Viral causes of acute respiratory infection among Egyptian children hospitalized with severe acute asthma exacerbation

Background: Viral respiratory infections are associated with nearly 80% of asthma exacerbation episodes. These can have severe adverse outcomes in patients with established asthma

Aim: The aim of the study was to identify the viral causes of acute respiratory infection that precipitate acute asthma exacerbation in Egyptian asthmatic children

Patients and methods: The current prospective study was conducted in Cairo University Children's Hospitals from December 2010 to December 2011. All asthmatic children [n=130] aged 2-12 years admitted with asthma exacerbation due to severe lower respiratory tract infection were included. All cases were subjected to nasopharyngeal or throat swabs that were analyzed for common respiratory viruses, including respiratory syncytial virus [RSV], human metapneumovirus [hMPV], influenza B [Flu B], human parainfluenza virus [hPIV], influenza A [H1N1], and adenovirus [ADV] using the real-time PCR technique. All patients were followed up to record the outcome

Results: PCR analysis was positive for one respiratory virus in 54 asthmatic patients [41.5%] and was negative in 76 patients [58.5%], with a high predominance of RSV [51.9%] and hMPV [25.9%] especially in winter and early spring months. Hypoxia was detected in all patients with RSV infection; of these patients, 21.4% were admitted to the ICU, 14.3% required mechanical ventilation, and 14.3% died. In contrast, among those with hMPV infection, hypoxia was detected in 71.4%; none required ICU admission or mechanical ventilation

Conclusion and recommendations: Viral etiology of lower respiratory tract infections constitutes an important cause of acute asthma exacerbation in asthmatic children admitted to children's hospitals in Cairo, supporting the need for large-scale multicentric studies on asthmatic patients over multiple years using a wider-panel PCR for detection of respiratory viruses

disintegrin and metalloproteinase 33 [ADAM33] gene polymorphism association with asthma in Egyptian children

A disintegrin and metalloproteinase-encoding gene [ADAM33], was recently identified as an asthma susceptibility gene. ADAM33 protein is expressed in smooth muscle cells of bronchi and pulmonary fibroblasts, playing a major role in airway remodeling. Earlier studies, have mostly confirmed a link between ADAM33 and asthma as well as bronchial hyperresponsiveness. This work studied a group of Egyptian asthmatic children for 3 ADAM33 single nucleotide polymorphisms [SNPs], previously identified as putative risk alleles: T1 G > A[rs2280091], T2 A > G[rs2280090], V4 G > C[rs2787094] using Polymerase Chain Reaction - restriction fragment length polymorphism [PCRRFLP] with emphasis on their relation to clinical [severity, smoking, family history, and atopic manifestations] and laboratory data [Ig Immunoglobulin E [Ig E] level and absolute eosinophilia] and pulmonary functions. Sixty [3-12 years old] asthmatic children and 32 matched controls were recruited. The genotype distribution for the SNPs showed no significant difference between the patients and the controls. A higher frequency of the [AA] genotype of T1 polymorphism was found in controls [75%] than in patients [41%], while the [AG] variant was higher in cases [46.6%] than in controls [21.9%] but with no statistically significant difference. Also the [GG] genotype was higher in cases [11.6%] than in controls [3.1%] but with no statistical significance. The allelic frequencies of T1 showed a higher [A] allele in controls [85.93%] than cases [65%] and higher [G] allele in cases [35%] than controls [14.06%], showing a high significant difference. No correlation was found between [T1, T2, and V4] and the demographic, clinical and laboratory parameters, except SNP T1 showing a positive correlation with Ig E level, and SNP V4 showing a positive correlation with passive smoking as a precipitating factor and borderline significance with absolute eosinophilia. In conclusion, no significant association was detected between these SNPs and asthma susceptibility in this study

value of stress thallium 201 scintigraphy in stable angina pectoris and for detecting the stenosed coronary artery in single vessel disease

The value of stress Thallium 201 scintigraphy for detecting coronary artery stenosis was estimated in 30 patients suffering from stable angina pectoris. The results were compared with coronary angiographic findings and exercise electrocardiographic results. Exercise electrocardiogram was conclusive in 16 patients [53.33], +ve in 11 patients [36.67%] and -ve in 21 patients. Thallium 201 scintigraphy was +ve in 21 patients [70%] and -ve in 9 patients [30%] with sensitivity of 80% and specificity of [80%]. The value of Thallium 201 for detecting individual coronary artery stenosis was analyzed in these patients. The sensitivity for detecting greater than 50% narrowing in the LAD, RCA and LCX was [80%]. [75%] and [50%]

Systolic time intervals in uncomplicated non insulin dependent diabetics in the absence of clinical data of ischaemic heart disease, relation between blood glucose level and PEP/LVET

Systolic time intervals were measured in 55 non insulin dependent diabetic patients having no clinical and electrocardiographic evidence of ischaemic heart disease [29 male and 26 female with mean age 50.3 +/- 11.5]. Results were compared to 19 normal subjects [12 male and 7 female with age 44.6 +/- 15.6]. PEPI was found prolonged among diabetics [133.7 +/- 8.2] compared to normals [129.9 +/- 5.7], P<0.05. LVETI was found shortened in diabetics [408.02 +/- 12.5] compared to the control group [416.4 + 9.01] P <0.02. QS2 changes were insignificant. The ratio PEP/LVET was significantly increased in diabetics 360.6 +/- 33.02, compared to control group, 339.4 +/- 19.5 P<0.02. Echocardiographic EF and FS showed no significant difference in diabetics compared to the control group. The ratio PEP/LVET showed positive linear relationship with the blood glucose levels in diabetics [r = +0.77]. Thus, it was apparent that systolic time intervals as sensitive parameter of left ventricular function showed variations in non insulin diabetics compared to normal subjects as LV function was affected in diabetics while echocardiographic EF and FS showed no significant difference. So, these parameters could by applied serially for early detection of development of diabetic cardiomyopathy