Survey of the management of patients with bronchiectasis: a pilot investigation in Asian populations

Background/Aims@#Although international guidelines for bronchiectasis management have been published in Western countries, there is a lack of data about their application in Asian populations including patients with different phenotypes. We aimed to investigate the current status of bronchiectasis management in Asian populations. @*Methods@#A nationwide questionnaire survey was performed of Asian respiratory specialists from South Korea, Japan, Taiwan, Singapore, Vietnam, and Sri Lanka. Participants were invited by e-mail to answer a questionnaire comprising 25 questions based on international guidelines for the management of bronchiectasis. @*Results@#A total of 221 physicians participated in the survey. About half of them were Korean (50.2%), with the next most common nationalities being Japanese (23.1%), Taiwanese (13.6%), and Singaporean (7.7%). Only 18 (8.1%) responders had local guidelines for bronchiectasis. While 85 (38.5%) responders checked sputum acid-fast bacillus smear/culture about 1 to 3 times per year, only a small proportion of responders routinely performed a serum immunoglobulin test (36/221, 16.3%) or evaluated for allergic bronchopulmonary aspergillosis (41/221, 18.6%). Less than half (43.4%) of responders performed eradication treatment in patients with drug-sensitive Pseudomonas aeruginosa infection, mainly due to the limited availability of inhaled antibiotics (34.8%). In addition, 58.6% of responders considered physiotherapy such as airway clearance and pulmonary rehabilitation. @*Conclusions@#Discrepancies might exist between guideline recommendations and practice for bronchiectasis management in Asian populations, partly due to the limited availability of treatment in each country. The development of local guidelines that consider the phenotypes and situation will help to standardize and improve the management of bronchiectasis.

Asia Pacific Association of Allergy Asthma and Clinical Immunology White Paper 2020 on climate change, air pollution, and biodiversity in Asia-Pacific and impact on allergic diseases

Air pollution, climate change, and reduced biodiversity are major threats to human health with detrimental effects on a variety of chronic noncommunicable diseases in particular respiratory and cardiovascular diseases. The extent of air pollution both outdoor and indoor air pollution and climate change including global warming is increasing-to alarming proportions particularly in the developing world especially rapidly industrializing countries worldwide. In recent years, Asia has experienced rapid economic growth and a deteriorating environment and increase in allergic diseases to epidemic proportions. Air pollutant levels in many Asian countries especially in China and India are substantially higher than are those in developed countries. Moreover, industrial, traffic-related, and household biomass combustion, indoor pollutants from chemicals and tobacco are major sources of air pollutants, with increasing burden on respiratory allergies. Here we highlight the major components of outdoor and indoor air pollutants and their impacts on respiratory allergies associated with asthma and allergic rhinitis in the Asia-Pacific region. With Asia-Pacific comprising more than half of the world's population there is an urgent need to increase public awareness, highlight targets for interventions, public advocacy and a call to action to policy makers to implement policy changes towards reducing air pollution with interventions at a population-based level.

Childhood Obesity Is a High-risk Factor for Hypertriglyceridemia: A Case-control Study in Vietnam

OBJECTIVES: To investigate the relationship between dyslipidemia and obesity status among Viet-namese adolescents. METHODS: In this case-control study, 282 adolescents (6–11 years), including 88 obese cases and 194 normal-weight controls, were recruited from a population-based cross-sectional study from two provinces in Vietnam. The anthropometric, blood lipid, and other laboratory test results of the study subjects were analyzed. RESULTS: Obese children tended to have more visceral fat (Pearson's r = 0.795, p < 0.0001) than subcutaneous fat (Pearson's r = 0.754, p < 0.0001), and this difference was associated with an increase in blood triglyceride level (Pearson's r = 0.232, p < 0.05) and a strikingly high rate of hypertriglyceridemia (38.6%). We also found that birth weight and parental body mass index were related to the status of obesity among the study subjects. However, only birth weight was significantly higher in the obese group than in the normal weight group. These findings indicate the effect of prenatal nutrition on childhood obesity. Furthermore, high-birth weight children had a surprisingly high rate of obesity. CONCLUSION: Together, our data suggest that obesity increased the risk for hypertriglyceridemia, which was, at least partially, due to prenatal nutrition.

Worm egg contamination in vegetable samples in Vu Phuc commune, Thai Binh province

Vegetable samples collected in Vu Phuc commune (Thai Binh province) were investigated for worm egg contamination. A 50% cumulative contamination rate was found among the investigated samples, of which Ascaris was 48.8%, Trichuris 42.2%, hookworm 17.8%. The intensity of contamination per 100gr of vegetable was 14+/-7.2 with Ascaris, 10.2+/- 5.6 with Trichuris, 4.4+/-1.8 with hookworm. The contamination rate was 60% in the samples of leaf-eating and raw-eating and 50% in root-eating vegetable. Dead eggs were found in 12.2% and developing eggs were found in 44.4% of samples.

Study on clinical features, complication and treatment of biliary ascariasis in Hue central hospital

A study on 126 patients with biliary ascariasis (female/male: 4/1) in December 1997 in Hue Central Hospital has shown that the disease is initiated suddenly with severe pain in the right subcostal area and right chest (most common), vomiting, icterus, history of disease (80%). The common complications are bile duct infection, acute gallbladder infection, pancreatic reactions, acute pancreatitis, bile duct haemorrhage, bile duct abscess. Drugs: Pyrantil, antibiotics.

Contribution to highlight the biliary ascariasis in women with pregnancy who admitted Hue Central Hospital between 1/1998 to 4/1999

The study aims to identify the rate of pregnancy patients in childbearing-age female who have biliary ascariasis. Fetal abnormalities have not found. Complications as biliary infection, acute pancreatitis and pancreatic reactions were observed.

A study on the situation of the acute pancreatitis in the digestive department of Hue Central hospital during 1994-1998

248 patients participated to a study. The standards of the clinical diagnosis are: epigastric sudden severe pain, pyrexia, vomiting, especially non- remission of pain after vomiting with or without pancreatic pain. The paraclinical: blood amylase must be higher 4 times than normal level; abdominal ultrasound had image of the pancreatic edema and image of ascaris in the pancrea -bile duct (29.44%). If the ascuris is not a cause of the acute pancreatitis, the stress can be a cause of the migration of ascris. Recommendations: use of antihelmintic, use of gentamicine, ampicilline and amoxycilline for patients with accute pancreatitis. In case of the acute pancreatitis due to ascaries, it should combine with antibiotic for anaerobic microbial.