scholarly journals Novel Variants of Respiratory Syncytial Virus A ON1 Associated With Increased Clinical Severity of Bronchiolitis

2020 ◽  
Vol 222 (1) ◽  
pp. 102-110
Author(s):  
Fabio Midulla ◽  
Greta Di Mattia ◽  
Raffaella Nenna ◽  
Carolina Scagnolari ◽  
Agnese Viscido ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Amino Acid ◽  
Severity Score ◽  
Multinomial Logistic Regression ◽  
Clinical Severity ◽  
Term Infants ◽  
Clinical Severity Score ◽  
Glycosylation Sites ◽  
Novel Variants ◽  
Syncytial Virus

Abstract Background A study of respiratory syncytial virus-A (RSV A) genotype ON1 genetic variability and clinical severity in infants hospitalized with bronchiolitis over 6 epidemic seasons (2012–2013 to 2017–2018) was carried out. Methods From prospectively enrolled term infants hospitalized for bronchiolitis, samples positive for RSV A ON1 (N = 139) were sequenced in the second half of the G gene. Patients’ clinical data were obtained from medical files and each infant was assigned a clinical severity score. ANOVA comparison and adjusted multinomial logistic regression were used to evaluate clinical severity score and clinical parameters. Results The phylogenetic analysis of 54 strains showed 3 distinct clades; sequences in the last 2 seasons differed from previous seasons. The most divergent and numerous cluster of 2017–2018 strains was characterized by a novel pattern of amino acid changes, some in antigenic sites. Several amino acid changes altered predicted glycosylation sites, with acquisition of around 10 new O-glycosylation sites. Clinical severity of bronchiolitis increased in 2016–2017 and 2017–2018 and changed according to the epidemic seasons only. Conclusions Amino acid changes in the hypervariable part of G protein may have altered functions and/or changed its immunogenicity, leading to an impact on disease severity.

scholarly journals Genetic Diversity and Molecular Epidemiology of Circulating Respiratory Syncytial Virus in Central Taiwan, 2008–2017

Viruses ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 32
Author(s):  
Chun-Yi Lee ◽  
Yu-Ping Fang ◽  
Li-Chung Wang ◽  
Teh-Ying Chou ◽  
Hsin-Fu Liu
Keyword(s):  
Respiratory Syncytial Virus ◽  
Amino Acid ◽  
Temporal Evolution ◽  
Local Level ◽  
Hypervariable Region ◽  
Amino Acid Sequences ◽  
Sequence Alignments ◽  
Glycosylation Sites ◽  
Syncytial Virus ◽  
Central Taiwan

In this study, we investigated the molecular evolution and phylodynamics of respiratory syncytial virus (RSV) over 10 consecutive seasons (2008–2017) and the genetic variability of the RSV genotypes ON1 and BA in central Taiwan. The ectodomain region of the G gene was sequenced for genotyping. The nucleotide and deduced amino acid sequences of the second hypervariable region of the G protein in RSV ON1 and BA were analyzed. A total of 132 RSV-A and 81 RSV-B isolates were obtained. Phylogenetic analysis revealed that the NA1, ON1, and BA9 genotypes were responsible for the RSV epidemics in central Taiwan in the study period. For RSV-A, the NA1 genotype predominated during the 2008–2011 seasons. The ON1 genotype was first detected in 2011 and replaced NA1 after 2012. For RSV-B, the BA9 and BA10 genotypes cocirculated from 2008 to 2010, but the BA9 genotype has predominated since 2012. Amino acid sequence alignments revealed the continuous evolution of the G gene in the ectodomain region. The predicted N-glycosylation sites were relatively conserved in the ON1 (site 237 and 318) and BA9 (site 296 and 310) genotype strains. Our results contribute to the understanding and prediction of the temporal evolution of RSV at the local level.

scholarly journals Efficacy of nebulised L-adrenaline with 3% hypertonic saline versus normal saline in bronchiolitis

2016 ◽  
Vol 7 (1) ◽  
pp. 15
Author(s):  
Shabnam Sharmin ◽  
Laila Helaly ◽  
Zakir Hossain Sarker ◽  
Ruhul Amin ◽  
Shafi Ahmed ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Hypertonic Saline ◽  
Normal Saline ◽  
Severity Score ◽  
Saline Group ◽  
Clinical Severity ◽  
Clinical Severity Score ◽  
Group I ◽  
Group Ii

<p><strong>Background:</strong> Bronchiolitis is one of the most common respiratory diseases requiring hospitalization. Nebulized epineph­rine and salbutamol therapy has been used in different centres with varying results. <strong></strong></p><p><strong>Objective:</strong> The objective of the study was to compare the efficacy of nebulised adrenaline diluted with 3% hypertonic saline with nebulised adrenaline diluted with normal saline in bronchiolitis. <strong></strong></p><p><strong>Methods:</strong> Fifty three infants and young children with bronchiolitis, age ranging from 2 months to 2 years, presenting in the emergency department of Manikganj Sadar Hospital were enrolled in the study. After initial evaluation, patients were randomized to receive either nebulized adrenaline I .5 ml ( 1.5 mg) diluted with 2 ml of3% hypertonic saline (group I) ornebulised adrenaline 1.5 ml (1.5 mg) diluted with 2 ml of normal saline (group II). Patients were evaluated again 30 minutes after nebulization. <strong></strong></p><p><strong>Results:</strong> Twenty eight patients in the group I (hypertonic saline) and twenty five in groupII (normal saline) were included in the study. After nebulization, mean respiratory rate decreased from 63.7 to 48.1 (p&lt;.01), mean clinical severity score decreased from 8.5 to 3.5 (p&lt;.01) and mean oxygen satw·ation increased 94.7% to 96.9% (p&lt;.01) in group I. In group II, mean respiratory rate decreased from 62.4 to 47.4 (p&lt;.01), mean clinical severity score decreased from 7.2 to 4.1 (p&lt;.01) and mean oxygen saturation increased from 94. 7% to 96. 7% (p&lt;.01). Mean respiratory rate decreased by 16 in group I versus 14.8 (p&gt;.05) in group 11, mean clinical severity score decreased by 4.6 in group versus 3 (p&lt;.05) in group, and mean oxygen saturation increased by 2.2% and 1.9% in group and group respectively. Difference in reduction in clinical severity score was statistically significant , though the changes in respiratory rate and oxygen saturation were not statistically significant. <strong></strong></p><p><strong>Conclusion:</strong> The study concluded that both nebulised adrenaline diluted with 3% hypertonic saline and nebulised adrenaline with normal saline are effective in improving respiratory rate, clinical severity score and oxygen saturation in infants with bronchiolitis; and nebulised adrenaline with hypertonic saline is more effective than nebulised adrenaline with normal saline in improving clinical severity score in bronchiolitis.</p>

scholarly journals Positive Selection Results in Frequent Reversible Amino Acid Replacements in the G Protein Gene of Human Respiratory Syncytial Virus

2009 ◽  
Vol 5 (1) ◽  
pp. e1000254 ◽  
Author(s):  
Viviane F. Botosso ◽  
Paolo M. de A. Zanotto ◽  
Mirthes Ueda ◽  
Eurico Arruda ◽  
Alfredo E. Gilio ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Amino Acid ◽  
Positive Selection ◽  
G Protein ◽  
Protein Gene ◽  
Human Respiratory Syncytial Virus ◽  
Syncytial Virus

Σύγκριση της αποτελεσματικότητας της χειρουργικής επέμβασης της σαφηνεκτομής και τοπικών εκριζώσεων στην αντιμετώπιση των συμπτωμάτων σε ασθενείς με χρόνια φλεβική νόσο

2021 ◽  
Author(s):  
Χρυσάνθη Παπαγεωργοπούλου
Keyword(s):  
Severity Score ◽  
Clinical Severity ◽  
Cronbach’S Alpha ◽  
Cronbach's Alpha ◽  
Clinical Severity Score ◽  
Venous Clinical Severity Score

Στόχος: Ο στόχος της μελέτης είναι η επικύρωση του 3D εργαλείου βαθμολόγησης – αξιολόγησης για τη χρόνια φλεβική νόσο, όπως προτάθηκε στο SYM VEIN consensus. Μέθοδος: Η παρούσα κλινική μελέτη είναι μία προοπτική μελέτη κοόρτης που περιλαμβάνει συνολικά τριάντα πέντε (35) ασθενείς, κατόπιν συναίνεσης, με χρόνια φλεβική νόσο. Οι ασθενείς αυτοί που θα υποβάλλονταν σε σαφηνεκτομή εκτιμήθηκαν με το αναθεωρημένο Venous Clinical Severity Sore (r-VCSS), με το CIVIQ-20 ερωτηματολόγιο για την ποιότητα ζωής και με το 3D σύστημα βαθμονόμησης του SYM VEIN consensus, προεγχειρητικά και τέσσερεις εβδομάδες μετά την επέμβαση. Το συνολικό αποτελέσματα του 3D εργαλείου αξιολόγησης ελέγχθηκε για την ανταπόκρισή του, για την αξιοπιστία του και για τη δομική του εγκυρότητα.Αποτελέσματα: Το συνολικό αποτέλεσμα του 3D εργαλείου αξιολόγησης αποδείχθηκε καλής αξιοπιστίας και εσωτερικής συνοχής (Cronbach’s alpha 0,85). Η πρωταρχική ανάλυση των καταληκτικών σημείων ταυτοποίησε τρεις ομάδες συμπτωμάτων (παραισθησία, καυστικό άλγος, κνησμός vs αίσθημα βάρους, αίσθημα οιδήματος, κνησμός vs σύνδρομο ανήσυχων ποδιών, πάλλων πόνος) αποδεικνύοντας μία υψηλή συσχέτιση των συμπτωμάτων που περιλαμβάνονται στην ίδια ομάδα και πιθανώς μοιράζονται κοινή παθοφυσιολογία, ενδεικτικό της επαρκούς δομικής εγκυρότητας του εργαλείου αξιολόγησης. Το συνολικό αποτέλεσμα του 3D εργαλείου αξιολόγησης είχε σημαντική συσχέτιση με το r-VCSS και το αποτέλεσμα του CIVIQ-20 (rho 0,46, p = 0,005 and rho 0,65, p < 0,001, αντίστοιχα), ενδεικτικό της επαρκούς συγκλίνουσας εγκυρότητας. Μετά τη σαφηνεκτομή, παρατηρήθηκαν στατιστικώς σημαντικές μειώσεις (p < 0,001) του συνολικού αποτελέσματος του 3D εργαλείου αξιολόγησης, αλλά και των επιμέρους αποτελεσμάτων του 3D εργαλείου για όλα τα φλεβικά συμπτώματα εκτός από δύο, ενδεικτικό της εξαιρετικής ανταπόκρισης του εργαλείου στη θεραπεία. Η διάμεση τιμή της συνολικής βαθμολογίας του 3D εργαλείου αξιολόγησης μειώθηκε από το 31 στο 6 (83,8% μείωση, p < 0,001), η διάμεση τιμή του r-VCSS μειώθηκε από το 6 στο 0 (100% μείωση, p < 0,001), και η μέση τιμή της βαθμολογίας του CIVIQ-20 μειώθηκε από το 24 στο 14 (40% μείωση, p < 0,001). Η διαφορά της ποσοστιαίας αλλαγής της διάμεσης τιμής των αποτελεσμάτων μεταξύ των r-VCSS και του CIVIQ-20 σε σύγκριση με τη συνολική βαθμολογία του 3D εργαλείου αξιολόγησης ήταν στατιστικώς σημαντική (p = 0,005 and p < 0,001, αντίστοιχα).Συμπέρασμα: Το συνολικό αποτέλεσμα του 3D SYM VEIN εργαλείου αξιολόγησης έχει καλή αξιοπιστία, δομική εγκυρότητα και εξαιρετική ανταπόκριση στη θεραπεία, παρά του ότι είναι λιγότερο επιρρεπές στην αλλαγή μετά τη σαφηνεκτομή, σε σύγκριση με την αναθεωρημένη μορφή του Venous Clinical Severity Score (r-VCSS).

scholarly journals Evaluation of liquid or foam sclerotherapy in small varicose veins (ceap c1) with venous clinical severity score

2018 ◽  
Vol 64 (12) ◽  
pp. 1117-1121 ◽  
Author(s):  
Mehmet Ali Kaygin ◽  
Umit Halici
Keyword(s):  
Severity Score ◽  
Skin Necrosis ◽  
Varicose Veins ◽  
Clinical Severity ◽  
Foam Sclerotherapy ◽  
Clinical Severity Score ◽  
Severity Scores ◽  
Study Results ◽  
Venous Clinical Severity Score ◽  
The Mean

SUMMARY OBJECTIVE: We aimed to evaluate the efficacy of liquid or foam sclerotherapy of varicose veins using venous clinical severity scores and possible complications. METHODS: A total of 318 patients (268 females, 50 males) who were treated with liquid or foam sclerotherapy between January 2012 and December 2012 were included in this study. RESULTS: Skin necrosis was observed in only 6 patients (1. 8%), thrombophlebitis in 10 patients (3. 1%), and hyperpigmentation in 18 patients (5. 6%) in this study group. The mean venous clinical severity score was calculated as: pain score, 1. 23 ± 0.88; varicose vein score,1.85 ± 0. 8; edema score, 0.64 ± 0.77). Pain and edema decreased at the control examination, 1 month after completion of sclerotherapy sessions. Varicose veins completely disappeared after sclerotherapy. While the decrease in edema in the foam sclerotherapy group was significantly less (P<0.001), the decline in pain showed an increasing trend (P=0.069). While skin necrosis did not develop after foam sclerotherapy, rates of pigmentation and local thrombophlebitis were similar (P>0.05). CONCLUSION: In conclusion, we observed that both sclerotherapy methods are effective with a low rate of complications, alleviating the complaints of patients with small varicose veins, and providing considerable improvement in venous clinical severity scores.

scholarly journals High-mobility group box-1 protein from CC10+ club cells promotes type 2 response in the later stage of respiratory syncytial virus infection

2019 ◽  
Vol 316 (1) ◽  
pp. L280-L290 ◽  
Author(s):  
Sisi Chen ◽  
Guangyuan Yu ◽  
Jun Xie ◽  
Wei Tang ◽  
Leiqiong Gao ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
High Mobility ◽  
Clinical Severity ◽  
High Mobility Group ◽  
Hmgb1 Protein ◽  
Club Cells ◽  
Hmgb1 Expression ◽  
Syncytial Virus ◽  
Tract Infections

The type 2 immune response, induced by infection of respiratory syncytial virus (RSV), has been linked to asthma development, but it remains unclear how the response is initiated. Here, we reported that the high-mobility group box-1 (HMGB1) protein promotes the type 2 response in the later stage of RSV infection. In mice, we found that type 2 cytokines were elevated in the later stages, which were strongly diminished after administration of anti-HMGB1 antibodies. Further investigation revealed that HMGB1 expression was localized to CC10+ club cells in the lung. In the clinic, levels of HMGB1 in nasopharyngeal aspirates in hospitalized infants with RSV bronchiolitis [median (interquartile range) 161.20 ng/ml (68.06–221.30)] were significantly higher than those without lower respiratory tract infections [21.94 ng/ml (12.12–59.82); P < 0.001]. Moreover, higher levels of HMGB1 correlated with clinical severity. These results reveal a link between viral infection and the asthma-like type 2 responses that are associated with long-term consequences.

scholarly journals Performance characteristics of the venous clinical severity score

2002 ◽  
Vol 36 (5) ◽  
pp. 889-895 ◽  
Author(s):  
Mark H. Meissner ◽  
Cynthia Natiello ◽  
Stephen C. Nicholls
Keyword(s):  
Severity Score ◽  
Performance Characteristics ◽  
Clinical Severity ◽  
Clinical Severity Score ◽  
Venous Clinical Severity Score

scholarly journals Comparative evaluation of nebulised 3% saline versus nebulised 0.9% saline in the treatment of acute bronchiolitis

2019 ◽  
Vol 6 (3) ◽  
pp. 1182
Author(s):  
Pragalatha Kumar A. ◽  
Indhuja Rajarathinam ◽  
Aruna Gowdra
Keyword(s):  
Hospital Stay ◽  
Severity Score ◽  
Length Of Hospital Stay ◽  
Signs And Symptoms ◽  
Clinical Severity ◽  
Controlled Study ◽  
Acute Bronchiolitis ◽  
Clinical Severity Score ◽  
Group A ◽  
Group B

Background: Acute bronchiolitis is the most common respiratory tract infection in young children. Despite the high prevalence of acute bronchiolitis, no consensus exists on the management. Studies have shown that except oxygen therapy, no other treatment found to be effective. Hence, the present study was conducted to find out the efficacy of nebulised 3% saline versus is 0.9% saline for the treatment of acute bronchiolitis.Methods: A prospective randomized controlled study of 150 children between the age group of 2 months to 24 months with signs and symptoms of Acute Bronchiolitis admitted to Indira Gandhi Institute of Child Health, Bangalore from January 2016 to December 2016 formed the study group, they were randomized into 2 groups, one received 3% saline nebulization and the other received 0.9% saline.Results: A total of 150 children were enrolled in the study, 75 children (group A) received 0.9% saline and 75 children (group B) received 3% saline. At 24 hours, the mean clinical severity score for group A was 2.49±1.03 and group B was 2.16±0.49 (P=0.013). The duration of hospital stay was shorter (1-3 days) in 3% saline with a mean of 2.35 days and was longer (3-5 days) in 0.9% saline with mean value of 4.04 days which was statistically significant (p <0.001).Conclusions: 3% saline nebulization can be used as an effective treatment for acute bronchiolitis. It significantly reduced the clinical severity score and length of hospital stay compared to 0.9% normal saline.

Health Care Resource Utilization of Late Premature Versus Term Infants With Bronchiolitis

2020 ◽  
Vol 59 (8) ◽  
pp. 778-786
Author(s):  
David Greenberg ◽  
Ron Dagan ◽  
Eilon Shany ◽  
Shalom Ben-Shimol ◽  
Noga Givon-Lavi
Keyword(s):  
Health Care ◽  
Respiratory Syncytial Virus ◽  
Preterm Infants ◽  
Resource Utilization ◽  
Health Care Resource ◽  
Term Infants ◽  
Late Preterm Infants ◽  
Health Care Resource Utilization ◽  
Duration Of Hospitalization ◽  
Syncytial Virus

It is controversial whether it is cost-beneficial for late preterm infants to receive respiratory syncytial virus prophylaxis. This study compares community and hospital health care resource utilization (HCRU) of late premature infants (33-36 weeks gestational age) with term infants (>36 weeks gestational age) hospitalized with bronchiolitis. This was a retrospective, population-based, observational study spanning a 9-year period (2004-2012). HCRU data were obtained from the Health Maintenance Organization “Clalit” and included duration of hospitalization, physician visits, laboratory tests, and treatments. Compared with term infants, late preterm infants had significantly longer duration of hospitalization and higher admission rates to pediatric intensive care unit. They also had higher rates of mean outpatients clinic visits, total outpatient clinic and specialist visits, blood chemistry, and virology testing. HCRU of term infants with bronchiolitis was also substantial, indicating that they also can greatly benefit from respiratory syncytial virus prophylaxis. These findings can guide stakeholders in decisions concerning the prevention of bronchiolitis and will be useful in performing further cost-benefit analysis.

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