation (alIo-HSCT) is rare but severe.We examine the role of pre-HSCT chemotherapeutic exposure,pre-HSCT comorbidities,and transplant-related complications in the development of BOS after allo-HSCT.Methods A nested case-control study was designed.Cases with BOS and controls matched for the year of alIo-HSCT and length of the follow-up were identified from a cohort of 1646 patients who underwent alIo-HSCT for treatment of hematologic malignancies between 2006 and 2011.Antithymocyte globulin was used in the partial matched related and unrelated matched donor HSCT,or patients with severe aplastic anemia.Results Thirty-six patients suffered from BOS; the mean age at the time of presentation was (32.7±12.4) years,and the mean time to presentation was (474±350) days post-HSCT.A pre-HSCT cyclophosphamide dose of >3.2 g/m2 (OR=8.74,P=0.025),chronic graft-versus-host disease (moderate to severe) (OR=12.02,P=0.000),and conditioning regimens without antithymocyte globulin (OR=2.79,P=0.031) were independently associated with BOS.Conclusions We found that higher pre-HSCT cyclophosphamide exposure,a conditioning regimen without antithymocyte globulin,and moderate to severe chronic graft-versus-host disease are significantly and independently associated with BOS.Based on these results,we can identify patients who are at a higher risk of developing BOS after alIo-HSCT,select a more appropriate therapeutic strategy,and improve the outcome of HSCT recipients.

  9. Impaired Capacity of Fibroblasts to Support Airway Epithelial Progenitors in Bronchiolitis Obliterans Syndrome

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    Zhang, Su-Bei; Sun, Xin; Wu, Qi; Wu, Jun-Ping; Chen, Huai-Yong

    2016-01-01

    Background: Bronchiolitis obliterans syndrome (BOS) often develops in transplant patients and results in injury to the respiratory and terminal airway epithelium. Owing to its rising incidence, the pathogenesis of BOS is currently an area of intensive research. Studies have shown that injury to the respiratory epithelium results in dysregulation of epithelial repair. Airway epithelial regeneration is supported by stromal cells, including fibroblasts. This study aimed to investigate whether the supportive role of lung fibroblasts is altered in BOS. Methods: Suspensions of lung cells were prepared by enzyme digestion. Lung progenitor cells (LPCs) were separated by fluorescence-activated cell sorting. Lung fibroblasts from patients with BOS or healthy controls were mixed with sorted mouse LPCs to compare the colony-forming efficiency of LPCs by counting the number of colonies with a diameter of ≥50 μm in each culture. Statistical analyses were performed using the SPSS 17.0 software (SPSS Inc., USA). The paired Student's t-test was used to test for statistical significance. Results: LPCs were isolated with the surface phenotype of CD31- CD34- CD45- EpCAM+ Sca-1+. The colony-forming efficiency of LPCs was significantly reduced when co-cultured with fibroblasts isolated from patients with BOS. The addition of SB431542 increased the colony-forming efficiency of LPCs to 1.8%; however, it was still significantly less than that in co-culture with healthy control fibroblasts (P < 0.05). Conclusion: The epithelial-supportive capacity of fibroblasts is impaired in the development of BOS and suggest that inefficient repair of airway epithelium could contribute to persistent airway inflammation in BOS. PMID:27569228

  10. Impaired Capacity of Fibroblasts to Support Airway Epithelial Progenitors in Bronchiolitis Obliterans Syndrome

    Institute of Scientific and Technical Information of China (English)

    Su-Bei Zhang; Xin Sun; Qi Wu; Jun-Ping Wu; Huai-Yong Chen

    2016-01-01

    Background:Bronchiolitis obliterans syndrome (BOS) often develops in transplant patients and results in injury to the respiratory and terminal airway epithelium.Owing to its rising incidence,the pathogenesis of BOS is currently an area of intensive research.Studies have shown that injury to the respiratory epithelium results in dysregulation of epithelial repair.Airway epithelial regeneration is supported by stromal cells,including fibroblasts.This study aimed to investigate whether the supportive role of lung fibroblasts is altered in BOS.Methods:Suspensions of lung cells were prepared by enzyme digestion.Lung progenitor cells (LPCs) were separated by fluorescence-activated cell sorting.Lung fibroblasts from patients with BOS or healthy controls were mixed with sorted mouse LPCs to compare the colony-forming efficiency of LPCs by counting the number of colonies with a diameter of≥50 μm in each culture.Statistical analyses were performed using the SPSS 17.0 software (SPSS Inc.,USA).The paired Student's t-test was used to test for statistical significance.Results:LPCs were isolated with the surface phenotype ofCD31-CD34-CD45-EpCAM+Sca-1 +.The colony-forming efficiency of LPCs was significantly reduced when co-cultured with fibroblasts isolated from patients with BOS.The addition ofSB431542 increased the colony-forming efficiency of LPCs to 1.8%;however,it was still significantly less than that in co-culture with healthy control fibroblasts (P < 0.05).Conclusion:The epithelial-supportive capacity of fibroblasts is impaired in the development of BOS and suggest that inefficient repair of airway epithelium could contribute to persistent airway inflammation in BOS.

  11. Bronchiolitis Obliterans with Organizing Pneumonia (BOOP)

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    ... What can you tell me about cryptogenic organizing pneumonia? Answers from Teng Moua, M.D. Previously called bronchiolitis obliterans with organizing pneumonia, cryptogenic organizing pneumonia (COP) is a rare lung ...

  12. Bortezomib-Induced Bronchiolitis Obliterans Organizing Pneumonia

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    E. Vandeix

    2012-01-01

    Full Text Available Introduction. Bortezomib is a proteasome inhibitor indicated for the treatment of multiple myeloma patients. The most frequent side effects are gastrointestinal and neurological. Serious pulmonary complications have been described rarely. Observation. This case involves a 74-year-old man suffering from IgG Kappa myeloma treated with bortezomib, melphalan, and dexamethasone. After administering chemotherapy, the patient developed an acute respiratory distress syndrome (ARDS. A surgical pulmonary biopsy proved the existence of bronchiolitis obliterans organizing pneumonia (BOOP lesions. Systemic corticotherapy led to a rapid improvement in the patient’s condition. Conclusion. This is the first reported histologically confirmed case of bortezomid-induced BOOP. Faced with severe respiratory symptoms in the absence of other etiologies, complications due to bortezomid treatment should be evoked and corticotherapy considered.

  13. Performance of long-term CT monitoring in diagnosing bronchiolitis obliterans after lung transplantation

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    Berstad, Audun E. [Department of Radiology, Rikshospitalet University Hospital, Sognsvannsveien 20, N-0027 Oslo (Norway)]. E-mail: a.e.berstad@medisin.uio.no; Aalokken, Trond Mogens [Department of Radiology, Rikshospitalet University Hospital, Sognsvannsveien 20, N-0027 Oslo (Norway); Kolbenstvedt, Alf [Department of Radiology, Rikshospitalet University Hospital, Sognsvannsveien 20, N-0027 Oslo (Norway); Bjortuft, Oystein [Department of Thoracic Medicine, Rikshospitalet University Hospital, Sognsvannsveien 20, N-0027 Oslo (Norway)

    2006-04-15

    Aim: The purpose of the study was to evaluate the ability of CT, including expiratory scans with minimum intensity projection in predicting the development of bronchiolitis obliterans syndrome after lung transplantation. Materials and methods: Forty consecutive patients, 29 bilateral and 11 single lung transplanted, were followed-up with regular scans for a median of 36 months. Air trapping was evaluated on expiratory scans constructed from two short spiral scans with minimum intensity projection-technique, one at the level of the carina and the other midway between the right diaphragm and the carina. Air trapping was scored on a 16-point scale. Bronchiolitis obliterans syndrome was diagnosed according to established clinical criteria and quantified spirometrically. Results: Bronchiolitis obliterans syndrome developed in 17 patients (43%) after a median of 12 months. Air trapping and bronchiectasis was seen before the diagnosis of bronchiolitis obliterans syndrome in only two and one patient, respectively. Interobserver agreement for air trapping score was good (kappa = 0.65). Air trapping scores performed significantly better than that achieved by chance alone in determining the presence of bronchiolitis obliterans syndrome (P = 0.0025). An air trapping score of 4 or more provided the best results with regard to sensitivity and specificity in diagnosing bronchiolitis obliterans syndrome. The sensitivity, specificity, positive and negative predictive values of an air trapping of 4 or more in the diagnosis of bronchiolitis obliterans syndrome were 77, 74, 68 and 81%, respectively. Conclusion: Expiratory CT scans with minimum intensity projection-reconstruction did not predict the development of bronchiolitis obliterans syndrome in most patients. The findings seriously limit the clinical usefulness of long-term CT monitoring for diagnosing bronchiolitis obliterans syndrome after lung transplantation.

  14. Managing bronchiolitis obliterans syndrome (BOS) and chronic lung allograft dysfunction (CLAD) in children: what does the future hold?

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    Snell, Gregory I; Paraskeva, Miranda; Westall, Glen P

    2013-08-01

    The success of pediatric lung transplantation continues to be limited by long-term graft dysfunction. Historically this has been characterized as an obstructive spirometric defect in the form of the bronchiolitis obliterans syndrome (BOS). It is recognized, however, that this does not reflect many of the other acknowledged etiologies of chronic lung dysfunction-noting it is the sum of the parts that contribute to respiratory morbidity and mortality after transplant. The term chronic lung allograft dysfunction (CLAD) has been coined to reflect these other entities and, in particular, a group of relatively recently described lung disorders called the restrictive allograft syndrome (RAS). RAS is characterized by a restrictive spirometric defect. Although these entities have not yet been studied in a pediatric setting their association with poor compliance, antibody-mediated rejection (AMR), and post-infectious lung damage (particularly viral) warrants attention by pediatric lung transplant teams. Current therapy for the BOS subset of CLAD is otherwise limited to changing immunosuppressants and avoiding excessive infectious risk by avoiding over-immunosuppression. Long-term macrolide therapy in lung transplantation is not of proven efficacy. Reviewing previous BOS studies to explore restrictive spirometric cases and joint projects via groups like the International Pediatric Lung Transplant Collaborative will be the way forward to solve this pressing problem.

  15. Bronchiolitis obliterans organising pneumonia simulating bronchial carcinoma

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    Murphy, J.; Flower, C. [Department of Radiology, Addenbrooke`s Hospital, University of Cambridge Teaching Hospital (United Kingdom); Schnyder, P. [Department of Radiology, University Hospital, Lausanne (Switzerland); Herold, C. [Department of Radiology, University Hospital of Vienna (Austria)

    1998-09-01

    Idiopathic bronchiolitis obliterans organising pneumonia (BOOP) is an uncommon but well-recognised condition that usually presents radiologically as bilateral multifocal patchy areas of consolidation on the chest radiograph and on computed tomography (CT). Five cases are described in which the presenting feature was that of a solitary pulmonary nodule. Four of these nodules showed evidence of cavitation and three patients presented with haemoptysis. In all cases the appearances closely resembled bronchial carcinoma. (orig.) With 5 figs., 21 refs.

  16. Protection against bronchiolitis obliterans syndrome is associated with allograft CCR7+ CD45RA- T regulatory cells.

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    Aric L Gregson

    Full Text Available Bronchiolitis obliterans syndrome (BOS is the major obstacle to long-term survival after lung transplantation, yet markers for early detection and intervention are currently lacking. Given the role of regulatory T cells (Treg in modulation of immunity, we hypothesized that frequencies of Treg in bronchoalveolar lavage fluid (BALF after lung transplantation would predict subsequent development of BOS. Seventy BALF specimens obtained from 47 lung transplant recipients were analyzed for Treg lymphocyte subsets by flow cytometry, in parallel with ELISA measurements of chemokines. Allograft biopsy tissue was stained for chemokines of interest. Treg were essentially all CD45RA(-, and total Treg frequency did not correlate to BOS outcome. The majority of Treg were CCR4(+ and CD103(- and neither of these subsets correlated to risk for BOS. In contrast, higher percentages of CCR7(+ Treg correlated to reduced risk of BOS. Additionally, the CCR7 ligand CCL21 correlated with CCR7(+ Treg frequency and inversely with BOS. Higher frequencies of CCR7(+ CD3(+CD4(+CD25(hiFoxp3(+CD45RA(- lymphocytes in lung allografts is associated with protection against subsequent development of BOS, suggesting that this subset of putative Treg may down-modulate alloimmunity. CCL21 may be pivotal for the recruitment of this distinct subset to the lung allograft and thereby decrease the risk for chronic rejection.

  17. Rituximab-Induced Bronchiolitis Obliterans Organizing Pneumonia

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    Ahmet B. Ergin

    2012-01-01

    Full Text Available Rituximab-induced lung disease (R-ILD is a rare entity that should be considered in patients treated with rituximab who present with dyspnea, fever, and cough, but no clear evidence of infection. A variety of pathologic findings have been described in this setting. Bronchiolitis obliterans organizing pneumonia (BOOP is the most common clinicopathologic diagnosis, followed by interstitial pneumonitis, acute respiratory distress syndrome (ARDS, and hypersensitivity pneumonitis. Prompt diagnosis and treatment with corticosteroids are essential as discussed by Wagner et al. (2007. Here we present a case of an 82-year-old man who was treated with rituximab for recurrent marginal zone lymphoma. After the first infusion of rituximab, he reported fever, chills, and dyspnea. On computed tomography imaging, he was found to have bilateral patchy infiltrates, consistent with BOOP on biopsy. In our patient, BOOP was caused by single-agent rituximab, in the first week after the first infusion of rituximab. We reviewed the relevant literature to clarify the different presentations and characteristics of R-ILD and raise awareness of this relatively overlooked entity.

  18. A genetic polymorphism in the CAV1 gene associates with the development of bronchiolitis obliterans syndrome after lung transplantation

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    Kastelijn Elisabeth A

    2011-11-01

    Full Text Available Abstract Background Caveolin 1 (Cav-1 is the primary structural component of cell membrane invaginations called 'caveolae'. Expression of Cav-1 is implicated in the pathogenesis of pulmonary fibrosis. Genetic polymorphisms in the CAV1 gene influence the function of Cav-1 in malignancies and associate with renal allograft fibrosis. Chronic allograft rejection after lung transplantation, called 'bronchiolitis obliterans syndrome' (BOS, is also characterised by the development of fibrosis. In this study, we investigated whether CAV1 genotypes associate with BOS and whether Cav-1 serum levels are influenced by the CAV1 genotype and can be used as a biomarker to predict the development of BOS. Methods Twenty lung transplant recipients with BOS (BOSpos, ninety without BOS (BOSneg and four hundred twenty-two healthy individuals donated DNA samples. Four SNPs in CAV1 were genotyped. Serial Cav-1 serum levels were measured in a matched cohort of 10 BOSpos patients and 10 BOSneg patients. Furthermore, single-time point Cav-1 serum levels were measured in 33 unmatched BOSneg patients and 60 healthy controls. Results Homozygosity of the minor allele of rs3807989 was associated with an increased risk for BOS (odds ratio: 6.13; P = 0.0013. The median Cav-1 serum level was significantly higher in the BOSpos patients than in the matched BOSneg patients (P = 0.026. Longitudinal analysis did not show changes in Cav-1 serum levels over time in both groups. The median Cav-1 serum level in the group of 43 BOSneg patients was lower than that in the healthy control group (P = 0.046. In lung transplant recipients, homozygosity of the minor allele of rs3807989 and rs3807994 was associated with increased Cav-1 serum levels. Conclusion In lung transplant recipients, the CAV1 SNP rs3807989 was associated with the development of BOS and Cav-1 serum levels were influenced by the CAV1 genotype.

  19. Achromobacter xylosoxidans induced bronchiolitis obliterans in cystic fibrosis.

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    De Baets, F; Schelstraete, P; Haerynck, F; Van Biervliet, S; De Bruyne, R; Franckx, H; Van Daele, S

    2014-04-01

    We report a 12-year-old boy with progressive bronchiolitis obliterans caused by Achromobacter xylosoxidans (Ax) colonization after liver transplantation, resulting in a steep decline in lung function.

  20. Nitrofurantoin-Associated Bronchiolitis Obliterans Organizing Pneumonia: Report of a Case

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    Mark E Fenton

    2008-01-01

    Full Text Available Bronchiolitis obliterans organizing pneumonia due to nitrofurantoin has rarely been reported and is associated with poor outcomes. A case of nitrofurantoin-associated bronchiolitis obliterans organizing pneumonia responsive to drug withdrawal and corticosteroids is presented.

  1. The number of FoxP3+ cells in transbronchial lung allograft biopsies does not predict bronchiolitis obliterans syndrome within the first five years after transplantation

    DEFF Research Database (Denmark)

    Krustrup, Dorrit; Iversen, Martin; Martinussen, Torben;

    2015-01-01

    Background: An important limitation to the success of lung transplantation is the development of bronchiolitis obliterans syndrome (BOS). It has been hypothesized that regulatory T lymphocytes (Tregs) are related to the risk of BOS. We aim to evaluate whether the number of forkhead box P3 (FoxP3......+) cells/mm2 in lung allograft biopsies is a predictor of long-term outcome. Materials and Methods: A total of 58 consecutive lung transplant patients were included in the study. For 233 routine surveillance biopsy samples, the numbers of FoxP3+ cells/mm2 were assessed by immunohistochemical staining...... with antibodies against FoxP3. BOS scores were calculated for the first five yr after transplantation. Results: We determined that acute rejection was related to the time elapsed from transplantation to BOS with hazard ratios of 3.18 (p = 0.02) and 3.73 (p = 0.04) when comparing the levels of acute rejection...

  2. The Impact of Alemtuzumab and Basiliximab Induction on Patient Survival and Time to Bronchiolitis Obliterans Syndrome in Double Lung Transplantation Recipients.

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    Furuya, Y; Jayarajan, S N; Taghavi, S; Cordova, F C; Patel, N; Shiose, A; Leotta, E; Criner, G J; Guy, T S; Wheatley, G H; Kaiser, L R; Toyoda, Y

    2016-08-01

    We examined the effect of alemtuzumab and basiliximab induction therapy on patient survival and freedom from bronchiolitis obliterans syndrome (BOS) in double lung transplantation. The United Network for Organ Sharing database was reviewed for adult double lung transplant recipients from 2006 to 2013. The primary outcome was risk-adjusted all-cause mortality. Secondary outcomes included time to BOS. There were 6117 patients were identified, of whom 738 received alemtuzumab, 2804 received basiliximab, and 2575 received no induction. Alemtuzumab recipients had higher lung allocation scores compared with basiliximab and no-induction recipients (41.4 versus 37.9 versus 40.7, p alemtuzumab and basiliximab recipients compared with patients who received no induction (2321 versus 2352 versus 1967 days, p = 0.001). Alemtuzumab (hazard ratio 0.80, 95% confidence interval 0.67-0.95, p = 0.009) and basiliximab induction (0.88, 0.80-0.98, p = 0.015) were independently associated with survival on multivariate analysis. At 5 years, alemtuzumab recipients had a lower incidence of BOS (22.7% versus 55.4 versus 55.9%), and its use was independently associated with lower risk of developing BOS on multivariate analysis. While both induction therapies were associated with improved survival, patients who received alemtuzumab had greater median freedom from BOS.

  3. Bronchiolitis obliterans organizing pneumonia after irradiation therapy for breast cancer

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    Kitagawa, Satoshi; Aoshima, Masahiro; Ohmagari, Norio; Tada, Hiroshi; Chohnabayashi, Naohiko; Suzuki, Kohyu [Saint Luke' s International Hospital, Tokyo (Japan)

    2003-02-01

    We report three cases of bronchiolitis obliterans organizing pneumonia (BOOP) that developed after irradiation therapy following breast cancer. All patients presented with cough and fever for 3 to 10 months after the completion of irradiation. Chest radiographs and computed tomography (CT) in all three patients demonstrated a consolidation outside the irradiated fields. Their laboratory data revealed increased C-reactive protein and increased erythrocyte sedimentation rates. Transbronchial lung biopsy was performed in all patients, and plugs of granulation tissue in the bronchioles and interstitial infiltration by mononuclear cells were found. Corticosteroid treatment resulted in rapid clinical improvement. BOOP was diagnosed from the histological and clinical findings. Although the etiology of BOOP still remains unknown, there may be a subgroup of such patients in whom the BOOP is induced by irradiation for breast cancer. These cases were assumed to be in a series of reported cases of BOOP primed by radiotherapy. (author)

  4. Linear opacities on HRCT in bronchiolitis obliterans organising pneumonia

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    Murphy, J.M.; Flower, C.D.R. [Dept. of Radiology, Addenbrookes Hospital, Univ. of Cambridge (United Kingdom); Schnyder, P.; Leuenberger, P. [Depts. of Radiology and Medicine, University Hospital, CHUV, Lausanne (Switzerland); Verschakelen, J. [Dept. of Radiology, University Hospital, Leuven (Belgium)

    1999-07-01

    The aim of this study was to report the high-resolution computed tomography (HRCT) appearances of linear opacities that may occur in isolation or in combination with other changes in bronchiolitis obliterans organising pneumonia (BOOP). Eleven patients with BOOP and linear opacities on HRCT were identified at three independent teaching hospitals. The HRCT images and clinical course of each patient were reviewed. Two distinct types of linear opacity were identified. The type-1 opacity extended in a radial manner along the line of the bronchi towards the pleura and was usually intimately related to bronchi. The type-2 opacity occurred in a sub-pleural location and bore no relationship to the bronchi. Both types occurred most commonly in the lower lobes, frequently were associated with multi-focal areas of consolidation and usually completely resolved with treatment. There was no associated bronchiectasis, irreversible volume loss or a reticular or honeycomb pattern. In 2 patients linear opacities were the sole abnormality on HRCT. Bronchiolitis obliterans organising pneumonia may occur in a pure ''linear form'' or HRCT may demonstrate linear opacities in addition to multi-focal consolidation. (orig.)

  5. Bronchiolitis obliterans organising pneumonia associated with the use of nitrofurantoin.

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    Cameron, R J; Kolbe, J; Wilsher, M L; Lambie, N

    2000-03-01

    The spectrum of nitrofurantoin lung injury continues to widen. The case histories are presented of two patients who developed lung disease associated with the use of nitrofurantoin with histological features of bronchiolitis obliterans organising pneumonia (BOOP), a rare but recognised form of drug induced injury. The two middle aged women presented with respiratory symptoms after prolonged treatment with nitrofurantoin. Both had impaired lung function and abnormal computed tomographic scans, and their condition improved when nitrofurantoin was withdrawn and corticosteroid treatment commenced. The favourable outcome in these two patients contrasts with the fatal outcome of the two other reported cases of nitrofurantoin induced BOOP. We suggest that the previous classification of nitrofurantoin induced lung injury into "acute" and "chronic" injury is an oversimplification in view of the wide variety of pathological entities that have subsequently emerged.

  6. Bronquiolite obliterante na forma nodular Bronchiolitis obliterans in nodular form

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    PAULO DE ALMEIDA

    2002-11-01

    Full Text Available Paciente com 54 anos, do sexo feminino, ex-tabagista, que após duas semanas de um resfriado comum procurou atendimento médico devido a tosse com expectoração amarela, obstrução nasal e desconforto facial. Sua radiografia do tórax mostra lesão nodular no lobo superior esquerdo compatível com nódulo pulmonar solitário. Submetida a uma toracotomia exploradora, foi estabelecido o diagnóstico de bronquiolite obliterante com pneumonia em organização (BOOP.A 54 year old female patient, public servant, ex-smoker, after two weeks of a common cold complained of cough with yellow sputum, nasal obstruction and facial pain. A chest X-ray showed a solitary nodular lesion in the upper left lobe. The patient was submitted to a left thoracotomy, which established the diagnosis of bronchiolitis obliterans organizing pneumonia (BOOP.

  7. Bronchiolitis obliterans organizing pneumonia syndrome primed by radiation therapy to the breast. The Groupe d'Etudes et de Recherche sur les Maladies Orphelines Pulmonaires (GERM"O"P)

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    Crestani, B; Valeyre, D; Roden, S; Wallaert, B; Dalphin, J C; Cordier, J F

    1998-12-01

    Reports of bronchiolitis obliterans organizing pneumonia (BOOP) occurring in women after radiation therapy for breast cancer have suggested that radiation to the lung could participate in the development of BOOP. We now describe the clinical, radiographic, functional, and bronchoalveolar lavage characteristics of this syndrome in a series of 15 patients reported to the Groupe d'Etudes et de Recherche sur les Maladies "Orphelines" Pulmonaires (GERM"O"P) in France. All 15 women (60 +/- 6 yr of age) fulfilled the following inclusion criteria: (1) radiation therapy to the breast within 12 mo, (2) general and/or respiratory symptoms lasting for at least 2 wk, (3) lung infiltrates outside the radiation port, and (4) no specific cause. The patients presented with fever, nonproductive cough, mild dyspnea, and peripheral alveolar opacities on chest radiograph with a characteristic migratory pattern. In five patients, BOOP was found at lung pathologic analysis. In all the patients dramatic improvement was obtained with corticosteroids, but relapses occurred in 12 patients while tapering or after stopping corticosteroids. This report demonstrates that a characteristic BOOP syndrome may occur after radiation therapy to the breast, including tangential radiation to the lung, thus suggesting that radiation therapy may prime the development of BOOP.

  8. Biopsy-verified bronchiolitis obliterans and other noninfectious lung pathologies after allogeneic hematopoietic stem cell transplantation

    DEFF Research Database (Denmark)

    Uhlving, Hilde Hylland; Andersen, Claus B; Christensen, Ib Jarle

    2015-01-01

    Bronchiolitis obliterans (BO) is a serious complication of allogeneic hematopoietic stem cell transplantation (HSCT). Lung biopsy is the gold standard for diagnosis. This study describes the course of BO and assesses the congruity between biopsy-verified BO and a modified version of the National...... Institutes of Health's consensus criteria for BO syndrome (BOS) based exclusively on noninvasive measures. We included 44 patients transplanted between 2000 and 2010 who underwent lung biopsy for suspected BO. Of those, 23 were diagnosed with BO and 21 presented other noninfectious pulmonary pathologies......, and maximal mid-expiratory flow throughout follow-up, but there was no difference in the change in pulmonary function from the time of lung biopsy. The BO diagnosis was not associated with poorer overall survival. Fifty-two percent of patients with biopsy-verified BO and 24% of patients with other...

  9. Bronchiolitis obliterans after allogenic bone marrow transplantation: HRCT findings

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Jung Im; Jung, Won Sang; Hahn, Seong Tai; Park, Seog Hee [St. Mary' s Hospital, College of Medicine, Seoul (Korea, Republic of); Min, Chang Ki; Kim, Chun Choo [College of Medicine, The Catholic University, Seoul (Korea, Republic of)

    2004-06-15

    To evaluate the high resolution computed tomography (HRCT) findings of bronchiolitis obliterans (BO) after bone marrow transplantation (BMT). During the past three years, 11 patients were diagnosed as having BO after BMT when they developed irreversible air flow obstruction, with an FEV{sub 1} value of less than 80% of the baseline value, without any clinical evidence of infection. All 11 patients underwent HRCT, of whom eight also underwent follow-up HRCT. The HRCT images were assessed retrospectively for the presence of decreased lung attenuation, segmental or subsegmental bronchial dilatation, diminution of peripheral vascularity, centrilobular nodules, and branching linear structure on the inspiratory images. The lobar distribution of the decreased lung attenuation and bronchial dilatation was also examined. The presence of air trapping was investigated on the expiratory images. The interval changes of the HRCT findings were evaluated in those patients who had follow-up images. Abnormal HRCT findings were present in all cases; the most common abnormalities were decreased lung attenuation (n=11), subsegmental bronchial dilatation (n=6), diminution of peripheral vascularity (n=6), centrilobular nodules or branching linear structure (n=3), and segmental bronchial dilatation (n=3). Expiratory air trapping was noted in all patients. The decreased lung attenuation and bronchial dilatations were more frequent or extensive in the lower lobes. Interval changes were found in all patients with follow-up HRCT: increased extent of decreased lung attenuation (n=7); newly developed or progressed bronchial dilatation (n=4); and increased lung volume (n=3). HRCT scans are abnormal in patients with BO, with the most commonly observed finding being areas of decreased lung attenuation. While the HRCT findings are not specific, it is believed that their common features can assist in the diagnosis of BO in BMT recipients.

  10. Bronchiolitis obliterans after allo-SCT: clinical criteria and treatment options

    DEFF Research Database (Denmark)

    Uhlving, H H; Buchvald, F; Heilmann, C J;

    2012-01-01

    Bronchiolitis obliterans (BO) following allogeneic haematopoietic SCT (HSCT) is a serious complication affecting 1.7-26% of the patients, with a reported mortality rate of 21-100%. It is considered a manifestation of chronic graft-versus-host disease, but our knowledge of aetiology and pathogenesis...

  11. Diffuse micronodular pattern of bronchiolitis obliterans organizing pneumonia: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, In Jae; Jang, Seung Hun; Min, Kwang Seon; Whang, Im Kyung; Lee, Yul; Bae, Sang Hoon [Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang (Korea, Republic of)

    2006-10-15

    The typical radiographic findings of bronchiolitis obliterans organizing pneumonia (BOOP) are known to be patchy air-space consolidation that is often subpleural, and with or without ground-glass opacities. However, there are scant radiologic reports about the micronodular pattern of BOOP. We report here on a case of BOOP that manifested as diffusely scattered ill-defined centrilobular micronodules on HRCT.

  12. Bronchiolitis in Kartagener's syndrome.

    Science.gov (United States)

    Homma, S; Kawabata, M; Kishi, K; Tsuboi, E; Narui, K; Nakatani, T; Saiki, S; Nakata, K

    1999-12-01

    The association of diffuse bronchiolitis in patients with Kartagener's syndrome (KS) has not been reported previously. The aim of this study was to present the morphological characteristics of bronchiolitis in patients with KS. Eight patients (four males, four females; mean age 37.9+/-18.7 yrs), clinically diagnosed as KS with the classical triad of chronic pansinusitis, bronchiectasis and situs in versus with dextrocardia, were evaluated. Routine chest radiography showed bronchiectasis and dextrocardia in all patients. Chest computed tomography (CT) showed diffuse centrilobular small nodules up to 2 mm in diameter throughout both lungs in six out of eight patients. Pulmonary function tests revealed marked obstructive impairment in all patients (forced expiratory volume in one second 57.0+/-11.3%, residual volume/total lung capacity 45.+/-12.7%, maximum midexpiratory flow 0.92+/-0.72 L x s(-1), forced vital capacity 74.1+/-12.2% (all mean +/- SD)). The examination of cilial movement of the bronchus revealed immotility in all of the five patients examined. The ultrastructure showed ciliary dynein arm defects in all patients. Histopathological examination of lung specimens obtained at autopsy or by video-assisted thoracoscopic surgery showed obliterative thickening of the walls of the membranous bronchioli with infiltration of lymphocytes, plasma cells and neutrophils, but most of the distal respiratory bronchioli were spared and alveolar spaces were overinflated. Pathologically, the diffuse centrilobular small nodules on the chest CT mainly corresponded to membranous bronchiolitis. This is the first report demonstrating that the association of diffuse bronchiolitis might be one of the characteristic features of the lung in Kartagener's syndrome.

  13. Lupus and pulmonary nodules consistent with bronchiolitis obliterans organizing pneumonia induced by carbamazepine in a man

    OpenAIRE

    Awatef Kelati; Salim Gallouj; Mariame Meziane; Fatima Zahra Mernissi

    2016-01-01

    Several drugs have been implicated in the induction of systemic lupus erythematosus (SLE), but there are only some observations of carbamazepine induced SLE since the first case described in 1966, this drug has also been implicated in the induction of other disorders and rarely pulmonary toxicity; but the occurrence of two rare side effects of this drug: the induced SLE and pulmonary nodules consistent with the bronchiolitis obliterans organizing pneumonia in same patient is really unusual an...

  14. Rapamycin Blocks Fibrocyte Migration and Attenuates Bronchiolitis Obliterans in a Murine Model

    Science.gov (United States)

    Gillen, Jacob R.; Zhao, Yunge; Harris, David A.; LaPar, Damien J.; Stone, Matthew L.; Fernandez, Lucas G.; Kron, Irving L.; Lau, Christine L.

    2014-01-01

    Background Fibrocytes are integral in the development of fibroproliferative disease. The CXCL12/CXCR4 chemokine axis has been shown to play a central role in fibrocyte migration and the development of bronchiolitis obliterans post lung transplantation. Inhibition of the mTOR (mammalian target of rapamycin) pathway with rapamycin has been shown to decrease expression of both CXCR4 and its receptor agonist, CXCL12. Thus, we hypothesize that rapamycin treatment would decrease fibrocyte trafficking into tracheal allografts and prevent bronchiolitis obliterans. Methods A total alloantigenic mismatch, murine heterotopic tracheal transplant model of bronchiolitis obliterans was used. Animals were either treated with rapamycin or dimethyl sulfoxide (DMSO) for 14 days post tracheal transplant. Fibrocyte levels were assessed via flow cytometry, and allograft neutrophil, CD3+ T-cell, macrophage, and smooth muscle actin levels were assessed via immunohistochemistry. Tracheal luminal obliteration was assessed on hematoxylin and eosin stains. Results Compared to DMSO controls, rapamycin-treated mice showed a significant decrease in fibrocyte levels in tracheal allografts. Fibrocytes levels in recipient’s blood showed a similar pattern, although not statistically significant. Furthermore, animals treated with rapamycin showed a significant decrease in tracheal allograft luminal obliteration compared to controls. Based on immunohistochemistry analyses, populations of α-SMA positive cells, neutrophils, CD3+ T-cells, and macrophages were all decreased in rapamycin-treated allograft versus DMSO controls. Conclusions Rapamycin effectively reduces recruitment of fibrocytes into tracheal allografts and mitigates development of tracheal luminal fibrosis. Further studies are needed to determine the cellular and molecular mechanisms that mediate the protective effect of rapamycin against bronchiolitis obliterans. PMID:23561805

  15. Sauropus androgynus (L.) Merr. Induced Bronchiolitis Obliterans: From Botanical Studies to Toxicology

    OpenAIRE

    Hamidun Bunawan; Siti Noraini Bunawan; Syarul Nataqain Baharum; Normah Mohd Noor

    2015-01-01

    Sauropus androgynus L. Merr. is one of the most popular herbs in South Asia, Southeast Asia, and China where it was known as a slimming agent until two outbreaks of pulmonary dysfunction were reported in Taiwan and Japan in 1995 and 2005, respectively. Several studies described that the excessive consumption of Sauropus androgynus could cause drowsiness, constipation, and bronchiolitis obliterans and may lead to respiratory failure. Interestingly, this herb has been used in Malaysia and Indon...

  16. Bronchiolitis obliterans organizing pneumonia after tangential beam irradiation to the breast. Discrimination from radiation pneumonitis

    Energy Technology Data Exchange (ETDEWEB)

    Nambu, Atsushi; Ozawa, Katsura; Kanazawa, Masaki; Miyata, Kazuyuki [Kofu Municipal Hospital (Japan); Araki, Tsutomu; Ohki, Zennosuke [Yamanashi Medical Coll., Tamaho (Japan)

    2002-06-01

    We report a case of bronchiolitis obliterans organizing pneumonia (BOOP) secondary to tangential beam irradiation to the breast, which occurred seven months after the completion of radiotherapy. Although radiation pneumonitis is an alternative consideration, BOOP could be differentiated from it by its relatively late onset and extensive distribution, which did not respect the radiation field. This disease should always be kept in mind in patients with a history of tangential beam irradiation to the breast. (author)

  17. Bronchiolitis Obliterans Organizing Pneumonia in Swine Associated with Porcine Circovirus Type 2 Infection

    Directory of Open Access Journals (Sweden)

    Ching-Chang Cheng

    2011-01-01

    Full Text Available Bronchiolitis obliterans organizing pneumonia (BOOP is a chronic respiratory disease. Although the pathogenesis of BOOP is still incompletely understood, BOOP is responsive to steroids and has a good prognosis. In our five pigs with chronic postweaning multisystemic wasting syndrome (PMWS, typical BOOP lesions were revealed. All five porcine lungs showed typical intraluminal plugs, and porcine circovirus type 2 (PCV2 was identified. They also exhibited similar pathologic findings such as proliferation of type II pneumocytes and myofibroblasts (MFBs, extracellular collagen matrix (ECM deposition, and fragmentation of elastic fibers. MFBs migration correlative molecules, for instance, gelatinase A, B and osteopontin, appeared strongly in the progressing marginal area of polypoid intraluminal plugs of fibrotic lesion. These molecules colocalized with the active MFBs. Both gelatinase activity and intercellular level of active MFBs were significantly increased (<.05. Porcine chronic bronchopneumonia leads to BOOP and it is associated with PCV2 persistent infection. Swine BOOP demonstrates similar cellular constituents with human BOOP. Perhaps their molecular mechanisms of pathogenesis operate in a similar way. Thus we infer that the swine BOOP can be considered as a potential animal model for human BOOP associated with natural viral infection. Moreover, it is more convenient to obtain samples.

  18. Oxygen-sensitive {sup 3}He-MRI in bronchiolitis obliterans after lung transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Gast, Klaus K. [Klinikum der Johannes Gutenberg-Universitaet, Klinik und Poliklinik fuer diagnostische und interventionelle Radiologie, Mainz (Germany); Biedermann, Alexander [Klinikum der Johannes Gutenberg-Universitaet, 3. Medizinische Klinik, Pulmonologie, Mainz (Germany); Herweling, Annette [Klinikum der Johannes Gutenberg-Universitaet, Klinik fuer Anaesthesiologie, Mainz (Germany); Schreiber, Wolfgang G. [Klinikum der Johannes Gutenberg-Universitaet, Klinik und Poliklinik fuer diagnostische und interventionelle Radiologie, MR-Physik, Mainz (Germany); Schmiedeskamp, Joerg [Max-Planck-Institut fuer Polymerforschung, Mainz (Germany); Mayer, Eckhard [Klinikum der Johannes Gutenberg-Universitaet, Klinik fuer Herz-, Thorax- und Gefaesschirurgie, Mainz (Germany); Heussel, Claus P. [Abteilung fuer Radiologie, Thoraxklinik Heidelberg, Heidelberg (Germany); Markstaller, Klaus; Eberle, Balthasar [Inselspital/Universitaetsspital, Klinik fuer Anaesthesiologie, Bern (Switzerland); Kauczor, Hans-Ulrich [Radiologie, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg (Germany)

    2008-03-15

    Oxygen-sensitive {sup 3}He-MRI was studied for the detection of differences in intrapulmonary oxygen partial pressure (pO{sub 2}) between patients with normal lung transplants and those with bronchiolitis obliterans syndrome (BOS). Using software developed in-house, oxygen-sensitive {sup 3}He-MRI datasets from patients with normal lung grafts (n = 8) and with BOS (n = 6) were evaluated quantitatively. Datasets were acquired on a 1.5-T system using a spoiled gradient echo pulse sequence. Underlying diseases were pulmonary emphysema (n = 10 datasets) and fibrosis (n = 4). BOS status was verified by pulmonary function tests. Additionally, {sup 3}He-MRI was assessed blindedly for ventilation defects. Median intrapulmonary pO{sub 2} in patients with normal lung grafts was 146 mbar compared with 108 mbar in patients with BOS. Homogeneity of pO2 distribution was greater in normal grafts (standard deviation pO2 34 versus 43 mbar). Median oxygen decrease rate during breath hold was higher in unaffected patients (-1.75 mbar/s versus -0.38 mbar/s). Normal grafts showed fewer ventilation defects (5% versus 28%, medians). Oxygen-sensitive {sup 3}He-MRI appears capable of demonstrating differences of intrapulmonary pO2 between normal lung grafts and grafts affected by BOS. Oxygen-sensitive {sup 3}He-MRI may add helpful regional information to other diagnostic techniques for the assessment and follow-up of lung transplant recipients. (orig.)

  19. Biopsy-verified bronchiolitis obliterans and other noninfectious lung pathologies after allogeneic hematopoietic stem cell transplantation.

    Science.gov (United States)

    Uhlving, Hilde Hylland; Andersen, Claus B; Christensen, Ib Jarle; Gormsen, Magdalena; Pedersen, Karen Damgaard; Buchvald, Frederik; Heilmann, Carsten; Nielsen, Kim Gjerum; Mortensen, Jann; Moser, Claus; Sengeløv, Henrik; Müller, Klaus Gottlob

    2015-03-01

    Bronchiolitis obliterans (BO) is a serious complication of allogeneic hematopoietic stem cell transplantation (HSCT). Lung biopsy is the gold standard for diagnosis. This study describes the course of BO and assesses the congruity between biopsy-verified BO and a modified version of the National Institutes of Health's consensus criteria for BO syndrome (BOS) based exclusively on noninvasive measures. We included 44 patients transplanted between 2000 and 2010 who underwent lung biopsy for suspected BO. Of those, 23 were diagnosed with BO and 21 presented other noninfectious pulmonary pathologies, such as cryptogenic organizing pneumonia, diffuse alveolar damage, interstitial pneumonia, and nonspecific interstitial fibrosis. Compared with patients with other noninfectious pulmonary pathologies, BO patients had significantly lower values of forced expiratory volume in 1 second (FEV1), FEV1/forced vital capacity, and maximal mid-expiratory flow throughout follow-up, but there was no difference in the change in pulmonary function from the time of lung biopsy. The BO diagnosis was not associated with poorer overall survival. Fifty-two percent of patients with biopsy-verified BO and 24% of patients with other noninfectious pulmonary pathology fulfilled the BOS criteria. Pathological BO diagnosis was not superior to BOS criteria in predicting decrease in pulmonary function beyond the time of biopsy. A lung biopsy may provide a characterization of pathological patterns that can extend our knowledge on the pathophysiology of HSCT-related lung diseases.

  20. Strong association between respiratory viral infection early after hematopoietic stem cell transplantation and the development of life-threatening acute and chronic alloimmune lung syndromes

    NARCIS (Netherlands)

    Versluys, A. Birgitta; Rossen, John W. A.; van Ewijk, Bart; Schuurman, Rob; Bierings, Marc B.; Boelens, Jaap J.

    2010-01-01

    Alloimmune lung syndromes (allo-LS), including idiopathic pneumonia syndrome, bronchiolitis obliterans syndrome, and bronchiolitis obliterans organizing pneumonia, are severe complications after hematopoietic stem cell transplantation (HSCT). In our cohort of 110 pediatric patients, 30 had allo-LS (

  1. Lupus and pulmonary nodules consistent with bronchiolitis obliterans organizing pneumonia induced by carbamazepine in a man

    Directory of Open Access Journals (Sweden)

    Awatef Kelati

    2016-10-01

    Full Text Available Several drugs have been implicated in the induction of systemic lupus erythematosus (SLE, but there are only some observations of carbamazepine induced SLE since the first case described in 1966, this drug has also been implicated in the induction of other disorders and rarely pulmonary toxicity; but the occurrence of two rare side effects of this drug: the induced SLE and pulmonary nodules consistent with the bronchiolitis obliterans organizing pneumonia in same patient is really unusual and -to our knowledge- the second observation reported in the literature.

  2. Bronchiolitis obliterans organizing pneumonia after adjuvant thoracic radiotherapy for breast cancer. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Yamada, Katsuyasu; Ogasawara, Tomohiko; Akita, Yuko; Miyazaki, Mikinori; Inukai, Akihiro; Shinjo, Keiko; Suzuki, Masayuki [Nagoya Daini Red Cross Hospital (Japan)

    2001-02-01

    We report a case of recurrent cough and migratory pulmonary infiltrates in a 55-year-old woman after adjuvant thoracic radiotherapy for breast cancer. The pulmonary infiltrates were initially limited to the area adjacent to the irradiated breast, but later migrated to the opposite lung. The diagnosis of bronchiolitis obliterans organizing pneumonia (BOOP) was made using transbronchial biopsy, which disclosed intraluminal fibrosis in the distal airspace, together with a radiographic appearance typical of BOOP. This case was assumed to be in a series of reported cases of BOOP primed by radiotherapy. (author)

  3. 小儿闭塞性细支气管炎%Bronchiolitis obliterans in children

    Institute of Scientific and Technical Information of China (English)

    陈强

    2010-01-01

    @@ 闭塞性细支气管炎(bronchiolitis obliterans,BO)是与小气道炎症性损伤相关的慢性气流阻塞综合征,是一种相对少见而严重的慢性阻塞性肺病.其主要临床特点是反复或持续气促、喘息或咳嗽,运动耐力差,肺部有细湿啰音和喘鸣音,对支气管扩张剂无反应[1].

  4. Bronchiolitis obliterans organising pneumonia. A report of 11 cases and a review of the literature.

    Science.gov (United States)

    Lamont, J; Verbeken, E; Verschakelen, J; Demedts, M

    1998-10-01

    The clinical syndrome "Bronchiolitis Obliterans Organising Pneumonia" (BOOP) has to be considered in patients with a flu-like illness since some weeks, fine crackles, and on chest X-ray bilateral patchy infiltrates. There is no response to antibiotics. BOOP is essentially idiopathic, but associations to other conditions exist. Lung function is often restrictive; biochemistry is not pathognomonic. BAL shows a mixed cellular pattern. The gold standard for pathologic diagnosis is open or thoracoscopic lung biopsy. However, a BOOP pattern or reaction is often seen on histologic specimens without the clinical-radiologic features of the BOOP-entity. Therapy consists of corticosteroids, which have to be prescribed for a long time at a rather high dose. Recurrence is frequent, but prognosis is good. Evolution to respiratory insufficiency and death is rare and may occur in rapidly progressive BOOP. This study reports on 11 cases (6 males/5 females) of clinical-pathological BOOP-syndrome (mean age 58 yrs, range 17-73 yrs), with an unexpectedly high mortality rate of 36% (4 cases). The disease was idiopathic in 7, and was associated with intake of amiodarone (in 1), with past Mycoplasma pneumonia (in 1) and with connective tissue disease (in 2). There was a history of a flu-like syndrome, cough and dyspnea of a mean duration of 4 months (range 1 week to 8 months). Lung function was mostly restrictive or/and obstructive with a diffusing capacity ranging between 47 and 95% predicted; there was hypoxia in about half of the patients. Chest X-ray and computed tomography (CT) scan showed a patchy consolidation with linear opacities (unilateral in 4 patients, bilateral in 5) and/or a ground glass pattern (in 4 patients), and a focal pseudo-tumoral lesion (in 1). Bronchoalveolar lavage showed a variable pattern of mixed, or eosinophilic or neutrophilic alveolitis. Histologic diagnosis was based on open lung biopsy (in 3), on thoracoscopic biopsy (in 2), on transbronchial biopsy (in 2

  5. Successful treatment of Bronchiolitis obliterans with organizing pneumonia in dialysis patient

    Directory of Open Access Journals (Sweden)

    Vivek B Kute

    2012-01-01

    Full Text Available A 42-year-old end stage renal disease (ESRD patient was admitted with fever, anorexia, malaise, non-productive cough, and dyspnea, of one-week duration. Multiple cultures of the blood, sputum, and urine were negative for microorganisms. The possibility of bronchiolitis obliterans with organizing pneumonia (BOOP was considered when patient with pulmonary infiltrate did not respond to conventional antibiotic therapy and frequent hemodyalisis. High-resolution computed tomography of the chest revealed patchy air-space consolidation, ground-glass opacities, and small nodular opacities, predominantly located at the peripheral part of the lungs. Cultures and stains of bronchoalveolar lavage (BAL specimen and bronchoscopic biopsy of lung tissue were negative for organisms [bacteria, mycobacterium tuberculosis, PCP, fungus, and atypical organism] and showed evidence of BOOP. Patient recovered completely with early diagnosis and treatment with steroids and underwent successful renal transplantation with wife as donor without postoperative complication and relapse.

  6. Bronchiolitis Obliterans

    Science.gov (United States)

    ... dangerous chemicals to avoid: Acetaldehyde Acetaldehyde is in cannabis and e-cigarette smoke. It irritates the skin, ... infections, a connective tissue disorder such as rheumatoid arthritis , a medication reaction, and after a bone marrow, ...

  7. Pulmonary radiation injury manifested by signs of bronchiolitis obliterans with organizing pneumonia after postoperative breast cancer radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Ogata, Kenichi; Shibata, Kazumi; Nishio, Tetsuo [Kitakyusyu Municipal Medical Center, Fukuoka (Japan); Kawarada, Yuji; Hara, Nobuyuki

    1999-12-01

    A 67-year-old woman underwent surgery for cancer of both breast (right: mastectomy, left: conserving surgery), and received 60 Gy radiation to the left postoperative breast. Three months later, cough and fever developed. A chest radiograph demonstrated infiltrative shadows in the left lung field. Transbronchial lung biopsy specimens disclosed organizing exudates in the alveolar spaces and bronchioles. After treatment with prednisolone, the clinical symptoms and radiographic infiltrates disappeared. This was a case of pulmonary radiation injury pathologically manifested by signs of bronchiolitis obliterans with organizing pneumonia. (author)

  8. A case of radiation pulmonary injury simulating bronchiolitis obliterans organizing pneumonia following postoperative radiotherapy for breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Katoh, Toshiyuki; Iwata, Masaru; Yoshida, Norio; Katagiri, Akira; Takeda, Naoya [Kariya General Hospital, Aichi (Japan)

    2001-09-01

    A 57-year-old female underwent conservative surgery for a left sided breast cancer, and received 48 Gy postoperative radiation therapy. One year later, a chest CT scan disclosed bilateral patchy ground glass opacities. She had no subjective symptom. These abnormal opacities disappeared spontaneously without any treatment. We considered this was a radiation lung injury simulating bronchiolitis obliterans organizing pneumonia. We emphasize that the symptomless and spontaneous resolution of this type of lung injury should be kept is mind. (author)

  9. Increased respiratory disease mortality at a microwave popcorn production facility with worker risk of bronchiolitis obliterans.

    Directory of Open Access Journals (Sweden)

    Cara N Halldin

    Full Text Available BACKGROUND: Bronchiolitis obliterans, an irreversible lung disease, was first associated with inhalation of butter flavorings (diacetyl in workers at a microwave popcorn company. Excess rates of lung-function abnormalities were related to cumulative diacetyl exposure. Because information on potential excess mortality would support development of permissible exposure limits for diacetyl, we investigated respiratory-associated mortality during 2000-2011 among current and former workers at this company who had exposure to flavorings and participated in cross-sectional surveys conducted between 2000-2003. METHODS: We ascertained workers' vital status through a Social Security Administration search. Causes of death were abstracted from death certificates. Because bronchiolitis obliterans is not coded in the International Classification of Disease 10(th revision (ICD-10, we identified respiratory mortality decedents with ICD-10 codes J40-J44 which encompass bronchitis (J40, simple and mucopurulent chronic bronchitis (J41, unspecified chronic bronchitis (J42, emphysema (J43, and other chronic obstructive pulmonary disease (COPD (J44. We calculated expected number of deaths and standardized mortality ratios (SMRs with 95% confidence intervals (CI to determine if workers exposed to diacetyl experienced greater respiratory mortality than expected. RESULTS: We identified 15 deaths among 511 workers. Based on U.S. population estimates, 17.39 deaths were expected among these workers (SMR = 0.86; CI:0.48-1.42. Causes of death were available for 14 decedents. Four deaths among production and flavor mixing workers were documented to have a multiple cause of 'other COPD' (J44, while 0.98 'other COPD'-associated deaths were expected (SMR = 4.10; CI:1.12-10.49. Three of the 4 'other COPD'-associated deaths occurred among former workers and workers employed before the company implemented interventions reducing diacetyl exposure in 2001. CONCLUSION: Workers

  10. Sauropus androgynus (L.) Merr. Induced Bronchiolitis Obliterans: From Botanical Studies to Toxicology

    Science.gov (United States)

    Bunawan, Hamidun; Bunawan, Siti Noraini; Baharum, Syarul Nataqain; Noor, Normah Mohd.

    2015-01-01

    Sauropus androgynus L. Merr. is one of the most popular herbs in South Asia, Southeast Asia, and China where it was known as a slimming agent until two outbreaks of pulmonary dysfunction were reported in Taiwan and Japan in 1995 and 2005, respectively. Several studies described that the excessive consumption of Sauropus androgynus could cause drowsiness, constipation, and bronchiolitis obliterans and may lead to respiratory failure. Interestingly, this herb has been used in Malaysia and Indonesia in cooking and is commonly called the “multigreen” or “multivitamin” plant due to its high nutritive value and inexpensive source of dietary protein. The plant is widely used in traditional medicine for wound healing, inducing lactation, relief of urinary disorders, as an antidiabetic cure and also fever reduction. Besides these medicinal uses, the plant can also be used as colouring agent in food. This review will explore and compile the fragmented knowledge available on the botany, ethnobotany, chemical constitutes, pharmacological properties, and toxicological aspects of this plant. This comprehensive review will give readers the fundamental, comprehensive, and current knowledge regarding Sauropus androgynus L. Merr. PMID:26413127

  11. Can acute interstitial pneumonia be differentiated from bronchiolitis obliterans organizing pneumonia by high-resolution CT?

    Energy Technology Data Exchange (ETDEWEB)

    Mihara, Naoki; Johkoh, Takeshi [Osaka Univ., Suita (Japan). Medical School; Ichikado, Kazuya (and others)

    2000-10-01

    In the early stages, clinical and chest radiographic findings of acute interstitial pneumonia (AIP) are often similar to those of bronchiolitis obliterans organizing pneumonia (BOOP). However, patients with AIP have a poor prognosis, while those with BOOP can achieve a complete recovery after corticosteroid therapy. The objective of this study was to identify differences in high-resolution CT (HRCT) findings between the two diseases. The study included 27 patients with AIP and 14 with BOOP who were histologically diagnosed [open-lung biopsy (n=7), autopsy (n=17), transbronchial lung biopsy (n=17)]. The frequency and distribution of various HRCT findings for each disease were retrospectively evaluated. Traction bronchiectasis, interlobular septal thickening, and intralobular reticular opacities were significantly more prevalent in AIP (92.6%, 85.2%, and 59.3%, respectively) than in BOOP (42.9%, 35.7%, and 14.3%, respectively) (p<0.01). Parenchymal nodules and peripheral distribution were more prevalent in BOOP (28.6% and 57.1%, respectively) than in AIP (7.4% and 14.8%, respectively) (p<0.01). Areas with ground-glass attenuation, air-space consolidation, and architectural distortion were common in both AIP and BOOP. For a differential diagnosis of AIP and BOOP, special attention should be given to the following HRCT findings: traction bronchiectasis, interlobular septal thickening, intralobular reticular opacities, parenchymal nodules, pleural effusion, and peripheral zone predominance. (author)

  12. Bronchiolitis obliterans following exposure to sulfur mustard: chest high resolution computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Ghanei, Mostafa E-mail: m.ghanei@bmsu.ac.ir; Mokhtari, Majid; Mohammad, Mehdi Mir; Aslani, Jafar

    2004-11-01

    Background: Pulmonary complications are known to occur in over half of the patients exposed to sulfur mustard (SM). Chemical weapons of mass destruction (WMD) including SM were used by Iraq during Iran-Iraq war between 1983 and 1989. We undertook this study to evaluate the chest high resolution computerized tomography (HRCT) as a diagnostic tool in patients with documented exposure to SM and chronic respiratory symptoms. Method: The medical records of 155 patients exposed to SM during Iran-Iraq war and suffered respiratory complications were reviewed. Chest HRCTs of these patients were examined. Ten healthy controls with no history of exposure to HD were matched for age, gender, and chest HRCT protocol applied. Results: Fifty chest HRCTs of these patients were randomly selected for this study. The most frequent findings were; air trapping 38 (76%), bronchiectasis 37 (74%), mosaic parenchymal attenuation (MPA) 36 (72%), irregular and dilated major airways 33 (66%) bronchial wall thickening (BWT) 45 (90%), and interlobular septal wall thickening (SWT) 13 (26%), respectively. Air trapping in one patient (10%) was the only positive finding in the control group. Conclusions: Chest HRCT findings of bronchiectasis, air trapping, MPA, SWT, and BWT were seen in our patients 15 years after exposure to HD. These findings suggest the diagnosis of bronchiolitis obliterans (BO). We did not encounter chest HRCT features consistent with pulmonary fibrosis.

  13. Sauropus androgynus (L. Merr. Induced Bronchiolitis Obliterans: From Botanical Studies to Toxicology

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    Hamidun Bunawan

    2015-01-01

    Full Text Available Sauropus androgynus L. Merr. is one of the most popular herbs in South Asia, Southeast Asia, and China where it was known as a slimming agent until two outbreaks of pulmonary dysfunction were reported in Taiwan and Japan in 1995 and 2005, respectively. Several studies described that the excessive consumption of Sauropus androgynus could cause drowsiness, constipation, and bronchiolitis obliterans and may lead to respiratory failure. Interestingly, this herb has been used in Malaysia and Indonesia in cooking and is commonly called the “multigreen” or “multivitamin” plant due to its high nutritive value and inexpensive source of dietary protein. The plant is widely used in traditional medicine for wound healing, inducing lactation, relief of urinary disorders, as an antidiabetic cure and also fever reduction. Besides these medicinal uses, the plant can also be used as colouring agent in food. This review will explore and compile the fragmented knowledge available on the botany, ethnobotany, chemical constitutes, pharmacological properties, and toxicological aspects of this plant. This comprehensive review will give readers the fundamental, comprehensive, and current knowledge regarding Sauropus androgynus L. Merr.

  14. Long Term Follow-Up of Sulfur Mustard Related Bronchiolitis Obliterans Treatment

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    Hamidreza Abtahi

    2016-10-01

    Full Text Available Bronchiolitis obliterans (BO is the most remarkable pulmonary sequels of war-related sulfur mustard inhalation. There is little if any data about long-term efficacy of associated BO treatment. Five years spirometric records of three groups of patients with obstructive pulmonary diseases (asthma, COPD, BO and documented sulfur mustard inhalation were evaluated. The BO patients were treated with inhaled Seretide 125-250/25 (2 puffs BID, azithromycin (250 mg, three times/week and N-acetylcysteine (1200-1800/day. Asthma and COPD patients were treated according to existing guidelines. Seventy-three (38 asthma, 16 COPD and 19 BO patients completed the 5 years follow-up. Basal and final FEV1 in BO patients (2.69±0.81 and 2.39±0.65 respectively were not significantly different from COPD patients (2.46±0.56 and 1.96±0.76 respectively. There was also no significant difference between the yearly FEV1 decline in BO patients compared to COPD patients (60±84 cc vs. 99±79 cc respectively, P=0.163. The non-significant difference of FEV1 decline in BO compared to COPD patients suggests the effectiveness of azithromycin, inhaled steroid and N-acetyl cysteine in BO patients. Considering safety and possible effectiveness, this treatment is recommended until more data is available from controlled clinical studies.

  15. Bronquiolite obliterante com pneumonia em organização Bronchiolitis obliterans organizing pneumonia

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    Gabriela Addor

    2004-04-01

    Full Text Available Uma paciente 48 anos apresentou-se, assintomática, mas com achado radiológico de condensações alveolares, algumas constituindo nódulos em lobo superior direito, lobo médio e língula com predomínio perihilar. Foi considerado o diagnóstico diferencial de neoplasia, sarcoidose, doenças granulomatosas e tuberculose, entre outras doenças. O diagnóstico de bronquiolite obliterante com pneumonia em organização foi estabelecido através de videotoracoscopia e foi iniciado o tratamento com esteróides. Houve boa evolução com resolução radiológica.48 years-old woman, asymptomatic, presented with radiographic findings of patchy airspace consolidation with nodular opacities in the upper right lobe, middle lobe and lingula. The differential diagnoses of neoplasms, sarcoidosis, granulomatous diseases and tuberculosis were considered. Diagnosis of Bronchiolitis obliterans organizing pneumonia was made by means of videothoracoscopy whereupon treatment with corticosteroids was begun. The patient had a positive evolution with resolution of the radiographic finding.

  16. 闭塞性细支气管机化性肺炎%Bronchiolitis obliterans organizing pneumonia

    Institute of Scientific and Technical Information of China (English)

    卢宏柱; 赵亮

    2011-01-01

    @@ 闭塞性细支气管机化性肺炎(bronchiolitis obliterans organizing pneumonia,BOOP)是一个临床病理术语,其特征是以细支气管腔、肺泡管以及一些肺泡有肉芽组织形成,伴有间质和气腔内不同程度的单核细胞和泡沫巨噬细胞的浸润[1-2].

  17. Secondary bronchiolitis obliterans organizing pneumonia during treatment of chronic hepatitis C: role of pegylated interferon alfa-2a

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    Ronaldo Soares Martins

    2012-10-01

    Full Text Available The treatment of chronic hepatitis C has frequent side effects such as cytopenias and neuropsychiatric symptoms. However, pulmonary toxicity associated with interferon is rarely described. This paper describes the clinical case of a 67-year-old female patient with chronic hepatitis C who presented an acute onset of dry cough, dyspnoea, and fever 36 weeks after the use of pegylated interferon alfa-2a and ribavirin. The lung biopsy confirmed the diagnosis of a bronchiolitis obliterans organizing pneumonia (BOOP. Corticotherapy was initiated, with clinical and radiological improvement. This paper aims to advise physicians to this occasional, though severe, adverse event related to hepatitis C virus (HCV treatment.

  18. 肺移植后OB动物模型的研究进展%Progress on animal model of bronchiolitis obliterans after lung transplantation

    Institute of Scientific and Technical Information of China (English)

    康乐

    2014-01-01

    肺移植(lung transplantation,LT)已成为治疗终末期肺疾病患者生命的一个重要手段.细支气管闭塞综合征(bronchiolitis obliterans syndrome,BOS)作为LT术后的一种并发症广泛存在,其特征性病理表现为闭塞性细支气管炎(obliterative bronchiolitis,OB):细支气管周围有淋巴细胞浸润,最终导致纤维瘢痕的形成和细支气管闭塞.理想的动物模型有助于研究的进一步开展.目前,研究肺移植缺少一种理想的动物模型.了解肺移植后闭塞性细支气管炎的发病机制,有助于改善肺移植病人的生活质量,延长肺移植后患者生存率.本研究23将就肺移植后的闭塞性细支气管炎模型做一综述.

  19. Bronchiolitis Obliterans Organizing Pneumonia as an Initial Presentation of Systemic Lupus Erythematosus: A Rare Case Report and Literature Review

    Science.gov (United States)

    Wang, Hung-Ping; Chen, Chun-Ming; Chen, Yih-Yuan; Chen, Wei

    2016-01-01

    The etiology of bronchiolitis obliterans organizing pneumonia (BOOP) remains controversial. While it has been reportedly associated with several connective tissue disorders, there are only rare reports of BOOP associated with systemic lupus erythematosus (SLE). Herein, we report a 56-year-old female patient who presented with dyspnea on exertion, cough, fever, and joint pain of her left wrist and fingers as initial symptoms. Laboratory tests revealed positivity for anti-nuclear antibody, anti-Ro, and anti-double strand DNA antibody. In this case, the patient with SLE had respiratory illness as the initial symptom due to BOOP in the absence of clear etiology. The diagnosis of BOOP was confirmed by thoracic surgery biopsy. Her respiratory symptoms and radiologic findings significantly improved following prednisolone treatment. PMID:27200095

  20. Migratory pneumonitis similar to bronchiolitis obliterans organizing pneumonia after conservative treatment of breast cancer. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Matsuura, Kanji; Hirokawa, Yutaka; Matsuura, Akiko; Akagi, Yukio; Ito, Katsuhide [Hiroshima Univ. (Japan). School of Medicine

    1999-07-01

    We report the case of a 63-year-old woman who developed cough and fever with migratory lung infiltrates three months after completion of right breast irradiation following conservative surgery. Lung infiltrates were initially localized in the irradiated area, but later spread to unirradiated areas in both lungs. No cause of migratory pneumonitis other than irradiation was found, and we clinically diagnosed this case as radiation-induced migratory pneumonitis similar to Bronchiolitis Obliterans Organizing Pneumonia(BOOP), without lung biopsy. Steroid therapy resulted incomplete resolution of lung infiltrates. The reported case clearly differed from typical radiation pneumonitis. We suggest that lung irradiation might trigger the development of migratory pneumonitis with a clinical pattern similar to that of BOOP. (author)

  1. Bronquiolitis obliterante con neumonía organizada y enfermedad de Crohn Bronchiolitis obliterans organizing pneumonia and Crohn’s disease

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    P. Gil-Simón

    2008-03-01

    Full Text Available Las manifestaciones extraintestinales respiratorias en la enfermedad inflamatoria intestinal (EII son excepcionales. Presentamos un caso de bronquiolitis obliterante con neumonía organizada (BONO en paciente con enfermedad de Crohn, en remisión clínica sin tratamientos farmacológicos.Extraintestinal respiratory manifestations in inflammatory bowel disease (IBD are rare. We present a case of bronchiolitis obliterans organizing pneumonia (BOOP in a patient with Crohn's disease, with clinical remission with no drug therapy.

  2. 儿童感染后闭塞性细支气管炎研究进展%Post-infectious bronchiolitis obliterans in children

    Institute of Scientific and Technical Information of China (English)

    吴小英

    2012-01-01

    闭塞性细支气管炎(bronchiolitis obliterans,BO)是一种由严重小气道炎症损伤引起的少见的慢性气道阻塞性肺疾病.BO常见病因有感染、心肺或骨髓移植、吸入有毒物质、胃食管反流、结缔组织病及药物性等.儿童以感染后BO(post-infectious bronchiolitis obliterans,PIBO)最常见.文章综述PIBO研究进展.%Bronchiolitis obliterans (BO) is a rare form of chronic obstructive lung disease that follows a severe inflammatory insult to the small airways. The common etiologies of BO include infection, transplantations of the lung, the heart or the bone-marrow, toxic inhalation, gastroesophageal reflux, connective tissue disorders, drugs and so on. In children, post-infectious BO (PIBO) is the most common form. This article reviews the recent progress of PIBO in children.

  3. Quantitative computed tomography assessment of graft-versus-host disease-related bronchiolitis obliterans in children: A pilot feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Gi [Yonsei University College of Medicine, Department of Radiology and Research Institute of Radiological Science, Severance Children' s Hospital, Seoul (Korea, Republic of); Ajou University Medical Center, Department of Radiology, Ajou University School of Medicine, Suwon (Korea, Republic of); Shin, Hyun Joo; Kim, Myung-Joon; Lee, Mi-Jung [Yonsei University College of Medicine, Department of Radiology and Research Institute of Radiological Science, Severance Children' s Hospital, Seoul (Korea, Republic of); Kim, Yoon Hee; Sohn, Myung Hyun; Kim, Kyung Won [Yonsei University College of Medicine, Department of Pediatrics and Institute of Allergy, Severance Children' s Hospital, Seoul (Korea, Republic of); Lyu, Chuhl Joo [Yonsei University College of Medicine, Department of Pediatric Hematology and Oncology, Severance Children' s Hospital, Seoul (Korea, Republic of)

    2015-10-15

    To suggest a simple method that can quantify air trapping from chest CT in children with graft-versus-host disease (GVHD)-related bronchiolitis obliterans (BO). This institutional review board-approved retrospective study included eight GVHD-related BO patients (age, 6 - 17 years) who underwent both 31 CTs of variable settings and pulmonary function tests (PFT). The attenuation values of lung parenchyma in normal (An) and air trapping (Aa) areas were obtained. Individualized threshold [(An + Aa)/2] and fixed threshold of -950 HU were set for air trapping quantification. Spearman correlation analysis and generalized linear mixed models were used for statistical analysis. The mean value of individualized threshold was -830.2 ± 48.3 HU. The mean air trapping lung volume percentage with individualized threshold and -950 HU were 45.4 ± 18.9 % and 1.4 ± 1.9 %, respectively. The air trapping lung volume percentage with individualized threshold showed a significant negative correlation with the PFT of FEV1/FVC% in all data (γ = -0.795, P <.001) and in the correction of repetition (γ = -0.837, P =.010). We suggest a simple and individualized threshold attenuation setting method for air trapping quantification insusceptible to CT imaging protocols or respiratory phase control in children with GVHD-related BO. (orig.)

  4. ETIOLOGICAL STRUCTURE OF VIRAL RESPIRATORY DISEASES IN ADULT PATIENTS WITH BRONCHIAL ASTHMA EXACERBATION AND CHRONICAL BRONCHIOLITIS OBLITERANS

    Directory of Open Access Journals (Sweden)

    V. Z. Krivitskaya

    2015-01-01

    Full Text Available Exacerbation of bronchial asthma (BA and common deterioration of health during chronic bronchiolitis obliterans (ChBO are associated with viral infections in adults in 64 and 83% respectively. Mixed virus-viral associations were shown in 21–25% of cases. Respiratory syncytial infections were diagnosed with the highest frequency (50% in patients with BA. Influenza A(H1N1pdm09 and adenoviral infections dominated in persons with ChBO in 50 and 42% of cases, respectively. Response of virus-specific IgG in patients with BA and ChBO indicates the acute course of influenza A(H1N1pdm09 (63% of seroconversions. There were no reactions of IgG which is specific to respiratory syncytial virus in 75% of cases and to adenovirus in 83% of cases, that is the risk factor for occurrence of latent/persistent infection. Presence of structural components of respiratory syncytial virus in the upper respiratory tract had been revealed in three patients with asthma within at least 21–28 days. Respiratory syncytial viral infections and pandemic influenza A(H1N1 pdm09 in patients with BA and ChBO are characterized by the presence of an allergic component, which is indicated by the high levels of virus-specific IgE in blood. An adenoviral infection, in contrast, has no such peculiarity. 

  5. Lung transplantation for bronchiolitis obliterans syndrome after allo-SCT

    DEFF Research Database (Denmark)

    Holm, A M; Riise, Gerdt; Hansson, Leif Helmuth

    2013-01-01

    and Finland were recorded and compared with survival data from the Scandiatransplant registry. In total, LTx after allo-SCT had been performed in 13 patients. Allo-SCT was done because of AML (n=6), CML (n=3), ALL (n=2), immunodeficiency (n=1) and aplastic anemia (n=1). All developed clinical c...

  6. Saddle pulmonary embolus and bronchiolitis obliterans with organizing pneumonia develop simultaneously after first cyclophosphamide, methotrexate, 5FU chemotherapy for breast cancer.

    Science.gov (United States)

    Al-Hameed, Fahad M

    2015-06-01

    A 62-year-old woman underwent a right mastectomy with axillary node dissection for a poorly differentiated ductal carcinoma. One month later, she underwent a left nephrectomy for a renal cell carcinoma. Two weeks after, she received her first cycle of cyclophosphamide, methotrexate, and 5FU (CMF) as a part of her breast cancer treatment. We describe an unusual case of non-occlusive saddle pulmonary embolus with extensive bilateral deep vein thrombosis and severe bronchiolitis obliterans with organizing pneumonia developing simultaneously after the first CMF chemotherapy for breast cancer.

  7. 儿童闭塞性细支气管炎%Bronchiolitis obliterans in children

    Institute of Scientific and Technical Information of China (English)

    王维; 申昆玲

    2009-01-01

    闭塞性细支气管炎(bronchiolitis obliterans,BO)是1901年德国病理学家Lange首次报道并命名的。从病理学角度,BO被定义为两种类型的支气管损伤:狭窄性细支气管炎和增殖性细支气管炎。从临床意义上讲,BO是一种与小气道炎症损伤相关的慢性气流阻塞综合征。各种因素导致的细支气管上皮细胞和上皮下结构的损伤和炎症,及机体对以上损伤和炎症的不正当修复是BO的发病原因。

  8. Bronchiolitis as a feature of kartagener syndrome: a case report.

    Science.gov (United States)

    Ozkaya, Sevket; Sahin, Unal; Gumus, Aziz; Taşç, Filiz; Cnarka, Halit; Yavuz, Asiye

    2011-01-01

    Kartagener syndrome (KS), also known as immotile cilia syndrome or as a primary ciliary dyskinesia, is characterized by the triad of situs inversus, bronchiectasis, and chronic pansinusitis. A few studies reported that diffuse bronchiolitis might be one of the characteristic features of the lung in KS. We aimed to present the radiologic characteristics of KS, including diffuse bronchiolitis, sinus aplasia, and situs inversus totalis in a single case.

  9. Bronchiolitis: adopting a unifying definition and a comprehensive etiological classification.

    Science.gov (United States)

    Papiris, Spyros A; Malagari, Katerina; Manali, Effrosyni D; Kolilekas, Likurgos; Triantafillidou, Christina; Baou, Katerina; Rontogianni, Dimitra; Bouros, Demosthenes; Kagouridis, Konstantinos

    2013-06-01

    Bronchiolitis is an inflammatory and potentially fibrosing condition affecting mainly the intralobular conducting and transitional small airways. Secondary bronchiolitis participates in disease process of the airways and/or the surrounding lobular structures in the setting of several already defined clinical entities, mostly of known etiology, and occurs commonly. Primary or idiopathic bronchiolitis dominates and characterizes distinct clinical entities, all of unknown etiology, and occurs rarely. Secondary bronchiolitis regards infections, hypersensitivity disorders, the whole spectrum of smoking-related disorders, toxic fumes and gas inhalation, chronic aspiration, particle inhalation, drug-induced bronchiolar toxicities, sarcoidosis and neoplasms. Idiopathic or primary bronchiolitis defines clinicopathologic entities sufficiently different to be designated as separate disease entities and include cryptogenic constrictive bronchiolitis, diffuse panbronchiolitis, diffuse idiopathic pulmonary neuroendocrine cell hyperplasia, neuroendocrine hyperplasia in infants, bronchiolitis obliterans syndrome in lung and allogeneic hematopoietic cell transplantation, connective tissue disorders, inflammatory bowel disease and bronchiolitis obliterans organizing pneumonia. Most of the above are pathological descriptions used as clinical diagnosis. Acute bronchiolitis, though potentially life threatening, usually regresses. Any etiology chronic bronchiolitis contributes to morbidity and/or mortality if it persists and/or progresses to diffuse airway narrowing and distortion or complete obliteration. Bronchiolitis in specific settings leads to bronchiolectasis, resulting in bronchiectasis.

  10. Associação de bronquiolite obliterante pós-infecciosa e hemossiderose pulmonar na infância Postinfectious bronchiolitis obliterans accompanied by pulmonary hemosiderosis in childhood

    Directory of Open Access Journals (Sweden)

    Leonardo Araújo Pinto

    2006-12-01

    Full Text Available Descreve-se uma apresentação rara de bronquiolite obliterante associada a hemossiderose pulmonar, em paciente de nove anos com sintomas respiratórios persistentes iniciados após episódio de bronquiolite aguda grave aos sete meses. Após o episódio agudo, apresentou sintomas respiratórios persistentes, piorando significativamente aos sete anos, quando começou a apresentar dificuldade respiratória em pequenos esforços. A tomografia computadorizada de tórax demonstrou achados compatíveis com bronquiolite obliterante. A biópsia pulmonar a céu aberto demonstrou numerosos macrófagos corados com hemossiderina, além dos achados compatíveis com bronquiolite obliterante. O diagnóstico de hemossiderose pulmonar pode estar ocasionalmente associado a bronquiolite obliterante em crianças com seqüela pós-viral grave.In the present report, we describe an unusual presentation of post-infectious bronchiolitis obliterans accompanied by pulmonary hemosiderosis in a nine-year-old boy with persistent respiratory symptoms subsequent to an episode of acute bronchiolitis occurring at the age of seven months. After the episode, the persistent respiratory symptoms worsened significantly, and, by the age of seven, the patient began to have difficulty breathing after minimal exertion. Computed tomography of the chest presented findings consistent with bronchiolitis obliterans. Open lung biopsy revealed numerous hemosiderin-laden macrophages, as well as other findings consistent with bronchiolitis obliterans. Pulmonary hemosiderosis can occasionally be accompanied by bronchiolitis obliterans in children with severe sequelae after an episode of viral infection.

  11. Impact of long-term treatment with inhaled corticosteroids and bronchodilators on lung function in a patient with post-infectious bronchiolitis obliterans

    Science.gov (United States)

    Calabrese, Cecilia; Corcione, Nadia; Rea, Gaetano; Stefanelli, Francesco; Meoli, Ilernando; Vatrella, Alessandro

    2016-01-01

    ABSTRACT Post-infectious bronchiolitis obliterans (PIBO) is a small airways disease characterized by fixed airflow limitation. Therefore, inhaled bronchodilators and corticosteroids are not recommended as maintenance therapy options. The management of PIBO currently consists only of close monitoring of affected patients, aimed at the prevention and early treatment of pulmonary infections. In recent years, there has been an increase in the incidence of PIBO in the pediatric population. Patients with PIBO are characterized by a progressive decline in lung function, accompanied by a decrease in overall functional capacity. Here, we report the case of a relatively young man diagnosed with PIBO and followed for three years. After short- and long-term therapy with an inhaled corticosteroid/long-acting ß2 agonist combination, together with an inhaled long-acting antimuscarinic, the patient showed relevant improvement of airway obstruction that had been irreversible at the time of the bronchodilator test. The lung function of the patient worsened when he interrupted the triple inhaled therapy. In addition, a 3-week pulmonary rehabilitation program markedly improved his physical performance. PMID:27383939

  12. Impact of long-term treatment with inhaled corticosteroids and bronchodilators on lung function in a patient with post-infectious bronchiolitis obliterans

    Directory of Open Access Journals (Sweden)

    Cecilia Calabrese

    Full Text Available ABSTRACT Post-infectious bronchiolitis obliterans (PIBO is a small airways disease characterized by fixed airflow limitation. Therefore, inhaled bronchodilators and corticosteroids are not recommended as maintenance therapy options. The management of PIBO currently consists only of close monitoring of affected patients, aimed at the prevention and early treatment of pulmonary infections. In recent years, there has been an increase in the incidence of PIBO in the pediatric population. Patients with PIBO are characterized by a progressive decline in lung function, accompanied by a decrease in overall functional capacity. Here, we report the case of a relatively young man diagnosed with PIBO and followed for three years. After short- and long-term therapy with an inhaled corticosteroid/long-acting 2 agonist combination, together with an inhaled long-acting antimuscarinic, the patient showed relevant improvement of airway obstruction that had been irreversible at the time of the bronchodilator test. The lung function of the patient worsened when he interrupted the triple inhaled therapy. In addition, a 3-week pulmonary rehabilitation program markedly improved his physical performance.

  13. A N UNUSUAL CASE OF SWYER - JAMES - MACLE O DS SYNDROME WITH DEXTROCARDIA

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    Sahana

    2015-05-01

    Full Text Available Swyer - James/MacLeod S yndrome ( SJMS is an uncommon disease with the haracteristic radiological feature of "unilateral hyperlucency" due to loss of pulmonary vasculature and air trapping . SJMS is considered to be a form of bronchiolitis obliterans that fol lows viral bronchiolitis and pneumonitis . This report describes a rare case of Swyer - James syndrome with dextrocardia diagnosed in a 3 year s old child during evaluation for recurrent respiratory infections . KEYWORDS : Swyer - James/MacLeod syndrome ; Unilateral Hyperlucency ; Bronchiolitis obliterans ; Chest X - ray ; Dextrocardia .

  14. Impact of long-term treatment with inhaled corticosteroids and bronchodilators on lung function in a patient with post-infectious bronchiolitis obliterans.

    Science.gov (United States)

    Calabrese, Cecilia; Corcione, Nadia; Rea, Gaetano; Stefanelli, Francesco; Meoli, Ilernando; Vatrella, Alessandro

    2016-01-01

    Post-infectious bronchiolitis obliterans (PIBO) is a small airways disease characterized by fixed airflow limitation. Therefore, inhaled bronchodilators and corticosteroids are not recommended as maintenance therapy options. The management of PIBO currently consists only of close monitoring of affected patients, aimed at the prevention and early treatment of pulmonary infections. In recent years, there has been an increase in the incidence of PIBO in the pediatric population. Patients with PIBO are characterized by a progressive decline in lung function, accompanied by a decrease in overall functional capacity. Here, we report the case of a relatively young man diagnosed with PIBO and followed for three years. After short- and long-term therapy with an inhaled corticosteroid/long-acting 2 agonist combination, together with an inhaled long-acting antimuscarinic, the patient showed relevant improvement of airway obstruction that had been irreversible at the time of the bronchodilator test. The lung function of the patient worsened when he interrupted the triple inhaled therapy. In addition, a 3-week pulmonary rehabilitation program markedly improved his physical performance. RESUMO A bronquiolite obliterante pós-infecciosa (BOPI) é uma doença das pequenas vias aéreas caracterizada por limitação fixa do fluxo aéreo. Portanto, os broncodilatadores e os corticosteroides inalatórios não são recomendados como opções de terapia de manutenção. Atualmente, o manejo da BOPI consiste apenas de um acompanhamento rigoroso dos pacientes afetados, visando à prevenção e ao tratamento precoce de infecções pulmonares. A incidência de BOPI tem aumentado na população pediátrica nos últimos anos. Os pacientes com BOPI caracterizam-se por um declínio progressivo da função pulmonar, associado a uma diminuição da capacidade funcional global. Relatamos aqui o caso de um homem relativamente jovem diagnosticado com BOPI, acompanhado por três anos. Ap

  15. 儿童闭塞性细支气管炎26例临床研究%Clinical characteristics of bronchiolitis obliterans in pediatric patients

    Institute of Scientific and Technical Information of China (English)

    陈德晖; 徐佳兴; 龚小燕; 钟南山; 林育能; 蓝淑玲; 潘小安; 曾庆思; 何振涛; 梁铭; 张碧云; 吴上志

    2012-01-01

    目的 分析儿童闭塞性细支气管炎(bronchiolitis obliterans,BO)的临床特点、影像学特点、实验室检查、治疗方法与临床转归.方法 2009年6月-2011年4月期间广州医学院第一附属医院儿科病房诊断为BO的住院患儿26例.分析BO患儿病原学及临床特点、危险因素、影像学特点、实验室检查、治疗方法及治疗反应.结果 26例中男18例,女8例,发病年龄4.5个月~8岁;病程(6.2±3.5)个月,随诊时间在2个月~2年.临床表现为不同程度的持续喘息(26例,100%),反复咳嗽(24例,92%)、运动不耐受(22例,85%)、气促(21例,81%)、三凹征(20例,77%)、痰鸣(16例,62%)、肺部反复湿哕音(10例,38%)、唇周紫绀(3例,12%).未见杵状指(趾).18例(69%)病原学检测阳性,支原体11例(42%),呼吸道合胞病毒4例(15%),副流感病毒、流感病毒甲型、乙型各2例(8%),博卡病毒1例(4%),其中混合感染阳性者占8例(31%).胸部X线平片检查未见异常者16例(62%),肺炎样改变10例(38%),其中仅1例疑似肺间质改变.所有病例的胸部高分辨CT(HRCT)均有肺部空气潴留、肺灌注不良的马赛克征.19例患儿检测了抗中性粒细胞胞浆抗体(ANCA),其中PANCA阳性10例(53%),CANCA阳性8例(42%).所有患儿均使用口服、全身激素与低剂量阿奇霉素治疗,其中13例(50%)治疗后咳嗽、喘息的严重程度及发作频率有明显改善,喘息、三凹征改善的天数为(7.1±4.8)d;13例(50%)激素效果不理想,或HRCT无改变者加用甲氨蝶呤后喘息、三凹征改善,时间为(16.4±11.0)d.HRCT下病灶修复时间滞后于症状改善时间,HRCT最长随访时间是1.5年,大部分病例肺部病灶仅部分吸收好转,尚无一例病灶完全吸收.结论 呼吸道感染是儿童BO发生的重要病因,临床以长期持续的喘息、咳嗽、活动不耐受、气促、三凹征为主要表现,但缺乏特异性,胸部X线平片不能提供

  16. Nasal tolerance with collagen v protein reverts bronchovascular axis remodeling in experimental bronchiolitis obliterans Tolerância nasal com a proteína colágeno V reverte o remodelamento no eixo broncovascular na bronquiolite obliterante experimental

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    Ana Garippo

    2007-01-01

    Full Text Available INTRODUCTION: The precise role of the remodeling process and possible therapies for bronchiolitis obliterans remain to be established. OBJETIVE: In the present study, we sought to validate the importance of nasal collagen V tolerance to verify whether bronchovascular axis remodeling could be reverted by this therapeutic approach when compared to steroid treatment. METHODS: Mice were randomly divided into 4 groups: control, bronchiolitis obliterans, collagen V tolerance, and prednisone groups. Morphometry was employed to evaluate bronchovascular axis dimensions, collagen density, and immune cell response. Collagen V nasal tolerance and steroid-treated mice showed significantly lower values of terminal bronchiole wall thickness and reduction in peribronchovascular cells; bronchioalveolar lymphoid tissue; and CD3+, CD4+, CD8+, and CD20+ lymphocytes. A significant decrease in CD68+ macrophage density was found in prednisone-treated mice. In addition, a strong quantitative relationship was found between collagen V tolerance, and reduction in density of immune cells and collagen. RESULTS: Our results indicate that bronchovascular axis remodeling in bronchiolitis obliterans can be reverted by collagen V nasal tolerance, possibly as the result of T-cell suppression. CONCLUSION: We concluded that the tolerance effects in this model were strongly related to the improvement in bronchovascular remodeling, and these may be an appropriate targets for further prospective studies on nasal collagen V tolerance.INTRODUÇÃO: A participação precisa do processo de remodelamento e possíveis implicações no tratamento da bronquiolite obliterante ainda não está estabelecida. OBJETIVOS: Estabelecer a importância da tolerância nasal induzida pelo colágeno do tipo V e verificar se o processo de remodelamento do eixo broncovascular pode ser revertido com esta estratégia terapêutica comparada ao efeito do tratamento com esteróides. MATERIAL E M

  17. Guía clínica para el diagnóstico y cuidado de niños/adolescentes con bronquiolitis obliterante post-infecciosa, 2009 Clinical guide for diagnosis and care of children and adolescents with post-infectious bronchiolitis obliterans, 2009

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    LUIS E VEGA-BRICEÑO

    2009-01-01

    Full Text Available La bronquiolitis obliterante (BO es un síndrome clínico poco frecuente en niños, caracterizado por la obstrucción crónica al flujo de aire asociado a cambios inflamatorios y distintos grados de fibrosis en la vía aérea pequeña. Si bien existen muchas etiologías, la causa más frecuente se asocia a infecciones respiratorias virales, principalmente adenovirus. No existe un consenso para establecer su diagnóstico; sin embargo, se considera un espectro de síntomas persistentes asociados a un patrón en mosaico, bronquiectasias y atelectasias persistentes. El papel de la biopsia pulmonar ha sido cuestionado por su bajo rendimiento, invasividad y complicaciones. No existe un tratamiento específico por lo que el manejo es soporte. Probablemente la mejor estrategia constituya el empleo de antibióticos en forma agresiva, soporte kinésico y nutricional constante y una precoz rehabilitación pulmonar. Estas guías clínicas representan un esfuerzo multidisciplinario, basado en evidencias actuales para brindar herramientas prácticas para el diagnóstico y cuidado de niños y adolescentes con BO post infecciosa.Bronchiolitis obliterans in children is an infrequent clinical syndrome, characterized by chronic airflow obstruction associated to inflammatory changes and different degrees of fibrosis in the small airways. Etiologies are varied but the most frequent one is the association with viral infections, mainly adenovirus. There is no consensus regarding diagnostic criteria, but a spectrum of persistent symptoms together with a mosaic pattern, bronchiectasis and persistent atelectasis is considered useful. Pulmonary biopsy has been questioned because of its low yield, invasiveness and complications. No specific treatment is available, therefore its treatment is supportive. Probably the best strategy is the aggressive use of antibiotics, constant kinesic and nutritional support and early pulmonary rehabilitation. This clinical guide represents

  18. Paraneoplastic autoimmune multiorgan syndrome (paraneoplastic pemphigus with unusual manifestations and without detectable autoantibodies

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    Jimena Sanz-Bueno

    2014-01-01

    Full Text Available We describe a patient with paraneoplastic autoimmune multiorgan syndrome (PAMS secondary to a lymphoblastic T- cell lymphoma who presented with a lichenoid dermatitis and vitiligo, later developing bronchiolitis obliterans and autoimmune hepatitis. Notably, he had no detectable autoantibodies. The development of vitiligo and autoimmune hepatic involvement probably indicate a role for cytotoxic T- cell lymphocytes in the pathogenesis of this syndrome.

  19. 儿童闭塞性支气管炎合并闭塞性细支气管炎伴机化性肺炎一例并文献复习%Bronchitis obliterans associated with bronchiolitis obliterans with organizing pneumonia in a child and literature review

    Institute of Scientific and Technical Information of China (English)

    韩青; 史彧; 李红霞; 唐文伟; 刘红霞; 赵德育

    2016-01-01

    目的 探讨闭塞性支气管炎合并闭塞性细支气管炎伴机化性肺炎儿童临床-影像-病理学特点.方法 回顾1例南京医科大学附属南京儿童医院呼吸科2012-2013年收治的肺炎支原体肺炎后合并闭塞性细支气管炎伴机化性肺炎的儿童闭塞性支气管炎患儿临床诊治情况、影像学表现、组织病理学所见,并复习相关文献.结果 10岁女童,反复咳嗽、咯黄脓痰、不规则发热1个月,左下肺呼吸音低并有管状呼吸音;肺部影像示左下肺支气管扩张、扭曲,远端肺不张.纤维支气管镜见支气管黏膜滤泡增生,左下支气管亚段以下闭塞、痰栓.肺组织切面灰红、灰黄,局灶肉质变,管腔内少量黄色分泌物;镜下见肺组织纤维结缔组织增生、见泡沫细胞及Masson小体.肺炎支原体抗体IgM>1∶160.经红霉素等抗感染,纤维支气管镜灌洗后一度改善,但因病情反复最终行左肺切除,术后恢复良好.检索1990年1月-2016年1月CNKI中文数据库及PubMed,以“闭塞性支气管炎”与“闭塞性细支气管炎伴机化性肺炎”同时检索,没有检索到国内外任何文献.结论 闭塞性支气管炎合并闭塞性细支气管炎伴机化性肺炎患儿表现为发热及呼吸道症状迁延不愈,肺部呼吸音低、管状呼吸音;肺炎支原体抗体阳性.影像学表现支气管扩张、远端肺不张.病理学检查可见肺纤维结缔组织增生、Masson小体.经肺叶切除病情好转.%Objective To investigate the clinical-radiologic-pathologic features of bronchitis obliterans that complicated with bronchiolitis obliterans with organizing pneumonia (BOOP).Method The clinical manifestations,characteristic imaging and pathology of a case with pediatric Mycoplasma pneumoniae pneumonia (MPP) complicated with bronchitis obliterans and BOOP were summarized and relative articles were reviewed.Result A 10-year-old girl complained of recurrent paroxysmal cough and episodes of

  20. Bronquiolite obliterante pós-infecciosa: aspectos clínicos e exames complementares de 48 crianças Post-infectious bronchiolitis obliterans: clinical aspects and complementary testing of 48 children

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    Rosaly Vieira dos Santos

    2004-02-01

    obliterans (BO is variable. OBJECTIVE: Substantiate the clinical characteristics, the evolution and the complementary tests of 48 patients with post infectious bronchiolitis obliterans (BO. METHOD: Observational and retrospective study. Diagnosis of BO was based upon clinical criteria, CT scan findings and exclusion of other diseases. History prior to diagnosis and complementary tests were evaluated as well as initial and final values of oxygen saturation. RESULTS: Mean age of patients at the acute stage of the infectious disease was of 9.6 Thirty two of the patients were male. All were hospitalized during the acute stage, 14 of them (29% in the ICU. Four patients died two years after onset of acute bronchiolitis. During evolution all required emergency care due to exacerbation of the pulmonary condition and 24 (50% were hospitalized, 2 of them in the ICU. The majority continued presenting cough, wheezing, crackles and hyperinflation, however to a lesser degree. Mean of initial arterial saturation was of 89% and final of 92%. The most common infectious agents in the sputum samples were H. influenzae, S. pneumoniae and M. caterrhalis. Increased serum IgM and IgG were found in 9 and 7 patients respectively. The most frequent findings at thorax CT scan were mosaic perfusion, bronchioectasis, atelectasis and bronchial wall thickening. CONCLUSION: Post infectious BO is a chronic and severe disease with persistent symptoms that in general affect infants. Positive serum cultures and increased serum immunoglobulins are suggestive of a chronic infectious inflammatory condition.

  1. Xenon ventilation CT using dual-source and dual-energy technique in children with bronchiolitis obliterans: correlation of xenon and CT density values with pulmonary function test results

    Energy Technology Data Exchange (ETDEWEB)

    Goo, Hyun Woo; Yang, Dong Hyun; Seo, Joon Beom; Chae, Eun Jin; Lee, Jeongjin [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Medical Center, Songpa-gu, Seoul (Korea); Hong, Soo-Jong; Yu, Jinho; Kim, Byoung-Ju [University of Ulsan College of Medicine, Department of Pediatrics, Asan Medical Center, Seoul (Korea); Krauss, Bernhard [Siemens Medical Solutions AG-Computed Tomography, Forchheim (Germany)

    2010-09-15

    Xenon ventilation CT using dual-source and dual-energy technique is a recently introduced, promising functional lung imaging method. To expand its clinical applications evidence of additional diagnostic value of xenon ventilation CT over conventional chest CT is required. To evaluate the usefulness of xenon ventilation CT using dual-source and dual-energy technique in children with bronchiolitis obliterans (BO). Seventeen children (age 7-18 years; 11 boys) with BO underwent xenon ventilation CT using dual-source and dual-energy technique. Xenon and CT density values were measured in normal and hyperlucent lung regions on CT and were compared between the two regions. Volumes of hyperlucent regions and ventilation defects were calculated with thresholds determined by visual and histogram-based analysis. Indexed volumes of hyperlucent lung regions and ventilation defects were correlated with pulmonary function test results. Effective doses of xenon CT were calculated. Xenon (14.6 {+-} 6.4 HU vs 26.1 {+-} 6.5 HU; P < 0.001) and CT density (-892.8 {+-} 25.4 HU vs -812.3 {+-} 38.7 HU; P < 0.001) values were significantly lower in hyperlucent regions than in normal lung regions. Xenon and CT density values showed significant positive correlation for the entire lung in 16 children ({gamma} = 0.55 {+-} 0.17, P < 0.001 or =0.017) and for hyperlucent regions in 13 children ({gamma} = 0.44 {+-} 0.16, P < 0.001 or =0.001-0.019). Indexed volumes and volume percentages of hyperlucent lung regions and ventilation defects showed strong negative correlations with forced expiratory volume [FEV1, ({gamma} = -0.64-0.85, P {<=} 0.006)], FEV1/forced vital capacity [FVC, ({gamma} = -0.63-0.84, P {<=} 0.008)], and forced midexpiratory flow rate [FEF{sub 25-75}, ({gamma} = -0.68-0.88, P {<=} 0.002). Volume percentages of xenon ventilation defects (35.0 {+-} 16.4%)] were not significantly different from those of hyperlucent lung regions (38.2 {+-} 18.6%). However, mismatches between the

  2. Bronchiolitis - discharge

    Science.gov (United States)

    RSV bronchiolitis - discharge; Respiratory syncytial virus bronchiolitis - discharge ... Your child has bronchiolitis , which causes swelling and mucus to build up in the smallest air passages of the lungs. In the hospital, ...

  3. Clinical Observation on Aerosol Inhalation Combined with Oral Corti Cos-teroids in Treatment of Bronchiolitis Obliterans in Children%雾化吸入与口服糖皮质激素联合治疗儿童闭塞性细支气管炎临床分析

    Institute of Scientific and Technical Information of China (English)

    薛斌

    2016-01-01

    Objective To discuss and observe the clinical effect of aerosol inhalation combined with oral corti costeroids in treatment of bronchiolitis obliterans in children. Methods 116 cases of children with bronchiolitis obliterans diagnosed from December 2010 to June 2015 were collected and randomly divided into two groups with 58 cases in each, the observation group were treated with budesonide inhalation aerosol and oral corti costeroids, the control group were also treated budes-onide inhalation aerosol and oral corti costeroids, but the dose was different, and the treatment effects and asthma control situations were compared. Results The effective rate and asthma control scale were respectively 93.1%and (23.4±1.2) marks in the observation group, which were obviously better than those in the control group, P<0.05. Conclusion The clinical effect of aerosol inhalation combined with oral corti costeroids in treatment of bronchiolitis obliterans in children is satisfactory.%目的:探讨雾化吸入与口服糖皮质激素联合治疗儿童闭塞性细支气管炎临床疗效。方法方便选取2010年12月—2015年6月确诊的116例闭塞性细支气管炎患儿,随机分为观察组(布地奈德雾化吸入和口服泼尼松)和对照组(同观察组,但剂量不同)各58例,比较治疗效果和哮喘控制情况。结果观察组有效率为93.1%,哮喘控制得分为(23.4±1.2)分,均明显优于对照组(P<0.05)。结论雾化吸入与口服糖皮质激素协同治疗儿童闭塞性细支气管炎临床效果满意。

  4. Test de marcha de seis minutos en niños con bronquiolitis obliterante postviral: Correlación con espirometría Six minute walk test in children with post-infectious obliterans bronchiolitis: Its relation with spirometry

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    DANIEL ZENTENO A

    2008-03-01

    Full Text Available la Bronquiolitis Obliterante (BO postviral produce alteraciones en la función pulmonar que pueden repercutir en la capacidad para realizar ejercicio, la cual se puede evaluar con el test de marcha de 6 minutos (TM6. Objetivo: Estudiar con esta prueba a niños con BO postviral y determinar la relación entre variables espirométricas y los resultados del TM6. Veintisiete pacientes, se estudiaron con espirometría basal y TM6. Se relacionaron variables espirométricas con resultados del TM6: distancia caminada, índice de Borg (IB, saturación de oxígeno (Sa0(2 y frecuencia cardíaca (FC, mediante Rho de Spearman utilizando SPSS 11,5. No hubo correlación entre la distancia caminada y ninguna variable espirométrica; la CVF sólo se correlacionó con Sa0(2 final (rho = 0,4; p = 0,02. El resto de las variables espirométricas se correlacionaron con IB, Sa0(2 y FC; destacando VEF1 con: IB (rho = -0,7; p Post infectious obliterans bronchiolitis (OB causes persistent pulmonary function impairment and could affect patient ability to perform exercise. Six minute-walk test (6MWT is a useful tool to study these aspects. Objective: Children with OB were evaluated with spirometry and 6MWT and the relationship between spirometrics measurements and 6MWT were determined. Twenty-seven children with OB were studied with a base line spirometry and 6MWT. Correlation between spirometry and 6MWT: covered distance, Borg index (BI, oxygen saturation (0(2S and heart rate (HR, were carried out using Rho of Spearman with SPSS 11.5. There was not relation between the covered distance and spirometrics values; only FVC correlates with final 0(2S (rho = 0.4; p = 0.02. The other spirometrics variables correlates with BI, 0(2S andHR; Interestingly FEV1correlates with: BI (rho = -0.7; p < 0.01, 0(2S (rho = 0.5; p < 0.01 and HR (rho = -0.5; p < 0.01. BI was significant related to FEV1/FVC (rho = -0.7; p < 0.01 and FEF25-75 (rho = -0.8; p < 0.01. Airflow obstruction

  5. Función pulmonar y calidad de vida en niños y adolescentes con bronquiolitis obliterante por adenovirus Pulmonary function and quality of life in children and adolescents with bronchiolitis obliterans post-adenoviral infection

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    Stefhanie Nayar E

    2011-09-01

    Full Text Available Introducción: La infección por adenovirus es una causa importante de neumonía en niños chilenos. La bronquiolitis obliterante (BOPI es la complicación más importante. Existen pocos estudios donde evalúen la función pulmonar y la calidad de vida de los pacientes con BOPI. Objetivo: Evaluar la función pulmonar y la calidad de vida de los pacientes con BOPI y la correlación entre ambas variables. Métodos: Se incluyeron 14 niños con BOPI en elpoliclínico de la unidad de broncopulmonar de un hospital público de niños. Período de estudio: abril de 2009-abril de 2010. La función pulmonar se evaluó en una visita médica por espirometría, curva flujo / volumen y la determinación de volumen de gas intratorácico. Los índices analizados fueron los siguientes CVF, VEF1, FEV25-75, VEF1/CVF, VR,CPT, VR y VR / CPT. En la misma visita se realizó una encuesta auto-administrada de Calidad de Vida (PedsQL, versión 4.0, español de Chile para investigar la calidad de vida global, física y psi-cosocial. Se aplicó la correlación lineal de Pearson entre calidad de vida y los parámetros de función pulmonar. Se consideró estadísticamente significativo unp Introduction: Adenovirus infection is an important cause of pneumonia in Chilean children. Postinfectious Bronchiolitis Obliterans (PIBO is the most important complication. There are few studies assessing pulmonary function and quality of life in PIBO patients. Objective: The aim of this study is to assess the pulmonary function and the quality of life ofpatients with PIBO and the correlation between both variables. Methods: 14 children with PIBO in follow up at the pediatric pulmonology outpatient clinic of a public children hospital were included in this study. Study period: April 2009 - April 2010. Pulmonary function was assessed in a medical visit by spirometry, flow/volume curve and intrathoracic gas volume measurement. The following indices were analyzed FVC, FEV1, FEV25-75, FEV1/FVC

  6. Função pulmonar de crianças e adolescentes com bronquiolite obliterante pós-infecciosa Pulmonary function in children and adolescents with postinfectious bronchiolitis obliterans

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    Rita Mattiello

    2010-08-01

    Full Text Available OBJETIVO: Descrever a função pulmonar de crianças e adolescentes com bronquiolite obliterante pós-infecciosa (BOPI e avaliar potenciais fatores de risco para pior função pulmonar. MÉTODOS: A função pulmonar de 77 participantes, com idades de 8-18 anos, foi avaliada por meio de espirometria e pletismografia. Os seguintes parâmetros foram analisados: CVF, VEF1, FEF25-75%, VEF1/CVF, VR, CPT, VR/CPT, volume de gás intratorácico e specific airway resistance (sRaw, resistência específica das vias aéreas. Foi utilizada a regressão de Poisson para investigar os seguintes potenciais fatores de risco para pior função pulmonar: sexo, idade do primeiro sibilo, idade ao diagnóstico, história familiar de asma, exposição ao tabaco, tempo de hospitalização e tempo de ventilação mecânica. RESULTADOS: A idade média foi de 13,5 anos. Houve uma diminuição importante de VEF1 e FEF25-75%, assim como um aumento de VR e sRaw, característicos de doença obstrutiva das vias aéreas. Os parâmetros mais afetados e as médias percentuais dos valores previstos foram VEF1 = 45,9%; FEF25-75% = 21,5%; VR = 281,1%; VR/CPT = 236,2%; e sRaw = 665,3%. Nenhum dos potenciais fatores de risco avaliados apresentou uma associação significativa com pior função pulmonar. CONCLUSÕES: As crianças com BOPI apresentaram um padrão comum de comprometimento grave da função pulmonar, caracterizado por uma obstrução importante das vias aéreas e um expressivo aumento de VR e sRaw. A combinação de medidas espirométricas e pletismográficas pode ser mais útil na avaliação do dano funcional, assim como no acompanhamento desses pacientes. Fatores de riscos conhecidos para doenças respiratórias não parecem estar associados a pior função pulmonar em BOPI.OBJECTIVE: To describe the pulmonary function in children and adolescents with postinfectious bronchiolitis obliterans (PIBO, as well as to evaluate potential risk factors for severe impairment of

  7. Avaliação do estado nutricional de crianças e adolescentes com bronquiolite obliterante pós-infecciosa Assessment of nutritional status in children and adolescents with post-infectious bronchiolitis obliterans

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    Vera Lúcia Bosa

    2008-08-01

    bronchiolitis obliterans and to analyze associations with clinical and nutritional factors. METHODS: The study included 57 patients. Nutritional status was assessed using z scores for weight/age, stature/age, weight/stature in children, and stature/age and body mass index percentiles in adolescents. Body composition was assessed via tricipital skin folds, subscapular skin folds, and the sum of both plus the muscular circumference of the arm; pulmonary function was also investigated in subjects over 8 years old. RESULTS: The high percentages of malnutrition and risk for malnutrition are noteworthy: 21.7 and 17.5%, respectively. Among children, weight/age and stature/age detected higher percentages of malnutrition (21.6 and 16.2%, while weight/stature underestimated this diagnosis. Among adolescents, body mass index detected a high percentage of malnutrition (25% and of risk for malnutrition (20%. Body composition analysis detected 51% of patients with low muscle reserves, and the majority of patients had normal fat reserves. Compromised pulmonary function was associated with poor performance at exercise (r = 0.434; p = 0.024. Malnutrition and/or nutritional risk and low muscle reserves were significantly associated with the 6-minute walk test (p = 0.032; p = 0.030. There was no association between spirometry and the nutritional variables (p > 0.05. CONCLUSIONS: These results emphasize the need for nutritional intervention, and suggest that, in addition to using weight and height indices for nutritional assessment, it is necessary to combine these with an analysis of body composition, so that a larger number of patients with malnutrition and/or at an increased risk of developing malnutrition may be identified and correctly managed.

  8. Acute bronchiolitis.

    Science.gov (United States)

    Teshome, Getachew; Gattu, Rajender; Brown, Reginald

    2013-10-01

    Bronchiolitis is the most common lower respiratory tract infection to affect infants and toddlers. High-risk patients include infants younger than 3 months, premature infants, children with immunodeficiency, children with underlying cardiopulmonary or neuromuscular disease, or infants prone to apnea, severe respiratory distress, and respiratory failure. Bronchiolitis is a self-limited disease in healthy infants and children. Treatment is usually symptomatic, and the goal of therapy is to maintain adequate oxygenation and hydration. Use of a high-flow nasal cannula is becoming common for children with severe bronchiolitis.

  9. Bloom syndrome with lung involvement

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    Nair Girija

    2009-01-01

    Full Text Available We report a case of a 24-year old male presented with cough and breathlessness with diabetes mellitus and diagnosed as a case of bloom syndrome. He was a product of consanguineous marriage, having short stature, dolicocephaly, polydactyly, prominent nose with telangiectasia face. The respiratory system examination revealed bilateral coarse crepitations and wheezes and the chest X-ray revealed emphysema with right middle zone inhomogenous opacity. Also, CT thorax examination revealed bilateral cystic bronchiectasis with bronchiolitis obliterans. Bloom′s syndrome was diagnosed on the basis of clinical features.

  10. Bloom syndrome with lung involvement.

    Science.gov (United States)

    Nair, Girija; Lobo, Ivona; Jayalaksmi, T K; Uppe, Abhay; Jindal, Savita; Chandra, Abhishek; Swami, Shivani

    2009-07-01

    We report a case of a 24-year old male presented with cough and breathlessness with diabetes mellitus and diagnosed as a case of bloom syndrome. He was a product of consanguineous marriage, having short stature, dolicocephaly, polydactyly, prominent nose with telangiectasia face. The respiratory system examination revealed bilateral coarse crepitations and wheezes and the chest X-ray revealed emphysema with right middle zone inhomogenous opacity. Also, CT thorax examination revealed bilateral cystic bronchiectasis with bronchiolitis obliterans. Bloom's syndrome was diagnosed on the basis of clinical features.

  11. Avaliação funcional durante o exercício em crianças e adolescentes com bronquiolite obliterante pós-infecciosa Functional capacity assessment during exercise in children and adolescents with post-infectious bronchiolitis obliterans

    Directory of Open Access Journals (Sweden)

    Rita Mattiello

    2008-08-01

    Full Text Available OBJETIVO: Avaliar a capacidade funcional no exercício em crianças e adolescentes com bronquiolite obliterante pós-infecciosa. MÉTODOS: Foram estudadas 20 crianças com bronquiolite obliterante pós-infecciosa, com idade de 8 a 16 anos, que estavam em acompanhamento ambulatorial. Os pacientes realizaram teste cardiopulmonar do exercício (TCPE em esteira, teste de caminhada de 6 minutos (TC6, espirometria e pletismografia, seguindo diretrizes da American Thoracic Society (ATS, European Respiratory Society (ERS e American College of Chest Physicians (ACCP. Para o cálculo dos percentuais esperados, foram utilizados Armstrong (TCPE, Geiger (TC6, Knudson (espirometria e Zapletal (pletismografia. RESULTADOS: A idade média foi de 11,4±2,2 anos; 70% meninos; peso: 36,8±12,3 kg; altura: 143,8±15,2 cm. Os pacientes apresentaram os fluxos diminuídos na espirometria e os volumes aumentados na pletismografia, comparados com a população de referência. No TCPE, 11 pacientes apresentaram valores do consumo de oxigênio (VO2 de pico reduzidos (OBJECTIVE: To assess functional capacity during exercise in children and adolescents with post-infectious bronchiolitis obliterans (PIBO. METHODS: 20 children with PIBO, aged 8-16 years old, and in follow-up at an outpatient clinic carried out cardiopulmonary exercise testing (CPET, a 6-minute walk test (6MWT and pulmonary function tests (PFT, according to American Thoracic Society (ATS, European Respiratory Society (ERS and American College of Chest Physicians (ACCP guidelines. Results were expressed as percentages of predicted reference values: Armstrong's for CPET, Geiger's for 6MWT, Knudson's for spirometry, and Zapletal's for plethysmography. RESULTS: Mean age (± SD was 11.4±2.2 years; 70% were boys; mean weight: 36.8±12.3 kg; mean height: 143.8±15.2 cm. When compared to reference values, PFT detected lower airflows (spirometry and higher volumes (plethysmography. Eleven patients had reduced peak VO2

  12. Bronquiolite obliterante: perfil clínico e radiológico de crianças acompanhadas em ambulatório de referência Bronquiolitis obliterante: perfil clínico y radiológico de 35 niños acompañados en ambulatorio de referencia Bronchiolitis obliterans: clinical and radiological profile of children followed-up in a reference outpatient clinic

    Directory of Open Access Journals (Sweden)

    Carolina Arcanjo Lino

    2013-03-01

    los pediatras frente a lactantes silbadores graves y perennes.OBJECTIVES: To describe the clinical and radiological characteristics of patients with bronchiolitis obliterans. METHODS: This is a retrospective and descriptive study. Data were collected from patients diagnosed with bronchiolitis obliterans between 2004 and 2008 in the Pediatric Pulmonology Clinic of Hospital Infantil Albert Sabin, in Ceará, Northeast Brazil. Such diagnosis was based on clinical and tomographic criteria. Previous history, clinical findings at the diagnosis, complementary exams, and follow-up data were evaluated. RESULTS: 35 children diagnosed with bronchiolitis obliterans were identified. There was a predominance of male patients (3:1. The mean age at the onset of symptoms was 7.5 months, and bronchiolitis obliterans was diagnosed at a mean age of 21.8 months. The most common clinical findings were crackles/wheezing, tachypnea, dyspnea, and chest deformity. Post-infectious etiology was the main cause of bronchiolitis obliterans. Predominant findings at chest X-ray and high resolution computed tomography were peri-bronchial thickening and mosaic pattern, respectively. The treatment was variable and individualized. The majority of patients improved during follow-up, despite the persistence of respiratory symptoms. CONCLUSIONS: In this study, the predominance of male patients and post-infectious etiology was noted, corroborating scientific literature. The most common tomographic findings were similar to those described in previous studies (mosaic pattern, peri-bronchial thickening, and bronchiectasis. Evidence about the treatment of this disease is still lacking. The diagnosis was delayed, which indicates that clinical suspicion of bronchiolitis obliterans is necessary in children with persistent and severe wheezing.

  13. 儿童闭塞性细支气管炎的临床表现与高分辨率CT特点%Clinical manifestations and high resolution CT features of bronchiolitis obliterans

    Institute of Scientific and Technical Information of China (English)

    周俊霖; 丁山; 朱晓华; 郑巍

    2012-01-01

    Objective To study the clinical manifestations and high resolution CT( HRCT) characteristics of bronchiolitis obliter-ans(BO) , so that to improve the understanding of it. Methods Clinical and CT data in 27 patients(22 boys and 5 girls, aged from 2 months to 5 years, and mean age 15. 4 months) with clinical confirmation of BO were retrospectively analysed. All the patients pres-ented with persistent cough and asthma. All cases underwent chest radiograph, HRCT examinations and blood gas analysis. 10 ca-ses and 5 cases underwent bronchoscopy and pulmonary function test, respectively. Results In 27 cases,24 cases were post-infec-tions BO and the others were premature infants after injury of lungs. Hypoxemia in 14 cases and respiratory failure in 4 cases were showed by blood gas analysis. Ten cases who underwent bronchoscopy showed chronic endobronchial infection. HRCT features in-cluded direct signs (peripheral bronchiectasis and bronchial wall thickening in 16 cases, centrilobular nodules in 5 cases) and indirect signs(bronchiectasis and bronchial wall thickening in 20 cases, air trapping signs in 5 cases, mosaic perfusion signs in 25 cases, con-solidation in 10 cases and atelectasis in 5 cases). Conclusion In most of the patients with BO present following infections. HRCT is of important value in the early diagnosis and evaluation of outcome of BO.%目的 探讨闭塞性支气管炎(BO)的临床表现与高分辨率CT(HRCT)特点,提高对本病的认识.方法 回顾性分析27例经临床诊断证实的儿童闭塞性细支气管炎的临床和CT资料,年龄2个月~5岁,平均15.4月,男22例,女5例.反复咳喘病程均在6周以上.27例患儿均行X线胸片,肺部高分辨率CT及血气分析.10例行电子纤维支气管镜检查,5例行肺功能检查.结果 27例确诊为BO患儿,3例为早产儿肺损伤后,余24例为感染后.血气分析示低氧血症14例,呼吸衰竭4例.10例行电子纤维支气管镜检查均提示有支气管内膜慢性感

  14. Swyer-James-Macleod Syndrome Presenting with Pulmonary Hypertension

    Directory of Open Access Journals (Sweden)

    Sh Hajsadeghi

    2010-09-01

    Full Text Available Swyer–James–MacLeod Syndrome is a rare condition as a result of childhood pulmonary infection, especially bronchiolitis obliterans or viral bronchiolitis/pneumonia. It appears as increased radiolucency on chest Xray, in the absence of obstructing lesions and can be confused for other thoracic disease processes such as a large pulmonary emboli or congenital bronchial and/or pulmonary vasculature malformations. We introduce a 46-year-old male patient presented with symptoms and signs of pulmonary hypertension which was initially misdiagnosed as chronic pulmonary emboli. This case highlights the possibility of pulmonary hypertension to be one of the cardinal manifestations of this syndrome, and outlines the significance of application of computedtomography in confirming the diagnosis of SJMS and in eliminating other diseases.

  15. TCM Treatment of Thromboangiitis Obliterans -A Report of 64 Cases

    Institute of Scientific and Technical Information of China (English)

    门军章; 门九章

    2005-01-01

    @@ Thromboangiitis Obliterans (TAO), a common peripheral vascular disease with a long illness course and grave sufferings, can cause acromelic gangrene, ulcer and even amputation at the late stage. We have for many years used TCM syndrome differentiation to diagnose and treat the disease with good therapeutic results. The treatment of 64 TAO cases from 2001 to 2002 is reported as follows.

  16. Bronchiolitis obliterans organizing pneumonia during low-dose amiodarone therapy

    NARCIS (Netherlands)

    Jessurun, GAJ; Hoogenberg, K; Crijns, HJGM

    1997-01-01

    Two cases of amiodarone-induced pulmonary toxicity during a relatively short period of low-dose amiodarone treatment are reported. The toxicity risk of amiodarone is determined by cumulative factors in individual patients.

  17. Surgical treatment of balanitis xerotica obliterans.

    Science.gov (United States)

    Campus, G V; Ena, P; Scuderi, N

    1984-04-01

    Balanitis xerotica obliterans, or kraurosis penis, is a chronic progressive scleroatrophic process of the penis, prepuce, and urethral meatus. This syndrome is due to lichen sclerosus et atrophicus of the genital region. We have observed 32 patients, whose ages ranged from 24 to 78, with different clinical and pathologic findings. Clinical symptomatology consisted of painful erection with secondary impotence, burning, itching, and urinary disorders. The treatment in the early stages is pharmacologic; stenosis of the meatus, phimosis, scar adhesions, fissures, and erosions of glans and prepuce prescribe a surgical treatment. We have performed modified circumcision, meatotomy and meatoplasty, removal of the scleroatrophic tract and subsequent grafting. The functional results were satisfactory.

  18. Balanitis xerotica obliterans in children.

    Science.gov (United States)

    Garat, J M; Chéchile, G; Algaba, F; Santaularia, J M

    1986-08-01

    This report is based on 7 children with balanitis xerotica obliterans. Of these patients 5 had stenosis of the urethral meatus that required meatotomy and the postoperative results were good. The frequency of balanitis xerotica obliterans in children at our center, as well as the findings of other authors, suggests that possibly more cases would be diagnosed during infancy if all dried foreskin were examined systematically.

  19. [Balanitis xerotica obliterans].

    Science.gov (United States)

    Calcagno, C

    2007-01-01

    Balanitis xerotica obliterans (BXO), first described by Stuhmer in 1928, is a chronic, progressive, atrophic, sclerosing process involving prepuce, glans and urethra. Its aetiology is unknown. After a short terminological excursus and a review of the aetiological hypothesis, we have focused on BXO in daily urological practice. We are here describing the clinical presentation and its differential diagnosis with premalignant and malignant lesions of the penis. We tried to define the relationship between BXO and squamous cell carcinoma of the penis. Particular attention was then cast on urethral stenosis. Finally, we focused on the treatment of BXO: corticosteroid local therapy as first line treatment or as adjuvant therapy after circumcision, surgical therapy including circumcision, laser therapy of the glans lesions, meatoplasty in the stenosis of the anterior urethra. We also stressed the need for histological examination of the preputial specimen for a correct follow-up and for medicolegal reasons.

  20. Acute viral bronchiolitis and its sequelae in developing countries.

    Science.gov (United States)

    Fischer, Gilberto Bueno; Teper, Alejandro; Colom, Alejandro J

    2002-12-01

    Acute viral bronchiolitis (AVB) is a common disease found throughout the world. Various aspects of it are being studied: its epidemiology, diagnosis, prognosis and treatment. Most of these studies are being conducted in developed countries, with only a few taking place in developing countries. Risk factors such as poor nutrition, an adverse environment and early weaning should be studied where these features are common. Treatment aspects such as cost-effectiveness in low income settings need further study. Use of ribavirin and respiratory syncytial virus (RSV)-immunoglobulin are good examples. Post-bronchiolitic sequelae also need to be studied in low income countries. There is evidence that bronchiolitis obliterans is unusually frequent in some Latin-American countries such as Argentina and Brazil. It will be helpful to undertake combined studies in countries with the same socio-economics, investigating the preventive and management aspects of AVB and its sequelae to reduce the morbidity and mortality.

  1. Urethro-balanitis xerotica obliterans.

    Science.gov (United States)

    Mallo, N; Garat, J M; Santaularia, J; Hernandez, J

    1978-01-01

    A clinical report of 5 cases of balanitis xerotica obliterans (BXO) with urethral involvement is presented. Involvement of the urethra in the BXO is emphasized and the fact that this process is often unnoticed, is stressed. The clinical and histological characteristics of this disease are described in its different localizations. Investigations are suggested to diagnose urethral involvement and the suitable therapy is outlined.

  2. Bronchiolitis: the recent evidence.

    Science.gov (United States)

    Mustafa, Ghulam

    2014-01-01

    Bronchiolitis is an active area of research across the spectrum from genetic mechanisms to population-based research. Surveillance studies are identifying new causes of bronchiolitis and exploring the role of viral co-infections. The studies have revealed that comorbidities are an important determinant to predict the course of the illness. Also the specific physical findings and diagnostic tests used to predict the outcomes in bronchiolitis do not have high predictive value. The pulse oximetry, probably, is a double edge sword. It has contributed to better childcare but is also likely contributing to longer hospitalizations and greater use of health care resources. The available data is yet largely against the routine use of bronchodilators or corticosteroids, though a combination of these two looks promising future trend. The role of nebulized hypertonic saline in bronchiolitis is getting a wider acceptance and is likely to get established a part of routine care.

  3. Down syndrome : A novel risk factor for respiratory syncytial virus bronchiolitis - A prospective birth-cohort study

    NARCIS (Netherlands)

    Bloemers, Beatrijs L. P.; van Furth, Marceline; Weijerman, Michel E.; Gemke, Reinoud J. B. J.; Broers, Chantal J. M.; van den Ende, Kimberly; Kimpen, Jan L. L.; Strengers, Jan L. M.; Bont, Louis J.

    2007-01-01

    OBJECTIVES. Respiratory syncytial virus is the single-most important cause of lower respiratory tract infections in children. Preterm birth and congenital heart disease are known risk factors for severe respiratory syncytial virus infections. Although Down syndrome is associated with a high risk of

  4. Adult diagnosis of Swyer-James-MacLeod syndrome: a case report

    Directory of Open Access Journals (Sweden)

    Gouveia Paulo

    2011-01-01

    Full Text Available Abstract Introduction Swyer-James-MacLeod syndrome or unilateral hyperlucent lung syndrome is a rare entity associated with postinfectious bronchiolitis obliterans occurring in childhood. It is characterized by hypoplasia and/or agenesis of the pulmonary arteries resulting in pulmonary parenchyma hypoperfusion. Case presentation Here we report the case of a 53-year-old Caucasian woman with Swyer-James-MacLeod syndrome found in the differential diagnosis workup for a new onset of heart failure, secondary to pulmonary arterial hypertension complicated by a patent ductus arteriosus. Conclusion Typically, this disorder is diagnosed in childhood after evaluation for recurrent respiratory infections, but sometimes an indolent course means diagnosis is not made until adulthood.

  5. Infectious pathogens and bronchiolitis outcomes.

    Science.gov (United States)

    Hasegawa, Kohei; Mansbach, Jonathan M; Camargo, Carlos A

    2014-07-01

    Bronchiolitis is a common early childhood illness and an important cause of morbidity, it is the number one cause of hospitalization among US infants. Bronchiolitis is also an active area of research, and recent studies have advanced our understanding of this illness. Although it has long been the conventional wisdom that the infectious etiology of bronchiolitis does not affect outcomes, a growing number of studies have linked specific pathogens of bronchiolitis (e.g., rhinovirus) to short- and long-term outcomes, such as future risk of developing asthma. The authors review the advent of molecular diagnostic techniques that have demonstrated diverse pathogens in bronchiolitis, and they review recent studies on the complex link between infectious pathogens of bronchiolitis and the development of childhood asthma.

  6. Spontaneous thoracic air-leakage syndrome in patients following allogeneic hematopoietic stem cell transplantation: Causes, CT-follow up and patient outcome

    Energy Technology Data Exchange (ETDEWEB)

    Vogel, Monika [Department of Diagnostic Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076 Tuebingen (Germany)]. E-mail: monika.vogel@med.uni-tuebingen.de; Brodoefel, Harald [Department of Diagnostic Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076 Tuebingen (Germany); Bethge, Wolfgang [Department of Internal Medicine-Oncology, Eberhard-Karls-University, Ottfried-Mueller-Str. 5, 72070 Tuebingen (Germany); Faul, Christoph [Department of Internal Medicine-Oncology, Eberhard-Karls-University, Ottfried-Mueller-Str. 5, 72070 Tuebingen (Germany); Hartmann, Joerg [Department of Internal Medicine-Oncology, Eberhard-Karls-University, Ottfried-Mueller-Str. 5, 72070 Tuebingen (Germany); Schimmel, Heiko [Department of Pathology, Eberhard-Karls-University, Liebermeisterstrasse 8, 72076 Tuebingen (Germany); Wehrmann, Manfred [Department of Pathology, Eberhard-Karls-University, Liebermeisterstrasse 8, 72076 Tuebingen (Germany); Claussen, Claus D. [Department of Diagnostic Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076 Tuebingen (Germany); Horger, Marius [Department of Diagnostic Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076 Tuebingen (Germany)

    2006-12-15

    Objective: The purpose of this article is to describe and illustrate the acute and follow-up imaging features, clinical constellation and outcome of patients with thoracic air-leakage syndrome following allogeneic hematopoietic stem cell transplantation (allo-HCT). Methods: Patients with evidence of thoracic air-leakage, i.e. spontaneous pneumomediastinum, spontaneous pneumothorax or interstitial emphysema after allo-HCT were retrospectively identified by a chart review. Acute and follow-up morphology, duration and patient outcome were analyzed on CT (HRCT or MSCT with HR-reconstructions). Correlation was made with histological results of transbronchial biopsy. Results: The 6 patients included (3 male and 3 female, 14-64 years old) with thoracic air-leakage after allo-HCT all had histologically proven bronchiolitis obliterans (BO) or bronchiolitis obliterans organizing pneumonia (BOOP). Thoracic air-leakage consisted of spontaneous pneumomediastinum associated with active invasive pulmonary aspergillosis (IPA) in 4/6 and spontaneous pneumothorax or interstitial emphysema each in 1/6 patients. Duration of thoracic air-leakage was 7-135 days. Of the patients with spontaneous pneumomediastinum, 3/4 died of IPA. One patient survived until complete regression of spontaneous pneumomediastinum. One patient died 7 days after spontaneous pneumothorax and one survived developing chronic interstitial emphysema. Conclusion: In all cases, thoracic air-leakage was associated to BO or BOOP. In the majority of cases with additional IPA, thoracic air-leakage is more indicative for severity of pulmonary disease than a life-threatening entity itself.

  7. Treatment of acute viral bronchiolitis.

    Science.gov (United States)

    Eber, Ernst

    2011-01-01

    Acute viral bronchiolitis represents the most common lower respiratory tract infection in infants and young children and is associated with substantial morbidity and mortality. Respiratory syncytial virus is the most frequently identified virus, but many other viruses may also cause acute bronchiolitis. There is no common definition of acute viral bronchiolitis used internationally, and this may explain part of the confusion in the literature. Most children with bronchiolitis have a self limiting mild disease and can be safely managed at home with careful attention to feeding and respiratory status. Criteria for referral and admission vary between hospitals as do clinical practice in the management of acute viral bronchiolitis, and there is confusion and lack of evidence over the best treatment for this condition. Supportive care, including administration of oxygen and fluids, is the cornerstone of current treatment. The majority of infants and children with bronchiolitis do not require specific measures. Bronchodilators should not be routinely used in the management of acute viral bronchiolitis, but may be effective in some patients. Most of the commonly used management modalities have not been shown to have a clear beneficial effect on the course of the disease. For example, inhaled and systemic corticosteroids, leukotriene receptor antagonists, immunoglobulins and monoclonal antibodies, antibiotics, antiviral therapy, and chest physiotherapy should not be used routinely in the management of bronchiolitis. The potential effect of hypertonic saline on the course of the acute disease is promising, but further studies are required. In critically ill children with bronchiolitis, today there is little justification for the use of surfactant and heliox. Nasal continuous positive airway pressure may be beneficial in children with severe bronchiolitis but a large trial is needed to determine its value. Finally, very little is known on the effect of the various

  8. Viral bronchiolitis for the clinician.

    Science.gov (United States)

    Fitzgerald, Dominic A

    2011-04-01

    Viral bronchiolitis is common, and about 98-99% of infants are managed in the home. Because about 95% of infants < 2 years old are infected with respiratory syncytial virus, however, bronchiolitis is the commonest reason for admission to hospital in the first 6 months of life. It is usually a self-limiting condition lasting around a week in previously well children. About 1% of infants are admitted to hospital, and about 10% of hospitalised infants will require admission to the intensive care unit. Respiratory syncytial virus is isolated from about 70% of infants hospitalised with bronchiolitis. The emphasis of hospital treatment is to ensure adequate hydration and oxygenation. Other than supplemental oxygen, little in the way of pharmacological treatment has been demonstrated to alter the course of the illness or the risk of wheezing in the months following bronchiolitis.

  9. Balanitis xerotica obliterans involving anterior urethra.

    Science.gov (United States)

    Herschorn, S; Colapinto, V

    1979-12-01

    Balanitis xerotica obliterans (BXO) is known to affect the urethral meatus, glans, and prepuce. We describe a case of biopsy-proved BXO that involves not only the usual areas but the anterior urethra as well. Of added interest is the subsequent development of squamous cell carcinoma in the fossa navicularis. The literature is reviewed.

  10. Penile squamous cell carcinoma arising from balanitis xerotica obliterans.

    Science.gov (United States)

    Pride, H B; Miller, O F; Tyler, W B

    1993-09-01

    Squamous cell carcinoma arising from balanitis xerotica obliterans is rarely reported. We describe an 83-year-old man in whom metastatic penile squamous cell carcinoma developed after 18 years of observation for balanitis xerotica obliterans. It is important to recognize the possibility of this uncommon complication of balanitis xerotica obliterans, because survival of patients with squamous cell carcinoma depends on early diagnosis and treatment.

  11. Screening with spirometry is a useful predictor of later development of noninfectious pulmonary syndromes in patients undergoing allogeneic stem cell transplantation.

    Science.gov (United States)

    Thompson, Philip A; Lim, Andrew; Panek-Hudson, Yvonne; Tacey, Mark; Hijazi, Ramzi; Ng, Ashley P; Szer, Jeff; Ritchie, David; Bajel, Ashish

    2014-06-01

    Noninfectious pulmonary syndromes (NIPS) frequently complicate allogeneic stem cell transplantation (allo-SCT). The most common and serious is the bronchiolitis obliterans syndrome, characterized by irreversible fixed airflow obstruction, impaired quality of life, and a high mortality. Treatment for established symptomatic disease is relatively ineffective. We therefore sought to identify potential predictive factors for development of NIPS, which may identify patients at risk in whom earlier intervention may be of benefit. Spirometry and diffusing capacity for carbon monoxide were performed before allo-SCT, day 100, and 1 year after allo-SCT. We retrospectively analyzed spirometry in consecutive patients having allo-SCT from 2004 to 2010, along with computed tomography and bronchoalveolar lavage results to identify cases of NIPS. Cases of bronchiolitis obliterans syndrome were defined as per current National Institutes of Health consensus guidelines. Spirometry results and baseline variables were compared between patients with and without NIPS to identify early predictors and risk factors for NIPS. Of 235 assessable patients, 23 (9.8%) developed NIPS. Median time of onset was day 367 (interquartile range [IQR], 144 to 544 days). Changes in forced expiratory volume in 1 second (ΔFEV1.0) was the best predictor of later NIPS development. Median ΔFEV1.0 from pretransplant to day 100 in patients later developing NIPS was -12% (IQR, -25% to -1%) versus -1% (IQR, -7% to +6%) in unaffected patients, P = .002. From pretransplant to 1 year, ΔFEV1.0 was -19% (IQR, -37% to -6%) versus -3% (IQR, -10% to +4%) in patients later developing NIPS and unaffected patients, respectively, P Spirometry is a potentially useful screening test for identification of presymptomatic NIPS. We recommend 3-monthly spirometry surveillance for up to 2 years post-transplant. Our findings require prospective validation to identify patients in whom earlier intervention may potentially modify the

  12. [Thromboangiitis obliterans (Buerger's disease): update 2015].

    Science.gov (United States)

    Klein-Weigel, Peter; Volz, Theresa Sophie; Richter, Jutta

    2015-10-01

    Thromboangiitis obliterans (Buerger's disease) is a vasculitis with undulating clinical course multisegmentarily affecting small and medium-sized arteries and veins. The disease is closely linked to tobacco-use. Increasing knowledge of autoimmunologic mechanisms in the complex pathophyiology of the disease let to the formulation of an autoimmunity-hypothesis now serving as a new paradigma. New treatment options comprise progenitor-cell-therapy, immunoadsorption, use of sendothelin-receptor-blocking agent Bosentan, and prescriptions of antiphosphodiesterase-V-inhibitors.

  13. The surgical treatment of Balanitis Xerotica Obliterans

    OpenAIRE

    2011-01-01

    Background: Balanitis Xerotica Obliterans (BXO) is a chronic, often progressive disease, which can lead to phimosis and urethral stenosis, affecting both urinary and sexual function. Steroid creams are usually the first-line treatment but have a limited role and surgical intervention is frequently necessary. Conservative surgical procedures (circumcision) are often preferred in the first instance with the premise that recurrence of disease will require a more definitive reconstruction. This s...

  14. An Approach to Relativity of the Lower Extremity Atherosclerosis Obliterans Syndrome Differentiation Typing and Endothelial Function%下肢动脉硬化闭塞症辨证分型与血管内皮功能相关性探讨

    Institute of Scientific and Technical Information of China (English)

    李建鹏; 王峥

    2011-01-01

    Objective:To research the relativity of the lower extremity atherosclerosis obliterans (ASO) syndrome differentiation typing and endothelial function.Methods: 161 cases of ASO in various typings based on syndrome differentiation were observed, the endothelial function indexes were detected.SPSS11.5 for windows software was adopted for statistical treatment.Results :ASO patients had severe endothelial dysfunction(ED) ,ET- 1 and TXB2 in blood plasma of Damp -heat pouring down syndrome group were significantly higher than other groups' s( P < 0.01 ), and the same result to Blood stasis syndrome group' s.But NO in blood serum and 6 - Keto - PGF1α in blood plasma of Damp - heat pouring down syndrome group and Blood stasis syndrome group were significantly lower than Yin -cold congealing syndrome group and Spleen- kidney yang deficiency syndrome group's(P < 0.05 )Conclusion: With respect to the severity of ED, Damp - heat pouring down syndrome group is highest, Blood stasis syndrome group take second place, Yin -cold congealing syndrome group and Spleen -kidney yang deficiency syndrome group is lower.%目的:探讨不同证型的下肢动脉硬化闭塞症(ASO)与血管内皮功能的相关性.方法:选择ASO患者共161例,经辨证后检测各证型患者血管内皮功能指标,采用SPSS 11.5软件包对数据进行统计学处理.结果:ASO患者存在较为严重的血管内皮功能障碍(ED),湿热下注证组患者血浆ET-1、TXB2水平高于其它证型组(P<0.01),血脉瘀阻证为其次;而血清NO水平在此两证型中低于阴寒结聚证及脾肾阳虚证(P<0.05).结论:下肢动脉硬化闭塞症(ASO)湿热下注证血管内皮功能障碍(ED)最为严重,其次为血脉瘀阻证,阴寒结聚证及脾肾阳虚证内皮功能障碍相对较轻.

  15. A case of bronchiolitis obliterans organizing pneumonia (BOOP) after breast conserving therapy for early breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Hayashi, Shinya; Kiryuu, Takuji; Maeda, Sunao; Hoshi, Hiroaki; Shimokawa, Kuniyasu [Gifu Univ. (Japan). School of Medicine; Kawaguchi, Shimpei

    2001-03-01

    A case of BOOP occurring after radiotherapy for breast cancer was reported. TBLB and BAL were performed at the time of diagnosis. This case suggested that radiographic changes began in the irradiated area, then later spread to non-irradiated areas. In this article, we discussed the peculiary radiographic image, pathological manifestation, BAL characteristics and clinical course in this sequela. (author)

  16. Local interleukin-10 production during respiratory syncytial virus bronchiolitis is associated with post-bronchiolitis wheeze

    NARCIS (Netherlands)

    Schuurhof, Annemieke; Janssen, Riny; de Groot, Hanneke; Hodemaekers, Hennie M.; de Klerk, Arja; Kimpen, Jan L. L.; Bont, Louis

    2011-01-01

    Background: Respiratory syncytial virus (RSV) is the most common cause of bronchiolitis in infants. Following RSV bronchiolitis, 50% of children develop post-bronchiolitis wheeze (PBW). Animal studies have suggested that interleukin (IL)-10 plays a critical role in the pathogenesis of RSV bronchioli

  17. FINDINGS OF CHEST RADIOGRAPH AND SPIRAL COMPUTED TOMOGRAPHY IN SWYER-JAMES SYNDROME

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective To evaluate the value of X-ray and spiral computed tomography (SCT) in the diagnosis of SwyerJames syndrome (SJS).Methods A total of 28 patients, 12 males and 16 females, were studied retrospectively. Ages ranged from 11 to 57 years, the mean age was 32 years. All patients underwent inspiratory chest X-ray films, 5 with expiratory chest films and 1 with bronchogram. Furthermore, inspiratory and expiratory SCT scans were performed. The SCT findings were analyzed and compared with X-ray films.Results SCT demonstrated 56 lobes with hyperlucency and diminished vascularity. The size of 51 lobes were smaller and 5 were normal. X-ray films showed that hyperlucency was only in 29 lobes, in which 19 lobes were smallsized and the other 10 lobes normal. There were 56 lobes with air-trapping on expiratory SCT scans, but only 5 lobes with air-trapping on expiratory X-ray films. Bronchogram in 1 case demonstrated bronchiectasis and bronchiolitis obliterans. SCT showed 24 patients with bronchiectasis, 9 patients with tuberculosis, 10 patients with bronchiolitis, and 2 with segmental collapse. Conclusion SCT scan is superior to chest radiography in the diagnosis and differential diagnosis of SJS.

  18. Carbon dioxide laser treatment of balanitis xerotica obliterans.

    Science.gov (United States)

    Ratz, J L

    1984-05-01

    A case of balanitis xerotica obliterans unresponsive to topical therapy is presented. The condition was successfully corrected following epithelial vaporization with the carbon dioxide laser, the patient remaining free of recurrence for 21 months postoperatively.

  19. Balanitis xerotica obliterans complicating hypospadias repair.

    Science.gov (United States)

    Kumar, M V; Harris, D L

    1999-01-01

    We review the literature and report a series of eight cases of balanitis xerotica obliterans (BXO) developing in patients following primary hypospadias repair. The ages of these patients ranged from 8 to 25 years with BXO developing from 1 to 16 years postoperatively. Six patients were treated by excision of the BXO tissue and two-stage urethroplasties with full-thickness grafts. Three of these patients had further recurrence of BXO and had re-do urethroplasty using a combination of bladder and buccal mucosa. The last two patients in this series had re-do urethroplasty using bladder mucosa only and bladder-buccal mucosa technique, respectively, as first choice for BXO complicating their hypospadias repair.

  20. Penile carcinoma arising in balanitis xerotica obliterans.

    Science.gov (United States)

    Goolamali, S I; Pakianathan, M

    2006-02-01

    Squamous cell carcinoma of the penis is an uncommon cancer, though in one study it accounted for 90% of all penile cancers. Its association with balanitis xerotica obliterans (BXO) is a rare though recognized occurrence. We describe a case of a 46-year-old Caucasian male who first presented to our open-access clinic with a mild phimosis. An elective circumcision was performed and histological examination of the circumcision specimen showed BXO. He was lost to follow-up but re-presented three years later with a persistent tender penile ulcer which on biopsy showed no obvious sinister pathology. He returned a further two years later with a short history of bleeding from the ulcer, and another biopsy now confirmed penile squamous cell carcinoma. Our case emphasizes the importance of regular review of patients with BXO, in particular those with persistent symptoms.

  1. Testing for meningitis in children with bronchiolitis.

    Science.gov (United States)

    Stefanski, Michael; Williams, Ronald; McSherry, George; Geskey, Joseph

    2014-01-01

    Viral bronchiolitis accounts for almost 20% of all-cause hospitalizations of infants (ie, children younger than age 1 year). The annual incidence of fever in viral bronchiolitis has been documented at 23% to 31%. However the incidence of concurrent serious bacterial infections is low (1%-7%), with meningitis occurring in less than 1% to 2% of cases, but lumbar puncture is performed in up to 9% of viral bronchiolitis cases. To our knowledge, no study has examined clinical factors that influence a physician’s decision to perform a lumbar puncture in the setting of viral bronchiolitis. We present a retrospective, case-control study of hospitalized infants younger than one year diagnosed with viral bronchiolitis who underwent lumbar puncture as part of an evaluation for meningitis. The objective of the study was to determine clinical factors that influence a physician’s decision to perform a lumbar puncture in the setting of viral bronchiolitis. Although the presence of apnea, cyanosis, meningeal signs, positive urine culture results, and young age were factors found to be preliminarily associated with the performance of a lumbar puncture in the setting of bronchiolitis, young age was the only significant clinical factor found after multivariable regression; no other demographic, clinical, laboratory, or radiologic variables were found to be significant.

  2. Bronchiolitis: from empiricism to scientific evidence.

    Science.gov (United States)

    Carraro, S; Zanconato, S; Baraldi, E

    2009-04-01

    Bronchiolitis is the most common viral infection of the lower respiratory tract in infants in their first year of life, with an incidence peak between 3 and 9 months of age. The clinical profile of bronchiolitis results from the inflammatory obstruction of the small airways. The etiological agent involved is respiratory syncytial virus (RSV) in more than 50% of cases. The first international guidelines on the management of children with bronchiolitis have recently been published. The first was produced by a special subcommittee created by the American Academy of Pediatrics (AAP) with the support of a few important international associations that deal with respiratory diseases including the American Thoracic Society and the European Respiratory Society; the second was drawn up by the Scottish Intercollegiate Guidelines Network (SIGN). This review sets out to update the management of children with bronchiolitis by discussing the salient points relating to diagnosis, treatment and prevention on the basis of the recommendations in these documents.

  3. [Pediatrics. New treatment options for viral bronchiolitis].

    Science.gov (United States)

    Rochat, I; Hafen, G

    2013-01-16

    The combination of nebulized epinephrine and high dose dexamethasone, or nebulized hypertonic saline, are promising new therapeutic strategies for viral bronchiolitis in the young infant. However, further research is needed before a general recommendation can be given.

  4. Follicular Bronchiolitis: A Literature Review

    Science.gov (United States)

    Okafor, Ndubuisi C.; Ramirez, Jose F.; Smolley, Laurence

    2015-01-01

    Follicular bronchiolitis (FB) also known as hyperplasia of the bronchial associated lymphoid tissue (BALT), or bronchiolar nodular lymphoid hyperplasia, is an entity characterized by the development of lymphoid follicles with germinal centers in the walls of small airways. FB is thought to be caused by antigenic stimulation of BALT, followed by a polyclonal lymphoid hyperplasia. It is currently classified as one of the reactive pulmonary lymphoid disorders in a group known as the lymphoproliferative pulmonary diseases (LPDs). FB is a pathological diagnosis that can be seen in several clinical settings, including connective tissue diseases, immunodeficiency states, autoimmune diseases, infections, obstructive airway diseases, as well as several types of interstitial lung diseases (ILDs). Its characteristics need to be carefully identified and differentiated from other closely related diseases in the group of LPDs due to significant differences in treatment and prognosis. PMID:26500941

  5. Pulse oximetry in bronchiolitis: is it needed?

    Directory of Open Access Journals (Sweden)

    Hendaus MA

    2015-10-01

    Full Text Available Mohamed A Hendaus,1,2 Fatima A Jomha,3 Ahmed H Alhammadi,1,2 1Department of Pediatrics, General Pediatrics Division, Hamad Medical Corporation, 2Weill-Cornell Medical College, Doha, Qatar; 3School of Pharmacy, Lebanese International University, Khiara, Lebanon Abstract: Infants admitted to health-care centers with acute bronchiolitis are frequently monitored with a pulse oximeter, a noninvasive method commonly used for measuring oxygen saturation. The decision to hospitalize children with bronchiolitis has been largely influenced by pulse oximetry, despite its questionable diagnostic value in delineating the severity of the illness. Many health-care providers lack the appropriate clinical fundamentals and limitations of pulse oximetry. This deficiency in knowledge might have been linked to changes in the management of bronchiolitis. The aim of this paper is to provide the current evidence on the role of pulse oximetry in bronchiolitis. We discuss the history, fundamentals of operation, and limitations of the apparatus. A search of the Google Scholar, Embase, Medline, and PubMed databases was carried out for published articles covering the use of pulse oximetry in bronchiolitis. Keywords: bronchiolitis, children, monitor, oxygen

  6. Preliminary assessment based on Delphi method on the arteriosclerosis obliterans syndrome differentiation basis importance%基于德尔菲法对下肢动脉硬化闭塞症辨证依据重要性评估探讨

    Institute of Scientific and Technical Information of China (English)

    张凡帆; 庞鹤; 高颖

    2012-01-01

    Objective: Through the Delphi expert consultation method, assess the importance of syndrome differentiation basis in arteriosclerosis obliterans, contribute the foundation for the standardization research of syndrome. Methods: sent questionnaires to 30 national experts, through analyzing the result of descriptive statistics, factor analysis, Kendall weighting coefficients, investgated and assessed the importance of syndrome differentiation basis about the local symptoms, systemic symptoms, tongue manifestation and pulse condition in arteriosclerosis obliteration. Results: local symptoms got the highest score in expert concentration degree, coordination degree and weight coefficient, which should be as the main syndrome in syndrome differentiation, the contribution of tongue manifestation was second. Pulse and systemic symptoms got the lowest scores in expert concentration, coordination degree and the weight coefficient, so how to grasp and application those symptoms in actual clinical syndrome differentiation should still need further study. Conclusion: This study displayed that the experts authority degree, concentration degree were both pretty good, but the experts didn't get the uniform conclusion about the importance of locaf symptoms, systemic symptoms, tongue manifestation and pulse in syndrome differentiation, we should continue summarizing and research in future clinical work.%目的:通过德尔菲专家咨询法,探讨下肢动脉硬化闭塞症辨证依据的重要性,为证候规范化研究打下基础.方法:向全国30名专家发出调查问卷,通过描述统计、Kendall系数分析、权重系数计算,对局部症状、全身其他症状、舌象、脉象作为下肢动脉硬化闭塞症辨证依据的重要性进行分析研究.结果:局部症状作为专家集中程度最大、协调程度最大、权重系数最大的一组指标在辨证中应作为主证,舌象的贡献度次之.脉象和全身症状专家集中程度小,协调程度小,

  7. 老年动脉硬化闭塞症常见中医证候的计量诊断研究%The Quantitative Diagnosis of Common Chinese Medicine Syndromes in Senile Arteriosclerosis Obliterans

    Institute of Scientific and Technical Information of China (English)

    熊卫红; 赵晖; 陈家旭; 胡立胜; 张葆现; 章新根

    2012-01-01

    Objective To research the quantitative diagnosis of three common Chinese medicine syndromes in arteriosclerotic obliteration (ASO) through establishing the differential diagnosis table for syndrome index measurement. Methods The syn-dromes information of 179 ASO patients was collected by epidemiological cross-sectional surveys. The differential diagnosis ta-ble for ASO syndrome index measurement was established with sum of index and the diagnostic threshold was determined. The sum of index was used to do the quantitative differential diagnosis on the basis of the diagnostic threshold. The efficiency of the differential diagnosis table for ASO syndrome index measurement was evaluated through backward-looking and forward-looking test. Results The diagnostic threshold of syndrome of cold congealing in the vessels and networks, syndrome of blood stasis in the vessels and networks and syndrome of stasis heat in the vessels and networks was 426, 404 and 406 respectively. The sensitivity and specificity of three syndromes were all above 90%, the diagnosing coincident rate were all above 97% and the misdiagnosing rate and missed diagnosing rate were all below 6%. Conclusion The differential diagnosis table for ASO syn-drome index measurement, sum of index and the critical value of sum of index is effective and functional for quantitative diagno-sis of Chinese medicine syndromes.%目的 通过建立动脉硬化闭塞症(ASO)证候指数计量鉴别诊断表,对ASO 3个常见中医证候进行计量诊断研究.方法 采用流行病学横断面调查方法,收集179例ASO患者证候资料,用指数和法建立ASO证候指数计量鉴别诊断表,确定ASO证候的诊断临界值,在诊断临界值的基础上运用指数和法做定量鉴别诊断,并通过回代性检验和前瞻性检验对ASO证候指数计量鉴别诊断表的诊断效能进行评价.结果 脉络寒凝证的诊断临界值为426;脉络血瘀证的诊断临界值为404,脉络瘀

  8. The treatment of balanitis xerotica obliterans with testosterone propionate ointment.

    Science.gov (United States)

    Pasieczny, T A

    1977-01-01

    Balanitis xerotica obliterans (BXO) and kraurosis penis are thought to be synonymous. Clinically and histopathologically they probably represent the same disease process as lichen sclerosus et atrophicus (LSA) but also involve the urethral mucosa. The treatment of choice is considered to be 2 1/2% testosterone propionate ointment which gives better results than strong corticosteroid applications, yet without their side effects.

  9. Continuous wave carbon dioxide treatment of balanitis xerotica obliterans.

    Science.gov (United States)

    Rosemberg, S K; Jacobs, H

    1982-05-01

    Herein is presented the first case of balanitis xerotica obliterans treated successfully by carbon dioxide-continuous wave (CW-CO2) laser vaporization. This method appears to be a safe addition to other well-known treatment modalities, offering minimal postoperative discomfort, preservation of anatomic landmarks and function, and excellent cosmetic results.

  10. Risk factors for hospital admission with RSV bronchiolitis in England: a population-based birth cohort study.

    Directory of Open Access Journals (Sweden)

    Joanna Murray

    Full Text Available OBJECTIVE: To examine the timing and duration of RSV bronchiolitis hospital admission among term and preterm infants in England and to identify risk factors for bronchiolitis admission. DESIGN: A population-based birth cohort with follow-up to age 1 year, using the Hospital Episode Statistics database. SETTING: 71 hospitals across England. PARTICIPANTS: We identified 296618 individual birth records from 2007/08 and linked to subsequent hospital admission records during the first year of life. RESULTS: In our cohort there were 7189 hospital admissions with a diagnosis of bronchiolitis, 24.2 admissions per 1000 infants under 1 year (95%CI 23.7-24.8, of which 15% (1050/7189 were born preterm (47.3 bronchiolitis admissions per 1000 preterm infants (95% CI 44.4-50.2. The peak age group for bronchiolitis admissions was infants aged 1 month and the median was age 120 days (IQR = 61-209 days. The median length of stay was 1 day (IQR = 0-3. The relative risk (RR of a bronchiolitis admission was higher among infants with known risk factors for severe RSV infection, including those born preterm (RR = 1.9, 95% CI 1.8-2.0 compared with infants born at term. Other conditions also significantly increased risk of bronchiolitis admission, including Down's syndrome (RR = 2.5, 95% CI 1.7-3.7 and cerebral palsy (RR = 2.4, 95% CI 1.5-4.0. CONCLUSIONS: Most (85% of the infants who are admitted to hospital with bronchiolitis in England are born at term, with no known predisposing risk factors for severe RSV infection, although risk of admission is higher in known risk groups. The early age of bronchiolitis admissions has important implications for the potential impact and timing of future active and passive immunisations. More research is needed to explain why babies born with Down's syndrome and cerebral palsy are also at higher risk of hospital admission with RSV bronchiolitis.

  11. Local interleukin-10 production during respiratory syncytial virus bronchiolitis is associated with post-bronchiolitis wheeze

    Directory of Open Access Journals (Sweden)

    Hodemaekers Hennie M

    2011-09-01

    Full Text Available Abstract Background Respiratory syncytial virus (RSV is the most common cause of bronchiolitis in infants. Following RSV bronchiolitis, 50% of children develop post-bronchiolitis wheeze (PBW. Animal studies have suggested that interleukin (IL-10 plays a critical role in the pathogenesis of RSV bronchiolitis and subsequent airway hyperresponsiveness. Previously, we showed that ex vivo monocyte IL-10 production is a predictor of PBW. Additionally, heterozygosity of the single-nucleotide polymorphism (SNP rs1800872 in the IL10 promoter region was associated with protection against RSV bronchiolitis. Methods This study aimed to determine the in vivo role of IL-10 in RSV pathogenesis and recurrent wheeze in a new cohort of 235 infants hospitalized for RSV bronchiolitis. IL-10 levels in nasopharyngeal aspirates (NPAs were measured at the time of hospitalization and the IL10 SNP rs1800872 genotype was determined. Follow-up data were available for 185 children (79%. Results Local IL-10 levels during RSV infection turned out to be higher in infants that later developed physician diagnosed PBW as compared to infants without PBW in the first year after RSV infection (958 vs 692 pg/ml, p = 0.02. The IL10 promoter SNP rs1800872 was not associated with IL-10 concentration in NPAs. Conclusion The relationship between high local IL-10 levels during the initial RSV infection and physician diagnosed PBW provides further evidence of the importance of the IL-10 response during RSV bronchiolitis.

  12. The surgical treatment of Balanitis Xerotica Obliterans

    Directory of Open Access Journals (Sweden)

    A Hartley

    2011-01-01

    Full Text Available Background: Balanitis Xerotica Obliterans (BXO is a chronic, often progressive disease, which can lead to phimosis and urethral stenosis, affecting both urinary and sexual function. Steroid creams are usually the first-line treatment but have a limited role and surgical intervention is frequently necessary. Conservative surgical procedures (circumcision are often preferred in the first instance with the premise that recurrence of disease will require a more definitive reconstruction. This study looked at patients with pathologically proven BXO referred to the Plastic Surgery Unit at James Cook University Hospital between 2005 and 2009. The aim was to look at their management in the past and subsequent management by us. We also looked at whether early referral of progressive and recurrent BXO patients to reconstructive surgery could have prevented unnecessary delay in resolving symptoms at an earlier stage. Materials and Methods: Data was collected retrospectively and information regarding the exact anatomical location affected, the extent of the disease, the referring specialty and any previous surgical interventions was obtained. Alterations in urinary and sexual function and relief of symptoms following reconstructive surgery were analysed. Results: Of the 23 patients in the study, 43% had previous surgery and 60% of those had undergone two or more procedures. Twenty-one percent of patients had a history of BXO for over five years. Forty-seven percent of patients had alteration in their urinary function and 48% alteration in their sexual function due to the disease, prior to referral. Early results showed remarkable improvement in urinary and sexual function following reconstructive surgery in this group. Conclusions: Steroid creams have been shown to limit the progression of the disease but do not offer a cure in the majority of cases. Circumcision can be a curative procedure in early disease. Although there is conflicting evidence for

  13. Balanitis xerotica obliterans--a review.

    Science.gov (United States)

    Das, S; Tunuguntla, H S

    2000-12-01

    Balanitis xerotica obliterans (BXO) is a scarcely known disease, wrongly considered rare. With a high degree of suspicion and histologic examination, the condition will prove to be much more frequent than one generally believes. The etiology of the condition is unknown at present. Many cases of BXO occurring after circumcision may be cases of secondary phimosis due to BXO not being recognized at the time of surgery. Most of the cases of BXO are seen in the third to fifth decades of life, even though they may occur at the extremes of age. Biopsy of the lesions is not essential in all cases and is indicated to differentiate from penile cancer and in atypical cases. Early diagnosis and treatment of BXO are very important in preventing the urological complications of the diseases such as urethral stricture. Treatment of BXO depends on the anatomic location of the lesions and their extent and severity, together with the rapidity of progression of the disease process. The treatment may vary from topical corticosteroids, laser vaporization in early cases to meatoplasty and urethroplasty in extensive cases. Topical pharmacotherapy is useful in the early stages to reduce the initial symptoms and slow down the progression, but is not effective in all cases and is not the curative treatment of disease. Meatal stenosis, phimosis, scar adhesions, fissures, erosions of glans and prepuce and involvement of the urethra are indications for surgical treatment. Surgery seems to be the only treatment that can relieve the symptoms of advanced disease. Modified circumcision, with total removal of inner preputial layer, definitively relieves phimosis without any recurrence. Meatotomy will not prevent the recurrence of meatal stenosis. Excision of the scleroatrophic tract and grafting of the glans base, coronal sulcus, and the end of the shaft give a complete relief of pain during erection and intercourse in circumcised patients with balanopreputial adhesions and restore the elasticity of

  14. Squamous cell carcinoma of the penis arising from balanitis xerotica obliterans.

    Science.gov (United States)

    Giannakopoulos, X; Basioukas, K; Dimou, S; Agnantis, N

    1996-01-01

    Penile squamous cell carcinoma arising from balanitis xerotica obliterans is rarely reported. We describe a 58-year-old man in whom penile squamous cell carcinoma developed after 25 years of observation for balanitis xerotica obliterans. It is important to recognize the possibility of this uncommon complication of balanitis xerotica obliterans, because survival of patients with squamous cell carcinoma depends on early diagnosis and treatment.

  15. Genome-Wide Association Study of Polymorphisms Predisposing to Bronchiolitis

    Science.gov (United States)

    Pasanen, Anu; Karjalainen, Minna K.; Bont, Louis; Piippo-Savolainen, Eija; Ruotsalainen, Marja; Goksör, Emma; Kumawat, Kuldeep; Hodemaekers, Hennie; Nuolivirta, Kirsi; Jartti, Tuomas; Wennergren, Göran; Hallman, Mikko; Rämet, Mika; Korppi, Matti

    2017-01-01

    Bronchiolitis is a major cause of hospitalization among infants. Severe bronchiolitis is associated with later asthma, suggesting a common genetic predisposition. Genetic background of bronchiolitis is not well characterized. To identify polymorphisms associated with bronchiolitis, we conducted a genome-wide association study (GWAS) in which 5,300,000 single nucleotide polymorphisms (SNPs) were tested for association in a Finnish–Swedish population of 217 children hospitalized for bronchiolitis and 778 controls. The most promising SNPs (n = 77) were genotyped in a Dutch replication population of 416 cases and 432 controls. Finally, we used a set of 202 Finnish bronchiolitis cases to further investigate candidate SNPs. We did not detect genome-wide significant associations, but several suggestive association signals (p bronchiolitis. These preliminary findings require further validation in a larger sample size. PMID:28139761

  16. Respiratory syncytial virus (RSV) and its propensity for causing bronchiolitis.

    Science.gov (United States)

    Pickles, Raymond J; DeVincenzo, John P

    2015-01-01

    Infants and young children with acute onset of wheezing and reduced respiratory airflows are often diagnosed with obstruction and inflammation of the small bronchiolar airways, ie bronchiolitis. The most common aetological agents causing bronchiolitis in young children are the respiratory viruses, and of the commonly encountered respiratory viruses, respiratory syncytial virus (RSV) has a propensity for causing bronchiolitis. Indeed, RSV bronchiolitis remains the major reason why previously healthy infants are admitted to hospital. Why RSV infection is such a predominant cause of bronchiolitis is the subject of this review. By reviewing the available histopathology of RSV bronchiolitis, both in humans and relevant animal models, we identify hallmark features of RSV infection of the distal airways and focus attention on the consequences of columnar cell cytopathology occurring in the bronchioles, which directly impacts the development of bronchiolar obstruction, inflammation and disease.

  17. [Ozone therapy in the advanced stages of arteriosclerosis obliterans].

    Science.gov (United States)

    Romero Valdés, A; Menéndez Cepero, S; Gómez Moraleda, M; Ley Pozo, J

    1993-01-01

    Fifteen patients with atherosclerosis obliterans at the lower limbs, no candidates to revascularizing surgery were submitted to ozone therapy. An improvement statistically significant was noticed in the treatment groups since amputation ratio decreased (26.7%) and the need of pain's surgery procedures (13.3%) in comparison with the control group (46.7 and 26.7% respectively). Ozone therapy is considered as a good way in the management of the atherosclerosis with obliteration in late period.

  18. Bronchiolitis: what the clinician should know

    Directory of Open Access Journals (Sweden)

    Roberto Antonucci

    2015-10-01

    Full Text Available Bronchiolitis is an acute infection of the lower respiratory tract affecting infants and young children, with Respiratory Syncytial Virus (RSV being the most common pathogen. Bronchiolitis is generally a mild disease, but may present with severe signs and symptoms requiring hospitalization. Risk factors including prematurity, bronchopulmonary dysplasia, immunodeficiency and congenital heart defects may predispose patients to develop a severe disease. The diagnosis should be based on clinical evaluation, without supportive radiographic and laboratory studies. Etiological diagnosis may be helpful to decrease the hospital transmission of virus and to avoid inappropriate use of antibiotics.The mainstay of therapy for bronchiolitis is supportive care, which should be directed at maintaining adequate oxygenation, ensuring a proper respiratory toilet, and meeting the requirements of fluids and nutrition. The use of nebulized hypertonic saline should be limited to hospitalized patients. Severe respiratory failure may require mechanical ventilatory support. Neither corticosteroids nor antibiotics offer consistent benefit in the treatment of bronchiolitis, and thus should not be used. A trial of a bronchodilator may be appropriate, but should be continued exclusively if a prompt favorable response occurs. Effective interventions to prevent the spread of RSV infection include hand washing or disinfection by caregivers and contact isolation. The use of palivizumab, a monoclonal antibody directed against RSV, is a safe prophylactic option, but should be restricted to children at high-risk for severe RSV disease, during the epidemic period. Current evidence suggests that early RSV bronchiolitis predisposes children to recurrent wheezing and asthma in the first decade of life.Proceedings of the 11th International Workshop on Neonatology and Satellite Meetings · Cagliari (Italy · October 26th-31st, 2015 · From the womb to the adultGuest Editors: Vassilios

  19. Envolvimento pulmonar na síndrome de Sweet paraneoplásica Pulmonary involvement in paraneoplastic Sweet's syndrome

    Directory of Open Access Journals (Sweden)

    Marcelo Pavesi

    2006-12-01

    Full Text Available Síndrome de Sweet (dermatose neutrofílica febril aguda é caracterizada por lesões cutâneas inflamatórias acompanhadas por febre, leucocitose e mal-estar, devendo ser reconhecida por hematologistas, já que freqüentemente é paraneoplásica. O envolvimento sistêmico pode estar presente e o comprometimento pulmonar, apesar de raro, tem sido reportado na forma de infiltração pulmonar bilateral, bronquiolite obliterante e derrame pleural. Há infiltração neutrofílica densa na histologia. Apresentamos o caso de uma paciente com leucemia mielóide crônica que desenvolveu a síndrome de Sweet com infiltrações pulmonares não infecciosas, as quais não foram responsivas à antibioticoterapia, porém mostraram melhora clínica com a corticoterapia.Sweet's syndrome (acute febrile neutrophilic dermatosis is characterized by inflammatory skin lesions accompanied by fever, leukocytosis and malaise, it should be recognized by hematologists, because it can be a paraneoplastic manifestation. Systemic involvement may be present and lung lesions, despite of the rarity, have been reported in the form of bilateral pulmonary infiltrations, bronchiolitis obliterans and pleural effusion. Histopathology shows dense neutrophilic infiltrates. We present a patient with chronic myeloid leukemia who developed Sweet's syndrome with bilateral pulmonary infiltrations, which were non-responsive to antibiotics but showed clinical improvement on steroid therapy.

  20. High incidence of balanitis xerotica obliterans in boys with phimosis: prospective 10-year study.

    Science.gov (United States)

    Kiss, András; Király, László; Kutasy, Balázs; Merksz, Miklós

    2005-01-01

    This prospective study was designed to address the incidence and clinical and histologic characteristics of balanitis xerotica obliterans in a large random pediatric population with phimosis. We investigated 1178 boys who presented consecutively with phimosis between 1991 and 2001. All patients who underwent complete circumcision and surgical specimens were typed histologically as early, intermediate, or late forms of this disorder or as nonspecific chronic inflammation. Patients with balanitis xerotica obliterans were controlled at 1, 6, and 12 months postoperatively, then yearly. Balanitis xerotica obliterans was found in 471 of the 1178 patients (40%), with the highest incidence in boys aged 9 to 11 years (76%). Secondary phimosis occurred in 93% of boys with balanitis xerotica obliterans and in 32% of those without the disorder. In six instances of balanitis xerotica obliterans, meatotomy and in one meatoplasty was performed, as well as circumcision. On histologic evaluation, we found 19% had early, 60% intermediate, and 21% late form of balanitis xerotica obliterans. Glanular lesions disappeared completely within 6 months in 229 out of 231 patients. Our data strongly suggest that the true incidence of childhood balanitis xerotica obliterans is higher than previously assumed. Its incidence peaks in the 9 to 11 years age group, in whom secondary phimosis was almost exclusively caused by balanitis xerotica obliterans.

  1. Follicular bronchiolitis: a rare disease in children

    Science.gov (United States)

    Kanık, Esra Toprak; Yılmaz, Özge; Türkeli, Ahmet; Şahin, Şebnem; Yüksel, Hasan

    2014-01-01

    Follicular bronchiolitis (FB) is a benign progressive lung disease. It is characterized with lymphoplasmocellular infiltration and hyperplastic follicles in the peribronchial areas in the small airways. Follicular bronchiolitis should be considered in cases where chronic cough, recurrent upper respiratory tract infections and progressive dyspnea are observed in children. The diagnosis should be supported by lung biopsy. A 8-year old female patient presented to our hospital with complaints including continuing cough and wheezing. Bilateral extensive rales and rhonchi in the lungs were heard on auscultation and lung graphy revealed reticuloglandular appearance. Bilateral extensive septal thickennings, reticulonodular appearance, patchy bronchiectasis, bronchiolectasis and peribronchial thickennings were found on high-resolution thoracal computarized tomography. A diagnosis of follicular bronchiolitis was made as a result of lung biopsy. Improvement was observed in the complaints and findings of our patient after methylprednisolone treatment. This patient was presented to emphasize rare interstitial lung diseases should also be considered in children who present with a clinical picture of chronic bronchial obstruction and do not respond to standard treatment. PMID:26078687

  2. Long-term antibiotic therapy for balanitis xerotica obliterans.

    Science.gov (United States)

    Shelley, W B; Shelley, E D; Grunenwald, M A; Anders, T J; Ramnath, A

    1999-01-01

    In an open uncontrolled study of 3 patients with balanitis xerotica obliterans we have observed significant improvement after long-term systemic antibiotic therapy. Two of the patients noticed softening of the skin as well as disappearance of pruritus, tenderness, and inflammatory changes within 3 weeks of receiving oral and intramuscular penicillin. The third patient experienced the same degree of improvement after a regimen of dirithromycin, 500 mg/day. Stopping the antiobiotic for 1 month resulted in relapse, with improvement again on resumption.

  3. Interleukin-15 is associated with disease severity in viral bronchiolitis.

    Science.gov (United States)

    Leahy, T Ronan; McManus, Ross; Doherty, Derek G; Grealy, Robert; Coulter, Tanya; Smyth, Paul; Blackshields, Gordon; Sheils, Orla; Carr, Michael J; Purandare, Nikhil; Geary, Michael; Hodemaekers, Hennie M; Janssen, Riny; Bont, Louis; Slattery, Dubhfeasa; Ryan, Thomas

    2016-01-01

    Disease severity in viral bronchiolitis in infancy is difficult to predict and has been linked to host innate immunity. The study aimed to investigate the innate cytokine interleukin-15 (IL-15) as a marker of disease severity.A prospective single-centre observational study was conducted in a university-affiliated paediatric teaching hospital, comparing children (0-18 months) hospitalised for viral bronchiolitis, those admitted to the paediatric intensive care unit with severe disease and healthy age-matched controls. IL-15-related parameters were compared between groups. PCR and microRNA (miRNA) sequencing was undertaken on natural killer (NK) cells collected from study participants.Samples from 88 children with viral bronchiolitis and 43 controls enrolled between 2009 and 2012 were analysed. Peripheral blood mononuclear cell (PBMC) IL-15 mRNA expression was significantly higher in those with moderate severity bronchiolitis compared with controls and those with severe disease. Serum IL-15 levels correlated with disease severity. The relative frequency of NK cells in peripheral blood was significantly reduced in participants with bronchiolitis. The NK cell miRNA transcriptome in bronchiolitis was distinct. Targets of de-regulated miRNA were differentially expressed in bronchiolitis, including JAK3, STAT5A and NFKB1 on the IL-15 signalling pathway.IL-15 is associated with disease severity in children hospitalised with viral bronchiolitis.

  4. RSV bronchiolitis in healthy term infants: prediction and pathogenesis

    NARCIS (Netherlands)

    Houben, M.L.

    2011-01-01

    The global estimated annual numbers of non-severe and severe (i.e. hospitalized) respiratory syncytial virus (RSV) infections in children younger than five are 34 and 3.4 million. Most children with RSV bronchiolitis are treated outside the hospital and most children with RSV bronchiolitis are healt

  5. Association of nasopharyngeal microbiota profiles with bronchiolitis severity in infants hospitalised for bronchiolitis.

    Science.gov (United States)

    Hasegawa, Kohei; Mansbach, Jonathan M; Ajami, Nadim J; Espinola, Janice A; Henke, David M; Petrosino, Joseph F; Piedra, Pedro A; Shaw, Chad A; Sullivan, Ashley F; Camargo, Carlos A

    2016-11-01

    Little is known about the relationship between the specific airway microbiota composition and severity of bronchiolitis. We aimed to identify nasopharyngeal microbiota profiles and link these profiles to acute severity in infants hospitalised for bronchiolitis.We conducted a multicentre prospective cohort study of 1005 infants (age microbiota profiles and their association with bronchiolitis severity. The primary outcome was intensive care use, i.e. admission to an intensive care unit or use of mechanical ventilation.We identified four nasopharyngeal microbiota profiles: three profiles were dominated by one of Haemophilus, Moraxella or Streptococcus, while the fourth profile had the highest bacterial richness. The rate of intensive care use was highest in infants with a Haemophilus-dominant profile and lowest in those with a Moraxella-dominant profile (20.2% versus 12.3%; unadjusted OR 1.81, 95% CI 1.07-3.11, p=0.03). After adjusting for 11 patient-level confounders, the rate remained significantly higher in infants with Haemophilus-dominant profiles (OR 1.98, 95% CI 1.08-3.62, p=0.03). These findings were externally validated in a separate cohort of 307 children hospitalised for bronchiolitis.

  6. [Para-neoplastic autoimmune multi-organ syndrome associated with follicular lymphoma: a case report and literature review].

    Science.gov (United States)

    Chen, D; Lin, C Y; Han, X; Chen, B; Lu, Z H; Chang, X Y; Duan, M H

    2016-12-14

    Objective: To broaden our knowledge of para-neoplastic autoimmune multi-organ syndrome (PAMS). Methods: A patient with PAMS associated with follicular lymphoma and bronchiolitis obliterans treated in our hospital was retrospectively analyzed and the clinical features of PAMS were reviewed. Results: A 49-year-old female patient suffered from painful ulcers in the oral cavity and vagina, dry cough and dyspnea. Imaging examinations suggested multiple lymph node enlargements. Inguinal lymph node biopsy revealed follicular lymphoma. Although the oral and vaginal ulcers went into remission with glucocorticoid and thalidomide therapy and follicular lymphoma gained partial remission with six cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisolone) chemotherapy, respiratory failure still progressed. Conclusion: PAMS should be considered in patients with unexplained oral mucosa ulcers and dyspnea, which didn't match with the chest image manifestations. Extensive work-up should be performed to find out the potential tumor after diagnosis of PAMS. Early diagnosis and complete removal of tumor were essential to PAMS treatment.

  7. Recidiva en bronquiolitis obliterante con neumonía en organización: BOOP RELAPSE IN BRONCHOLITIS OBLITERANS ORGANIZING PNEUMONIA: BOOP

    Directory of Open Access Journals (Sweden)

    JUAN I. VARGAS RT.

    2003-01-01

    Full Text Available Las recaídas son frecuentes en la bronquiolitis obliterante con neumonía en organización (BOOP, sin embargo, existe poca información con respecto a su causa. Se presenta el caso de una mujer de 63 años con un cuadro clínico radiológico compatible con BOOP. No se identificó una causa subyacente por lo que se planteó el diagnóstico de neumonía en organización criptogénica o COP. Se realizaron biopsias transbronquiales que demostraron una neumonía crónica organizada y bronquiolitis proliferativa. Se trató con prednisona con buena respuesta. Al octavo mes de tratamiento, mientras se disminuía la dosis de esteroides, comenzó con disnea y tos y aparición de nuevas opacidades pulmonares radiológicos, las que regresaron rápidamente al aumentar la dosis de esteroides. Discutimos las causas posibles de la recidiva de esta patología y su relación con la disminución de la dosis de esteroidesAlthough relapses are frequent in bronchiolitis obliterans organizing pneumonia (BOOP, there is scant information regarding the causes underlying its occurrence. We report a 63 year old woman with clinical and radiological features compatible with BOOP. No underlying cause was identified so she was thought to have cryptogenic BOOP or cryptogenic organizing pneumonia (COP. A transbronchial lung biopsy demonstrated chronic organizing pneumonia and features of proliferative bronchiolitis. She was successfully treated with prednisone. On the eighth month of steroid therapy, while tapering the dose, she begun with cough and dyspnea and developed new lung infiltrates on the chest x-ray film. The infiltrates cleared rapidly after increasing the dose of steroids. We discuss the possible causes of relapse in BOOP and its relation to steroid therapy

  8. Balanitis xerotica obliterans with urethral stricture after hypospadias repair.

    Science.gov (United States)

    Uemura, S; Hutson, J M; Woodward, A A; Kelly, J H; Chow, C W

    2000-01-01

    Three cases of urethral stricture due to balanitis xerotica obliterans (BXO) after hypospadias repair are reported. The first patient showed white, dense scarring on the prepuce before the hypospadias repair and developed a stricture of the urethra after the operation. The second and the third were uneventful for 6 and 2 years, respectively, after the hypospadias repair, and then developed urethral strictures. Pathologic diagnosis of the stenotic lesion is essential. Complete excision of the affected urethra with topical steroid ointment or sublesional triamcinolone injection is recommended for this condition. Although the complication of BXO after hypospadias repair is rare (3 out of 796 cases with hypospadias in our series), surgeons need to be aware of this condition as a cause for late onset of urethral problems.

  9. Management of acute viral bronchiolitis in children: Evidence beyond guidelines.

    Science.gov (United States)

    Iqbal, Shaikh Mohammed

    2012-01-01

    Acute viral bronchiolitis is one of the leading causes of worldwide admission of children under 2 years of age during winter months. There is a lack of consensus regarding the clinical definition of acute viral bronchiolitis in children and hence the management varies across the globe. The purpose of this article is to review the epidemiology, etiology, risk factors, pathophysiology, clinical presentation, assessment and management of children with respiratory syncytial virus (RSV) bronchiolitis. The available evidence in the worldwide literature suggests that supportive and symptomatic management is still the mainstay of management in this condition. The key to reducing the morbidity and mortality in children with RSV bronchiolitis is through prevention of infection through immunoprophylaxis especially in high-risk children.

  10. Mechanisms underlying epithelium-dependent relaxation in rat bronchioles

    DEFF Research Database (Denmark)

    Kroigaard, Christel; Dalsgaard, Thomas; Simonsen, Ulf

    2010-01-01

    This study investigated the mechanisms underlying epithelium-derived hyperpolarizing factor (EpDHF)-type relaxation in rat bronchioles. Immunohistochemistry was performed, and rat bronchioles and pulmonary arteries were mounted in microvascular myographs for functional studies. An opener of small...... (SK(Ca)) and intermediate (IK(Ca))-conductance calcium-activated potassium channels, NS309 (6,7-dichloro-1H-indole-2,3-dione 3-oxime) was used to induce EpDHF-type relaxation. IK(Ca) and SK(Ca)3 positive immunoreactions were observed mainly in the epithelium and endothelium of bronchioles and arteries......, respectively. In 5-hydroxytryptamine (1 microM)-contracted bronchioles (828 +/- 20 microm, n = 84) and U46619 (0.03 microM)-contracted arteries (720 +/- 24 microm, n = 68), NS309 (0.001-10 microM) induced concentration-dependent relaxations that were reduced by epithelium/endothelium removal and by blocking IK...

  11. Advances in the treatment and prevention of severe viral bronchiolitis.

    Science.gov (United States)

    Domachowske, Joseph B; Rosenberg, Helene F

    2005-01-01

    Viral bronchiolitis continues to be a major public health problem. Prevention of severe RSV-associated bronchiolitis has been achieved in high-risk infants by passive administration of the humanized monoclonal anti-RSV-F antibody, palivizumab. Development of more potent anti-RSV neutralizing antibodies is underway, and vaccine development continues to progress. Supportive therapy is the mainstay for the treatment of established infection while new antiviral and anti-inflammatory strategies are being explored in preclinical trials.

  12. CPAP and High-Flow Nasal Cannula Oxygen in Bronchiolitis.

    Science.gov (United States)

    Sinha, Ian P; McBride, Antonia K S; Smith, Rachel; Fernandes, Ricardo M

    2015-09-01

    Severe respiratory failure develops in some infants with bronchiolitis because of a complex pathophysiologic process involving increased airways resistance, alveolar atelectasis, muscle fatigue, and hypoxemia due to mismatch between ventilation and perfusion. Nasal CPAP and high-flow nasal cannula (HFNC) oxygen may improve the work of breathing and oxygenation. Although the mechanisms behind these noninvasive modalities of respiratory support are not well understood, they may help infants by way of distending pressure and delivery of high concentrations of warmed and humidified oxygen. Observational studies of varying quality have suggested that CPAP and HFNC may confer direct physiologic benefits to infants with bronchiolitis and that their use has reduced the need for intubation. No trials to our knowledge, however, have compared CPAP with HFNC in bronchiolitis. Two randomized trials compared CPAP with oxygen delivered by low-flow nasal cannula or face mask and found some improvements in blood gas results and some physiologic parameters, but these trials were unable to demonstrate a reduction in the need for intubation. Two trials evaluated HFNC in bronchiolitis (one comparing it with headbox oxygen, the other with nebulized hypertonic saline), with the results not seeming to suggest important clinical or physiologic benefits. In this article, we review the pathophysiology of respiratory failure in bronchiolitis, discuss these trials in detail, and consider how future research studies may be designed to best evaluate CPAP and HFNC in bronchiolitis.

  13. Causal direction between respiratory syncytial virus bronchiolitis and asthma studied in monozygotic twins

    DEFF Research Database (Denmark)

    Poorisrisak, Porntiva; Halkjaer, Liselotte Brydensholt; Thomsen, Simon Francis;

    2010-01-01

    Respiratory syncytial virus (RSV) bronchiolitis has been associated with later development of asthma, wheezing, abnormal pulmonary function, and sensitization. Our aim was to determine the differential effect within monozygotic (MZ) twin pairs discordant for severe RSV bronchiolitis in infancy...

  14. Serum levels of 25(OH vitamin D and immunoglobulin E in infants with bronchiolitis

    Directory of Open Access Journals (Sweden)

    Bahaa El Din Mohamed Hassanein

    2016-06-01

    Conclusions: Serum 25(OH vitamin D was found in decreased quantities in infants with bronchiolitis and it was negatively correlated with serum IgE, suggesting that vitamin D may play a role in the pathogenesis of bronchiolitis.

  15. Diagnosis of occlusive lesions of upper extremity arteries in patients with thromboangiitis obliterans.

    Science.gov (United States)

    Pokrovskiĭ, A V; Kuntsevich, G I; Dan, V N; Chupin, A V; Kalinin, A A; Alekperov, R T; Makhmudova, L S

    2003-01-01

    The study accrued 84 patients suffering from thromboangiitis obliterans (TO) examined and treated at the A.V. Vishnevsky Institute of Surgery, RAMS, over the period 1988 to 2002. Based on the complaints on the part of the upper extremities the patients were distributed into four groups. Sixteen (19.1%) TO patients did not make any complaints on the part of the arms (degree I ischemia). Thirty-eight (45.2%) patients complained of numbness and paresthesia, chiefly of the tips of the fingers on both hands (degree II ischemia). Six (7.1%) persons complained of pains in the hands at physical exercise (decree III ischemia). Ulcers and necroses of the fingers were present in 24 (28.6%) patients (degree IV ischemia). The diagnostic procedures for arterial lesion of the upper extremities included laboratory investigations, duplex scanning of the great arteries, of the arteries of the hands, fingers and nail matrix, wide-field capillaroscopy, oxygen tension measurements, and angiography as well. Comparison of the clinical manifestations of arterial lesion of the upper extremities in TO patients to the data supplied by different research methods has revealed a direct correlation between the degree of ischemia and the pathomorphological as well as functional changes which increased as the ischemic syndrome was aggravated. As a result of the present work, there have been studied and systematized the criteria for the diagnosis of the degree of arterial lesion of the upper extremities in TO patients, based on the data, supplied by duplex scanning, capillaroscopy, measurements of transcutaneous oxygen tension and angiography. In addition, there has been studied the role of the humoral component of immunity in the delineation of inflammatory activity in patients with TO.

  16. Targeting novel antigens in the arterial wall in thromboangiitis obliterans.

    Directory of Open Access Journals (Sweden)

    Murat Akkus

    2010-06-01

    Full Text Available Thromboangiitis obliterans is an inflammatory disease possibly resulting from cigarette smoking as a primary etiologic factor, perhaps as a delayed type of hypersensitivity or toxic angiitis. As little is known about the pathogenesis of the disease, we aimed to determine novel antigens that might be responsible from the local inflammatory reactions and structural changes observed in this disease. An indirect immunoperoxidase technique is used to examine the tissue samples obtained from the dorsalis pedis artery of affected individuals with twenty monoclonal antibodies. Among these several antigens which are not previously reported in TAO like CD34, CD44 and CD90 were determined in the tissue samples examined. On the other hand, many other antigens like cytokine/chemokine receptors, several enzymes and leukocyte/lymphocyte antigens were lacking giving some clues about the local pathological reactions. We briefly discussed our findings for several critical antigens those first described in the present work, possibly having roles in the development of the disease. Expression of the CD90/CD11c receptor/ligand pair seems to play an important role in mononuclear cell recruitment to the damage site. Vascular invasion of not only tunica intima but also the tunica media in affected vessels is clearly demonstrated using endothelial cell specific antigens.

  17. Association of folic acid supplementation during pregnancy and infant bronchiolitis.

    Science.gov (United States)

    Veeranki, Sreenivas P; Gebretsadik, Tebeb; Dorris, Stacy L; Mitchel, Edward F; Hartert, Tina V; Cooper, William O; Tylavsky, Frances A; Dupont, William; Hartman, Terryl J; Carroll, Kecia N

    2014-04-15

    Viral bronchiolitis affects 20%-30% of infants; because there is no known effective treatment, it is important to identify risk factors that contribute to its pathogenesis. Although adequate folate intake during the periconceptional period prevents neural tube defects, animal data suggest that higher supplementation may be a risk factor for child respiratory diseases. Using a population-based retrospective cohort of 167,333 women and infants, born in 1995-2007 and enrolled in the Tennessee Medicaid program, we investigated the association between the filling of folic acid-containing prescriptions and infant bronchiolitis. We categorized women into the following 4 groups in relation to the first trimester: "none" (no prescription filled), "first trimester only," "after first trimester," and "both" (prescriptions filled both during and after the first trimester). Overall, 21% of infants had a bronchiolitis diagnosis, and 5% were hospitalized. Most women filled their first prescriptions after the fifth to sixth weeks of pregnancy, and most prescriptions contained 1,000 µg of folic acid. Compared with infants born to women in the "none" group, infants born to women in the "first trimester only" group had higher relative odds of bronchiolitis diagnosis (adjusted odds ratio = 1.17, 95% confidence interval: 1.11, 1.22) and greater severity (adjusted odds ratio = 1.16, 95% confidence interval: 1.11, 1.22). This study's findings contribute to an understanding of the implications of prenatal nutritional supplement recommendations for infant bronchiolitis.

  18. Mycoplasma Pneumoniae and Chlamydophila pneumoniae in hospitalized children with bronchiolitis.

    Science.gov (United States)

    Zirakishvili, D; Chkhaidze, I; Barnabishvili, N

    2015-03-01

    Bronchiolitis is an acute lower respiratory tract infection in early childhood caused mainly by different viruses. Etiology of bronchiolitis have been studied in different environments and populations. Respiratory syncytial virus (RSV), human Metapneumovirus (hMPV), human Bocavirus (hBoV), human Rhinoviruses (hRV) have consistently been shown to predominate. Few studies however have attempted to determine whether other pathogens, particularly Mycoplasma Pneumoniae (MP) and Chlamydophila pneumoniae (CP), are associated with bronchiolitis in children under 2 years of age. The aim of this study was to determine the prevalence and clinical features of MP and CP in children under the age of 2 years presenting to the Iashvili Central Children Hospital in Tbilisi with various severities and clinical manifestations of bronchiolitis. Acute and convalescent serum samples were tested by ELISA for IgM and IgG antibodies to RSV, CP and MP.37 children under two years of age were studied. In 19 patients out of 37 (51.35%) etiological diagnosis were established and in 18 patients (48.65%) no pathogens were found. 11 patients (29.72%) had either CP or MP and 8 patients (21.62%) had RSV. Children infected with CP and MP had less severe bronchiolitis than those infected with RSV. Co-infection was not associated with disease severity. There were no statistically significant differences between groups with respect to length of hospital stay. Our study underlines the importance of atypical bacterial pathogens in acute bronchiolitis in children under 2 years and highlights the complex epidemiology and clinical features of these pathogens in this age group.

  19. Case of a congenital urethral duplication being unmasked following circumcision for balanitis xerotica obliterans.

    Science.gov (United States)

    Boyd, Matthew; Woodward, Mark; Lambert, Anthony

    2010-07-01

    We present the case of an 11-year-old boy diagnosed with an Effmann Type II A1 urethral duplication after routine circumcision for balanitis xerotica obliterans (BXO). We discuss the pathophysiology, investigation and management both of BXO and urethral duplication.

  20. Extensive balanitis xerotica obliterans of urethrocutaneous fistula presenting as mass in scrotum.

    Science.gov (United States)

    Kumar, Santosh; Nagappa, Bhubnesh; Ganesamoniv, Raguram

    2010-08-01

    A rare case of extensive lichen sclerosis (balanitis xerotica obliterans) involving the anterior urethra, urethrocutaneous fistula, and scrotum is described in a middle-aged man who presented with a history of obstructive voiding symptoms. He was managed by excision of mass along with the fistulae and staged buccal mucosal urethroplasty.

  1. Neonatal bronchial hyperresponsiveness precedes acute severe viral bronchiolitis in infants

    DEFF Research Database (Denmark)

    Chawes, Bo L K; Poorisrisak, Porntiva; Johnston, Sebastian L;

    2012-01-01

    Respiratory syncytial virus and other respiratory tract viruses lead to common colds in most infants, whereas a minority develop acute severe bronchiolitis often requiring hospitalization. We hypothesized that such an excessive response to respiratory tract viral infection is caused by host factors...

  2. Chest physical therapy in acute viral bronchiolitis: an updated review.

    Science.gov (United States)

    Postiaux, Guy; Zwaenepoel, Bruno; Louis, Jacques

    2013-09-01

    We describe the various therapies for infant acute viral bronchiolitis and the contradictory results obtained with chest physical therapy. The treatment target is bronchial obstruction, which is a multifactorial phenomenon that includes edema, bronchoconstriction, and increased mucus production, with a clinical grading defined as severe, moderate, or mild. Chest physical therapy is revisited in its various modalities, according to preliminary scoring of the disease.

  3. Viral etiology in infants hospitalized for acute bronchiolitis.

    Science.gov (United States)

    Azkur, Dilek; Özaydın, Eda; Dibek-Mısırlıoğlu, Emine; Vezir, Emine; Tombuloğlu, Duygu; Köse, Gülşen; Kocabaş, Can N

    2014-01-01

    Acute bronchiolitis is predominantly a viral disease. Respiratory syncytial virus is the most common agent, but other newly identified viruses have also been considered as causes. The aim of the present study is to determine the respiratory viruses causing acute bronchiolitis in hospitalized infants. Infants younger than 2 years of age who were hospitalized for acute viral bronchiolitis in a children's hospital between November 2011 and May 2012 were evaluated for the presence of viruses as etiologic agents using a realtime polymerase chain reaction method.A total of 55 infants were included in this study. The mean age of the children was 6.98±5.53 months, and 63.6% were male. In the 55 children, 63 viruses were detected. A single viral pathogen was detected in 47 (85.5%) patients, and two viruses were co-detected in 8 (14.6%) patients. Respiratory syncytial virus was the most common virus identified, accounting for 25 (45.5%) cases, followed by rhinovirus (n=9, 16.4%), and human metapneumovirus (n = 8, 14.5%).Although respiratory syncytial virus remains the major viral pathogen in infants hospitalized for acute broncholitis, more than half of bronchiolitis cases are associated with other respiratory viruses.

  4. Mechanical ventilation drives inflammation in severe viral bronchiolitis.

    Directory of Open Access Journals (Sweden)

    Marije P Hennus

    Full Text Available INTRODUCTION: Respiratory insufficiency due to severe respiratory syncytial virus (RSV infection is the most frequent cause of paediatric intensive care unit admission in infants during the winter season. Previous studies have shown increased levels of inflammatory mediators in airways of mechanically ventilated children compared to spontaneous breathing children with viral bronchiolitis. In this prospective observational multi-center study we aimed to investigate whether this increase was related to disease severity or caused by mechanical ventilation. MATERIALS AND METHODS: Nasopharyngeal aspirates were collected <1 hour before intubation and 24 hours later in RSV bronchiolitis patients with respiratory failure (n = 18 and non-ventilated RSV bronchiolitis controls (n = 18. Concentrations of the following cytokines were measured: interleukin (IL-1α, IL-1β, IL-6, monocyte chemotactic protein (MCP-1 and macrophage inflammatory protein (MIP-1α. RESULTS: Baseline cytokine levels were comparable between ventilated and non-ventilated infants. After 24 hours of mechanical ventilation mean cytokine levels, except for MIP-1α, were elevated compared to non-ventilated infected controls: IL-1α (159 versus 4 pg/ml, p<0.01, IL-1β (1068 versus 99 pg/ml, p<0.01, IL-6 (2343 versus 958 pg/ml, p<0.05 and MCP-1 (174 versus 26 pg/ml, p<0.05. CONCLUSIONS: Using pre- and post-intubation observations, this study suggests that endotracheal intubation and subsequent mechanical ventilation cause a robust pulmonary inflammation in infants with RSV bronchiolitis.

  5. Acute viral bronchiolitis in South Africa: Diagnostic flow.

    Science.gov (United States)

    White, D A; Zar, H J; Madhi, S A; Jeena, P; Morrow, B; Masekela, R; Risenga, S; Green, R

    2016-04-01

    Bronchiolitis may be diagnosed on the basis of clinical signs and symptoms. In a young child, the diagnosis can be made on the clinical pattern of wheezing and hyperinflation. Clinical symptoms and signs typically start with an upper respiratory prodrome, including rhinorrhoea, low-grade fever, cough and poor feeding, followed 1 - 2 days later by tachypnoea, hyperinflation and wheeze as a consequence of airway inflammation and air trapping.The illness is generally self limiting, but may become more severe and include signs such as grunting, nasal flaring, subcostal chest wall retractions and hypoxaemia. The most reliable clinical feature of bronchiolitis is hyperinflation of the chest, evident by loss of cardiacdullness on percussion, an upper border of the liver pushed down to below the 6th intercostal space, and the presence of a Hoover sign(subcostal recession, which occurs when a flattened diaphragm pulls laterally against the lower chest wall).Measurement of peripheral arterial oxygen saturation is useful to indicate the need for supplemental oxygen. A saturation of <92% at sea level and 90% inland indicates that the child has to be admitted to hospital for supplemental oxygen. Chest radiographs are generally unhelpful and not required in children with a clear clinical diagnosis of bronchiolitis.Blood tests are not needed routinely. Complete blood count tests have not been shown to be useful in diagnosing bronchiolitis or guiding its therapy. Routine measurement of C-reactive protein does not aid in management and nasopharyngeal aspirates are not usually done.Viral testing adds little to routine management. Risk factors in patients with severe bronchiolitis that require hospitalisation and may even cause death, include prematurity, congenital heart disease and congenital lung malformations.

  6. Clinical analysis on 17 patients with bronchiolitis obliterans organizing pneumonia%隐原性机化性肺炎与继发性机化性肺炎

    Institute of Scientific and Technical Information of China (English)

    曹敏; 蔡后荣; 方大楼

    2007-01-01

    目的 了解机化性肺炎(organizing pneumonia,OP)的临床特点、类型、治疗及疗效,初步探讨隐原性机化性肺炎(COP)与继发性OP在临床表现、预后等方面的异同.方法 回顾性分析自2002年7月至2007年4月我院17例OP患者的临床资料.结果 15例为隐原性机化性肺炎,2例为继发于多发性肌炎的机化性肺炎.临床主要表现为咳嗽、进行性活动后呼吸困难,可有发热、盗汗等,肺部闻及爆裂音;影像学表现为双肺多发斑片状肺泡浸润影或线状、网格状影或结节状阴影,肺功能呈限制性通气功能减退,弥散功能降低.肾上腺皮质激素对隐原性机化性肺炎的疗效显著,而对继发于多发性肌炎的机化性肺炎的疗效欠佳.结论 机化性肺炎是一临床病理综合征,易误诊为肺部感染、肿瘤等.隐原性机化性肺炎对肾上腺皮质激素有良好的效果,而继发于多发性肌炎的机化性肺炎临床表现重且预后差.

  7. Coexistence of axial spondyloarthritis and thromboangiitis obliterans in a young woman

    Directory of Open Access Journals (Sweden)

    G. Lopalco

    2015-06-01

    Full Text Available A peculiar coexistence of axial spondyloarthritis and ischemia of the feet and the fourth finger of the left hand in a young woman, who was a heavy smoker, is discussed in this report. This picture was considered within the context of thromboangiitis obliterans. Positivity of anti-nuclear antibodies and mild elevation of inflammatory parameters were noted. Computed tomography angiograms of upper and lower limbs showed luminal narrowing and occlusion of the left humeral, left anterior/posterior tibial and right anterior tibial arteries. Daily iloprost perfusions were started, and smoking cessation was strongly recommended. Coldness and rest pain in the distal extremities improved within a few weeks. The possibility that spondyloarthritis might precede the clinical picture of thromboangiitis obliterans should be considered in heavy smokers.

  8. Histopathological and immunological studies in a cohort of balanitis xerotica obliterans.

    Science.gov (United States)

    Datta, C; Dutta, S K; Chaudhuri, A

    1993-06-01

    Balanitis xerotica obliterans consisting of 52 cases had been studied in the present series. This disease entity is an insidious sclerosing disease of unknown aetiology, affecting mainly the skin and mucous membrane of glans, prepuce and sometimes the fossa navicularis urethrae or even terminal urethra. Atrophic white patches on external genitalia and obstructive uropathy are two common presenting features. It has been classified as local form of lichen sclerosus et atrophicus. Poor local hygiene, circumcision and association of auto-immune diseases like vitiligo are responsible as suggested in this study. Routine tests detected associated cystitis in 8 cases, haematuria in 4 cases, non-reactive VDRL in all cases and impaired glucose tolerance in 5 cases. Immunoglobulin profile (39 cases) showed altered pattern, suggesting some chronic antigenic stimulation. Out of 33 cases where biopsy done, histologically proved typical balanitis xerotica obliterans was found in 19 cases. Malignant change was noted in one case only. Circumcision and dilatation offered temporary relief.

  9. Seasonal Timing of Infant Bronchiolitis, Apnea and Sudden Unexplained Infant Death.

    Directory of Open Access Journals (Sweden)

    Chantel D Sloan

    Full Text Available Rates of Sudden Unexplained Infant Death (SUID, bronchiolitis, and central apnea increase in winter in temperate climates. Though associations between these three conditions are suggested, more work is required to establish if there is a causal pathway linking bronchiolitis to SUID through inducing central apnea. Utilizing a large population-based cohort of infants studied over a 20-year period (n = 834,595, from birth years 1989-2009, we analyzed ecological associations between timing of SUID cases, bronchiolitis, and apnea healthcare visits. Data were analyzed between 2013 and 2015. We used a Cox Proportional Hazards model to analyze possible interactions between maternal smoking and maternal asthma with infant bronchiolitis on time to SUID. SUID and bronchiolitis both occurred more frequently in winter. An increase in bronchiolitis clinical visits occurred within a few days prior to apnea visits. We found a temporal relationship between infant bronchiolitis and apnea. In contrast, no peak in SUID cases was seen during peaks of bronchiolitis. Among those without any bronchiolitis visits, maternal smoking was associated with an increased risk of SUID: Hazard Ratio (HR of 2.38 (95% CI: 2.11, 2.67, p-value <0.001. Maternal asthma was associated with an increased risk of SUID among infants with at least one bronchiolitis visit: HR of 2.40 (95% CI: 1.04, 5.54, p-value = 0.04. Consistent trends between bronchiolitis, apnea, and SUID were not established due to small numbers of SUID cases. However, interaction analysis revealed potential differential associations of bronchiolitis and SUID by maternal smoking, maternal asthma status.

  10. Effectiveness of chest physiotherapy in infants hospitalized with acute bronchiolitis: a multicenter, randomized, controlled trial.

    OpenAIRE

    Vincent Gajdos; Sandrine Katsahian; Nicole Beydon; Véronique Abadie; Loïc de Pontual; Sophie Larrar; Ralph Epaud; Bertrand Chevallier; Sylvain Bailleux; Alix Mollet-Boudjemline; Jean Bouyer; Sylvie Chevret; Philippe Labrune

    2010-01-01

    Editors' Summary Background Bronchiolitis, which is usually caused by the respiratory syncytial virus (RSV), is the commonest infection of the lower respiratory tract (the lungs and the passages through which air enters the lungs) in infants. A third of all children have bronchiolitis during their first year of life. The illness begins with stuffiness, a runny nose, a mild cough, and mild fever. Then, as the smallest airways in the lung (the bronchioles) become inflamed (swell) and blocked wi...

  11. Granulomatous Bronchiolitis with Necrobiotic Pulmonary Nodules in Chrohn's Disease

    Directory of Open Access Journals (Sweden)

    Hugh J Freeman

    2004-01-01

    Full Text Available A 37-year-old man with extensive Crohn's disease of the stomach, small and large intestine for almost a decade developed respiratory symptoms and radiological findings suggestive of pneumonia that failed to resolve with antibiotic treatment. Computed tomography scanning of his lungs showed extensive changes with cavitated parenchymal nodules. Histological evaluation of an open lung biopsy showed granulomatous bronchiolitis and pulmonary necrobiosis. Treatment with steroids and immunosuppression resulted in complete resolution of his clinical symptoms of pneumonia and abnormal computed tomography imaging changes. Granulomatous bronchiolitis and necrobiotic nodules may be a manifestation of Crohn's disease in the absence of microbial agents, including mycobacteria or fungal agents. While a multiplicity of complex pulmonary changes may occur in Crohn's disease, their clinical recognition and precise pathological definition may be particularly important if treatment with a biological agent, such as infliximab, is being considered.

  12. Granulomatous bronchiolitis with necrobiotic pulmonary nodules in Crohn's disease.

    Science.gov (United States)

    Freeman, Hugh J; Davis, Jennifer E; Prest, Marcia E; Lawson, Edward J

    2004-11-01

    A 37-year-old man with extensive Crohn's disease of the stomach, small and large intestine for almost a decade developed respiratory symptoms and radiological findings suggestive of pneumonia that failed to resolve with antibiotic treatment. Computed tomography scanning of his lungs showed extensive changes with cavitated parenchymal nodules. Histological evaluation of an open lung biopsy showed granulomatous bronchiolitis and pulmonary necrobiosis. Treatment with steroids and immunosuppression resulted in complete resolution of his clinical symptoms of pneumonia and abnormal computed tomography imaging changes. Granulomatous bronchiolitis and necrobiotic nodules may be a manifestation of Crohn's disease in the absence of microbial agents, including mycobacteria or fungal agents. While a multiplicity of complex pulmonary changes may occur in Crohn's disease, their clinical recognition and precise pathological definition may be particularly important if treatment with a biological agent, such as infliximab, is being considered.

  13. Bronchodilators for treatment of mild bronchiolitis: a factorial randomised trial.

    Science.gov (United States)

    Wang, E E; Milner, R; Allen, U; Maj, H

    1992-01-01

    A randomised double blind trial was conducted to determine the efficacy of inhaled bronchodilators, salbutamol and ipratropium bromide, compared with placebo in the treatment of bronchiolitis. Patients, who were 2 months to 2 years of age and without underlying cardiac or pulmonary disease, received drug 1 (salbutamol or saline placebo) followed one hour later by drug 2 (ipratropium bromide or placebo). Both agents were administered every four hours. The patients were allocated to one of four groups according to a factorial design. The four groups were similar in demographic characteristics, initial oxygenation, and clinical score. The change in oxygen saturation of recipients of both agents was significantly better than that of recipients of salbutamol alone or ipratropium bromide alone. This change, however, was not statistically different from that of the control group. No difference was observed in the clinical score or hospital duration. Inhaled bronchodilators did not improve the condition of hospitalised mild bronchiolitis. PMID:1533504

  14. Extensive balanitis xerotica obliterans (BXO) involving the anterior urethra and scrotum.

    Science.gov (United States)

    Singh, Iqbal; Ansari, M S

    2006-01-01

    We describe an unusual case of balanitis xerotica obliterans (BXO) involving the entire anterior urethra and the scrotum that had presented as a palpable nodular scrotal mass with obstructive voiding symptoms in middle aged man. He was managed by a staged urethroplasty. We report the first such case of BXO involving the scrotum resulting in a nodular mass that has not been described and reported till date.

  15. Detection of human papillomavirus types in balanitis xerotica obliterans and other penile conditions.

    OpenAIRE

    1995-01-01

    OBJECTIVES--To determine the prevalence of human papillomavirus (HPV) types 6, 11, 16 and 18 in foreskin biopsies from patients with balanitis xerotica obliterans (BXO) and other penile conditions. MATERIALS AND METHODS--Foreskin biopsy specimens from 24 patients with penile lesions and 5 control patients were analysed by type-specific polymerase chain reaction (PCR). RESULTS--HPV6 or HPV16 were not detected in patients with BXO. HPV6 was detected in 2 controls. CONCLUSIONS--Genital papilloma...

  16. Expression of Transglutaminase in Foreskin of Children with Balanitis Xerotica Obliterans

    OpenAIRE

    2016-01-01

    Balanitis xerotica obliterans (BXO) is a chronic inflammatory skin disorder of unclear etiology. The etiology and the exact molecular mechanisms underlying the disease are still unknown. The human transglutaminase (TG) family consists of several proteins with catalytic activity essential for biological processes. In the present research we investigated the transcript levels of three TGs in patients operated on for congenital phimosis without or with histologically confirmed BXO; Thirty childr...

  17. Granulomatous Bronchiolitis with Necrobiotic Pulmonary Nodules in Chrohn's Disease

    OpenAIRE

    Hugh J Freeman; Jennifer E Davis; Marcia E Prest; Edward J Lawson

    2004-01-01

    A 37-year-old man with extensive Crohn's disease of the stomach, small and large intestine for almost a decade developed respiratory symptoms and radiological findings suggestive of pneumonia that failed to resolve with antibiotic treatment. Computed tomography scanning of his lungs showed extensive changes with cavitated parenchymal nodules. Histological evaluation of an open lung biopsy showed granulomatous bronchiolitis and pulmonary necrobiosis. Treatment with steroids and immunosuppressi...

  18. Herpes simplex virus bronchiolitis in a cannabis user

    Directory of Open Access Journals (Sweden)

    Daniel H. Libraty

    2014-01-01

    Full Text Available Herpes simplex virus (HSV lower respiratory tract infections in adults are uncommon. We present a case of HSV bronchiolitis and pneumonitis in an immunocompetent individual, likely linked to chronic habitual marijuana use and a herpetic orolabial ulcer. The case serves as a reminder to consider HSV as a potential unusual cause of lower respiratory tract infection/inflammation in individuals with chronic habitual marijuana use.

  19. Current treatment for acute viral bronchiolitis in infants.

    Science.gov (United States)

    Martinón-Torres, Federico

    2003-08-01

    This paper provides an update and critical review of available data on the treatment of acute viral bronchiolitis in previously healthy infants, with special focus on new or promising therapies. The main potential benefits of medical assistance in these patients reside in the careful monitoring of their clinical status, the maintenance of adequate hydration and oxygenation, the preservation of the airway opened and cleared of secretions and the option to perform parental education. There is no convincing evidence that any other form of therapy will reliably provide beneficial effects in infants with bronchiolitis and currently, any treatment beyond supportive care should be prescribed on a case-by-case basis with watchful appraisal of its effects. Therapies such as ribavirin, IFN, vitamin A, antibiotics, mist therapy or anticholinergics, have not demonstrated any measurable clinical effect. Several studies and meta-analyses with beta(2)-agonists and corticosteroids have failed to show any benefit of significant extent, however, physicians keep favouring their use. Presently, adrenaline has received rather consistent support from clinical trials but it is not yet widely prescribed. There are other therapeutic strategies, for instance, heliox, hypertonic saline, noninvasive ventilation, physical therapy techniques, thickened feeds or palivizumab that have shown promising potential benefits, but evidence supporting its use is still limited and further studies should be warranted. In the meantime, infants with acute viral bronchiolitis should be treated following evidence-based clinical practice guidelines, keeping the patient central in the process and being sensitive to social, cultural and familiar influences on their treatment strategy.

  20. High Concentrations of Amniotic Fluid Proinflammatory Cytokines in Healthy Neonates Are Associated With Low Risk of Respiratory Syncytial Virus Bronchiolitis

    NARCIS (Netherlands)

    Houben, Michiel L.; Rovers, Maroeska M.; Wilbrink, Berry; Belderbos, Mirjam E.; Bloemen-Carlier, Eltje M.; Visser, Gerard H. A.; Kimpen, Jan L. L.; Bont, Louis

    2012-01-01

    Background: The burden of respiratory syncytial virus (RSV) bronchiolitis in individual children and their families, the medical system and society is considerable. Mechanisms underlying RSV bronchiolitis in healthy term infants are largely unknown. Sterile intraamniotic inflammation and chorioamnio

  1. High concentrations of amniotic fluid proinflammatory cytokines in healthy neonates are associated with low risk of respiratory syncytial virus bronchiolitis.

    NARCIS (Netherlands)

    Houben, M.L.; Rovers, M.M.; Wilbrink, B.; Belderbos, M.E.; Bloemen-Carlier, E.M.; Visser, G.H.; Kimpen, J.L.L.; Bont, L.

    2012-01-01

    BACKGROUND: : The burden of respiratory syncytial virus (RSV) bronchiolitis in individual children and their families, the medical system and society is considerable. Mechanisms underlying RSV bronchiolitis in healthy term infants are largely unknown. Sterile intraamniotic inflammation and chorioamn

  2. Therapeutic approach to bronchiolitis: why pediatricians continue to overprescribe drugs?

    Directory of Open Access Journals (Sweden)

    de Seta Federica

    2010-10-01

    Full Text Available Abstract Background Bronchiolitis guidelines suggest that neither bronchodilators nor corticosteroids, antiviral and antibacterial agents should be routinely used. Although recommendations, many clinicians persistently prescribe drugs for bronchiolitis. Aim of the study To unravel main reasons of pediatricians in prescribing drugs to infants with bronchiolitis, and to possibly correlate therapeutic choices to the severity of clinical presentation. Also possible influence of socially deprived condition on therapeutic choices is analyzed. Methods Patients admitted to Pediatric Division of 2 main Hospitals of Naples because of bronchiolitis in winter season 2008-2009 were prospectively analyzed. An RDAI (Respiratory Distress Assessment Instrument score was assessed at different times from admission. Enrolment criteria were: age 1-12 months; 1st lower respiratory infection with cough and rhinitis with/without fever, wheezing, crackles, tachypnea, use of accessory muscles, and/or nasal flaring, low oxygen saturation, cyanosis. Social deprivation status was assessed by evaluating school graduation level of the origin area of the patients. A specific questionnaire was submitted to clinicians to unravel reasons of their therapeutic behavior. Results Eighty-four children were enrolled in the study. Mean age was 3.5 months. Forty-four per cent of patients presented with increased respiratory rate, 70.2% with chest retractions, and 7.1% with low SaO2. Mean starting RDAI score was 8. Lung consolidation was found in 3.5% on chest roentgenogram. Data analysis also unraveled that 64.2% matched clinical admission criteria. Social deprivation status analysis revealed that 72.6% of patients were from areas "at social risk". Evaluation of length of stay vs. social deprivation status evidenced no difference between "at social risk" and "not at social risk" patients. Following therapeutic interventions were prescribed: nasal suction (64.2%, oxygen administration (7

  3. T cell subset analysis in peripheral blood of children with RSV bronchiolitis

    NARCIS (Netherlands)

    De Weerd, W; Twilhaar, WN; Kimpen, JLL

    1998-01-01

    Respiratory syncytial virus (RSV) bronchiolitis is partially an immune-mediated disease in which RSV-specific T cells play a predominant role. The peripheral blood T cell response was studied in patients with RSV bronchiolitis in order to detect evidence for T cell redistribution during natural RSV

  4. Dynamics of Nasopharyngeal Pneumococcal Carriage During the Course of Viral Bronchiolitis

    NARCIS (Netherlands)

    Faber, Tina E.; Schuurs, Theo A.; Veeger, Nic J. G. M.; Hennus, Marije P.; Bont, Louis J.

    2016-01-01

    The effect of viral infection on nasopharyngeal carriage of Streptococcus pneumoniae during childhood is not well known. We studied dynamics of pneumococcal colonization by quantitative PCR during the natural course of viral bronchiolitis. At time of admission, 47(47%) of 100 patients with bronchiol

  5. CT findings of respiratory bronchiolitis caused by cigarette smoking

    Energy Technology Data Exchange (ETDEWEB)

    Katagiri, Siro; Osima, K.; Kim, S. [Chiba Tokusyukai Hospital, Funabashi (Japan)

    1998-07-01

    CT scans were performed in 11 cases of respiratory bronchiolitis caused by cigarette smoking. Characteristics of CT findings were as follows: Remarkable visualization of the branching in peripheral bronchi within secondary lobules, multiple ground-glass opacities of centrilobular or lobular size adjacent to the above mentioned bronchial branching, thickening of the bronchial wall without dilatation, and no or minimal centrilobular emphysema. These characteristic CT findings were observed in all of 11 cases, who are current smokers, and never observed in non-smokers, ex-smokers and patients with apparent centrilobular emphysema. (author)

  6. Chronic lung allograft dysfunction after lung transplantation: novel insights into immunological mechanisms

    NARCIS (Netherlands)

    Budding, K.

    2016-01-01

    Lung transplantation (LTx) is the final treatment option for patients suffering from end-stage lung diseases. Survival after LTx is hampered by the development of chronic lung allograft dysfunction which presents itself in an obstructive form as the bronchiolitis obliterans syndrome (BOS). BOS is ha

  7. Urethral stone presenting as a stop valve--a rare complication of balanitis xerotica obliterans.

    Science.gov (United States)

    Dogra, P N; Singh, I; Khaitan, A

    2001-01-01

    Balanitis xerotic obliterans (BXO) is the genital subcategory of lichen sclerosis et atrophicus. The association of BXO with urethral stone causing interruption of the urinary stream and voiding by manual displacement of the urethral stone has not been described before. We describe one such case of a young boy with BXO and urethral stone who voided by manually displacing the stone for over a year. The case is reported to emphasize the ingenuity of the patient in continuing to void for over a year despite the association of the impacted urethral stone with urethral stricture and BXO.

  8. The physiological effects of human immunoglobulin on severe bronchiolitis patients before and after treatment.

    Science.gov (United States)

    Shan, Yan-Hua; Zhang, Yong-Gang; Zhang, Jian-Hua; Wang, Dong; Li, Xiao-Xia; Zhang, Jie; Wang, Xi-Mei; Luo, Song-Yuan

    2015-01-01

    The goal of the present study is to explore the physiological effects of injected human immunoglobulin on patients with severe bronchiolitis before and after treatment. 86 young children with severe bronchiolitis were randomly divided into the observation group (43 cases) and the treatment group (43 cases). On the basis of conventional therapy, the children in the treatment group were given human immunoglobulin (400 mg/kg, 1-3 times) via intravenous injection. 60 healthy young children, as determined by a physical examination given at the Zhumadian Central Hospital, were enrolled as the control group. The T lymphocytes, cytokines, IgA, IgG, and IgM immunoglobulins in the peripheral blood of all 3 groups were measured. The clinical efficacy of the immunoglobulins to mitigate the effects of bronchiolitis and the amount of time for the reduction of symptoms to occur were observed. The serum Ca, Fe, and Zn levels of children with severe bronchiolitis were significantly lower than those of the healthy control group (p bronchiolitis than in the children in the healthy control group (p bronchiolitis children was significantly shorter for those in the treatment group than for those in the observation group. Human immunoglobulin via intravenous injection showed active therapeutical effects on trace elements, T lymphocytes, and cytokines in patients with severe bronchiolitis.

  9. Full-thickness skin grafts from eyelids to penis, plus split-thickness grafts in chronic balanitis xerotica obliterans.

    Science.gov (United States)

    Rudolph, R; Walther, P

    1997-02-01

    Balanitis xerotica obliterans is a progressive, sclerotic, constrictive scar-forming disease process of the penile prepuce that can involve the frenulum and urethral meatus. Full-thickness skin grafting from the upper eyelids supplemented with split-thickness skin grafting was successfully used in a patient to end a 57-year symptomatic course.

  10. Prevention and treatment of respiratory syncytial virus bronchiolitis and postbronchiolitic wheezing

    Directory of Open Access Journals (Sweden)

    Kimpen Jan LL

    2002-06-01

    Full Text Available Abstract Respiratory syncytial virus (RSV is the primary cause of hospitalization for acute respiratory tract illness in general and specifically for bronchiolitis in young children. The link between RSV bronchiolitis and reactive airway disease is not completely understood, even though RSV bronchiolitis is frequently followed by recurrent episodes of wheezing. Therapy with ribavirin does not appear to significantly reduce long-term respiratory outcome of RSV lower respiratory tract infection, and corticosteroid or bronchodilator therapy may possibly improve outcomes only on a short-term basis. No vaccine against RSV is yet available. It is not known whether prophylaxis with RSV intravenous immune globulin or palivizumab can reduce postbronchiolitic wheezing.

  11. Obliterative bronchiolitis in workers in a coffee-processing facility - Texas, 2008-2012.

    Science.gov (United States)

    2013-04-26

    Obliterative bronchiolitis, a rare, irreversible form of fixed obstructive lung disease, has been identified in workers exposed to flavoring chemicals while working in the microwave-popcorn and flavoring-manufacturing industries; the occupational risk to workers outside these industries is largely unknown. This report describes two cases of obliterative bronchiolitis identified in workers employed in a small coffee-processing facility. Both patients' illness was misdiagnosed before they received a diagnosis of work-related obliterative bronchiolitis, which had not been identified previously in the coffee-processing industry. These cases reinforce the need for exposure evaluation in all industries in which workers are exposed to flavoring chemicals. Additionally, a high index of suspicion is required when these potentially exposed workers have progressive shortness of breath. If obliterative bronchiolitis is suspected, immediate protection from further exposure is crucial to prevent further deterioration of lung function.

  12. Viral bronchiolitis in children: a common condition with few therapeutic options.

    Science.gov (United States)

    Nicolai, A; Ferrara, M; Schiavariello, C; Gentile, F; Grande, M E; Alessandroni, C; Midulla, F

    2013-10-01

    Even though bronchiolitis is a disease that has been recognized for many years, there are still few therapeutic strategies beyond supportive therapies. Bronchiolitis is the most frequent cause of hospital admission in children less than 1 year of age. The incidence is estimated to be about 150° million cases a year worldwide, and 2-3% of these cases require hospitalization. It is acknowledged that viruses cause bronchiolitis, but most of the studies focus on RSV. The RSV causes a more severe form of bronchiolitis in children with risk factors including prematurity, cardiovascular disease and immunodeficiency. Other viruses involved in causing bronchiolitis include RV, hMPV, hBoV and co-infections. The RV seems to be associated with a less severe acute disease, but there is a correlation between the early infection and subsequent wheezing bronchitis and asthma in later childhood and adulthood. The supportive therapies used are intravenous fluids and oxygen supplement administered by nasal cannula or CPAP in most complicated patients. Additional pharmacological therapies include epinephrine, 3% hypertonic saline and corticosteroids. The Epinephrine seems to have the greatest short-term benefits and reduces the need of hospital admission, whereas hypertonic saline and corticosteroids seem to reduce the length of hospital stay. As bronchiolitis is such a prevalent disease in children and RV seems to play an important role, perhaps more studies should center around the RV's contribution to the initial disease and following pathology.

  13. Lack of effect of zinc sulfate on wheezing after bronchiolitis in infants less than two years

    Directory of Open Access Journals (Sweden)

    R Abasi

    2014-10-01

    Full Text Available Backgrounds & aim: Wheezing after bronchiolitis is known as a risk factor for asthma. No cure or effective vaccine has been identified for such disease. The purpose of this study was to determine the effects of zinc sulfate on persistent wheezing after bronchiolitis in infants less than two years. Methods: The present randomized clinical trial study was conducted on 90 infants under two years of age suffering from the first attack with a clinical diagnosis of bronchiolitis wheezing hospitalized in Imam Sajjad Hospital, Yasuj. All infants were equally placed in test groups and control group. In addition to bronchiolitis usual treatment, test group received 20 mg of elemental zinc for seven days. Patient information including risk factors associated with wheezing and persistent wheezing were compared 48 hours and two weeks after treatment. Data were analyzed using chi-square and t tests. Results: In all 90 infants diagnosed with bronchiolitis, wheezing was observed. After 48 hours and two weeks wheezing was continued in 67 patients (74.4% and 54 patients (60% respectively Conclusion: The results showed Zinc sulfate had no effect on the improvement of wheezing after bronchiolitis.

  14. Bronquiolite associada à exposição a aroma artificial de manteiga em trabalhadores de uma fábrica de biscoitos no Brasil Bronchiolitis associated with exposure to artificial butter flavoring in workers at a cookie factory in Brazil

    Directory of Open Access Journals (Sweden)

    Zaida do Rego Cavalcanti

    2012-06-01

    Full Text Available OBJETIVO: Relatar quatro casos de bronquiolite decorrente de exposição a aroma artificial de manteiga em uma fábrica de biscoitos no Brasil. MÉTODOS: Descrevemos os achados clínicos, espirométricos e tomográficos nos quatro pacientes, assim como achados de biópsia pulmonar em um dos pacientes. RESULTADOS: Os quatro pacientes eram homens jovens, não fumantes, e desenvolveram obstrução persistente ao fluxo aéreo (relação VEF1/CVF reduzida e VEF1 de 25-44% do previsto após 1-3 anos de exposição a diacetil, sem a utilização de equipamentos de proteção individual, em uma fábrica de biscoitos. A TCAR mostrou achados indicativos de bronquiolite. Em um paciente, a biópsia pulmonar cirúrgica mostrou bronquiolite obliterante associada a células gigantes. CONCLUSÕES: A bronquiolite decorrente de exposição a flavorizantes artificiais deve ser considerada em trabalhadores com obstrução ao fluxo aéreo no Brasil.OBJECTIVE: To report the cases of four patients with bronchiolitis caused by exposure to artificial butter flavoring at a cookie factory in Brazil. METHODS: We described the clinical, tomographic, and spirometric findings in the four patients, as well as the lung biopsy findings in one of the patients. RESULTS: All four patients were young male nonsmokers and developed persistent airflow obstruction (reduced FEV1/FVC ratio and FEV1 at 25-44% of predicted after 1-3 years of exposure to diacetyl, without the use of personal protective equipment, at a cookie factory. The HRCT findings were indicative of bronchiolitis. In one patient, the surgical lung biopsy revealed bronchiolitis obliterans accompanied by giant cells. CONCLUSIONS: Bronchiolitis resulting from exposure to artificial flavoring agents should be included in the differential diagnosis of airflow obstruction in workers in Brazil.

  15. Treatment of urethral strictures in balanitis xerotica obliterans (BXO) using circular buccal mucosal meatoplasy: Experience of 15 cases

    OpenAIRE

    2014-01-01

    Objectives: Balanitis xerotica obliterans (BXO) related strictures involving the external urethral meatus. We reviewed our result with the use of circular mucosal graft in the reconstruction of strictures. Methods: Between March 1997 and January 2012, 15 patients underwent circular buccal mucosal urethroplasy for BXO related anterior urethral strictures. Urethral catheter was removed within 2 weeks. Follow-up included patient symptoms assessment, cosmetic outcome and uroflowmetry. Results: Me...

  16. A RARE CASE REPORT OF SQUAMOUS CELL CARCINOMA OF URETHRA ARISING FROM SUBSTITUTED PENILE SKIN FLAP WITH BALANITIS XEROTICA OBLITERANS

    OpenAIRE

    2016-01-01

    A 44-year-old male presented with ulcerative growth over dorsal penile shaft along with multiple urethrocutaneous fistula. A total penectomy, scrotal excision and perineal urethrostomy were done. Past history of treatment for penile urethral stricture due to Balanitis Xerotica Obliterans (BXO) by substitution urethroplasty using pedicled preputial penile skin flap five years back. On gross as well as histopathological examination, the tumour was found to be arising from the skin ...

  17. Clinical profile of bronchiolitis in infants younger than 90 days in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Syed Amir Ahmad

    2014-01-01

    Full Text Available Background: Bronchiolitis is a self-limiting disease of children caused by viral infections of the small airways with a wide spectrum of illness severity. Search of the literature reveals a need for refinement of criteria for testing for concomitant severe bacterial infections as well as appropriate therapeutic interventions for patients <90-day-old diagnosed with clinical bronchiolitis. We believe that a better understanding of the disease spectrum will help optimize health-care delivery to these patients. Aims: The aim of this study was to determine the clinical profile at presentation, disease course and outcome of bronchiolitis in <3-month-old infants who presented to our Pediatric Emergency Department (PED during one disease season. Settings: Retrospective chart review during one bronchiolitis season, from November 1, 2011 to April 20, 2012. Subjects: All <90-day-old infants presenting with clinical bronchiolitis presenting to Urban PED of a tertiary care university hospital during one bronchiolitis season. Materials and Methods: A retrospective chart review based on computer records of all emergency department visits of infants less than 90 days with a clinical diagnosis of bronchiolitis, covering the period between November 1, 2011 and April 30, 2012. Results: Out of the total of 1895 infants <90 days of age, 141 had a clinical diagnosis of bronchiolitis and 35 needed admission to hospital. Blood for culture was obtained from 47 infants, urine for culture was obtained from 46 infants and cerebrospinal fluid for culture was obtained from eight infants. One case of bacteremia was documented, but this was found to be a contaminant. No cases of meningitis occurred among these infants. However, one infant had a positive urine culture consistent with infection (Escherichia coli . Conclusion: Based on the results, it can be conclude that the risk of bacteremia or meningitis among infants <90 days of age with fever and bronchiolitis is low. The

  18. Inhaled corticosteroids stabilize constrictive bronchiolitis after hematopoietic stem cell transplantation.

    Science.gov (United States)

    Bashoura, L; Gupta, S; Jain, A; Couriel, D R; Komanduri, K V; Eapen, G A; Safdar, A; Broglio, K R; Adachi, R; Dickey, B F

    2008-01-01

    Post transplantation constrictive bronchiolitis (PTCB) is the most common pulmonary complication among long-term survivors of allogeneic hematopoietic stem cell transplantation (HSCT). It is a late manifestation of GVHD. Its treatment with high-dose systemic corticosteroids and other immunosuppressive regimens is associated with multiple side effects. Topical corticosteroids are used for the treatment of other manifestations of GVHD to minimize these side effects. We conducted a retrospective analysis of a series of adult patients to evaluate the efficacy of high-dose inhaled corticosteroids in the treatment of PTCB. Seventeen patients with new-onset airflow obstruction were diagnosed with PTCB. Their forced expiratory volume in 1 s (FEV1) declined from a median of 84% (range, 56-119) before HSCT to 53% (26-82) after HSCT. All patients received inhaled fluticasone propionate 500-940 microg two times daily. Symptoms of airway obstruction improved and FEV1 stabilized 3-6 months after treatment. We conclude that high-dose inhaled corticosteroids may be effective in the treatment of PTCB and propose a plausible mechanism of its action. A prospective evaluation of its efficacy is warranted.

  19. Increased Risk of Pneumonia and Bronchiolitis after Bacterial Colonization of the Airways as Neonates

    DEFF Research Database (Denmark)

    Vissing, Nadja Hawwa; Chawes, Bo Lk; Bisgaard, Hans

    2013-01-01

    Rationale: The frequency of pneumonia and bronchiolitis exhibits considerable variation in otherwise healthy children, and suspected risk factors explain only a minor proportion of the variation. We hypothesized that alterations in the airway microbiome in early life may be associated with suscep......Rationale: The frequency of pneumonia and bronchiolitis exhibits considerable variation in otherwise healthy children, and suspected risk factors explain only a minor proportion of the variation. We hypothesized that alterations in the airway microbiome in early life may be associated...... with susceptibility to pneumonia and bronchiolitis in young children. Objectives: To investigate the relation between neonatal airway colonization and pneumonia and bronchiolitis during the first three years of life. Methods: Participants comprised children of the COPSAC2000 cohort; a prospective birth cohort study...... of 411 children born to asthmatic mothers. Aspirates from the hypopharynx at age four weeks were cultured for S.pneumoniae, H.influenzae, M.catarrhalis, and S.aureus. Clinical information on pneumonia and bronchiolitis within the first three years of life was prospectively collected by the research...

  20. Bronchiolitis associated with Mycoplasma pneumoniae in infants in Suzhou China between 2010 and 2012.

    Science.gov (United States)

    Wang, Yuqing; Hao, Chuangli; Ji, Wei; Yan, Yongdong; Shao, Xuejun; Xu, Jun

    2015-01-19

    Viruses cause most cases of bronchiolitis in infants; consequently the importance of other agents such as Mycoplasma pneumoniae (MP) in the etiology of bronchiolitis may not be fully recognized. We investigated the prevalence and seasonal distribution of bronchiolitis caused by MP in 674 children admitted to the Children's Hospital affiliated with Soochow University from January 2010 to December 2012. The presence of MP was confirmed by real-time PCR. During the 3 years, we identified MP in 17.2% of the children with bronchiolitis. The annual MP detection rates were 16.6% in 2010, 17.8% in 2011, and 17.2% in 2012. MP was detected throughout the year, with a peak from July to September. The median age of MP-positive children was 10 months. Common clinical manifestations included cough, wheezing, and high fever. Moist and/or wheezing rales were frequent, and pulmonary interstitial infiltration was seen in 66.4% of chest X-rays. Patients with MP infection were older, were more likely to have pulmonary interstitial infiltration, and had shorter hospital stays than those with respiratory syncytial virus infection. Our study revealed MP as an important cause of bronchiolitis, with peaks of occurrence during the summer and early autumn. Pulmonary interstitial infiltrations were a common event.

  1. Intravenous fluids versus gastric-tube feeding in hospitalized infants with viral bronchiolitis: a randomized, prospective pilot study.

    Science.gov (United States)

    Kugelman, Amir; Raibin, Karine; Dabbah, Husein; Chistyakov, Irina; Srugo, Isaac; Even, Lea; Bzezinsky, Nurit; Riskin, Arieh

    2013-03-01

    The American Academy of Pediatrics recommends intravenous fluids for infants with bronchiolitis who are unable to sustain oral feedings. Our randomized, prospective pilot study shows that gastric tube feeding (in 31 infants) is feasible and demonstrated comparable clinical outcomes with intravenous fluids (in 20 infants) among hospitalized infants ≤6 months of age with moderate bronchiolitis.

  2. Use of flow cytometry to investigate the cytokine response pattern in infants with respiratory syncytial virus infection and bronchiolitis

    Institute of Scientific and Technical Information of China (English)

    陈志敏; 杜立中; 毛建华; 汤永民

    2002-01-01

    Objective: To investigate the cytokine response pattern (IL-4/IFN-γ) in infants with RSV infections and bronchiolitis during the acute phase. Methods: Four-color flow cytometry was used to measure intracellular IL-4 and IFN-γ expressions in peripheral blood CD3+ and CD8+ lymphocytes from RSV-infected and bronchiolitis infants. Serum IL-4 and IFN-γ levels were also determined. Results: RSV-infected and bronchiolitis infants showed no statistical differences from not-RSV-infected or pneumonia infants and control in the frequency of IL-4 and IFN-γ expressions in CD3+CD8- lymphocytes, showed no obvious Th1/Th2 imbalance, while IFN-γ was expressed much more frequently in CD3+CD8+ lymphocytes. Systematically, RSV-infected and bronchiolitis infants showed much lower levels of serum IL-4 and IL-4/IFN-γ ratios and much higher serum IFN-γ levels than control. However, there were no statistical differences in the above three indices between RSV-infected and not-RSV infected infants or between bronchiolitis and pneumonia infants, except that bronchiolitis infants had a higher level of serum IFN-γ than pneumonia infants statistically. Conclusions: There is no type-2 cytokine response predominance in the acute phase of RSV infection and bronchiolitis. IL-4 production is suppressed and IFN-γ production upregulated, the latter being most prominent in bronchiolitis infants.

  3. Randomised double blind placebo controlled trial of prednisolone in children admitted to hospital with respiratory syncytial virus bronchiolitis

    NARCIS (Netherlands)

    van Woensel, JBM; Wolfs, TFW; vanAalderen, WMC; Brand, PLP; Kimpen, JLL

    1997-01-01

    Background - Experimental and clinical evidence suggests that respiratory syncytial virus (RSV) bronchiolitis is an immune mediated disease. Corticosteroids might therefore be effective in the treatment of RSV bronchiolitis. Methods - A randomised double blind trial was conducted in children up to t

  4. Montelukast as an episodic modifier for acute viral bronchiolitis: a randomized trial.

    Science.gov (United States)

    Zedan, Magdy; Gamil, Nareman; El-Assmy, Mohamed; Fayez, Engy; Nasef, Nehad; Fouda, Ashraf; Settin, Ahmed

    2010-01-01

    This study was designed to evaluate the effect of once-daily montelukast therapy on the clinical progress and the cytokine profile of patients with acute viral bronchiolitis. A randomized, double-blind, placebo-controlled trial included 85 patients (mean age, 3.5 +/- 2.35 months), clinically diagnosed as first-episode acute bronchiolitis in addition to 10 healthy controls of matched age and sex. Patients were randomly assigned to receive either montelukast (4-mg sachets; n = 47) or placebo (n = 38) daily from the time of admission until discharge. The primary outcome measure was the length of hospital stay (LOS), and clinical severity scores (CSs) and changes in plasma levels of interferon gamma and interleukin-4 were secondary outcomes. LOS for the montelukast group was found to be significantly lower than that of the placebo group (p viral bronchiolitis.

  5. Dynamics of nasopharyngeal pneumococcal carriage during the course of viral bronchiolitis.

    Science.gov (United States)

    Faber, Tina E; Schuurs, Theo A; Veeger, Nic J G M; Hennus, Marije P; Bont, Louis J

    2016-08-01

    The effect of viral infection on nasopharyngeal carriage of Streptococcus pneumoniae during childhood is not well known. We studied dynamics of pneumococcal colonization by quantitative PCR during the natural course of viral bronchiolitis. At time of admission, 47 (47%) of 100 patients with bronchiolitis carried pneumococci. In patients with viral bronchiolitis who did not receive antibiotics, pneumococcal load decreased from time of admission to discharge (n = 35, cycle threshold 23 vs. 25, P = 0.0017) and from discharge to follow-up (n = 22, cycle threshold 25 vs. 40, P = 0.003). We conclude that viral respiratory infection is negatively associated with pneumococcal colonization of the upper airways. Pediatr Pulmonol. 2016;51:863-867. © 2016 Wiley Periodicals, Inc.

  6. The Effects of Inhaled Steroids on Recurrent Wheeze After Acute Bronchiolitis

    Directory of Open Access Journals (Sweden)

    Patricia Green MD

    2015-07-01

    Full Text Available Background. Acute bronchiolitis infection during infancy is associated with an increased risk of asthma later in life. The objective of this study was to determine if inhaled steroids are effective in preventing the development of recurrent wheeze or asthma following acute bronchiolitis. Methods. Multiple databases and bibliographies of selected references were searched. Inclusion required (a a randomized controlled trial of inhaled steroids and control group, (b at least 2 weeks duration of therapy started during the acute phase of disease, and (c identification of the rate of recurrent wheeze or asthma at least 6 months after therapy. Results. Of 1410 studies reviewed, 8 reports were included in this meta-analysis (748 patients. The overall odds ratio for developing recurrent wheeze or asthma with treatment versus without treatment was 1.02 (95% confidence interval = 0.58-1.81. Conclusions. A course of inhaled steroids after acute bronchiolitis is not effective in preventing recurrent wheeze or asthma.

  7. Inter-society consensus document on treatment and prevention of bronchiolitis in newborns and infants.

    Science.gov (United States)

    Baraldi, Eugenio; Lanari, Marcello; Manzoni, Paolo; Rossi, Giovanni A; Vandini, Silvia; Rimini, Alessandro; Romagnoli, Costantino; Colonna, Pierluigi; Biondi, Andrea; Biban, Paolo; Chiamenti, Giampietro; Bernardini, Roberto; Picca, Marina; Cappa, Marco; Magazzù, Giuseppe; Catassi, Carlo; Urbino, Antonio Francesco; Memo, Luigi; Donzelli, Gianpaolo; Minetti, Carlo; Paravati, Francesco; Di Mauro, Giuseppe; Festini, Filippo; Esposito, Susanna; Corsello, Giovanni

    2014-10-24

    Acute bronchiolitis is the leading cause of lower respiratory tract infection and hospitalization in children less than 1 year of age worldwide. It is usually a mild disease, but some children may develop severe symptoms, requiring hospital admission and ventilatory support in the ICU. Infants with pre-existing risk factors (prematurity, bronchopulmonary dysplasia, congenital heart diseases and immunodeficiency) may be predisposed to a severe form of the disease. Clinical diagnosis of bronchiolitis is manly based on medical history and physical examination (rhinorrhea, cough, crackles, wheezing and signs of respiratory distress). Etiological diagnosis, with antigen or genome detection to identify viruses involved, may have a role in reducing hospital transmission of the infection. Criteria for hospitalization include low oxygen saturation (bronchiolitis, and the mainstay of therapy is supportive care. This consists of nasal suctioning and nebulized 3% hypertonic saline, assisted feeding and hydration, humidified O2 delivery. The possible role of any pharmacological approach is still debated, and till now there is no evidence to support the use of bronchodilators, corticosteroids, chest physiotherapy, antibiotics or antivirals. Nebulized adrenaline may be sometimes useful in the emergency room. Nebulized adrenaline can be useful in the hospital setting for treatment as needed. Lacking a specific etiological treatment, prophylaxis and prevention, especially in children at high risk of severe infection, have a fundamental role. Environmental preventive measures minimize viral transmission in hospital, in the outpatient setting and at home. Pharmacological prophylaxis with palivizumab for RSV bronchiolitis is indicated in specific categories of children at risk during the epidemic period. Viral bronchiolitis, especially in the case of severe form, may correlate with an increased incidence of recurrent wheezing in pre-schooled children and with asthma at school age

  8. A Belief Rule Based Expert System to Assess Bronchiolitis Suspicion from Signs and Symptoms under Uncertainty

    DEFF Research Database (Denmark)

    Karim, Rezuan; Hossain, Mohammad Shahadat; Khalid, Md. Saifuddin;

    2016-01-01

    developed generic belief rule-based inference methodology by using evidential reasoning (RIMER) acts as the inference engine of this BRBES while belief rule base as the knowledge representation schema. The knowledge base of the system is constructed by using real patient data and expert opinion from...... be measured with cent percent certainty, resulting in inaccuracy in determining the occurrence of Bronchiolitis. Therefore, this paper presents the development of a Belief Rule-Based Expert System (BRBES) to assess the suspicion of Bronchiolitis by using signs and symptoms under uncertainty. The recently...

  9. Effect of Ligustrazine Injection on Vascular Endothelial Cell of The Patients with Arteriosclerosis Obliterans

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective: To study the effect of ligustrazine injection (LI) on vascular endothelial cell of the patients with arteriosclerosis obliterans (ASO) and explore the new pathway of investigating effective vascular protective agents in Chinese medicinal herbs. Methods: Forty-six patients with ASO in the LI group treated by LI were observed, their circulating endothelial cells (CEC) were detected quantitatively before and after treatment. The results were compared with the CEC of 53 cases of healthy persons (control group) in the same period. Results: In the LI group, the immediate cure rate was 45.7% (21 cases), markedly effective rate 36.9% (17 cases) and the effective rate 17.4% (8 cases). The CEC of patients before treatment was 4.39±1.76/0.9μl, which was significantly higher than that of the healthy persons (1.53±0.42/0.9μl). It could be reduced after treatment, along with the improvement of symptoms and signs, to 2.43±0.87/0.9μl, P<0.01. Conclusion: LI in treating ASO not only displays extraordinary effect, but also has good effect in curing the damage of endothelial cells.

  10. Long standing balanitis xerotica obliterans resulting in renal impairment in a child.

    Science.gov (United States)

    Sandler, Gideon; Patrick, Emily; Cass, Danny

    2008-08-01

    Balanitis xerotica obliterans (BXO) is the most common cause of pathological phimosis in boys. Presented here is the case of a previously well 13-year-old boy who developed obstructive renal impairment (serum creatinine = 190 micromol/l) at least in part from phimosis due to BXO. A circumcision and, 2.5 months later, meatal dilatation were done. Nine months after his initial presentation, his serum creatinine returned to a permanently elevated nadir of 119 mumol/l. Presentation with the complications of phimosis can be delayed in teenage boys because they may feel embarrassed to come forward. Circumcision remains the definitive treatment of BXO induced phimosis though if the penile meatus is involved, more complex surgery is sometimes required. Topical steroids are useful for residual disease. Follow-up is very important due to the frequent involvement of the skin of the glans. In the very long term there is an increased chance of penile malignancy, which can occur even after circumcision.

  11. [Topical therapy of balanitis xerotica obliterans in childhood. Long-term clinical results and an overview].

    Science.gov (United States)

    Ebert, A-K; Vogt, T; Rösch, W H

    2007-12-01

    Balanitis xerotica obliterans (BXO) is a chronic and progressive dermatitis of unknown aetiology and incidence. Its management in childhood is controversial. Although in most cases only the prepuce is affected, meatal and urethral involvement may lead to major surgical reconstruction. Therefore complete surgical excision of the affected skin is considered to be mandatory. In case of involvement, incidental histological evidence or a relapse, or when complete removal of the affected skin is not possible, a topical therapy should be implemented. In a retrospective analysis of our study population (13 children) with BXO, relapse rate was lower after topical therapy with tacrolimus (Protopic), a highly selective immune modulator, than after the standard anti-inflammatory therapy with betamethasone. The use of tacrolimus ointment is a safe therapy with no severe side effects. Due to the fact that there are no predictive factors for progression or relapse of BXO, we consider a topical anti-inflammatory therapy is always indicated after any type of surgery for BXO. Follow-up monitoring should be close, so that any relapse can be detected and treated as early as possible.

  12. Expression of Transglutaminase in Foreskin of Children with Balanitis Xerotica Obliterans.

    Science.gov (United States)

    Russo, Tiziana; Currò, Monica; Barbera, Anna; Caccamo, Daniela; Antonuccio, Pietro; Arena, Salvatore; Montalto, Angela Simona; Parisi, Saveria; Marseglia, Lucia; Gitto, Eloisa; Ientile, Riccardo; Impellizzeri, Pietro; Romeo, Carmelo

    2016-09-14

    Balanitis xerotica obliterans (BXO) is a chronic inflammatory skin disorder of unclear etiology. The etiology and the exact molecular mechanisms underlying the disease are still unknown. The human transglutaminase (TG) family consists of several proteins with catalytic activity essential for biological processes. In the present research we investigated the transcript levels of three TGs in patients operated on for congenital phimosis without or with histologically confirmed BXO; Thirty children with acquired phimosis were enrolled. The removed foreskins were sent both for histological diagnosis and for quantitative real-time PCR to evaluate the transcript levels of keratinocyte (TG1), tissue (TG2), and epidermal (TG3) transglutaminase; We observed a decrease in TG1 and TG3 transcripts by about 70% (p BXO (n = 15) in comparison with patients without BXO (n = 15) and an increase in TG2 mRNA levels by 2.9 folds (p BXO and can be a consequence of damage to keratinocytes. Increased expression of TG2 can be the result of chronic inflammation. TG2 overexpression can play a pivotal role in triggering and maintaining the inflammatory response in BXO patients.

  13. [Balanitis xerotica obliterans with phimosis in elderly patients presenting with difficulty in urination].

    Science.gov (United States)

    Nemoto, Kaoru; Ishidate, Takuzo

    2013-06-01

    Eight elderly patients (average age 76.1±4.3 years) with balanitis xerotica obliterans (BXO) accompanied by phimosis presented with difficulty in urination. Preoperative average international prostate symptom score, average maximum urinary flow rate, and average volume of residual urine were 20.7±6.3 points (n=8), 5.1±3.6 ml/s (n=5), and 85.4±77.3 ml (n=8), respectively. Some of the patient's complaints, such as severe dribbling of urine, urinary stream division, and ballooning of the foreskin, were not included in the items of the major questionnaire on urination. Dorsal incision and circumcision was performed in all patients, and all were pathologically diagnosed with BXO. Meatoplasty was performed in one patient with a meatal stenosis. No coexistence of penile cancer was observed. Statistically significant improvements were observed in subjective and objective findings after treatment. In conclusion, BXO with phimosis in elderly patients should be considered as a cause of lower urinary tract symptoms.

  14. Expression of Transglutaminase in Foreskin of Children with Balanitis Xerotica Obliterans

    Directory of Open Access Journals (Sweden)

    Tiziana Russo

    2016-09-01

    Full Text Available Balanitis xerotica obliterans (BXO is a chronic inflammatory skin disorder of unclear etiology. The etiology and the exact molecular mechanisms underlying the disease are still unknown. The human transglutaminase (TG family consists of several proteins with catalytic activity essential for biological processes. In the present research we investigated the transcript levels of three TGs in patients operated on for congenital phimosis without or with histologically confirmed BXO; Thirty children with acquired phimosis were enrolled. The removed foreskins were sent both for histological diagnosis and for quantitative real-time PCR to evaluate the transcript levels of keratinocyte (TG1, tissue (TG2, and epidermal (TG3 transglutaminase; We observed a decrease in TG1 and TG3 transcripts by about 70% (p < 0.001 in foreskins from patients with BXO (n = 15 in comparison with patients without BXO (n = 15 and an increase in TG2 mRNA levels by 2.9 folds (p < 0.001; Reduced expression of both TG1 and TG3 was associated with the altered structure of the foreskin in BXO and can be a consequence of damage to keratinocytes. Increased expression of TG2 can be the result of chronic inflammation. TG2 overexpression can play a pivotal role in triggering and maintaining the inflammatory response in BXO patients.

  15. HRCT features in a 5-year-old child with follicular bronchiolitis

    Energy Technology Data Exchange (ETDEWEB)

    Reittner, P.; Fotter, R.; Lindbichler, F.; Tillich, M. [Department of Radiology, Karl-Franzens University and University Hospital Graz, Auenbruggerplatz 9, A-8036 Graz (Austria); Varga, E.M.; Zach, M. [Department of Pediatrics, Karl-Franzens University and University Hospital Graz, Graz (Austria); Popper, H. [Department of Pathology, Karl-Franzens University and University Hospital Graz, Graz (Austria)

    1997-11-01

    High-resolution CT (HRCT) is the most sensitive radiographic method to image small airways disease. We discuss the HRCT features of follicular bronchiolitis in a 5-year-old boy and correlate them with the histopathological findings. The changes described include centrilobular nodules, bronchiectasis and bronchiolectasis, branching opacities and areas of reduced lung attenuation. (orig.) With 2 figs., 5 refs.

  16. Absence of Bordetella pertussis Among Infants Hospitalized for Bronchiolitis in Finland, 2008-2010.

    Science.gov (United States)

    Korppi, Matti; Kivistö, Juho; Koponen, Petri; Lehtinen, Pasi; Remes, Sami; Piippo-Savolainen, Eija; Piedra, Pedro A; Espinola, Janice A; Camargo, Carlos A; Jartti, Tuomas

    2016-02-01

    In 169 Finnish infants hospitalized for bronchiolitis at age Bordetella pertussis and 16 viruses. Respiratory viruses were detected in 89% (71% with respiratory syncytial virus), but no infant had B. pertussis. The latter finding may reflect a positive effect from the broadening of the Finnish pertussis vaccination program in 2005.

  17. Safely Discharging Infants with Bronchiolitis from an Emergency Department: A Five Step Guide for Pediatricians

    Science.gov (United States)

    Stollar, Fabiola; Gervaix, Alain; Argiroffo, Constance Barazzone

    2016-01-01

    Recent publications have established the pulse oxygen saturation (SpO2) threshold of 90% for the hospitalization and discharge of infant patients with bronchiolitis. However, there is no clear recommendation regarding the Emergency Department (ED) observation period necessary before allowing safe home discharge for patients with SpO2 above 90%-92%. Our primary aims were to evaluate the risk factors associated with delayed desaturation in infants with SpO2 ≥ 92% on arrival at the ED as well as the ED observation period necessary before allowing safe home discharge. A secondary aim was to identify the risk factors for ED readmission. Of 581 episodes of bronchiolitis in patients 6KPa) were risk factors for delayed desaturation with OR varying from 1.7 to 7.5. In patients bronchiolitis from the ED. By using the threshold of an 11 hour ED observation period for patients ≥ 3 months old and a 25 hour period for patients bronchiolitis who are at risk of delayed desaturation. PMID:27690359

  18. Acute viral bronchiolitis in South Africa: Strategies for management and prevention.

    Science.gov (United States)

    Zar, H J; Madhi, S A; White, D A; Masekela, R; Risenga, S; Lewis, H; Feldman, C; Morrow, B; Jeena, P

    2016-04-01

    Management of acute viral bronchiolitis is largely supportive. There is currently no proven effective therapy other than oxygen for hypoxic children. The evidence indicates that there is no routine benefit from inhaled, rapid short-acting bronchodilators, adrenaline or ipratropium bromide for children with acute viral bronchiolitis. Likewise, there is no demonstrated benefit from routine use of inhaled or oral corticosteroids, inhaled hypertonic saline nebulisation, montelukast or antibiotics. The last should be reserved for children with severe disease, when bacterial co-infection is suspected. Prevention of respiratory syncytial virus (RSV) disease remains a challenge. A specific RSV monoclonal antibody, palivizumab, administered as an intramuscular injection, is available for children at risk of severe bronchiolitis, including premature infants, young children with chronic lung disease, immunodeficiency, or haemodynamically significant congenital heart disease. Prophylaxis should be commenced at the start of the RSV season and given monthly during the season. The development of an RSV vaccine may offer a more effective alternative to prevent disease, for which the results of clinical trials are awaited. Education of parents or caregivers and healthcare workers about diagnostic and management strategies should include the following: bronchiolitis is caused by a virus; it is seasonal; it may start as an upper respiratory tract infection with low-grade fever; symptoms are cough and wheeze, often with fast breathing; antibiotics are generally not needed; and the condition is usually self limiting, although symptoms may occur for up to four weeks in some children.

  19. The effect of 3% and 6% hypertonic saline in viral bronchiolitis: a randomised controlled trial.

    Science.gov (United States)

    Teunissen, Jasmijn; Hochs, Anne H J; Vaessen-Verberne, Anja; Boehmer, Annemie L M; Smeets, Carien C J M; Brackel, Hein; van Gent, René; Wesseling, Judith; Logtens-Stevens, Danielle; de Moor, Ronald; Rosias, Philippe P R; Potgieter, Steph; Faber, Marianne R; Hendriks, Han J E; Janssen-Heijnen, Maryska L G; Loza, Bettina F

    2014-10-01

    Bronchiolitis is a common disorder in young children that often results in hospitalisation. Except for a possible effect of nebulised hypertonic saline (sodium chloride), no evidence-based therapy is available. This study investigated the efficacy of nebulised 3% and 6% hypertonic saline compared with 0.9% hypertonic saline in children hospitalised with viral bronchiolitis. In this multicentre, double-blind, randomised, controlled trial, children hospitalised with acute viral bronchiolitis were randomised to receive either nebulised 3%, 6% hypertonic saline or 0.9% normal saline during their entire hospital stay. Salbutamol was added to counteract possible bronchial constriction. The primary endpoint was the length of hospital stay. Secondary outcomes were need for supplemental oxygen and tube feeding. From the 292 children included in the study (median age 3.4 months), 247 completed the study. The median length of hospital stay did not differ between the groups: 69 h (interquartile range 57), 70 h (IQR 69) and 53 h (IQR 52), for 3% (n=84) and 6% (n=83) hypertonic saline and 0.9% (n=80) normal saline, respectively, (p=0.29). The need for supplemental oxygen or tube feeding did not differ significantly. Adverse effects were similar in the three groups. Nebulisation with hypertonic saline (3% or 6% sodium chloride) although safe, did not reduce the length of stay in hospital, duration of supplemental oxygen or tube feeding in children hospitalised with moderate-to-severe viral bronchiolitis.

  20. [What evidence for chest physiotherapy in infants hospitalized for acute viral bronchiolitis?].

    Science.gov (United States)

    Bailleux, S; Lopes, D; Geoffroy, A; Josse, N; Labrune, P; Gajdos, V

    2011-04-01

    This article updates the respiratory physiotherapy technique used in France, and the rationale for its use. This paper reports the results of a recent randomized clinical trial that did not show any efficiency of respiratory physiotherapy (using increased expiratory acceleration) in infants hospitalized for a first episode of bronchiolitis. Further trials are necessary for evaluating this technique in infants who are not hospitalized.

  1. Acute Bronchiolitis. Which Patients Should Be Admitted to Intensive Care Units?

    Directory of Open Access Journals (Sweden)

    Ariel Efrén Uriarte Méndez

    2014-12-01

    Full Text Available Bronchiolitis is the most common viral infection of the lower respiratory tract in childhood; it is considered the most severe respiratory condition that affects children under 2 years of age. In general, mortality from bronchiolitis is low, but it can reach up to 30% in patients at risk. Twenty children have died from this condition in the pediatric hospital of Cienfuegos in the last 30 years. Bronchiolitis-related deaths account for approximately 4 % of all deaths from 2010 to date. This fact has led to the implementation of administrative measures to reduce deaths from this cause, which have not solved the problem. The aim of this paper is to present a set of criteria for admission of bronchiolitis patients to intensive care units in order to be considered by the administrators of the institution. These criteria based on the authors’ experience and scientific evidence reflected in the literature focus on preventing overcrowding of this service with patients not showing signs of serious condition, and on the contrary, timely identifying those likely to have an unfavourable outcome.

  2. A Patient with Bronchial Asthma in Whom Eosinophilic Bronchitis and Bronchiolitis Developed during Treatment

    Directory of Open Access Journals (Sweden)

    Yasutsugu Fukushima

    2010-01-01

    Full Text Available A 56-year-old woman was referred to our hospital because of dyspnea, wheezing, and a productive cough. Eight years before presentation, bronchial asthma was diagnosed and the patient received inhaled corticosteroids plus antiasthmatic agents (a long-acting inhaled p2-agonist, leukotriene modifiers, and theophylline. Chest radiography showed small diffuse nodular shadows, and a computed tomographic scan showed thickening of the bronchi and bronchioles, with diffuse centrilobular nodules in both lung fields. A blood test and microscopic examination of the bronchoalveolar fluid revealed marked eosinophilia. Transbronchial lung biopsy and transbronchial biopsy showed eosinophilic bronchitis and bronchiolitis. After treatment with oral prednisolone (40 mg daily and inhaled corticosteroids, the symptoms, blood eosinophilia, and radiographic findings improved. Recently, several similar cases of eosinophilic bronchiolitis have been reported. Studies of further cases and elucidation of the pathophysiology of eosinophilic bronchiolitis are necessary to establish a concept for this disease and to determine whether it should be classified as a subtype of bronchial asthma or as a distinct entity.

  3. Specific increase in local IL-17 production during recovery from primary RSV bronchiolitis

    NARCIS (Netherlands)

    Faber, T.E.; Groen, H.; Welfing, M.; Jansen, K.J.G.; Bont, L.J.

    2012-01-01

    Although Respiratory syncytial virus (RSV) bronchiolitis is the most important cause of hospital admission for infants during the winter season, the pathogenesis is largely unknown. Interleukin-17 (IL-17) concentrations were studied in nasopharyngeal aspirates from 21 non-ventilated and 17 ventilate

  4. Acute bronchiolitis in infancy as risk factor for wheezing and reduced pulmonary function by seven years in Akershus County, Norway

    Directory of Open Access Journals (Sweden)

    Gulbrandsen Pål

    2005-08-01

    Full Text Available Abstract Background Acute viral bronchiolitis is one of the most common causes of hospitalisation during infancy in our region with respiratory syncytial virus (RSV historically being the major causative agent. Many infants with early-life RSV bronchiolitis have sustained bronchial hyperreactivity for many years after hospitalisation and the reasons for this are probably multifactorial. The principal aim of the present study was to investigate if children hospitalised for any acute viral bronchiolitis during infancy in our region, and not only those due to RSV, had more episodes of subsequent wheezing up to age seven years and reduced lung function at that age compared to children not hospitalised for acute bronchiolitis during infancy. A secondary aim was to compare the hospitalised infants with proven RSV bronchiolitis (RS+ to the hospitalised infants with non-RSV bronchiolitis (RS- according to the same endpoints. Methods 57 infants hospitalised at least once with acute viral bronchiolitis during two consecutive winter seasons in 1993–1994 were examined at age seven years. An age-matched control group of 64 children, who had not been hospitalised for acute viral bronchiolitis during infancy, were recruited from a local primary school. Epidemiological and clinical data were collected retrospectively from hospital discharge records and through structured clinical interviews and physical examinations at the follow-up visit. Results The children hospitalised for bronchiolitis during infancy had decreased lung function, more often wheezing episodes, current medication and follow-up for asthma at age seven years than did the age matched controls. They also had lower average birth weight and more often first order family members with asthma. We did not find significant differences between the RSV+ and RSV- groups. Conclusion Children hospitalised for early-life bronchiolitis are susceptible to recurrent wheezing and reduced pulmonary function by

  5. A RARE CASE REPORT OF SQUAMOUS CELL CARCINOMA OF URETHRA ARISING FROM SUBSTITUTED PENILE SKIN FLAP WITH BALANITIS XEROTICA OBLITERANS

    Directory of Open Access Journals (Sweden)

    Rana Pratap

    2016-06-01

    Full Text Available A 44-year-old male presented with ulcerative growth over dorsal penile shaft along with multiple urethrocutaneous fistula. A total penectomy, scrotal excision and perineal urethrostomy were done. Past history of treatment for penile urethral stricture due to Balanitis Xerotica Obliterans (BXO by substitution urethroplasty using pedicled preputial penile skin flap five years back. On gross as well as histopathological examination, the tumour was found to be arising from the skin flap used for substitution. This case highlights the malignant potential of skin affected by BXO and is probably the only case report where a skin flap has turned malignant.

  6. High rate of viral identification and coinfections in infants with acute bronchiolitis

    Directory of Open Access Journals (Sweden)

    Milena Siciliano Nascimento

    2010-01-01

    Full Text Available OBJECTIVES: To determine the viruses and risk factors associated with hospital and intensive care unit (ICU admissions in infants with acute bronchiolitis. INTRODUCTION: Bronchiolitis is a major cause of morbidity in infants. Widespread use of molecular-based methods has yielded new insights about its etiology, but the impact of viral etiologies on early outcomes is still unclear. METHODS: Seventy-seven infants with bronchiolitis who were under two years of age and visited an emergency unit were included. Using molecular-based methods, samples were tested for 12 different respiratory viruses. Logistic regression models were used to identify clinical and virological variables associated with the main endpoints: hospital admission and ICU admission. RESULTS: We identified at least one virus in 93.5% of patients, and coinfections were found in nearly 40% of patients. RSV was the most common pathogen (63.6%, followed by rhinovirus (39%. Identification of RSV was only associated with an increased risk of hospital admission in the univariate model. Younger age and enterovirus infection were associated with an increased risk of hospital admission, while atopy of a first-degree relative showed a protective effect. Prematurity was associated with an increased risk of admission to the ICU. Coinfections were not associated with worse outcomes. CONCLUSIONS: Molecular-based methods resulted in high rates of viral identification but did not change the significant role of RSV in acute bronchiolitis. Younger age and enterovirus infection were risk factors for hospital admission, while prematurity appeared to be a significant risk factor for admission to the ICU in acute viral bronchiolitis.

  7. Whole blood gene expression in infants with respiratory syncytial virus bronchiolitis

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    Skjaeret Camilla

    2006-12-01

    Full Text Available Abstract Background Respiratory syncytial virus (RSV is a major cause of viral bronchiolitis in infants worldwide, and environmental, viral and host factors are all of importance for disease susceptibility and severity. To study the systemic host response to this disease we used the microarray technology to measure mRNA gene expression levels in whole blood of five male infants hospitalised with acute RSV, subtype B, bronchiolitis versus five one year old male controls exposed to RSV during infancy without bronchiolitis. The gene expression levels were further evaluated in a new experiment using quantitative real-time polymerase chain reaction (QRT-PCR both in the five infants selected for microarray and in 13 other infants hospitalised with the same disease. Results Among the 30 genes most differentially expressed by microarray nearly 50% were involved in immunological processes. We found the highly upregulated interferon, alpha-inducible protein 27 (IFI27 and the highly downregulated gene Charcot-Leyden crystal protein (CLC to be the two most differentially expressed genes in the microarray study. When performing QRT-PCR on these genes IFI27 was upregulated in all but one infant, and CLC was downregulated in all 18 infants, and similar to that given by microarray. Conclusion The gene IFI27 is upregulated and the gene CLC is downregulated in whole blood of infants hospitalised with RSV, subtype B, bronchiolitis and is not reported before. More studies are needed to elucidate the specificity of these gene expressions in association with host response to this virus in bronchiolitis of moderate severity.

  8. Hypoxia-inducible factor-1α expression in the different stages of rat thromboangiitis obliterans.

    Science.gov (United States)

    He, T; Qu, B H; Wang, D L; Hu, M

    2015-06-18

    We investigated the expression and effects of hypoxia-inducible factor-1α (HIF-1α) in rat thromboangiitis obliterans (TO). Rats were divided into sham and model groups. The model group was further divided into groups based on observation duration. Lauric acid was injected below an artery clamp to simulate TO in the model group; saline was used in the sham group. Clamps were removed 15 min after injection in both groups, and physiological changes were observed at different times (gross observation and hematoxylin and eosin staining). The animals were killed at various times following the operation and serum and muscle tissues were sampled. For the sham group: the endometrium was relatively intact; medial membrane and epineurium lesions were absent; and blood vessels and surrounding tissues had no inflammatory cell infiltration. For the model group: all subgroups displayed inflammation; large numbers of inflammatory cells were gathered; muscle tissue lost its normal texture and structure; and the internal elastic membrane was integrated. Compared with the preoperative status, HIF-1α expression increased significantly in all subgroups (P < 0.05); there was no change in the sham group. HIF-1α expression in each subgroup was different (F = 14.267, P < 0.05). Femoral artery injection of lauric acid can be used as a rat TO model owing to its simple application and success rate. HIF-1α expression increased in the early stage of TO and gradually decreased with the extension of ischemia time; it may play a leading role in TO development and can be used for diagnosis and cure evaluation.

  9. Skin phototype and local trauma in the onset of balanitis xerotica obliterans (BXO) in circumcised patients.

    Science.gov (United States)

    Villa, Massimo; Dragonetti, Emanuele; Grande, Michele; Bove, Pierluigi; Sansalone, Salvatore; Rulli, Francesco; Tambucci, Roberto; Tucci, Gianfranco; Baldi, Alfonso

    2012-01-01

    The association between balanitis xerotica obliterans (BXO) and skin disorders is long established, however, the role of skin phototype and local trauma in its onset has never been investigated in detail. Medical records of all Caucasian children circumcised over a 6-year period were reviewed. The excised skin underwent histological examination for BXO. Children with histological diagnosis of BXO were classified as group A, whereas children without histological diagnosis of BXO were classified as group B. The Fitzpatrick phototype (FT) was obtained in all children performing a personal or family interview with regards to their sunburn and suntan experience. According to their FT, both group A and B patients were divided into two subgroups: FT 1-2, with a higher tendency to sunburn due to their low skin melanin content; and FT 3-4 with a higher tendency to tan due to their higher skin melanin content. Maneuvers of mechanical reduction of the foreskin (MRF) performed at least 5-10 times per month during the year preceding circumcision was also considered. Statistical analysis was performed using univariate and multivariate analysis. A total of 297 patients met the inclusion criteria of our study: 78 patients were classified as group A and 219 as group B. The risk of developing BXO was significantly greater in FT 1-2 patients (n=76) (odd ratio=0.232, 95% confidence interval=0.124-0.435, pBXO (odds ratio= 5.344, 95% confidence interval=2.860-9.987, pBXO in circumcised individuals. Moreover, the data produced suggest should the advantages of repeated MRF be weighed against the increased risk of developing BXO, which in turn may increase complication rate of circumcision surgery.

  10. Efficacy of bosentan in patients with refractory thromboangiitis obliterans (Buerger disease)

    Science.gov (United States)

    Narváez, Javier; García-Gómez, Carmen; Álvarez, Lorenzo; Santo, Pilar; Aparicio, María; Pascual, María; López de Recalde, Mercè; Borrell, Helena; Nolla, Joan M.

    2016-01-01

    Abstract The cornerstone of therapy in thromboangiitis obliterans (TAO) is complete abstinence from tobacco. In addition to discontinuation of cigarette smoking, very few pharmacological and surgical options of controversial efficacy are available to date. New therapeutic options with greater efficacy are clearly needed to properly manage these patients. In this preliminary study, we assessed the effectiveness and safety of bosentan in a case series of 8 adults with TAO and severe ischemic ulceronecrotic lesions who were treated with bosentan after inadequate response to platelet inhibitors, vasodilators, and intravenous alprostadil. Additionally, we reviewed 18 well-documented patients with refractory TAO treated with bosentan, which was previously reported (PubMed 1965–2015). These 26 patients formed the basis of our present analysis. All were current smokers. The median duration of bosentan treatment (SD) was 4.5 ± 4 months (range 3–16). Eleven patients (42%) were unable to completely abstain from smoking during their follow-up. With bosentan treatment, no new ischemic lesions were observed in the target extremities. A complete therapeutic response was achieved in 80% of patients, whereas a partial response was observed in 12%. Two patients (8%) ultimately required amputation despite treatment. After discontinuation of bosentan, patients were followed for a median of 20 ± 14 months (range 3–60). Two patients whose trophic lesions had healed relapsed. When comparing patients who gave up smoking with those who were unable to completely abstain from smoking during follow-up, no significant differences were found in efficacy outcomes. Four patients (15%) developed adverse events, requiring bosentan discontinuation in 1 case. These preliminary data suggest that bosentan may be considered a therapeutic option for treatment of cases of severe TAO refractory to conventional treatment, and merit further evaluation in larger controlled, randomized clinical

  11. Treatment of respiratory syncytial virus bronchiolitis : 1995 poll of members of the European Society for Paediatric Infectious Diseases

    NARCIS (Netherlands)

    Kimpen, JLL; Schaad, UB

    1997-01-01

    Background. Among the lower respiratory tract infections during infancy requiring hospitalization, respiratory syncytial virus (RSV) bronchiolitis is the most frequent disease entity. Nevertheless treatment remains controversial. Methods. A poll among the European Society for Paediatric Infectious D

  12. Use of flow cytometry to investigate the cytokine response pattern in infants with respiratory syncytial virus infection and bronchiolitis

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Objective:To investigate the cytokine response pattern(IL-4/IFN-γ)in infants with RSV infections and bronchiolitis during the acute phase,Methods:Four-color flow cytometry was used to measure intracellular IL-4 and IFN-γ expressions in peripheral blood CD3+ and CD*+ lymphocytes from RSV-infected and bronchiolitis infants.Serum IL-4 and INF-γ levels were also determined.Results:RSV-infected and bronchiolitis infants showed no statistical differences from not-RSV-infected or pneumonia infants and control in the frequency of IL-4 and INF-γ levels were also determined.Results;RSV-infected and bronchiolitis infants showed no statistical differences from not-RSV-infected or pneumonia infants and control in the frequency of IL-4 and IFN-γ expressions in CD3+CD8- lymphocytes,showed no obvious Th1/Th2 imbalance,while IFN-γ was expressed much more frequently in CD3+CD*+ lymphocytes.Systematically,RSV-infected and bronchiolitis infants showed moch lower levels of serum IL-4 and IL-4/INF-γ ratios and much higher serum IFN-γ levels than control.Howerver,there were no statistical differences in the above three indices between RSV-infected and not-RSV infected infants or between bronchiolitis and pneumonia infants,except that bronchiolitis infants had a higher level of serum INF-γ than pneumonia infants statistically .Conclusions:There is no type-2 cytokine response predominance in the acute thase of RSV infection and bronchilitis.IL-4 productioin is suppressed and IFN-γ production upregulated,the latter being most prominent in bronchiolitis infants.

  13. Trends in Respiratory Syncytial Virus and Bronchiolitis Hospitalization Rates in High-Risk Infants in a United States Nationally Representative Database, 1997-2012.

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    Abigail Doucette

    Full Text Available Respiratory syncytial virus (RSV causes significant pediatric morbidity and is the most common cause of bronchiolitis. Bronchiolitis hospitalizations declined among US infants from 2000‒2009; however, rates in infants at high risk for RSV have not been described. This study examined RSV and unspecified bronchiolitis (UB hospitalization rates from 1997‒2012 among US high-risk infants.The Kids' Inpatient Database (KID infant annual RSV (ICD-9 079.6, 466.11, 480.1 and UB (ICD-9 466.19, 466.1 hospitalization rates were estimated using weighted counts. Denominators were based on birth hospitalizations with conditions associated with high-risk for RSV: chronic perinatal respiratory disease (chronic lung disease [CLD]; congenital airway anomalies (CAA; congenital heart disease (CHD; Down syndrome (DS; and other genetic, metabolic, musculoskeletal, and immunodeficiency conditions. Preterm infants could not be identified. Hospitalizations were characterized by mechanical ventilation, inpatient mortality, length of stay, and total cost (2015$. Poisson and linear regression were used to test statistical significance of trends.RSV and UB hospitalization rates were substantially elevated for infants with higher-risk CHD, CLD, CAA and DS without CHD compared with all infants. RSV rates declined by 47.0% in CLD and 49.7% in higher-risk CHD infants; no other declines in high-risk groups were observed. UB rates increased in all high-risk groups except for a 22.5% decrease among higher-risk CHD. Among high-risk infants, mechanical ventilation increased through 2012 to 20.4% and 13.5% of RSV and UB hospitalizations; geometric mean cost increased to $31,742 and $25,962, respectively, and RSV mortality declined to 0.9%.Among high-risk infants between 1997 and 2012, RSV hospitalization rates declined among CLD and higher-risk CHD infants, coincident with widespread RSV immunoprophylaxis use in these populations. UB hospitalization rates increased in all high

  14. [Nebulized hypertonic saline and acute viral bronchiolitis in infants: current aspects].

    Science.gov (United States)

    Sauvaget, E; David, M; Bresson, V; Retornaz, K; Bosdure, E; Dubus, J-C

    2012-06-01

    Acute viral bronchiolitis affects infants, is frequent, and can be severe. Its treatment is only based on symptoms. Hypertonic saline (HS) may act favorably in this situation by fighting virus-induced dehydration of the airway liquid surface. Because of an osmotic action, HS attracts the water from the epithelial cells and improves mucociliary clearance. Five double-blind placebo-controlled studies concerning hospitalized infants with acute viral bronchiolitis showed that repeated nebulizations of 3% HS induce a 20% improvement in the clinical severity score and reduced the hospital length of stay by 24h. Tolerance is excellent. On the other hand, a few questions remain unresolved: what is the optimal salt concentration? What is the recommended nebulizer? What is the best frequency for nebulizer use? Can nebulized HS be used at home? What are the results with systematic physiotherapy when HS is used?

  15. Respiratory dysfunction and proinflammatory chemokines in the pneumonia virus of mice (PVM) model of viral bronchiolitis.

    Science.gov (United States)

    Bonville, Cynthia A; Bennett, Nicholas J; Koehnlein, Melissa; Haines, Deborah M; Ellis, John A; DelVecchio, Alfred M; Rosenberg, Helene F; Domachowske, Joseph B

    2006-05-25

    We explore relationships linking clinical symptoms, respiratory dysfunction, and local production of proinflammatory chemokines in the pneumonia virus of mice (PVM) model of viral bronchiolitis. With a reduced inoculum of this natural rodent pathogen, we observe virus clearance by day 9, while clinical symptoms and respiratory dysfunction persist through days 14 and 17 postinoculation, respectively. Via microarray and ELISA, we identify expression profiles of proinflammatory mediators MIP-1alpha, MCP-1, and MIP-2 that correlate with persistent respiratory dysfunction. MIP-1alpha is localized in bronchial epithelium, which is also the major site of PVM replication. Interferon-gamma was detected in lung tissue, but at levels that do not correlate with respiratory dysfunction. Taken together, we present a modification of our pneumovirus infection model that results in improved survival and data that stand in support of a connection between local production of specific mediators and persistent respiratory dysfunction in the setting of acute viral bronchiolitis.

  16. The relationship between nasopharyngeal CCL5 and microbiota on disease severity among infants with bronchiolitis.

    Science.gov (United States)

    Hasegawa, Kohei; Mansbach, Jonathan M; Ajami, Nadim J; Petrosino, Joseph F; Freishtat, Robert J; Teach, Stephen J; Piedra, Pedro A; Camargo, Carlos A

    2017-03-17

    Emerging evidence suggests that the airway microbiota plays an important role in viral bronchiolitis pathobiology. However, little is known about the combined role of airway microbiota and CCL5 in infants with bronchiolitis. In this multicenter prospective cohort study of 1,005 infants (age airway CCL5 levels and microbiota profiles with regard to the risk of both intensive care use (Pinteraction =0.02) and hospital length-of-stay ≥3 days (Pinteraction =0.03). Among infants with lower CCL5 levels, the Haemophilus-dominant microbiota profile was associated with a higher risk of intensive care use (OR, 3.20; 95%CI, 1.18-8.68; P=0.02) and hospital length-of-stay ≥3 days (OR, 4.14; 95%CI, 2.08-8.24; Pmicrobiota profiles and these severity outcomes (all P≥0.10). This article is protected by copyright. All rights reserved.

  17. Etiological diagnosis reduces the use of antibiotics in infants with bronchiolitis

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    Ângela Esposito Ferronato

    2012-09-01

    Full Text Available OBJECTIVE: Acute bronchiolitis is a leading cause of infant hospitalization and is most commonly caused by respiratory syncytial virus. Etiological tests are not required for its diagnosis, but the influence of viral screening on the therapeutic approach for acute bronchiolitis remains unclear. METHODS: A historical cohort was performed to assess the impact of viral screening on drug prescriptions. The study included infants up to one year of age who were hospitalized for bronchiolitis. Virus screening was performed using immunofluorescence assays in nasopharyngeal aspirates. The clinical data were obtained from the patients' medical records. Therapeutic changes were considered to be associated with viral screening when made within 24 hours of the release of the results. RESULTS: The frequency of prescriptions for beta agonists, corticosteroids and antibiotics was high at the time of admission and was similar among the 230 patients. The diagnosis of pneumonia and otitis was associated with the introduction of antibiotics but did not influence antibiotics maintenance after the results of the virus screening were obtained. Changes in the prescriptions were more frequent for the respiratory syncytial virus patients compared to patients who had negative viral screening results (p =0.004, especially the discontinuation of antibiotics (p<0.001. The identification of respiratory syncytial virus was associated with the suspension of antibiotics (p= 0.003, even after adjusting for confounding variables (p = 0.004; however, it did not influence the suspension of beta-agonists or corticosteroids. CONCLUSION: The identification of respiratory syncytial virus in infants with bronchiolitis was independently associated with the discontinuation of antibiotics during hospitalization

  18. Aerosolised hypertonic saline in hospitalized young children with acute bronchiolitis: a randomized controlled clinical trial.

    OpenAIRE

    Maheshkumar, K B; B.P. Karunakara; Nagalli, Manjunath Mallikarjuna; Mallikarjuna, H B

    2013-01-01

    ABSTRACT: Objectives: To determine the effectiveness of aerosolised 3% saline in hospitalised children with acute bronchiolitis. Design: Prospective, randomized, double blinded clinical study. Setting: Referral teaching hospital, from October 2007 to March 2009. Patients: 40 children [age less than 2 yrs] were enrolled sequentially and randomized into 2 groups [20 each; Group- A - 3% saline and Group-B [Normal saline]. Intervention: 4 nebulizations [3% saline or normal s...

  19. Azithromycin attenuates airway inflammation in a mouse model of viral bronchiolitis

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    Brody Steven L

    2010-06-01

    Full Text Available Abstract Background Viral bronchiolitis is the leading cause of hospitalization in young infants. It is associated with the development of childhood asthma and contributes to morbidity and mortality in the elderly. Currently no therapies effectively attenuate inflammation during the acute viral infection, or prevent the risk of post-viral asthma. We hypothesized that early treatment of a paramyxoviral bronchiolitis with azithromycin would attenuate acute and chronic airway inflammation. Methods Mice were inoculated with parainfluenza type 1, Sendai Virus (SeV, and treated daily with PBS or azithromycin for 7 days post-inoculation. On day 8 and 21 we assessed airway inflammation in lung tissue, and quantified immune cells and inflammatory mediators in bronchoalveolar lavage (BAL. Results Compared to treatment with PBS, azithromycin significantly attenuated post-viral weight loss. During the peak of acute inflammation (day 8, azithromycin decreased total leukocyte accumulation in the lung tissue and BAL, with the largest fold-reduction in BAL neutrophils. This decreased inflammation was independent of changes in viral load. Azithromycin significantly attenuated the concentration of BAL inflammatory mediators and enhanced resolution of chronic airway inflammation evident by decreased BAL inflammatory mediators on day 21. Conclusions In this mouse model of paramyxoviral bronchiolitis, azithromycin attenuated acute and chronic airway inflammation. These findings demonstrate anti-inflammatory effects of azithromycin that are not related to anti-viral activity. Our findings support the rationale for future prospective randomized clinical trials that will evaluate the effects of macrolides on acute viral bronchiolitis and their long-term consequences.

  20. Impact on parents of bronchiolitis hospitalization of full-term, preterm and congenital heart disease infants

    Directory of Open Access Journals (Sweden)

    Lapillonne Alexandre

    2012-10-01

    Full Text Available Abstract Background The objective of this work was to explore the impact on parents of the bronchiolitis hospitalization of their infant using the Impact of Bronchiolitis Hospitalization Questionnaire (IBHQ©. Methods Four hundred sixty-three infants aged less than 1 year and hospitalized for bronchiolitis were included in a French observational study during the 2008–2009 season. Parents were asked to complete the IBHQ at hospital discharge and 3 months later. IBHQ scores, ranging from 0 (no impact to 100 (highest impact, were compared according to gestational age (full-term, 33–36 wGA, ≤ 32 wGA and the presence of congenital heart disease (CHD. The potential drivers of impact were explored using multivariate linear regressions. Results The study included 332 full-terms, 71 infants born at 33–36 wGA, and 60 at ≤ 32 wGA; 28 infants had a CHD. At hospital discharge, 9 of the 12 IBHQ mean scores were above 40, indicating a marked impact on parents. Three months later, all mean scores were lower but 5 were still greater than 40. At discharge, the length of hospitalization had a significant effect on IBHQ worries and distress, fear for future, guilt and impact on daily organization scores (p Conclusions Bronchiolitis hospitalization has conspicuous emotional, physical and organizational consequences on parents and siblings, which persist 3 months after hospital discharge. The main drivers of the impact were length of hospital stay and parents’ educational level, while infants’ gestational age or the presence of a CHD had little influence.

  1. Role of nitric oxide in experimental obliterative bronchiolitis (chronic rejection) in the rat.

    OpenAIRE

    Kallio, E A; Koskinen, P K; Aavik, E; Vaali, K; Lemstöm, K B

    1997-01-01

    The role of nitric oxide in obliterative bronchiolitis development, i.e., chronic rejection, was investigated in the heterotopic rat tracheal allograft model. An increase in the intragraft inducible nitric oxide synthase (iNOS) mRNA and mononuclear inflammatory cell iNOS immunoreactivity was demonstrated during progressive loss of respiratory epithelium and airway occlusion in nontreated allografts compared to syngeneic grafts. In nontreated allografts, however, intragraft nitric oxide produc...

  2. Epinephrine Improves the Efficacy of Nebulized Hypertonic Saline in Moderate Bronchiolitis: A Randomised Clinical Trial.

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    J Carlos Flores-González

    Full Text Available There is no evidence that the epinephrine-3% hypertonic saline combination is more effective than 3% hypertonic saline alone for treating infants hospitalized with acute bronchiolitis. We evaluated the efficacy of nebulized epinephrine in 3% hypertonic saline.We performed a randomized, double-blind, placebo-controlled clinical trial in 208 infants hospitalized with acute moderate bronchiolitis. Infants were randomly assigned to receive nebulized 3% hypertonic saline with either 3 mL of epinephrine or 3 mL of placebo, administered every four hours. The primary outcome measure was the length of hospital stay.A total of 185 infants were analyzed: 94 in the epinephrine plus 3% hypertonic saline group and 91 in the placebo plus 3% hypertonic saline group. Baseline demographic and clinical characteristics were similar in both groups. Length of hospital stay was significantly reduced in the epinephrine group as compared with the placebo group (3.94 ±1.88 days vs. 4.82 ±2.30 days, P = 0.011. Disease severity also decreased significantly earlier in the epinephrine group (P = 0.029 and P = 0.036 on days 3 and 5, respectively.In our setting, nebulized epinephrine in 3% hypertonic saline significantly shortens hospital stay in hospitalized infants with acute moderate bronchiolitis compared to 3% hypertonic saline alone, and improves the clinical scores of severity from the third day of treatment, but not before.EudraCT 2009-016042-57.

  3. Acute viral bronchiolitis in children- a very common condition with few therapeutic options.

    Science.gov (United States)

    Wainwright, Claire

    2010-03-01

    Acute viral bronchiolitis remains a cause of substantial morbidity and health care costs in young infants. It is the most common lower respiratory tract condition and most common reason for admission to hospital in infants. Many respiratory viruses have been associated with acute viral bronchiolitis although respiratory syncytial virus (RSV) remains the most frequently identified virus. Most infants have a mild self limiting illness while others have more severe illness and require hospital admission and some will need ventilatory support. Differences in innate immune function in response to the respiratory viral insult as well as differences in the geometry of the airways may explain some of the variability in clinical pattern. Young age and history of prematurity remain the most important risk factors although male gender, indigenous status, exposure to tobacco smoke, poor socioeconomic factors and associated co-morbidities such as chronic lung disease and congenital heart disease increase the risks of more severe illness. Supportive therapy remains the major treatment option as no specific treatments to date have been shown to provide clinically important benefits except for inhaled hypertonic saline. Prophylaxis of high risk infants with palivizumab should be considered although the cost effectiveness is still unclear. Many questions remain regarding optimal management approaches for infants requiring hospitalisation with bronchiolitis including use of nasogastric feeding, the optimal role of supplemental oxygen, optimal use of hypertonic saline and the role of combinations of therapies, the use of heliox or modern physiotherapy approaches.

  4. Rib fractures after chest physiotherapy for bronchiolitis or pneumonia in infants

    Energy Technology Data Exchange (ETDEWEB)

    Chalumeau, Martin [Service de Pneumologie et d' Allergologie Pediatriques, Hopital Necker-Enfants Malades, Paris (France); Service de Pediatrie, Hopital Saint-Vincent-de-Paul, Paris (France); Foix-l' Helias, Laurence; Scheinmann, Pierre; Zuani, Pierre [Service de Pneumologie et d' Allergologie Pediatriques, Hopital Necker-Enfants Malades, Paris (France); Gendrel, Dominique [Service de Pediatrie, Hopital Saint-Vincent-de-Paul, Paris (France); Ducou-le-Pointe, Hubert [Service de Radiologie, Hopital d' Enfants Armand-Trousseau, Avenue du Docteur Arnold Netter, 75571 Paris Cedex 12 (France)

    2002-09-01

    Heading AbstractBackground. The reported causes of rib fractures in infants are: child abuse, accidental injury, cardiopulmonary resuscitation, bone fragility, birth trauma and severe cough.Objective. To report chest physiotherapy (CPT) as a new cause of rib fractures in five infants.Materials and methods. We retrospectively identified all infants with rib fractures after CPT for bronchiolitis or pneumonia over a 4-year period in two paediatric and one paediatric radiology units in three university hospitals in Paris.Results. Five boys were identified. Their median age was 3 months. None had any other potential cause of rib fractures. The indication for CPT was bronchiolitis in four cases and pneumonia in one. The median number of rib fractures was four (range 1-5). Fractures were located between the 3rd and 8th ribs; they were lateral in four patients and posterior in one; they were unilateral in four patients and bilateral in one. Evolution was favourable in all cases. The prevalence of rib fractures after CPT during the study period was estimated at 1 in 1,000 infants hospitalised for bronchiolitis or pneumonia.Conclusions. CPT should be considered a potential, but very rare cause of rib fractures in infants. It can be of clinical relevance when rib fractures are the only feature suggestive of child abuse. (orig.)

  5. The Use of Albuterol in Young Infants Hospitalized with Acute RSV Bronchiolitis

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    Michael T. Del Vecchio

    2012-01-01

    Full Text Available Objective. To evaluate the effects of albuterol use in young infants admitted with respiratory syncytial virus (RSV bronchiolitis with regards to length of time on supplemental oxygen and length of stay (LOS. To consider the possibility that albuterol use may increase the need for supplemental oxygen and increase LOS. Design, Setting, and Participants. Full-term infants between the ages of 11 days and 90 days (=316 were included in this retrospective study. Infants included were hospitalized with a diagnosis of RSV bronchiolitis at a university-affiliated children’s hospital. Results. In 4 of 5 severity groups, patients who received albuterol required more time on supplemental oxygen and had longer LOS. The differences only reached statistical significance in one of the severity groups in regards to LOS. Conclusions. The use of albuterol does not appear to be useful in the treatment of young infants with RSV bronchiolitis and may actually be harmful, in regards to increased supplemental oxygen need.

  6. Altered cardiac rhythm in infants with bronchiolitis and respiratory syncytial virus infection

    Directory of Open Access Journals (Sweden)

    Galeone Carlotta

    2010-10-01

    Full Text Available Abstract Background Although the most frequent extra-pulmonary manifestations of respiratory syncytial virus (RSV infection involve the cardiovascular system, no data regarding heart function in infants with bronchiolitis associated with RSV infection have yet been systematically collected. The aim of this study was to verify the real frequency of heart involvement in patients with bronchiolitis associated with RSV infection, and whether infants with mild or moderate disease also risk heart malfunction. Methods A total of 69 otherwise healthy infants aged 1-12 months with bronchiolitis hospitalised in standard wards were enrolled. Pernasal flocked swabs were performed to collect specimens for the detection of RSV by real-time polymerase chain reaction, and a blood sample was drawn to assess troponin I concentrations. On the day of admission, all of the infants underwent 24-hour Holter ECG monitoring and a complete heart evaluation with echocardiography. Patients were re-evaluated by investigators blinded to the etiological and cardiac findings four weeks after enrolment. Results Regardless of their clinical presentation, sinoatrial blocks were identified in 26/34 RSV-positive patients (76.5% and 1/35 RSV-negative patients (2.9% (p Conclusions RSV seems associated with sinoatrial blocks and transient rhythm alterations even when the related respiratory problems are mild or moderate. Further studies are needed to clarify the mechanisms of these rhythm problems and whether they remain asymptomatic and transient even in presence of severe respiratory involvement or chronic underlying disease.

  7. Chronic rejection of a lung transplant is characterized by a profile of specific autoantibodies

    DEFF Research Database (Denmark)

    Hagedorn, Peter; Burton, Christopher M.; Carlsen, Jørn;

    2010-01-01

    Obliterative bronchiolitis (OB) continues to be the major limitation to long-term survival after lung transplantation. The specific aetiology and pathogenesis of OB are not well understood. To explore the role of autoreactivity in OB, we spotted 751 different self molecules onto glass slides......, and used these antigen microarrays to profile 48 human serum samples for immunoglobulin G (IgG) and IgM autoantibodies; 27 patients showed no or mild bronchiolitis obliterans syndrome (BOS; a clinical correlate of OB) and 15 patients showed medium to severe BOS. We now report that these BOS grades could...

  8. The Effect(s of Vitamin A on Persistent Wheezing after Bronchiolitis in Infants Aged 1-12 Months

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    S Sharafian

    2015-04-01

    Full Text Available Background & aim: Viral bronchiolitis is one of the most common causeS of lower respiratory tract infection and almost responsible for 1-3% of hospitalization among children under one year of age. Post bronchiolitis wheezing is the main risk factor for childhood asthma, and its control can decrease incidence of the disease in future. The purpose of this study was to investigate the effect of vitamin A on persistent wheezing after bronchiolitis. Methods: The present double blind clinical trial was conducted on 84 patients aged 1 to 12 months of age who were admitted in Imam Sajad Hospital of Yasuj from October 2012 to 2013. After viral bronchiolitis diagnosis of patients with history and physical exam, they were divided into two similar groups of control and case randomly. Control group received cold and wet nebulized oxygen and bronchodilator and case group received the same protocol together with 5000 IU/kg Vitamin A intramascularlly. Both groups were examined by the same physician before, one and two weeks after treatment and quality and severity of wheezing was recorded. Data were analyzed by statistical student T – test and chi square test. Results: Intensity and quality of wheezing was similar in both groups before the intervention(85/0 = p=0.858 whereas a significant reduction was observed in the severity of wheezing in the group receiving vitamin A compared with the control group (05/0> p<0.05. Conclusion: A significant decrease was observed in persistent wheezing after intramascular administration of a dose of vitamin A in patients requiring hospitalization due to viral bronchiolitis. Administrating one dose vitamin A intramuscularly in patients who need hospitalization due to bronchiolitis, may decrease post bronchiolitis and persistent wheezing.

  9. Predicting the severity of acute bronchiolitis in infants: should we use a clinical score or a biomarker?

    Science.gov (United States)

    Amat, Flore; Henquell, Cécile; Verdan, Matthieu; Roszyk, Laurence; Mulliez, Aurélien; Labbé, André

    2014-11-01

    Krebs von den Lungen 6 antigen (KL-6) has been shown to be a useful biomarker of the severity of Respiratory syncytial virus bronchiolitis. To assess the correlation between the clinical severity of acute bronchiolitis, serum KL-6, and the causative viruses, 222 infants with acute bronchiolitis presenting at the Pediatric Emergency Department of Estaing University Hospital, Clermont-Ferrand, France, were prospectively enrolled from October 2011 to May 2012. Disease severity was assessed with a score calculated from oxygen saturation, respiratory rate, and respiratory effort. A nasopharyngeal aspirate was collected to screen for a panel of 20 respiratory viruses. Serum was assessed and compared with a control group of 38 bronchiolitis-free infants. No significant difference in KL-6 levels was found between the children with bronchiolitis (mean 231 IU/mL ± 106) and those without (230 IU/mL ± 102), or between children who were hospitalized or not, or between the types of virus. No correlation was found between serum KL-6 levels and the disease severity score. The absence of Human Rhinovirus was a predictive factor for hospitalization (OR 3.4 [1.4-7.9]; P = 0.006). Older age and a higher oxygen saturation were protective factors (OR 0.65[0.55-0.77]; P bronchiolitis for the first time, clinical outcome depends more on the adaptive capacities of the host than on epithelial dysfunction intensity. Many of the features of bronchiolitis are affected by underlying disease and by treatment.

  10. Pooled Sequencing of Candidate Genes Implicates Rare Variants in the Development of Asthma Following Severe RSV Bronchiolitis in Infancy

    Science.gov (United States)

    Torgerson, Dara G.; Giri, Tusar; Druley, Todd E.; Zheng, Jie; Huntsman, Scott; Seibold, Max A.; Young, Andrew L.; Schweiger, Toni; Yin-Declue, Huiqing; Sajol, Geneline D.; Schechtman, Kenneth B; Hernandez, Ryan D.; Randolph, Adrienne G.; Bacharier, Leonard B.; Castro, Mario

    2015-01-01

    Severe infection with respiratory syncytial virus (RSV) during infancy is strongly associated with the development of asthma. To identify genetic variation that contributes to asthma following severe RSV bronchiolitis during infancy, we sequenced the coding exons of 131 asthma candidate genes in 182 European and African American children with severe RSV bronchiolitis in infancy using anonymous pools for variant discovery, and then directly genotyped a set of 190 nonsynonymous variants. Association testing was performed for physician-diagnosed asthma before the 7th birthday (asthma) using genotypes from 6,500 individuals from the Exome Sequencing Project (ESP) as controls to gain statistical power. In addition, among patients with severe RSV bronchiolitis during infancy, we examined genetic associations with asthma, active asthma, persistent wheeze, and bronchial hyperreactivity (methacholine PC20) at age 6 years. We identified four rare nonsynonymous variants that were significantly associated with asthma following severe RSV bronchiolitis, including single variants in ADRB2, FLG and NCAM1 in European Americans (p = 4.6x10-4, 1.9x10-13 and 5.0x10-5, respectively), and NOS1 in African Americans (p = 2.3x10-11). One of the variants was a highly functional nonsynonymous variant in ADRB2 (rs1800888), which was also nominally associated with asthma (p = 0.027) and active asthma (p = 0.013) among European Americans with severe RSV bronchiolitis without including the ESP. Our results suggest that rare nonsynonymous variants contribute to the development of asthma following severe RSV bronchiolitis in infancy, notably in ADRB2. Additional studies are required to explore the role of rare variants in the etiology of asthma and asthma-related traits following severe RSV bronchiolitis. PMID:26587832

  11. Pooled Sequencing of Candidate Genes Implicates Rare Variants in the Development of Asthma Following Severe RSV Bronchiolitis in Infancy.

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    Dara G Torgerson

    Full Text Available Severe infection with respiratory syncytial virus (RSV during infancy is strongly associated with the development of asthma. To identify genetic variation that contributes to asthma following severe RSV bronchiolitis during infancy, we sequenced the coding exons of 131 asthma candidate genes in 182 European and African American children with severe RSV bronchiolitis in infancy using anonymous pools for variant discovery, and then directly genotyped a set of 190 nonsynonymous variants. Association testing was performed for physician-diagnosed asthma before the 7th birthday (asthma using genotypes from 6,500 individuals from the Exome Sequencing Project (ESP as controls to gain statistical power. In addition, among patients with severe RSV bronchiolitis during infancy, we examined genetic associations with asthma, active asthma, persistent wheeze, and bronchial hyperreactivity (methacholine PC20 at age 6 years. We identified four rare nonsynonymous variants that were significantly associated with asthma following severe RSV bronchiolitis, including single variants in ADRB2, FLG and NCAM1 in European Americans (p = 4.6x10-4, 1.9x10-13 and 5.0x10-5, respectively, and NOS1 in African Americans (p = 2.3x10-11. One of the variants was a highly functional nonsynonymous variant in ADRB2 (rs1800888, which was also nominally associated with asthma (p = 0.027 and active asthma (p = 0.013 among European Americans with severe RSV bronchiolitis without including the ESP. Our results suggest that rare nonsynonymous variants contribute to the development of asthma following severe RSV bronchiolitis in infancy, notably in ADRB2. Additional studies are required to explore the role of rare variants in the etiology of asthma and asthma-related traits following severe RSV bronchiolitis.

  12. Chronic Ulcers in Thromboangiitis Obliterans (Buerger's Disease: Updating Epidemiology, Physiopathology, and Bosentan—A Novel Strategy of Therapy

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    Ignacio López de Maturana

    2013-01-01

    Full Text Available Thromboangiitis obliterans (TAO or Buerger's disease is associated with both distal ulcers in the extremities and the possibility of amputation. The only treatment that has been shown to be effective in TAO is complete abstention from smoking. In spite of this, the disease progresses in up to 30 percent of cases and finally results in limb amputation. Only a few pharmacological and surgical options are available to date to improve healing ulcers in TAO. The efficacy of prostaglandin analogues is controversial. This paper summarizes the current evidence for medical treatment with bosentan in chronic ulcers in TAO patients. These available data up to date allow us to conclude that the beneficial effects of bosentan on improving endothelial function, inflammatory processes, and selective vasodilatation of damaged vessels result in a clinical enhancement regarding healing and preventive digital ulcers in such patients. In any case, these promising findings have to be confirmed with larger randomised trials.

  13. Treatment of urethral strictures in balanitis xerotica obliterans (BXO using circular buccal mucosal meatoplasy: Experience of 15 cases

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    Abdulmuttalip Simsek

    2014-03-01

    Full Text Available Objectives: Balanitis xerotica obliterans (BXO related strictures involving the external urethral meatus. We reviewed our result with the use of circular mucosal graft in the reconstruction of strictures. Methods: Between March 1997 and January 2012, 15 patients underwent circular buccal mucosal urethroplasy for BXO related anterior urethral strictures. Urethral catheter was removed within 2 weeks. Follow-up included patient symptoms assessment, cosmetic outcome and uroflowmetry. Results: Median follow-up was 20.5 months (range 4 to 96. Mean postoperative peak urinary flow rate obtained 1 month after catheter removal was 22.4 ml per second. All patients had a normal meatus and none had recurrent stricture, chordee or erectile dysfunction. A functional and cosmetic outcome was achieved in 100% of the patients. Conclusions: Circular mucosal graft technique for treatment of meatal strictures is an efficient method for the restoration of a functional and cosmetic penis.

  14. The effect of high flow nasal cannula therapy on the work of breathing in infants with bronchiolitis.

    Science.gov (United States)

    Pham, Trang M T; O'Malley, Lee; Mayfield, Sara; Martin, Simon; Schibler, Andreas

    2015-07-01

    The main physiological impact of high flow nasal cannula (HFNC) therapy is presumed to be a decrease in work of breathing (WOB). To assess this, diaphragmatic electrical activity and esophageal pressure changes were measured off then on HFNC delivered at 2 L/kg/min, in 14 infants with bronchiolitis and 14 cardiac infants. Electrical activity of the diaphragm (Edi) was measured using an Edi catheter with calculations of signal peak (EdiMAX ) and amplitude (EdiAMPL ). Pressure-rate and pressure-time products (PRP, PTP) were calculated from analyses of esophageal pressure. Changes in end-expiratory lung volume were measured using respiratory inductance plethysmography (RIPEEL ). The EdiMAX and EdiAMPL were significantly higher in infants with bronchiolitis than in cardiac infants (P bronchiolitis group, both were significantly reduced between HFNC states from 27.9 µV [20.4, 35.4] to 21.0 µV [14.8, 27.2] and from 25.1 µV [18.0, 32.2] to 19.2 µV [13.3, 25.1], respectively (mean, 95% CI, P bronchiolitis only (P bronchiolitis. A similar effect was demonstrated in cardiac infants, a group without signs of airway-obstruction.

  15. Study of montelukast for the treatment of respiratory symptoms of post-respiratory syncytial virus bronchiolitis in children

    DEFF Research Database (Denmark)

    Bisgaard, Hans; Flores-Nunez, Alejandro; Goh, Anne;

    2008-01-01

    (RSV) bronchiolitic respiratory symptoms. OBJECTIVES: To evaluate the efficacy and safety of montelukast, 4 and 8 mg, in treating recurrent respiratory symptoms of post-RSV bronchiolitis in children in a large, multicenter study. METHODS: This was a double-blind study of 3- to 24-month-old children who...... had been hospitalized for a first or second episode of physician-diagnosed RSV bronchiolitis and who tested positive for RSV. Patients (n = 979) were randomized to placebo or to montelukast at 4 or 8 mg/day for 4 weeks (period I) and 20 weeks (period II). The primary end point was percentage symptom.......7 (0.0, 11.3) for montelukast (4 mg) minus placebo and 5.9 (0.1, 11.7) for montelukast (8 mg) minus placebo. CONCLUSIONS: In this study, montelukast did not improve respiratory symptoms of post-RSV bronchiolitis in children....

  16. [Very rare and life-threatening complications of bocavirus bronchiolitis: pneumomediastinum and bilateral pneumothorax].

    Science.gov (United States)

    Yeşilbaş, Osman; Kıhtır, Hasan Serdar; Talip Petmezci, Mey; Balkaya, Seda; Hatipoğlu, Nevin; Meşe, Sevim; Şevketoğlu, Esra

    2016-01-01

    Human bocavirus (HBoV), that was first identified in 2005 and classified in Parvoviridae family, is a small, non-enveloped, single-stranded DNA virus, responsible for upper and lower respiratory tract infections, especially in young children. Although HBoV generally causes self-limited influenza-like illness, it may also lead to pneumonia, bronchiolitis, croup and asthma attacks. In this report, a case of acute bronchiolitis complicated with pneumomediastinum and bilateral pneumothorax caused by HBoV has been presented. A three-year-old boy was referred to our pediatric intensive care unit with a two day history of fever, tachypnea, hypoxia and respiratory failure. On auscultation, there were widespread expiratory wheezing and inspiratory crackles. The chest radiography yielded paracardiac infiltration and air trapping on the right lung and infiltration on the left lung. The patient had leukocytosis and elevated C-reactive protein level. On the second day of admission, respiratory distress worsened and chest radiography revealed right pneumothorax and subcutaneous emphysema in bilateral cervical region and left chest wall. He was intubated because of respiratory failure. In the thorax computed tomography, pneumomediastinum and bilateral pneumothorax were detected and right chest tube was inserted. Repetitive blood and tracheal aspirate cultures were negative. A nasopharyngeal swab sample was analyzed by multiplex real-time polymerase chain reaction method with the use of viral respiratory panel (FTD(®) Respiratory Pathogens 21 Kit, Fast-Track Diagnostics), and positive result was detected for only HBoV. On the ninth day of admission, pneumomediastinum and bilateral pneumothorax improved completely and he was discharged with cure. In conclusion, HBoV bronchiolitis may progress rare but severe complications, it should be kept in mind as an etiological agent of the respiratory tract infections especially children younger than five years old.

  17. Physical therapy for airway clearance improves cardiac autonomic modulation in children with acute bronchiolitis

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    Cynthia P. Jacinto

    2013-12-01

    Full Text Available BACKGROUND: The effects of physical therapy on heart rate variability (HRV, especially in children, are still inconclusive. OBJECTIVE: We investigated the effects of conventional physical therapy (CPT for airway clearance and nasotracheal suction on the HRV of pediatric patients with acute bronchiolitis. METHOD: 24 children were divided into two groups: control group (CG, n=12 without respiratory diseases and acute bronchiolitis group (BG, n=12. The heart rate was recorded in the BG at four different moments: basal recording (30 minutes, 5 minutes after the CPT (10 minutes, 5 minutes after nasotracheal suction (10 minutes, and 40 minutes after nasotracheal suction (30 minutes. The CG was subjected to the same protocol, except for nasotracheal suction. To assess the HRV, we used spectrum analysis, which decomposes the heart rate oscillations into frequency bands: low frequency (LF=0.04-0.15Hz, which corresponds mainly to sympathetic modulation; and high frequency (HF=0.15-1.2Hz, corresponding to vagal modulation. RESULTS: Under baseline conditions, the BG showed higher values in LF oscillations, lower values in HF oscillations, and increased LF/HF ratio when compared to the CG. After CPT, the values for HRV in the BG were similar to those observed in the CG during basal recording. Five minutes after nasotracheal suction, the BG showed a decrease in LF and HF oscillations; however, after 40 minutes, the values were similar to those observed after application of CPT. CONCLUSIONS: The CPT and nasotracheal suction, both used for airway clearance, promote improvement in autonomic modulation of HRV in children with acute bronchiolitis.

  18. Interferon gamma Profile in Egyptian Infants with Respiratory Syncytial Virus bronchiolitis

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    Maha E. Omran1, Mohamed AE. Fahmy2, Manal M. Zaher3

    2008-03-01

    Full Text Available Viral bronchiolitis is one of the leading causes for hospitalization of infants in the world and causes an estimated one million deaths per year worldwide. Respiratory syncytial virus (RSV is associated with the majority of cases. During the last few years it has become increasingly clear that T cells contribute to the abnormal regulation of the immune response in viral diseases since these cells are potent producers of a large variety of cytokines. It was reported that cord blood interferon gamma (IFN- responses were inversely related to the frequency of viral respiratory infections. To ascertain whether RSV infection promotes a different IFN- profile to that induced by other respiratory infections, thirty-two infants with severe bronchiolitis were enrolled in this study. RSV-IgM was detected by immunofluorescent technique in 23/32 patients. Serum IFN- levels in RSV+ infants were significantly lower than RSV- (p < 0.001. In vitro stimulation of peripheral blood cells followed by flow cytometery combined with intracellular cytokine staining revealed that both CD4+ and CD8+ cells contribute in IFN- production. The percentage of CD4+ cells producing IFN- in RSV+ was significantly lower (P < 0.05 than those in RSV-, while the difference in % of CD8+ between RSV+ and RSV- was non significant. Our conclusions are that RSV infection is associated with severe decreased IFN- responses. Both CD4+ and CD8+ cells contribute in IFN- production during RSV bronchiolitis. RSV infection promotes a different IFN- profile from that induced by other respiratory infections.

  19. Successful Colchicine Therapy in a Patient With Follicular Bronchiolitis Presumed to Be Asthma.

    Science.gov (United States)

    Goksel, Ozlem; Nart, Deniz; Ergonul, Ayse Gul; Sever, Fidan; Goksel, Tuncay

    2015-07-01

    Follicular bronchiolitis (FB) is a rare small-airway pathology that is associated mainly with connective tissue diseases. This case report presents a new, diagnosed, different airway disease in a non-smoker with rheumatoid arthritis in remission who was treated for presumed asthma, but was not controlled. She was ultimately diagnosed with FB after video-assisted thoracoscopic surgery. The clinical findings of FB were controlled successfully by colchicine after she did not respond to systemic steroid therapy. This is the first case report of FB associated with rheumatoid arthritis that responded to colchicine.

  20. Respiratory bronchiolitis: radiographic and CT findings in a pathologically proven case

    Energy Technology Data Exchange (ETDEWEB)

    Essadki, O.; Chartrand-Lefebvre, C.; Grenier, P. [Department of Radiology, Pitie-Salpetrire Hospital, Paris (France); Briere, J. [Department of Pathology, Laennec Hospital, Paris (France)

    1998-12-01

    A small number of cases of cigarette-smoking-associated respiratory bronchiolitis (RB) with positive findings on the chest radiograph have been reported in the literature. High-resolution computed tomography (HRCT) findings are available in even fewer cases. We describe the case of an asymptomatic female smoker presenting with a reticulomicronodular infiltrate on a routine chest radiograph. High-resolution CT was characterized by ground-glass opacities and centrilobular micronodules with an upper lobe predominance. Surgical biopsy revealed peribronchiolar lesions, with accumulation of brown pigmented macrophages in the lumen of alveolar and bronchiolar lumen, consistent with the pathologic diagnosis of RB. (orig.) With 3 figs., 12 refs.

  1. Lack of association between viral load and severity of acute bronchiolitis in infants

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    Ana Paula Duarte de Souza

    Full Text Available ABSTRACT Objective: To investigate the correlation between respiratory syncytial viral load and length of hospitalization in infants with acute wheezing episodes. Methods: This was a two-year, cross-sectional study of infants ≤ 12 months of age with bronchiolitis at the time of admission to a tertiary hospital. For the identification of respiratory viruses, nasopharyngeal secretions were collected. Samples were analyzed (throughout the study period by direct immunofluorescence and (in the second year of the study by quantitative real-time PCR. We screened for three human viruses: rhinovirus, respiratory syncytial virus, and metapneumovirus. Results: Of 110 samples evaluated by direct immunofluorescence, 56 (50.9% were positive for a single virus, and 16 (14.5% were positive for two or more viruses. Among those 72 samples, the most prevalent virus was respiratory syncytial virus, followed by influenza. Of 56 samples evaluated by quantitative real-time PCR, 24 (42.8% were positive for a single virus, and 1 (1.7% was positive for two viruses. Among those 25 samples, the most prevalent virus was again respiratory syncytial virus, followed by human rhinovirus. Coinfection did not influence the length of the hospital stay or other outcome s. In addition, there was no association between respiratory syncytial virus load and the length of hospitalization. Conclusions: Neither coinfection nor respiratory syncytial viral load appears to influence the outcomes of acute bronchiolitis in infants.

  2. TLR4 genotype and environmental LPS mediate RSV bronchiolitis through Th2 polarization

    Science.gov (United States)

    Caballero, Mauricio T.; Serra, M. Elina; Acosta, Patricio L.; Marzec, Jacqui; Gibbons, Luz; Salim, Maximiliano; Rodriguez, Andrea; Reynaldi, Andrea; Garcia, Alejandro; Bado, Daniela; Buchholz, Ursula J.; Hijano, Diego R.; Coviello, Silvina; Newcomb, Dawn; Bellabarba, Miguel; Ferolla, Fausto M.; Libster, Romina; Berenstein, Ada; Siniawaski, Susana; Blumetti, Valeria; Echavarria, Marcela; Pinto, Leonardo; Lawrence, Andrea; Ossorio, M. Fabiana; Grosman, Arnoldo; Mateu, Cecilia G.; Bayle, Carola; Dericco, Alejandra; Pellegrini, Mariana; Igarza, Ignacio; Repetto, Horacio A.; Grimaldi, Luciano Alva; Gudapati, Prathyusha; Polack, Norberto R.; Althabe, Fernando; Shi, Min; Ferrero, Fernando; Bergel, Eduardo; Stein, Renato T.; Peebles, R. Stokes; Boothby, Mark; Kleeberger, Steven R.; Polack, Fernando P.

    2015-01-01

    While 30%–70% of RSV-infected infants develop bronchiolitis, 2% require hospitalization. It is not clear why disease severity differs among healthy, full-term infants; however, virus titers, inflammation, and Th2 bias are proposed explanations. While TLR4 is associated with these disease phenotypes, the role of this receptor in respiratory syncytial virus (RSV) pathogenesis is controversial. Here, we evaluated the interaction between TLR4 and environmental factors in RSV disease and defined the immune mediators associated with severe illness. Two independent populations of infants with RSV bronchiolitis revealed that the severity of RSV infection is determined by the TLR4 genotype of the individual and by environmental exposure to LPS. RSV-infected infants with severe disease exhibited a high GATA3/T-bet ratio, which manifested as a high IL-4/IFN-γ ratio in respiratory secretions. The IL-4/IFN-γ ratio present in infants with severe RSV is indicative of Th2 polarization. Murine models of RSV infection confirmed that LPS exposure, Tlr4 genotype, and Th2 polarization influence disease phenotypes. Together, the results of this study identify environmental and genetic factors that influence RSV pathogenesis and reveal that a high IL-4/IFN-γ ratio is associated with severe disease. Moreover, these molecules should be explored as potential targets for therapeutic intervention. PMID:25555213

  3. Lack of association between viral load and severity of acute bronchiolitis in infants

    Science.gov (United States)

    de Souza, Ana Paula Duarte; Leitão, Lidiane Alves de Azeredo; Luisi, Fernanda; Souza, Rodrigo Godinho; Coutinho, Sandra Eugênia; da Silva, Jaqueline Ramos; Mattiello, Rita; Pitrez, Paulo Márcio Condessa; Stein, Renato Tetelbom; Pinto, Leonardo Araújo

    2016-01-01

    ABSTRACT Objective: To investigate the correlation between respiratory syncytial viral load and length of hospitalization in infants with acute wheezing episodes. Methods: This was a two-year, cross-sectional study of infants ≤ 12 months of age with bronchiolitis at the time of admission to a tertiary hospital. For the identification of respiratory viruses, nasopharyngeal secretions were collected. Samples were analyzed (throughout the study period) by direct immunofluorescence and (in the second year of the study) by quantitative real-time PCR. We screened for three human viruses: rhinovirus, respiratory syncytial virus, and metapneumovirus. Results: Of 110 samples evaluated by direct immunofluorescence, 56 (50.9%) were positive for a single virus, and 16 (14.5%) were positive for two or more viruses. Among those 72 samples, the most prevalent virus was respiratory syncytial virus, followed by influenza. Of 56 samples evaluated by quantitative real-time PCR, 24 (42.8%) were positive for a single virus, and 1 (1.7%) was positive for two viruses. Among those 25 samples, the most prevalent virus was again respiratory syncytial virus, followed by human rhinovirus. Coinfection did not influence the length of the hospital stay or other outcome s. In addition, there was no association between respiratory syncytial virus load and the length of hospitalization. Conclusions: Neither coinfection nor respiratory syncytial viral load appears to influence the outcomes of acute bronchiolitis in infants. PMID:27832233

  4. Computerized acoustic assessment of treatment efficacy of nebulized epinephrine and albuterol in RSV bronchiolitis

    Directory of Open Access Journals (Sweden)

    Talmon Gil

    2007-06-01

    Full Text Available Abstract Aim We evaluated the use of computerized quantification of wheezing and crackles compared to a clinical score in assessing the effect of inhaled albuterol or inhaled epinephrine in infants with RSV bronchiolitis. Methods Computerized lung sounds analysis with quantification of wheezing and crackles and a clinical score were used during a double blind, randomized, controlled nebulized treatment pilot study. Infants were randomized to receive a single dose of 1 mgr nebulized l-epinephrine or 2.5 mgr nebulized albuterol. Computerized quantification of wheezing and crackles (PulmoTrack® and a clinical score were performed prior to, 10 minutes post and 30 minutes post treatment. Results were analyzed with Student's t-test for independent samples, Mann-Whitney U test and Wilcoxon test. Results 15 children received albuterol, 12 received epinephrine. The groups were identical at baseline. Satisfactory lung sounds recording and analysis was achieved in all subjects. There was no significant change in objective quantification of wheezes and crackles or in the total clinical scores either within the groups or between the groups. There was also no difference in oxygen saturation and respiratory distress. Conclusion Computerized lung sound analysis is feasible in young infants with RSV bronchiolitis and provides a non-invasive, quantitative measure of wheezing and crackles in these infants. Trial registration number: ClinicalTrials.gov NCT00361452

  5. Nutritional status, metabolic state and nutrient intake in children with bronchiolitis.

    Science.gov (United States)

    De Cosmi, V; Mehta, N M; Boccazzi, A; Milani, G P; Esposito, S; Bedogni, G; Agostoni, C

    2017-05-01

    Nutrition has a coadjuvant role in the management of children with acute diseases. We aimed to examine nutritional status, macronutrient requirements and actual macronutrient delivery in bronchiolitis. The nutritional status was classified according to WHO criteria and resting energy expenditure (MREE) was measured using an indirect calorimeter. Bland-Altman analysis was used to examine the agreement between MREE and estimated energy expenditure (EEE) with standard equations. Based on the ratio MREE/EEE in relation to Schofield equation on admission, we defined the subjects' metabolic status. A total of 35 patients were enrolled and 46% were malnourished on admission, and 25.8% were hypermetabolic, 37.1% hypometabolic and 37.1% normometabolic. We performed a 24-h recall in 10 children and 80% were overfed (AEI: MREE >120%). Mean bias (limits of agreement) with MREE was 8.9 (-73.9 to 91.8%) for Schofield; 61.0 (-41 to 163%) for Harris-Benedict; and 9.9 (-74.4 to 94.2%) for FAO-WHO equation. Metabolism of infants with bronchiolitis is not accurately estimated by equations.

  6. The Association between Polymorphism of CARD8 rs2043211 and Susceptibility to Arteriosclerosis Obliterans in Chinese Han Male Population

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    Kun Zhang

    2017-01-01

    Full Text Available Background and aims: Cholesterol crystals have been shown to cause inflammation. As a response to cholesterol crystal accumulation, the NLRP3 inflammasome is activated to produce IL-1β which eventually leads to atherosclerotic lesions. As a part of innate immunity, CARD8 is involved in the modulation of above mentioned inflammatory activities. The primary objective of this study was to investigate the association between polymorphism of CARD8 rs2043211 and susceptibility to arteriosclerosis obliterans (ASO in Chinese Han male population. Methods: 758 male arteriosclerosis obliterans patients and 793 male controls were genotyped for rs2043211 with the TaqMan allele assays. Fasting blood-glucose (FBG, total cholesterol (TC, triglycerides (TG, urea nitrogen, creatinine, Serum uric acid, high density lipoprotein, low density lipoprotein, ALT, AST, and IL-1β in the blood were detected for all subjects. Clinical data were recorded to analyze the genotype-phenotype. Independent samples t-test was used to perform the comparisons between two groups. Odds ratios (ORs with 95% confidence intervals (CIs were calculated to measure the strength of relationship in the genotype distribution and allele frequencies between patients and controls. The analysis of variance was used for a genotype-phenotype analysis of the ASO patients. Results: The genotypic and allelic frequencies in the ASO group were significantly different from that in the control group (P = 0.014 by genotype, P = 0.003 by allele. Those carrying the genotype TT had a higher risk for ASO than those carrying the genotype AA (OR = 1.494, 95%CI1.131-1.974, P = 0.005.The difference was also significant after the adjustment for the history of smoking, TC, LDL, fasting blood glucose, systolic blood pressure and BMI(OR = 1.525, 95%CI1.158-2.009, P = 0.003. Conclusion: Our finding suggests that the polymorphism of CARD8 rs2043211 is probably associated with the development of ASO in Chinese Han male

  7. RESPIRATORY VIRAL-INFECTIONS AGGRAVATE AIRWAY DAMAGE CAUSED BY CHRONIC REJECTION IN RAT LUNG ALLOGRAFTS

    NARCIS (Netherlands)

    WINTER, JB; GOUW, ASH; GROEN, M; WILDEVUUR, C; PROP, J

    1994-01-01

    Airway damage resulting in bronchiolitis obliterans occurs frequently in patients after heart-lung and lung transplantation. Generally, chronic rejection is assumed to be the most important cause of bronchiolitis obliterans. However, viral infections might also be potential causes of airway damage a

  8. The role of TLR4 and CD14 polymorphisms in the pathogenesis of respiratory syncytial virus bronchiolitis in greek infants.

    Science.gov (United States)

    Goutaki, M; Haidopoulou, K; Pappa, S; Tsakiridis, P; Frydas, E; Eboriadou, M; Hatzistylianou, M

    2014-01-01

    Clinical manifestations of respiratory syncytial virus (RSV) infection vary from minimal disease to severe acute bronchiolitis. The structural complex of TLR4/CD14 participates in the virus recognition as a component of natural immune response. Genetic variations of TLR4/CD14 may explain great variations in disease severity. The aim of this study was to investigate the possible role of polymorphisms of TLR4, Asp299Gly and Thr399Ile and CD14, C-159T and C-550T in the development of RSV bronchiolitis. Our study included two groups of Greek infants and young children (A and B). Group A consisted of 50 infants ≤2 years of age hospitalised with bronchiolitis and group B of 99 previously healthy children aged 4-14 years (control group) with a free past medical history. RSV was identified by PCR of genetic material that was extracted from nasopharyngeal samples collected from all patients. Blood samples were used to extract DNA and by using the PCR-RFLP method we performed TLR4 and CD14 genotyping. We found no association between TLR4 polymorphisms (Asp299Gly and Thr399Ile) and the development of acute bronchiolitis. For CD14 polymorphisms, a positive association was found between the C-159T and the development of bronchiolitis (p=0.05) but not for the other loci. There were no differences detected in the frequencies of the four polymorphisms studied among infants with RSV and non-RSV bronchiolitis. It is concluded that protein CD14 may have a functional role in the viral conjunction to the structural complex TLR4/CD14. The association between the polymorphism C-159T and the manifestation of disease found in our study points out that the severity in the development of acute bronchiolitis is not specified exclusively by the pathogen, but the immune response of the host also plays a significant role. More extensive multicentric studies need to take place, in order to lead to safer conclusions.

  9. Noninvasive Transcutaneous Monitoring in Long-Term Follow-Up of Patients With Thromboangiitis Obliterans Treated With Intravenous Iloprost.

    Science.gov (United States)

    Melillo, Elio; Grigoratos, Chrysanthos; Sanctis, Francesco De; Spontoni, Paolo; Nuti, Marco; Dell'Omodarme, Matteo; Ferrari, Mauro; Balbarini, Alberto

    2015-07-01

    We evaluated the effectiveness of intravenous iloprost (IVI) in outpatients with thromboangiitis obliterans (TAO) and lower limb noninvasive transcutaneous monitoring (TCM) at follow-up (FU). Ten consecutive patients with TAO underwent IVI therapy. Transcutaneous oxygen (TcPo 2) and carbon dioxide (TcPco 2) determination and laser Doppler flowmetry (LDF) were performed before and after IVI at 3, 6, and 12 months of FU. Clinical response was positive in 7 patients, whereas 3 nonresponders underwent a second IVI cycle with 1 showing a late positive clinical response. After 12 months of FU, all patients were alive without amputations. Supine and dependent TcP2 levels significantly improved (P < .005). Hallux LDF values showed significant change with the maximal hyperemic test at 44°C (P < .005). Forefoot maximal hyperemic test at 44°C LDF (P < .005) and improved venous arterial reflex (P < .05) showed statistically significant time evolution. We demonstrated some degree of IVI effectiveness and evaluated TCM in patients with TAO.

  10. Composition of the inflammatory infiltrate in pediatric penile lichen sclerosus et atrophicus (balanitis xerotica obliterans): a prospective, comparative immunophenotyping study.

    Science.gov (United States)

    Hinchliffe, S A; Ciftci, A O; Khine, M M; Rickwood, A M; Ashwood, J; McGill, F; Clapham, E M; van Velzen, D

    1994-01-01

    Dermatopathological evaluation of pediatric preputial inflammatory disease rarely allows for specific diagnosis other than pediatric penile lichen sclerosus et atrophicus (balanitis xerotica obliterans, LSA/BXO). A prospective immunopathological study was performed on 20 consecutive, unselected, clinically and histopathologically confirmed LSA/BXO cases to determine the relative presence of T and B lymphocytes. There were seven cases with early stages of disease, eight with florid disease, and five with later stages of disease. Two ritual circumcision specimens and 12 specimens with non-LSA/BXO balanitis, collected during the same period, were used as controls. The infiltrate in LSA/BXO patients was wholly composed of T cells (positive with UCLH-1 antibody) in all cases. B cells (positive with L-26 antibody) were found only focally in small, discreet, easily recognizable (follicular or early follicle-like) aggregates, positioned slightly deeper than the band-like infiltrate of T cells. T cells were inconspicuous in 9 of the 12 control specimens. In the three other controls, T cells were much more obvious and these patients showed clinical features possibly suggestive of LSA/BXO in early, prediagnosable phases of development. We conclude that limited immunophenotyping may be a useful adjunct to diagnosis in pediatric cases in which only limited tissue is available or the disease may be more difficult to classify with confidence.

  11. Racemic epinephrine compared to salbutamol in hospitalized young children with bronchiolitis; a randomized controlled clinical trial [ISRCTN46561076

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    LeBlanc John C

    2005-05-01

    Full Text Available Abstract Background Bronchiolitis is the most common cause of lower respiratory tract illness in infancy, and hospital admission rates appear to be increasing in Canada and the United States. Inhaled beta agonists offer only modest short-term improvement. Trials of racemic epinephrine have shown conflicting results. We sought to determine if administration of racemic epinephrine during hospital stay for bronchiolitis improved respiratory distress, was safe, and shortened length of stay. Methods The study was a randomized, double-blind controlled trial of aerosolized racemic epinephrine compared to salbutamol every one to 4 hours in previously well children aged 6 weeks to ≤ 2 years of age hospitalized with bronchiolitis. The primary outcome was symptom improvement as measured by the Respiratory Distress Assessment Instrument (RDAI; secondary outcomes were length of stay in hospital, adverse events, and report of symptoms by structured parental telephone interview one week after discharge. Results 62 children with a mean age of 6.4 months were enrolled; 80% of children had Respiratory Syncytial Virus (RSV. Racemic epinephrine resulted in significant improvement in wheezing and the total RDAI score on day 2 and over the entire stay (p 0.05. Adverse events were not significantly different in the two arms. At one week post-discharge, over half of parents reported that their child still had a respiratory symptom and 40% had less than normal feeding. Conclusion Racemic epinephrine relieves respiratory distress in hospitalized infants with bronchiolitis and is safe but does not abbreviate hospital stay. Morbidity associated with bronchiolitis as identified by parents persists for at least one week after hospital discharge in most infants.

  12. The use of C-reactive protein in predicting bacterial co-Infection in children with bronchiolitis

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    Mohamad Fares

    2011-03-01

    Full Text Available Background: Bronchiolitis is a potentially life-threatening respiratory illness commonly affecting children who are less than two years of age. Patients with viral lower respiratory tract infection are at risk for co-bacterial infection. Aim: The aim of our study was to evaluate the use of C-reactive protein (CRP in predicting bacterial co-infection in patients hospitalized for bronchiolitis and to correlate the results with the use of antibiotics. Patients and Methods: This is a prospective study that included patients diagnosed with bronchiolitis admitted to Makassed General Hospital in Beirut from October 2008 to April 2009. A tracheal aspirate culture was taken from all patients with bronchiolitis on admission to the hospital. Blood was drawn to test C-reactive protein level, white cell count, transaminases level, and blood sugar level. Results: Forty-nine patients were enrolled in the study and were divided into two groups. Group 1 included patients with positive tracheal aspirate culture and Group 2 included those with negative culture. All patients with a CRP level ≥2 mg/dL have had bacterial co-infection. White cell count, transaminases and blood sugar levels were not predictive for bacterial co-infection. The presence of bacterial co-infection increased the length of hospital stay in the first group by 2 days compared to those in the second group. Conclusion: Bacterial co-infection is frequent in infants with moderate to severe bronchiolitis and requires admission. Our data showed that a CRP level greater than 1.1 mg/dL raised suspicion for bacterial co-infection. Thus, a tracheal aspirate should be investigated microbiologically in all hospitalized patients in order to avoid unnecessary antimicrobial therapy and to shorten the duration of the hospital stay.

  13. Effectiveness of chest physiotherapy in infants hospitalized with acute bronchiolitis: a multicenter, randomized, controlled trial.

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    Vincent Gajdos

    2010-09-01

    Full Text Available Acute bronchiolitis treatment in children and infants is largely supportive, but chest physiotherapy is routinely performed in some countries. In France, national guidelines recommend a specific type of physiotherapy combining the increased exhalation technique (IET and assisted cough (AC. Our objective was to evaluate the efficacy of chest physiotherapy (IET + AC in previously healthy infants hospitalized for a first episode of acute bronchiolitis.We conducted a multicenter, randomized, outcome assessor-blind and parent-blind trial in seven French pediatric departments. We recruited 496 infants hospitalized for first-episode acute bronchiolitis between October 2004 and January 2008. Patients were randomly allocated to receive from physiotherapists three times a day, either IET + AC (intervention group, n=246 or nasal suction (NS, control group, n=250. Only physiotherapists were aware of the allocation group of the infant. The primary outcome was time to recovery, defined as 8 hours without oxygen supplementation associated with minimal or no chest recession, and ingesting more than two-thirds of daily food requirements. Secondary outcomes were intensive care unit admissions, artificial ventilation, antibiotic treatment, description of side effects during procedures, and parental perception of comfort. Statistical analysis was performed on an intent-to-treat basis. Median time to recovery was 2.31 days, (95% confidence interval [CI] 1.97-2.73 for the control group and 2.02 days (95% CI 1.96-2.34 for the intervention group, indicating no significant effect of physiotherapy (hazard ratio [HR]=1.09, 95% CI 0.91-1.31, p=0.33. No treatment by age interaction was found (p=0.97. Frequency of vomiting and transient respiratory destabilization was higher in the IET + AC group during the procedure (relative risk [RR]=10.2, 95% CI 1.3-78.8, p=0.005 and RR=5.4, 95% CI 1.6-18.4, p=0.002, respectively. No difference between groups in bradycardia with or

  14. Better newborn vitamin D status lowers RSV-associated bronchiolitis in infants.

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    Maxwell, Christy S; Carbone, Elena T; Wood, Richard J

    2012-09-01

    Each year 1.5 million children under the age of 5 years die from pneumonia. In the United States, respiratory syncytial virus (RSV) is the number one cause of bronchiolitis and pneumonia in children under 1 year of age. Low serum 25(OH)D is associated with an increased risk of lower respiratory tract infections (LRTI). Two recent studies have provided important information concerning the association between cord blood 25(OH)D and subsequent risk of developing respiratory infection in very young children. These findings support the need in future studies to determine the extent to which an intervention to change the vitamin D status of mothers during pregnancy can reduce the risk of RSV-associated LRTI in their offspring. An answer to this question would have significant worldwide public health importance given the high prevalence of low vitamin D status worldwide and the high mortality burden accompanying infectious lung diseases in young children.

  15. The impact of viral dynamics on the clinical severity of infants with respiratory syncytial virus bronchiolitis.

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    Zhou, Lili; Xiao, Qiuyan; Zhao, Yao; Huang, Ailong; Ren, Luo; Liu, Enmei

    2015-08-01

    The impact of dynamic respiratory syncytial virus (RSV) load on the clinical severity of hospitalized infants with bronchiolitis has not been clarified. Nasopharyngeal aspirates were obtained from 60 infants who were diagnosed with bronchiolitis within 96 hr of wheezing onset upon admission and on days 3, 5, and 7 in the hospital, and 17 respiratory viruses were detected. The RSV load was quantified by real-time qPCR for RSV subtypes A and B at different time points. Scoring criteria were used to evaluate the degree of severity. A total of 40 infants were determined to be RSV-positive, nine were identified as RSV subtype A (RSVA), and 31 were RSV subtype B (RSVB). The peak RSV load was observed upon admission, and the RSV load decreased significantly over time; in addition, this decrease began to have significant differences on day 5. There was a positive correlation between the RSV load and the clinical score (r(2)  = 0.121 and P < 0.001). According to the clinical scores, the infants in the severe group tended to have higher RSV loads than those in the moderate and mild groups. Multivariate logistic regression models revealed that the viral load on day 3 was independently associated with the degree of severity. This study elucidated that a higher mean RSV load was associated with a more severe disease and a longer duration of hospitalization and symptoms. This study also clarified RSV replication in infants and provides a theoretical basis for specifying an anti-RSV therapy strategy.

  16. Environmental characterization of a coffee processing workplace with obliterative bronchiolitis in former workers.

    Science.gov (United States)

    Duling, Matthew G; LeBouf, Ryan F; Cox-Ganser, Jean M; Kreiss, Kathleen; Martin, Stephen B; Bailey, Rachel L

    2016-10-02

    Obliterative bronchiolitis in five former coffee processing employees at a single workplace prompted an exposure study of current workers. Exposure characterization was performed by observing processes, assessing the ventilation system and pressure relationships, analyzing headspace of flavoring samples, and collecting and analyzing personal breathing zone and area air samples for diacetyl and 2,3-pentanedione vapors and total inhalable dust by work area and job title. Mean airborne concentrations were calculated using the minimum variance unbiased estimator of the arithmetic mean. Workers in the grinding/packaging area for unflavored coffee had the highest mean diacetyl exposures, with personal concentrations averaging 93 parts per billion (ppb). This area was under positive pressure with respect to flavored coffee production (mean personal diacetyl levels of 80 ppb). The 2,3-pentanedione exposures were highest in the flavoring room with mean personal exposures of 122 ppb, followed by exposures in the unflavored coffee grinding/packaging area (53 ppb). Peak 15-min airborne concentrations of 14,300 ppb diacetyl and 13,800 ppb 2,3-pentanedione were measured at a small open hatch in the lid of a hopper containing ground unflavored coffee on the mezzanine over the grinding/packaging area. Three out of the four bulk coffee flavorings tested had at least a factor of two higher 2,3-pentanedione than diacetyl headspace measurements. At a coffee processing facility producing both unflavored and flavored coffee, we found the grinding and packaging of unflavored coffee generate simultaneous exposures to diacetyl and 2,3-pentanedione that were well in excess of the NIOSH proposed RELs and similar in magnitude to those in the areas using a flavoring substitute for diacetyl. These findings require physicians to be alert for obliterative bronchiolitis and employers, government, and public health consultants to assess the similarities and differences across the industry to

  17. 闭塞性干燥性龟头炎研究进展%Balanitis xerotica obliterans

    Institute of Scientific and Technical Information of China (English)

    张堂德; 邓俐

    2010-01-01

    闭塞性干燥性龟头炎是一种病因不明的慢性萎缩性皮肤黏膜疾病,通常主要累及男女生殖器与前尿道的表皮和真皮结缔组织.临床上特征性损害是侵及包皮和阴茎的白色丘疹和斑片,可导致包皮变硬,继发性包茎及尿道口狭窄.发生在阴茎龟头的硬化萎缩性苔藓又称闭塞性干燥性龟头炎.对闭塞性干燥性龟头炎的病因、发病机制、临床表现、组织病理及治疗等方面的进展概述.%Balanitis xerotiea obliterans (BXO) is a chronic atrophic mucocutaneous disorder of unknown etiology.It mainly affects the epidermis and dermal connective tissue of genital and anterior urethral skin of both males and females.Clinically.it is characterized by white papules or plaques on the foreskin and penis that may result in the stiffening of prepuce followed by phimosis and meatal stenosis.Lichen sclerosus is a term used as a synonym for BXO of the glans penis.This paper offers an update on the knowledge about the etiology,pathogenesis,clinical manifestations,histopathology and treatment of BXO.

  18. The Role of Human Milk Immunomodulators in Protecting Against Viral Bronchiolitis and Development of Chronic Wheezing Illness

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    Dani-Louise Dixon

    2015-07-01

    Full Text Available Infants who are breastfed are at an immunological advantage when compared with formula fed infants, evidenced by decreased incidence of infections and diminished propensity for long term conditions, including chronic wheeze and/or asthma. Exclusive breastfeeding reduces the duration of hospital admission, risk of respiratory failure and requirement for supplemental oxygen in infants hospitalised with bronchiolitis suggesting a potentially protective mechanism. This review examines the evidence and potential pathways for protection by immunomodulatory factors in human milk against the most common viral cause of bronchiolitis, respiratory syncytial virus (RSV, and subsequent recurrent wheeze in infants. Further investigations into the interplay between respiratory virus infections such as RSV and how they affect, and are affected by, human milk immunomodulators is necessary if we are to gain a true understanding of how breastfeeding protects many infants but not all against infections, and how this relates to long-term protection against conditions such as chronic wheezing illness or asthma.

  19. The Role of Human Milk Immunomodulators in Protecting Against Viral Bronchiolitis and Development of Chronic Wheezing Illness.

    Science.gov (United States)

    Dixon, Dani-Louise

    2015-07-07

    Infants who are breastfed are at an immunological advantage when compared with formula fed infants, evidenced by decreased incidence of infections and diminished propensity for long term conditions, including chronic wheeze and/or asthma. Exclusive breastfeeding reduces the duration of hospital admission, risk of respiratory failure and requirement for supplemental oxygen in infants hospitalised with bronchiolitis suggesting a potentially protective mechanism. This review examines the evidence and potential pathways for protection by immunomodulatory factors in human milk against the most common viral cause of bronchiolitis, respiratory syncytial virus (RSV), and subsequent recurrent wheeze in infants. Further investigations into the interplay between respiratory virus infections such as RSV and how they affect, and are affected by, human milk immunomodulators is necessary if we are to gain a true understanding of how breastfeeding protects many infants but not all against infections, and how this relates to long-term protection against conditions such as chronic wheezing illness or asthma.

  20. Gene Polymorphism of Toll-Like Receptors and Lung Function at Five to Seven Years of Age after Infant Bronchiolitis.

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    Eero Lauhkonen

    Full Text Available Toll-like receptors (TLR play a crucial role in innate immunity, protecting the host from pathogens such as viruses. Genetic variations in TLRs have been associated with the severity of viral bronchiolitis in infancy and with the later occurrence of post-bronchiolitis asthma. The aim of the present study was to evaluate if there are any exploratory associations between TLR gene polymorphisms and lung function at 5 to 7 years of age in former bronchiolitis patients.We performed impulse oscillometry (IOS at the median age of 6.3 years for 103 children who had been hospitalized for bronchiolitis at less than six months of age. The main parameters evaluated were airway resistance and reactance at 5Hz in baseline and post-exercise measurements. Data on single nucleotide polymorphisms (SNP of TLR1 rs5743618, TLR2 rs5743708, TLR6 rs5743810 and TLR10 rs4129009 (TLR2 subfamily and TLR3 rs3775291, TLR4 rs4986790, TLR7 rs179008, TLR8 rs2407992 and TLR 9 rs187084 were available for analyses.The TLR4 rs4986790 wild genotype A/A was associated with a greater Rrs5 response (0.72 vs. -0.42, p = 0.03 to exercise. In TLR6 rs5743810, the minor allele T was associated with greater Rrs5 response (0.80 vs. -0.03, p = 0.04 to exercise. In TLR7 rs179008, the major allele A was associated with baseline decline in dRrs/df (-1.03 vs 0.61, p = 0.01 and increased Fres (2.28 vs. 0.89, p = 0.01 in girls.Among the nine studied TLRs, only TLR7 rs179008 showed some exploratory associations with post-bronchiolitis lung function deficiency, and polymorphisms of TLR4 rs4986790, and TLR6 rs5743810 in particular, with airway reactivity. These findings call for further confirmatory studies.

  1. G-protein coupled receptor auto-antibodies in thromboangiitis obliterans (Buerger's disease) and their removal by immunoadsorption.

    Science.gov (United States)

    Klein-Weigel, Peter F; Bimmler, Marion; Hempel, Petra; Schöpp, Sebastian; Dreusicke, Siegrid; Valerius, Jana; Bohlen, Anne; Boehnlein, Joana M; Bestler, Daniel; Funk, Stephanie; Elitok, Saban

    2014-09-01

    Hintergrund: Histopathologische und serologische Befunde sprechen für eine Immunpathogenese der Thromboangiitis obliterans (TAO, Buerger’sche Erkrankung). Autoantikörper scheinen eine wichtige Rolle im Krankheitsgeschehen zu spielen. Es wurden wiederholt positive therapeutische Effekte durch eine Immunadsorption (IA) gezeigt. Wir analysierten agonistische Autoantikörper (agAAK), die gegen G-Protein gekoppelte Rezeptoren (GPCR) gerichtet sind und analysierten, ob diese durch eine IA effektiv beseitigt werden können. Patienten und Methoden: Zwischen Dezember 2012 und Mai 2014 wurden 11 Patienten mittels IA über 5 konsekutive Tage behandelt. Die agAAK wurden unter Verwendung spezifischer ELISA-Techniken bestimmt. Ergebnisse: AgAAK wurden bei 9 von 11 Patienten (81.8 %) gefunden. Multiple agAAK waren bei 7 Patienten (63.6 %) nachweisbar. Darüber hinaus wurde ein agAAK-Cluster entdeckt, das sich gegen Loop1 des adrenergen α1-Rezeptors und Loop1 des Endothelin A (ETA)-Rezeptors richtet, und sich bei 72.7 % respektive 54.5 % der TAO-Patienten nachweisen ließ. AgAAK gegen Epitop 1 oder 2 des Angiotensin-1-Rezeptors wurden bei 3 Patienten, agAAK gegen Loop1/2 des Proteinase-aktivierten Rezeptor (PAR) wurden bei 2 Patienten nachgewiesen. AgAAK gegen den ETA-Rezeptor traten niemals ohne gleichzeitigen Nachweis von agAAK gegen den α1-adrenergen Rezeptor auf und waren immer gegen Loop1 gerichtet. Unmittelbar nach Beendigung der IA ließen sich bei 81.8 % aller Patienten und bei 77.8 % aller Fälle mit positiven agAAK vor der IA keine agAAK mehr nachgewiesen. Schlussfolgerungen: Wir konnten bei Patienten mit aktiver TAO agAAK gegen GPCR und darüber hinaus ein Antikörper-Cluster nachweisen, das sich bevorzugt gegen Loop1 des α-1-adrenergen Rezeptors und Loop1 des ETA-Rezeptors richtet. Die agAAK wurden mehrheitlich erfolgreich durch die IA eliminiert. Wir sind der Auffassung, dass gegen GPCR-gerichtete agAAK eine wichtige Rolle in der Pathogenese der TAO spielen und

  2. Impact of hospitalizations for bronchiolitis in preterm infants on long-term health care costs in Italy: a retrospective case-control study

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    Roggeri DP

    2016-08-01

    Full Text Available Daniela Paola Roggeri,1 Alessandro Roggeri,1 Elisa Rossi,2 Salvatore Cataudella,2 Nello Martini,3 1ProCure Solutions, Nembro, Bergamo, 2CINECA Interuniversity Consortium, Bologna, 3Accademia Nazionale di Medicina, Rome, Italy Purpose: Bronchiolitis is an acute inflammatory injury of the bronchioles, and is the most frequent cause of hospitalization for lower respiratory tract infections in preterm infants. This was a retrospective, observational, case-control study conducted in Italy, based on administrative database analysis. The aim of this study was to evaluate differences in health care costs of preterm infants with and without early hospitalization for bronchiolitis. Patients and methods: Preterm infants born in the period between January 1, 2009 and December 31, 2010 and hospitalized for bronchiolitis in the first year of life were selected from the ARNO Observatory database and observed for the first 4 years of life. These preterm infants were compared (paired 1–3 with preterm infants who were not hospitalized for bronchiolitis in the first year of life and with similar characteristics. Only direct health care costs reimbursed by the Italian National Health Service were considered for this study (drugs, hospitalizations, and diagnostic/therapeutic procedures. Results: Of 40,823 newborns in the accrual period, 863 were preterm with no evidence of prophylaxis, and 22 preterm infants were hospitalized for bronchiolitis (cases and paired with 62 controls. Overall, cases had 74% higher average cost per infant in the first 4 years of life than controls (18,624€ versus 10,189€, respectively. The major cost drivers were hospitalizations, accounting for >90% in both the populations. The increase in total yearly health care cost between cases and controls remained substantial even in the fourth year of life for all cost items. A relevant increase in hospitalizations and drug consumption linked to respiratory tract diseases was noted in

  3. Nutritional status, breastfeeding, and evolution of Infants with acute viral bronchiolitis.

    Science.gov (United States)

    Dornelles, Cristina T L; Piva, Jefferson P; Marostica, Paulo J C

    2007-09-01

    Acute viral bronchiolitis is a common respiratory infectious disease of infancy. A prospective study was carried out with 175 infants aged up to six months to evaluate their nutritional and breastfeeding status as possible risk factors for unfavourable evolution of previously-healthy infants from a care hospital. Immunofluorescence test for virus and anthropometric assessment were performed. Outcomes were length of oxygen-use, length of hospital stay, and type of hospital unit needed. Seventy-three percent of the infants were well-nourished, 6% undernourished, 8.6% at a nutritional risk, 10.9% overweight, and 1.7% obese. Eighty-one percent of the undernourished and nutritionally at-risk infants and 72% of the well-nourished, overweight, and obese infants did not receive exclusive breastfeeding. The median length of hospital stay was four days and of oxygen-use was 60 hours. The nutritional status did not affect the clinical course of previously-healthy infants with acute viral brochiolitis. The duration of exclusive breastfeeding, but not type of breastfeeding, was inversely related to the length of oxygen-use and the length of hospital stay. Shorter exclusive breastfeeding was observed in infants who were assigned to a paediatric ward or to an intensive care unit. In conclusion, longer duration of breastfeeding was associated with better clinical outcomes.

  4. Prevention of bronchiolitis from the hospital to home: enviromental and pharmacological strategies

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    Andrea Dotta

    2015-10-01

    Full Text Available Bronchiolitis is one of the major cause of mortality and morbidity during infancy, with high hospitalization rate during epidemic season for high risk infants during the first year of life. There is no specific therapy with proven efficacy apart hydration and hypertonic saline. Mild forms can be treated in outpatient setting avoiding a useless hospitalization. Enviromental prevention is crucial in hospital setting, in outpatient ambulatory and at home: for this purpose hand hygiene, tobacco exposure, breastfeeding must be emphasized with families and caregivers. Pharmacological prophylaxis uses a humanized monoclonal antibody (palivizumab shown effective in reducing hospitalization rate in preterm infants < 35 weeks gestational age, infants with bronchopulmonary dysplasia and infants with congenital heart disease. During the last 2 years different recommandations and guidelines confirmed the importance of prophylaxis with palivizumab with some differences between Groups and Societies based on different healthcare systems. In any case it is important a good contact between hospital and all caregivers of these patients to reduce the viral exposure and increase the defense capability of high risk patients. Proceedings of the 11th International Workshop on Neonatology and Satellite Meetings · Cagliari (Italy · October 26th-31st, 2015 · From the womb to the adultGuest Editors: Vassilios Fanos (Cagliari, Italy, Michele Mussap (Genoa, Italy, Antonio Del Vecchio (Bari, Italy, Bo Sun (Shanghai, China, Dorret I. Boomsma (Amsterdam, the Netherlands, Gavino Faa (Cagliari, Italy, Antonio Giordano (Philadelphia, USA

  5. Microdialysis as a tool for drug quantification in the bronchioles of anaesthetized pigs.

    Science.gov (United States)

    Rottbøll, Lisa A H; Friis, Christian

    2014-03-01

    Target site drug determinations are crucial for optimizing treatment of infectious diseases. There is limited knowledge of antibiotic drug penetration into the pulmonary epithelial lining fluid (PELF) and a lack of easily performed methods for continuous drug sampling hereof. The aim of this study was to develop a readily accessible microdialysis (MD) method for antibiotic drug quantification in PELF of pigs. The fluoroquinolone danofloxacin was administered to anaesthetized pigs allocated to three groups: intravenous injection, intravenous infusion and intramuscular injection. MD probes were guided through a tracheostomy into the distal bronchioles using an insertion tube. Intravenously administered inulin served as a marker of extracellular fluid contamination of PELF. Concentrations of free drug in MD fractions were compared to total and non-protein-bound drug concentrations in plasma. Rising and declining danofloxacin plasma concentrations were rapidly reflected in PELF, suggesting an efficient drug transport across the blood bronchial barrier. The AUC FREE DRUG PELF /AUC FREE DRUG PLASMA ratio was 1.8 (S.D. 0.4, 95% CL 1.4-2.3). Although the probes were placed without fiberscopic or other special equipment, the danofloxacin concentrations in PELF were consistent within the different administration groups. The described MD method for drug quantification in PELF is easily accessible and provides repeatable results. However, trace amount of inulin was detected in the MD fractions, suggesting a local tissue reaction induced by the MD membrane. The significance of this finding needs to be clarified in future studies.

  6. Elevated IL-3 and IL-12p40 levels in the lower airway of infants with RSV-induced bronchiolitis correlate with recurrent wheezing.

    Science.gov (United States)

    Bertrand, Pablo; Lay, Margarita K; Piedimonte, Giovanni; Brockmann, Pablo E; Palavecino, Christian E; Hernández, Jury; León, Miguel A; Kalergis, Alexis M; Bueno, Susan M

    2015-12-01

    Respiratory Syncytial Virus (RSV) is the first cause of hospitalization due to bronchiolitis in infants. RSV bronchiolitis has been linked to asthma and recurrent wheezing, however the mechanisms behind this association have not been elucidated. Here, we evaluated the cytokine and chemokine profiles in the airways in infants with RSV bronchiolitis. Nasopharyngeal Aspirates (NPA) and Bronchoalveolar Lavage Fluids (BALF) from infants hospitalized due to RSV bronchiolitis and healthy controls were analyzed for cytokine and chemokine production. We observed elevated levels of Th2 cytokines (IL-3, IL-4, IL-10 and IL-13), pro-inflammatory cytokines and chemokines (IL-1β, IL-6, TNF-β, MCP-1/CCL2, MIP-1α/CCL3 and IL-8/CXCL8) in BALF from infants with RSV bronchiolitis, as compared to controls. We found a direct correlation of IL-3 and IL-12p40 levels with the development of recurrent wheezing later in life. These results suggest that IL-3 and IL-12p40 could be considered as molecular predictors for recurrent wheezing due to RSV infection.

  7. Advancement of T helper17 cells in bronchiolitis%Th17与毛细支气管炎的研究进展

    Institute of Scientific and Technical Information of China (English)

    张国辉

    2013-01-01

    Bronchiolitis is a common lower respiratory infection disease in children younger than two years old.The main pathogen of bronchiolitis is respiratory syncytial virus,which is also associated with the asthma.By now,it is still unknown about the pathogenesis of bronchiolitis.Recent findings provide that T helper17(Th17) cells play an important role in bronchiolitis.This review summarizes the progresses of regulation of Th17 cells development,Th17 cells function,and the relationship between Th17 cells and bronchiolitis.%毛细支气管炎(毛支)是2岁以下小儿常见的下呼吸道感染性疾病,主要病原体是呼吸道合胞病毒,是需住院治疗的常见呼吸道疾病,且与哮喘的发病密切相关.目前毛支的发病机制尚未完全阐明,近年来发现T辅助性17细胞(Th17)在其发病中占有重要地位.该文就近年来对Th17在毛支发病机制方面的研究进展作一综述.

  8. ASSESSMENT OF HEMATOLOGICAL PARAMETERS, ACID-BASE STATUS AND ARTERIAL BLOOD GAS TEST BEFORE AND AFTER TREATMENT OF ACUTE BRONCHIOLITIS IN CHILDREN

    Directory of Open Access Journals (Sweden)

    Zuvdija Cecunjanin

    2016-08-01

    Full Text Available Objective: The purpose of our retrospective study was to investigate the necessity of some laboratory testing in patients with acute bronchiolitis before and after treatment. Methods: We have taken blood samples of all children puncturing the cubital vein, and analyzed it using the Colter appliances-automatic counter blood count, for analyzes of a number of erythrocytes, leukocytes, platelets, differential blood count, Hct, Hb. CRP concentration in serum of patients determined by laser nephelometry with CardioPhase® high sensitivity C-reactive protein (hsCRP. For assessment of acid-base status and arterial blood gas analysis were used ABL5 and ABL700 Radiometer Copenhagen. We monitored the following parameters: pH, pCO2, HCO3-, total CO2, base excess, pO2, SpO2. Results: There was a significant improvement of hypoxemia after management of acute bronchiolitis in the form of a significant increase in average values of pO2 and SpO2 after treatment of acute bronchiolitis. The average value of the number of leukocytes and value of CRP in children were significantly decreased before and after management of acute bronchiolitis. There was no significant difference in duration of hospitalization in term and preterm newborns. Conclusion: No routine diagnostic tests are used routinely. However, there is an improvement of hypoxemia after management of acute bronchiolitis in children.

  9. Immune mechanisms of obliterative bronchiolitis following lung transplantation%肺移植闭塞性细支气管炎免疫机制研究进展

    Institute of Scientific and Technical Information of China (English)

    王光锁; 王正; 孙宗全

    2008-01-01

    闭塞性细支气管炎是影响肺移植患者长期生存的主要因素.适应性免疫一直是肺移植排斥反应的研究重点.但是越来越多的研究表明,体液免疫、自体免疫、固有免疫等亦是闭塞性细支气管炎发生的重要因素.%Chronic rejection remains the leading cause of chronic allograft dysfunction and late mortality after lung transplantation. Adaptive immune system and its cellular-based rejection has been the focus in the development of obliterative bronchiolitis. Recent research has identified that humoral immunity, autoimmunity, and innate immunity also contribute to obliterative bronchiolitis. This paper presents an updated review of the immune mechanisms for obliterative bronchiolitis following lung transplantation.

  10. Concentrations of IL-15, IL-18, IFN-γ and activity of CD4(+), CD8(+) and NK cells at admission in children with viral bronchiolitis.

    Science.gov (United States)

    Grześk, Elżbieta; Kołtan, Sylwia; Dębski, Robert; Wysocki, Mariusz; Gruszka, Marzena; Kubicka, Małgorzata; Kołtan, Andrzej; Grześk, Grzegorz; Manysiak, Sławomir; Odrowąż-Sypniewska, Grażyna

    2010-09-01

    The pathogenesis of viral bronchiolitis is poorly understood. The aim of this study was to analyze interleukin (IL)-15, IL-18 and interferon (IFN)-γ concentrations and the activity of NK cells and CD4(+) and CD8(+) lymphocytes in 23 children not older than 30 months of age with acute viral bronchiolitis using blood samples drawn within the first 24 h of their hospital admission, in comparison to a healthy group. In children with bronchiolitis, the mean concentrations of IL-15, IL-18 and IFN-γ were 9.39±11.55, 884.03±645.44 and 17.92±27.14 pg/ml, respectively, and were significantly higher than those in the control group [2.34±0.61 pg/ml (p<0.05), 248.69±98.73 pg/ml (p<0.001) and 2.75±1.72 pg/ml (p<0.005), respectively]. In the bronchiolitis group, mean z-scores were -1.15±1.9 for CD4(+) cells and -0.9±1.23 for CD8(+) cells; these scores were significantly lower than those of the general Polish population (p<0.001 and <0.01, respectively). However, the mean z-score of the ratio of CD4(+)/CD8(+) and the NK cell count in children with bronchiolitis did not differ significantly from those of the controls. In conclusion, cytokines such as IL-15, IL-18 and IFN-γ play a role in the pathogenesis of bronchiolitis in children.

  11. Bronchiolitis and Leukotriene Receptor Antagonist%毛细支气管炎与白三烯受体拮抗剂

    Institute of Scientific and Technical Information of China (English)

    马晓晖

    2011-01-01

    Bronchiolitis is the most common lower respiratory tract infection in infants, the major cause of which is virus infection. Studies have indicated that there are many similarities in pathophysiology between bronchiolitis and asthma, and there are many inflammatory mediators involved,which result in airway hyperresponsiveness, and lead to wheeze. Among the inflammatory mediators, leukotriene plays an important role in bronchiolitis airway inflammation, so leukotriene receptor antagonist is an effective treatment for bronchiolitis.Here is to review the mechanism of leukotriene receptor antagonist and its clinical studies in bronchiolitis,in order to disclose a better treatment and effective early intervention method of bronchiolitis, and to cut down the relapse rate of wheezing.%毛细支气管炎是婴幼儿常见的下呼吸道感染性疾病,病毒感染是主要致病原因.毛细支气管炎的病理、生理变化与哮喘有许多相同之处,许多炎性介质参与其中,造成呼吸道高反应,诱发喘息.在这些炎性介质中,白三烯在毛细支气管炎呼吸道炎症的发生中起到重要作用,而白三烯受体拮抗剂在毛细支气管炎的治疗中取得较好疗效.现就白三烯受体拮抗剂的作用机制及其在毛细支气管炎中的临床研究进行综述,探讨毛细支气管炎的治疗及早期干预以及降低喘息复发率的有效方法.

  12. Incidence and risk factors of hospitalization for bronchiolitis in preterm children: a retrospective longitudinal study in Italy

    Directory of Open Access Journals (Sweden)

    Mucchino Eleonora

    2009-09-01

    Full Text Available Abstract Background Bronchiolitis is a distressing, potentially life-threatening respiratory condition that affects infants. We evaluated the incidence and risk factors of hospitalization for broncholitis in preterm infants (i.e., a gestational age of Methods Retrospective cohort study that linked data from four health administrative databases in the Lazio region (a region of central Italy: the birth register, the hospital discharge register, and two ad-hoc databases that record the doses of Palivizumab administered at two local health units. Results Among 2407 preterm infants, 137 had at least one hospitalization for bronchiolitis in the first 18 months of life, an overall incidence rate of 4.70 per 100 person-years (95%CI: 3.98-5.56; similar incidence rates were observed by calendar year. A multiple Poisson model showed that the following characteristics were associated with higher incidence: younger age of the infant, the period between October-April, male gender, low Apgar score at birth, low birth weight, and low maternal educational level. At least one dose of Palivizumab was administered to 324 (13.5% children; a dramatic increase from 2000 (2.8% to 2006 (19.1% (p Conclusion In Italy the incidence of hospitalization for bronchiolitis, and its associated risk factors, are similar to that found in other countries. Although Palivizumab use is associated with the most important characteristics of severe prematurity, other aspects of its non-use in children with congenital heart disease, the age and the birth country of the mother suggest the need for public health measures that can reduce these health disparities. Finally, the estimated effectiveness of Palivizumab in routine practice, although not significant, confirms the results of previous clinical trials, but its impact on modifying the temporal trend in this population is still negligible.

  13. Severe Respiratory Syncytial Virus Bronchiolitis in Infants Is Associated with Reduced Airway Interferon Gamma and Substance P

    Science.gov (United States)

    Semple, Malcolm G.; Dankert, Hinke M.; Ebrahimi, Bahram; Correia, Jailson B.; Booth, J. Angela; Stewart, James P.; Smyth, Rosalind L.; Hart, C. Anthony

    2007-01-01

    Background Severe human respiratory syncytial virus (hRSV) bronchiolitis in previously well infants may be due to differences in the innate immune response to hRSV infection. Aim: to determine if factors mediating proposed mechanisms for severe bronchiolitis differ with severity of disease. Methodology/Principle Findings 197 infants admitted to hospital with hRSV bronchiolitis were recruited and grouped according to no oxygen requirement (n = 27), oxygen dependence (n = 114) or mechanical ventilation (n = 56). We collected clinical data, nasopharyngeal aspirate (NPA) and if ventilated bronchoalveolar lavage (BAL). Interferon-gamma (IFN-γ), substance P (SP), interleukin 9 (IL-9), urea and hRSV load, were measured in cell free supernatant from NPA and BAL. Multivariate analysis compared independent effects of clinical, virological and immunological variables upon disease severity. IFN-γ and SP concentrations were lower in NPA from infants who required oxygen or mechanical ventilation. Viral load and IL-9 concentrations were high but did not vary with severity of disease. Independent predictors of severe disease (in diminishing size of effect) were low weight on admission, low gestation at birth, low NPA IFN-γ and NPA SP. Nasal airway sampling appears to be a useful surrogate for distal airway sampling since concentrations of IFN-γ, SP, IL-9 and viral load in NPA correlate with the same in BAL. Conclusions Our data support two proposed mechanisms for severe hRSV disease; reduced local IFN-γ response and SP mediated inflammation. We found large amounts of hRSV and IL-9 in airways secretions from the upper and lower respiratory tract but could not associate these with disease severity. PMID:17940602

  14. Hospitalisations for respiratory syncytial virus bronchiolitis in Akershus, Norway, 1993–2000: a population-based retrospective study

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    Bratlid Dag

    2004-12-01

    Full Text Available Abstract Background RSV is recognized as the most important cause of serious lower respiratory tract illness in infants and young children worldwide leading to hospitalisation in a great number of cases, especially in certain high-risk groups. The aims of the present study were to identify risk groups, outcome and incidences of hospitalisation for RSV bronchiolitis in Norwegian children under two years of age and to compare the results with other studies. Methods We performed a population-based retrospective survey for the period 1993–2000 in children under two years of age hospitalised for RSV bronchiolitis. Results 822 admissions from 764 patients were identified, 93% had one hospitalisation, while 7% had two or more hospitalisations. Mean annual hospitalisation incidences were 21.7 per 1.000 children under one year of age, 6.8 per 1.000 children at 1–2 years of age and 14.1 per 1.000 children under two years of age. 77 children (85 admissions belonged to one or more high-risk groups such as preterm birth, trisomy 21 and congenital heart disease. For preterm children under one year of age, at 1–2 years of age and under two years of age hospitalisation incidences per 1.000 children were 23.5, 8.7 and 16.2 respectively. The incidence for children under two years of age with trisomy 21 was 153.8 per 1.000 children. Conclusion While the overall hospitalisation incidences and outcome of RSV bronchiolitis were in agreement with other studies, hospitalisation incidences for preterm children were lower than in many other studies. Age on admission for preterm children, when corrected for prematurity, was comparable to low-risk children. Length of hospitalisation and morbidity was high in both preterm children, children with a congenital heart disease and in children with trisomy 21, the last group being at particular high risk for severe disease.

  15. Viral bronchiolitis in young rats causes small airway lesions that correlate with reduced lung function.

    Science.gov (United States)

    Sorkness, Ronald L; Szakaly, Renee J; Rosenthal, Louis A; Sullivan, Ruth; Gern, James E; Lemanske, Robert F; Sun, Xin

    2013-11-01

    Viral illness with wheezing during infancy is associated with the inception of childhood asthma. Small airway dysfunction is a component of childhood asthma, but little is known about how viral illness at an early age may affect the structure and function of small airways. We used a well-characterized rat model of postbronchiolitis chronic airway dysfunction to address how postinfectious small airway lesions affect airway physiological function and if the structure/function correlates persist into maturity. Brown Norway rats were sham- or virus inoculated at 3 to 4 weeks of age and allowed to recover from the acute illness. At 3 to 14 months of age, physiology (respiratory system resistance, Newtonian resistance, tissue damping, and static lung volumes) was assessed in anesthetized, intubated rats. Serial lung sections revealed lesions in the terminal bronchioles that reduced luminal area and interrupted further branching, affecting 26% (range, 13-39%) of the small airways at 3 months of age and 22% (range, 6-40%) at 12 to 14 months of age. At 3 months of age (n = 29 virus; n = 7 sham), small airway lesions correlated with tissue damping (rs = 0.69) but not with Newtonian resistance (rs = 0.23), and Newtonian resistance was not elevated compared with control rats, indicating that distal airways were primarily responsible for the airflow obstruction. Older rats (n = 7 virus; n = 6 sham) had persistent small airway dysfunction and significantly increased Newtonian resistance in the postbronchiolitis group. We conclude that viral airway injury at an early age may induce small airway lesions that are associated quantitatively with small airway physiological dysfunction early on and that these defects persist into maturity.

  16. CT densitovolumetry in children with obliterative bronchiolitis: correlation with clinical scores and pulmonary function test results

    Directory of Open Access Journals (Sweden)

    Helena Mocelin

    2013-12-01

    Full Text Available OBJECTIVE: To determine whether air trapping (expressed as the percentage of air trapping relative to total lung volume [AT%] correlates with clinical and functional parameters in children with obliterative bronchiolitis (OB.METHODS: CT scans of 19 children with OB were post-processed for AT% quantification with the use of a fixed threshold of −950 HU (AT%950 and of thresholds selected with the aid of density masks (AT%DM. Patients were divided into three groups by AT% severity. We examined AT% correlations with oxygen saturation (SO2 at rest, six-minute walk distance (6MWD, minimum SO2 during the six-minute walk test (6MWT_SO2, FVC, FEV1, FEV1/FVC, and clinical parameters.RESULTS: The 6MWD was longer in the patients with larger normal lung volumes (r = 0.53. We found that AT%950 showed significant correlations (before and after the exclusion of outliers, respectively with the clinical score (r = 0.72; 0.80, FVC (r = 0.24; 0.59, FEV1 (r = −0.58; −0.67, and FEV1/FVC (r = −0.53; r = −0.62, as did AT%DM with the clinical score (r = 0.58; r = 0.63, SO2 at rest (r = −0.40; r = −0.61, 6MWT_SO2 (r = −0.24; r = −0.55, FVC (r = −0.44; r = −0.80, FEV1 (r = −0.65; r = −0.71, and FEV1/FVC (r = −0.41; r = −0.52.CONCLUSIONS: Our results show that AT% correlates significantly with clinical scores and pulmonary function test results in children with OB.

  17. Treatment of Infantile Bronchiolitis with Jie Jing Ding Chuan Zhi Xiao Tang——A Report of 45 Cases

    Institute of Scientific and Technical Information of China (English)

    Feng Xiaochun; An Xiaoran; Mao Shuzhang

    2006-01-01

    Objective:To evaluate the therapeutic effectiveness of Jie Jing Ding Chuan Zhi Xiao Tang (解痉定喘止哮汤 the Tetany- Pant- and Wheeze-relieving Decoction) on infantile bronchiolitis. Method: Seventy-five eligible cases were randomly divided into a treatment group (N = 45) and a control group (N=30). Patients in the treatment group were treated with Tetany-Pant- and Wheeze-relieving Decoction, the ingredients of which include Su Zi (苏子 Fructus Perillae), Di Long (地龙 Pheretima), Qian Hu (前胡 Radix Peucedani),Bai Qu Cai (白屈菜 Herba Chelidonii), Ma Huang (麻黄 Herba Ephedrae), Ku Xing Ren (苦杏仁 Semen Armeniacae Amarum), Bai Gou (白果 Semen Gingkgo), Quan Xie (全蝎 Scorpio), Bai Xian Pi (白鲜皮Cortex Dictamni), Jiang Can (僵蚕 Bombyx Batryticatus), She Gan (射干 Rhizoma Belamcandae) and Dong Hua ( 冬花 Flos Farfarae). Patients in the control group were treated with Xiao Er Ke Chun Ling Chong Ji (小儿咳喘灵冲剂 Medicinal Granules for Infantile Cough and Pant). Result: A total effective rate of 93.3% was achieved in the treatment group and only 73.3% was obtained in the control group.Conclusion: The Tetany- Pant- and Wheeze-relieving Decoction is significantly effective in treating infantile bronchiolitis (P<0.05).

  18. Early experience with lung transplantation using donors after cardiac death.

    Science.gov (United States)

    Mason, David P; Murthy, Sudish C; Gonzalez-Stawinski, Gonzalo V; Budev, Marie M; Mehta, Atul C; McNeill, Ann M; Pettersson, Gösta B

    2008-05-01

    Lung transplantations that utilize donor organs after cardiac death (DCD) can substantially increase the number of available allografts for waiting recipients. Unfortunately, reported clinical outcomes are limited and widespread acceptance is slow. To further examine the potential of this modality, the results of 4 patients transplanted with DCD organs, implementing a protocol of controlled organ retrieval (Maastricht Classification III), were reviewed. There were no operative deaths; extracorporeal membrane oxygenation was required in 1 patient secondary to severe primary graft dysfunction. Three patients are alive and well at 4, 15 and 21 months; 1 patient died at 34 months with bronchiolitis obliterans syndrome, in part attributable to medication non-compliance.

  19. Activation of endothelial and epithelial KCa2.3 calcium-activated potassium channels by NS309 relaxes human small pulmonary arteries and bronchioles

    DEFF Research Database (Denmark)

    Kroigaard, Christel; Dalsgaard, Thomas; Nielsen, Gorm;

    2012-01-01

    -dependent relaxations. NS309 was equally potent in relaxing pulmonary arteries, but less potent in bronchioles, than salbutamol. NS309 relaxations were blocked by the KCa2 channel blocker apamin, while the KCa3.1 channel blocker, charybdotoxin failed to reduce relaxation to NS309 (0.011 mu M). CONCLUSIONS...

  20. New Progress in Drug Therapy in Children with Bronchiolitis%小儿毛细支气管炎的药物治疗新进展

    Institute of Scientific and Technical Information of China (English)

    庞智东

    2015-01-01

    本文主要介绍小儿毛细支气管炎的药物治疗进展。通过查阅整理相关资料,再结合丰富的临床经验,对小儿毛细支气管炎的药物治疗予以综述分析。小儿毛细支气管炎的药物治疗主要分为中医、西医及中西结合三种方式。小儿毛细支气管炎的临床诊治,应根据患儿状况及病情程度,合理选取药物治疗、给药方式及剂量,往往中西结合的疗效更为理想。%This paper described progress in drug treatment of children with bronchiolitis. After a review of the compilation of relevant data, combined with a wealth of clinical experience, be re-viewed analysis of the drug treatment of children with bronchiolitis. Drug treatment of children with bronchiolitis are divided into traditional Chinese medicine, Western medicine and Western combined in three ways.The clinical diagnosis of bronchiolitis in children, should be based on the situation of children and severity, reasonable selection of medication, administration and dosage, often more desirable effect of combining Chinese and Western.

  1. 毛细支气管炎发病中细胞因子作用的研究进展%Research progress on cytokine of bronchiolitis

    Institute of Scientific and Technical Information of China (English)

    张秀秀; 曲书强

    2011-01-01

    Bronchiolitis is the most common lower respiratory tract inflammation in infants caused by a variety of pathogens.As bronchiolitis and asthma share similar clinical manifestations,changes of cytokines and inflammatory factors,it is believed that brondiiorhitis has a similar pathogenesis as asthma.Therefore,researches on cytokines in bronchiolitis are of great importance to reveal the pathogenesis and explore new treatments of bronchiolitis.%毛细支气管炎是由多种病原引起的婴幼儿最常见的下呼吸道感染性疾病.由于毛细支气管炎与哮喘具有相似的临床表现、细胞因子和炎症因子的改变,认为其可能具有与哮喘相似的发病机制.因此,毛细支气管炎细胞因子研究对揭示毛细支气管炎的发病机制,探索毛细支气管炎新的治疗方法具有极其重要的作用.

  2. Nebulized hypertonic saline treatment reduces both rate and duration of hospitalization for acute bronchiolitis in infants: an updated meta-analysis.

    Science.gov (United States)

    Chen, Yen-Ju; Lee, Wen-Li; Wang, Chuang-Ming; Chou, Hsin-Hsu

    2014-12-01

    Nebulized hypertonic saline (HS) treatment reduced the length of hospitalization in infants with acute bronchiolitis in a previous meta-analysis. However, there was no reduction in the admission rate. We hypothesized that nebulized HS treatment might significantly decrease both the duration and the rate of hospitalization if more randomized controlled trials (RCTs) were included. We searched MEDLINE, PubMed, CINAHL, and the Cochrane Central Register of Controlled Trials (CENTRAL) without a language restriction. A meta-analysis was performed based on the efficacy of nebulized HS treatment in infants with acute bronchiolitis. We used weighted mean difference (WMD) and risk ratio as effect size metrics. Eleven studies were identified that enrolled 1070 infants. Nebulized HS treatment significantly decreased the duration and rate of hospitalization compared with nebulized normal saline (NS) [duration of hospitalization: WMD = -0.96, 95% confidence interval (CI) = -1.38 to -0.54, p bronchiolitis infants post-treatment (Day 1: WMD = -0.77, 95% CI = -1.30 to -0.24, p = 0.005; Day 2: WMD = -0.85, 95% CI = -1.30 to -0.39, p bronchiolitis in infants.

  3. IL1RL1 Gene Variants and Nasopharyngeal IL1RL-a Levels Are Associated with Severe RSV Bronchiolitis : A Multicenter Cohort Study

    NARCIS (Netherlands)

    Faber, Tina E.; Schuurhof, Annemieke; Vonk, Annelies; Koppelman, Gerard H.; Hennus, Marije P.; Kimpen, Jan L. L.; Janssen, Riny; Bont, Louis J.

    2012-01-01

    Background: Targets for intervention are required for respiratory syncytial virus (RSV) bronchiolitis, a common disease during infancy for which no effective treatment exists. Clinical and genetic studies indicate that IL1RL1 plays an important role in the development and exacerbations of asthma. Hu

  4. T-2 toxin impairs murine immune response to respiratory reovirus and exacerbates viral bronchiolitis.

    Science.gov (United States)

    Li, Maoxiang; Harkema, Jack R; Islam, Zahidul; Cuff, Chistopher F; Pestka, James J

    2006-11-15

    Exposure to immunosuppressive environmental contaminants is a possible contributing factor to increased occurrence of viral respiratory diseases. The objective of this study was to test the hypothesis that the trichothecene mycotoxin T-2 toxin (T-2), a frequent food contaminant, alters host resistance to lung infection by reovirus, a model respiratory virus. Balb/c mice (4 week old) were treated intraperitoneally with T-2 toxin (1.75 mg/kg bw) or saline vehicle and then intranasally instilled 2 h later with 10(7) plaque forming unit (PFU) of reovirus, strain Lang (T1/L) or saline vehicle. At 10 days post-instillation (PI), both virus plaque-forming responses and reovirus L2 gene expression were 10-fold higher in lungs of T-2-treated mice compared to controls. No-effect and lowest-effect levels for T-2-induced suppression of reovirus clearance were 20 and 200 microg/kg bw, respectively. Respiratory reovirus infection resulted in a mild bronchiolitis with minimal alveolitis, which was markedly exacerbated by T-2 pretreatment. Reovirus exposure induced marked increases in total cells, neutrophils and lymphocytes at 3 and 7 days PI in bronchial alveolar lavage fluid (BALF) whereas macrophages were increased only at 7 days PI. Although prior T-2 exposure attenuated total cell and macrophage counts in BALF of control and infected mice at 3 days PI, the toxin potentiated total cell, macrophage, neutrophil and lymphocyte counts in infected mice at 7 days PI. At 3 days PI, T-2 suppressed reovirus-induced IFN-gamma elevation in BALF, but enhanced production of IL-6 and MCP-1. T-2 pretreatment also suppressed reovirus-specific mucosal IgA responses in lung and enteric tract, but potentiated serum IgA and IgG responses. Taken together, T-2 increased lung viral burden, bronchopneumonia and pulmonary cellular infiltration in reovirus-infected mice. These effects might be attributable to reduced alveolar macrophage levels as well as modulated cytokine and mucosal Ig responses.

  5. Bronquiolite aguda, uma revisão atualizada Acute bronchiolitis, an updated review

    Directory of Open Access Journals (Sweden)

    Werther Brunow de Carvalho

    2007-04-01

    Full Text Available A bronquiolite aguda (BA é um diagnóstico freqüente de internação hospitalar em pediatria, ocasionada principalmente pelo vírus sincicial respiratório (VSR. Ocorre epidemicamente nos meses de outono e inverno. Algumas populações de crianças (recém-nascidos pré-termo, cardiopatia congênita, doença pulmonar crônica, imunocomprometidos, desnutridos, entre outros apresentam maior risco de morbidade e mortalidade. Os vírus multiplicam-se nas células epiteliais ciliadas, e a inflamação e os debris celulares ocasionam obstrução da via aérea, hiperinsuflação, atelectasia localizada, chiado e alterações das trocas gasosas. Não existem evidências definitivas em relação aos tratamentos utilizados para esta doença. O tratamento inclui a utilização de oxigênio, hidratação, beta-2 agonistas por via inalatória, epinefrina racêmica, DNase recombinante, fisioterapia respiratória, entre outros. Medidas profiláticas: administração de anticorpos monoclonais (palivizumab. A maioria das crianças com BA, independentemente da gravidade da doença, recuperam-se sem seqüelas. O curso natural desta doença, habitualmente, varia entre sete a dez dias, mas algumas crianças permanecem doentes por semanas.Acute bronchiolitis (AB is a frequent cause of hospitalization among children and its main etiological agent is respiratory syncytial virus (RSV. It occurs epidemically during autumn and winter. Some populations of children such as premature newborns, infants with congenital heart disease and those with chronic lung disease, immunocompromised, undernourished, among others, present increased morbidity and mortality risk. The virus multiplies in epithelial ciliated cells while inflammation and cellular debris cause obstruction of the airways, hyperinflation, atelectasis, and wheezing and gas exchange imbalance. Definitive evidence still does not exist about treatment of this disease, Treatment includes oxygen therapy, hydration

  6. Swyer-James syndrome in a 7-year-old female

    Directory of Open Access Journals (Sweden)

    Jun Mori

    2016-10-01

    Full Text Available Swyer-James syndrome is a rare syndrome that occurs as a result of repeated bronchiolitis and pneumonitis in childhood. Most cases are asymptomatic, and subsequent diagnosis may not occur until adulthood. We present the case of a 7-year-old female with Swyer-James syndrome, which was initially diagnosed and treated as asthma. The patient developed respiratory distress and atelectasis which were treated with biphasic cuirass ventilation. This case suggests that Swyer-James syndrome should be a concern in patients with chronic cough and wheezing, and highlights the importance of taking a careful history and appropriate radiological investigations for diagnosis. Once Swyer-James syndrome is diagnosed, prophylaxis and appropriate management of respiratory infections becomes important.

  7. Household tobacco smoke and admission weight predict severe bronchiolitis in infants independent of deprivation: prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Malcolm G Semple

    Full Text Available OBJECTIVES: To examine demographic, environmental and clinical factors associated with severe bronchiolitis in infants admitted to hospital and quantify the independent effects of these factors. DESIGN: Prospective cohort study. SETTING: Alder Hey Children's Hospital, Liverpool, United Kingdom. PARTICIPANTS: 378 infants admitted to hospital with a diagnosis of bronchiolitis, of whom 299 (79% were antigen positive to respiratory syncytial virus (RSV. OUTCOME: Severity of disease during admission, defined as "no need for supplemental oxygen" (reference group, "any need for supplemental oxygen" and "any need for mechanical ventilation". RESULTS: Univariate analysis found male sex (p = 0.035 and tobacco smoking by a household member (p<0.001 were associated with need for both supplemental oxygen and mechanical ventilation. Premature birth, low gestation, low birth weight, low admission weight and low corrected age on admission were also associated with need for mechanical ventilation (all p≤0.002. Deprivation scores (IMD 2004 were significantly higher in households where a member smoked compared to non-smoking households (p<0.001. The odds of smoking predicted by deprivation were 7 times higher (95%CI (3.59, 14.03, when comparing the least and most deprived quintiles of the study population. Family history of atopic disease and deprivation score were not associated with severe disease. Multivariate multinomial logistic regression which initially included all covariates, found household tobacco smoking (adjusted OR = 2.45, 95%CI (1.60, 3.74 predicted need for oxygen supplementation. Household tobacco smoking (adjusted OR = 5.49, (2.78, 10.83 and weight (kg on admission (adjusted OR = 0.51, (0.40, 0.65 were both significant predictors in the final model for mechanical ventilation. The same associations and similar size of effects were found when only children with proven RSV infection were included in analysis. CONCLUSIONS: Low

  8. Local C-Reactive Protein Expression in Obliterative Lesions and the Bronchial Wall in Posttransplant Obliterative Bronchiolitis

    Directory of Open Access Journals (Sweden)

    Outi E. Päiväniemi

    2009-01-01

    Full Text Available The local immunoreactivity of C-reactive protein (CRP was studied in a heterotopic porcine model of posttranplant obliterative bronchiolitis (OB. Bronchial allografts and control autografts were examined serially 2–28 days after subcutaneous transplantation. The autografts stayed patent. In the allografts, proliferation of inflammatory cells (P<.0001 and fibroblasts (P=.02 resulted in occlusion of the bronchial lumens (P<.01. Influx of CD4+ (P<.001 and CD8+ (P<.0001 cells demonstrated allograft immune response. CRP positivity simultaneously increased in the bronchial walls (P<.01, in macrophages, myofibroblasts, and endothelial cells. Local CRP was predictive of features characteristic of OB (R=0.456–0.879, P< .05−P<.0001. Early obliterative lesions also showed CRP positivity, but not mature, collagen-rich obliterative plugs (P<.05. During OB development, CRP is localized in inflammatory cells, myofibroblasts and endothelial cells probably as a part of the local inflammatory response.

  9. Diagnosis of bronchdyskinetic syndrome of patients with dust-induced respiratory system diseases

    Energy Technology Data Exchange (ETDEWEB)

    Levitskaya, V.L.

    1987-12-01

    Bronchospastic syndrome aggravates non-specific, chronic diseases of lungs. Methods of pneumotachography and registration of parameters of flux/content loop enhances diagnosis of ventilatory insufficiency of patients with dust-related diseases. The flux/content loop presents a graphic record of speed of flow of inhaled and exhaled air depending on volume of lungs. Seventy Donbass miners with pneumoconiosis and chronic bronchitis were investigated. Measurements were made of following parameters: speed of inhaled and exhaled air, vital capacity and speed of air at 75%, 50% and 25% of vital capacity. Miners were then treated with salbutamol, an antispasmodic, and same parameters measured. Results are presented in a table showing change in parameters of pneumotachography of exhalation during salbutamol tests. Following salbutamol course, patients with pneumconiosis had a positive reaction in 67% of cases, negative in 24%, none in 9%; those with chronic bronchitis had a positive reaction in 79% and negative in 21% of cases. Respiratory disturbances of lung diseases are due to dyskinesia of bronchioles. Failure to respond to salbutamol, a sympathomimetic, may be due to heightened tone of bronchioles due to parasympathetic innervation requiring a cholinolytic to open bronchiole pathways. Method of pneumotachography with registration of parameter of flow/content loop is combined with pharmacologic tests with antispasmodic preparations to reveal location and mechanism of disturbance of bronchial tone and to determine choice of adequate treatment. 8 refs.

  10. Effectiveness of 3% hypertonic saline nebulization in acute bronchiolitis among Indian children: A quasi-experimental study

    Directory of Open Access Journals (Sweden)

    Harsh V Gupta

    2016-01-01

    Full Text Available Objective: To compare the effects of 3% hypertonic saline (HS and 0.9% normal saline with nebulized 0.9% normal saline with salbutamol in patients of acute viral bronchiolitis. Materials and Methods: Participants were divided into three groups, that is, 3% HS group, 0.9% normal saline group and 0.9% saline with salbutamol group. Four doses at interval of 6 h were given daily until discharge. Average CS score and length of hospital stay were compared. One-way analysis of variance paired t-test and Chi-square test were utilized for statistical analysis. Results: The mean ages of the patients in three groups were 6.03 ± 3.71, 5.69 ± 3.34 and 5.48 ± 3.35 respectively. The 3rd day CS scores for all the groups were 1.0 ± 1.1, 1.9 ± 1.1 and 3.3 ± 0.5 respectively (P = 0.000. The average length of hospital stay was 3.4 ± 1.7, 3.7 ± 1.9 and 4.9 ± 1.4 days respectively (P = 0.001. Conclusion: The present study concludes that 3% HS nebulization (without additional bronchodilators is an effective and safe treatment for nonasthmatic, moderately ill patients of acute bronchiolitis. The economic benefit of this comparably priced modality of treatment can be enormous in terms of hospital costs with parents returning to work sooner.

  11. Effectiveness of 3% hypertonic saline nebulization in acute bronchiolitis among Indian children: A quasi-experimental study

    Science.gov (United States)

    Gupta, Harsh V.; Gupta, Vivek V.; Kaur, Gurmeet; Baidwan, Amitoz S.; George, Pardeep P.; Shah, Jay C.; Shinde, Kushal; Malik, Ruku; Chitkara, Neha; Bajaj, Krushnan V.

    2016-01-01

    Objective: To compare the effects of 3% hypertonic saline (HS) and 0.9% normal saline with nebulized 0.9% normal saline with salbutamol in patients of acute viral bronchiolitis. Materials and Methods: Participants were divided into three groups, that is, 3% HS group, 0.9% normal saline group and 0.9% saline with salbutamol group. Four doses at interval of 6 h were given daily until discharge. Average CS score and length of hospital stay were compared. One-way analysis of variance paired t-test and Chi-square test were utilized for statistical analysis. Results: The mean ages of the patients in three groups were 6.03 ± 3.71, 5.69 ± 3.34 and 5.48 ± 3.35 respectively. The 3rd day CS scores for all the groups were 1.0 ± 1.1, 1.9 ± 1.1 and 3.3 ± 0.5 respectively (P = 0.000). The average length of hospital stay was 3.4 ± 1.7, 3.7 ± 1.9 and 4.9 ± 1.4 days respectively (P = 0.001). Conclusion: The present study concludes that 3% HS nebulization (without additional bronchodilators) is an effective and safe treatment for nonasthmatic, moderately ill patients of acute bronchiolitis. The economic benefit of this comparably priced modality of treatment can be enormous in terms of hospital costs with parents returning to work sooner. PMID:27141475

  12. Usefulness of preoperative coronary angiography and brain computed tomography in cases of coronary artery disease and cerebrovascular disease undergoing revascularization for arteriosclerosis obliterans

    Energy Technology Data Exchange (ETDEWEB)

    Sakurada, Tall; Shibata, Yoshiki [Southern Tohoku Fukushima Hospital (Japan)

    2003-05-01

    Coronary angiography and brain computed tomography were preoperatively performed to evaluate the clinical condition of coronary artery disease and cerebrovascular disease in 101 patients (mean age, 68.4 years) with revascularization for arteriosclerosis obliterans. Eighty patients had hypertension, 12 had diabetes, and 26 had hyperlipidemia. Seventy-one patients (70.3%) had coronary stenosis. Significant stenoses in major coronary artery branches were confirmed in 35 patients, including 13 patients with old myocardial infarction. Coronary artery bypass grafting and percutaneous coronary angioplasty were performed in 2 and 7 patients with critical stenosis, respectively. Of 57 patients, who underwent brain computed tomography, abnormalities were found in 52 patients (91.2%), including cortical infarction in 9, lacunar infarction in 35, and leukoaraiosis in 27 patients. During the follow-up period 13 patients died (including 3 cases of myocardial infarction and 3 cases of stroke). Actuarial survival rate at 5 years was 80.4%. The influence of ischemic heart disease and cerebrovascular disease on early and late mortality after surgical reconstruction for peripheral occlusive vascular disease is significant. Using visual diagnostic techniques, such as coronary angiography and brain computed tomography, long term survivor should be closely observed for multiple arteriosclerotic vascular diseases. (author)

  13. 毛细支气管炎患儿微量元素的相关性研究%Trace Elements in Children with Bronchiolitis Correlation

    Institute of Scientific and Technical Information of China (English)

    苏绍斌

    2011-01-01

    Objective: Children with bronchiolitis by measuring the trace elements zinc,iron,copper, calcium,magnesium, lead content in order to understand the existence of bronchiolitis micronutrient deficiencies. Methods: To infants under 2 years old were divided into two groups: 60 patients with bronchiolitis group and 60 healthy control group. Bronchiolitis group were measured and the control group of zinc, iron, copper, calcium, magnesium, lead content and compared. Results: Bronchiolitis group of zinc, iron and calcium content is lower than the healthy group, two groups were significantly different. The two groups of trace elements copper, magnesium, lead, there was no significant difference in the content. Tip bronchiolotis lack of trace elements zinc, iron, calcium. Conclusions: By deficient in zinc,calcium treatment of bronchiolitis in children can significantly eliminate the clinical signs and symptoms, shorten the course and hospital stay, lower cost of treatment in children,is safe and effective%目的:通过测定毛细支气管炎患儿微量元素锌、铁、铜、钙、镁、铅的含量以了解毛支患儿是否存在微量元素缺乏.方法:将2岁以下的婴幼儿研究对象分为两组:60例毛支组和60例健康对照组.分别测定毛支组和对照组的微量元素锌、铁、铜、钙、镁、铅的含量并进行比较.结果:毛细支气管炎组锌、铁、钙的含量低于健康组,两组相比有显著差异.而两组的微量元素铜、镁、铅的含量则无显著差异.提示毛支患儿缺乏微量元素锌、铁、钙.结论:通过补充微量元素锌、钙治疗毛细支气管炎能显著消除患儿的临床症状和体征,缩短病程和住院时间,降低患儿治疗费用,既安全又有效.

  14. Dumping Syndrome

    Science.gov (United States)

    ... System & How it Works Digestive Diseases A-Z Dumping Syndrome What is dumping syndrome? Dumping syndrome occurs when food, especially sugar, ... the colon and rectum—and anus. What causes dumping syndrome? Dumping syndrome is caused by problems with ...

  15. Analysis on the risk factors for severe bronchiolitis.%重型毛细支气管炎危险因素分析

    Institute of Scientific and Technical Information of China (English)

    肖红梅

    2012-01-01

    Objective To investigate the high risk factors of severe bronchiolitis in children. Methods Eighty-one children with bronchiolitis were divided into common group and severe group, according to the severity of the disease. The medical history of each case was collected, including sex, age, body weight, feeding patterns, fetal age, eczema history, and smoking history of family members. Case control analysis and statistical analysis were carried out between the two groups. Results The incidences of severe bronchiolitis were significantly higher than that of common bronchiolitis in children with male sex, premature delivery history, under 3 months old, non-breastfeeding (P0.05). Conclusion Male sex, premature delivery history, age under 3 months, and non-breastfeeding are the high risk factors of severe bronchiolitis. Careful history taking, including sex, age, delivery mode, feeding patterns, is necessary in clinical reception of children with bronchiolitis. And early-stage active intervention should be taken to prevent the occurrence of severe type bronchiolitis. Prevention of premature delivery and promoting breast feeding are the key to prevent severe bronchiolitis.%目的 探讨重型毛细支气管炎发生的高危因素.方法 将81例毛细支气管炎患儿根据病情分为普通型和重型,于病历中采集性别、年龄、体重、喂养方式、胎龄、湿疹史、家中有无经常吸烟者病史,两组比较,进行病例对照分析及统计学分析.结果 重型毛细支气管炎在男性、早产儿、年龄<3个月、非母乳喂养患儿的发生率高于普通型,两组比较差异有统计学意义(P<0.05);肥胖儿、有湿疹史和家中有经常吸烟者患儿的发生率比较差异无统计学意义(P>0.05).结论 男性、早产儿、年龄<3个月、非母乳喂养是重型毛细支气管炎发生的高危因素,接诊毛细支气管炎患儿时应仔细询问性别、年龄、出生情况和喂养方式病史特点,并进

  16. Disseminated rhinovirus C8 infection with infectious virus in blood and fatal outcome in a child with repeated episodes of bronchiolitis.

    Science.gov (United States)

    Lupo, Julien; Schuffenecker, Isabelle; Morel-Baccard, Christine; Bardet, Julie; Payen, Valérie; Kaiser, Laurent; Constant, Samuel; Lobrinus, Johannes Alexander; Lin-Marq, Nathalie; Lina, Bruno; Morand, Patrice; Tapparel, Caroline

    2015-05-01

    We report a fatal case of acute lower respiratory tract disease with human rhinovirus C (HRV-C) as the unique cause in a 19-month-old girl with a history of repeated episodes of bronchiolitis. HRV-C type 8 nucleic acids were observed in respiratory, stool, and cerebrospinal fluid samples, and infectious virions were isolated from patient serum after inoculation onto reconstituted airway epithelia.

  17. 毛细支气管炎患儿血清微量元素分析%Analysis of trace elements in the serum of children with bronchiolitis

    Institute of Scientific and Technical Information of China (English)

    侯淑萍; 付荣

    2011-01-01

    目的:探讨血清中微量元素水平与毛细支气管炎的关系.方法:将住院的133例毛细支气管炎患儿作为观察组,同期门诊查体的120例健康儿童列为对照组,对其进行血清微量元素测定,并对两组检测结果进行统计学分析.结果:观察组患儿血清中锌含量低于健康儿童组,差异有统计学意义(P<0.05).结论:毛细支气管炎患儿锌缺乏,需及时补充.%Objective: To investigate the relationship between trace elements level in the serum and bronchiolitis patients.Methods: 133 cases of bronchiolitis children as the observation group, 120 cases of healthy children as control group, recorded the contents of serum trace elements, results of two groups were statistically analyzed.Results: The level of serum zinc of the observation group was lower than that of the control group, difference was statistically significant (P<0.05).Conclusion: Zinc in the serum of children with bronchiolitis is deficiency, needs to be supplemented.

  18. Bronquiolite aguda por rinovírus em lactentes jovens Rhinovirus and acute bronchiolitis in young infants

    Directory of Open Access Journals (Sweden)

    Paulo M. C. Pitrez

    2005-10-01

    Full Text Available OBJETIVO: Determinar a prevalência de infecção por rinovírus em lactentes menores de 6 meses hospitalizados por bronquiolite aguda. MÉTODOS: Foram selecionados de forma prospectiva lactentes hospitalizados com diagnóstico de bronquiolite aguda, no Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul, no período entre maio e setembro de 2002. Foi pesquisada a presença de vírus respiratórios no aspirado nasofaríngeo (ANF, através de imunofluorescência direta para vírus sincicial respiratório, parainfluenza, influenza e adenovírus. Para detecção do rinovírus, foi utilizada a reação de transcrição reversa, seguida de reação em cadeia da polimerase, específicas para picornavírus, seguidas de hibridização com sonda específica para rinovírus. RESULTADOS: Foram selecionados 45 lactentes hospitalizados com diagnóstico de bronquiolite aguda. A mediana da idade dos pacientes selecionados foi de 2 meses. Foram encontradas amostras positivas para vírus respiratórios em 35/45 (77,8% casos. Foi detectado mais de um vírus em 7/35 (20% amostras. Das amostras positivas, o vírus sincicial respiratório foi detectado em 33/35 (94% casos. O rinovírus foi detectado em 6/35 casos (17%. CONCLUSÕES: O rinovírus foi o segundo agente mais freqüentemente detectado em secreção nasal de lactentes jovens hospitalizados por bronquiolite aguda.OBJECTIVE: To determine the prevalence of rhinovirus infection in hospitalized young infants with acute bronchiolitis. METHODS: Hospitalized children with acute bronchiolitis admitted to the Hospital São Lucas/PUCRS between May and September 2002 were selected prospectively. Nasopharyngeal samples were assayed for respiratory syncytial virus, parainfluenza, influenza and adenovirus by immunofluorescence. For rhinovirus test a reverse transcription-polymerase chain reaction for picornavirus was used, followed by hybridization with rhinovirus specific probes. RESULTS

  19. Serotonin syndrome

    Science.gov (United States)

    Hyperserotonemia; Serotonergic syndrome; Serotonin toxicity; SSRI - serotonin syndrome; MAO - serotonin syndrome ... two medicines that affect the body's level of serotonin are taken together at the same time. The ...

  20. Lung transplantation in a Chinese single center:7 years of experience

    Institute of Scientific and Technical Information of China (English)

    HE Wen-xin; ZHANG Peng; LIU Ming; JIANG Ge-ning; DING Jia-an; GAO Wen; ZHU Yu-ming; ZHOU Xiao; CHEN Chang; WANG Hao; FAN Jiang

    2011-01-01

    Background Lung transplantation (LT) is a viable option for patients with end-stage lung diseases,but in China,the supply is limited,and the experience with LT is rare too. This study aimed to evaluate the survival and postoperative complications of recipients undergone LT.Methods From January 2003 to May 2010,all patients who underwent LT were included. The clinical data of recipients were analyzed retrospectively,including demographic characteristics,survival rate,and the occurrences of postoperative complications,acute rejection and bronchiolitis obliterans syndrome. Results In total,37 patients underwent LT. The early mortality (<30 days) was 14% (5/37). Cumulative survival rate was 78%,70%,70% and 42% at 1,3,5 and 6 years,respectively. In 37 patients,5 (14%) developed fungal infections,9 (24%)pulmonary bacterial infections,and 6 (16%) had bronchial anastomosis complications after LT. At three months posttransplantation,a significant improvement was observed in lung function (P <0.05). Fifteen recipients (41%) developed acute rejection within the first year. Freedom from bronchiolitis obliterans syndrome was 89%,85% and 80% at 1,2 and 3years after transplantation.Conclusions Despite the limited number of cases,the survival and occurrences of complications after LT were comparable to the international experience. Single LT may be a reasonable option for some patients with end-stage pulmonary diseases.

  1. Pulmonary manifestations of Sjögren's syndrome.

    Science.gov (United States)

    Flament, Thomas; Bigot, Adrien; Chaigne, Benjamin; Henique, Helene; Diot, Elisabeth; Marchand-Adam, Sylvain

    2016-06-01

    In 9-20% of cases, Sjögren's syndrome is associated with various respiratory symptoms. The most typical manifestations are chronic interstitial lung disease (ILD) and tracheobronchial disease. The most common manifestation of ILD is nonspecific interstitial pneumonia in its fibrosing variant. Other types of ILD, such as organising pneumonia, usual interstitial pneumonia and lymphocytic interstitial pneumonitis, are rare. Their radiological presentation is less distinctive, and definitive diagnosis may require the use of transbronchial or surgical lung biopsy. Corticosteroid therapy is the mainstay of ILD treatment in Sjögren's syndrome, but the use of other immunosuppressive drugs needs to be determined. ILD is a significant cause of death in Sjögren's syndrome. Tracheobronchial disease is common in Sjögren's syndrome, characterised by diffuse lymphocytic infiltration of the airway. It is sometimes responsible for a crippling chronic cough. It can also present in the form of bronchial hyperresponsiveness, bronchiectasis, bronchiolitis or recurrent respiratory infections. The management of these manifestations may require treatment for dryness and/or inflammation of the airways. Airway disease has little effect on respiratory function and is rarely the cause of death in Sjögren's syndrome patients. Rare respiratory complications such as amyloidosis, lymphoma or pulmonary hypertension should not be disregarded in Sjögren's syndrome patients.

  2. Pulmonary manifestations of Sjögren's syndrome

    Directory of Open Access Journals (Sweden)

    Thomas Flament

    2016-06-01

    Full Text Available In 9–20% of cases, Sjögren's syndrome is associated with various respiratory symptoms. The most typical manifestations are chronic interstitial lung disease (ILD and tracheobronchial disease. The most common manifestation of ILD is nonspecific interstitial pneumonia in its fibrosing variant. Other types of ILD, such as organising pneumonia, usual interstitial pneumonia and lymphocytic interstitial pneumonitis, are rare. Their radiological presentation is less distinctive, and definitive diagnosis may require the use of transbronchial or surgical lung biopsy. Corticosteroid therapy is the mainstay of ILD treatment in Sjögren's syndrome, but the use of other immunosuppressive drugs needs to be determined. ILD is a significant cause of death in Sjögren's syndrome. Tracheobronchial disease is common in Sjögren's syndrome, characterised by diffuse lymphocytic infiltration of the airway. It is sometimes responsible for a crippling chronic cough. It can also present in the form of bronchial hyperresponsiveness, bronchiectasis, bronchiolitis or recurrent respiratory infections. The management of these manifestations may require treatment for dryness and/or inflammation of the airways. Airway disease has little effect on respiratory function and is rarely the cause of death in Sjögren's syndrome patients. Rare respiratory complications such as amyloidosis, lymphoma or pulmonary hypertension should not be disregarded in Sjögren's syndrome patients.

  3. 雾化吸入治疗小儿毛细支气管炎的护理研究进展%A research progress on nursing for aerosol inhalation in the treatment of children with bronchiolitis

    Institute of Scientific and Technical Information of China (English)

    陈领; 陈素娟

    2016-01-01

    Bronchiolitis is a common disease in children, which usually presents runny nose, cough and shortness of breath.Severe bronchiolitis can cause dyspnea and it seriously impacts the health of children. Supportive care is the basis for the treatment of bronchiolitis.Aerosol inhalation plays an important role in the treatment of bronchiolitis.This paper will review recent inhalation therapy and nursing progress of bronchiolitis from the aspect of aerosolized medication selection and aerosolized mode, nursing intervention on inhalation.%毛细支气管炎是小儿常见病,通常表现为流涕、咳嗽和呼吸急促,严重可引起呼吸困难,严重影响患儿健康. 支持治疗是目前治疗毛细支气管炎的基础,雾化吸入对治疗小儿毛细支气管炎具有重要作用,本文将从雾化药物的选择、雾化方式的选择及雾化吸入的护理干预等方面对近年来雾化吸入治疗小儿毛细支气管炎的研究及护理进展作一综述.

  4. Diagnostic role of magnetic resonance angiography in Swyer James syndrome: Case series of two cases

    Directory of Open Access Journals (Sweden)

    Parashari Umesh

    2010-01-01

    Full Text Available Swyer James syndrome is a rare syndrome which occurs due to viral illness in early childhood. The post infective obliterative bronchiolitis results in arrest of lung growth and alveolarization with reduced vascularity resulting in classical radiological features. We describe two cases of patients fulfilling all the criteria of the syndrome - 1 Unilateral hyperlucent small lung in chest radiograph with air trapping on expiration, small ipsilateral hila and pulmonary artery. 2 Diffuse decrease in attenuation of lung parenchyma with bronchiectasis and reduction in vascularity. 3 Unilateral pruned tree appearance on angiography (MRA. The clinical presentation was recurrent chest infection in a child and infrequent bouts of hemoptysis in a middle aged female. The study demonstrates the role of magnetic resonance angiography in diagnosing the condition.

  5. Inflammatory Lung Disease in Rett Syndrome

    Directory of Open Access Journals (Sweden)

    Claudio De Felice

    2014-01-01

    Full Text Available Rett syndrome (RTT is a pervasive neurodevelopmental disorder mainly linked to mutations in the gene encoding the methyl-CpG-binding protein 2 (MeCP2. Respiratory dysfunction, historically credited to brainstem immaturity, represents a major challenge in RTT. Our aim was to characterize the relationships between pulmonary gas exchange abnormality (GEA, upper airway obstruction, and redox status in patients with typical RTT (n = 228 and to examine lung histology in a Mecp2-null mouse model of the disease. GEA was detectable in ~80% (184/228 of patients versus ~18% of healthy controls, with “high” (39.8% and “low” (34.8% patterns dominating over “mixed” (19.6% and “simple mismatch” (5.9% types. Increased plasma levels of non-protein-bound iron (NPBI, F2-isoprostanes (F2-IsoPs, intraerythrocyte NPBI (IE-NPBI, and reduced and oxidized glutathione (i.e., GSH and GSSG were evidenced in RTT with consequently decreased GSH/GSSG ratios. Apnea frequency/severity was positively correlated with IE-NPBI, F2-IsoPs, and GSSG and negatively with GSH/GSSG ratio. A diffuse inflammatory infiltrate of the terminal bronchioles and alveoli was evidenced in half of the examined Mecp2-mutant mice, well fitting with the radiological findings previously observed in RTT patients. Our findings indicate that GEA is a key feature of RTT and that terminal bronchioles are a likely major target of the disease.

  6. 血栓闭塞性脉管炎动物模型研究进展%Research Development on Animal Models of Thromboangiitis Obliterans

    Institute of Scientific and Technical Information of China (English)

    王懿; 孙蓉

    2012-01-01

    目的 对血栓闭塞性脉管炎(thromboangiitis obliterans TAO)动物模型制备方法进行综述,以寻找更加适合临床实际的造模方法.方法 对近20年国内外TAO造模方法相关文献进行整理、分析、归纳.结果 在已有TAO造模方法中,大鼠是首选造模动物,烟草致敏、寒冻、注射TAO免疫复合物等造摸方法虽然成模率都较好,也各有优缺点;以股动脉注射月桂酸改进模型与临床病理变化更相吻合,也被广泛应用于药理学活性发现和药效评价中.结论 针对TAO发病机制的造模方法目前鲜有报道.因此,在深入探讨TAO发病机制基础上的造模方法学研究与模型制备,是创新药物发现与新药药效评价的前提.%Objective To summarize preparation methods of TAO in animals, and find a more suitable method of making model in clinical research. Methods The related references in recent 20 years both at home and abroad about model making methods of TAO were analyzed, collated and summarized. Results In all the methods, rats were the first selected animal, and the methods of tobacco sensitization, cold aspic, injecting immune complex of TAO were better for making models, but each method had its merits and demerits. Method of injecting lauric acid into atreira cruralis without ZT viscose final encapsulation was most related to the clinical pathological changes, and was widely used in the research on pharmacology activity and efficacy evaluation. Conclusion The research on model making methods related with pathogenesis of TAO was rarely reported. So the research on methodology of model making related with the pathogenesis of TAO should be explored deeply, and that was the premise in discovery of innovation drug and evaluation of new drug efficacy.

  7. Clinical experience of Prof. ZHAO Kun for treating bronchiolitis with Mahuang Fuzi Xixin decoction%赵坤教授运用麻黄附子细辛汤加减治疗毛细支气管炎经验

    Institute of Scientific and Technical Information of China (English)

    古华倩; 顾丽丽; 赵坤

    2014-01-01

    To investigate application of Mahuang Fuzi Xixin decoction in treating bronchiolitis. To analyze the unique advantages of TCM treatment of bronchiolitis. Professor ZHAO Kun tells:onset of bronchiolitis related with exogenous pathogenic cold, lung, spleen and kidney three dirty less closely related and should be treated with Mahuang Fuzi Xixin decoction for yang and cold-off.%探讨赵坤教授运用麻黄附子细辛汤治疗毛细支气管炎的经验。分析中医药治疗毛细支气管炎的独特优势。赵坤教授认为:毛细支气管炎的发作与外感寒邪、肺脾肾三脏不足密切相关,治疗上应予麻黄附子细辛汤温阳散寒、疏风宣肺。

  8. 定喘汤治疗毛细支气管炎临床研究%Clinical research on treating bronchiolitis with the asthma-reliving decoction

    Institute of Scientific and Technical Information of China (English)

    王志敏

    2012-01-01

      Objective: To research the clinical effect of asthma-reliving decoction in treating bronchiolitis. Methods: 66 cases of children with bronchiolitis were randomly divided into the treatment group and the control group, 33 cases in each group. The treatment group was given the asthma-reliving decoction for oral use on the basis of western medicine, while the control group was given only western medicine for anti-infection and symptomatic treatment. Compared the pyretolysis time, tussis extinction time, pulmonary rales extinction time and the total efficiency between the two groups. Results: Compared with the control group, the pyretolysis time, tussis extinction time, pulmonary rales extinction time and the total efficiency of the treatment group had significant difference (P<0.05). Conclusion: The asthma-reliving decoction was effective in treating bronchiolitis.%  目的:研究定喘汤治疗毛细支气管炎临床疗效.方法:66例毛细支气管炎患者随机分为治疗组和对照组各33例,对照组用西药抗感染及对症治疗,治疗组在对照组用药的基础上加中药定喘汤口服,对比两组退热时间、咳嗽消失时间、肺部啰音消失时间及综合疗效.结果:治疗组退热时间、咳嗽消失时间、肺部罗音消失时间及总有效率与对照组相比差异有统计学意义(P<0.05).结论:定喘汤治疗毛细支气管炎效果确切.

  9. 甲泼尼龙治疗毛细支气管炎疗效观察%Clinical observation of methylprednisolone for bronchiolitis

    Institute of Scientific and Technical Information of China (English)

    石菊红; 方春艳

    2009-01-01

    Objective To compare the Clinical observation of Methylprednisolone (Mps) and dexamethasone in the treatment of Bronchiolitis. Methods Fifty-eight cases with bronchiolitis were randomly divided into the control group (n=29,intravenous injection of dexamethasone) and the treatment group (n=29, intravenous drip of Mps). Results The duration of pant and wheeze and cough and days in hospital were shorter in the treatment group than that in the control group .The difference was significant(P<0.01). Conclusion The Methylprednisolone is better than dexamethasone for bronchiolitis of children.%目的 比较甲泼尼龙与地塞米松治疗毛细支气管炎的疗效.方法 58例毛细支气管炎患儿随机分为两组,对照组(29例)在常规治疗基础上加用地塞米松静脉推注,治疗组(29例)在常规治疗基础上加用甲泼尼龙静脉滴注.结果 治疗组喘息消失、咳嗽消失、肺部啰音消失时间及住院时间均较对照组缩短,差异有统计学意义(P<0.01).结论 甲泼尼龙治疗毛细支气管炎疗效优于地塞米松.

  10. Parental and household smoking and the increased risk of bronchitis, bronchiolitis and other lower respiratory infections in infancy: systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Britton John

    2011-01-01

    Full Text Available Abstract Background Passive smoke exposure increases the risk of lower respiratory infection (LRI in infants, but the extensive literature on this association has not been systematically reviewed for nearly ten years. The aim of this paper is to provide an updated systematic review and meta-analysis of studies of the association between passive smoking and LRI, and with diagnostic subcategories including bronchiolitis, in infants aged two years and under. Methods We searched MEDLINE and EMBASE (to November 2010, reference lists from publications and abstracts from major conference proceedings to identify all relevant publications. Random effect pooled odds ratios (OR with 95% confidence intervals (CI were estimated. Results We identified 60 studies suitable for inclusion in the meta-analysis. Smoking by either parent or other household members significantly increased the risk of LRI; odds ratios (OR were 1.22 (95% CI 1.10 to 1.35 for paternal smoking, 1.62 (95% CI 1.38 to 1.89 if both parents smoked, and 1.54 (95% CI 1.40 to 1.69 for any household member smoking. Pre-natal maternal smoking (OR 1.24, 95% CI 1.11 to 1.38 had a weaker effect than post-natal smoking (OR 1.58, 95% CI 1.45 to 1.73. The strongest effect was on bronchiolitis, where the risk of any household smoking was increased by an OR of 2.51 (95% CI 1.96 to 3.21. Conclusions Passive smoking in the family home is a major influence on the risk of LRI in infants, and especially on bronchiolitis. Risk is particularly strong in relation to post-natal maternal smoking. Strategies to prevent passive smoke exposure in young children are an urgent public and child health priority.

  11. 重症毛细支气管炎的综合护理干预%Comprehensive Nursing Intervention of Severe Bronchiolitis

    Institute of Scientific and Technical Information of China (English)

    彭永健

    2013-01-01

    Objective: To investigate the application effect of comprehensive nursing measures of aerosol inhalation, percussion on back, postural drainage, suctioning and compression spray on children with severe bronchiolitis. Methods:We applied comprehensive nursing measures of aero-sol inhalation, percussion on back, postural drainage, suctioning and compression spray on twelve children with severe bronchiolitis and observed the nursing effect. Results:According to comprehen-sive nursing, twelve children’s respiratory rate, heart rate and arterial blood oxygen saturation were improved obviously. Conclusion:Comprehensive nursing measures of aerosol inhalation, per-cussion on back, postural drainage, suctioning and compression spray can help children with severe bronchiolitis maintain airway patency, alleviate hypoxia, live through the acute phase smoothly and discharge from hospital with recovery.%  目的:探讨雾化吸入、拍背、体位引流、吸痰、压喷等综合护理措施对重症毛细支气管炎患儿的应用效果。方法:对12例患重症毛细支气管炎的婴幼儿采取压喷吸入、胸部叩击、体位引流、吸痰等综合护理措施,观察护理效果。结果:经过综合护理后12例患儿的呼吸、心率、血氧饱和度均得到明显改善。结论:通过压喷吸入、拍背、体位引流、吸痰等综合护理措施,能有效帮助重症毛支患儿保持气道通畅,缓解缺氧,平稳度过急性期直至痊愈出院。

  12. 毛细支气管炎与哮喘相关性的研究进展%Research Progress on Association of Bronchiolitis with Asthma

    Institute of Scientific and Technical Information of China (English)

    刘晓梅

    2011-01-01

    Asthma is the most common chronic airway inflammatory disease that threatens the public health worldwide. Bronchiolitis manifests mainly as wheezing in childhood and is likely to progress into asthma. A long-term follow-up study shows that pediatric patients with bronchiolitis have a 22.1%~ 53. 2% of likelihood to suffer from asthma , significantly higher than that in normal children. The two major wheezing disorders in childhood are associated in some way. Extensive studies show that the progression of bronchiolitis into asthma depends on a variety of factors, including genetics , immunity , infection , environmental factors, susceptibility , and feeding. This article reviews the potential associations in the sense of genetics , immunity , and infection.%哮喘是当今世界威胁公共健康最常见的呼吸道慢性炎症性疾病.毛细支气管炎是婴幼儿时期以喘憋为突出临床表现的疾病,患儿易于病后发生哮喘,长期随访观察22.1% ~53.2%患哮喘,明显高于正常儿童.作为婴幼儿时期两个重要的喘息性疾病存在一定的相关性,研究显示毛细支气管炎发展为哮喘与遗传、免疫、感染、环境影响、特应质、喂养方式等诸多因素有关.现仅从遗传、免疫、感染等方面阐述其可能存在的相关性.

  13. Rett syndrome: An autoimmune disease?

    Science.gov (United States)

    De Felice, Claudio; Leoncini, Silvia; Signorini, Cinzia; Cortelazzo, Alessio; Rovero, Paolo; Durand, Thierry; Ciccoli, Lucia; Papini, Anna Maria; Hayek, Joussef

    2016-04-01

    Rett syndrome (RTT) is a devastating neurodevelopmental disease, previously included into the autistic spectrum disorders, affecting almost exclusively females (frequency 1:10,000). RTT leads to intellective deficit, purposeful hands use loss and late major motor impairment besides featuring breathing disorders, epilepsy and increased risk of sudden death. The condition is caused in up to 95% of the cases by mutations in the X-linked methyl-CpG binding protein 2 (MECP2) gene. Our group has shown a number of previously unrecognized features, such as systemic redox imbalance, chronic inflammatory status, respiratory bronchiolitis-associated interstitial lung disease-like lung disease, and erythrocyte morphology changes. While evidence on an intimate involvement of MeCP2 in the immune response is cumulating, we have recently shown a cytokine dysregulation in RTT. Increasing evidence on the relationship between MeCP2 and an immune dysfunction is reported, with, apparently, a link between MECP2 gene polymorphisms and autoimmune diseases, including primary Sjögren's syndrome, systemic lupus erythematosus, rheumatoid arthritis, and systemic sclerosis. Antineuronal (i.e., brain proteins) antibodies have been shown in RTT. Recently, high levels of anti-N-glucosylation (N-Glc) IgM serum autoantibodies [i.e., anti-CSF114(N-Glc) IgMs] have been detected by our group in a statistically significant number of RTT patients. In the current review, the Authors explore the current evidence, either in favor or against, the presence of an autoimmune component in RTT.

  14. Marfan Syndrome

    Science.gov (United States)

    Marfan syndrome is a disorder that affects connective tissue. Connective tissues are proteins that support skin, bones, ... fibrillin. A problem with the fibrillin gene causes Marfan syndrome. Marfan syndrome can be mild to severe, ...

  15. Metabolic Syndrome

    Science.gov (United States)

    ... hypertension, hypertriglyceridemia, insulin resistance syndrome, low HDL cholesterol, Metabolic Syndrome, overweight, syndrome x, type 2 diabetes Family Health, Kids and Teens, Men, Women January 2005 Copyright © American Academy of Family PhysiciansThis ...

  16. Williams syndrome

    Science.gov (United States)

    Williams-Beuren syndrome ... Williams syndrome is caused by not having a copy of several genes. Parents may not have any family history of the condition. However, people with Williams syndrome have a 50% chance of passing the ...

  17. Food intake during the previous 24 h as a percentage of usual intake: a marker of hypoxia in infants with bronchiolitis: an observational, prospective, multicenter study

    Directory of Open Access Journals (Sweden)

    Corrard François

    2013-01-01

    Full Text Available Abstract Background Hypoxia associated with bronchiolitis is not always easy to assess on clinical grounds alone. The aim of this study was to determine the value of food intake during the previous 24 hours (bottle and spoon feeding, as a percentage of usual intake (24h FI, as a marker of hypoxia, and to compare its diagnostic value with that of usual clinical signs. Methods In this observational, prospective, multicenter study, 18 community pediatricians, enrolled 171 infants, aged from 0 to 6 months, with bronchiolitis (rhinorrhea + dyspnea + cough + expiratory sounds. Infants with risk factors (history of prematurity, chronic heart or lung disorders, breast-fed infants, and infants having previously been treated for bronchial disorders were excluded. The 24h FI, subcostal, intercostal, supracostal retractions, nasal flaring, respiratory rate, pauses, cyanosis, rectal temperature and respiratory syncytial virus test results were noted. The highest stable value of transcutaneous oxygen saturation (SpO2 was recorded. Hypoxia was noted if SpO2 was below 95% and verified. Results 24h FI ≥ 50% was associated with a 96% likelihood of SpO2 ≥ 95% [95% CI, 91–99]. In univariate analysis, 24h FI  Conclusion In practice, the measure of 24 h FI may be useful in identifying hypoxia and deserves further study.

  18. 维生素D与毛细支气管炎的研究进展%Advances in correlation of vitamin D and bronchiolitis

    Institute of Scientific and Technical Information of China (English)

    涂李娟; 赵力芳; 庞随军

    2015-01-01

    Traditional physiological role of vitamin D is to maintain the normal growth and development of human tissue cells .Vitamin D deficiency can reduce the absorption and usage of cal-cium and risk of suffering from rickets ,osteomalacia disease ,ect.Recently, the study of vitamin D and bronchiolitis is becoming more and more , studies have shown that vitamin D treatment of bron-chiolitis have certain effect and can reduce the onset of wheezing in the future .%维生素D的传统生理作用是维持人体组织细胞的正常生长发育,其缺乏会导致人体钙元素的吸收及利用率的降低,严重时可导致儿童佝偻病、骨软化症的发生。随着人们对维生素D作用的进一步研究发现,维生素D对毛细支气管炎有一定的治疗作用,并能减少日后喘息发作。

  19. 持续正压通气在重症毛细支气管炎中的应用%The clinical application of continuous positive airway pressure in severe bronchiolitis

    Institute of Scientific and Technical Information of China (English)

    史瑞鹤; 刘恩梅

    2015-01-01

    毛细支气管炎是小婴儿最常见的下呼吸道感染性疾病,目前尚无特异性治疗,主要以对症支持治疗为主,近年来其治疗方法的探索一直是临床热点。持续正压通气(CPAP)作为一种安全、有效、无创的治疗方法,能有效缓解毛细支气管炎患儿的症状,改善预后,其临床应用越来越受到重视。文章对持续正压通气在重症毛细支气管炎患儿中的临床应用进行综述。%Bronchiolitis is the most common lower respiratory tract disease in infants. There is no speciifc treatment for it and the treatment is mainly supportive. The management of bronchiolitis is the clinical hotspot recently. Continuous positive airway pressure (CPAP) has gained more attention in clinical application as it is a safe, effective, and noninvasive method and can effectively relieve symptoms of bronchiolitis and improve prognosis. This paper reviews the clinical application of CPAP in infants with severe bronchiolitis.

  20. 100 cases Bronchiolitis Hypercoagulable State and the Effectiveness of Heparin Therapy%毛细支气管炎合并高凝状态100例及肝素抗凝治疗的有效性研究

    Institute of Scientific and Technical Information of China (English)

    胡敏

    2013-01-01

    目的探讨毛细支气管炎合并高凝状态及肝素抗凝治疗的有效性。方法测定2011年10月~2012年6月四川省简阳市中医院儿科收治的100例毛细支气管炎患儿治疗前后的D-二聚体(D-Dimer)、抗凝血酶Ⅲ(AT-Ⅲ)、凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血时间(APTT)、纤维蛋白原(Fbg)及氧饱和度(SaO2),并进行对比。结果100例毛细支气管炎患儿中50例的D-Dimer升高,治疗前50例患儿的AT-Ⅲ活性及SaO2明显降低,TT、APTT明显缩短。经肝素治疗后,50例治疗组患儿的D-Dmuer下降、SaO2升高、TT延长、Fbg下降。结论毛细支气管炎存在高凝状态;肝素抗凝治疗对毛细支气管炎合并高凝状态是有效的。%Objective To explore the hypercoagulable state of bronchiolitis and the ef ective anticoagulation treatment with heparin. Method D-Dimer、AT-Ⅲ、TT、PT、APTT、 Fbg and SaO2 levels were measured and compared in bronchiolitis before and after treatment with heparin. Results D-Dimer level was increased in 50 of 100 cases of bronchiolitis patients. In 50 patients with bronchiolitis before treatment with heparin, AT-Ⅲ And SaO2 levels were significantly lower and TT、APTT were remarkably shorter than in normal group. In 50 patients with bronchiolitis after treatment with heparin, D-Dimer and Fbg levels were significantly reduced, while SaO2 and TT levels were obviously increased. Conclusions There exists hypercoagulable state in bronchiolitis; Anticoagulation treatment with heparin in hypercoagulable state of bronchiolitis were ef ective.

  1. 血清CysLTs在毛细支气管炎和哮喘中的作用%Serum CysLTs in the Role of Bronchiolitis and Asthma

    Institute of Scientific and Technical Information of China (English)

    夏明月; 孙莉; 李明丽; 马瑞

    2013-01-01

    Objective:To explore the function and significance of CysLTs serum expression in bronchiolitis and asthma. Methods:80 cases of bronchiolitis children (bronchiolitis group) and 80 children with asthma (asthma group) were randomly selected. 40 healthy children served as control group. The levels of serum CysLTs in al groups were detected by enzyme-linked imnmnosorbent assays (ELISA). One-way ANOVA and T-test were performed to test the dif erence among the 3 groups. Results the serum CysLTs levels of children at acute stage of bronchiolitis and asthma group were higher than those of healthy children (P0.05). In remission period the serum CysLTs levels of bronchiolitis group were lower than that of asthma group (P0.05). The serum levels of asthma group were higher than that of control group (P0.05),均明显高于对照组(P0.05);哮喘组缓解期血清CysLTs水平高于健康对照组(P<0.05)。结论 CysLTs参与了毛支和哮喘的病理过程,但毛支恢复期血清CysLTs水平低于哮喘缓解期接近正常,揭示毛支不同于哮喘存在长期的气道过敏性炎症,故恢复期血清CysLTs水平,可以作为预测毛细支气管炎患儿以后发展为哮喘可能性的指标。

  2. 毛细支气管炎演变为哮喘的相关因素研究%Studies of the influences of bronchiolitis on development of asthma

    Institute of Scientific and Technical Information of China (English)

    朱丽丽

    2012-01-01

    哮喘是威胁儿童健康最常见的慢性气道炎症性疾病之一.毛细支气管炎显著增加了儿童哮 喘的发病风险,研究毛细支气管炎向哮喘发展的相关因素是近年研究热点,它有助于深入认识哮喘发生、发展的机制,为哮喘提供新的防治措施.目前研究认为,毛细支气管炎在遗传学、免疫学、环境因素(如病毒感染)等方面影响着哮喘的发展,而毛细支气管炎是否直接导致儿童哮喘的发展,通过预防毛细支气管炎能否降低儿童哮喘的发病率仍有待进一步研究.%Asthma is one of the most chronic airway inflammatory disease,threating the children's health.Bronchiolitis significantly increased the risk of childhood asthma,and many studies have focused on looking for the related factors between bronchiolitis and asthma in recent years.It may be helpful to understand the pathogenesis of the asthma,so as to find new measures for asthma's prevention and treatment.In present studies,bronchiolitis influenced the development of asthma in genetics,immunity,environmental factors and so on.So far,whether bronchiolitis directly causes the development of the childhood asthma,the prevention of bronchiolitis could reduce the asthma morbidity or not,both need more evidences yet.

  3. Kindler syndrome

    Directory of Open Access Journals (Sweden)

    Kaviarasan P

    2005-01-01

    Full Text Available Kindler syndrome is a rare autosomal recessive disorder associated with skin fragility. It is characterized by blistering in infancy, photosensitivity and progressive poikiloderma. The syndrome involves the skin and mucous membrane with radiological changes. The genetic defect has been identified on the short arm of chromosome 20. This report describes an 18-year-old patient with classical features like blistering and photosensitivity in childhood and the subsequent development of poikiloderma. The differential diagnosis of Kindler syndrome includes diseases like Bloom syndrome, Cockayne syndrome, dyskeratosis congenita, epidermolysis bullosa, Rothmund-Thomson syndrome and xeroderma pigmentosum. Our patient had classical cutaneous features of Kindler syndrome with phimosis as a complication.

  4. 热毒宁治疗小儿毛细支气管炎临床研究%Clinical Research of Reduning in the Treatment of Pediatric Bronchiolitis

    Institute of Scientific and Technical Information of China (English)

    王友军

    2012-01-01

    目的:观察热毒宁注射液治疗小儿毛细支气管炎的临床效果.方法:选100倒确诊为毛细支气管炎患儿,随机分为治疗组56例,对照组44例.在常规治疗基础上,治疗组给予热毒宁注射液(江苏康缘药业股份有限公司)0.6 mL·(kg·d)-1加入5%葡萄糖注射液中,每天1次,静脉滴注,对照组用利巴韦林10 mg·(kg- d)-1,静脉滴注,每天1次,两组疗程均为10d.结果:治疗结束后,治疗组与对照组有效率分别为98.21%和88.64%,经统计学处理,差异有统计学意义(P<0.05);治疗组在退热、减轻咳嗽闷喘症状、减少肺部啰音及不良反应等方面均明显优于对照组(P<0.05).结论:热毒宁治疗毛细支气管灸疗效显著,不良反应少.%Objective;To observe the clinical effect of redlining in the treatment of pediatric bronchiolitis. Methods:Choose 100 cases di-agnosed as pediatric bronchiolitis and divide them into the treatment group of 56 cases and control group of 44 cases. The treatment group is given redlining (Jiangsu KangYuan pharmaceutical corporation) 0.6 mL · (kg · d) ‐1 added in 5% of glucose injection based on routine therapy. Both the course of treatment is 10 days. Results:The total effective rate of the two groups is 98- 21% and 88.64% respectively after treatment. The difference is statistically significant( P <0.05) according to statistical treatment. The treatment group has advantage in pyretolysis,relieving cough and wheeze symptoms,reducing lung stuffy and side effect compared the control group(P< 0.05). Conclusion;Redlining has evident effect in the treatment of pediatric bronchiolitis and deserves clinic application.

  5. Study on Effectiveness of Low Dose Theophylline as Add-on to Inhaled Corticosteroid for Patients with Sulfur Mustard Induced Bronchiolitis

    Directory of Open Access Journals (Sweden)

    Yunes Panahi

    2013-12-01

    Full Text Available Background: Theophylline may reverse steroid resistance and decrease inflammation in patients with chronic pulmonary disease and sulfur mustard (SM induced bronchiolitis. This study was designed to assess the effects of low-dose theophylline on improvement of pulmonary function tests (PFTs of SM exposed patients.Methods: In this comparative observational study, a group of SM-exposed victims during the Iraq-Iran war who were treated with oral slow releasing (SR theophylline, salmetrol, fluxitide, omeprazole and NAC (study group were compared to a group of age and gender matched SM-exposed patients who received same medications except oral SR theophylline (historical control group. PFTs were measured at the beginning of the study and after 8 weeks of the treatment.Results: In total, 33 subjects in the study group and 27 subjects in the control group were studied. Mean (SD age of all subjects was 51 (14.1 years. In the study group, on the 8th week post-treatment, PFTs decreased, though the differences of tests between before and after treatment were not significant. In the control group, all the tests decreased in the same period and these reductions were not also significant. However, the changes in PFTs were significantly different between the two groups. The results of most PFTs in the controls decreased in greater extents compared to theophylline treated patients. This shows that despite theophylline was unable to improve the patients; it was partially able to decelerate the reductions in PFTs.Conclusion: Theophylline may not improve PFTs of SM exposed patients but it may decelerate the progress of the underlying respiratory disease. Further studies in this setting with higher doses of theophylline and longer term of evaluation are needed to better understand the pathophysiological mechanism of SM induced bronchiolitis and the effectiveness of the treatment with theophylline.   How to cite this article: Panahi Y, Poursaleh Z, Amini-Harandi A

  6. α-干扰素治疗毛细支气管炎疗效观察%Therapeutic Effect of IFN-αin Treating Bronchiolitis

    Institute of Scientific and Technical Information of China (English)

    苏丽霞

    2013-01-01

    Objective:To observe the therapeutic effect of interferon-α(IFN-α)on the infants with bronchiolitis. Method:64 cases with bronchiolitis were divided randomly into IFN-αtreatment group(32 cases)and control group(32 cases). Both groups got some routine treatments. The treatment group received additional intramuscular injection IFN-α[(50~100 kU/(kg·d),qd×5 d].The difference of improvement of symptoms and physical signs were observed in both groups. Result:The periods of the remission and disappearance of cough,asthma and rales were significantly shorter in the treatment group than those in the control group,The total effective rate of treatment group and control group were 91%and 81%respectively. The difference was significant(P<0.05).Conclusion:IFN-αtreatment is effective in treating bronchiolitis,and it is reliable and should be used widely.%目的:探讨α-干扰素治疗婴幼儿毛细支气管炎的临床疗效。方法:将64例毛细支气管炎患儿随机分为治疗组32例和对照组32例,对照组采用常规治疗方法,治疗组在此基础上加用α-干扰素5~10万U/(kg·d)肌肉注射,1次/d,疗程5 d。观察患儿咳嗽、喘息及肺部喘鸣音、湿啰音消退时间。结果:治疗组咳嗽、喘息及肺部体征消失时间均短于对照组,治疗组和对照组总有效率分别为91%和81%,两组比较差异均有统计学意义(P<0.05)。结论:α-干扰素治疗毛细支气管炎有确切的临床疗效,值得在临床推广使用。

  7. A COMPARATIVE STUDY TO ASSESS THE EFFE CTS OF NEBULISED 3% HYPERTONIC SALINE, 0.9% NORMAL SALINE AND SALBUTALMOL IN MANAGEMENT OF ACUTE BRONCHIOLITIS AMONG INDIAN CHILDREN

    Directory of Open Access Journals (Sweden)

    Gaurav

    2015-03-01

    Full Text Available AIMS AND OBJECTIVES: To compare the effects of nebulised 3% hypertonic saline , 0.9% saline and salbutamol in patients of acute bronchiolitis . DESIGN: R andomised controlled trial . SETTING: tertiary care teaching hospital . MATERIAL AND METHODS: 100 Children with age 1 to 24 months admitted in hospital with clinical diagnosis of acute bronchiolitis for 2 consecutive years were included in the study. Participants were divided into 3 groups – 3% hypertonic saline (HS , 0.9% norm al saline and salbutalmol. 4 doses of nebulisation at an interval of 6 hours were given daily in each group till discharge. RESULTS: The mean age of the patients in the study population was 5.7 ± 3.4 months. Maximum number of the patients i.e. 65.7% belong ed to the age group of 0 - 6 months. There was male preponderance in all 3 groups. Baseline Clinical Severity (CS scores in 3%HS , 0.9% Normal Saline and Salbutamol groups were 5.9±1.5 , 5.5±1.0 and 5.1±2.3 respectively (p=0.146. After treatment , the CS scor es dropped to 1.0±1.1 , 3.3±0.5 and 1.9±1.1 in 3%HS , 0.9% Normal Saline and Salbutamol groups respectively on the 3 rd day of treatment (p<0.01. Length of hospital stay in 3% HS , 0.9% Normal Saline and Salbutamol groups was 3.4±1.7 , 4.9±1.4 and 3.7±1.9 days respectively , which was found to be statistically significant (p= 0.001. CONCLUSION: 3% Hypertonic Saline nebulization (without additional bronchodilators is an effective and safe treatment in patients of acute bronchiolitis. It significantly reduces th e CS scores and length of hospital stay as compared to 0.9% Normal Saline and Salbutamol nebulizations.

  8. A spirometric journey following lung transplantation

    Science.gov (United States)

    Fuller, Jeremy; Paraskeva, Miranda; Thompson, Bruce; Snell, Greg; Westall, Glen

    2014-01-01

    Spirometry is regarded as the primary tool for the evaluation of lung function in lung transplant (LTx) recipients. Spirometry is crucial in detecting the various phenotypes of chronic lung allograft dysfunction (CLAD), including restrictive allograft syndrome (RAS) and bronchiolitis obliterans syndrome (BOS) – note that these phenotypes potentially have different etiologies and therapies. Following LTx for idiopathic pulmonary fibrosis, a 60-year-old male recipient’s lung function began to gradually improve, peaking at 5 months post-LTx. Subsequently, with increasing impairment of graft function, the diagnosis of BOS was made. A second LTx was performed and lung function subsequently began to increase again. Unfortunately, another year on, lung function deteriorated again – this time due to the development of RAS, antibody-mediated rejection was implicated as the possible underlying cause. This case report highlights the importance of spirometry in assessing the patterns of CLAD following LTx. PMID:25473588

  9. Belatacept for Maintenance Immunosuppression in Lung Transplantation

    Directory of Open Access Journals (Sweden)

    Christine Hui PharmD

    2014-06-01

    Full Text Available Belatacept is a novel immunosuppressant that blocks a T-cell costimulation pathway and is approved for use in adult kidney transplant recipients. Its safety and efficacy have not been established after lung transplantation. We present a case of a lung transplant recipient treated with belatacept. A 56-year-old man underwent bilateral lung retransplantation for bronchiolitis obliterans syndrome (BOS. In the third year posttransplant, he developed hemolytic uremic syndrome (HUS attributed to tacrolimus. Tacrolimus was changed to sirolimus. One month later, he presented with worsening renal function and HUS attributed to sirolimus. Plasmapheresis and steroid pulse were initiated with clinical improvement, and sirolimus was switched to belatacept. He experienced no episodes of cellular rejection but developed recurrent BOS. Complications during treatment included anemia and recurrent pneumonias. The safety and efficacy of belatacept in lung transplantation remains unclear; further studies are needed.

  10. Evolução e característica de lactantes com bronquiolite viral aguda submetidos à ventilação mecânica em uma unidade de terapia intensiva pediátrica brasileira Outcome and characteristics of infants with acute viral bronchiolitis submitted to mechanical ventilation in a Brazilian pediatric intensive care

    Directory of Open Access Journals (Sweden)

    Fernanda Umpierre Bueno

    2009-06-01

    bronquiolite viral aguda.OBJECTIVE: To describe the characteristics and the outcome of infants with acute viral bronchiolitis submitted to mechanical ventilation. METHODS: We performed a retrospective study enrolling all infants (less than 12 months old admitted with the diagnosis of acute viral bronchiolitis and submitted to mechanical ventilation in an university affiliated Brazilian pediatric intensive care unit between March, 2004 and September, 2006 (3 consecutives winters. The mechanical ventilation parameters' employed on 1st, 2nd, 3rd, 7th day and before extubation were evaluated as well as the evolution (mortality rate, presence of acute respiratory distress syndrome and the prevalence of complications. The groups were compared using the Student t test, the Mann-Whitney U test and the Chi-square test. RESULTS: Fifty-nine infants were included (3.8 ± 2.7 months old, 59% male, with 9.0 ± 9.4 days on mechanical ventilation. Prior mechanical ventilation, non invasive ventilation was instituted in 71% of children. Anemia was observed in 78% of the sample. In 51 infants (86.5% the lower airway obstructive pattern was maintained up to tracheal extubation with a nil mortality and low prevalence of pneumothorax (7.8%. Acute respiratory distress syndrome occurred in 8 infants (13.5%, with higher mortality and a higher prevalence of pneumothorax (62.5%. CONCLUSIONS: The declining mortality in acute viral bronchiolitis is observed even in non developed regions, involving children with high rates of anemia and premature labor. The low mortality is associated with the maintenance of the lower airway obstructive pattern during the period on mechanical ventilation. The development of acute respiratory distress syndrome is associated with increased mortality and higher prevalence of complications, representing the actual challenge in the management of children with severe acute viral bronchiolitis.

  11. Treating Bronchiolitis in Infants

    Science.gov (United States)

    ... Genitals and Urinary Tract Glands & Growth Head Neck & Nervous System Heart Infections Learning Disabilities Obesity Orthopedic Prevention Sexually Transmitted Skin Tobacco Treatments Injuries & ...

  12. Analysis the Related Risk Factors for Asthma Following Bronchiolitis%小儿毛细支气管炎哮喘病因分析

    Institute of Scientific and Technical Information of China (English)

    罗艳红

    2013-01-01

    Objective:To analyze the related risk factors for asthma following bronchiolitis.Method:The clinical data of 110 patients with bronchiolitis in our hospital from August 2010 to January 2013 were analyzed retrospectively.Result:Children obesity,illness weight,family history of asthma and specific physical fitness were important in infantile capillary bronchitis asthma risk factors,and the patient’s age,gender,feeding way were not important in infantile capillary bronchitis asthma risk factors.Conclusion:Capillary bronchitis and asthma risk factors are prone to asthma,in the process of clinical treatment for control and prevention,as far as possible risk factors,which can improve the patient’s prognosis.%目的:分析影响小儿毛细支气管炎哮喘的相关危险因素。方法:对本院在2010年8月-2013年1月收治的110例毛细支气管炎患者的临床资料进行回顾性分析。结果:患儿的肥胖程度、病情轻重、哮喘家族史和特异性体质是发生小儿毛细支气管炎哮喘的重要危险因素,而患儿的年龄、性别、喂养方式并不是发生小儿毛细支气管炎哮喘的重要危险因素。结论:毛细支气管炎合并哮喘危险因素容易发生哮喘,在临床治疗过程中应尽量控制和预防危险因素,可以改善患儿的预后。

  13. Evaluation of percutaneous transluminal angioplasty for treatment of infrapopliteal arteriosclerosis obliterans%经皮腔内血管成形术治疗膝下动脉粥样硬化闭塞症的评价

    Institute of Scientific and Technical Information of China (English)

    张玉超; 黄英; 李维敏; 陆信武; 黄新天; 陆民; 蒋米尔

    2012-01-01

    Objective To assess the therapeutic effect of percutaneous transluminal angioplasty ( PTA )on the treatment of infrapopliteal arteriosclerosis obliterans( ASOs ). Methods From Jan. 2007 to Jun. 2011, clinical data of patients with infrapopliteal ASO undergoing PTA at our department were retrospectively reviewed. Results Infrapopliteal PTA was performed on 138 lower limbs for 138 patients( mean age,77. 31 ±7. 52 year - old ). The mean diameter of balloon catheters used for infrapopliteal arteries was 2. 8 mm( 2 mm ~4 mm ), with the mean length of 110. 6 mm( 40 mm ~ 170 mm ). There were no severe complications occurring intraoperatively or postoperatively. Early results showed that all patients had significant improvement in ischemic symptoms( 100% ), and no patients had limb loss. During a mean follow -up of 24. 1 months( 4 ~ 58 months ), the rate of improvement in ischemic symptoms for treated limbs was 78. 4% and the limb salvage rate was 93. 9% at 2 years. Conclusion Minimal invasive PTA for the treatment of infrapopliteal ASO is safe and effective for improving ischemic symptoms of lower limbs and limb salvage.%目的 评价经皮腔内血管成形术(percutaneous transluminal angioplasty,PTA)治疗膝下动脉粥样硬化闭塞症(arteriosclerosis obliterans,ASO)的疗效.方法 回顾性研究2007年1月至2011年6月我科收治的累及膝下动脉ASO并行PTA治疗的患者的临床资料.结果 138例患者,平均年龄(77.31±7.52)岁,治疗膝下动脉所用球囊平均直径 2.8mm(2~4mm),平均长度110.6mm(40~170mm),术中及术后无严重并发症.术后早期治疗肢体临床症状明显改善率为100%,无截肢患者.平均随访24.1个月(4~58个月),治疗肢体术后2年临床症状明显改善率78.4%,救肢率93.9%.结论 PTA治疗膝下动脉ASO可有效改善临床缺血症状并提高救肢率.

  14. Edwards' syndrome.

    Science.gov (United States)

    Crawford, Doreen; Dearmun, Annette

    2016-12-08

    Edwards' syndrome is a serious genetic condition that affects fetal cellular functions, tissue development and organogenesis. Most infants with the syndrome are female, but there is no race predominance.

  15. Metabolic Syndrome

    Science.gov (United States)

    Metabolic syndrome is a group of conditions that put you at risk for heart disease and diabetes. These ... doctors agree on the definition or cause of metabolic syndrome. The cause might be insulin resistance. Insulin is ...

  16. Angelman Syndrome

    Science.gov (United States)

    ... this syndrome often display hyperactivity, small head size, sleep disorders, and movement and balance disorders that can cause ... this syndrome often display hyperactivity, small head size, sleep disorders, and movement and balance disorders that can cause ...

  17. Lynch Syndrome

    Science.gov (United States)

    ... colon cancer may include surgery, chemotherapy and radiation therapy. Cancer screening for people with Lynch syndrome If you ... et al. Milestones of Lynch syndrome: 1895-2015. Nature Reviews Cancer. http://www.nature.com/nrc/journal/vaop/ncurrent/ ...

  18. Cushing's Syndrome

    Science.gov (United States)

    Cushing's syndrome is a hormonal disorder. The cause is long-term exposure to too much cortisol, a hormone ... cause your body to make too much cortisol. Cushing's syndrome is rare. Some symptoms are Upper body obesity ...

  19. Paraneoplastic Syndromes

    Science.gov (United States)

    ... dementia, seizures, sensory loss in the limbs, and vertigo or dizziness. Paraneoplastic syndromes include Lambert-Eaton myasthenic ... dementia, seizures, sensory loss in the limbs, and vertigo or dizziness. Paraneoplastic syndromes include Lambert-Eaton myasthenic ...

  20. Turner Syndrome

    Science.gov (United States)

    Turner syndrome is a genetic disorder that affects a girl's development. The cause is a missing or incomplete ... t work properly. Other physical features typical of Turner syndrome are Short, "webbed" neck with folds of skin ...

  1. Dravet Syndrome

    Science.gov (United States)

    ... Craniosynostosis Information Page Creutzfeldt-Jakob Disease Information Page Cushing's Syndrome Information Page Dandy-Walker Syndrome Information Page Deep Brain Stimulation for Parkinson's Disease Information Page Dementia Information ...

  2. Apert Syndrome.

    Science.gov (United States)

    Datta, Saikat; Saha, Sandip; Kar, Arnab; Mondal, Souvonik; Basu, Syamantak

    2014-09-01

    Apert syndrome is one of the craniosynostosis syndromes which, due to its association with other skeletal anomalies, is also known as acrocephalosyndactyly. It is a rare congenital anomaly which stands out from other craniosynostosis due to its characteristic skeletal presentations.

  3. Velocardiofacial Syndrome

    Science.gov (United States)

    Gothelf, Doron; Frisch, Amos; Michaelovsky, Elena; Weizman, Abraham; Shprintzen, Robert J.

    2009-01-01

    Velocardiofacial syndrome (VCFS), also known as DiGeorge, conotruncal anomaly face, and Cayler syndromes, is caused by a microdeletion in the long arm of Chromosome 22. We review the history of the syndrome from the first clinical reports almost half a century ago to the current intriguing molecular findings associating genes from the…

  4. Fraser syndrome

    Directory of Open Access Journals (Sweden)

    Kalpana Kumari M

    2008-04-01

    Full Text Available Fraser syndrome or cryptophthalmos is a rare autosomal recessive disorder characterized by major features such as cryptophthalmos, syndactyly and abnormal genitalia. The diagnosis of this syndrome can be made on clinical examination and perinatal autopsy. We present the autopsy findings of a rare case of Fraser syndrome in a male infant.

  5. Rowell syndrome

    Directory of Open Access Journals (Sweden)

    Ramesh Y Bhat

    2014-01-01

    Full Text Available Rowell syndrome is a rare disease consisting of erythema multiforme-like lesions associated with lupus erythematosus. The syndrome occurs mostly in middle-aged women. The authors describe the syndrome in a 15-year-old boy who responded well to systemic steroids and hydroxychloroquine.

  6. Clinical research on treating bronchiolitis in TCM%小儿推拿合中药宣肺定喘汤治疗毛细支气管炎临床研究

    Institute of Scientific and Technical Information of China (English)

    褚付英

    2014-01-01

    目的:观察应用小儿推拿合中药宣肺定喘汤治疗毛细支气管炎的临床疗效,大力推广有效的绿色治疗。方法:观察69例采用小儿推拿合中药宣肺定喘汤的门诊治疗效果。结果:有效率达97.04%。结论:此疗法疗效显著。%Objective: To observe clinical effects of TCM on bronchiolitis. Methods: 69 patients were given massage plus the Xuanfei Dingchuan decoction. Results:The efficiency was 97.04%. Conclusion:The TCM therapy shows good effects on bronchiolitis.

  7. Refeeding syndrome.

    Science.gov (United States)

    Fernández López, M T; López Otero, M J; Alvarez Vázquez, P; Arias Delgado, J; Varela Correa, J J

    2009-01-01

    Refeeding syndrome is a complex syndrome that occurs as a result of reintroducing nutrition (oral, enteral or parenteral) to patients who are starved or malnourished. Patients can develop fluid-balance abnormalities, electrolyte disorders (hypophosphataemia, hypokalaemia and hypomagnesaemia), abnormal glucose metabolism and certain vitamin deficiencies. Refeeding syndrome encompasses abnormalities affecting multiple organ systems, including neurological, pulmonary, cardiac, neuromuscular and haematological functions. Pathogenic mechanisms involved in the refeeding syndrome and clinical manifestations have been reviewed. We provide suggestions for the prevention and treatment of refeeding syndrome. The most important steps are to identify patients at risk, reintroduce nutrition cautiously and correct electrolyte and vitamin deficiencies properly.

  8. [Metabolic syndrome].

    Science.gov (United States)

    Mitsuishi, Masanori; Miyashita, Kazutoshi; Itoh, Hiroshi

    2009-02-01

    Metabolic syndrome, which is consisted of hypertension, dyslipidemia and impaired glucose tolerance, is one of the most significant lifestyle-related disorders that lead to cardiovascular diseases. Among many upstream factors that are related to metabolic syndrome, obesity, especially visceral obesity, plays an essential role in its pathogenesis. In recent studies, possible mechanisms which connect obesity to metabolic syndrome have been elucidated, such as inflammation, abnormal secretion of adipokines and mitochondrial dysfunction. In this review, we focus on the relationship between obesity and metabolic syndrome; and illustrate how visceral obesity contributes to, and how the treatments for obesity act on metabolic syndrome.

  9. [Autoinflammatory syndrome].

    Science.gov (United States)

    Ida, Hiroaki; Eguchi, Katsumi

    2009-03-01

    The autoinflammatory syndromes include a group of inherited diseases that are characterized by 1) seemingly unprovoked episodes of systemic inflammations, 2) absence of high titer of autoantibody or auto-reactive T cell, and 3) inborn error of innate immunity. In this article, we will focus on the clinical features, the pathogenesis related the genetic defects, and the therapeutic strategies in the representative disorders including familial Mediterranean fever (FMF), TNF receptor associated periodic syndrome (TRAPS), cryopyrin-associated periodic syndrome (CAPS), hyper-IgD with periodic fever syndrome (HIDS), syndrome of pyogenic arthritis with pyoderma gangrenosum and acne (PAPA), and Blau syndrome. Recent advances in genetics and molecular biology have proceeded our understanding of the pathogenesis of autoinflammatory syndromes.

  10. Interleukin-8,RANTES gene polymorphism and respiratory syncytial virus bronchiolitis%白介素8、RANTES基因多态性与呼吸道合胞病毒毛细支气管炎

    Institute of Scientific and Technical Information of China (English)

    田曼; 陈荣华

    2008-01-01

    呼吸道合胞病毒(respiratory syncytial virus,RSV)感染2岁以下几乎所有的儿童,但只有少数发展为比较严重的毛细支气管炎及毛细支气管炎后反复喘息.随着对其遗传学研究的不断深入,通过对RSV毛细支气管炎患儿基因型的分析,发现白介素8、RANTES存在基因多态性,且可能与RSV毛细支气管炎及毛细支气管炎后反复喘息的易感性相关.%Respiratory syncytial virus(RSV)infects nearly all children under two years old,but only minority of them developed serious bronchiolitis and subsequent wheezing.Whether there is a genetic component is not known.The common single nucleotide polymorphisms in the promoter region of interleukin-8(IL-8)and RANTES upstream of the transcription start site affect their mRNA levels and protein expressions.This review includes the new researches about the genetic association between the IL-8,RANTES gene polymorphism and RSV bronchiolitis and post-bronchiolitis wheezing.

  11. Uso de surfactante exógeno no tratamento da bronquiolite viral grave: relato de caso Exogenous surfactant treatment for severe acute viral bronchiolitis: case report

    Directory of Open Access Journals (Sweden)

    Luciano S. Vitola

    2001-04-01

    Full Text Available OBJETIVO: descrever os possíveis efeitos clínicos e laboratoriais da instilação traqueal de surfactante exógeno a um lactente com bronquiolite viral aguda grave e submetido a ventilação mecânica. RELATO: menina de 2 meses de idade com diagnóstico clínico de bronquiolite viral aguda e submetida a ventilação mecânica, necessitando de altos picos de pressão inspiratória positiva (35 a 45 cmH2O e elevada fração de oxigênio inspirado (FiO2= 0,9, sem resposta clínica favorável ou melhora na gasometria arterial. Optou-se por instilar surfactante exógeno endotraqueal (Exosurf®, Glaxo - 50 mg/kg para permitir utilizar um regime ventilatório menos agressivo. RESULTADOS: quatro horas após a administração do surfactante, foi possível reduzir o pico inspiratório de pressão (PIP de 35 para 30 cmH2O; a FiO2 de 0,9 para 0,6 e aumentar a pressão positiva ao final da expiração (PEEP de 6 para 9 cmH2O. Neste período observou-se uma elevação na relação paO2/FiO2 de 120 para 266. Ao completar 24 horas, a FiO2 pôde ser reduzida até 0,4. DISCUSSÃO: neste relato pretendemos demonstrar que a inativação do surfactante pode ser um fator decisivo na evolução desfavorável de alguns casos graves de bronquiolite. A instilação traqueal de surfactante, nestes casos, além de promover uma rápida resposta clínica, permite que se adotem técnicas ventilatórias menos agressivas.OBJECTIVE: to describe the possible clinical and laboratory effects of exogenous surfactant instillation into the tracheal tube of a child with severe acute bronchiolitis undergoing mechanical ventilation. CASE REPORT: a 2-month-old girl with clinical diagnosis of acute viral bronchiolitis underwent mechanical ventilation. She required high positive inspiratory peak pressure (35 to 45 cmH2O and high inspiratory fraction of oxygen (FiO2 = 0.9, but showed no clinical response or improvement in the arterial blood gas analysis. An exogenous surfactant (Exosurf

  12. Effect of Tulobuterol Patches on Bronchiolitis%妥洛特罗贴剂治疗毛细支气管炎疗效观察

    Institute of Scientific and Technical Information of China (English)

    赵浦; 梁洁竞; 王毅; 孙禄; 袁迅玲

    2013-01-01

    Objective:To observe the therapeutic effect of tulobuterol patches infant bronchiolitis Methods: Seventy-one bronchiolitis infants were randomly divided into groups therapy (n=36), control (n=35). Both were given the same comprehensive treatment (anti-inflammatory, anti-virus, cough relieving phlegm dissipation, etc), and the therapy group given additional tulobuterol patches(0.5mg) affixed to chest at bedtime, the control given procaterol hydrochloride tablet, 1μg/kg orally once at bedtime. The courses lasted 7d . Themajor symptoms, sign disappearance time and treatment time were observed, and the incidence of adverse reactions calculated to evaluate therapeutic effect. Results: The extinction time of asthma, lung wheezing, cough were all shorter in therapy group than in control group(P,0.05). Localized skin redness occurred in 1 patient of therapy group(2.8%), adverence reactions in 4 of control group (11.4%), the difference was significant (P<0.05). Conclusion:Tulobuterol patches have a certain effect in treatment of infant bronchiolitis, with faster effect, fewer adverse reactions and good compliance.%  目的:观察妥洛特罗贴剂治疗婴幼儿毛细支气管炎的临床疗效。方法:将71例毛细支气管炎患儿随机分为治疗组(36例)和对照组(35例)。2组均给予相同的综合治疗,治疗组另给予妥洛特罗贴剂(阿米迪,0.5mg/贴),每晚20时贴于前胸或背部;对照组给予盐酸丙卡特罗片(美普清片)1μg/kg睡前1次口服。疗程7天。观察2组患儿主要症状、体征消失的时间,计算不良反应发生率。结果:治疗组喘憋消失时间及肺部喘鸣音消失时间、咳嗽消失时间均短于对照组,差异有统计学意义。治疗组有1例(2.8%)发生局部皮肤发红瘙痒,对照组8例(22.9%)发生不良反应,2组不良反应发生率组间差异有统计学意义(P<0.05)。结论:妥洛特罗贴剂治疗小儿毛细支气管炎显效快,副

  13. 雾化布地奈德治疗毛细支气管炎临床分析%Clinic analysis of treating bronchiolitis by budesonide atomizing inhalation

    Institute of Scientific and Technical Information of China (English)

    吉大章; 王玉屏; 张小燕

    2012-01-01

    [Objective] To analyse the efficacy and possible mechanism of treating children bronchiolitis caused by respiratory syncytial virus (RSV) and post-infection inflammation of the air passage by budesonide atomizing inhalation. [Methods] 120 children diagnosed with RSV bronchiolitis were randomly divided to atomizing group and common group. The number of pant days during the acute and recovery stage,hospitalization days and recurrence cases of these two groups were recorded and compared. The blood serum eosinophilic cationic proteins (ECP) , IL-6, IL-8 and IL-10 during the acute and recovery stage were tested and compared between the two groups,and statistics analysis was carried out. [Results] There was statistics significance (P<0. 05) of the pant days, hospitalization days and recurrence cases compared between these two groups. The values of ECP,IL-6 and IL-8 in the acute stage were higher than those in the recovery stage (P< 0. 05). The value of IL-10 in the acute stage was lower than in the recover stage (P<0. 05). The difference had statistics significance (Pbronchiolitis, and certain effects in preventing post-infection inflammation of air passage.%[目的]探讨吸入布地奈德治疗儿童呼吸道合胞病毒(respiratory syncytial virus,RSV)毛细支气管炎及感染后气道炎症的效果与可能发生机制. [方法]将确诊RSV毛细支气管炎120名患儿随机分成雾化组和常规组,记录比较急性期和恢复期喘息持续天数、住院天数及喘息再发例数;检测比较急性期与恢复期血清嗜酸粒细胞阳离子蛋白(eosinophil cationic protein,ECP) 、IL-6、IL-8、IL-10结果,进行统计学分析. [结果] 两组比较喘息持续天数、住院天数及喘息再发例数有统计学意义(P均<0.05);ECP、IL-6、IL-8值

  14. Efficacy of erigeron breviscapus combined with alprostadil in treating senile diabetic arteriosclerosis obliterans of the lower extremities: A clinical analysis of 25 cases%灯盏细辛联合前列地尔治疗老年糖尿病下肢动脉硬化闭塞症25例疗效观察

    Institute of Scientific and Technical Information of China (English)

    陈燕霞

    2012-01-01

    Objective To explore the clinical efficacy of erigeron breviscapus combined with alprostadil in treating senile diabetic arteriosclerosis obliterans of lower extremities. Methods Fifty patients with senile diabetes complicated with arteriosclerosis obliterans of lower extremities were randomly divided into two groups. The treatment group received lamps asarum injection combined with alprostadil. The control group (n = 25) received alprostadil treatment. The course of treatment was 2 weeks. Results The total efficacy rate of the treatment group was 96% , and the control group was 76% . The two groups had statistical difference (P<0. 05). The treatment group was significantly better than the control group. Conclusion Erigeron breviscapus combined with alprostadil in treatment of elderly patients with diabetic arteriosclerosis obliterans of lower extremities has better curative effect.%目的 针对灯盏细辛注射液联合前列地尔治疗老年糖尿病下肢动脉硬化闭塞症的疗效观察.方法 50例老年糖尿病合并下肢动脉硬化闭塞症患者随机分为2组,治疗组采用灯盏细辛注射液联合前列地尔,对照组25例采用前列地尔治疗,疗程2周.结果 治疗组总有效率96%,对照组总有效率76%,两组比较有统计学差异(P<0.05),治疗组明显优于对照组.结论 灯盏细辛联合前列地尔治疗老年糖尿病下肢动脉硬化闭塞症有较好的疗效.

  15. Bronchiole tube Pulmonary Alveolus cancer 80 Example Clinical Treatment Analysis%细支气管肺泡癌80例临床治疗分析

    Institute of Scientific and Technical Information of China (English)

    王研; 仇桂龙

    2014-01-01

    Objective Bronchioloalveoar cell carcinoma(BAC)is in an adenocarcinoma of lung hypotype.This research is discussion bronchiole pulmonary alveolus cancer clinical symptom,pathology type,elephant characteristic,diagnosis treatment principle and prognosis.Method Collected from January,2000 80 example bronchiole tube bronchioloalveoar cell carcinoma(BAC)patient's clinical manifestation which admitted to January,2006,discussed the bronchial tube pulmonary alveolus cancer the treatment new pattern and the prognosis.Result Complex therapy curative effect surpasses the sole treatment result.Clinical by stages,pathology type,phantom study characteristic,treatment principle and patient lifetime close correlation.Conclusion The BAC treatment pattern should by the complex therapy primarily .Cannot the sur-gery patient be supposed to use first the chemotherapy after the later period the molecular target to continue the therapy to the treatment birthplace to be possible to obtain the good curative effect.Analyzes this group to conform to the above condition 27 example case of illness,the longest lifetime is 97 months,the position lifetime is 25 months.%目的:细支气管肺泡癌(BAC)是肺腺癌中的一个亚型。本研究探讨细支气管肺泡癌临床症状、病理类型、像特点、诊断治疗原则及预后。方法收集我院2000年1月至2006年1月收治的80例BAC患者的临床表现,探讨支气管管肺泡癌的治疗新模式及预后。结果综合治疗的疗效优于单一治疗效果。临床分期、病理类型、影像学特点、治疗原则与患者生存期密切相关。结论对BAC的治疗模式应以综合治疗为主。对晚期不能手术的患者应采用先化疗后分子靶向治疗的贯续疗法可取得较好的疗效。分析本组符合上述条件的27例病例,最长生存期为97个月,中位生存期为25个月。

  16. Indicación de la fisioterapia respiratoria convencional en la bronquiolitis aguda Indications of conventional chest physiotherapy in acute bronchiolitis

    Directory of Open Access Journals (Sweden)

    Liliana Bohé

    2004-06-01

    Full Text Available Los objetivos de este trabajo fueron evaluar la utilidad de la fisioterapia respiratoria convencional en el tratamiento de la bronquiolitis aguda y determinar su influencia sobre los días de hospitalización. Se realizó un ensayo clínico controlado aleatorizado, donde se incluyeron dieciseis pacientes con bronquiolitis que fueron tratados dos veces al día con fisioterapia torácica y se compararon con dieciséis pacientes control, con la misma patología, quienes recibían sólo aspiración nasofaríngea. El grupo de tratamiento presentó un promedio en el score clínico de dificultad respiratoria al ingreso de 5.56 (± 1.96 y al alta 3.25 (± 1.27. El grupo control presentó un score de 5.75 (± 1.61 y 3.12 (± 1.30, p=0.77 y p=0.76 respectivamente. Respecto al promedio en los días de hospitalización fue de 4.00 (± 2.00 en el grupo de tratamiento y de 3.87 (± 1,30 para el grupo control, p=0.84. Concluimos que la fisioterapia respiratoria no aporta beneficio en su uso rutinario en el manejo de la broquiolitis aguda ni acorta los días de hospitalización.To evaluate the benefits of conventional chest physiotherapy in acute bronchiolitis, 32 patients were allocated in a randomized controlled trial, 16 were given twice daily chest physiotherapy compared with 16 controls who were not given chest physiotherapy. The treatment group showed a mean clinical score for respiratory disability at admission of 5.56 (± 1.96, and 3.25 (± 1.27 when discharged. The control group presented a score of 5.75 (± 1.61 and 3.12 (± 1.30, p=0.77 and p=0.76 respectively. The mean length of illness in hospital in the treatment group was 4.00 (± 2.00 vs 3.87 (± 1.30 in the control group, p=0.84. Chest physiotherapy does not produce clinically important benefits in the treatment of acute bronchiolitis.

  17. Lung and heart lung transplantation at the University of Alberta 1986-2010.

    Science.gov (United States)

    Lien, Dale C; Weinkauf, Justin; Jackson, Kathleen; Kapasi, Ali; Nador, Roland; Meyer, Steven; Stewart, Kenneth; Modry, Dennis; Mullen, John

    2010-01-01

    The lung transplantation program at the University of Alberta has been in existence for 25 years. The current volume is 35-40 new lung transplants per year. We offer single-lung, bilateral lung, heart/lung and bilateral living lobar transplantation as options. Experience has allowed for widening of the indications and acceptance of patients with more risk. Donor evaluation and management has allowed for extended donors to be included in the donor pool. Results will likely continue to improve with increased understanding of the mechanisms and management of bronchiolitis obliterans syndrome. Our research interests have been in the areas of risk analysis, outcome assessment, and quality of life changes from transplantation.

  18. Computed tomography findings of postoperative complications in lung transplantation; Achados tomograficos nas complicacoes pos-operatorias do transplante pulmonar

    Energy Technology Data Exchange (ETDEWEB)

    Hochhegger, Bruno; Irion, Klaus Loureiro; Marchiori, Edson; Bello, Rodrigo; Moreira, Jose; Camargo, Jose Jesus [Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS (Brazil). Postgraduate Program in Respiratory Sciences; Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Postgraduate Program in Radiological Sciences], e-mail: brunorgs@mail.ufsm.br

    2009-03-15

    Due to the increasing number and improved survival of lung transplant recipients, radiologists should be aware of the imaging features of the postoperative complications that can occur in such patients. The early treatment of complications is important for the long-term survival of lung transplant recipients. Frequently, HRCT plays a central role in the investigation of such complications. Early recognition of the signs of complications allows treatment to be initiated earlier, which improves survival. The aim of this pictorial review was to demonstrate the CT scan appearance of pulmonary complications such as reperfusion edema, acute rejection, infection, pulmonary thromboembolism, chronic rejection, bronchiolitis obliterans syndrome, cryptogenic organizing pneumonia, post transplant lymphoproliferative disorder, bronchial dehiscence and bronchial stenosis. (author)

  19. An international ISHLT/ATS/ERS clinical practice guideline:

    DEFF Research Database (Denmark)

    Meyer, Keith C; Raghu, Ganesh; Verleden, Geert M

    2014-01-01

    Bronchiolitis obliterans syndrome (BOS) is a major complication of lung transplantation that is associated with poor survival. The International Society for Heart and Lung Transplantation, American Thoracic Society, and European Respiratory Society convened a committee of international experts...... to March, 2013. The expert committee discussed the available research evidence upon which the updated definition of BOS, identified risk factors and recommendations are based. The committee followed the GRADE (Grading of Recommendation, Assessment, Development and Evaluation) approach to develop specific......, and several risk factors have been identified that have a significant association with the onset of BOS. Currently available therapies have not been proven to result in significant benefit in the prevention or treatment of BOS. Adequately designed and executed randomised controlled trials that properly...

  20. Histopathological Analogies in Chronic Pulmonary Lesions between Cattle and Humans: Basis for an Alternative Animal Model

    Science.gov (United States)

    Ramírez-Romero, Rafael; Nevárez-Garza, Alicia M.; Rodríguez-Tovar, Luis E.; Wong-González, Alfredo; Ledezma-Torres, Rogelio A.; Hernández-Vidal, Gustavo

    2012-01-01

    Most of the natural cases of pneumonia in feedlot cattle are characterized by a longer clinical course due to chronic lung lesions. Microscopically, these lesions include interstitial fibroplasia, bronchitis, bronchiectasis, bronchiolitis obliterans, and epithelial metaplasia of the airways. Herein, the aim was to review, under a medical perspective, the pathologic mechanisms operating in these chronic pneumonic lesions in calves. Based on the similarities of these changes to those reported in bronchiolitis obliterans/organising pneumonia (BO/OP) and chronic obstructive pulmonary disease (COPD) in human beings, calves are proposed as an alternative animal model. PMID:22629176

  1. Histopathological Analogies in Chronic Pulmonary Lesions between Cattle and Humans: Basis for an Alternative Animal Model

    Directory of Open Access Journals (Sweden)

    Rafael Ramírez-Romero

    2012-01-01

    Full Text Available Most of the natural cases of pneumonia in feedlot cattle are characterized by a longer clinical course due to chronic lung lesions. Microscopically, these lesions include interstitial fibroplasia, bronchitis, bronchiectasis, bronchiolitis obliterans, and epithelial metaplasia of the airways. Herein, the aim was to review, under a medical perspective, the pathologic mechanisms operating in these chronic pneumonic lesions in calves. Based on the similarities of these changes to those reported in bronchiolitis obliterans/organising pneumonia (BO/OP and chronic obstructive pulmonary disease (COPD in human beings, calves are proposed as an alternative animal model.

  2. HRCT findings of chest complications in patients with leukemia

    Energy Technology Data Exchange (ETDEWEB)

    Tanaka, Nobuyuki; Matsumoto, Tsuneo; Miura, Gouji; Emoto, Takuya; Matsunaga, Naofumi [Department of Radiology, Yamaguchi University School of Medicine (Japan)

    2002-06-01

    High-resolution CT (HRCT) findings of several chest complications occurring in leukemic patients were reviewed. Although most entities show non-specific HRCT findings including ground-glass opacity and air-space consolidation, characteristic findings are observed in several pulmonary complications including Pneumocystis carinii pneumonia, fungal infections, miliary tuberculosis, leukemic infiltration, pulmonary edema, bronchiolitis obliterans, and bronchiolitis obliterans organizing pneumonia. A combination of these characteristic HRCT findings and the information obtained from the clinical setting may help in achieving a correct diagnosis of chest complications occurring in leukemic patients. (orig.)

  3. Rheumatoid arthritis and cryptogenic organising pneumonitis.

    Science.gov (United States)

    Rees, J H; Woodhead, M A; Sheppard, M N; du Bois, R M

    1991-05-01

    We describe three patients with rheumatoid arthritis who presented with non-specific pulmonary symptoms, a restrictive defect in lung function and bilateral changes on chest radiograph. Lung histology showed characteristic features of cryptogenic organising pneumonitis and treatment with steroids produced significant improvement. The clinical and laboratory features of cryptogenic organising pneumonitis (otherwise known as bronchiolitis obliterans organising pneumonia, 'BOOP') are discussed and compared with those of bronchiolitis obliterans with which the condition should not be confused. Cryptogenic organising pneumonitis should be considered as one of the pulmonary manifestations of rheumatoid arthritis, but lung biopsy is essential to make the diagnosis.

  4. Wellens' syndrome

    Directory of Open Access Journals (Sweden)

    Franco Lai

    2007-12-01

    Full Text Available We report a case of quite rare cause of thoracic pain suspected by emergency physician as Wellens’ syndrome. Wellens’ syndrome is a pattern of electrocardiographic T-wave changes associated with critical, proximal left anterior descending artery (LAD. This syndrome is about 10-15% of all unstable angina in emergency department (ED. The cardiologic consult was obtained in ED and it was not conclusive for a Wellens’ syndrome, so that the diagnostistic planning was wrong. The authors point out the importance of this syndrome in ED and the necessity of an urgent angiographic study as every acute coronary syndrome presented in ED. We remark the importance in ED to recognize these changes associated with critical LAD obstruction and the high risk for anterior wall myocardial infarction.

  5. [Autoinflammatory syndromes].

    Science.gov (United States)

    Lamprecht, P; Gross, W L

    2009-06-01

    In its strict sense, the term "autoinflammatory syndromes" comprises the hereditary periodic fever syndromes (HPF), which are caused by mutations of pattern-recognition receptors (PRR) and perturbations of the cytokine balance. These include the crypyrinopathies, familial Mediterranean fever, TNF-receptor associated periodic fever syndrome (TRAPS), hyper-IgD and periodic syndrome (HIDS), pyogenic sterile arthritis, pyoderma gangrenosum and acne (PAPA) syndrome, NALP12-HPF, and the Blau syndrome. The diseases are characterized by spontaneous activation of cells of the innate immunity in the absence of ligands. Autoantibodies are usually not found. HPF clinically present with recurrent fever episodes and inflammation, especially of serosal and synovial interfaces and the skin. Intriguingly, PRR-mediated autoinflammtory mechanisms also play a role in a number of chronic inflammatory and autoimmune diseases.

  6. Metabolic syndrome

    Directory of Open Access Journals (Sweden)

    Gogia Atul

    2006-02-01

    Full Text Available The Metabolic syndrome is a widely prevalent and multi-factorial disorder. The syndrome has been given several names, including- the metabolic syndrome, the insulin resistance syndrome, the plurimetabolic syndrome, and the deadly quartet. With the formulation of NCEP/ATP III guidelines, some uniformity and standardization has occurred in the definition of metabolic syndrome and has been very useful for epidemiological purposes. The mechanisms underlying the metabolic syndrome are not fully known; however resistance to insulin stimulated glucose uptake seems to modify biochemical responses in a way that predisposes to metabolic risk factors. The clinical relevance of the metabolic syndrome is related to its role in the development of cardiovascular disease. Management of the metabolic syndrome involves patient-education and intervention at various levels. Weight reduction is one of the main stays of treatment. In this article we comprehensively discuss this syndrome- the epidemiology, pathogenesis, clinical relevance and management. The need to do a comprehensive review of this particular syndrome has arisen in view of the ever increasing incidence of this entitiy. Soon, metabolic syndrome will overtake cigarette smoking as the number one risk factor for heart disease among the US population. Hardly any issue of any primary care medical journal can be opened without encountering an article on type 2 diabetes, dyslipidemia or hypertension. It is rare to see type 2 diabetes, dyslipidemia, obesity or hypertension in isolation. Insulin resistance and resulting hyperinsulinemia have been implicated in the development of glucose intolerance (and progression to type 2 diabetes, hypertriglyceridemia, hypertension, polycystic ovary yndrome, hypercoagulability and vascular inflammation, as well as the eventual development of atherosclerotic cardiovascular disease manifested as myocardial infarction, stroke and myriad end organ diseases. Conversely

  7. Revesz syndrome

    Directory of Open Access Journals (Sweden)

    Dayane Cristine Issaho

    2015-04-01

    Full Text Available Revesz syndrome is a rare variant of dyskeratosis congenita and is characterized by bilateral exudative retinopathy, alterations in the anterior ocular segment, intrauterine growth retardation, fine sparse hair, reticulate skin pigmentation, bone marrow failure, cerebral calcification, cerebellar hypoplasia and psychomotor retardation. Few patients with this syndrome have been reported, and significant clinical variations exist among patients. This report describes the first Brazilian case of Revesz syndrome and its ocular and clinical features.

  8. Urofacial syndrome

    Directory of Open Access Journals (Sweden)

    Kamal F Akl

    2012-01-01

    Full Text Available The urofacial syndrome is characterized by functional obstructive uropathy asso-ciated with an inverted smile. The importance of the subject is that it sheds light, not only on the muscles of facial expression, but also on the inheritance of voiding disorders and lower urinary tract malformations. We report a 10-year-old-male patient who had the urofacial syndrome. Early diagnosis of the urofacial syndrome is important to avoid upper urinary tract damage and renal failure.

  9. Gorlin syndrome

    Directory of Open Access Journals (Sweden)

    Basanti Devi

    2013-01-01

    Full Text Available Gorlin Syndrome, a rare genodermatosis, otherwise known as Nevoid basal cell carcinoma syndrome (NBCCS is a multisystem disease affecting skin, nervous system, eyes, endocrine glands, and bones. It is characterized by multiple basal cell carcinomas, palmoplantar pits, jaw cysts, and bony deformities like kyphoscoliosis and frontal bossing. We would like to report a case of Gorlin syndrome with classical features, as this is a rare genodermatosis.

  10. Gorlin syndrome.

    Science.gov (United States)

    Devi, Basanti; Behera, Binodini; Patro, Sibasish; Pattnaik, Subhransu S; Puhan, Manas R

    2013-05-01

    Gorlin Syndrome, a rare genodermatosis, otherwise known as Nevoid basal cell carcinoma syndrome (NBCCS) is a multisystem disease affecting skin, nervous system, eyes, endocrine glands, and bones. It is characterized by multiple basal cell carcinomas, palmoplantar pits, jaw cysts, and bony deformities like kyphoscoliosis and frontal bossing. We would like to report a case of Gorlin syndrome with classical features, as this is a rare genodermatosis.

  11. Down Syndrome: Eye Problems

    Science.gov (United States)

    ... En Español Read in Chinese What causes Down syndrome? Down syndrome is caused by a duplication of all ... in persons with Down syndrome. How common is Down syndrome? The frequency of Down syndrome is approximately 1 ...

  12. Facts about Down Syndrome

    Science.gov (United States)

    ... Down syndrome. View charts » What is Down Syndrome? Down syndrome is a condition in which a person ... in height as children and adults Types of Down Syndrome There are three types of Down syndrome. People ...

  13. 180例毛细支气管炎患儿长期随访及其发展为哮喘的相关因素分析%Research of relative factors between bronchiolitis and asthma by long time follow-up of 180 children bronchiolitis patients

    Institute of Scientific and Technical Information of China (English)

    李仁清

    2013-01-01

    目的 对某院住院治疗的180例毛细支气管炎患儿进行长期随访,对其中可能是发展为哮喘的影响因素进行分析.方法 对该院住院治疗的180例毛细支气管炎患儿临床资料进行回顾性分析,所有患儿均随访5年.对性别、家族史、免疫球蛋白、喂养方式、吸入激素、过敏体质及被动吸烟可能是发展为哮喘的影响因素进行Logistic回归分析.结果 180例患儿中共有35例发展为哮喘,发生率为19.4%.单因素分析结果显示:哮喘患儿与非哮喘患儿在家族史、免疫球蛋白、喂养方式、吸入激素、过敏体质及被动吸烟方面差异有统计学意义(P<0.05);多因素分析结果显示:家族史、过敏体质及被动吸烟是毛细支气管炎患儿发展为哮喘的风险因素.母乳喂养、吸入激素、免疫球蛋白的使用是保护因素.结论 家族史、过敏体质及被动吸烟是毛细支气管炎患儿发展为哮喘的风险因素,临床上给予母乳喂养、吸入激素及免疫球蛋白的治疗可减少哮喘的发生.%OBJECTIVE 180 children bronchiolitis patients with the hospitalization treatment were followed up long time, then the relative factors between bronchiolitis and asthma were analyzed. METHODS The data of 180 children bronchiolitis patients with the hospitalization treatment were retrospectively analyzed. All the children were followed up for five years. Sex, family history , immunoglobulin, feeding patterns, inhaled corticosteroid, allergic constitution and passive smoking were observed. Logistic regression analysis was used to analyze the relationship between the factors and asthma. RESULTS 35 of 180 patients (19.4%) with bronchiolitis converted to asthma. Univariate analysis results showed that there were significant difference of family history, immunoglobulin, feeding patterns, inhaled corticosteroid, allergic constitution and passive smoking between the children with or without asthma (P< 0

  14. Significance of peripheral blood interleukin-12 in capillary bronchiolitis patients%毛细支气管炎患儿外周血白细胞介素-12的意义

    Institute of Scientific and Technical Information of China (English)

    王秀芳; 杨慧彬; 宋丽; 张艳丽; 许春娜

    2014-01-01

    Objective To discuss the role of interleukin (IL)-12 in capillary bronchiolitis disease.Methods Fifty-nine cases of capillary bronchiolitis children under 2 years old were enrolled as the bronchiolitis group Ⅰ(n =28) and bronchiolitis group Ⅱ(n =31),36 cases of children with bronchopneumonia of the same age and 31 cases of children suffered from non-infectious diseases such as hernia and renal calculus of the same age were enrolled as bronchopneumonia control group and normal control group respectively.The peripheral blood IL-12 levels of four groups were detected by enzyme-linked immunosorbent assay.Results The levels of the peripheral blood IL-12 in bronchiolitis group Ⅰ,bronchiolitis group Ⅱ,bronchopneumonia control group and normal control group were (34.72±7.96) pg/ml,(55.30 ±6.72) pg/ml,(56.79±10.36) pg/ml and (61.23 ± 11.51) pg/ml respectively.The level of the peripheral blood IL-12 in bronchiolitis group I was significantly lower than that in bronchiolitis group Ⅱ,bronchopneumonia control group and normal control group respectively (P <0.05),and the level of the peripheral blood IL-12 in bronchiolitis group ⅡⅡ was significantly lower than that in bronchopneumonia control group and normal control group respectively (P < 0.05),but there was no significant difference between bronchopneumonia control group and normal control group (P > 0.05).Conclusion The level of IL-12 is one of the important factors for bronchiolitis disease,the reducing of serum level of IL-12 in children who have a high risk factor of capillary bronchiolitis is more obvious.%目的 探讨白细胞介素(interleukin,IL)-12在毛细支气管炎发病过程中的意义.方法 选取59例2岁以下毛细支气管炎患儿,分为毛支Ⅰ组(n=28)和毛支Ⅱ组(n=31),其中毛支Ⅰ组为具有特应质高危因素的患儿,毛支Ⅱ组为无特应质高危因素的患儿.同期住院的同年龄段支气管肺炎患儿36例和患有疝气、肾结石等

  15. Fatores de risco associados à hospitalização por bronquiolite aguda no período pós-neonatal Risk factors associated with hospitalization for bronchiolitis in the post-neonatal period

    Directory of Open Access Journals (Sweden)

    Elaine P Albernaz

    2003-08-01

    Full Text Available OBJETIVO: Investigar a relação entre fatores socioeconômicos, características maternas, aleitamento e hospitalização por bronquiolite no período pós-neonatal. MÉTODOS: Estudo caso-controle, aninhado a estudo de coorte de 5.304 crianças nascidas na cidade de Pelotas, RS. O estudo de coorte constitui-se de quatro subestudos, cada um com métodos e logística específicos. As mães foram entrevistadas por meio de questionário padronizado, em visitas hospitalares e domiciliares. Foram definidos como casos as crianças com idade entre 28 e 364 dias, que haviam sido hospitalizadas por bronquiolite. RESULTADOS: De 5.304 crianças da coorte, 113 (2,1% foram hospitalizadas por bronquiolite. A análise multivariada hierarquizada, realizada pela regressão logística, mostrou os seguintes resultados: renda familiar, assim como idade gestacional, estiveram inversamente relacionadas ao risco de hospitalização por bronquiolite. O aleitamento materno desempenhou um fator protetor; crianças com tempo de aleitamento materno inferior a um mês tiveram risco 7 vezes maior de serem hospitalizadas por bronquiolite aguda nos primeiros três meses de vida. O risco de hospitalização por bronquiolite foi 57% maior naquelas expostas ao fumo materno. CONCLUSÕES: A hospitalização por bronquiolite está inversamente relacionada com renda familiar, idade gestacional e tempo de aleitamento materno, e diretamente relacionada com exposição a fumo materno. Não foi evidenciada associação com paridade ou história materna de asma brônquica.OBJECTIVE: To investigate the relationship between socioeconomic factors, maternal characteristics, breastfeeding, and hospitalization for bronchiolitis in the post-neonatal period. METHODS: A nested case-control study with a cohort of 5,304 children born in the city of Pelotas, Brazil, was conducted. The cohort study consisted of four sub-studies with their own methods and logistics. Mothers were interviewed using a

  16. 毛细支气管炎患儿单次潮气肺功能测定的临床意义%Clinical significance of single tidal breathing testing in bronchiolitis

    Institute of Scientific and Technical Information of China (English)

    李睿; 王吉安; 许家增; 杨慧敏

    2014-01-01

    目的:探讨毛细支气管炎患儿测定单次潮气肺功能的临床意义。方法检测和比较住院且<1岁的756例初次喘息毛细支气管炎患儿和115例支气管肺炎患儿的单次潮气肺功能。部分达峰时间比≤第20百分位和≥第80百分位的毛细支气管炎患儿出院1年后电话随访其喘息情况。结果毛细支气管炎患儿与支气管肺炎患儿比较,达峰时间比,达峰容积比,吸气时间,吸呼比,呼出25%、50%潮气容积时的呼气流速的差异有统计学意义(P均<0.05)。达峰时间比≤第20百分位的毛细支气管炎患儿1年内再喘息的比例为37.5%;达峰时间比≥第80百分位的毛细支气管炎患儿1年内再喘息比例为11.3%,两组差异有统计学意义(P<0.05)。结论单次潮气肺功能测定提示,阻塞程度较重的毛细支气管炎患儿再次喘息的可能性较大。%Objective To study clinical signiifcance of single tidal breathing testing in bronchiolitis. Methods Infants with bronchiolitis at ifrst wheezing (bronchiolitis group, n=756), and 115 infants with bronchopneumonia (bronchopneumonia group) hospitalized were enrolled. Tidal breathing parameters were analyzed in two groups. Bronchiolitis group was divided according to percentiles of the fraction of exhaled time at peak tidal expiratory lfow to total expiratory time (TPTEF/TE). The episodes of recurrent wheezing of infants below the 20th or above the 80th percentile of TPTEF/TE were followed up by phone calls within 1 year after discharge from the hospital. Results There were signiifcant differences in TPTEF/TE, VPEF/VE, Ti, Ti/Te, TEF75 and TEF50 between bronchiolitis group and bronchopneumonia group. The recurrent wheezing rate of infants with bronchiolitis below the 20th percentile of TPTEF/TE was signiifcantly higher than that above the 80th percentile of TPTEF/TE (37.5%vs 11.3%). Conclusions There is the greater possibility of recurrent wheezing in the infants with the

  17. 下肢动脉硬化性闭塞症介入治疗的回顾性分析%Interventional Revascularization of the Lower Limbs Arteriosclerosis Obliterans:A Retrospective Study

    Institute of Scientific and Technical Information of China (English)

    吴正阳; 鲁海涛; 朱悦琦; 谭华桥; 赵俊功

    2012-01-01

    目的 回顾性分析下肢动脉硬化性闭塞症(arteriosclerosis obliterans,ASO)介入治疗的临床疗效和通畅率.方法 从2009年10月到2011年7月,32例(39条下肢)下肢ASO患者在上海交通大学附属第六人民医院行介入治疗.回顾性分析32例ASO患者的血管造影图像,根据病变长度和程度分级.对手术成功患者随访,随访期3 ~16个月,平均随访期(8.7±1.9)个月.随访期内每3个月进行一次下肢MRA或CTA检查,并搜集相关临床资料.结果 技术成功率93%,踝肱指数(ankle-brachial index,ABI)从术前的0.47±0.11提高至术后的0.68±0.02,在随访期末20例取得了稳定疗效,总的通畅率为77%,保肢率为97%.结论 介入治疗ASO安全可行,取得了良好的临床效果及通畅率,其长期疗效尚需进一步观察.%Objective To retrospectively evaluated the clinical efficacy of interventional revascularization for lower limbs arteriosclerosis obliterans (ASO). Methods From Oct 2009 to July 2011, 32 patients (39 limbs) with lower limbs ASO performed interventional revascularization in our center. Angiography was retrospectively analyzed, and every lesion categorized and classified according to its length and severity. The mean follow up period was 3 - 162 months, mean 8.7 ± 1.9 months. Lower limb magnetic resonance angiography (MRA) or computed tomography angiography (CTA) was performed every 3 months during follow-up. The clinical data were collected. Results 93% technical success rate was obtained. Ankle-brachial index (ABI) improved from 0. 47 ±0. 11 to 0. 68 ± 0. 02. At the end of follow up, 20 patients maintained a stable outcome, gained a 77% patency rate and 97% limb salvage rate. Conclusion Interventional revascularization is safe and feasible in the treatment of lower limbs ASO. With encouraging clinical outcome and patency rate, further research is warranted to evaluate long-term outcome.

  18. Franceschetti syndrome

    Directory of Open Access Journals (Sweden)

    Vikrant Kasat

    2011-01-01

    Full Text Available Franceschetti syndrome is an autosomal dominant disorder of craniofacial development with variable expressivity. It is commonly known as Treacher Collins syndrome (TCS. It is named after E. Treacher Collins who described the essential components of the condition. It affects both genders equally. This article reports a case of TCS in an 18-year-old female.

  19. Turner Syndrome

    Directory of Open Access Journals (Sweden)

    Akcan AB.

    2013-06-01

    Full Text Available Turner syndrome is an important cause of short stature in girls and primer amenorrhea in young women that is usually caused by loss of part or all of an X chromosome. This topic will review the clinical manifestations, diagnosis and management of Turner syndrome.

  20. Proteus syndrome

    Directory of Open Access Journals (Sweden)

    George Renu

    1993-01-01

    Full Text Available A case of proteus syndrome in a 20 year old male is repoted. Hemihypertrophy, asymmetric megalodactyly, linear epidermal naevus, naevus flammeus, angiokeratoma, lymphangioma circumscriptum, thickening of the palms and soles, scoliosis and varicose veins were present. There are only few reports of these cases in adults. The syndrome has not been reported from India.

  1. Poland syndrome

    OpenAIRE

    Chandra Madhur Sharma; Shrawan Kumar; Meghwani, Manoj K.; Agrawal, Ravi P.

    2014-01-01

    Poland′s syndrome is a rare congenital condition, characterized by the absence of the sternal or breastbone portion of the pectoralis major muscle, which may be associated with the absence of nearby musculoskeletal structures. We hereby report an 8-year-old boy with typical features of Poland syndrome, the first documented case from Uttar Pradesh, India.

  2. Poland syndrome

    Directory of Open Access Journals (Sweden)

    Chandra Madhur Sharma

    2014-01-01

    Full Text Available Poland′s syndrome is a rare congenital condition, characterized by the absence of the sternal or breastbone portion of the pectoralis major muscle, which may be associated with the absence of nearby musculoskeletal structures. We hereby report an 8-year-old boy with typical features of Poland syndrome, the first documented case from Uttar Pradesh, India.

  3. Myelodysplastic Syndromes

    Science.gov (United States)

    ... your body, the white blood cells that fight infections, and the platelets that help with blood clotting. If you have a myelodysplastic syndrome, the stem cells do not mature into healthy blood cells. ... anemia, or easy bleeding. Myelodysplastic syndromes often do ...

  4. LEOPARD syndrome

    Science.gov (United States)

    ... L, Strano S, Carbone A, Calvieri C, Giustini S. LEOPARD syndrome. Dermatol Online J . 2008;14(3):7. PMID: 18627709 www.ncbi.nlm.nih.gov/pubmed/18627709 . Sarkozy A, Digilio MC, Dallapiccola B. LEOPARD syndrome. Orphanet J Rare Dis . 2008;3:13. PMID: ...

  5. Wallenberg's Syndrome

    Science.gov (United States)

    ... way, which makes it difficult to keep their balance when they walk. Treatment Treatment for Wallenberg's syndrome is symptomatic. A feeding ... way, which makes it difficult to keep their balance when they walk. Treatment Treatment for Wallenberg's syndrome is symptomatic. A feeding ...

  6. Turner Syndrome

    Directory of Open Access Journals (Sweden)

    Ravinder K. Gupta, Ritu Gupta, Sunil Dutt Sharma

    2006-10-01

    Full Text Available Turner Syndrome is one of the important chromosomal disorders characterised by loss (total or part ofsex chromosome. The manifestations being peripheral edema, short stature, extra skin fold, webbing ofneck, renal and cardiovascular anomalies, sexual infantilism, learning disability etc. We present here aone month female baby who had classical features of Turner Syndrome. The karyotape analysis wasconsistent with the diagnosis.

  7. Antiphospholipid syndrome

    DEFF Research Database (Denmark)

    Cervera, Ricard; Piette, Jean-Charles; Font, Josep

    2002-01-01

    To analyze the clinical and immunologic manifestations of antiphospholipid syndrome (APS) in a large cohort of patients and to define patterns of disease expression.......To analyze the clinical and immunologic manifestations of antiphospholipid syndrome (APS) in a large cohort of patients and to define patterns of disease expression....

  8. Arterialização do arco venoso do pé para tratamento da tromboangeíte obliterante Arterialization of the venous arch of the foot for the treatment of thromboangiitis obliterans

    Directory of Open Access Journals (Sweden)

    Cesar Roberto Busato

    2008-09-01

    Full Text Available Em isquemia crítica sem leito arterial distal, um dos modos de irrigar o membro isquêmico é derivar o fluxo de maneira retrógrada através do sistema venoso. As primeiras tentativas de fístulas arteriovenosas terapêuticas datam do início do século passado. Realizadas na parte proximal dos membros inferiores, não obtiveram resultados favoráveis. A partir da década de 70, com os trabalhos pioneiros de Lengua, as fístulas passaram a ser estendidas até o pé, e os bons resultados apareceram em várias publicações. Os autores relatam a evolução de um caso de tromboangeíte obliterante submetida ao procedimento. Essa é uma cirurgia de indicação precisa, que requer estudo pré-operatório arterial e venoso e observância a detalhes de técnica operatória.In critical ischemia without arterial run-off, it is possible to irrigate the ischemic limb by turning the course of the flow reversely through the venous system. The first experiments with therapeutic arteriovenous fistulas date from the beginning of the last century. They were performed in the proximal area of the lower limbs, but showed unfavorable results. Since the 1970's, with the pioneer studies of Lengua, fistulas started being extended to the foot and several publications have reported good outcomes. The authors report the evolution of a case of thromboangiitis obliterans which was submitted to the procedure. This is an accurate surgical procedure which requires arterial and venous preoperative study and the observance of technical operative details.

  9. MiR-142-3p attenuates the migration of CD4⁺ T cells through regulating actin cytoskeleton via RAC1 and ROCK2 in arteriosclerosis obliterans.

    Science.gov (United States)

    Liu, Jiawei; Li, Wen; Wang, Siwen; Wu, Yidan; Li, Zilun; Wang, Wenjian; Liu, Ruiming; Ou, Jingsong; Zhang, Chunxiang; Wang, Shenming

    2014-01-01

    The migration of CD4+ T cells plays an important role in arteriosclerosis obliterans (ASO). However, the molecular mechanisms involved in CD4+ T cell migration are still unclear. The current study is aimed to determine the expression change of miR-142-3p in CD4+ T cells from patients with ASO and investigate its role in CD4+ T cell migration as well the potential mechanisms involved. We identified by qRT-PCR and in situ hybridization that the expression of miR-142-3p in CD4+ T cells was significantly down-regulated in patients with ASO. Chemokine (C-X-C motif) ligand 12 (CXCL12), a common inflammatory chemokine under the ASO condition, was able to down-regulate the expression of miR-142-3p in cultured CD4+ T cells. Up-regulation of miR-142-3p by lentivirus-mediated gene transfer had a strong inhibitory effect on CD4+ T cell migration both in cultured human cells in vitro and in mouse aortas and spleens in vivo. RAC1 and ROCK2 were identified to be the direct target genes in human CD4+ T cells, which are further confirmed by dual luciferase assay. MiR-142-3p had strong regulatory effects on actin cytoskeleton as shown by the actin staining in CD4+ T cells. The results suggest that the expression of miR-142-3p is down-regulated in CD4+ T cells from patients with ASO. The down-regulation of miR-142-3p could increase the migration of CD4+ T cells to the vascular walls by regulation of actin cytoskeleton via its target genes, RAC1 and ROCK2.

  10. MiR-142-3p attenuates the migration of CD4⁺ T cells through regulating actin cytoskeleton via RAC1 and ROCK2 in arteriosclerosis obliterans.

    Directory of Open Access Journals (Sweden)

    Jiawei Liu

    Full Text Available The migration of CD4+ T cells plays an important role in arteriosclerosis obliterans (ASO. However, the molecular mechanisms involved in CD4+ T cell migration are still unclear. The current study is aimed to determine the expression change of miR-142-3p in CD4+ T cells from patients with ASO and investigate its role in CD4+ T cell migration as well the potential mechanisms involved. We identified by qRT-PCR and in situ hybridization that the expression of miR-142-3p in CD4+ T cells was significantly down-regulated in patients with ASO. Chemokine (C-X-C motif ligand 12 (CXCL12, a common inflammatory chemokine under the ASO condition, was able to down-regulate the expression of miR-142-3p in cultured CD4+ T cells. Up-regulation of miR-142-3p by lentivirus-mediated gene transfer had a strong inhibitory effect on CD4+ T cell migration both in cultured human cells in vitro and in mouse aortas and spleens in vivo. RAC1 and ROCK2 were identified to be the direct target genes in human CD4+ T cells, which are further confirmed by dual luciferase assay. MiR-142-3p had strong regulatory effects on actin cytoskeleton as shown by the actin staining in CD4+ T cells. The results suggest that the expression of miR-142-3p is down-regulated in CD4+ T cells from patients with ASO. The down-regulation of miR-142-3p could increase the migration of CD4+ T cells to the vascular walls by regulation of actin cytoskeleton via its target genes, RAC1 and ROCK2.

  11. 真腔内技术治疗股腘动脉硬化闭塞症55例%True lumen technique in the application of endovascular treatment for femoropopliteal arteriosclerosis obliterans of the lower extremities

    Institute of Scientific and Technical Information of China (English)

    于小滨; 李晓强; 孟庆友; 钱爱民; 桑宏飞; 戎建杰; 朱礼炜; 雷锋锐

    2015-01-01

    Objective To evaluate the clinical effect of the application of true lumen technology in endovascular treatment of femoropopliteal arteriosclerosis obliterans of the lower extremity.Methods From April 2009 to April 2013, 60 limbs in 55 patients of femoropopliteal arteriosclerosis obliterans received endovascular treatment using the true lumen technique.The average length of occlusion artery before operation was(13 ±3)cm, and the average ABI(ankle brachial index)was 0.47 ± 0.06.With the help of Roadmap, the vertical artery catheter and small diameter guide wire were usually applied during the operation,and we used the "rotation" technique to make sure guide wire goes through the occlusive segment in the true lumen.After the accomplishment of the guide wire, we performed angioplasty and atherectomy.Patients were followed up regularly by ultrasound or CTA.Results The technical success rate was 91.7%.We performed PTA in 9 cases, PTA and stent placement in 41 cases and 5 cases received endovascular atherectomy.The average number of stent placed during operation was 1.6 ± 0.6 and average length of stent was(8.2 ± 1.4)cm.The average ABI 3 days after operation was 0.73 ±0.10 (P <0.01).13 cases developed complications and amputation was done in 1 case.48 legs in 46 patients were followed up for the average period of (24 ± 11) months.The average ABI of 6 months, 12 months and 24 months after operation were 0.72 ±0.15, 0.67 ±0.13 and 0.63 ±0.19 respectively.The primary patency rate, assistant patency rate and secondary patency rate in 12 months and 24 months were 73.0%, 81.1%, 89.2% and 63.6%, 68.2% , 72.7% respectively.Conclusions The high successful rate and satisfactory early result could be obtained through the application of true lumen technology in the endovascular treatment of femoropopliteal atherosclerosis obliterans.%目的 总结真腔内通过闭塞段技术治疗下肢股腘动脉硬化闭塞症的临床疗效.方法 2009年3月至2013

  12. CHARGE syndrome

    Directory of Open Access Journals (Sweden)

    Prasad Chitra

    2006-09-01

    Full Text Available Abstract CHARGE syndrome was initially defined as a non-random association of anomalies (Coloboma, Heart defect, Atresia choanae, Retarded growth and development, Genital hypoplasia, Ear anomalies/deafness. In 1998, an expert group defined the major (the classical 4C's: Choanal atresia, Coloboma, Characteristic ears and Cranial nerve anomalies and minor criteria of CHARGE syndrome. Individuals with all four major characteristics or three major and three minor characteristics are highly likely to have CHARGE syndrome. However, there have been individuals genetically identified with CHARGE syndrome without the classical choanal atresia and coloboma. The reported incidence of CHARGE syndrome ranges from 0.1–1.2/10,000 and depends on professional recognition. Coloboma mainly affects the retina. Major and minor congenital heart defects (the commonest cyanotic heart defect is tetralogy of Fallot occur in 75–80% of patients. Choanal atresia may be membranous or bony; bilateral or unilateral. Mental retardation is variable with intelligence quotients (IQ ranging from normal to profound retardation. Under-development of the external genitalia is a common finding in males but it is less apparent in females. Ear abnormalities include a classical finding of unusually shaped ears and hearing loss (conductive and/or nerve deafness that ranges from mild to severe deafness. Multiple cranial nerve dysfunctions are common. A behavioral phenotype for CHARGE syndrome is emerging. Mutations in the CHD7 gene (member of the chromodomain helicase DNA protein family are detected in over 75% of patients with CHARGE syndrome. Children with CHARGE syndrome require intensive medical management as well as numerous surgical interventions. They also need multidisciplinary follow up. Some of the hidden issues of CHARGE syndrome are often forgotten, one being the feeding adaptation of these children, which needs an early aggressive approach from a feeding team. As the child

  13. Neuroacanthocytosis Syndromes

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    Walker Ruth H

    2011-10-01

    Full Text Available Abstract Neuroacanthocytosis (NA syndromes are a group of genetically defined diseases characterized by the association of red blood cell acanthocytosis and progressive degeneration of the basal ganglia. NA syndromes are exceptionally rare with an estimated prevalence of less than 1 to 5 per 1'000'000 inhabitants for each disorder. The core NA syndromes include autosomal recessive chorea-acanthocytosis and X-linked McLeod syndrome which have a Huntington´s disease-like phenotype consisting of a choreatic movement disorder, psychiatric manifestations and cognitive decline, and additional multi-system features including myopathy and axonal neuropathy. In addition, cardiomyopathy may occur in McLeod syndrome. Acanthocytes are also found in a proportion of patients with autosomal dominant Huntington's disease-like 2, autosomal recessive pantothenate kinase-associated neurodegeneration and several inherited disorders of lipoprotein metabolism, namely abetalipoproteinemia (Bassen-Kornzweig syndrome and hypobetalipoproteinemia leading to vitamin E malabsorption. The latter disorders are characterized by a peripheral neuropathy and sensory ataxia due to dorsal column degeneration, but movement disorders and cognitive impairment are not present. NA syndromes are caused by disease-specific genetic mutations. The mechanism by which these mutations cause neurodegeneration is not known. The association of the acanthocytic membrane abnormality with selective degeneration of the basal ganglia, however, suggests a common pathogenetic pathway. Laboratory tests include blood smears to detect acanthocytosis and determination of serum creatine kinase. Cerebral magnetic resonance imaging may demonstrate striatal atrophy. Kell and Kx blood group antigens are reduced or absent in McLeod syndrome. Western blot for chorein demonstrates absence of this protein in red blood cells of chorea-acanthocytosis patients. Specific genetic testing is possible in all NA syndromes

  14. HYDROLETHALUS SYNDROME

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    Aradhana

    2013-06-01

    Full Text Available INTRODUCTION: Hydrolethalus Syndrome (HLS is a rare lethal genetic syndrome, recognized as a consequence of a study on Meckle syndrome in Finland .1 HLS is characterized by multiple developmental defects of fetus which include fetal hydrocephalus, agenesis of corpus callosum, absent midline structures of brain, Cleft lip and cleft palate, defective lobulation of lungs, micrognathia and very characteristic abnormality of polydactyly. About 80% of patients have polydactyly, in hands it is postaxial and preaxial in feet with duplicated big toe. A highly characteristic hallux duplex is seen in almost no other situation .2 Club feet is also common.

  15. Hubris syndrome.

    Science.gov (United States)

    Owen, David

    2008-08-01

    Hubris syndrome is associated with power, more likely to manifest itself the longer the person exercises power and the greater the power they exercise. A syndrome not to be applied to anyone with existing mental illness or brain damage. Usually symptoms abate when the person no longer exercises power. It is less likely to develop in people who retain a personal modesty, remain open to criticism, have a degree of cynicism or well developed sense of humour. Four heads of government in the last 100 years are singled out as having developed hubris syndrome: David Lloyd George, Margaret Thatcher, George W Bush and Tony Blair.

  16. CLOVES syndrome.

    Science.gov (United States)

    Bloom, Jacob; Upton, Joseph

    2013-12-01

    A cohort of patients with overgrowth syndromes has been identified with congenital lipomatous overgrowth, dysregulated fat deposits, and mixed vascular malformations. The acronym CLOVES was given on a heuristic basis to stand for congenital lipomatous overgrowth (CLO), vascular malformation (V), epidermal nevi (E), and scoliosis and spinal deformities (S). These patients have upper limb anomalies with variable phenotypes. Although hand anomalies alone cannot make the diagnosis, the foot, truncal, cutaneous and spinal anomalies are particularly diagnostic. CLOVES syndrome has emerged as a distinct clinical entity diagnosed by clinical and radiographic examinations. The overgrowth pattern is now easily distinguished from other overgrowth syndromes.

  17. Detection of serum lactic dehydrogenase of infants with bronchiolitis and its clinical significance.%毛细支气管炎患儿血清乳酸脱氢酶水平的变化及临床意义

    Institute of Scientific and Technical Information of China (English)

    代东伶; 王缨; 何柳芳; 刘晓红

    2012-01-01

    Objective To investigate the level of serum lactic dehydrogenase( LDH )of infants with bronchiolitis and its clinical significance. Methods According to the clinical manifestation, 131 infant cases with bronchiolitis were divided into two groups, severe case group ( group S ) and mild case group ( group M ). Serum lactic dehydrogenase was detected by automatic biochemistry analyzer and compared between bronchiolitis cases and control subjects. Results Compared with control group, the infants with bronchiolitis had higher LDH level ( P <0.05 ). On admission, LDH was 316. 3 ±84.6 IU/L in group M and 567. 8 ±101.5 IU/L in group S( P <0.05 ),and it was 188.6 ±59.5 IU/L and 195. 4 ±63.3 IU/L respectively after one week treatment ( P <0.05 ). Moreover, all cases in group M had remission,but 7 cases in group S did not have remission or even aggravated and accompanied by further elevated LDH. Conclusion The changes of LDH level in infants with bronchiolitis may indicate the severity of clinical symptoms, and it makes a significant contribution to evaluate the prognosis of bronchiolitis.%目的 探讨毛细支气管炎患儿血清乳酸脱氢酶(LDH)水平及其临床意义.方法 将131例毛细支气管炎患儿按临床症状分为重症组和轻症组两组,并与正常对照组进行比较.结果 与正常对照组比较,毛细支气管炎患儿LDH显著升高(P<0.05);入院时,轻症组与重症组LDH分别为316.3±84.6 IU/L、567.8±101.5 IU/L(P<0.05),经过1周治疗后轻症组与重症组LDH分别为188.6±59.5 IU/L、195.4±63.3 IU/L(P<0.05);而且治疗1周后轻症组临床症状均缓解,而重症组有7例患儿临床症状无缓解甚至加重,LDH水平进一步升高.结论 毛细支气管炎患儿血清LDH的改变可以提示临床症状轻重,对预后判断也具有临床意义.

  18. 呼吸道合胞病毒毛细支气管炎患儿IL-17改变的意义%Changes of serum IL-17 level in infants with respiratory syncytial virus bronchiolitis

    Institute of Scientific and Technical Information of China (English)

    王同友; 王红兵

    2012-01-01

    目的 探讨呼吸道合胞病毒(RSV)感染毛细支气管炎患儿IL-17改变的意义.方法 采用ELISA方法检测30例RSV感染毛细支气管炎患儿(RSV毛支组)、30例非RSV感染支气管肺炎患儿(非RSV肺炎组)以及 25例健康对照儿(对照组)血清中IL-17浓度,并进行比较分析.结果 RSV毛支组患儿血清IL-17水平明显高于其他2组(P<0.01);非RSV肺炎组患儿血清IL-17水平高于对照组(P<0.01).结论 小儿呼吸道合胞病毒性毛细支气管炎的发生和发展与IL-17异常表达有关.%Objective To explore the change of interleukin 17 (IL -17) in infants with respiratory syncytial virus bronchiolitis and their clinical significance . Methods Serum IL — 17 of 30 respiratory syncytial virus ( RSV) bronchioli— tis infants, 30 pneumonia infants without RSV infection and 25 health controls were detected by using ELISA method. Results Level of serum IL -17 were obviously higher in RSV bronchiolitis infants than those in pneumonia infants with -out RSV infection and health controls (P <0.01). Level of serum IL — 17 of pneumonia infants without RSV was obvi — ously high compared with normal group (P <0.01). Conclusion IL -17 may play an important role in the pathogene-sis of RSV Bronchiolitis in infant.

  19. Clincial observation on treating bronchiolitis in infants in the integrative medicine%中西医结合治疗婴幼儿毛细支气管炎的疗效观察

    Institute of Scientific and Technical Information of China (English)

    王宽富

    2012-01-01

      目的:探讨中西医结合治疗婴幼儿毛细支气管炎的疗效.方法:将132例毛细支气管炎婴幼患儿随机分为观察组(72例)和对照组(60例),两组均给与利巴韦林、普米克和可必特等药物治疗,观察组加用麻杏石甘汤治疗.结果:观察组在发热消失时间、喘息缓解时间、肺部啰音消失时间及住院时间均较单纯西药治疗更短(P<0.05),总有效率也更高(P<0.05).结论:麻杏石甘汤治疗婴幼儿毛细支气管炎疗效显著,值得临床推广应用.%  Objective:To explore the clinical effects of the integrative medicine in treating bronchiolitis in infants. Methods:132 cases of bronchiolitis in infants were randomly divided into the observation group (72 cases) and the control group (60 cases), the two groups were given ribavirin, pulmicort and combivent and other medicines for treatment, the observation group added the Maxing Shigan decoction. Results: The fever disappeared time, respite relief time, pulmonary rales disappeared time and hospital stay time in the observation group were shorter than that in the pure modern medicine treatment (P<0.05), also the total efficiency was higher (P<0.05). Conclusion:The Maxing Shigan decoction had a significant effect in treating bronchiolitis in infants, was worth promoting in clinical.

  20. 甘露聚糖结合凝集素基因多态性与毛细支气管炎的相关性研究%Correlation between the genetic polymorphism of mannose-binding lectin and bronchiolitis

    Institute of Scientific and Technical Information of China (English)

    陈秋燕; 刘一心

    2012-01-01

    目的 探讨甘露聚糖结合凝集素(MBL)与毛细支气管炎是否具有相关性.方法 用ELISA法定量检测50例病例组与50例对照组MBL的血浆水平(ng/ml),并用聚合酶链反应、DNA序列测定法分析其MBL基因第1外显子第52、54、57位密码子的碱基序列.结果 (1)甘露聚糖结合凝集素GTC等位基因频率约为0.135,未见52和57位密码子的点突变;(2)比较病例组、对照组的GTC等位基因频率、血浆水平差异均无统计学意义.结论 未发现MBL的基因多态性与毛细支气管炎的易感性有相关性.%Objective To study the distribution of the genetic polymorphism of the mannose-binding lectin (MBL) codon-52,54,57, and approach the correlation between MBL and the bronchiolitis. Methods Serum levels of MBL were measured by ELIS A method with human MBL ELISA kit. The genotypes of MBL gene codon-52, 54, 57 were detected by DNA sequences. Results No significant difference had been found in the allele frequency of GTC and MBL serum levels between bronchiolitis group and healthy group. Conclusion The polymorphism of the MBL gene does not associate with bronchiolitis.

  1. 综合护理干预辅助治疗毛细支气管炎的疗效观察%The efficacy of Comprehensive nursing intervention as adjunctie treatment in the Children with Bronchiolitis

    Institute of Scientific and Technical Information of China (English)

    戴静

    2013-01-01

    Objective To explore the efficacy of comprehensive nursing intervention as adjunctie treatment in the children with bronchiolitis. Methods 102 cases of children with bronchiolitis were randomly divided into two groups. All patients were given the routing drug therapy, and the experiment group was given additional comprehensive nursing intervention including psychiatric nursing, aerosol inhalation and chest physiotherapy on the base of routing drug treatment. Results The experiment group were significantly more efficient than the control group in the main symptoms,signs and hospitalization days were shorter than the control group (P < 0.01), first cure rate were higher than the routing drug therapy (P < 0.05). Conclusion Appropriate comprehensive nursing intervention is beneficial for the rehabilitation of the children with bronchiolitis.%目的探讨护理干预对毛支气管炎治疗的辅助效果。方法102例患儿随机分为两组,均给予常规治疗,观察组在常规治疗的基础上对加用心理护理、雾化吸入和胸部叩击等综合护理干预措施。结果观察组咳嗽、喘憋、肺部体征消失时间和住院天数均较对照组缩短(P <0.05),提高治愈率。结论综合护理干预措施有利于毛细支气管炎患儿的康复。

  2. Mechanism and progress of inhalation hypertonic saline in treatment of bronchiolitis%高渗盐水雾化治疗毛细支气管炎的机制及进展

    Institute of Scientific and Technical Information of China (English)

    裴艳萍; 庞随军; 李元霞

    2015-01-01

    在婴儿期,毛细支气管炎为常见的下呼吸道感染性疾病.多由呼吸道合胞病毒引起,且发病季节以冬季多见.目前对其治疗主要为支持治疗,但具体治疗方案仍存在争议.虽然现今临床上多采用了支气管扩张剂及皮质醇类,实际上却不应作为常规用药的推荐.随着治疗方案的研究,高渗盐水雾化引起了临床工作者足够的重视,且西班牙儿科协会将高渗盐水雾化作为治疗毛细支气管炎的唯一指定用药.故该文对高渗盐水雾化治疗毛细支气管炎的机制及进展等方面作一综述,希望对毛细支气管炎的临床治疗有所帮助.%In infancy,bronchiolitis is the most common acute infection of the lower respiratory tract.It is mainly caused by respiratory syncytial virus,it invades mostly in winter.The treatment is mainly the support therapy at present,but the current treatment of bronchiolitis is still controversial.Bronchodilators and cortieosteroids are widely used but not routinely recommended.Hypertonic saline is currently the only drug recommended by the Spanish Association of Pediatrics in treatment guidelines.Therefore,this article summarizes the atomization mechanism and progress of inhalation hypertonic saline.It is hoped that it can be helpful to the clinical treatment of bronchiolitis.

  3. [Autoinflammatory syndromes/fever syndromes].

    Science.gov (United States)

    Schedel, J; Bach, B; Kümmerle-Deschner, J B; Kötter, I

    2011-05-01

    Hereditary periodic (fever) syndromes, also called autoinflammatory syndromes, are characterized by relapsing fever and additional manifestations such as skin rashes, mucosal manifestations, or joint symptoms. Some of these disorders present with organ involvement and serological signs of inflammation without fever. There is a strong serological inflammatory response with an elevation of serum amyloid A (SAA), resulting in an increased risk of secondary amyloidosis. There are monogenic disorders (familial mediterranean fever (FMF), hyper-IgD-syndrome (HIDS), cryopyrin-associated periodic syndromes (CAPS), "pyogenic arthritis, acne, pyoderma gangrenosum" (PAPA), and "pediatric granulomatous arthritis (PGA) where mutations in genes have been described, which in part by influencing the function of the inflammasome, in part by other means, lead to the induction of the production of IL-1β. In "early-onset of enterocolitis (IBD)", a functional IL-10 receptor is lacking. Therapeutically, above all, the IL-1 receptor antagonist anakinra is used. In case of TRAPS and PGA, TNF-antagonists (etanercept) may also be used; in FMF colchicine is first choice. As additional possible autoinflammatory syndromes, PFAPA syndrome (periodic fever with aphthous stomatitis, pharyngitis and adenitis), Schnitzler syndrome, Still's disease of adult and pediatric onset, Behçet disease, gout, chronic recurrent multifocal osteomyelitis (CRMO) and Crohn's disease also are mentioned.

  4. Noonan syndrome

    Science.gov (United States)

    ... chest shape (most often a sunken chest called pectus excavatum) Webbed and short-appearing neck Exams and Tests ... to consider genetic counseling before having children. Images Pectus excavatum References Ali O, Donohoue PA. Noonan syndrome. In: ...

  5. Marfan syndrome

    Science.gov (United States)

    ... at least once every year. Alternative Names Aortic aneurysm - ... syndrome. In: Kliegman RM, Stanton BF, St Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 702. ...

  6. Usher Syndrome

    Science.gov (United States)

    ... optic nerve (arrow) looks very pale, the vessels (stars) are very thin and there is characteristic pigment, ... syndrome gene have a child together, with each birth there is a: 1-in-4 chance of ...

  7. Bart syndrome

    Directory of Open Access Journals (Sweden)

    Gaikwad Anil

    1993-01-01

    Full Text Available An infant presenting with extensive aplasia cutis on lower extremities later developed blisters on skin and mucous membrane. Clinical features and histopathological examination of skin favoured the diagnosis of Bart syndrome.

  8. Beals Syndrome

    Science.gov (United States)

    ... arachnoldactyly (CCA), which refers to the joint contractures (shortening) that are key features of the syndrome. How ... remain contracted for long periods of time, the muscles can become tight and short, restricting movement. When ...

  9. Isaac's Syndrome

    Science.gov (United States)

    ... Page NINDS Wernicke-Korsakoff Syndrome Information Page NINDS Whiplash Information Page NINDS Infantile Spasms Information Page NINDS ... Support Library Clinical Research Next Steps Pre-Funding: After Review Terms of Award Pre-Award Start-up ...

  10. Zellweger Syndrome

    Science.gov (United States)

    ... Page NINDS Wernicke-Korsakoff Syndrome Information Page NINDS Whiplash Information Page NINDS Infantile Spasms Information Page NINDS ... Support Library Clinical Research Next Steps Pre-Funding: After Review Terms of Award Pre-Award Start-up ...

  11. Neurocutaneous Syndromes

    Science.gov (United States)

    ... affect kids include: neurofibromatosis, types 1 and 2 (NF1 and NF2) Sturge-Weber syndrome tuberous sclerosis (TS) ... forms of this disorder are neurofibromatosis type 1 (NF1), neurofibromatosis type 2 (NF2), and Schwannomatosis. NF1 is ...

  12. [Mobius syndrome].

    Science.gov (United States)

    Vladuţiu, Cristina; Duma, Ionela

    2012-01-01

    Mobius syndrom, an anomaly in cranial nerve developement, presents with a remarkable clinical polymorphism. The rare occurence of this pathology and the questions raised by the diagnosis and treatment determined us to make this presentation.

  13. Autoinflammatory syndromes.

    Science.gov (United States)

    Galeazzi, M; Gasbarrini, G; Ghirardello, A; Grandemange, S; Hoffman, H M; Manna, R; Podswiadek, M; Punzi, L; Sebastiani, G D; Touitou, I; Doria, A

    2006-01-01

    The autoinflammatory disorders are a new and expanding classification of inflammatory diseases characterized by recurrent episodes of systemic inflammation in the absence of pathogens, autoantibodies or antigen specific T cells. These disorders are caused by primary dysfunction of the innate immune system, without evidence of adaptive immune dysregulation. Innate immune abnormalities include aberrant responses to pathogen associated molecular patterns (PAMPs) like lipopolysaccharide and peptidoglycan, prominent neutrophilia in blood and tissues, and dysregulation of inflammatory cytokines (IL-1beta, TNF-alpha) or their receptors. The autoinflammatory diseases comprise both hereditary (Familial Mediterranean Fever, FMF; Mevalonate Kinase Deficiency, MKD; TNF Receptor Associated Periodic Syndrome, TRAPS; Cryopyrin Associated Periodic Syndrome, CAPS; Blau syndrome; Pyogenic sterile Arthritis, Pyoderma gangrenosum and Acne syndrome, PAPA; Chronic Recurrent Multifocal Osteomyelitis, CRMO) and multifactorial (Crohn's and Behçet's diseases) disorders. Mutations responsible for FMF, TRAPS, CAPS, PAPA are in proteins involved in modulation of inflammation and apoptosis.

  14. [Refeeding syndrome].

    Science.gov (United States)

    Ševela, Stanislav; Novák, František; Kazda, Antonín; Brodská, Helena

    2016-01-01

    Despite being known more than 60 years, refeeding syndrome (RS) still bears many uncertainties. For example, its definition is not clear and definite, and the attitude to it varies from the complete neglect to over-prevention.The term "refeeding syndrome" refers to electrolyte and metabolic changes occurring in malnourished patients after the readministration of nutrition. These changes concern especially to phosphates and ions. Potassium, magnesium, naturism and fluids balance are involved. The changes lead to cell energetic metabolism and electric potential disturbances, with related clinical symptoms.Fully developed refeeding syndrome is quite rare; nevertheless it can be fatal for the patient. However, even its development can lead to many complications increasing the patient's morbidity and the length of stay in the hospital. Yet the refeeding syndrome is more or less predictable and if kept in mind also preventable.The aim of this article is to get the reader to know more about this metabolic phenomenon and possible attitudes towards it.

  15. Barth Syndrome

    DEFF Research Database (Denmark)

    Saric, Ana; Andreau, Karine; Armand, Anne-Sophie

    2016-01-01

    Mutations in the gene encoding the enzyme tafazzin, TAZ, cause Barth syndrome (BTHS). Individuals with this X-linked multisystem disorder present cardiomyopathy (CM) (often dilated), skeletal muscle weakness, neutropenia, growth retardation, and 3-methylglutaconic aciduria. Biopsies of the heart,...

  16. Cockayne syndrome

    DEFF Research Database (Denmark)

    Karikkineth, Ajoy C; Scheibye-Knudsen, Morten; Fivenson, Elayne;

    2017-01-01

    Cockayne syndrome (CS) is a disorder characterized by a variety of clinical features including cachectic dwarfism, severe neurological manifestations including microcephaly and cognitive deficits, pigmentary retinopathy, cataracts, sensorineural deafness, and ambulatory and feeding difficulties...

  17. Gardner Syndrome

    Science.gov (United States)

    ... or central nervous system tumor less than 1% Stomach cancer 0.5% Bile duct cancer small, but increased Adrenal gland cancer small, but increased What are the screening options for Gardner syndrome? The screening options for ...

  18. Metabolic syndrome

    Science.gov (United States)

    ... obesity ). This body type may be described as "apple-shaped." Insulin resistance. Insulin is a hormone produced ... Syndrome Browse the Encyclopedia A.D.A.M., Inc. is accredited by URAC, also known as the ...

  19. Down Syndrome

    Science.gov (United States)

    ... Diagnostic tests that can identify Down syndrome include: Amniocentesis. A sample of the amniotic fluid surrounding the ... somewhat higher risk of miscarriage than second trimester amniocentesis. Cordocentesis. In this test, also known as percutaneous ...

  20. Turner Syndrome

    Science.gov (United States)

    ... in the inner layer of the aorta (aortic dissection). A defect in the valve between the heart ... Turner syndrome are at increased risk of aortic dissection during pregnancy, they should be evaluated by a ...

  1. Eagle's Syndrome

    OpenAIRE

    Pinheiro, Thaís Gonçalves; Soares,Vítor Yamashiro Rocha; Ferreira,Denise Bastos Lage; Raymundo,Igor Teixeira; Nascimento, Luiz Augusto; Oliveira, Carlos Augusto Costa Pires de

    2013-01-01

    Summary Introduction: Eagle's syndrome is characterized by cervicopharyngeal signs and symptoms associated with elongation of the styloid apophysis. This elongation may occur through ossification of the stylohyoid ligament, or through growth of the apophysis due to osteogenesis triggered by a factor such as trauma. Elongation of the styloid apophysis may give rise to intense facial pain, headache, dysphagia, otalgia, buzzing sensations, and trismus. Precise diagnosis of the syndrome is diffic...

  2. SAPHO syndrome.

    Science.gov (United States)

    Carneiro, Sueli; Sampaio-Barros, Percival D

    2013-05-01

    SAPHO syndrome is a disorder characterized by Synovitis, Acne, Pustulosis, Hyperostosis, and Osteitis. As the osteoarticular and skin manifestations often do not occur simultaneously and there are no validated diagnostic criteria, the diagnosis can be difficult. Clinical and imaging investigation is necessary to establish the many differential diagnoses of SAPHO syndrome. The etiopathogenesis involves infectious (probably Propionibacterium acnes), immunologic, and genetic factors. Treatment is based on information gathered from case reports and small series, and is related to specific skin or articular symptoms.

  3. D-二聚体定量检测在毛细支气管炎中的应用%Application of quantitative detection of D-dimer in bronchiolitis

    Institute of Scientific and Technical Information of China (English)

    陈学高

    2015-01-01

    Objective To investigate the clinical significance of D-dimer changes in children with bronchiol-itis. Methods 61 children with bronchiolitis were selected and divided into the normal group and the severe group based on their situation, and 11 healthy children were taken as the control group. The levels of D-dimer were detec-ted. Results The level of D-dimer was significantly higher in the study group than in the control group, and it was higher in the severe group than in the normal group (P<0. 01). After the treatment, the level of D-dimer decreased significantly in the severe group (P<0. 01). Conclusion The level of plasma D-dimer can be used to judge the se-verity of bronchiolitis.%目的:探讨毛细支气管炎患儿D-二聚体( D-D)水平变化及临床意义。方法随机选取61例毛细支气管炎住院患儿,根据病情程度分为普通组与重症组,同时选取11例同龄健康婴儿作为正常对照组。检测其血浆D-二聚体水平。结果毛细支气管炎患儿组血浆D-二聚体水平显著高于对照组,重症毛细支气管炎患儿血浆D-二聚体水平显著高于普通患儿组,差异具有统计学意义(P<0.01)。而且重症毛细支气管炎患儿治疗前后血浆D-二聚体水平差异显著,具有统计学意义( P<0.01)。结论血浆D-二聚体水平检测可用于毛细支气管炎病情严重程度的判定。

  4. 毛细支气管炎患儿血清25-(OH) D3与免疫球蛋白水平的变化%Serum levels of 25-(OH) D3 and immunoglobulin in children with bronchiolitis

    Institute of Scientific and Technical Information of China (English)

    江志贵; 吴洁; 刘玲; 林艳; 杨翠艳

    2012-01-01

    目的 研究毛细支气管炎患儿血清25-(OH) D3与免疫球蛋白水平的变化及临床意义.方法 采用酶联免疫法检测35例毛细支气管炎患儿急性期和恢复期及20例健康儿童血清25-( OH) D3水平,速率散射比浊法测定免疫球蛋白含量.结果 毛细支气管炎患儿急性期血清25-( OH )D3、IgG及IgA水平明显低于健康儿童组,而血清IgE明显高于健康儿童组,差异均有统计学意义(P<0.05).毛细支气管炎患儿恢复期血清25-(OH)D3水平较急性期增高,而IgE水平较急性期降低,差异有统计学意义(P<0.05).与健康儿童组比较,毛细支气管炎患儿恢复期血清25-(OH)D3及IgA水平明显降低,而血清IgE明显增高,差异亦有统计学意义(P<0.05).毛细支气管炎患儿急性期血清25-( OH)D3水平与IgG、IgA呈正相关(分别r=0.36,P<0.05;r =0.63,P<0.01),与IgE呈负相关(r=-0.72,P<0.01).毛细支气管炎患儿恢复期血清25-(OH)D3水平与IgE呈负相关(r=-0.34,P<0.05).结论 毛细支气管炎患儿血清25-(OH) D3水平降低及免疫球蛋白水平失衡,提示25-(OH)D3及免疫球蛋白在其发病中起重要作用.%Objective To study the changes in the serum levels of 25-(OH)D3 and immunoglobulins in children with bronchiolitis, and the clinical significance of these changes. Methods Serum levels of 25-( OH) D3 were measured using ELJSA in 35 children with bronchiolitis in the acute and recovery phases and 20 healthy children. Serum levels of immunoglobulins were determined by rate nephelometry. Results Compared with the healthy children, serum 25-(OH) D3, IgG and IgA levels in children with bronchiolitis in the acute phase were significantly lower and, in contrast, serum IgE levels were significantly higher ( P < 0. 05). Serum 25-( OH) D3 levels increased and serum IgE levels decreased significantly in the recovery phase compared with the acute phase in children with bronchiolitis ( P < 0. 05 ). However, compared with the healthy

  5. Neutrophil activation and protease imbalance in respiratory tract of infants with respiratory syncytial virus bronchiolitis%呼吸道合胞病毒毛细支气管炎患儿中性粒细胞活化及蛋白酶平衡的研究

    Institute of Scientific and Technical Information of China (English)

    刘金玲; 陈志敏

    2009-01-01

    Objective To better understand the neutrophil activation and protease imbalance in respiratory syncytial virus (RSV) bronchiolitis. Methods Pediatric patients with RSV bronchiolitis were collected,11 with the Lowell scores ≥ 10 (severe group),and 19 with the Lowell scores 0.05).结论 呼吸道合胞病毒毛支气道局部存在大量中性粒细胞聚集活化和蛋白酶系统失衡,并可能在其发病中起重要作用.

  6. Carpenter syndrome.

    Science.gov (United States)

    Hidestrand, Pip; Vasconez, Henry; Cottrill, Carol

    2009-01-01

    Carpenter syndrome is a rare autosomal recessive disorder that belongs to a group of rare craniosynostosis syndromes (Bull Soc Med Paris 1906;23:1310). Carpenter syndrome is the rarest, with only occasional patients seen. There are 3 common features in all of these syndromes: craniosynostosis (skull base abnormalities, with early fusion in different sutures), midface hypoplasia, and musculoskeletal abnormalities. Clinical features of Carpenter syndrome include peculiar facies, asymmetry of the skull, polydactyly, brachymesophalangy, mild soft tissue syndactyly, obesity, hypogenitalism, congenital heart disease, and mental retardation (J Pediatr 1966;69:1; Am J Roentgenol 1969;106). The brachycephaly is caused by early fusion in the coronal, sagittal, and lambdoidal sutures (Proc R Soc Med Sect Study Dis Child 1909). Most of the affected patients have a surgical procedure between 3 to 9 months of age to open the cranial vault to make space for the brain to grow (Plast Reconstr Surg 1978;62:335). We present a patient with Carpenter syndrome who is unusual in that she is an adult who has never had surgical intervention.

  7. Expression of Prothrombinase/fibroleukin Gene fg12 in Lung Impairment in a Murine Severe Acute Respiratory Syndrome Model

    Institute of Scientific and Technical Information of China (English)

    Wei-ming YAN; Jia-quan HUANG; Xiao-ping LUO; Qin NING

    2007-01-01

    To evaluate the role of murine fibrinogen like protein 2 (mfgl2) /fibroleukin in lung impairment in Severe acute respiratory syndrome (SARS), a murine SARS model induced by Murine hepatitis virus strain 3 (MHV-3) through trachea was established. Impressively, all the animals developed interstitial pneumonia with extensive hyaline membranes formation within alveoli, and presence of micro-vascular thrombosis in the pulmonary vessels. MHV-3 nucleocapsid gene transcripts were identified in multiple organs including lungs, spleen etc. As a representative proinflammatory gene, mfgl2 prothrombinase expression was evident in terminal and respiratory bronchioles, alveolar epithelia and infiltrated cells in the lungs associated with fibrin deposition and micro-vascular thrombosis. In summary, the established murine SARS model could mimic the pathologic characteristics of lungs in patients with SARS. Besides the physical damages due to virus replication in organs, the up-regulation of novel gene mfgl2 in lungs may play a vital role in the development of SARS associated lung damage.

  8. Juvenile Polyposis Syndrome

    Science.gov (United States)

    ... Types of Cancer > Juvenile Polyposis Syndrome Request Permissions Juvenile Polyposis Syndrome Approved by the Cancer.Net Editorial Board , 12/2015 What is juvenile polyposis syndrome? Juvenile polyposis syndrome (JPS) is a ...

  9. Cardiac Syndrome X

    Science.gov (United States)

    ... Kawasaki Disease Long Q-T Syndrome Marfan Syndrome Metabolic Syndrome Mitral Valve Prolapse Myocardial Bridge Myocarditis Obstructive Sleep Apnea Pericarditis Peripheral Vascular Disease Rheumatic Fever Sick Sinus Syndrome Silent Ischemia Stroke Sudden ...

  10. What is Metabolic Syndrome?

    Science.gov (United States)

    ... from the NHLBI on Twitter. What Is Metabolic Syndrome? Metabolic syndrome is the name for a group of ... that may play a role in causing metabolic syndrome. Outlook Metabolic syndrome is becoming more common due to a ...

  11. Down Syndrome (For Kids)

    Science.gov (United States)

    ... continue Do a Lot of People Have Down Syndrome? Down syndrome is not contagious , so you can't ... have it. What's Life Like for Kids With Down Syndrome? Many kids with Down syndrome go to regular ...

  12. Metabolic Syndrome (For Parents)

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old Metabolic Syndrome KidsHealth > For Parents > Metabolic Syndrome A A A ... this is a condition called metabolic syndrome . About Metabolic Syndrome Not to be confused with metabolic disease (which ...

  13. Metabolic Syndrome (For Parents)

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old Metabolic Syndrome KidsHealth > For Parents > Metabolic Syndrome Print A A ... this is a condition called metabolic syndrome . About Metabolic Syndrome Not to be confused with metabolic disease (which ...

  14. [Haemodynamic role of blood-plasma circulating cell-free DNA and contained therein high-molecular-weight CpG-rich fraction in pathogenesis of arterial hypertension and atherosclerosis obliterans of carotid arteries].

    Science.gov (United States)

    Konorova, I L; Veĭko, N N; Ershova, E S; Antelava, A L; Chechetkin, A O

    2009-01-01

    blood plasma. A higher level thereof leads to a rise in the HR and to the appearance of neurological symptomatology. Hence, CpG-DNA circulating in the composition of pDNA is a constantly acting endogenous blood factor decreasing the HR (the Toms's effect) and normalizing AP under physiological conditions, being however a cause of their increase and impairment of blood circulation in the pathogenesis of AH and atherosclerosis obliterans of the CAs.

  15. 人股动脉粥样硬化相关蛋白的鉴定及其生物学作用%Proteomics analysis on pathogenesis of human atherosclerosis obliterans in human femoral artery

    Institute of Scientific and Technical Information of China (English)

    赵振; 赵海光; 蒋米尔

    2011-01-01

    Objective We used proteomic profiling in an attempt to differentiate and identify histological proteins that were associated with atherosclerosis obliterans (ASO) of human femoral artery.Methods We comparatively analyzed the proteome of 8 atherosclerotic and 5 normal femoral arteries. The differentially expressed proteins were visualized by two dimensional electrophoresis (2-DE) and sequenced by matrix assisted laser desorption/ionization mass spectrometry (MALDI-TOF-MS). The protein identification program was used to search the National Center for Biotechnology Information (NCBI) database and International Protein Index (IPI). Results A total of 53 distinct spots corresponding to 13 different proteins were identified by MALDI-TOF-MS using the NCBI and IPI databases. The function information of these 13 proteins mainly involved the pathogenetic mechanisms such as inflammation, innate immunity, oxidative stress, lipid metabolism, amyloid degeneration and so on. Conclusion ASO is associated with distinct patterns of protein expression in the femoral arteries, and differentially expressed 13 proteins may contribute to the pathogenesis. These findings might provide needed biomarkers for ASO and new insight into its pathophysiology.%目的 应用比较蛋白质组学方法探讨人动脉粥样硬化闭塞症(ASO)差异蛋白质的表达及其在ASO发病机制中的作用.方法 选取ASO股动脉8例及正常股动脉5例,提取组织蛋白质,行双向凝胶电泳分离、质谱分析及数据库查询,获得差异蛋白信息.结果 成功建立ASO和正常股动脉双向电泳图谱,含量相差大于2倍以上的蛋白质53个,27个上调,26个下调,质谱鉴定出13种蛋白质,主要与炎症、免疫、氧化应激、脂质代谢等相关.结论 ASO与正常股动脉蛋白质组明显差异,差异蛋白质可能在ASO中起重要作用.

  16. 闭塞性动脉硬化症患者肢端汗出速率、温度变化观察%Observation of sweating rate and temperature variation in arteriosclerosis obliterans patients

    Institute of Scientific and Technical Information of China (English)

    王雁南; 张启明; 杨建业; 刘中华

    2013-01-01

    Objective To investigate the evaluative meaning of the traditional Chinese medicine (TCM)sweat detector and temperature detector to atheriosclerosis obliterans (ASO).Methods 68 limb plantar of ASO patients and 20 left plantar of healthy subjects were tested by TCM sweat detector and temperature detector to observe the differences of sweating rate and temperature between the two groups.Results ①Sweating rate and temperature of ASO patients' limb plantar showed different graphic morphology from that of healthy control group.The sweating rate of patients was worse than that of healthy subjects in responding to external stimuli.②ASO patients'limb plantar baseline values of the sweating rate and temperature were lower than that of healthy subjects,and the result was statistical significant (P<0.01).Conclusion Data obtained from TCM sweat detector and temperature detector can be used to distinguish ASO patients from healthy people.%目的 研究中医汗出检测仪和体表温度检测仪对下肢动脉硬化闭塞症(ASO)的评价意义.方法 选取68例ASO患者和20例健康人,应用中医汗出检测仪和体表温度检测仪,分别检测患者患肢足底和健康人左侧足底的汗出速率、温度,比较2组汗出速率和温度的不同.结果 ASO患者肢端汗出速率和温度均表现出不同于健康对照组的图形形态,患者的肢端汗出速率对外界刺激的反应较正常人差;ASO患者的肢端汗出速率和温度的基线值均低于健康对照组,其差异具有统计学意义(P<0.01).结论 中医汗出检测仪和体表温度检测仪所测数据可用于区分ASO患者与健康人群.

  17. Pfeiffer syndrome

    Directory of Open Access Journals (Sweden)

    Fryns Jean-Pierre

    2006-06-01

    Full Text Available Abstract Pfeiffer syndrome is a rare autosomal dominantly inherited disorder that associates craniosynostosis, broad and deviated thumbs and big toes, and partial syndactyly on hands and feet. Hydrocephaly may be found occasionally, along with severe ocular proptosis, ankylosed elbows, abnormal viscera, and slow development. Based on the severity of the phenotype, Pfeiffer syndrome is divided into three clinical subtypes. Type 1 "classic" Pfeiffer syndrome involves individuals with mild manifestations including brachycephaly, midface hypoplasia and finger and toe abnormalities; it is associated with normal intelligence and generally good outcome. Type 2 consists of cloverleaf skull, extreme proptosis, finger and toe abnormalities, elbow ankylosis or synostosis, developmental delay and neurological complications. Type 3 is similar to type 2 but without a cloverleaf skull. Clinical overlap between the three types may occur. Pfeiffer syndrome affects about 1 in 100,000 individuals. The disorder can be caused by mutations in the fibroblast growth factor receptor genes FGFR-1 or FGFR-2. Pfeiffer syndrome can be diagnosed prenatally by sonography showing craniosynostosis, hypertelorism with proptosis, and broad thumb, or molecularly if it concerns a recurrence and the causative mutation was found. Molecular genetic testing is important to confirm the diagnosis. Management includes multiple-staged surgery of craniosynostosis. Midfacial surgery is performed to reduce the exophthalmos and the midfacial hypoplasia.

  18. Acute respiratory distress syndrome (ARDS): HRCT findings in survivors

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Jung Im; Park, Seog Hee; Lee, Jae Mun; Song, Jeong Sup; Lee, Kyo Young [The Catholic Univ. College of Medicine, Seoul (Korea, Republic of)

    1999-08-01

    The purpose of this report is to describe the high-resolution computed tomography (HRCT) findings of the lung in survivors of acute respiratory distress syndrome (ARDS). Among eleven patients who survived ARDS for one year, chest radiography and HRCT revealed pulmonary fibrosis in four. Causes of ARDS included pneumonia during pregnancy, near drowning, pneumonia during liver cirrhosis, and postoperative sepsis. Thoracoscopic biopsy and histopathologic correlation were available in one patient. HRCT showed diffuse interlobular septal thickening, ground glass opacity, parenchymal distortion, and traction bronchiectasis. Fuzzy centrilobular nodules were seen in two patients and one patient had multiple, large bullae in the left hemithorax. In all patients, lesions affected the upper and anterior zones of the lung more prominently. The distribution of pulmonary fibrosis was characteristic and reflected the pathogenesis of lung injury; fibrosis was largely due to hyperoxia caused by ventilator care. In one patient, histopathologic correlation showed that imaging findings were accounted for by thickening of the alveolar septum along with infiltration of chronic inflammatory cells and fibrosis. Fuzzy centrilobular nodules corresponded with bronchiolitis.

  19. Clinical observations on aerodynamic wave plus Alprostadil for the treatment of diabetes lower limb arteriosclerosis obliterans%空气动力波联合前列地尔治疗糖尿病下肢动脉硬化闭塞症的临床观察

    Institute of Scientific and Technical Information of China (English)

    余红梅; 胡清; 曾玉琴; 汪晓芬; 王娜娜; 龚丽; 李雪锋

    2014-01-01

    目的:观察空气动力波联合前列地尔治疗糖尿病下肢动脉硬化症的临床疗效,并探讨其治疗机制。方法将符合纳入标准的54例患者随机分为2组,治疗组30例采用空气动力波联合前列地尔治疗,对照组28例仅采用前列地尔治疗,治疗2个疗程后评定2组临床疗效,并观察治疗前后下肢动脉血管内径、血流量及踝肱指数的变化情况。结果治疗2个疗程后,治疗组疗效优于对照组(P<0.05);治疗组下肢血管内径、血流量、踝肱指数改善程度均优于对照组(P均<0.05)。结论空气动力波联合前列地尔治疗糖尿病下肢动脉硬化症安全有效,其疗效优于单一前列地尔治疗。%Objective It is to observe the clinical efficacy of aerodynamic wave plus Alprostadil on diabetic lower limb ar -teriosclerosis obliterans ,and to explore its mechanism .Methods 54 patients with diabetic lower limb arteriosclerosis obliterans were randomly allocated to treatment groups of 34 cases and control groups of 20 cases, the treatment group were treated with Aerodynamic wave plus Alprostadil , the control group were treated with Alprostadil only .After two treatment courses , the clin-ical curative effects of both groups were assessed , and the changes of blood vessel diameter of lower extremity artery , blood flow and ankle brachial index ( ABI) before and after treatment were observed .Results After two treatment courses , the cura-tive effect of treatment group was better than that of control group (P<0.05), and the improvements of blood vessel diameter of lower extremity artery, blood flow and ABI were also better than those of control group (P<0.05).Conclusion Aerody-namic wave plus Alprostadil is effective and safe in the treatment for diabetic lower limb arteriosclerosis obliterans .Its effect is superior to that of treatment with Alprostadil only .

  20. 音乐疗法在基层医院辅助治疗毛细支气管炎疗效观察%The Clinical Observation of Musicotherapy through Bronchiolitis by Adjuvant Therapy in Primary Hospital

    Institute of Scientific and Technical Information of China (English)

    牛俊岩; 王艳芳; 王爱民; 邸素敏; 张敬华

    2011-01-01

    Objective: To observe music therapy in the adjuvant treatment of primary hospital bronchiolitis.Methods:the treatment group were treated based on the use of music therapy adjuvant therapy.Results:The recovery in vital signs,cough,wheezing and pulmonary symptoms disappeared,length of hospital stay was sinificantly shorter than the control group P<0.01.2 groups were compared the efficiency of P<0.01.Conclusion:Music therapy was effective adjuvant treatment of bronchiolitis.%目的:观察音乐疗法在基层医院辅助治疗毛细支气管炎的疗效.方法:治疗组在常规治疗基础上加用音乐疗法辅助治疗.结果:治疗组在生命体征恢复,咳嗽、喘憋及肺部体征消失,住院时间较对照组明显缩短P<0.05.2组显效率比较P<0.05.结论:音乐疗法辅助治疗毛细支气管炎疗效明显.

  1. Research of relative factors between bronchiolitis and asthma by long time follow-up of 206 children bronchiolitis patients%长期随访206例毛细支气管炎患儿发展为哮喘的相关因素分析

    Institute of Scientific and Technical Information of China (English)

    刘志刚

    2014-01-01

    OBJECTIVE:206 children bronchiolitis patients with the hospitalization treatment were fol owed up long time, then the relative factors between bronchiolitis and asthma were analyzed. METHODS:The data of 206 children bronchiolitis patients with the hospitalization treatment were retrospectively analyzed. Al the children were fol owed up for three years. Sex, family history,childbirth,feeding pat erns,al ergy history,immunoglobulin,intestinal tract probiotics,inhaled corticosteroid,al ergic constitution, repeat respiratory tract infections and passive smoking were observed. Logistic regression analysis was used to analyze the relationship between the factors and asthma. RESULTS:48 of 206 patients (23.3%) with bronchiolitis converted to asthma. Univariate analysis results showed that there were significant difference of family history, immunoglobulin, feeding pat erns, inhaled corticosteroid, al ergic constitution and passive smoking between the chil-dren with or without asthma (P﹤0.05). Logistic regression analysis showed that family history, al ergic constitution , repeat respiratory tract infections and passive smoking were the risk factors for asthma, and breast feeding,inhaled corticosteroid, repeat respiratory tract infections and immunoglobulin were the protective factors. CONCLUSION:Family history, Individual al ergic constitution,respiratory tract infections and passive smoking were the risk factors for asthma. Breast feed-ing,inhaled corticosteroid treatment , intestinal tract probiotics and immunoglobulin wil decrease the occurrence of asthma.%目的:对住院治疗的206例毛细支气管炎患儿进行随访2年,对其中可能是发展为哮喘的影响因素进行分析。方法:对住院治疗的206例毛细支气管炎患儿临床资料进行回顾性分析,所有患儿均随访2年。对性别、家族史、生产史、喂养史、过敏史、丙种球蛋白、益生菌应用史、吸入糖皮质激素及被动吸烟可能是发展为哮

  2. [Serotonin syndrome].

    Science.gov (United States)

    Lheureux, P; Penaloza, A; De Cottenier, V; Ullmann, U; Gris, M

    2002-10-01

    The serotonin syndrome is a hyperserotoninergic state resulting from an excess of intrasynaptic 5-hydroxytryptamine, induced by multiple psychotropic agents, but also non psychiatric drugs. It is a potentially dangerous and sometimes lethal condition. The clinical manifestations usually include cognitive, neuromuscular and autonomic features and are mediated by the action of serotonin on various subtypes of receptors. The main differential diagnosis is the neuroleptic malignant syndrome. Treatment is mainly supportive. No pharmacological agent has been definitely demonstrated really effective. However, reports of cases treated with the 5-HT2 blockers, including cyproheptadine or chlorpromazine have suggested that these agents could have some efficacy. Serotonin syndrome is a toxic condition which requires heightened clinical awareness among physicians in order to prevent, recognize, and treat the condition promptly.

  3. Lemierre's syndrome

    DEFF Research Database (Denmark)

    Johannesen, Katrine M; Bodtger, Uffe

    2016-01-01

    necrophorum. We found a total of 137 cases of LS, of which 47 were infected with F. necrophorum and others with Staphylococcus and Streptococcus. Complications of this rare but severe disease included osteomyelitis, meningitis, and acute respiratory distress syndrome. Mortality was extremely high in the pre....../or swelling in the throat or neck, as well as respiratory symptoms. Laboratory findings show elevated infectious parameters and radiological findings show thrombosis of the internal jugular vein and emboli in the lungs or other organs. The syndrome is often associated with an infection with Fusobacterium......This is a systematic review of cases with Lemierre's syndrome (LS) in the past 5 years. LS is characterized by sepsis often evolving after a sore throat or tonsillitis and then complicated by various septic emboli and thrombosis of the internal jugular vein. Symptoms include sepsis, pain, and...

  4. Microcephaly syndromes.

    Science.gov (United States)

    Abuelo, Dianne

    2007-09-01

    The objective of this article is to review microcephaly from a genetics point of view, especially with regard to the process of identification of syndromes in which small head circumference occurs. Microcephaly can be due to either genetic or environmental causes. It can be the only positive finding or may be part of a syndrome of congenital anomalies. The genetic etiology can be caused by autosomal dominant, autosomal recessive, or X-linked genes or various types of chromosome anomalies. Some of the gene mutations have been identified recently. Syndromic microcephaly is associated with a large number of conditions. Some can be diagnosed, or at least suspected, based on their characteristic facial dysmorphism, and others can be searched for using databases of genetic disorders.

  5. Postconcussional Syndrome

    Directory of Open Access Journals (Sweden)

    Necla Keskin

    2013-02-01

    Full Text Available Postconcussional syndrome is characterized by somatic, cognitive and psychiatric (emotional, behavioral symptoms that occurs after mild traumatic brain injury. It has been known that these symptoms recover fully within 3-6 months almost in 90% of patients. Although its etiology is still controversial, biological, psychological and social factors may account for the development and continuation of the symptoms. Diagnosis is based on the subjective complaints. To find out an objective method for definite diagnosis, trials searching for both neuroimaging and specific serum biomarkers stil continue. The treatment of the syndrome is mainly of palliative nature. Information, education, reassurance and multifaceted rehabilitation programmes can be beneficial. There are promising trials reporting the effectiveness of cognitive behavioral therapy in the treatment of postconcussional syndrome. [Archives Medical Review Journal 2013; 22(1.000: 96-109

  6. Compartment syndromes

    Science.gov (United States)

    Mubarak, S. J.; Pedowitz, R. A.; Hargens, A. R.

    1989-01-01

    The compartment syndrome is defined as a condition in which high pressure within a closed fascial space (muscle compartment) reduces capillary blood perfusion below the level necessary for tissue viability'. This condition occurs in acute and chronic (exertional) forms, and may be secondary to a variety of causes. The end-result of an extended period of elevated intramuscular pressure may be the development of irreversible tissue injury and Volkmann's contracture. The goal of treatment of the compartment syndrome is the reduction of intracompartmental pressure thus facilitating reperfusion of ischaemic tissue and this goal may be achieved by decompressive fasciotomy. Controversy exists regarding the critical pressure-time thresholds for surgical decompression and the optimal diagnostic methods of measuring intracompartmental pressures. This paper will update and review some current knowledge regarding the pathophysiology, aetiology, diagnosis, and treatment of the acute compartment syndrome.

  7. Refeeding syndrome

    Directory of Open Access Journals (Sweden)

    Tripathy Swagata

    2008-01-01

    Full Text Available We report a case of a fifty-year-old male who was admitted with a three month history of increasing weakness, prostration, decreasing appetite and inability to swallow. The patient was a chronic alcoholic, unemployed, and of very poor socioeconomic background. The patient was initially investigated for upper GI malignancy, Addisons disease, bulbar palsy and other endocrinopathies. Concurrent management was started for severe electrolyte abnormalities and enteral nutritional supplementation was begun. By the fourth day of feeding patient developed severe hypophosphatemia and other life-threatening features suggesting refeeding syndrome. The patient was managed for the manifestations of refeeding syndrome. A final diagnosis of chronic alcoholic malnutrition with refeeding syndrome was made. Refeeding of previously starving patients may lead to a variety of complications including sudden death.

  8. Fraser syndrome

    DEFF Research Database (Denmark)

    Barisic, Ingeborg; Odak, Ljubica; Loane, Maria

    2013-01-01

    Fraser syndrome is a rare autosomal recessive disorder characterized by cryptophthalmos, cutaneous syndactyly, laryngeal, and urogenital malformations. We present a population-based epidemiological study using data provided by the European Surveillance of Congenital Anomalies (EUROCAT) network...... of birth defect registries. Between January 1990 and December 2008, we identified 26 cases of Fraser syndrome in the monitored population of 12,886,464 births (minimal estimated prevalence of 0.20 per 100,000 or 1:495,633 births). Most cases (18/26; 69%) were registered in the western part of Europe, where...... was particularly high (42%). Most cases of Fraser syndrome (85%) are suspected prenatally, often due to the presence of the association of renal agenesis and cryptophthalmos. In the European population, a high proportion (82%) of pregnancies is terminated, thus reducing the live birth prevalence to a third...

  9. Metabolic Syndrome

    Directory of Open Access Journals (Sweden)

    Sevil Ikinci

    2010-10-01

    Full Text Available Metabolic Syndrome is a combination of risk factors including common etiopathogenesis. These risk factors play different roles in occurence of atherosclerotic diseases, type 2 diabetes, and cancers. Although a compromise can not be achieved on differential diagnosis for MS, the existence of any three criterias enable to diagnose MS. These are abdominal obesity, dislipidemia (hypertrigliceridemia, hypercholesterolemia, and reduced high density lipoprotein hypertension, and elevated fasting blood glucose. According to the results of Metabolic Syndrome Research (METSAR, the overall prevalence of MS in Turkey is 34%; in females 40%, and in males it is 28%. As a result of “Western” diet, and increased frequency of obesity, MS is observed in children and in adolescents both in the world and in Turkey. Resulting in chronic diseases, it is thought that the syndrome can be prevented by healthy lifestyle behaviours. [TAF Prev Med Bull 2010; 9(5.000: 535-540

  10. Banff study of pathologic changes in lung allograft biopsy specimens with donor-specific antibodies

    DEFF Research Database (Denmark)

    Wallace, William Dean; Li, Ning; Andersen, Claus B;

    2016-01-01

    -DSAs, and no antibodies (NABs) present. The significance of each histologic variable was reviewed. RESULTS: We found no statistically significant association with acute cellular rejection, airway inflammation, or bronchiolitis obliterans and the presence or absence of antibodies. However, biopsy specimens with DSAs had...

  11. 闭塞性毛细支气管炎1例

    Institute of Scientific and Technical Information of China (English)

    朴香淑

    2009-01-01

    @@ 1901年德国病理学家Lange首次报道并命名了闭塞性毛细支气管炎(bronchiolitis obliterans,BO)[1].吉林省通化市人民医院收治了1例闭塞性毛细支气管炎.现报道如下:

  12. Dyspnea during Advanced Cancer

    Science.gov (United States)

    ... by chemotherapy. Conditions that are not related to cancer: Chronic obstructive pulmonary disease (COPD), such as chronic bronchitis or emphysema . ... depends on the type and stage of the cancer being treated. Laser therapy for tumors inside large ... Postradiation bronchiolitis obliterans Steroid ...

  13. Eagle's Syndrome

    Directory of Open Access Journals (Sweden)

    Pinheiro, Thaís Gonçalves

    2014-01-01

    Full Text Available Introduction: Eagle's syndrome is characterized by cervicopharyngeal signs and symptoms associated with elongation of the styloid apophysis. This elongation may occur through ossification of the stylohyoid ligament, or through growth of the apophysis due to osteogenesis triggered by a factor such as trauma. Elongation of the styloid apophysis may give rise to intense facial pain, headache, dysphagia, otalgia, buzzing sensations, and trismus. Precise diagnosis of the syndrome is difficult, and it is generally confounded by other manifestations of cervicopharyngeal pain. Objective: To describe a case of Eagle's syndrome. Case Report: A 53-year-old man reported lateral pain in his neck that had been present for 30 years. Computed tomography (CT of the neck showed elongation and ossification of the styloid processes of the temporal bone, which was compatible with Eagle's syndrome. Surgery was performed for bilateral resection of the stylohyoid ligament by using a transoral and endoscopic access route. The patient continued to present pain laterally in the neck, predominantly on his left side. CT was performed again, which showed elongation of the styloid processes. The patient then underwent lateral cervicotomy with resection of the stylohyoid process, which partially resolved his painful condition. Final Comments: Patients with Eagle's syndrome generally have a history of chronic pain. Appropriate knowledge of this disease is necessary for adequate treatment to be provided. The importance of diagnosing this uncommon and often unsuspected disease should be emphasized, given that correct clinical-surgical treatment is frequently delayed. The diagnosis of Eagle's syndrome is clinical and radiographic, and the definitive treatment in cases of difficult-to-control pain is surgical.

  14. Factors Associated with the Occurrence of Asthma after Bronchiolitis%毛细支气管炎后支气管哮喘发生的相关因素分析

    Institute of Scientific and Technical Information of China (English)

    李志华

    2013-01-01

    Objective:To analyze and study the related factors of bronchial asthma after bronchiolitis.Method:84 cases underwent bronchiolitis treatment as the object of study,statistics,analysis of the clinical data(content statistics,analysis include age,gender,disease,etiology and allergen detection),follow-up,diagnosis for the children’s respiratory tract infection and onset of bronchial asthma of children after leaving hospital,according to whether the occurrence of asthma in children,using Logistic statistical analysis might lead to bronchial asthma factors and these factors and bronchial asthma related degree was analyzed.Result:84 cases of capillary bronchitis patients in five years after discharge,there were 32 cases with bronchial asthma. Disease(asthma)group and non onset group multiple factors in children with asthma,family history,lower respiratory tract recurrent infections, with bronchiolitis children age,illness,there were significant differences(P<0.05). It could be said that these factors affect the incidence of bronchial asthma. And the child’s gender,living environment and other factors and the incidence of bronchial asthma had no obvious correlation.Conclusion:Patients with bronchiolitis severity,family history of asthma,accompanied by severe eczema and other LRTI are the main risk factors of bronchial asthma after bronchiolitis.%  目的:分析和探究毛细支气管炎后发生支气管哮喘的相关因素。方法:选取本院就诊的84例毛细支气管炎患儿为研究对象,对其临床资料进行统计、分析(包括患者的年龄、性别、病情、病原学及过敏原检测等),患儿出院后对患儿的呼吸道感染以及气管哮喘的发作情况进行随访、诊断,根据患儿是否发生支气管哮喘,采用Logistic回归分析方法分析可能引起支气管哮喘的因素以及这些因素与支气管哮喘发病的相关程度。结果:84例毛细支气管炎患儿在出院后5年内,有32例发

  15. Analysis of related factors of bronchial asthma after bronchiolitis%毛细支气管炎后支气管哮喘发生的相关因素分析

    Institute of Scientific and Technical Information of China (English)

    廖先辉

    2015-01-01

    Objective To explore the related factors of bronchial asthma after bronchiolitis.MethodsClinical data of 66 children with bronchiolitis who were admitted to our hospital from January,2007 to January,2008 were analyzed retrospectively and the conditions of respiratory tract infection and bronchial asthma of these children after discharge were analyzed.Factors that may cause bronchial asthma and correlations between these factors and bronchial asthma attacks were analyzed in Logistic regression analysis method according to conditions of bronchial asthma of these children.Children were given 5-year follow-ups after discharge,those with bronchial asthma were allocated as the disease group while those without bronchial asthma were allocated to the normal group. Results Children were given 5-year follow-ups after discharge,among whom 25 were with bronchial asthma and the rate was 37.88%.The family history of asthma,lower respiratory tract infection,age and condition of bronchiolitis,etc.all of children in two groups were found to have significant differences after various factors in two groups were compared.These differences had statistically significance(P<0.05).ConclusionSevere conditions,the family history of asthma, accompanied with lower respiratory tract infection etc.all of children with bronchiolitis were all main factors of bronchial asthma caused by bronchiolitis.%目的:探讨毛细支气管炎后与支气管哮喘发生的相关因素。方法对我院2007年1月~2008年1月期间收治的66例毛细支气管炎患儿的临床资料进行回顾性分析,在患儿出院后对其呼吸道感染与气管哮喘发作情况进行分析,并根据患儿的支气管哮喘发生情况采用Logistic回归分析法对可能引发支气管哮喘的因素及这些因素和支气管哮喘发病之前的相关性进行分析。患儿出院给予5年随访,发生支气管哮喘者归为发病组,而未发病者归为正常组。结果患儿出院给予5

  16. Relationship between respiratory syncytial virus bronchiolitis and bronchial asthma%呼吸道合胞病毒毛细支气管炎与支气管哮喘的相关性研究

    Institute of Scientific and Technical Information of China (English)

    李宾; 吴福玲; 冯学斌; 韩兆东; 李营营; 石涛

    2012-01-01

    Objective To explore the relationship between bronchiolitis caused by respiratory syncytial virus (RSV) and bronchial asthma. Methods The levels of interferon-γ (IFN-7) , interleukin-4 (IL-4) , interleukin-10 (IL-10), transforming growth factor-13 (TGF-|3) and interleukin-17 (IL-17) in 31 infants with RSV bronchiolitis, 25 infants with asthma, 27 infants with non-RSV pneumonia and 24 healthy infants were detected by ELISA. Results IL-10 and TGF-P levels in infants with RSV bronchiolitis and infants with asthma were significantly lower than those in the non-RSV pneumonia group and the normal control group (P 0.05) , and also no significant differences were observed between the common pneumonia group and the normal control group ( P > 0.05) . Conclusions The same changes of the levels of IFN-γ, IL-4, IL-10, TGF-P and IL-17 in infants with RSV bronchiolitis and infants with asthma may be a common pathogenesis of RSV bronchiolitis and asthma.%目的 探讨呼吸道合胞病毒(RSV)毛细支气管炎(毛支)与支气管哮喘两者发病机制的相关性.方法采用ELISA法检测31例RSV毛支患儿、25例支气管哮喘患儿、27例非RSV肺炎患儿和24例健康儿童外周血IFN-γ、IL-4、IL-10、TGF-β、IL-17水平,并进行比较分析.结果 RSV毛支患儿和哮喘患儿的IL-10、TGF-β水平显著低于非RSV肺炎患儿和健康对照儿童,而IL-4、IL-17水平则显著高于非RSV肺炎患儿和健康对照儿童(P均< 0.05).RSV毛支患儿和哮喘患儿的IFN-γ/IL-4、IL-10/IL-17比例显著低于非RSV肺炎患儿和健康对照儿童(P均<0.05),哮喘患儿的TGF-β/IL-17显著低于非RSV肺炎患儿与健康对照儿童(P均<0.05).RSV毛支患儿与哮喘患儿之间、非RSV肺炎患儿与健康对照儿童之间IFN-γ、IL-4、IL-10、TGF-β、IL-17水平及其比值IFN-γ/IL-4、IL-10/IL-17、TGF-β/IL-17的差异均无统计学意义(P均>0.05).结论 RSV毛支患儿与哮喘患儿存在相同的外周血细胞因子IFN-γ、IL-4

  17. [PFAPA syndrome].

    Science.gov (United States)

    André, Suzete Costa Anjos; Vales, Fernando; Cardoso, Eduardo; Santos, Margarida

    2009-01-01

    PFAPA syndrome is characterized by periodic fever, pharyngitis, cervical adenitis and aphthous stomatitis. The bouts of fever can last for days or even weeks. Between crises, patients remain asymptomatic for variable periods. It appears before the age of five and has limited duration (4-8 years). Its aetiopathogeny is unknown. Corticoids are the treatment of choice. Tonsillectomy has been proposed as a solution but remains controversial. We present the case of a 4-year-old girl with PFAPA syndrome who underwent tonsillectomy in January, 2008, and we review the literature.

  18. Lemierre's syndrome.

    LENUS (Irish Health Repository)

    O'Dwyer, D N

    2012-02-01

    Lemierre\\'s syndrome is a rare disease that results in an oropharyngeal infection, which precipitates an internal jugular vein thrombosis and metastatic infection. Fusobacterium necrophorum is an anaerobic Gram-negative bacillus and has been identified as the causative agent. We describe the case of a young girl whose presentation and diagnosis were confounded by a history of valvular heart disease. Infection of heart valves can produce many of the signs and symptoms associated with Lemierre\\'s syndrome. We describe the diagnosis, investigation and optimal management of this rare disorder.

  19. Waardenburg syndrome

    Directory of Open Access Journals (Sweden)

    Tagra Sunita

    2006-01-01

    Full Text Available Waardenburg syndrome is a rare inherited and genetically heterogenous disorder of neural crest cell development. Four distinct subtypes showing marked interfamilial and intrafamilial variability have been described. We report a girl showing constellation of congenital hearing impairment with 110 dB and 105 dB loss in right and left ear respectively, hypoplastic blue iridis, white forelock, dystopia canthorum and broad nasal root. Other affected relatives of the family, with variable features of the syndrome, have been depicted in the pedigree.

  20. Eisenmengers syndrom

    DEFF Research Database (Denmark)

    Jensen, Annette Schophuus; Iversen, Kasper; Vejlstrup, Niels G;

    2009-01-01

    Congenital heart disease with left-to-right shunt can induce proliferation, vasoconstriction and thrombosis in the pulmonary vascular bed. Eventually, the patient may develop Eisenmenger syndrome defined as pulmonary arterial hypertension caused by high pulmonary vascular resistance with right......-to-left shunt and cyanosis. Patients with Eisenmenger syndrome suffer a high risk of complications in connection with acute medical conditions, extra-cardiac surgery and pregnancy. This article describes the precautions that should be taken to reduce morbidity and mortality in these patients. Udgivelsesdato...

  1. Olmsted syndrome

    Directory of Open Access Journals (Sweden)

    Kumar Pramod

    2008-01-01

    Full Text Available Olmsted syndrome is a rare disorder characterized by the combination of periorificial, keratotic plaques and bilateral palmoplantar keratoderma. New associated features are being reported. Olmsted syndrome is particularly rare in a female patient, and we report such a case in a six year-old Indian girl, who presented with keratoderma of her soles since birth and on her palms since the age of two years along with perioral and perinasal hyperkeratosis. She had sparse, light brown, thin hair. Although the psychomotor development of the child was normal until 18 months of age, the keratoderma plaques had restricted the child′s mobility after that stage.

  2. [Wilkie's syndrome].

    Science.gov (United States)

    Bognár, Gábor; Ledniczky, György; Palik, Eva; Zubek, László; Sugár, István; Ondrejka, Pál

    2008-10-01

    Loss of retroperitoneal fatty tissue as a result of a variety of debilitating conditions and noxa is believed to be the etiologic factor of superior mesenteric artery syndrome. A case of a 35 years old female patient with severe malnutrition and weight loss is presented, who developed superior mesenteric artery syndrome. Various theories of etiology, clinical course and treatment options of this uncommon disease are discussed. In our case, conservative management was inefficient, while surgical treatment aiming to bypass the obstruction by an anastomosis between the jejunum and the proximal duodenum (duodenojejunostomy) was successful. An interdisciplinary teamwork provides the most beneficial diagnostic and therapeutic result in this often underestimated disease.

  3. Turner Syndrome

    Directory of Open Access Journals (Sweden)

    Ramachandran Sudarshan

    2012-08-01

    Full Text Available Turner syndrome is a genetic disorder that affects mostly females. Affected females have characteristic features such as short stature, premature ovarian failure, and several other features. Oral manifestations of this condition are not much discussed in the literature. But reported literature includes teeth, palate, periodontal and salivary changes. So the aim of this review is to illustrate the general manifestations, and especially the oral manifestations of Turner syndrome and evaluate their possible management. [Archives Medical Review Journal 2012; 21(4.000: 246-252

  4. Gorlin Syndrome

    Directory of Open Access Journals (Sweden)

    Siroos Risbaf

    2013-01-01

    Full Text Available Gorlin syndrome is a dominant autosomal familial disorder. The manifestations begin at an early age and a combination of phenotypic abnormalities such special facial appearance, jaw cysts and skeletal anomalies are seen in this disease. A 22-year-old woman referred to Zahedan Dental School complaining of pain on the left cheek. During the examination, several cutaneous lesions in the neck, pits in palm and sole and multiple jaw cysts were observed. According to the clinical symptoms, lesion biopsy and reports of Gorlin syndrome radiography were presented.

  5. Morbihan syndrome.

    Science.gov (United States)

    Veraldi, Stefano; Persico, Maria Chiara; Francia, Claudia

    2013-04-01

    We report a case of severe Morbihan syndrome (chronic erythematous edema of the upper portion of the face) in a 60-year-old man. The syndrome was characterized clinically by erythematous edema involving the forehead, glabella, and both eyelids, because of which the patient was not able to open completely his eyes. Furthermore, erythema and telangiectasiae were visible on the nose and cheeks. Laboratory and instrumental examinations were within normal ranges or negative. Histopathological examination showed dermal edema, perivascular and periadnexal lympho-histiocytic infiltrate, and sebaceous gland hyperplasia. Oral isotretinoin was ineffective despite the relatively long duration of the therapy (26 weeks).

  6. Morbihan syndrome

    Directory of Open Access Journals (Sweden)

    Stefano Veraldi

    2013-01-01

    Full Text Available We report a case of severe Morbihan syndrome (chronic erythematous edema of the upper portion of the face in a 60-year-old man. The syndrome was characterized clinically by erythematous edema involving the forehead, glabella, and both eyelids, because of which the patient was not able to open completely his eyes. Furthermore, erythema and telangiectasiae were visible on the nose and cheeks. Laboratory and instrumental examinations were within normal ranges or negative. Histopathological examination showed dermal edema, perivascular and periadnexal lympho-histiocytic infiltrate, and sebaceous gland hyperplasia. Oral isotretinoin was ineffective despite the relatively long duration of the therapy (26 weeks.

  7. Progress of inhaled hypertonic saline and epinephrine in the ictal treatment of patients with bronchiolitis%吸入高渗盐水及肾上腺素对毛细支气管炎患儿发作期治疗的研究进展

    Institute of Scientific and Technical Information of China (English)

    王浩

    2014-01-01

    该文回顾了雾化吸入高渗盐水及肾上腺素在临床上治疗患儿毛细支气管炎的应用.对在不同研究中使用雾化吸入高渗盐水及肾上腺素同其他雾化吸入药物治疗毛细支气管炎的疗效进行比较分析,证实雾化吸入高渗盐水及肾上腺素各自在治疗毛细支气管炎时,疗效显著,提示在小剂量高渗盐水及肾上腺素各自雾化吸入及联合使用对于临床治疗毛细支气管炎患儿起到重要的作用.%This paper reviews the application of nebulized hypertonic saline and adrenaline in the treatment of children with bronchiolitis.The efficacy of hypertonic saline and epinephrine in the treatment of bronchiolitis has been analyzed in different experiments.Confirming hypertonic saline and epinephrine respectively in the treatment of bronchiolitis has a significant effect.Prompted each inhalation and combined use of both play an important role in the treatment of bronchiolitis.

  8. Clinical significance of myeliod-derived suppressor cells in peripheral blood and serum interleukin-10 level detection in children with bronchiolitis%毛细支气管炎患儿外周血髓系抑制细胞及血清白细胞介素-10水平检测的意义

    Institute of Scientific and Technical Information of China (English)

    王秀芳; 雷瑞瑞; 张艳丽; 毕丹; 刘莹; 郭智兰; 韩影

    2013-01-01

    目的 检测毛细支气管炎患儿外周血髓系抑制细胞(MDSCs)占单个核细胞比例(MDSCs百分比)及血清IL-10水平,探讨其临床意义.方法 随机选取在郑州大学第三附属医院儿内科就诊的2岁以下毛细支气管炎患儿51例.其中男27例,女24例.分为特应质组(毛支Ⅰ组)(n=25)和非特应质组(毛支Ⅱ组)(n=26).同期随机选取郑州大学第三附属医院儿内科同年龄组外科疝气、肾结石等非感染性疾病术前患儿45例(无特应质疾病史及特应性疾病家族史)(其中男25例,女20例)作为对照组.抽取3组患儿静脉血4 mL,留取1 mL采用流式细胞术检测MDSCs;余3 mL留取血清标本,置-70℃冰箱保存,采用酶联免疫吸附法检测外周血IL-10水平.结果 1.各组患儿MDSCs百分比:毛支Ⅰ组[(3.17±0.24)%]、毛支Ⅱ组[(1.33±0.25)%]均高于对照组[(0.78±0.25)%](P均<0.01);毛支Ⅰ组MDSCs百分比高于毛支Ⅱ组,差异有统计学意义(P<0.01).2.各组患儿外周血IL-10水平比较:毛支Ⅰ组[(31.88 ±3.91) ng/L]、毛支Ⅱ组[(23.85 ±4.10) ng/L]均高于对照组[(13.63 ±2.83) ng/L](P均<0.01);毛支Ⅰ组外周血IL-10水平高于毛支Ⅱ组,差异有统计学意义(P<0.01).3.相关性分析:毛支Ⅰ组MDSCs百分比的分布趋势和血清IL-10水平呈正相关(r =0.717,P<0.01),毛支Ⅱ组、对照组MDSCs百分比与IL-10无相关性(r=0.262、-0.102,P均>0.05).结论 MDSCs通过上调IL-10水平在毛细支气管炎发展为哮喘的过程中起重要作用.%Objective To explore the clinical significance of detecting serum interleukin-10(IL-10) level and the proportion of myeloid-derived suppressor cells (MDSCs) in peripheral blood mononuclear cells (PBMCs) in children with bronchiolitis.Methods Fifty-one children with bronchiolitis less than 2 years old were randomly enrolled including 27 boys and 24 girls.They were divided into 2 groups:bronchiolitis group Ⅰ,25 children with atopic high risks were

  9. The Role of Human Coronaviruses in Children Hospitalized for Acute Bronchiolitis, Acute Gastroenteritis, and Febrile Seizures: A 2-Year Prospective Study.

    Directory of Open Access Journals (Sweden)

    Monika Jevšnik

    Full Text Available Human coronaviruses (HCoVs are associated with a variety of clinical presentations in children, but their role in disease remains uncertain. The objective of our prospective study was to investigate HCoVs associations with various clinical presentations in hospitalized children up to 6 years of age. Children hospitalized with acute bronchiolitis (AB, acute gastroenteritis (AGE, or febrile seizures (FS, and children admitted for elective surgical procedures (healthy controls were included in the study. In patients with AB, AGE, and FS, a nasopharyngeal (NP swab and blood sample were obtained upon admission and the follow-up visit 14 days later, whereas in children with AGE a stool sample was also acquired upon admission; in healthy controls a NP swab and stool sample were taken upon admission. Amplification of polymerase 1b gene was used to detect HCoVs in the specimens. HCoVs-positive specimens were also examined for the presence of several other viruses. HCoVs were most often detected in children with FS (19/192, 9.9%, 95% CI: 6-15%, followed by children with AGE (19/218, 8.7%, 95% CI: 5.3-13.3% and AB (20/308, 6.5%, 95% CI: 4.0-9.8%. The presence of other viruses was a common finding, most frequent in the group of children with AB (19/20, 95%, 95% CI: 75.1-99.8%, followed by FS (10/19, 52.6%, 95% CI: 28.9-75.6% and AGE (7/19, 36.8%, 95% CI: 16.3-61.6%. In healthy control children HCoVs were detected in 3/156 (1.9%, 95% CI: 0.4-5.5% NP swabs and 1/150 (0.7%, 95% CI: 0.02-3.3% stool samples. It seems that an etiological role of HCoVs is most likely in children with FS, considering that they had a higher proportion of positive HCoVs results than patients with AB and those with AGE, and had the highest viral load; however, the co-detection of other viruses was 52.6%.ClinicalTrials.gov NCT00987519.

  10. Marfan syndrome masked by Down syndrome?

    NARCIS (Netherlands)

    Vis, J.C.; Engelen, K. van; Timmermans, J.; Hamel, B.C.J.; Mulder, B.J.

    2009-01-01

    Down syndrome is the most common chromosomal abnormality. A simultaneous occurrence with Marfan syndrome is extremely rare. We present a case of a 28-year-old female with Down syndrome and a mutation in the fibrillin-1 gene. The patient showed strikingly few manifestations of Marfan syndrome. Althou

  11. Dumping Syndrome

    Science.gov (United States)

    ... stomach move to your small intestine in an uncontrolled, abnormally fast manner. This is most often related to changes in your stomach associated with surgery. Dumping syndrome can occur after any stomach operation or removal of the esophagus (esophagectomy). Gastric bypass surgery for ...

  12. Sotos Syndrome

    Science.gov (United States)

    ... 663-4637) Sotos Syndrome Support Association P.O. Box 4626 Wheaton IL Wheaton, IL 60189 info@sotossyndrome.org http://www.sotossyndrome.org/ Tel: 888-246-7772 The Arc of the United States 1825 K Street, NW ...

  13. Reifenstein syndrome

    Science.gov (United States)

    Androgens are most important during early development in the womb. People with Reifenstein syndrome can have a normal lifespan and be totally healthy, but they may have difficulty conceiving a child. In the most severe cases, boys with outer female genitals ...

  14. Nodding Syndrome

    Centers for Disease Control (CDC) Podcasts

    2013-12-19

    Dr. Scott Dowell, a CDC director, discusses the rare illness, nodding syndrome, in children in Africa.  Created: 12/19/2013 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 1/27/2014.

  15. Lemierre's syndrome

    DEFF Research Database (Denmark)

    Johannesen, Katrine; Bødtger, Uffe; Heltberg, Ole

    2014-01-01

    a variety of infectious complications. Rapid diagnosis and treatment is necessary to avoid severe complications or death. Close collaboration with local microbiologist is pivotal. Treatment consists of longterm treatment with penicillin and metronidazole. This is a case report of Lemierre's syndrome....

  16. [Waardenburg's syndrome].

    Science.gov (United States)

    Gimñenez, F; Carbonell, R; Pérez, F; Lozano, I

    1994-01-01

    Reporting one case of this condition type-2 with heterochromia iridis and cochlear deafness. The AA. review the syndrome's components and it nomenclature as well. They discuss about the convenience of including this deviation in the chapter of "diseases of the embryonic neural crest". The specific place of the gene responsibly in the chromosome-2 and the possibilities of genetic counselling are considered.

  17. Waardenburg's syndrome.

    Science.gov (United States)

    Yesudian, D P; Jayaraman, M; Janaki, V R; Yesudian, P

    1995-01-01

    Three children in a family of five presented with heterochromia iridis, lateral displacement of inner canthi and varying degrees of sensorineural deafness. All the 3 showed iris atrophy. The father of the children had only heterochromia iridis. A diagnosis of Waardenburg's syndrome Type I was made in the children with the father probably representing a forme fruste of the condition.

  18. Klinefelter Syndrome

    Directory of Open Access Journals (Sweden)

    Hande Peynirci

    2013-09-01

    Full Text Available Klinefelter syndrome is the most common sex chromosome disorder in males. Variation in clinical presentation and insufficient awareness of this syndrome among clinicians lead to fifty percent of patients remain undetected. Typical clinical features of Klinefelter syndrome are various degrees of hypogonadal symptoms, atrophic testes and gynaecomastia. However, these typical clinical symptoms may not be present in all patients. Even if serum testosterone levels are not markedly low, elevated serum follicle-stimulating hormone is a considerable laboratory finding. Definitive diagnosis is made by karyotype analysis of peripheral blood lymphocytes. It must be kept in mind that this analysis may be normal in rare conditions. Early recognition of patients during puberty and handling them as soon as possible is important. Testosterone replacement therapy results in increased muscle mass, bone mineral density and libido. The patient’s mood and self-esteem improve significantly. In general, patients with Klinefelter syndrome are accepted as infertile, however, assisted reproductive techniques may provide fertilization. Turk Jem 2013; 17: 63-7

  19. Aicardi Syndrome

    Science.gov (United States)

    ... such as lower tone around the head and trunk, microcephaly (small head circumference), and spasticity in the limbs. Typical findings in the brain of girls with Aicardi syndrome include heterotopias , which are groups of brain cells that, during development, migrated to the wrong area ...

  20. Gitelman syndrome.

    NARCIS (Netherlands)

    Knoers, N.V.A.M.; Levtchenko, E.N.

    2008-01-01

    Gitelman syndrome (GS), also referred to as familial hypokalemia-hypomagnesemia, is characterized by hypokalemic metabolic alkalosis in combination with significant hypomagnesemia and low urinary calcium excretion. The prevalence is estimated at approximately 1:40,000 and accordingly, the prevalence