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1.
PLoS One ; 15(8): e0237491, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32841256

RESUMO

PURPOSE: Viral upper respiratory infections are associated with significant health and economic impact. This study sought to determine the efficacy of routine immune system micronutrient supplementation on the incidence, duration and severity of common cold symptoms. METHODS: This pilot study was a randomized, double-blinded, placebo-controlled trial of N = 259 with asymptomatic participants aged 18 to 65 in two cold seasons of 2016 and 2017. The treatment group received an immune system targeted micronutrient caplet, while the placebo group received a micronized cellulose caplet externally identical to the treatment caplet. Weekly surveys were sent electronically to participants to document common cold incidence, duration and severity. Primary statistical results were obtained using mixed-effects logistic regressions to account for longitudinal measurements for participants. RESULTS: The odds of acquiring an upper respiratory infection, adjusted for potential confounders, was estimated to be 0.74 times lower in the treatment group (p = 0.14). The odds of reporting specific symptoms were statistically lower in the treatment arm compared to the placebo arm for runny nose (OR = 0.53, p = 0.01) and cough (OR = 0.51, p = 0.04). Shorter durations of runny nose and cough were also observed in the treatment arm compared to placebo (both p < 0.05). There was no significant difference in severity of symptoms in either group. The observed proportion of reported cold symptoms in the treatment group was lower compared to the placebo group between late January and February in two consecutive cold seasons. Given the physical, workplace and economic impact of upper respiratory infections, this low cost and low risk intervention should be further studied with more robust investigation and meticulous experimental design.


Assuntos
Resfriado Comum/tratamento farmacológico , Micronutrientes/uso terapêutico , Adolescente , Adulto , Idoso , Resfriado Comum/complicações , Resfriado Comum/epidemiologia , Resfriado Comum/patologia , Tosse/patologia , Suplementos Nutricionais , Método Duplo-Cego , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Razão de Chances , Faringite/patologia , Projetos Piloto , Efeito Placebo , Índice de Gravidade de Doença , Adulto Jovem
2.
3.
PLoS One ; 15(7): e0236346, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32726327

RESUMO

INTRODUCTION: Interstitial lung diseases (ILDs) include a wide variety of chronic progressive pulmonary diseases characterized by lung inflammation, fibrosis and hypoxemia and can progress to respiratory failure and even death. ILDs are associated with varying degrees of quality of life impairments in affected people. Studies on the quality of life in patients with ILDs are still limited, and there are few studies with long-term follow-up periods in these patients. METHODS: Data from patients who were clinically diagnosed with ILDs in the Respiratory Department, Beijing Chaoyang Hospital, Capital Medical University from January 2017 to February 2018 were collected. Clinical status and HRQoL were assessed at baseline and subsequently at 6- and 12-month intervals with the LCQ, mMRC, HADS, SF-36, and SGRQ. Multivariate linear regression was used to evaluate the determinants of the decline in HRQoL. RESULTS: A total of 139 patients with idiopathic interstitial pneumonia (IIP) and 30 with connective tissue disease-associated ILD (CTD-ILD) were enrolled, 140 of whom completed the follow-up. The mean age was 63.7 years, and 92 patients were men. At baseline, the decline in HRQoL assessed by the SF-36 and SGRQ was significantly associated with the mMRC, LCQ and HADS depression score. In the follow-up, changes in FVC%, DLco%, mMRC and LCQ were significantly associated with changes in HRQoL. CONCLUSIONS: HRQoL in both IIP and CTD-ILD patients deteriorates to varying degrees, and the trend suggests that poor HRQoL in these patients is associated with many determinants, primarily dyspnea, cough and depression. Improving HRQoL is the main aim when treating patients living with ILDs.


Assuntos
Doenças do Tecido Conjuntivo/epidemiologia , Pneumonias Intersticiais Idiopáticas/epidemiologia , Fibrose Pulmonar Idiopática/epidemiologia , Doenças Pulmonares Intersticiais/epidemiologia , Idoso , China/epidemiologia , Doenças do Tecido Conjuntivo/patologia , Tosse/epidemiologia , Tosse/patologia , Dispneia/epidemiologia , Dispneia/patologia , Feminino , Humanos , Pneumonias Intersticiais Idiopáticas/patologia , Fibrose Pulmonar Idiopática/patologia , Doenças Pulmonares Intersticiais/classificação , Doenças Pulmonares Intersticiais/patologia , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Testes de Função Respiratória , Fatores de Risco
4.
Clin Immunol ; 220: 108545, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32710937

RESUMO

COVID-19 rapidly turned to a global pandemic posing lethal threats to overwhelming health care capabilities, despite its relatively low mortality rate. The clinical respiratory symptoms include dry cough, fever, anosmia, breathing difficulties, and subsequent respiratory failure. No known cure is available for COVID-19. Apart from the anti-viral strategy, the supports of immune effectors and modulation of immunosuppressive mechanisms is the rationale immunomodulation approach in COVID-19 management. Diet and nutrition are essential for healthy immunity. However, a group of micronutrients plays a dominant role in immunomodulation. The deficiency of most nutrients increases the individual susceptibility to virus infection with a tendency for severe clinical presentation. Despite a shred of evidence, the supplementation of a single nutrient is not promising in the general population. Individuals at high-risk for specific nutrient deficiencies likely benefit from supplementation. The individual dietary and nutritional status assessments are critical for determining the comprehensive actions in COVID-19.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/dietoterapia , Tosse/dietoterapia , Fatores Imunológicos/uso terapêutico , Micronutrientes/uso terapêutico , Pandemias , Pneumonia Viral/dietoterapia , Betacoronavirus/efeitos dos fármacos , Betacoronavirus/imunologia , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/patologia , Tosse/diagnóstico , Tosse/imunologia , Tosse/patologia , Gerenciamento Clínico , Febre/diagnóstico , Febre/dietoterapia , Febre/imunologia , Febre/patologia , Humanos , Imunidade Celular/efeitos dos fármacos , Imunidade Inata/efeitos dos fármacos , Transtornos do Olfato/diagnóstico , Transtornos do Olfato/dietoterapia , Transtornos do Olfato/imunologia , Transtornos do Olfato/patologia , Pneumonia Viral/diagnóstico , Pneumonia Viral/imunologia , Pneumonia Viral/patologia , Insuficiência Respiratória/diagnóstico , Insuficiência Respiratória/dietoterapia , Insuficiência Respiratória/imunologia , Insuficiência Respiratória/patologia , Índice de Gravidade de Doença , Oligoelementos/uso terapêutico , Vitaminas/uso terapêutico
5.
Mol Med Rep ; 22(3): 2583-2587, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32705222

RESUMO

Since December 2019, an increasing number of cases associated with the 2019 novel coronavirus (2019­nCoV) have emerged in Wuhan, China, which has resulted in a rapid outbreak in China and worldwide. The present study aimed to describe the clinical, laboratory and radiological characteristics of 2019­nCoV pneumonia (NCP) in Zhejiang province, outside of Wuhan. A total of 74 patients with 2019­nCoV were continuously enrolled between January 22 and March 2, 2020 at Zhejiang Hospital. Diagnosis was confirmed at Zhejiang Hospital by reverse transcription­PCR (RT­PCR), which was approved by the Chinese government. Subsequently, the clinical features between positive­ and negative­NCP patients in Zhejiang were compared. Among the 74 hospitalized patients with suspected 2019­NCP, six patients (one male and five female patients) were confirmed to be infected with 2019­nCoV by RT­PCR. The average age of the confirmed patients was 40±13 years. There were three family clusters among the confirmed cases, one patient from each of these families had travel history or contact with patients from Wuhan within 2 weeks. Compared with non­NCP patients, the most common symptoms at onset for patients with NCP were fever (5/6; 83.3%) and cough (5/6; 83.3%), followed by dyspnea/pharyngalgia (2/6; 33.3%), whereas myalgia (1/6; 16.7%) and fatigue (1/6; 16.7%) were less common. All 74 patients with suspected NCP exhibited abnormal computerized tomography (CT) images. In total, 2/6 (33.3%) patients with confirmed NCP presented with bilateral pneumonia, and 21/68 (30.9%) non­NCP patients exhibited bilateral pneumonia, with bilateral distribution of patchy shadows or ground glass opacity. The present study revealed that epidemiological history was critical to the diagnosis of 2019­nCoV in low epidemic regions outside Hubei province. It was also identified that chest CT could not replace nucleic acid testing due to similar radiological manifestations.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Tosse/etiologia , Fadiga/etiologia , Febre/etiologia , Pneumonia Viral/complicações , Adulto , China/epidemiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Tosse/patologia , Fadiga/patologia , Feminino , Febre/patologia , Humanos , Incidência , Masculino , Pandemias , Pneumonia Viral/transmissão , Pneumonia Viral/virologia
7.
Med Clin North Am ; 104(3): 455-470, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32312409

RESUMO

Respiratory symptoms are common in patients living with serious illness, both in cancer and nonmalignant conditions. Common symptoms include dyspnea (breathlessness), cough, malignant pleural effusions, airway secretions, and hemoptysis. Basic management of respiratory symptoms is within the scope of primary palliative care. There are pharmacologic and nonpharmacologic approaches to treating respiratory symptoms. This article provides clinicians with treatment approaches to these burdensome symptoms.


Assuntos
Tosse/terapia , Estado Terminal/terapia , Dispneia/terapia , Hemoptise/terapia , Derrame Pleural Maligno/tratamento farmacológico , Analgésicos Opioides/administração & dosagem , Analgésicos Opioides/efeitos adversos , Analgésicos Opioides/uso terapêutico , Secreções Corporais/efeitos dos fármacos , Terapia Combinada/métodos , Tosse/epidemiologia , Tosse/etiologia , Tosse/patologia , Dispneia/epidemiologia , Dispneia/etiologia , Dispneia/patologia , Hemoptise/epidemiologia , Hemoptise/etiologia , Hemoptise/patologia , Humanos , Mortalidade/tendências , Cuidados Paliativos/normas , Derrame Pleural Maligno/epidemiologia , Derrame Pleural Maligno/mortalidade , Prevalência , Sistema Respiratório/efeitos dos fármacos , Sistema Respiratório/fisiopatologia , Fatores de Risco
8.
Infection ; 48(3): 445-452, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32301099

RESUMO

AIMS AND BACKGROUND: The COVID-19 outbreak spread in China and is a threat to the world. We reported on the epidemiological, clinical, laboratory, and radiological characteristics of children cases to help health workers better understand and provide timely diagnosis and treatment. METHODS: Retrospectively, two research centers' case series of 67 consecutive hospitalized cases including 53 adult and 14 children cases with COVID-19 between 23 Jan 2020 and 15 Feb 2020 from Jinan and Rizhao were enrolled in this study. Epidemiological, clinical, laboratory, and radiological characteristics of children and adults were analyzed and compared. RESULTS: Most cases in children were mild (21.4%) and conventional cases (78.6%), with mild clinical signs and symptoms, and all cases were of family clusters. Fever (35.7%) and dry cough (21.4%) were described as clinical manifestations in children cases. Dry cough and phlegm were not the most common symptoms in children compared with adults (p = 0.03). In the early stages of the disease, lymphocyte counts did not significantly decline but neutrophils count did in children compared with adults (p = 0.02). There was a lower level of CRP (p = 0.00) in children compared with adults. There were 8 (57.1%) asymptomatic cases and 6 (42.9%) symptomatic cases among the 14 children cases. The age of asymptomatic patients was younger than that of symptomatic patients (p = 0.03). Even among asymptomatic patients, 5 (62.5%) cases had lung injuries including 3 (60%) cases with bilateral involvement, which was not different compared with that of symptomatic cases (p = 0.58, p = 0.74). CONCLUSIONS: The clinical symptoms of children are mild, there is substantial lung injury even among children, but that there is less clinical disease, perhaps because of a less pronounced inflammatory response, and that the occurrence of this pattern appears to inversely correlate with age.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/patologia , Tosse/patologia , Febre/patologia , Pulmão/virologia , Pneumonia Viral/patologia , Adulto , Fatores Etários , Doenças Assintomáticas , Proteína C-Reativa/imunologia , Proteína C-Reativa/metabolismo , Criança , China/epidemiologia , Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/epidemiologia , Tosse/diagnóstico por imagem , Tosse/epidemiologia , Citocinas/imunologia , Citocinas/metabolismo , Febre/diagnóstico por imagem , Febre/epidemiologia , Humanos , Pulmão/diagnóstico por imagem , Pulmão/imunologia , Pulmão/patologia , Linfócitos/imunologia , Linfócitos/virologia , Neutrófilos/imunologia , Neutrófilos/virologia , Pandemias , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/epidemiologia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
9.
Clin Infect Dis ; 71(15): 769-777, 2020 07 28.
Artigo em Inglês | MEDLINE | ID: mdl-32176772

RESUMO

BACKGROUND: From December 2019 to February 2020, 2019 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a serious outbreak of coronavirus disease 2019 (COVID-19) in Wuhan, China. Related clinical features are needed. METHODS: We reviewed 69 patients who were hospitalized in Union hospital in Wuhan between 16 January and 29 January 2020. All patients were confirmed to be infected with SARS-CoV-2, and the final date of follow-up was 4 February 2020. RESULTS: The median age of 69 enrolled patients was 42.0 years (interquartile range 35.0-62.0), and 32 patients (46%) were men. The most common symptoms were fever (60 [87%]), cough (38 [55%]), and fatigue (29 [42%]). Most patients received antiviral therapy (66 [98.5%] of 67 patients) and antibiotic therapy (66 [98.5%] of 67 patients). As of 4 February 2020, 18 (26.9%) of 67 patients had been discharged, and 5 patients had died, with a mortality rate of 7.5%. According to the lowest SpO2 during admission, cases were divided into the SpO2 ≥ 90% group (n = 55) and the SpO2 < 90% group (n = 14). All 5 deaths occurred in the SpO2 < 90% group. Compared with SpO2 ≥ 90% group, patients of the SpO2 < 90% group were older and showed more comorbidities and higher plasma levels of interleukin (IL) 6, IL10, lactate dehydrogenase, and C reactive protein. Arbidol treatment showed tendency to improve the discharging rate and decrease the mortality rate. CONCLUSIONS: COVID-19 appears to show frequent fever, dry cough, and increase of inflammatory cytokines, and induced a mortality rate of 7.5%. Older patients or those with underlying comorbidities are at higher risk of death.


Assuntos
Infecções por Coronavirus/patologia , Infecções por Coronavirus/virologia , Pneumonia Viral/patologia , Pneumonia Viral/virologia , Adulto , Idoso , Betacoronavirus/patogenicidade , Proteína C-Reativa/metabolismo , China , Infecções por Coronavirus/metabolismo , Tosse/metabolismo , Tosse/patologia , Tosse/virologia , Feminino , Febre/metabolismo , Febre/patologia , Febre/virologia , Hospitalização , Humanos , Interleucina-10/metabolismo , Interleucina-6/metabolismo , Masculino , Pessoa de Meia-Idade , Pandemias , Alta do Paciente , Pneumonia Viral/metabolismo
10.
Am J Med ; 133(5): 544-551, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32007456

RESUMO

Cough is one of the most common complaints encountered in every setting; however, complications associated with coughing have received relatively little attention. An exhaustive systematic review of the English literature revealed an exceedingly large and varied spectrum of cough-induced complications affecting many systems, including upper airways, chest wall and thorax, abdominal wall, heart and aorta, central nervous system, eye, gastrointestinal tract, urogenital system, and emotional and psychological harm. Prospective studies and prevalence data are conspicuously missing. Reported cough-induced pathology ranges from rare (the majority) to common and from trivial (eg, lightheadedness, subconjunctival hemorrhage) to severe and life-threatening (eg, cervical artery dissection, rupture of a normal spleen). Other seemingly benign entities may mask a serious underlying pathology (eg, cough headache, cough syncope). A substantial proportion of patients experience anxiety and insomnia, and their quality of life is affected. Thus, the wide spectrum of cough-induced pathology need to be recognized and considered in patients complaining of cough. Suppression of cough must not be neglected in patients at risk, and areas of uncertainty need to be clarified by future prospective studies.


Assuntos
Tosse/complicações , Tosse/patologia , Humanos
12.
J Bronchology Interv Pulmonol ; 27(1): 30-35, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31651543

RESUMO

BACKGROUND: Prior studies assessing the diagnostic utility of bronchoscopy for chronic unexplained cough have focused primarily on identifying endobronchial anomalies to determine chronic cough etiology. On the basis of our institutional experience, expanding bronchoscopy to include cultures and biopsies can considerably increase its diagnostic yield for identifying the etiology of chronic unexplained cough. MATERIALS AND METHODS: This retrospective review analyzed bronchoscopies conducted in our institution between 2013 and 2017. Eligibility criteria were bronchoscopies conducted for chronic unexplained cough for which no etiology had been identified before the bronchoscopy. Microbiology, pathology, and cytology results from bronchoscopy were reviewed to identify the etiology of the cough. RESULTS: Over the study period, 169 bronchoscopies met the eligibility criteria. The average patient age at bronchoscopy was 59.7±14.8 years; 61% were female individuals. Direct visualization identified anatomic etiologies in 48 (28%) patients, most commonly tracheobronchomalacia, and less common conditions, such as tracheobronchopathia osteochondroplastica. Microbiology cultures were positive in 33 (20%) patients, principally Staphylococcus aureus, Streptococcus pneumoniae, Pseudomonas aeruginosa, and nontuberculosis mycobacterium. Pathology results from endobronchial biopsies identified respiratory conditions associated with cough, primarily eosinophilic bronchitis (n=15), as well as neurofibromatosis (n=1) and amyloidosis (n=1). Cytology results did not reveal alternate diagnoses not previously identified. CONCLUSION: Inclusion of bronchial washings and endobronchial biopsies during bronchoscopy for chronic unexplained cough increased diagnostic yield from 28%, attributable to directly visualized anatomic etiologies, to 41%. The addition of microbiology cultures and pathology analysis significantly increased the diagnostic yield of bronchoscopy in identifying the potential etiology of chronic heretofore unexplained cough.


Assuntos
Broncoscopia , Tosse/microbiologia , Tosse/patologia , Infecções Bacterianas/complicações , Técnicas Bacteriológicas , Biópsia , Broncopatias/complicações , Doença Crônica , Tosse/diagnóstico , Tosse/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
13.
Expert Opin Ther Pat ; 29(12): 943-963, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31726893

RESUMO

Introduction: Purinergic P2X3-P2X2/3 receptors are placed in nociceptive neurons' strategic location and show unique desensitization properties; hence, they represent an attractive target for many pain-related diseases. Therefore, a broad interest from academic and pharmaceutical scientists has focused on the search for P2X3 and P2X2/3 receptor ligands and has led to the discovery of numerous new selective antagonists. Some of them have been studied in clinical trials for the treatment of pathological conditions such as bladder disorders, gastrointestinal and chronic obstructive pulmonary diseases.Areas covered: This review provides a summary of the patents concerning the discovery of P2X3 and/or P2X2/3 receptor antagonists published between 2015 and 2019 and their potential clinical use. Thus, the structures and biological data of the most representative molecules are reported.Expert opinion: The 2016 publication of the crystallographic structure of the human P2X3 receptor subtype gave an improvement of published patents in 2017. Hence, a great number of small molecules with dual antagonist activity on P2X3-P2X2/3 receptors, a favorable pharmacokinetic profile, and reasonable oral bioavailability was discovered. The most promising compounds are the phenoxy-diaminopyrimidines including gefapixant (AF-219), and the imidazo-pyridines like BLU-5937, which are in phase III and phase II clinical trials, respectively, for refractory chronic cough.


Assuntos
Antagonistas do Receptor Purinérgico P2X/farmacologia , Receptores Purinérgicos P2X2/efeitos dos fármacos , Receptores Purinérgicos P2X3/efeitos dos fármacos , Animais , Tosse/tratamento farmacológico , Tosse/patologia , Descoberta de Drogas , Humanos , Dor/tratamento farmacológico , Dor/patologia , Patentes como Assunto , Antagonistas do Receptor Purinérgico P2X/farmacocinética , Receptores Purinérgicos P2X2/metabolismo , Receptores Purinérgicos P2X3/metabolismo
14.
Medicine (Baltimore) ; 98(43): e17349, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31651839

RESUMO

RATIONALE: Diffuse pulmonary lymphangiomatos (DPL) is a rare aggressive lymphatic disorder characterized by proliferation of anastomozing lymphatic vessels and extremely rare in adult patients. PATIENT CONCERNS: We report a case of diffuse pulmonary lymphangiomatosis in 59-year-old man presented with cough and sputum for 2 months. DIAGNOSES: Combining clinical manifestations with results of radiological, bronchoscopy, and surgical lung biopsy, it was consistent with the diagnosis of DPL. INTERVENTIONS: After bronchoalveolar lavage and biopsy, symptom of cough got worse suddenly accompanied by excessive chyloptysis. The patient received an emergency surgical intervention and low fat medium chain fat treatment. OUTCOMES: The patient was discharged with a much better health condition. LESSONS: This case report is the oldest patient reported in the English literature, to the best of our knowledge. Serious complications of bronchoscopy should be considered, especially in DPL patients with severely enlarged mediastinum or with thin-walled translucent vesicles under endoscopy.


Assuntos
Tosse/patologia , Pneumopatias/congênito , Linfangiectasia/congênito , Biópsia , Broncoscopia , Tosse/etiologia , Humanos , Pulmão/patologia , Pneumopatias/complicações , Pneumopatias/patologia , Linfangiectasia/complicações , Linfangiectasia/patologia , Masculino , Pessoa de Meia-Idade , Doenças Raras/patologia , Escarro
15.
Sci Transl Med ; 11(515)2019 10 23.
Artigo em Inglês | MEDLINE | ID: mdl-31645455

RESUMO

Improved tuberculosis (TB) prevention and control depend critically on the development of a simple, readily accessible rapid triage test to stratify TB risk. We hypothesized that a blood protein-based host response signature for active TB (ATB) could distinguish it from other TB-like disease (OTD) in adult patients with persistent cough, thereby providing a foundation for a point-of-care (POC) triage test for ATB. Three adult cohorts consisting of ATB suspects were recruited. A bead-based immunoassay and machine learning algorithms identified a panel of four host blood proteins, interleukin-6 (IL-6), IL-8, IL-18, and vascular endothelial growth factor (VEGF), that distinguished ATB from OTD. An ultrasensitive POC-amenable single-molecule array (Simoa) panel was configured, and the ATB diagnostic algorithm underwent blind validation in an independent, multinational cohort in which ATB was distinguished from OTD with receiver operator characteristic-area under the curve (ROC-AUC) of 0.80 [95% confidence interval (CI), 0.75 to 0.85], 80% sensitivity (95% CI, 73 to 85%), and 65% specificity (95% CI, 57 to 71%). When host antibodies against TB antigen Ag85B were added to the panel, performance improved to 86% sensitivity and 69% specificity. A blood-based host response panel consisting of four proteins and antibodies to one TB antigen can help to differentiate ATB from other causes of persistent cough in patients with and without HIV infection from Africa, Asia, and South America. Performance characteristics approach World Health Organization (WHO) target product profile accuracy requirements and may provide the foundation for an urgently needed blood-based POC TB triage test.


Assuntos
Tosse/diagnóstico , Triagem/métodos , Tuberculose Pulmonar/diagnóstico , Anticorpos Antibacterianos/análise , Tosse/microbiologia , Tosse/patologia , Humanos , Aprendizado de Máquina , Sistemas Automatizados de Assistência Junto ao Leito , Tuberculose Pulmonar/microbiologia , Tuberculose Pulmonar/patologia
16.
Chest ; 156(2): e47-e50, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31395268

RESUMO

CASE PRESENTATION: A 63-year-old woman presented with a 2-year history of nonproductive cough. She denied the presence of shortness of breath, chest pain, arthralgia, muscle weakness, weight loss, night sweats, and fatigue. She was a never smoker and had a history of arterial hypertension and diabetes. There was no history of asthma, allergic rhinitis, nasal polyps, or gastroesophageal reflux disease, known malignancy, or collagen tissue disease. She reported exposure to house mold. There was no family history of respiratory diseases. The patient denied alcohol consumption, illicit drug use, occupational exposures, any recent travel, or exposure to TB.


Assuntos
Calcinose/diagnóstico por imagem , Tosse/etiologia , Doenças Genéticas Inatas/diagnóstico por imagem , Pneumopatias/diagnóstico por imagem , Calcinose/complicações , Calcinose/patologia , Tosse/diagnóstico por imagem , Tosse/patologia , Feminino , Doenças Genéticas Inatas/complicações , Doenças Genéticas Inatas/patologia , Humanos , Pneumopatias/complicações , Pneumopatias/patologia , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
17.
Med Sci Monit ; 25: 5621-5629, 2019 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-31354164

RESUMO

BACKGROUND This study investigated the effects and underlying mechanisms of emodin on cough variant asthma (CVA) in mice. MATERIAL AND METHODS The bronchial asthma mouse model was successfully established by use of ovalbumin (OVA) sensitization and challenge. The BALB/c mice were divided into 6 groups: a control group, an OVA model without or with emodin (15, 30, 60 mg/kg) group, and a dexamethasone (0.5 mg/g) group. The effect of the treatment was determined by measuring airway responsiveness. The levels of immunoglobulin molecules, as well as inflammatory cytokines in bronchoalveolar lavage fluid (BALF) and serum, were determined by ELISA. The lung tissues were stained by hematoxylin-eosin (HE). The expressions of Notch receptors (Notch 1-3) and Delta-like (DLL) 4 in the lung tissues were detected by RT-PCR and Western blot analysis. RESULTS Compared with the model group, emodin treatment significantly increased the levels of immunoglobulin E (IgE) and IgG1/IgG2a in BALF and serum (p<0.05). HE results indicated that emodin inhibited the infiltration of inflammatory cells and that emodin reduced the levels of inflammatory cytokines, interleukin (IL)-5, IL-17, and interferon (IFN)-γ in BALF and serum (p<0.05). Furthermore, the expressions of Notch 1, 2, 3, and DLL4 in lung tissue were inhibited by emodin treatment. CONCLUSIONS The results demonstrated that emodin alleviated inflammation in CVA mice, which might be associated with suppression of the Notch pathway. Emodin might be a promising therapeutic agent for allergic asthma.


Assuntos
Asma/tratamento farmacológico , Emodina/farmacologia , Receptores Notch/metabolismo , Animais , Asma/metabolismo , Asma/patologia , Líquido da Lavagem Broncoalveolar , Tosse/tratamento farmacológico , Tosse/patologia , Citocinas/metabolismo , Modelos Animais de Doenças , Eosinófilos/metabolismo , Imunoglobulina E/sangue , Imunoglobulina G/sangue , Inflamação/metabolismo , Pulmão/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Ovalbumina/farmacologia
18.
Respir Med Res ; 76: 4-9, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31254946

RESUMO

INTRODUCTION: The impact of fractional exhaled nitric oxide (FENO) on the management of chronic cough (CC) is still inconclusive. The aim of the present study was to assess whether FENO is a good tool to predict the response to inhaled corticosteroids (ICS) in patients with CC. METHODS: Patients, referred for investigation of CC, had a FENO measurement determined as part of their first-line assessment. A methacholine test was performed as part of a second-line assessement. Patients were assigned to two groups according to their FENO values: a high FENO level group (â°¥25 ppb) and a normal FENO level group (<25 ppb). RESULTS: One hundred patients were included in the study. High FENO levels were found in 25 patients (25%). The proportion of patients who responded to ICS was significantly greater in the high FENO group compared to the normal FENO level group (86.4% vs 46.3%, P<0.05). FENO is a good tool to predict ICS response in patients with high FENO levels but a response to ICS cannot be ruled out in patients with normal FENO levels. In patients with normal FENO values, a methacholine test could be an interesting tool for a second-line assessment. Among the 13 patients with a positive methacholine test result, 11 responded to ICS whilst 2 did not. Of the patients with a negative methacholine test result, 3 responded to ICS whilst 13 did not. CONCLUSION: FENO may be a more reliable predictor of ICS response when used as part of a multi-step assessment procedure.


Assuntos
Corticosteroides/administração & dosagem , Tosse/diagnóstico , Tosse/tratamento farmacológico , Expiração/fisiologia , Óxido Nítrico/análise , Administração por Inalação , Adulto , Idoso , Testes Respiratórios/métodos , Testes de Provocação Brônquica , Doença Crônica , Tosse/metabolismo , Tosse/patologia , Monitoramento de Medicamentos/métodos , Feminino , França , Humanos , Masculino , Cloreto de Metacolina/farmacologia , Pessoa de Meia-Idade , Óxido Nítrico/metabolismo , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Resultado do Tratamento
19.
J Ethnopharmacol ; 239: 111915, 2019 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-31039428

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Adenophora triphylla var. japonica is frequently used as an oriental medicinal plant in Korea, China, and Japan for its anti-inflammatory, antitussive, and hepatoprotective effects. AIM OF THE STUDY: In the present study, the antitussive, expectorant, and anti-inflammatory effects of AR powder were investigated using animal models to evaluate their potential to treat respiratory disorders. MATERIALS AND METHODS: AR powder was administered orally to mice once daily for 11 days, at dose levels of 400, 200, and 100 mg/kg. Theobromine (TB), ambroxol (AM) and dexamethasone (DEXA) were used as standard drugs for antitussive effects, expectorant effects and anti-inflammatory effects, respectively. Evaluations of antitussive effects were based on changes in body weight, the number of cough responses and the histopathology of the lung and trachea. Expectorant effects were based on changes in the body weight, macroscopic observations of body surface redness, the mucous secretion of the trachea and histopathology of lung (secondary bronchus). Anti-inflammatory effects were based on changes in the body weight, macroscopic observations involving redness and edema of the treated ear, absolute and relative ear weights and histopathology of the treated ears. RESULTS: Allergic acute inflammation and coughing induced by exposure to NH4OH and symptoms of xylene-induced contact dermatitis were significantly inhibited by treatment with AR powder in a dose-dependent manner. Histological analyses revealed that AR powder decreased the OD values in trachea lavage fluid, reduced body surface redness, thicknesses of intrapulmonary secondary bronchus mucosa, and the number of PAS-positive mucous producing cells. Overall, AR powder administered at 200 mg/kg displayed superior antitussive and expectorant effects as compared to TB (50 mg/kg), and AM (250 mg/kg). At the highest concentration (400 mg/kg) AR powder displayed only moderately improved anti-inflammatory activities as compared to DEXA (1 mg/kg). CONCLUSION: The results obtained in this study suggest that AR powder exerts dose-dependent, favorable antitussive, expectorant, and anti-inflammatory activities achieved through modulation of the activity of mast cells and respiratory mucous production. Therefore, AR powder may serve as a therapeutic agent in various respiratory disorders, especially those that occur as a result of environmental toxicants.


Assuntos
Anti-Inflamatórios/uso terapêutico , Antitussígenos/uso terapêutico , Campanulaceae , Tosse/tratamento farmacológico , Dermatite de Contato/tratamento farmacológico , Expectorantes/uso terapêutico , Hidróxido de Amônia , Animais , Tosse/induzido quimicamente , Tosse/metabolismo , Tosse/patologia , Dermatite de Contato/patologia , Pulmão/efeitos dos fármacos , Pulmão/patologia , Masculino , Camundongos Endogâmicos ICR , Muco/efeitos dos fármacos , Muco/metabolismo , Raízes de Plantas , Pós , Mucosa Respiratória/efeitos dos fármacos , Mucosa Respiratória/metabolismo , Pele/efeitos dos fármacos , Pele/patologia , Traqueia/efeitos dos fármacos , Traqueia/patologia , Xilenos
20.
Medicine (Baltimore) ; 98(15): e15038, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30985653

RESUMO

RATIONALE: Sclerosing pneumocytoma is a rare benign lung neoplasm seen in middle aged adults with a female predominance. Originally thought to be vascular in origin, this rare entity is now understood to be epithelial in nature. On imaging, sclerosing pneumocytoma manifests as a well circumscribed nodule or mass, often juxtapleural in location. On histopathology, sclerosing pneumocytoma is composed of cuboidal "surface cells" and round "stromal cells," both of which show nuclear staining for thyroid transcription factor-1 (TTF-1). Here we review the existing literature on sclerosing pneumocytoma and present a case of sclerosing pneumocytoma in a highly unusual endobronchial location. PATIENT CONCERNS: This case is a 43 year old woman who presented with chronic cough. DIAGNOSIS: Imaging revealed a right upper lobe nodule with an endobronchial component. INTERVENTIONS AND OUTCOMES: Endoscopic biopsy was performed, and pathologic diagnosis was confirmed. LESSONS: Although extremely rare, endobronchial presentation of sclerosing pneumocytoma is possible, and should remain on the differential for patients with endobronchial pulmonary lesions. Pathologic tissue analysis is necessary to confirm this uncommon diagnosis.


Assuntos
Hemangioma Esclerosante Pulmonar/diagnóstico , Adulto , Brônquios/diagnóstico por imagem , Brônquios/patologia , Tosse/diagnóstico , Tosse/patologia , Diagnóstico Diferencial , Feminino , Humanos , Hemangioma Esclerosante Pulmonar/patologia
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