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Epidemiologia E Prevenzione 2023occupational exposure to vapours, gases, dusts and fumes (VGDF) plays an important role in the development and exacerbation of respiratory diseases. The aim of this...
OBJECTIVES
occupational exposure to vapours, gases, dusts and fumes (VGDF) plays an important role in the development and exacerbation of respiratory diseases. The aim of this study is to evaluate the possible association of occupational exposure to airborne pollutants and chronic respiratory diseases.
DESIGN
multicase-control study.
SETTING AND PARTICIPANTS
cases of chronic respiratory diseases and controls from the Italian multicentric study Gene Environment Interaction in Respiratory Diseases (GEIRD).
MAIN OUTCOME MEASURES
the occurrence of rhinitis, asthma, chronic bronchitis/chronic obstructive pulmonary disease (COPD), asthma severity, spirometry data, exhaled nitric oxide (FeNO) were examined in relation to chronic and acute occupational exposures to airborne pollutants using multiple regression models.
RESULTS
2,943 subjects were enrolled in the study. Regularm exposure to VGDF was associated with a higher prevalence of chronic bronchitis/COPD (OR 1.40, 95%CI 0.98-1.99), especially in those also having asthma (OR 1.80, 95%CI 1.14-2.85), a lower prevalence of remittent asthma (OR 0.53, 95%CI 0.29-0.96) and, in those with asthma, an increased activity of the disease (severity score) (OR 1.77, 95%CI 1.20-2.60). No associations were observed between occupational exposure and prevalence of rhinitis, spirometry and FeNO data. Finally, an association was found between acute exposure to airborne pollutants (occupational and non-occupational) and the respiratory diseases investigated, in particular active asthma and asthma associated chronic bronchitis/BPCO.
CONCLUSIONS
these data confirm a significant role of occupational exposure to airborne pollutants on respiratory health, underlying the importance of workplace exposure prevention, in particular for more susceptible subjects, as those with respiratory diseases.
Topics: Humans; Bronchitis, Chronic; Environmental Pollutants; Prevalence; Risk Factors; Occupational Diseases; Italy; Pulmonary Disease, Chronic Obstructive; Asthma; Occupational Exposure; Respiration Disorders; Workplace; Gases; Rhinitis
PubMed: 38639301
DOI: 10.19191/EP23.6.S3.008 -
Pediatric Transplantation May 2024Invasive fungal disease (IFD) is a frequent complication in pediatric lung transplant recipients, occurring in up to 12% of patients in the first year. Risk factors for... (Review)
Review
Identification of Irpex and Rhodotorula on surveillance bronchoscopy in a pediatric lung transplant recipient: A case report and review of literature of these atypical fungal organisms.
BACKGROUND
Invasive fungal disease (IFD) is a frequent complication in pediatric lung transplant recipients, occurring in up to 12% of patients in the first year. Risk factors for infection include impaired lung defenses and intense immunosuppressive regimens. While most IFD occurs from Aspergillus, other fungal conidia are continuously inhaled, and infections with fungi on a spectrum of human pathogenicity can occur.
CASE REPORT
We report a case of a 17-year-old lung transplant recipient in whom Irpex lacteus and Rhodotorula species were identified during surveillance bronchoscopy. She was asymptomatic and deemed to be colonized by Irpex lacteus and Rhodotorula species following transplant. 2 years after transplantation, she developed a fever, respiratory symptoms, abnormal lung imaging, and histological evidence of acute and chronic bronchitis on transbronchial biopsy. After developing symptoms concerning for a pulmonary infection and graft dysfunction, she was treated for a presumed IFD. Unfortunately, further diagnostic testing could not be performed at this time given her tenuous clinical status. Despite the initiation of antifungal therapy, her graft function continued to decline resulting in a second lung transplantation.
CONCLUSIONS
This case raises the concern for IFD in lung transplant recipients from Irpex species. Further investigation is needed to understand the pathogenicity of this organism, reduce the incidence and mortality of IFD in lung transplant recipients, and refine the approach to diagnosis and manage the colonization and isolation of rare, atypical fungal pathogens in immunocompromised hosts.
Topics: Adolescent; Female; Humans; Antifungal Agents; Bronchoscopy; Invasive Fungal Infections; Lung; Lung Transplantation; Polyporales; Rhodotorula; Transplant Recipients
PubMed: 38623871
DOI: 10.1111/petr.14759 -
Romanian Journal of Ophthalmology 2024To describe acute calcareous corneal degeneration as a complication of chronic graft-versus-host disease. Clinical case and review of the literature. We presented a... (Review)
Review
To describe acute calcareous corneal degeneration as a complication of chronic graft-versus-host disease. Clinical case and review of the literature. We presented a case of bilateral acute calcareous corneal degeneration in a patient with chronic graft-versus-host disease. Chronic graft-versus-host disease (cGVHD) occurs in 50-70% of bone marrow transplantation patients, the most frequent ocular complication being keratoconjunctivitis sicca (KCS). Calcareous corneal degeneration is a type of calcium deposition that can be secondary to chronic ocular inflammation or dry eye, but there are few cases reported of acute calcareous corneal degeneration and recurrent perforation in cGVHD. GVHD = Chronic graft-versus-host disease, aGVHD = Acute graft-versus-host disease, cGVHD = Chronic graft-versus-host disease, KCS = Keratoconjunctivitis sicca, PKP = Penetrating keratoplasty, AMT = Amniotic membrane transplantation, PRGF = Plasma rich in growth factors, OD = Right eye, OS = Left eye.
Topics: Humans; Keratoconjunctivitis Sicca; Bronchiolitis Obliterans Syndrome; Cornea; Corneal Dystrophies, Hereditary; Keratoplasty, Penetrating; Inflammation
PubMed: 38617729
DOI: 10.22336/rjo.2024.10 -
Thorax May 2024
Topics: Humans; Respiratory Syncytial Virus Infections; Infant; Neutrophils; Bronchiolitis; Bronchiolitis, Viral
PubMed: 38575318
DOI: 10.1136/thorax-2023-221130 -
Chinese Journal of Natural Medicines Mar 2024Carrimycin (CA), sanctioned by China's National Medical Products Administration (NMPA) in 2019 for treating acute bronchitis and sinusitis, has recently been observed to...
Carrimycin (CA), sanctioned by China's National Medical Products Administration (NMPA) in 2019 for treating acute bronchitis and sinusitis, has recently been observed to exhibit multifaceted biological activities, encompassing anti-inflammatory, antiviral, and anti-tumor properties. Despite these applications, its efficacy in sepsis treatment remains unexplored. This study introduces a novel function of CA, demonstrating its capacity to mitigate sepsis induced by lipopolysaccharide (LPS) and cecal ligation and puncture (CLP) in mice models. Our research employed in vitro assays, real-time quantitative polymerase chain reaction (RT-qPCR), and RNA-seq analysis to establish that CA significantly reduces the levels of pro-inflammatory cytokines, namely tumor necrosis factor-alpha (TNF-α), interleukin 1 beta (IL-1β), and interleukin 6 (IL-6), in response to LPS stimulation. Additionally, Western blotting and immunofluorescence assays revealed that CA impedes Nuclear Factor Kappa B (NF-κB) activation in LPS-stimulated RAW264.7 cells. Complementing these findings, in vivo experiments demonstrated that CA effectively alleviates LPS- and CLP-triggered organ inflammation in C57BL/6 mice. Further insights were gained through 16S sequencing, highlighting CA's pivotal role in enhancing gut microbiota diversity and modulating metabolic pathways, particularly by augmenting the production of short-chain fatty acids in mice subjected to CLP. Notably, a comparative analysis revealed that CA's anti-inflammatory efficacy surpasses that of equivalent doses of aspirin (ASP) and TIENAM. Collectively, these findings suggest that CA exhibits significant therapeutic potential in sepsis treatment. This discovery provides a foundational theoretical basis for the clinical application of CA in sepsis management.
Topics: Mice; Animals; Lipopolysaccharides; Mice, Inbred C57BL; Tumor Necrosis Factor-alpha; Interleukin-6; Punctures; Sepsis; Anti-Inflammatory Agents; Disease Models, Animal; Spiramycin
PubMed: 38553191
DOI: 10.1016/S1875-5364(24)60600-X -
Seminars in Respiratory and Critical... Jun 2024Systemic Lupus Erythematosus (SLE) is a multifaceted, multisystem autoimmune disorder with diverse clinical expressions. While prevalence reports vary widely, pulmonary... (Review)
Review
Systemic Lupus Erythematosus (SLE) is a multifaceted, multisystem autoimmune disorder with diverse clinical expressions. While prevalence reports vary widely, pulmonary involvement accounts for significant morbidity and mortality in SLE. This comprehensive review explores the spectrum of pulmonary disease in SLE, including upper airway manifestations (e.g., laryngeal affection), lower airway conditions (e.g., bronchitis, bronchiolitis, bronchiectasis), parenchymal diseases (e.g., interstitial lung disease, acute lupus pneumonitis, diffuse alveolar hemorrhage), pleural diseases (e.g., serositis, shrinking lung syndrome), and vascular diseases (e.g., pulmonary arterial hypertension, pulmonary embolism, acute reversible hypoxemia syndrome). We discuss diagnostic modalities, treatment strategies, and prognosis for each pulmonary manifestation. With diagnostics remaining a challenge and with the absence of standardized treatment guidelines, we emphasize the need for evidence-based guidelines to optimize patient care and improve outcomes in this complex disease.
Topics: Humans; Lupus Erythematosus, Systemic; Lung Diseases; Prognosis
PubMed: 38547915
DOI: 10.1055/s-0044-1782653 -
Diagnostics (Basel, Switzerland) Mar 2024Respiratory syncytial virus (RSV) infection represents a global and noteworthy cause of hospitalization and death in infants of less than 1 year of age. The typical...
Fatal Deterioration of a Respiratory Syncytial Virus Infection in an Infant with Abnormal Muscularization of Intra-Acinar Pulmonary Arteries: Autopsy and Histological Findings.
Respiratory syncytial virus (RSV) infection represents a global and noteworthy cause of hospitalization and death in infants of less than 1 year of age. The typical clinical manifestation is bronchiolitis, an inflammatory process of the small airways. The symptoms are usually a brief period of low-grade fever, cough, coryza, breathing difficulties, and reduced feeding. The progression of the disease is difficult to predict, even in previous healthy subjects. Symptoms may also be subtle and underestimated, thus leading to sudden unexpected infant death (SUID). In these cases, RSV infection is discovered at autopsy, either histologically or through real-time reverse transcription polymerase chain reaction (RT-PCR) performed on nasopharyngeal swabs. Herein, we describe a case of RSV infection in a 6-month-old infant with no risk factors, who rapidly deteriorated and unexpectedly died of respiratory insufficiency in a hospital setting. RT-PCR on nasopharyngeal swabs revealed RSV. The autopsy showed diffuse lymphogranulocytic bronchitis and bronchiolitis, and multiple foci of acute pneumonia. Abnormal muscularization of the intra-acinar pulmonary arteries was also observed, which likely contributed to worsening the lung impairment.
PubMed: 38535022
DOI: 10.3390/diagnostics14060601 -
Diagnostics (Basel, Switzerland) Mar 2024(1) Background: Acute asthma and bronchitis are common infectious diseases in children that affect lower respiratory tract infections (LRTIs), especially in preschool...
(1) Background: Acute asthma and bronchitis are common infectious diseases in children that affect lower respiratory tract infections (LRTIs), especially in preschool children (below six years). These diseases can be caused by viral or bacterial infections and are considered one of the main reasons for the increase in the number of deaths among children due to the rapid spread of infection, especially in low- and middle-income countries (LMICs). People sometimes confuse acute bronchitis and asthma because there are many overlapping symptoms, such as coughing, runny nose, chills, wheezing, and shortness of breath; therefore, many junior doctors face difficulty differentiating between cases of children in the emergency departments. This study aims to find a solution to improve the differential diagnosis between acute asthma and bronchitis, reducing time, effort, and money. The dataset was generated with 512 prospective cases in Iraq by a consultant pediatrician at Fallujah Teaching Hospital for Women and Children; each case contains 12 clinical features. The data collection period for this study lasted four months, from March 2022 to June 2022. (2) Methods: A novel method is proposed for merging two one-dimensional convolutional neural networks (2-1D-CNNs) and comparing the results with merging one-dimensional neural networks with long short-term memory (1D-CNNs + LSTM). (3) Results: The merged results (2-1D-CNNs) show an accuracy of 99.72% with AUC 1.0, then we merged 1D-CNNs with LSTM models to obtain the accuracy of 99.44% with AUC 99.96%. (4) Conclusions: The merging of 2-1D-CNNs is better because the hyperparameters of both models will be combined; therefore, high accuracy results will be obtained. The 1D-CNNs is the best artificial neural network technique for textual data, especially in healthcare; this study will help enhance junior and practitioner doctors' capabilities by the rapid detection and differentiation between acute bronchitis and asthma without referring to the consultant pediatrician in the hospitals.
PubMed: 38535020
DOI: 10.3390/diagnostics14060599 -
Zhonghua Xue Ye Xue Za Zhi = Zhonghua... Jan 2024To evaluate the status of, differences in, and factors influencing quality of life (QoL) in patients with chronic graft-versus-host disease (GVHD). From September 2021...
To evaluate the status of, differences in, and factors influencing quality of life (QoL) in patients with chronic graft-versus-host disease (GVHD). From September 2021 to February 2023, a cross-sectional study of 140 patients with chronic GVHD was conducted at our center. Symptom burden was assessed by the Lee Symptomatology Scale (LSS), and QoL was assessed by the Medical Outcome Study 36-Item Short-Form Health Survey (SF-36) (version 1) and five-level EuroQoL five-dimensional questionnaire (EQ-5D-5L). Data from 140 respondents, including 32 (22.9%) with mild chronic GVHD, 87 (62.1%) with moderate chronic GVHD, and 21 (15.0%) with severe chronic GVHD, were analyzed. Of the respondents, 61.4% were male, and the median transplantation age was 34 (15-68) years. The primary diagnoses were acute myeloid leukemia (50.0%), acute lymphoblastic leukemia (20.0%), and myelodysplastic syndrome (15.0%). The common chronic GVHD-affected organs included the skin in 74 patients (52.9%), the eyes in 57 patients (40.7%), and the liver in 50 patients (35.7%). Among the whole cohort, the eye (20.48±23.75), psychological (16.13±17.00), and oral (13.66±20.55) scores were highest in the LSS group. The physiological function (36.07±11.13), social function (36.10±10.68), and role-emotional functioning (38.36±11.88) scores were lowest in the SF-36 group. The EQ-5D index was 0.764. The total LSS scores for mild, moderate, and severe chronic GVHD were 6.51±6.15, 10.07±5.61, and 20.90±10.09, respectively. The SF-36 physical component scores (PCSs) were 43.12±6.38, 40.73±7.14, and 36.97±6.97, respectively, and the mental component scores (MCSs) were 43.00±8.47, 38.90±9.52, and 28.96±9.63, respectively. The EQ-5D values were 0.810±0.124, 0.762±0.179, and 0.702±0.198, respectively. The multivariate analysis showed that the overall symptom burden (=-0.517), oral symptom burden (=-0.456), National Institute of Health (NIH) criteria for the eyes (=-0.376), and nutrition-related symptom burden (=-0.211) were significantly negatively correlated with the PCS. The NIH score (=-0.260) was negatively correlated with the MCS score. Oral symptom burden (=-0.400), joint/fascia NIH criteria (=-0.332), number of involved systems (=-0.253), overall NIH criteria (=-0.205), and number of immunosuppressants taken (=-0.171) were significantly negatively correlated with the EQ-5D score (all <0.05). Medium to strong correlations were found between the EQ-5D score and the SF-36 score (||=0.384-0.571, <0.001). The QoL of patients with chronic GVHD is impaired, and the more severe the disease, the poorer the QoL. Overall symptom burden, severity of eyes, and oral symptom burden were the most important factors affecting QoL.
Topics: Humans; Male; Adult; Middle Aged; Aged; Female; Quality of Life; Bronchiolitis Obliterans Syndrome; Cross-Sectional Studies; Surveys and Questionnaires; Symptom Burden; Chronic Disease
PubMed: 38527839
DOI: 10.3760/cma.j.cn121090-20231008-00162 -
Geriatrics (Basel, Switzerland) Feb 2024It remains unclear if antibiotics should be used for the treatment of acute aspiration bronchitis to prevent the development of pneumonia. This study aimed to assess the...
BACKGROUNDS
It remains unclear if antibiotics should be used for the treatment of acute aspiration bronchitis to prevent the development of pneumonia. This study aimed to assess the associations between the use of antibiotics and the development of pneumonia among patients with acute aspiration bronchitis.
METHODS
We retrospectively reviewed consecutive patients with acute aspiration bronchitis aged ≥75 years. Acute aspiration bronchitis was defined as a condition with aspiration risk, high fever (body temperature, ≥37.5 °C), respiratory symptoms, and the absence of evidence of pneumonia.
RESULTS
There was no significant difference in the incidence of pneumonia between patients treated with and without antibiotics for acute aspiration bronchitis (6/44, 14% vs. 31/143, 22%; = 0.242). Lower estimated glomerular filtration rate (adjusted odds ratio, 0.956; 95% confidence interval, 0.920-0.993) was significantly associated with the development of pneumonia.
CONCLUSIONS
Antibiotic administration should not be routinely recommended to prevent pneumonia following acute aspiration bronchitis, and patients with decreased renal function should be closely monitored. A randomized controlled trial is necessary to validate these results.
PubMed: 38525743
DOI: 10.3390/geriatrics9020026