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ABSTRACT Objectives: to analyze the climate seasonality of respiratory diseases in children aged 0-9 years and present a model to predict hospital admissions for 2021 to 2022. Methods: verify, in a temporal manner, the correlation of admissions for pneumonia, bronchitis/bronchiolitis, and asthma with meteorological variables, aiming to demonstrate seasonality with the adjustment of temporal series models. Results: there was a seasonal effect in the number of registered cases for all diseases, with the highest incidence of registrations in the months of autumn and winter. Conclusions: it was possible to observe a tendency towards a decrease in the registration of pneumonia cases; In cases of admissions due to bronchitis and bronchiolitis, there was a slight tendency towards an increase; and, in occurrence rates of asthma, there was no variation in the number of cases.
RESUMEN Objetivos: analizar la estacionalidad climática de las enfermedades respiratorias en niños de 0 a 9 años y presentar un modelo para previsión de internaciones hospitalarias para los años de 2021 a 2022. Métodos: se propuso verificar, de manera temporal, la correlación de internaciones para neumonitis, bronquitis/bronquiolitis y asma con variables meteorológicas, visando verificar la estacionalidad con el ajuste de modelos de series temporales. Resultados: se percibió, para todas las enfermedades, el efecto estacional en el número de casos registrados, con el mayor número de registros en los meses de otoño e invierno. Conclusiones: fue posible constatar una tendencia de disminución en el registro de casos de neumonitis; ya para los casos de internaciones por bronquitis y bronquiolitis, se observó una leve tendencia de aumento; y, en relación las tasas de ocurrencia de asma, no hubo variación.
RESUMO Objetivos: analisar a sazonalidade climática das doenças respiratórias em crianças de 0 a 9 anos e apresentar um modelo para previsão de internações hospitalares para os anos de 2021 a 2022. Métodos: propôs-se verificar, de maneira temporal, a correlação de internações para pneumonia, bronquite/bronquiolite e asma com variáveis meteorológicas, visando verificar a sazonalidade com o ajuste de modelos de séries temporais. Resultados: percebeu-se, para todas as enfermidades, o efeito sazonal no número de casos registrados, com o maior número de registros nos meses de outono e inverno. Conclusões: foi possível constatar uma tendência de diminuição no registro de casos de pneumonia; já para os casos de internações por bronquite e bronquiolite, observou-se uma leve tendência de aumento; e, em relação as taxas de ocorrência de asma, não houve variação.
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Introduction: studies have highlighted the importance of gut microbiota (GM) to the host immune defenses, influencing the host development and physiology. Changes in the composition and diversity of GM have been detected in some disease and could be implicated in the pathophysiological mechanisms of them. Objective: the purpose of this study was to show an overview of the current knowledge about the GM of patients with airway diseases (AD). Methodology: the literature search was performed in four databases, using a combination of the descriptors: "Gastrointestinal Microbiome", "Gut Microbiome", "Gut Microbiota", "Cystic Fibrosis" (CF), "Asthma", "Pulmonary Hypertension" (HP) and/or "Chronic Obstructive Pulmonary Disease" (COPD). Results: fifteen studies were herein included: ten of CF and five of asthma. No study about other AD matched the inclusion criteria. In all studies about CF, changes were detected in GM, particularly quantitative and qualitative microbial changes. For asthma, data showed changes in GM also including a reduction of microbial richness, evenness and diversity and in the Bacteroidetes/Firmicutes ratio. Conclusions: the current data indicate the existence of GM changes in AD. However, due to the few studies for asthma and the lack of investigations on HP and COPD, it was not possible to confirm whether these GM changes are observed in other AD. Furthermore, this review shows the necessity of more studies in this area to characterize dysbiosis and which alterations are more frequent observed in AD patients.
Introdução: estudos têm destacado a importância da microbiota intestinal (GM) para as defesas imunológicas do hospedeiro, influenciando o desenvolvimento e a fisiologia do hospedeiro. Mudanças na composição e diversidade da GM foram detectadas em algumas doenças e podem estar implicadas nos mecanismos fisiopatológicos delas. Objetivo: o objetivo desta revisão foi avaliar estudos sobre a microbiota intestinal (MI) de pacientes com doenças das vias aéreas (DA). Metodologia: esta pesquisa bibliográfica foi realizada em quatro bases de dados, utilizando a combinação dos descritores: "Microbioma Gastrointestinal", "Microbioma Intestinal", "Microbiota Intestinal", "Fibrose Cística" (CF), "Asma", "Hipertensão Pulmonar" (HP), "Doença Pulmonar Obstrutiva Crônica" (DPOC). Resultados: quinze estudos foram incluídos: dez de FC e cinco de asma. Nenhum estudo sobre outra DA correspondeu aos critérios de inclusão. Em todos os estudos sobre FC, foram detectadas alterações na MI, particularmente alterações microbianas qualitativas e quantitativas. Para a asma, os dados mostraram mudanças na MI, incluindo também uma redução da quantidade, uniformidade e diversidade microbiana e na razão Bacteroidetes/Firmicutes. Conclusão: os dados atuais indicam a existência de alterações na MI nas DA. No entanto, devido aos poucos estudos para asma e à falta de investigações para HP e DPOC, não foi possível confirmar se essas alterações na MI são observadas em outras DA também. Além disso, esta revisão mostra a necessidade de mais estudos nessa área para caracterizar a disbiose e quais alterações são mais frequentes em pacientes com DA.
Subject(s)
Humans , Respiratory Tract Diseases , Asthma , Cystic Fibrosis , Pulmonary Disease, Chronic Obstructive , Gastrointestinal Microbiome , Hypertension, Pulmonary , DatabaseABSTRACT
Connective tissue diseases (CTDs) can affect all compartments of the lungs, including airways, alveoli, interstitium, vessels, and pleura. CTD-associated lung diseases (CTD-LDs) may present as diffuse lung disease or as focal lesions, and there is significant heterogeneity between the individual CTDs in their clinical and pathological manifestations. CTD-LDs may presage the clinical diagnosis a primary CTD, or it may develop in the context of an established CTD diagnosis. CTD-LDs reveal acute, chronic or mixed pattern of lung and pleural manifestations. Histopathological findings of diverse morphological changes can be present in CTD-LDs airway lesions (chronic bronchitis/bronchiolitis, follicular bronchiolitis, etc.), interstitial lung diseases (nonspecific interstitial pneumonia/fibrosis, usual interstitial pneumonia, lymphocytic interstitial pneumonia, diffuse alveolar damage, and organizing pneumonia), pleural changes (acute fibrinous or chronic fibrous pleuritis), and vascular changes (vasculitis, capillaritis, pulmonary hemorrhage, etc.). CTD patients can be exposed to various infectious diseases when taking immunosuppressive drugs. Histopathological patterns of CTD-LDs are generally nonspecific, and other diseases that can cause similar lesions in the lungs must be considered before the diagnosis of CTD-LDs. A multidisciplinary team involving pathologists, clinicians, and radiologists can adequately make a proper diagnosis of CTD-LDs.
Subject(s)
Humans , Bronchiolitis , Communicable Diseases , Connective Tissue Diseases , Connective Tissue , Diagnosis , Fibrin , Hemorrhage , Idiopathic Pulmonary Fibrosis , Lung Diseases , Lung Diseases, Interstitial , Lung , Pleura , Pleural Diseases , Population CharacteristicsABSTRACT
Pulmonary function testing(PFT) is an appropriate technique for comprehensive prevention and control of chronic airway diseases. In 2015, the National Clinical Research Center for Respiratory Diseases launched the national standardized training and assessment programme on clinical application and quality control of PFT. There are four steps for the overall programme. The first step is to establish the standard and outline of standardized training for PFT. The second step is to carry out standardized training based on the established standard and outline. The third step is to conduct post-training assessment, evaluate the training effect, and certify the trainees who master the training content. The last step is to carry out quality control in those who have obtained the certification,and evaluate the application of training content in clinical practice. With the progress of the programme, clinicians' awareness of the importance of PFT will be increased, physicians' and techinicians' operate on skills and clinical application abilities of PFT will be promoted, while the qualities of PFT in China will be improved. It will be of great significance to the construction of Pulmonary and Critical Care Medicine(PCCM).
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Objective@#Allergic airway diseases (AADs) are a group of heterogeneous disease mediated by T-helper type 2 (Th2) immune response and characterized with airway inflammation and remodeling, including allergic asthma, allergic rhinitis, and chronic rhinosinusitis with allergic background. This review aimed to discuss the abnormal epithelial-mesenchymal crosstalk in the pathogenesis of AADs.@*Data Sources@#Articles referred in this review were collected from the database of PubMed published in English up to January 2018.@*Study Selection@#We had done a literature search using the following terms "allergic airway disease OR asthma OR allergic rhinitis OR chronic sinusitis AND IL-25 OR IL-33 OR thymic stromal lymphopoietin OR fibrocyte". Related original or review articles were included and carefully analyzed.@*Results@#It is now believed that abnormal epithelial-mesenchymal crosstalk underlies the pathogenesis of AADs. However, the key regulatory factors and molecular events involved in this process still remain unclear. Epithelium-derived triple cytokines, including interleukin (IL)-25, IL-33, and thymic stromal lymphopoietin (TSLP), are shown to act on various target cells and promote the Th2 immune response. Circulating fibrocyte is an important mesenchymal cell that can mediate tissue remodeling. We previously found that IL-25-circulating fibrocyte axis was significantly upregulated in patients with asthma, which may greatly contribute to asthmatic airway inflammation and remodeling.@*Conclusions@#In view of the redundancy of cytokines and "united airway" theory, we propose a new concept that IL-25/IL-33/TSLP-fibrocyte axis may play a vital role in the abnormal epithelial-mesenchymal crosstalk in some endotypes of AADs. This novel idea will guide potential new intervention schema for the common treatment of AADs sharing common pathogenesis in the future.
Subject(s)
Humans , Asthma , Metabolism , Cytokines , Physiology , Interleukin-17 , Physiology , Interleukin-33 , PhysiologyABSTRACT
The respiratory tract is primary contact site of the body and environment,and it is ventilated by 10-20 thousand liters of air per day.Inevitably,the respiratory system comes into contact with airborne microbes,which contain the disease-causing pathogens.Airway epithelial cells (AECs) are known to have innate sensor functions,which are similar to the "professional" immune cells,such as alveolar macrophage and sub-or intra-epithelial dendritic cells (DCs).Thus AECs are able to detect invading microbial danger including different types of respiratory viruses,and mount a potent host response,for example,activating type Ⅰ interferon signaling pathway genes.To avoid chronic inflammation and maintain the immunological homeostasis,the pulmonary system has developed intrinsic mechanisms to control local immune responses.Most recently,the role of AECs in control of local immunity has gained much attention,as 1) AECs express the pattern recognition receptors (PRRs),such as Toll-like receptors,retinoic acid inducible gene Ⅰ (RIG-Ⅰ)-like receptor,and so on,thus AECs are equipped to Participate in innate detection of microbial encounter;2) To keep immunological homeostasis in the respiratory tract,AECs behave not only as innate immune sensors but also as immune modulators in parallel,through modulating the sensitivity of innate immune sensing of both AECs per se and sub-or intra-epithelial immune cells;3) Loss of modularity capacity of AECs might be involved in the development of chronic airway diseases.In present review,how the AECs act will be intensively discussed in response to respiratory viruses and modulate the local immunity through cis-and trans-factors (direct and indirect factors),as well as the consequence of impairment of this control of local immunity,in the development and exacerbation of airway diseases,such as acute and chronic rhinosinusitis.
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Objective To evaluate the extent and anatomic distribution of air trapping in lung in young asymptomatic female subjects to achieve early diagnosis of small airway diseases.Methods Fifty young females with normal pulmonary function were included retrospectively in this study.All subjects underwent both inspiratory and expiratory CT scans,the percentage of the area of air trapping(AT)and the percentage of the area of emphysema(Emph)were quantitatively analyzed.Comparison between bilateral lungs was analyzed using independent-samples t test;Comparisons among lobes were done using one-way ANOVA or Kruskal-Wallis rank sum test;Pairwise comparisons between lobes were conducted using LSD test or paired comparison;The effects of each lobe on AT were analyzed using Spearman's rank correlation coefficient,simple linear regression and multiple stepwise regression.Results There was a certain degree of air trapping in lung and a small amount of emphysema in young asymptomatic females.Air trapping was mainly located in the right middle lobe (RML)and bilateral upper lobes.The ratio of air trapping to volume was the highest in RML and the change of air trapping in the bilateral upper lobes had the greatest influence on the air trapping degree of the whole lung.Conclusion There is a certain degree of air trapping in lung in young asymptomatic females.The occurrence and development of air trapping in RML may be a sensitive biomarker for the early detection of pathophysiological changes in small airway diseases using imaging procedures.
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Se analizaron 44 historias de equinos admitidos en la Clínica de Grandes Animales de la Universidad Nacional de Colombia entre I semestre-1993 y II semestre-2007, para determinar las entidades obstructivas más prevalentes en el tracto respiratorio superior (cavidad nasal, faringe y laringe). Se determinó que el desplazamiento dorsal del paladar blando, la hemiplejia laríngea, la hiperplasia linfoide faríngea y las neoplasias fueron las entidades más prevalentes con 38,64%, 34,09%, 18,18% y 9,09%, respectivamente; el desplazamiento dorsal del paladar blando fue más común en animales de raza Paso Colombiano, lo que se atribuye a la posición recogida de cabeza y cuello durante el ejercicio. La hemiplejía laríngea, al igual que el desplazamiento, fue más común en animales de raza Paso Colombiano cuando se consideraron las razas individualmente; sin embargo, fueron los animales de las razas de deporte los más afectados (73,33%). Los hallazgos mencionados son semejantes a los reportados en la literatura.
A total of 44 clinical records of horses admitted between I semester-1993 and II semester-2007 to the Large Animal Hospital at the National University of Colombia were reviewed to determine which diseases were more prevalent in the upper respiratory tract (nasal cavity, pharynx and larynx) of these horses. It was determined that dorsal displacement of the soft palate, laryngeal hemiplegia, pharyngeal lymphoid hyperplasia and neoplasm were the most prevalent entities with a prevalence of 38.64%, 34.09%, 18.18% and 9.09%, respectively. Laryngeal hemiplegia and dorsal displacement of the soft palate were more common in the Paso breed than other breeds when individual breeds were considered; but the more affected were the sport breeds as a whole with 73.33%; all these findings are the similar to what is reported in the scientific literature.
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OBJETIVO: Analisar a sazonalidade climática dos atendimentos ambulatoriais por doença respiratória (DR) em menores de 15 anos. MÉTODOS: Estudo epidemiológico descritivo, realizado com dados dos Registros de Ocorrências Ambulatoriais das unidades básicas de saúde referentes ao período 2004-2005, do município de Tangará da Serra (MT). As estimativas populacionais foram obtidas do Instituto Brasileiro de Geografia e Estatística (IBGE), e os dados de umidade relativa do ar e temperatura, do Instituto Nacional de Meteorologia (INMET). Foram construídas taxas médias de atendimento ambulatorial por DR segundo sexo, faixa etária e localização anatômica. Calculou-se a razão seca/chuva dos atendimentos de acordo com a localização anatômica da DR. Utilizou-se o Epi-Info 3.2 para análise dos dados, com as diferenças de proporção testadas através do teste do qui-quadrado, ao nível de significância de 5 por cento. RESULTADOS: Indivíduos do sexo masculino tiveram taxa quase 50 por cento maior (37,3/25,0) de atendimentos ambulatoriais por doenças das vias aéreas inferiores que os do sexo feminino. As taxas de atendimentos ambulatoriais por DR em menores de 15 anos apresentaram variação com o aumento da idade, passando de 457,7 nos menores de 1 ano de idade para 133,5 no grupo de 10 a 14 anos. Os atendimentos por DR foram em média 21 por cento menos freqüentes(4.148/5.231) no período seco (p = 0,000). Observou-se picos de atendimento nos meses de março e agosto, mais acentuados em março, período chuvoso na região. CONCLUSÃO: Os atendimentos ambulatoriais por DR, especialmente por doenças das vias aéreas superiores, estão relacionados ao período chuvoso no município.
OBJECTIVE: To analyze the climatic seasonality of primary care visits for respiratory disease (RD) in children less than 15 years old. METHODS: This was a descriptive, epidemiological study based on data from the municipal records of primary care events from basic healthcare centers for the period 2004-2005, for the municipality of Tangará da Serra (MT), Brazil. Population estimates were obtained from the Brazilian Institute of Geography and Statistics (Instituto Brasileiro de Geografia e Estatística, IGBE), and data on temperature and relative humidity of the air, from the National Meteorology Institute (Instituto Nacional de Meteorologia, INMET). Mean rates of primary care visits for RD were calculated according to sex, age group and anatomic location of complaint. The ratio of dry season to rainy season visits was calculated according to anatomic location of the RD. Data were analyzed using Epi-Info 3.2, testing differences between proportions using the chi-square test to a significance level of 5 percent. RESULTS: Male children had an almost 50 percent greater (37.3/25.0) rate of primary care visits for diseases of the lower respiratory tract than did females. The rates of primary care visits due to RD in children under 15 years of age varied as age increased, varying from 457.7 of children less than 1 year of age to 133.5 in the 10 to 14 years-of-age group. During the dry season there were an average of 21 percent (4,148/5,231) fewer visits for RD (p = 0.000). Peaks in numbers of visits were observed during the months of March and August, being more accentuated in March, which is the wet season in the region. CONCLUSION: Primary care visits for RD, especially those due to upper airway diseases, are related to the rainy season in this municipality.