Effect of rapid influenza testing on the clinical management of paediatric influenza.

BACKGROUND: Rapid tests are now widely available to assist the diagnosis of influenza; implementation may optimise the use of antiviral and antibiotic agents in the clinical management of influenza. OBJECTIVE: To explore the clinical management of children with influenza-like illness (ILI) when rapid influenza tests were and were not performed. METHODS: Between 15 January 2007 and 30 April 2007, a standardised questionnaire was used to record the clinical features of children aged 1-12 years who presented to office-based paediatricians in Germany with febrile ILI during periods of local influenza activity. For each paediatric contact, a clinical diagnosis of either 'influenza positive', 'influenza negative' or 'suspected ILI' was made. Where performed, the outcome of a Clearview Exact Influenza A + B rapid test was recorded. Prescriptions for antiviral agents and antibiotic medications were also recorded. RESULTS: A total of 16 907 questionnaires were evaluated. After fever (an entry criteria for all children), cough (84.6%), fatigue/decreased activity (83.0%), rhinorrhoea (73.7%) and headache (67.1%) were the most common symptoms. Influenza was clinically diagnosed in 56.8% (9596/16 907) of cases. The antiviral oseltamivir was prescribed for 24.6% (178/725) of children who were influenza positive by symptom assessment alone and 60.1% (4618/7685) of children who were influenza positive by rapid test. Antibiotics were less commonly prescribed for children who were influenza positive by rapid test [3.5% (271/7685) versus 17.2% (125/725) for symptom assessment alone]. CONCLUSIONS: In children with ILI, a positive rapid test result for influenza promotes the rational use of antiviral agents and reduces the inappropriate use of antibiotic medications.

Green tea catechin polyphenols attenuate behavioral and oxidative responses to intermittent hypoxia.

RATIONALE: The intermittent hypoxia (IH) that characterizes sleep-disordered breathing impairs spatial learning and increases NADPH oxidase activity and oxidative stress in rodents. We hypothesized that green tea catechin polyphenols (GTPs) may attenuate IH-induced neurobehavioral deficits by reducing IH-induced NADPH oxidase expression, lipid peroxidation, and inflammation. OBJECTIVES: To assess the effects of GTP administered in drinking water on the cognitive, inflammatory, and oxidative responses to long-term (>14 d) IH during sleep in male Sprague-Dawley rats. METHODS: Cognitive assessments were conducted in the Morris water maze. We measured levels and expression of malondialdehyde (MDA), prostaglandin E(2), p47(phox) subunit of NADPH oxidase, receptor for advanced glycation end products (RAGE), and glial fibrillary acidic protein expression in rodent brain tissue. MEASUREMENTS AND MAIN RESULTS: GTP treatment prevented IH-induced decreases in spatial bias for the hidden platform during the Morris water maze probe trails as well as IH-induced increases in p47phox expression within the hippocampal CA1 region. In untreated animals, IH exposure was associated with doubling of cortical MDA levels in comparison to room air control animals, and GTP-treated animals exposed to IH showed a 40% reduction in MDA levels. Increases in brain RAGE and glial fibrillary acidic protein expression were observed in IH-exposed animals, and these increases were attenuated in animals treated with GTP. CONCLUSIONS: Oral GTP attenuates IH-induced spatial learning deficits and mitigates IH-induced oxidative stress through multiple beneficial effects on oxidant pathways. Because oxidative processes underlie neurocognitive deficits associated with IH, the potential therapeutic role of GTP in sleep-disordered breathing deserves further exploration.