Prevalence of β₂-agonist inhalation for outpatients in a pediatric emergency center during enterovirus D68 epidemic

BACKGROUND: Enterovirus D68 (EV-D68) has been reported to have caused severe bronchial asthma attacks and hospitalization epidemics in Japan in September 2015. OBJECTIVE: To investigate the prevalence of β2-agonist inhalation in a pediatric emergency center during a period of increased hospitalization for bronchial asthma, which was suggested to be associated with EV-D68. METHODS: We investigated the prevalence of β2-agonist inhalation in a pediatric emergency center in Saga city, Japan, from April 2013 to October 2015, and also clarified the trends in bronchial asthma hospitalization in the same area during that time. RESULTS: The prevalence of β2-agonist inhalation in the pediatric emergency center, September 2015 was highest when EV-D68 became widespread. The monthly average for β2-agonist inhalation during the study period was 91 cases, but the count in September 2015 was 255 cases. Hospitalized cases of bronchial asthma in September 2015 were increased for age ≥3 years and not increased for age <3 years, but the prevalence of β2-agonist inhalation at the pediatric emergency center was increased even under the age of 3 years. CONCLUSION: During the epidemic period for EV-D68, cases requiring β2-agonist inhalation were increased. The EV-D68 epidemic may be related to not only severe cases requiring hospitalization, but also exacerbation of relatively mild symptoms of bronchial asthma.

Determination of Residues of 26 β2-Agonists in Pork Liver by Reversed Phase High Performance Liquid Chromatography-Tandem Mass Spectrometry / 分析化学

A method for determination of residues of 26 β2-agonists in pork liver was developed using high performance liquid chromatography with tandem mass spectrometric ( HPLC-MS/MS ) . After enzymatic hydrolysis with β-Glucuronidase/Arylsulfatase for 12 hours, the pH of sample solution was adjusted to 1 using perchloric acid for protein precipitation. The precipitate was extracted with 0. 1mol/L perchloric acid aqueous. The extracts in the above two steps were combined and adjusted to pH 4 for the solid phase extraction ( MCX) . And then the 26 β2-agonists residues in the extracts were separated on a reversed phase HPLC column using a gradient elution program of 0. 1% formic acid aqueous solution (A) and 0. 1% formic acid in acetonitrile solution ( B) . Multiple reaction monitoring ( MRM) with positive polarity was selected to monitor qualitative and quantitative ion. Based on the optimized method, 26 β2-agonists could be analyzed in 15 min. The recoveries ranged from 64 . 0% to 112 . 7% for the 26 kinds ofβ2-agonists residues with three spiked levels of 5, 10 and 20 μg/kg. The relative standard deviations ( RSDs) were less than 15. 2%. The limits of detection (LOD) for the 26 kinds of β2-agonists were 0. 15-1. 35 μg/kg.

Study on Influences of Enzymolysis and Organic Solvent Extraction on Determination of 2 Kinds of β2-Agonist Residues in Sheep Plasma and Urine / 分析化学

Two kinds of β2-agonistresidues in sheep plasma and urine were disposed by enzymolysis and organic solvent extraction pretreatment methods, and UPLC-MS/MS was used for the qualitative and quantitative analysis. Detection results were compared to study the influences of two pretreatment methods. The experimental results showed that more than 95% of Ractopamine and 40% of Salbutamol exist in the conjugated form in sheep plasma. The detection results of 2 kinds of β2-agonist residues were significantly enhanced when adding β-glucuronidase/aryl sulfatase. The experimental repeatability is very poor ( RSD>40%) when the enzymolysis was not carried out. There were 57% of Ractopamine and less than 1% of Salbutamol exists in the conjugated form in sheep urine. Enzymolysis pretreatment method was useful for the Ractopamine residues determination in urine, and Enzymolysis pretreatment method was useless for Salbutamol determination in urine. Matrix effect of plasma was less than the effects of urine. The influence of organic solvent extraction pretreatment method on the detection results was unremarkable, and there was the possibility that organic solvent extraction could lead partial loss of target compound in extraction process. However, it did not influence the detection results by using internal standard calibration.

Progress in the management of childhood asthma

Asthma has become the most common chronic disease in childhood. Significant advances in epidemiological research as well as in therapy of pediatric asthma have been made over the past 2 decades. In this review, we look at certain aspects therapy of childhood asthma, both in the past and present. Literature review on allergen avoidance (including mites, cockroach and cat), intensive therapy with β₂-agonists in acute asthma (administering via continuous nebulization and intravenous routes), a revisit of theophylline use and its action, the use of inhaled corticosteroids in various phases of childhood asthma and sublingual immunotherapy in asthma are examined. Recent facts and dilemmas of these treatments are identified along with expression of our opinions, particularly on points of childhood asthma in the Asia-Pacific, are made in this review.