Adenovirus species C detection in children under four years of age with acute bronchiolitis or recurrent wheezing.

BACKGROUND: Lower respiratory tract viral infection is an important cause of morbidity and mortality in children worldwide. Among viral etiological agents the human Adenovirus (AdV) has been associated to mild or severe respiratory tract infection. OBJECTIVE: To detect the presence of human Adenovirus (AdV) in children with acute bronchiolitis or recurrent wheezing, describing their clinical features and determining Adenovirus species and AdV association to Respiratory Syncytial Virus (RSV), Human Metapneumovirus (MPV) and Parainfluenza virus (PIV). STUDY DESIGN: A total of 155 children bellow 48 months of age with acute bronchiolitis or recurrent wheezing were investigated for the presence of AdV, RSV, MPV and PIV in nasopharyngeal aspirate, by real-time PCR method. RESULTS: AdV, predominantly of species C, has been detected as the unique pathogen (AdVi) or in association to other pathogens (AdVa.), in 39/155 samples. Crackles were more frequent in children with AdV. RSVi was detected predominantly in children with acute bronchiolitis while AdVi and AdVa were detected more frequently in patients with recurrent wheezing. CONCLUSION: A small outbreak of AdV species C was observed in 2012 and 2013. AdV was detected more frequently in children with recurrent wheezing while RSVi was more frequent in infants with acute bronchiolitis.

Characteristics of childhood and adult-onset type 1 diabetes in a multi-ethnic population.

OBJECTIVE: To compare patients with classic type 1 diabetes (T1D) diagnosed in childhood and adulthood regarding clinical presentation, GADA and HLA DR B1*03/04 prevalence in a multi-ethnic population. METHODS: We studied 83 Brazilian patients with classic T1D divided in 2 groups: (1) diagnosed before 20 years old (n=42); (2) diagnosed at age 20 and up (n=41). All were interviewed and blood was sampled for GADA measurement and HLA DR B1 typing. RESULTS: The study population comprised 52 women and 31 men, 52 white and 31 non-white individuals with mean age of 29.94 (+/-10.95) years and mean disease duration of 10.37 (+/-7.37) years. The mean age at onset in groups 1 and 2 were, respectively, 11.48 and 27.2 years old. There were no significant differences between groups regarding diabetic ketoacidosis at presentation. A longer symptomatic period preceding the diagnosis was observed in group 2 (p=0.039). The prevalence of GADA and HLA DR B1*03/04 was similar between groups. HLA DR B1*13 was significantly more common in the group 1 (p=0.024). GADA was more prevalent among patients with HLA DR B1*03 (p=0.02). CONCLUSION: In this study, T1D diagnosed in adulthood was associated with longer symptomatic period preceding diagnosis and lower prevalence of HLA DR B1*13, but there were no differences regarding ketoacidosis as a form of disease presentation, GADA (+) or HLA DR B1* 03/04.