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1.
Virulence ; 11(1): 486-488, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32434416

RESUMO

Lack of an appropriate animal model to study severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiological agent responsible for COVID-19 pandemic disease, represents a significant hurdle in the process of understanding disease biology and evaluating therapeutic and preventive candidates. It is time for public health agencies to revisit regulation on transplantation of human pluripotent stem cells for the possibility of the development of a humanized mice model with a humanized lung.


Assuntos
Infecções por Coronavirus/patologia , Modelos Animais de Doenças , Células-Tronco Pluripotentes/transplante , Pneumonia Viral/patologia , Infecções Respiratórias/patologia , Transplante Heterólogo/legislação & jurisprudência , Animais , Humanos , Camundongos , Pandemias , Pesquisa/legislação & jurisprudência , Pesquisa/normas , Pesquisa/tendências , Transplante Heterólogo/tendências
2.
Vet Clin North Am Equine Pract ; 36(1): 87-103, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32145836

RESUMO

Indications for bronchoalveolar lavage, tracheal wash, and thoracocentesis for the diagnosis of respiratory diseases are discussed. Each technique is described in detail and illustrated by videos. Sample handling, preparation and evaluation are reviewed. The advantages and limitations of bronchoalveolar lavage and tracheal wash procedures as well as a critical comparison between the 2 techniques for equine asthma diagnosis are presented. Finally, validated cut-off values for equine asthma diagnosis are reviewed.


Assuntos
Doenças dos Cavalos/diagnóstico , Doenças Respiratórias/veterinária , Animais , Asma/diagnóstico , Asma/patologia , Asma/veterinária , Lavagem Broncoalveolar/veterinária , Líquido da Lavagem Broncoalveolar/citologia , Doenças dos Cavalos/patologia , Cavalos , Derrame Pleural/patologia , Derrame Pleural/veterinária , Doenças Respiratórias/diagnóstico , Doenças Respiratórias/patologia , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/patologia , Infecções Respiratórias/veterinária
3.
Ann Otol Rhinol Laryngol ; 129(1): 82-86, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31522522

RESUMO

OBJECTIVE: The identification of rare sources of laryngeal infection in immunocompetent patients. Recovered organisms were Mycobacterium tuberculosis (laryngeal tuberculosis [LTB]), Mycobacterium fortuitum (laryngeal Mycobacterium fortuitum [LMF]), and Blastomyces dermatiditis (laryngeal blastomycosis [LB]). METHOD: Single institution retrospective case series of three patients over a 2.5-year period and review of the literature on laryngeal infections by three atypical organisms. RESULTS: Three patients presented with hoarseness and cough; one additionally had throat pain (LTB). Indirect laryngoscopy demonstrated diffuse laryngeal ulceration (LTB, LMF) and an exophytic, contiguous glottic mass (LB). Direct microlaryngoscopic biopsies and cultures established the diagnoses, including a frozen section in one case (LB), which prevented a simultaneously planned surgical resection. Appropriate antimicrobial therapy yielded dramatic laryngeal and corresponding vocal improvement, for which we provide unique photo and audio documentation. In the last 10 years, fewer than 500 cases of LTB have been reported in the English language medical literature, principally outside the United States. To date, there have been reports of only 34 LB and no cases of LMF. CONCLUSION: Atypical infections of the larynx may be localized and mimic laryngeal cancer on endoscopy. Tissue examination as well as microbiologic samples are diagnostic and complementary.


Assuntos
Blastomicose/diagnóstico , Neoplasias Laríngeas/diagnóstico , Laringoscopia , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Tuberculose Laríngea/diagnóstico , Adulto , Biópsia , Blastomyces , Blastomicose/complicações , Blastomicose/patologia , Tosse/etiologia , Técnicas de Cultura , Diagnóstico Diferencial , Feminino , Rouquidão/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Mycobacterium não Tuberculosas/complicações , Infecções por Mycobacterium não Tuberculosas/patologia , Mycobacterium fortuitum , Infecções Respiratórias/complicações , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/patologia , Tuberculose Laríngea/complicações , Tuberculose Laríngea/patologia
4.
Infect Immun ; 87(12)2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31548321

RESUMO

Leptospirosis caused by pathogenic Leptospira is one of the most common zoonoses in the world. It is believed that humans become infected with it mainly through their skin and mucous membranes by contact with water or soil that is contaminated with urine excreted from infected animals. Recently, outbreaks have frequently occurred in the tropics, especially after flooding, but how leptospires cause mass infection remains poorly understood. In this study, we injected leptospires into the tracheas of hamsters under direct view and prove for the first time that leptospires can infect through the respiratory tract. We determined that a 50% lethal dose (LD50) of the Leptospira interrogans strain UP-MMC-SM (L495) for hamsters in transtracheal infection was 3.2 × 102 cells. The results of culture, macroscopic findings, and histopathological analysis suggested that intratracheally injected leptospires invaded the lung tissue, proliferated in the collagen-rich stroma adjacent to the bronchus and blood vessels, and then spread throughout the body via the bloodstream. In the lung, leptospires continuously infiltrated the alveolar wall without inflammatory cell infiltration, spread throughout the lung, and finally caused pulmonary hemorrhage. Our results revealed that the respiratory tract might be a portal of entry for leptospires. We speculate that some cases of leptospirosis might be caused by transbronchial infection from inhaling infectious aerosols containing leptospires during floods. Leptospira was also confirmed to be a unique pathogen that invades through the bronchus, proliferates in the collagen-rich lung stroma, and spreads through the alveolar interstitium throughout the lung without causing pneumonia.


Assuntos
Leptospira interrogans/patogenicidade , Leptospirose/patologia , Leptospirose/transmissão , Pneumopatias/patologia , Infecções Respiratórias/transmissão , Animais , Líquido da Lavagem Broncoalveolar/microbiologia , Cricetinae , Modelos Animais de Doenças , Leptospirose/microbiologia , Pulmão/patologia , Pneumopatias/microbiologia , Infecções Respiratórias/microbiologia , Infecções Respiratórias/patologia
5.
Biomed Res Int ; 2019: 7150942, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31534961

RESUMO

To date, topical therapies guarantee a better delivery of high concentrations of pharmacologic agents to the mucosa of the upper airways (UA). Recently, topical administration of ectoine has just been recognized as adjuvant treatment in the Allergic Rhinitis (AR) and Rhinosinusitis (ARS). The aim of this work is to review the published literature regarding all the potential therapeutic effects of ectoine in the acute and chronic inflammatory diseases of UA. Pertinent studies published without temporal limitation were selected searching on MEDLINE the following terms: "ectoine" and "nasal spray," "oral spray," "upper respiratory tract infections," "rhinosinusitis," "rhinitis," "rhinoconjunctivitis," "pharyngitis," and "laryngitis." At the end of our selection process, six relevant publications were included: two studies about the effect of ectoine on AR, one study about ARS, one study about rhinitis sicca anterior, and two studies about acute pharyngitis and/or laryngitis. Due to its moisturizing and anti-inflammatory properties, topical administration of ectoine could play a potential additional role in treatment of acute and chronic inflammatory diseases of UA, in particular in the management of sinonasal conditions improving symptoms and endoscopic findings. However, these results should be viewed cautiously as they are based on a limited number of studies; some of them were probably underpowered because of their small patient samples.


Assuntos
Diamino Aminoácidos/uso terapêutico , Infecções Respiratórias/tratamento farmacológico , Doença Aguda , Administração Tópica , Doença Crônica , Humanos , Inflamação/tratamento farmacológico , Inflamação/patologia , Laringite/tratamento farmacológico , Laringite/patologia , Sprays Orais , Infecções Respiratórias/patologia , Rinite/tratamento farmacológico , Rinite/patologia , Sinusite/tratamento farmacológico , Sinusite/patologia
6.
Nutrients ; 11(8)2019 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-31412594

RESUMO

Black ginseng (BG, CJ EnerG), prepared via nine repeated cycles of steaming and drying of fresh ginseng, contains more accessible acid polysaccharides and smaller and less polar ginsenosides than red ginseng (RG) processed only once. Because RG exhibits the ability to increase host protection against viral respiratory infections, we investigated the antiviral effects of BG. Mice were orally administered either BG or RG extract at 10 mg/kg bw daily for two weeks. Mice were then infected with a A(H1N1) pdm09 (A/California/04/2009) virus and fed extracts for an additional week. Untreated, infected mice were assigned to either the negative control, without treatments, or the positive control, treated with Tamiflu. Infected mice were monitored for 14 days to determine the survival rate. Lung tissues were evaluated for virus titer and by histological analyses. Cytokine levels were measured in bronchoalveolar lavage fluid. Mice treated with BG displayed a 100% survival rate against infection, while mice treated with RG had a 50% survival rate. Further, mice treated with BG had fewer accumulated inflammatory cells in bronchioles following viral infection than did mice treated with RG. BG also enhanced the levels of GM-CSF and IL-10 during the early and late stages of infection, respectively, compared to RG. Thus, BG may be useful as an alternative antiviral adjuvant to modulate immune responses to influenza A virus.


Assuntos
Antivirais/farmacologia , Vírus da Influenza A Subtipo H1N1/efeitos dos fármacos , Infecções por Orthomyxoviridae/prevenção & controle , Panax , Extratos Vegetais/farmacologia , Infecções Respiratórias/prevenção & controle , Animais , Antivirais/isolamento & purificação , Citocinas/metabolismo , Modelos Animais de Doenças , Feminino , Interações Hospedeiro-Patógeno , Vírus da Influenza A Subtipo H1N1/patogenicidade , Pulmão/metabolismo , Pulmão/patologia , Pulmão/virologia , Camundongos Endogâmicos BALB C , Infecções por Orthomyxoviridae/metabolismo , Infecções por Orthomyxoviridae/patologia , Infecções por Orthomyxoviridae/virologia , Panax/química , Extratos Vegetais/isolamento & purificação , Infecções Respiratórias/metabolismo , Infecções Respiratórias/patologia , Infecções Respiratórias/virologia , Carga Viral
7.
Eur J Clin Microbiol Infect Dis ; 38(11): 2177-2184, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31372902

RESUMO

The aim of this study was to analyze the clinical and laboratory characteristics of children with peripheral facial nerve palsy (pFP) with a focus on identifying infectious etiology and long-term outcome. We conducted an ICD-10-based retrospective chart review on children hospitalized with pFP between January 1, 2006, and December 31, 2016. Furthermore, a telephone-based follow-up survey was performed. A total of 158 patients were identified, with a median age of 10.9 years (interquartile range 6.4-13.7). An infectious disease was associated with pFP in 82 patients (51.9%); 73 cases were classified as idiopathic pFP (46.2%). Three cases occurred postoperatively or due to a peripheral tumor. Among the infectious diseases, we identified 33 cases of neuroborreliosis and 12 viral infections of the central nervous system (CNS), caused by the varicella-zoster virus, human herpesvirus 6, herpes simplex virus, enterovirus, and Epstein-Barr virus. Other infections were mainly respiratory tract infections (RTIs; 37 cases). Children with an associated CNS infection had more often headache and nuchal rigidity, a higher cerebrospinal fluid cell count, and a longer length of hospital stay. Long-term follow-up revealed an associated lower risk of relapse in CNS infection-associated pFP. Among all groups, permanent sequelae were associated with female sex, a shorter length of hospitalization, and a lower white blood cell count at presentation. pFP is frequently caused by an CNS infection or is associated with concurrent RTIs, with a potential impact on the short- and long-term clinical course.


Assuntos
Infecções do Sistema Nervoso Central/complicações , Paralisia Facial/etiologia , Infecções Respiratórias/complicações , Adolescente , Paralisia de Bell/complicações , Paralisia de Bell/patologia , Paralisia de Bell/fisiopatologia , Borrelia/isolamento & purificação , Infecções do Sistema Nervoso Central/líquido cefalorraquidiano , Infecções do Sistema Nervoso Central/patologia , Infecções do Sistema Nervoso Central/fisiopatologia , Líquido Cefalorraquidiano/citologia , Líquido Cefalorraquidiano/microbiologia , Líquido Cefalorraquidiano/virologia , Criança , Paralisia Facial/líquido cefalorraquidiano , Paralisia Facial/patologia , Paralisia Facial/fisiopatologia , Feminino , Seguimentos , Humanos , Masculino , Infecções Respiratórias/líquido cefalorraquidiano , Infecções Respiratórias/patologia , Infecções Respiratórias/fisiopatologia , Estudos Retrospectivos , Estações do Ano , Vírus/isolamento & purificação
8.
Arch Immunol Ther Exp (Warsz) ; 67(5): 325-334, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31363786

RESUMO

The purpose of this study is to describe both clinical and immunological features in large cohort of adult patients with IgG subclass deficiency, and response to immunoglobulin therapy. This is a retrospective study of data obtained from electronic medical records and paper charts of 78 patients with IgG subclass deficiency seen and followed at our immunology clinics from 2010 to 2016. Both isolated selective IgG subclass deficiency as well as combined (two) subclass deficiencies were observed. IgG3 subclass deficiency, isolated and in combination with other IgG subclass deficiency, is the most frequent of IgG subclass deficiency. A majority of patients presented with upper and lower respiratory tract infections, especially chronic sinusitis. Both allergic and autoimmune manifestations are common; however, there is no subclass preference. The proportions and absolute numbers of CD3+ T cells, CD4+ T and CD8+ T cells, CD19+ B cells, and CD3-CD16+CD56+ NK cells were normal in the majority of patients in all IgG subclass deficiencies. Total serum IgG levels did not correlate with IgG subclass levels across all IgG subclass deficiencies. Anti-pneumococcal polysaccharide antibody responses were impaired in 56% of patients. IgG3 subclass deficiency is the most common IgG subclass deficiency, and anti-polysaccharide antibody responses are distributed among IgG subclasses with modest preference in IgG2 subclass. The majority of patients treated with immunoglobulin responded by reduction in frequency of infections and requirement of antibiotics.


Assuntos
Deficiência de IgG/imunologia , Deficiência de IgG/patologia , Adulto , Idoso , Feminino , Humanos , Deficiência de IgG/sangue , Deficiência de IgG/tratamento farmacológico , Imunoglobulina G/administração & dosagem , Imunoglobulina G/sangue , Subpopulações de Linfócitos/imunologia , Subpopulações de Linfócitos/patologia , Masculino , Pessoa de Meia-Idade , Vacinas Pneumocócicas/imunologia , Infecções Respiratórias/sangue , Infecções Respiratórias/tratamento farmacológico , Infecções Respiratórias/imunologia , Infecções Respiratórias/patologia , Estudos Retrospectivos , Sinusite/sangue , Sinusite/tratamento farmacológico , Sinusite/imunologia , Sinusite/patologia , Resultado do Tratamento , Adulto Jovem
9.
BMC Infect Dis ; 19(1): 613, 2019 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-31299924

RESUMO

BACKGROUND: The Respiratory Syncytial Virus (RSV) A genotype ON1, which was first detected in Ontario (Canada) in 2010/11, appeared in Germany in 2011/12. Preliminary observations suggested a higher clinical severity in children infected with this new genotype. We investigated spread and disease severity of RSV-A ON1 in pediatric in- and outpatient settings. METHODS: During 2010/11 to 2016/17, clinical characteristics and respiratory samples from children with acute respiratory tract infections (RTI) were obtained from ongoing surveillance studies in 33 pediatric practices (PP), one pediatric hospital ward (PW) and 23 pediatric intensive care units (PICU) in Germany. RSV was detected in the respiratory samples by PCR; genotypes were identified by sequencing. Within each setting, clinical severity markers were compared between RSV-A ON1 and RSV-A non-ON1 genotypes. RESULTS: A total of 603 children with RSV-RTI were included (132 children in PP, 288 in PW, and 183 in PICU). Of these children, 341 (56.6%) were infected with RSV-A, 235 (39.0%) with RSV-B, and one child (0.2%) with both RSV-A and RSV-B; in 26 (4.3%) children, the subtype could not be identified. In the 341 RSV-A positive samples, genotype ON1 was detected in 247 (72.4%), NA1 in 92 (26.9%), and GA5 in 2 children (0.6%). RSV-A ON1, rarely observed in 2011/12, was the predominant RSV-A genotype in all settings by 2012/13 and remained predominant until 2016/17. Children in PP or PW infected with RSV-A ON1 did not show a more severe clinical course of disease compared with RSV-A non-ON1 infections. In the PICU group, hospital stay was one day longer (median 8 days, inter-quartile range (IQR) 7-12 vs. 7 days, IQR 5-9; p = 0.02) and duration of oxygen treatment two days longer (median 6 days, IQR 4-9 vs. 4 days, IQR 2-6; p = 0.03) for children infected with RSV-A ON1. CONCLUSIONS: In children, RSV-A ON1 largely replaced RSV-A non-ON1 genotypes within two seasons and remained the predominant RSV-A genotype in Germany during subsequent seasons. A higher clinical severity of RSV-A ON1 was observed within the group of children receiving PICU treatment, whereas in other settings clinical severity of RSV-A ON1 and non-ON1 genotypes was largely similar.


Assuntos
Infecções por Vírus Respiratório Sincicial/patologia , Vírus Sincicial Respiratório Humano/genética , Infecções Respiratórias/patologia , Pré-Escolar , Feminino , Genótipo , Alemanha/epidemiologia , Hospitais Pediátricos , Humanos , Lactente , Unidades de Terapia Intensiva Pediátrica , Tempo de Internação , Masculino , Filogenia , RNA Viral/metabolismo , Infecções por Vírus Respiratório Sincicial/epidemiologia , Infecções por Vírus Respiratório Sincicial/virologia , Vírus Sincicial Respiratório Humano/isolamento & purificação , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/virologia , Estações do Ano , Índice de Gravidade de Doença
11.
Biomed Res Int ; 2019: 4834396, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31119172

RESUMO

Lower respiratory tract infections (LRTIs) remain a challenge in African healthcare settings and only few data are available on their aetiology in Cameroon. The purpose of this study was to access the bacterial cause of LRTIs in patients in Cameroon by two methods. Methods. Participants with LRTIs were enrolled in the referral centre for respiratory diseases in Yaoundé city and its surroundings. To detect bacteria, specimens were tested by conventional bacterial culture and a commercial reverse-transcriptase real-time polymerase chain reaction (RT-PCR) assay. One hundred forty-one adult patients with LRTIs were enrolled in the study. Among the participants, 46.8% were positive for at least one bacterium. Streptococcus pneumoniae and Haemophilus influenzae were the most detected bacteria with 14.2% (20/141) followed by Klebsiella pneumoniae, 9.2% (13/141), Staphylococcus aureus, 7.1% (10/141), and Moraxella catarrhalis, 4.3% (6/141). Bacterial coinfection accounted for 23% (14/61) with Haemophilus influenzae being implicated in 19.7% (12/61). The diagnostic performance of RT-PCR for bacteria detection (43.3%) was significantly different from that of culture (17.7%) (p< 0.001). Only Streptococcus pneumoniae detection was associated with empyema by RT-PCR (p<0.001). These findings enhance understanding of bacterial aetiologies in order to improve respiratory infection management and treatment. It also highlights the need to implement molecular tools as part of the diagnosis of LRTIs.


Assuntos
Antibacterianos/uso terapêutico , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/microbiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Camarões/epidemiologia , Feminino , Haemophilus influenzae/isolamento & purificação , Haemophilus influenzae/patogenicidade , Humanos , Klebsiella pneumoniae/isolamento & purificação , Klebsiella pneumoniae/patogenicidade , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Mycobacterium tuberculosis/isolamento & purificação , Mycobacterium tuberculosis/patogenicidade , Pseudomonas aeruginosa/isolamento & purificação , Pseudomonas aeruginosa/patogenicidade , Infecções Respiratórias/tratamento farmacológico , Infecções Respiratórias/patologia , Staphylococcus aureus/isolamento & purificação , Staphylococcus aureus/patogenicidade , Streptococcus pneumoniae/isolamento & purificação , Streptococcus pneumoniae/patogenicidade , Adulto Jovem
12.
J BUON ; 24(2): 436-441, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31127988

RESUMO

PURPOSE: To investigate the risk factors for concurrent pulmonary infection after radical operation for colon cancer, providing a reference for the prevention and treatment of this condition. METHODS: A total of 486 patients subjected to radical operation for colon cancer in Shanghai Hudong Hospital from December 2014 to December 2017 composed the study group. Their clinicopathologic data and postoperative follow-up were reviewed, including gender, age, body mass index (BMI), preoperative albumin (ALB), preoperative hemoglobin (Hb), hypertension (HBP), diabetes mellitus (DM), smoking history, preoperative pulmonary ventilation dysfunction, tumor size, lymph node metastasis, operative time, intraoperative blood loss, blood transfusion and surgical method. Univariate and multivariate analyses were applied to investigate the risk factors influencing concurrent pulmonary infection after radical operation for colon cancer. The severity of pulmonary infection was assessed using the Clavien-Dindo classification system, and the severity ≥ Grade II suggested that postoperative pulmonary infection (POPI) occurred. RESULTS: Among 486 patients, 20 (4.12%) patients suffered from POPI, including 17 (3.50%) cases of Grade II infection, 2 (0.41%) cases of Grade IIIa infection and 1 (0.21%) case of Grade IVa infection. Univariate analysis showed that POPI was associated with age (≥75 years), gender (male), DM, smoking history, preoperative pulmonary function impairment and blood transfusion. Multivariate analysis indicated that age, preoperative pulmonary ventilation dysfunction, DM and blood transfusion were independent risk factors for POPI. CONCLUSIONS: Age, preoperative respiratory function impairment, DM and blood transfusion are considered as independent risk factors for pulmonary infection after radical operation for colon cancer.


Assuntos
Neoplasias do Colo/epidemiologia , Pneumopatias/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Infecções Respiratórias/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Perda Sanguínea Cirúrgica/fisiopatologia , Neoplasias do Colo/complicações , Neoplasias do Colo/patologia , Neoplasias do Colo/cirurgia , Feminino , Gastrectomia/efeitos adversos , Humanos , Pneumopatias/etiologia , Pneumopatias/patologia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/patologia , Infecções Respiratórias/etiologia , Infecções Respiratórias/patologia , Fatores de Risco
13.
Semin Diagn Pathol ; 36(3): 152-159, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31054790

RESUMO

Lower respiratory infections remain one of the top global causes of death and the emergence of new diseases continues to be a concern. In the first two decades of the 21st century, we have born witness to the emergence of newly recognized coronaviruses that have rapidly spread around the globe, including severe acute respiratory syndrome virus (SARS) and Middle Eastern respiratory syndrome virus (MERS). We have also experienced the emergence of a novel H1N1 pandemic influenza strain in 2009 that caused substantial morbidity and mortality around the world and has transitioned into a seasonal strain. Although we perhaps most frequently think of viruses when discussing emerging respiratory infections, bacteria have not been left out of the mix, as we have witnessed an increase in the number of infections from Legionella spp. since the organisms' initial discovery in 1976. Here, we explore the basic epidemiology, clinical presentation, histopathology, and clinical laboratory diagnosis of these four pathogens and emphasize themes in humans' evolving relationship with our natural environment that have contributed to the infectious burden. Histology alone is rarely diagnostic for these infections, but has been crucial to bettering our understanding of these diseases. Together, we rely on the diagnostic acumen of pathologists to identify the clinicopathologic features that raise the suspicion of these diseases and lead to the early control of the spread in our populations.


Assuntos
Infecções por Coronavirus/patologia , Influenza Humana/patologia , Legionelose/patologia , Infecções Respiratórias/patologia , Síndrome Respiratória Aguda Grave/patologia , Infecções por Coronavirus/diagnóstico , Humanos , Influenza Humana/diagnóstico , Legionelose/diagnóstico , Infecções Respiratórias/diagnóstico , Síndrome Respiratória Aguda Grave/diagnóstico
14.
Laryngoscope ; 129(9): 1993-1997, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31059600

RESUMO

OBJECTIVES/HYPOTHESIS: To describe recurrence patterns in patients with recurrent respiratory papillomatosis (RRP) following surgical intervention. STUDY DESIGN: Single-center, retrospective, longitudinal case series. METHODS: Initial and follow-up laryngoscopic examinations of seven previously untreated adult-onset RRP patients were reviewed. Patients were followed longitudinally for periods ranging from 3 months to 7 years. Lesion locations were recorded using a twenty-one region laryngeal schematic, and maps were generated to illustrate the distribution of disease before and after cold-knife or potassium-titanyl-phosphate laser intervention. Univariate and multivariate analyses were employed to examine variables affecting recurrence patterns. RESULTS: Across all patients, a statistically significant correlation between initial distribution and primary recurrence was observed. Seventy-five percent of new lesions were adjacent to regions with preexisting disease; 83% of new glottic lesions were adjacent to preexisting glottic lesions, and 66% of supraglottic lesions were adjacent to preexisting supraglottic regions. No statistically significant differences in recurrence rate were observed across sites. CONCLUSIONS: In previously untreated patients with adult-onset recurrent respiratory papillomatosis, lesions tended to recur either in the same regions or regions adjacent to those affected at the time of initial surgery. LEVEL OF EVIDENCE: 4 Laryngoscope, 129:1993-1997, 2019.


Assuntos
Glote/patologia , Infecções por Papillomavirus/patologia , Infecções Respiratórias/patologia , Adulto , Feminino , Glote/cirurgia , Humanos , Laringoscopia , Laringe/patologia , Laringe/cirurgia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Infecções por Papillomavirus/cirurgia , Infecções Respiratórias/cirurgia , Estudos Retrospectivos , Resultado do Tratamento
15.
Benef Microbes ; 10(5): 533-541, 2019 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-30964327

RESUMO

Streptococcus pneumoniae is able to activate coagulation and induce platelet aggregation, both of which are typical responses to systemic inflammation. The interactions between inflammation and coagulation and between soluble adhesion molecules and endothelial cells are important in the pathogenesis of an unbalanced haemostatic system. Therefore, an exaggerated and/or insufficiently controlled haemostatic activity may appreciably contribute to the severity of the disease. The aim of the present study was to evaluate the effect of the oral administration of Lactobacillus casei CRL 431 on platelet and endothelial activation mechanisms in a respiratory pneumococcal infection model in mice. S. pneumoniae induced an increase in platelet counts and enhanced the expression of P-selectin in control group, with higher endothelial activation in lung shown by the increase in von Willebrand factor (vWF) and vascular cell adhesion molecule 1 (VCAM-1) expression. Also, infection induced a decrease in CXCR-4 leukocytes, increased expression in annexinV and cell death at the pulmonary level and decreased antithrombin levels in bronchoalveolar lavage. In contrast, L. casei mice restored platelet counts, favoured faster P-selectin expression, lower vWF levels and VCAM-1 expression than control group. Also, L. casei induced higher levels of annexinV expression and lower cell death in the lung. Moreover, it was able to modulate antithrombin levels within the normal range, which would indicate lower coagulation activation and a protective effect locally exerted by L. casei. In this work, the ability of L. casei to favourably modulate platelet and endothelial functionality during a pulmonary infection with S. pneumoniae was demonstrated. Our findings offer a promising perspective for the use of this probiotic strain in the prevention of thrombotic complications associated with pneumococcal pneumonia, especially in at-risk patients. In addition, the use of L. casei would provide novel alternatives for the prevention and treatment of thrombosis associated with various diseases.


Assuntos
Plaquetas/fisiologia , Células Endoteliais/fisiologia , Lactobacillus casei/crescimento & desenvolvimento , Infecções Pneumocócicas/terapia , Probióticos/administração & dosagem , Infecções Respiratórias/terapia , Animais , Análise Química do Sangue , Modelos Animais de Doenças , Camundongos , Contagem de Plaquetas , Infecções Pneumocócicas/patologia , Infecções Respiratórias/patologia , Resultado do Tratamento
16.
PLoS One ; 14(4): e0214686, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30978196

RESUMO

BACKGROUND: The Gram-negative bacterium Kerstersia gyiorum, a potential etiological agent of clinical infections, was isolated from several human patients presenting clinical symptoms. Its significance as a possible pathogen has been previously overlooked as no disease has thus far been definitively associated with this bacterium. To better understand how the organism contributes to the infectious disease, we determined the complete genomic sequence of K. gyiorum SWMUKG01, the first clinical isolate from southwest China. RESULTS: The genomic data obtained displayed a single circular chromosome of 3, 945, 801 base pairs in length, which contains 3, 441 protein-coding genes, 55 tRNA genes and 9 rRNA genes. Analysis on the full spectrum of protein coding genes for cellular structures, two-component regulatory systems and iron uptake pathways that may be important for the success of the bacterial survival, colonization and establishment in the host conferred new insights into the virulence characteristics of K. gyiorum. Phylogenomic comparisons with Alcaligenaceae species indicated that K. gyiorum SWMUKG01 had a close evolutionary relationships with Alcaligenes aquatilis and Alcaligenes faecalis. CONCLUSIONS: The comprehensive analysis presented in this work determinates for the first time a complete genome sequence of K. gyiorum, which is expected to provide useful information for subsequent studies on pathogenesis of this species.


Assuntos
Alcaligenaceae/genética , Genoma Bacteriano , Infecções Respiratórias/patologia , Alcaligenaceae/classificação , Alcaligenaceae/isolamento & purificação , China , DNA Bacteriano/química , DNA Bacteriano/metabolismo , Humanos , Ferro/metabolismo , Lipopolissacarídeos/biossíntese , Filogenia , Infecções Respiratórias/microbiologia , Fatores de Virulência/genética
17.
PLoS One ; 14(4): e0214207, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30951544

RESUMO

Respiratory diseases are a major contributor to morbidity and mortality in many tropical countries, including Lao PDR. However, little has been published regarding viral or bacterial pathogens that can contribute to influenza-like illness (ILI) in a community setting. We report on the results of a community-based surveillance that prospectively monitored the incidence of ILI and its causative pathogens in Vientiane capital in Lao PDR. A cohort of 995 households, including 4885 study participants, were followed-up between May 2015 and May 2016. Nasopharyngeal swabs, throat swabs, and sputum specimens were collected from ILI cases identified through active case-finding. Real-Time PCR was used to test nasopharyngeal swabs for 21 respiratory pathogens, while throat and sputum samples were subjected to bacterial culture. Generalized linear mixed models were used to assess potential risk factors for associations with ILI. In total, 548 episodes of ILI were reported among 476 (9.7%) of the study participants and 330 (33.2%) of the study households. The adjusted estimated incidence of ILI within the study area was 10.7 (95%CI: 9.4-11.9) episodes per 100 person-years. ILI was significantly associated with age group (p<0.001), sex (p<0.001), and number of bedrooms (p = 0.04) in multivariate analysis. In 548 nasopharyngeal swabs, the most commonly detected potential pathogens were Streptococcus pneumoniae (17.0%), Staphylococcus aureus (11.3%), influenza A (11.1%; mostly subtype H3N2), rhinovirus (7.5%), and influenza B (8.0%). Streptococci were isolated from 42 (8.6%) of 536 throat swabs, most (27) of which were Lancefield Group G. Co-infections were observed in 132 (24.1%) of the 548 ILI episodes. Our study generated valuable data on respiratory disease burden and patterns of etiologies associated with community-acquired acute respiratory illness Laos. Establishment of a surveillance strategy in Laos to monitor trends in the epidemiology and burden of acute respiratory infections is required to minimize their impact on human health.


Assuntos
Vírus da Influenza A Subtipo H3N2/patogenicidade , Influenza Humana/epidemiologia , Infecções Respiratórias/epidemiologia , Rhinovirus/patogenicidade , Adolescente , Adulto , Criança , Pré-Escolar , Estudos de Coortes , Características da Família , Feminino , Humanos , Lactente , Vírus da Influenza A Subtipo H3N2/isolamento & purificação , Influenza Humana/diagnóstico , Influenza Humana/patologia , Influenza Humana/virologia , Laos/epidemiologia , Masculino , Pessoa de Meia-Idade , Faringe/patologia , Faringe/virologia , Reação em Cadeia da Polimerase em Tempo Real , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/patologia , Infecções Respiratórias/virologia
18.
Rev Mal Respir ; 36(4): 451-454, 2019 Apr.
Artigo em Francês | MEDLINE | ID: mdl-31005423

RESUMO

Pneumonia is frequently complicated by occurrence of acute respiratory distress syndrome (ARDS), consequently to dysregulated inflammatory response. However, mechanisms driving this dysregulation are poorly understood. To address this, "unconventional T-cells (UTC)" -γδT, NKT and MAIT cells- appear to be relevant targets due to their key role in orchestrating anti-microbial immune response in the lung. Thus, using an experimental and translational approach, we test the hypothesis that a tight regulation of UTC is mandatory to fine-tune host response, and, subsequently to prevent emergence of an aberrant response leading to excessive tissue damages, and eventually, ARDS.


Assuntos
Pneumonia/imunologia , Síndrome do Desconforto Respiratório do Adulto/imunologia , Linfócitos T/fisiologia , Doença Aguda , Dispneia/etiologia , Dispneia/patologia , Humanos , Pulmão/imunologia , Pulmão/patologia , Pneumonia/etiologia , Pneumonia/patologia , Síndrome do Desconforto Respiratório do Adulto/etiologia , Síndrome do Desconforto Respiratório do Adulto/patologia , Infecções Respiratórias/imunologia , Infecções Respiratórias/patologia , Índice de Gravidade de Doença
19.
Br J Nurs ; 28(5): 295-298, 2019 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-30907645

RESUMO

Respiratory disease has a major impact on the NHS and continues to be a growing problem as each year passes. However, through improving diagnosis and management of respiratory disease the problem could be lessened. Taking a sputum sample is common practice within respiratory medicine especially for patients with chronic obstructive pulmonary disease (COPD) and helps to diagnose, confirm infection and offer correct treatment. It is important that the multidisciplinary team are aware of how to appropriately obtain sputum samples and when to request them. It is important as a respiratory health professional to understand the patient's usual sputum history including colour, amount and viscosity. Antibiotic stewardship aims to reduce antibiotic resistance through offering the most appropriate antibiotics for those with a bacterial infection and to discourage antibiotic prescribing for those that have not. This should result in better patient outcomes and lower healthcare costs.


Assuntos
Diagnóstico de Enfermagem , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Infecções Respiratórias/diagnóstico , Manejo de Espécimes , Humanos , Doença Pulmonar Obstrutiva Crônica/enfermagem , Doença Pulmonar Obstrutiva Crônica/patologia , Infecções Respiratórias/tratamento farmacológico , Infecções Respiratórias/enfermagem , Infecções Respiratórias/patologia , Escarro/microbiologia , Medicina Estatal , Reino Unido
20.
Travel Med Infect Dis ; 30: 32-38, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30858034

RESUMO

BACKGROUND: Viral respiratory tract infections are frequent among Hajj pilgrims. However, it is still not known whether viruses are responsible for the symptoms observed in sick pilgrims or whether they only colonize sick and asymptomatic pilgrims. PATIENTS AND METHODS: A prospective cohort study was conducted among French Hajj pilgrims in 2016. Medical follow-up and systematic nasal swabbing were performed pre- and post-Hajj. Additional samples were obtained per-Hajj, at symptom onset in ill pilgrims. Viruses were identified using the BioFire FilmArray® Respiratory multiplex qualitative PCR panel. RESULTS: 109 pilgrims were included. 83.5% presented respiratory symptoms during Hajj and 39.5% were still symptomatic on return. 5.5% of pre-Hajj, 95.2% of per-Hajj (at symptom onset) and 46.5% of post-Hajj samples tested positive (p < 0.0001). Acquisition rates of rhinovirus/enterovirus, coronavirus 229E and influenza A virus were respectively 38.6%, 19.8% and 2.0%. Although rhinovirus/enterovirus, coronavirus 229E and influenza A clearance were respectively 70.6%, 71.4% and 100% on return, overall virus carriage proportion on return was 75.0% in pilgrims with influenza-like illness and 44.0% in those who have never experienced this symptoms or resolved it (OR = 4.05, 95% CI [1.02-16.02]). CONCLUSIONS: Viruses likely play some role in the pathogenesis of the respiratory tract infections at the Hajj. Point of care-rapid multiplex PCR assays are valuable diagnosis tools in this context when used at respiratory symptom onset or soon after.


Assuntos
Infecções Respiratórias/epidemiologia , Viagem/estatística & dados numéricos , Viroses/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , França , Humanos , Islamismo , Masculino , Pessoa de Meia-Idade , Infecções Respiratórias/patologia , Infecções Respiratórias/virologia , Arábia Saudita/epidemiologia , Viroses/patologia , Vírus
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