Small Airway Dysfunction Measured by Impulse Oscillometry and Fractional Exhaled Nitric Oxide Is Associated With Asthma Control in Children.

Background: Impulse oscillometry (IOS) and fractional exhaled nitric oxide (FeNO) are sensitive and non-invasive methods to measure airway resistance and inflammation, although there are limited population-based studies using IOS and FeNO to predict asthma control. Objective: This study aimed to investigate the utility of IOS and FeNO for assessing childhood asthma control in terms of small airway dysfunction and airway inflammation. Methods: This prospective observational cohort study enrolled 5,018 school children (aged 6-12 years), including 560 asthmatic children and 140 normal participants. FeNO, spirometry, IOS, bronchial dilation test, total IgE, and childhood asthma control test (C-ACT) were measured. FeNO, IOS, spirometry, and C-ACT results were correlated with childhood asthma with and without control. Results: Uncontrolled asthmatic children had abnormal FeNO, IOS, and spirometric values compared with control subjects (P < 0.05). IOS parameters with R5, R5-R20, X5, Ax, △R5, and FeNO can predict lower C-ACT scales by the areas under receiver operating characteristic curves (AUCs) (0.616, 0.625, 0.609, 0.622, 0.625, and 0.714). A combination of FeNO (>20 ppb) with IOS measure significantly increased the specificity for predicting uncontrolled asthma patients compared with FeNO alone (P < 0.01). A multiple regression model showed that small airway parameter (R5-R20) was the strongest risk factor [OR (95% CI): 87.26 (7.67-993.31)] for uncontrolled asthma patients. Poor control with lower C-ACT scales correlated with high FeNO (r = -0.394), R5 (r = -0.106), and R5-R20 (r = -0.129) in asthmatic children (P < 0.05). Conclusion: A combined use of FeNO and IOS measurements strongly predicts childhood asthma with or without control.

Diagnostic performance of the Sputum Gram Stain in predicting sputum culture results for critically ill pediatric patients with pneumonia.

BACKGROUND: The sputum Gram stain is an inexpensive, rapid, and convenient laboratory method that predicts the bacterial pathogens in patients with pneumonia. This study aimed to evaluate the diagnostic performance of this method in predicting sputum culture results for critically ill pediatric patients. METHODS: From June 2008 to June 2018, patients with pneumonia with an endotracheal or a tracheostomy tube in place in the Pediatric Intensive Care Unit at Changhua Christian Hospital were enrolled retrospectively. Sputum was collected from each patient via the artificial airway for Gram stain and culture evaluations of bacterial pathogens. Mixed culture results were excluded. A successful prediction was defined as a match of the sputum Gram stain and culture results. RESULTS: A total of 622 records were reviewed, of which 542 were analyzed. Haemophilus influenzae, Pseudomonas aeruginosa, and Streptococcus pneumoniae were the three most common pathogens found. The overall prediction success rate of the sputum Gram stain was 59.23%. The sensitivity of the method in predicting gram-negative bacilli (GNB), gram-negative cocci (GNC), and gram-positive cocci (GPC) was 0.45, 0.67, and 0.61, respectively. Its specificity in predicting GNB, GNC, and GPC was 0.87, 0.98, and 0.87, respectively. Its positive likelihood ratio in predicting GNB, GNC, and GPC was 3.46, 33.50, and 4.69, respectively. The highest prediction success rate among all pathogens was for GNC. CONCLUSION: The sputum Gram stain had high specificity and relatively low sensitivity in predicting the bacterial pathogens in critically ill pediatric patients. Its high specificity in predicting sputum culture results means that clinicians can confidently use sputum Gram stain results to guide their antibiotic choice for treatment.

Hydration properties and binding capacities of dietary fibers from bamboo shoot shell and its hypolipidemic effects in mice.

In the bamboo shoot processing industries, bamboo shoot shells are discarded without any utilization. As a cheap potential dietary fibers resource, bamboo shoot (Leleba oldhami Nakal) shell was decomposed to dietary fibers by multiple enzymes. The extraction yields of insoluble dietary fiber and soluble dietary fiber were 56.21% and 8.67%, respectively. The resulting fibers showed significant swelling capacity, water holding capacity and exhibit in vitro binding capacities to fat, cholesterol, bile acids and nitrites. The administration of bamboo shoot shell fibers improved the lipid metabolism disorderly situation of hyperlipidemia mice. Compared with normal group, total dietary fiber supplement could exhibit the lowest body weight gain (2.84%) in mice, and decrease total cholesterol, triglyceride and low density lipoprotein-cholesterol by 31.53%, 21.35% and 31.53%, respectively; while it can increase high density lipoprotein-cholesterol by 37.6%. The bamboo shoot shell fibers could be a potentially available dietary ingredient in functional food industries.

Characterization and Prebiotic Effect of the Resistant Starch from Purple Sweet Potato.

Purple sweet potato starch is a potential resource for resistant starch production. The effects of heat-moisture treatment (HMT) and enzyme debranching combined heat-moisture treatment (EHMT) on the morphological, crystallinity and thermal properties of PSP starches were investigated. The results indicated that, after HMT or EHMT treatments, native starch granules with smooth surface was destroyed to form a more compact, irregular and sheet-like structure. The crystalline pattern was transformed from C-type to B-type with decreasing relative crystallinity. Due to stronger crystallites formed in modified starches, the swelling power and solubility of HMT and EHMT starch were decreased, while the transition temperatures and gelatinization enthalpy were significantly increased. In addition, HMT and EHMT exhibited greater effects on the proliferation of bifidobacteria compared with either glucose or high amylose maize starch.

Characterization and hypoglycemic activity of a ß-pyran polysaccharides from bamboo shoot (Leleba oldhami Nakal) shells.

The bamboo shoot (Leleba oldhami Nakal) shell is a by-product during bamboo shoot processing. It is a cheap and available resource for dietary polysaccharides. Herein, a novel polysaccharide BSSP2a was isolated and characterized from the bamboo shoot shell polysaccharides, and it was identified as a homogeneous highly-branched beta type pyran polysaccharide with a molecular weight of 1.63×10(4)kDa, which consisted of arabinose, xylose, mannose, glucose and galactose at a molar ratio of 20.4:4.9:1:3.4:20.6. The crude polysaccharides (BSSP) from the bamboo shoots shell showed hypoglycemic activity on the high fat diet and streptozotocin induced diabetic mice in a dose-dependent manner. The administration of high dose BSSP (400mg/kg) improved body weight loss and serum insulin loss, and significantly decreased the blood glucose level, serum triglycerides as well as total cholesterol levels by 48.7%, 34.8% and 26.5%, respectively. The results highlight the potential of the bamboo shoot shell polysaccharides as a natural anti-diabetic agent.

Correlations between pulmonary function and childhood asthma control test results in 5-11-year-old children with asthma.

OBJECTIVES: We examined correlations between the two asthma assessment tools, pulmonary function tests, and Childhood Asthma Control Test (C-ACT) scores, in 5-11-year-old children with asthma to determine if the C-ACT scores could predict pulmonary function test results. MATERIALS AND METHODS: A total of 172 children with asthma aged 5-11 years completed C-ACT questionnaires and underwent pulmonary function testing. Correlations between these test results were examined. Patients were also placed into two groups, C-ACT scores ≤19 and >19, to determine if patients with scores >19 had better pulmonary function test results. RESULTS: Weak correlations were found between pulmonary function test results and childhood asthma control test scores in 5-11-year-old children with asthma, with or without the use of an asthma controller. These correlations included: 0.061 for FEV1 [confidence interval (CI): -0.022-0.049] and 0.074 for MMEF (CI: -0.013-0.037). The proportions of children with C-ACT test scores ≤19 group and those with scores >19 group were not significantly different. CONCLUSION: Correlations between C-ACT scores and pulmonary function test results were poor for children aged 5-11 years with asthma. FEV1, FVC, FEF25, FEF50, FEF75, MMEF, and PEFR were not significantly correlated with C-ACT scores.