粤东地区小儿呼吸道感染病原中首次检出人类偏肺病毒

目的分析人类偏肺病毒(hMPV)在粤东地区的感染情况及所致疾病的临床特点。方法(1)应用TemPCR技术对120例呼吸道感染患儿的鼻咽分泌物扩增多种病原体,并应用多重荧光微球技术检测hMPV等病毒核酸;(2)分析hMPV感染患儿的临床资料。结果120份标本中hMPV阳性6份(5%),占常见病毒阳性者的24%,占100例其他常见呼吸道病毒检测阴性患儿的6%。6株hMPV特异性核酸扩增片段核酸测序结果与GenBank中人类偏肺病毒AF371337(NL00-1)株的基因同源性>95%。6例hMPV阳性患儿中,临床表现为毛细支气管炎4例、喘息型肺炎1例、上呼吸道感染1例。结论hMPV是粤东地区小儿呼吸道感染的重要病毒性病原体之一,其感染主要引起小儿喘息性疾病。     

喘息婴幼儿潮气肺功能、呼出气一氧化氮及过敏原研究

目的:研究喘息婴幼儿潮气肺功能和呼出气一氧化氮(FeNO)的变化,着重探讨过敏体质在其中的潜在作用。方法:纳入成都市妇女儿童中心医院呼吸科2018年2月至2019年1月收治的急性下呼吸道感染婴幼儿285例,回顾性分析患儿的一般资料,喘息的危险因素,喘息与潮气肺功能及FeNO的关系,并通过亚组分析探究过敏因素在其中的作用...     

Issues in Design and Implementation in an Urban Birth Cohort Study: The Syracuse AUDIT Project

The Syracuse AUDIT (Assessment of Urban Dwellings for Indoor Toxics) project is a birth cohort study of wheezing in the first year of life in a low-income urban setting. Such studies are important because of the documented serious risks to children's health and the lack of attention and published work on asthma development and intervention in communities of this size. We studied 103 infants of mothers with asthma, living predominantly in inner-city households. Our study combines measurements of a large panel of indoor environmental agents, in-home infant assessments, and review of all prenatal and postnatal medical records through the first year of life. We found multiple environmental pollution sources and potential health risks in study homes including high infant exposure to tobacco smoke. The prevalence of maternal smoking during pregnancy was 54%; postnatal environmental tobacco smoke (ETS) exposure was nearly 90%. The majority (73%) of homes showed signs of dampness. Participants' lives were complicated by poverty, unemployment and single-parenthood. Thirty-three percent of fathers were not involved with their children, and 62% of subjects moved at least once during the study period. These socioeconomic issues had an impact on project implementation and led to modification of study eligibility criteria. Extensive outreach, follow up, and relationship-building were required in order to recruit and retain families and resulted in considerable work overload for study staff. Our experiences implementing the project will inform further studies on this and other similar populations. Future reports on this cohort will address the role of multiple environmental variables and their effects on wheezing outcome during the first year of life.Crawford, Hargrave, Liu, Anbar, Hall, Naishadham, Czerwinski, Webster, Lane, and Abraham are with the Department of Pathology, SUNY Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210, USA; Hunt is with the UNYSPEC Ltd., Baldwinsville, NY, USA.     

Relationship Between Distance of Schools from the Nearest Municipal Waste Incineration Plant and Child Health in Japan

In Japan, the main source of dioxins is incinerators. This study examined the relationship between the distance of schools from municipal waste incineration plants and the prevalence of allergic disorders and general symptoms in Japanese children. Study subjects were 450,807 elementary school children aged 6–12 years who attended 996 public elementary schools in Osaka Prefecture in Japan. Parents of school children completed a questionnaire that included items about illnesses and symptoms in the study child. Distance of each of the public elementary schools from all of the 37 municipal waste incineration plants in Osaka Prefecture was measured using geographical information systems packages. Adjustment was made for grade, socioeconomic status and access to health care per municipality. Decreases in the distance of schools from the nearest municipal waste incineration plant were independently associated with an increased prevalence of wheeze, headache, stomach ache, and fatigue (adjusted odds ratios [95% confidence intervals] for shortest vs. longest distance categories =1.08 [1.01–1.15], 1.05 [1.00–1.11], 1.06 [1.01–1.11], and 1.12 [1.08–1.17], respectively). A positive association with fatigue was pronounced in schools within 4 km of the second nearest municipal waste incineration plant. There was no evident relationship between the distance of schools from such a plant and the prevalence of atopic dermatitis or allergic rhinitis. The findings suggest that proximity of schools to municipal waste incineration plants may be associated with an increased prevalence of wheeze, headache, stomach ache, and fatigue in Japanese children.     

Inhalation of corticosteroids after hospital care for respiratory syncytial virus infection diminishes development of asthma in infants

The aim of the study was to assess the effect of inhaled corticosteroids on subsequent respiratory symptoms and asthma in infants hospitalized for respiratory syncytial virus infection (RSV). The study included 188 children below 12 mo of age, hospitalized because of RSV infection. During the winter of 1994/95 only selected children (13%) were given inhaled corticosteroids following discharge from the hospital. The following winter (1995/96), almost all children (86%) were given this treatment for 6-8 wk. Outcomes of the two different treatment regimens were compared by questionnaire 19-24 mo after discharge. Children hospitalized and treated during the winter of 1995/96 developed asthma (12% vs. 24%) and other severe symptoms of the respiratory tract less often than infants treated the year before. The frequency of children with less severe symptoms did not differ between the two treatment periods. Conclusion: The results indicate that inhalation of corticosteroids for 6-8 wk may reduce subsequent asthma and severe respiratory morbidity in infants hospitalized for RSV infection.     

Breastfeeding and Asthma Among Brazilian Children

We examined the association of breastfeeding and the presence of chronic respiratory symptoms among 5182 Brazilian schoolchildren 7-14 years of age who were participants in the International Study on Asthma and Allergies in Childhood (ISAAC). The prevalence of medically diagnosed asthma and current wheeze were respectively 4.6% (95% confidence interval [CI] 4.0%-5.2%) and 11.9% (95% CI 11.0%-12.8%). Ninety percent of the mothers in our study population had breastfed their child. After adjusting for potential confounding factors, we found that children who had not been breastfed were more likely to have a medical diagnosis of asthma (odds ration [OR] = 1.51, 95% CI 1.00-2.51), experience current wheeze (OR = 1.29, 95% CI 0.96-1.74), and wheeze after exercise (OR = 1.51, 95% CI 1.01-2.27) than children who had been breastfed for more than 6 months. This effect was only present among children with no family history of asthma (OR = 1.54, 95% CI 0.90-2.42 for medical diagnosis of asthma; OR = 1.27, 95% CI 0.93-1.75 for current wheezing; and OR = 1.74, 95% CI 1.12-2.6 for wheeze after exercise). We conclude that the low prevalence of asthma and wheeze observed in our population may be partly related to the high level of breastfeeding.