scholarly journals A study on HbA1c profile in children with asthma using inhaled corticosteroids

2017 ◽  
Vol 4 (3) ◽  
pp. 796 ◽  
Author(s):  
Sunil Daniel ◽  
Jose O.
Keyword(s):  
Blood Sugar ◽  
Inhaled Corticosteroids ◽  
Glycosylated Hemoglobin ◽  
Venous Blood ◽  
Pediatric Asthma ◽  
Total Study Population ◽  
Asthmatic Children ◽  
Children With Asthma ◽  
Study Population

Background: Inhaled corticosteroids (ICS) are the mainstay of treatment for persistent bronchial asthma in children. Even though ICS is comparatively safe, few systemic toxicities have been reported. We have conducted a study on HbA1c profile of 170 asthmatic children who are on ICS for atleast 6 months. Glycosylated hemoglobin (HbA1c), fasting blood sugar (FBS), Postprandial blood sugar (PPBS) levels were measured before initiating ICS and after 6 months using venous blood samples. HbA1c measured using immunoassay. The objective of the study was to detect prevalence of significant hyperglycemia among children with asthma who are on inhaled corticosteroids. Study design used as a prospective follow up study, setting of the study was to Pediatric asthma clinic, Govt. TDMCH, Alappuzha, Study population used Children between 3 to 12 years attending pediatric asthma clinic.Methods: Cumulative doses of ICS and bronchodialators were measured by providing an asthma diary to mark the dose of medication. FBS, PPBS, and HbA1c levels were measured before initiating ICS and after 6 months. To elucidate the assosiations comparisons between different parameters Chi-square test was used as non-parametric test. Student’s T- test was used to compare mean values between 2 groups and different groups. Initial and follow up two groups of HbA1c and ICS administrations were compared using paired and unpaired T-test.Results: There is a significant increase in the mean HbA1c of the total study population before and after treatment with ICS.Conclusions: Long term use of ICS can affect glucose metabolism of asthmatic children. 

scholarly journals Hypertension Burden and the Risk of New-Onset Atrial Fibrillation

Hypertension ◽  
2021 ◽  
Vol 77 (3) ◽  
pp. 919-928
Author(s):  
So-Ryoung Lee ◽  
Chan Soon Park ◽  
Eue-Keun Choi ◽  
Hyo-Jeong Ahn ◽  
Kyung-Do Han ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Total Study Population ◽  
Increased Risk ◽  
Burden Scale ◽  
History Of ◽  
Study Population ◽  
Korean National Health Insurance ◽  
Stage 1 ◽  
The Relationship

The association between the cumulative hypertension burden and the development of atrial fibrillation (AF) is unclear. We aimed to investigate the relationship between hypertension burden and the development of incident AF. Using the Korean National Health Insurance Service database, we identified 3 726 172 subjects who underwent 4 consecutive annual health checkups between 2009 and 2013, with no history of AF. During the median follow-up of 5.2 years, AF was newly diagnosed in 22 012 patients (0.59% of the total study population; 1.168 per 1000 person-years). Using the blood pressure (BP) values at each health checkup, we determined the burden of hypertension (systolic BP ≥130 mm Hg or diastolic BP ≥80 mm Hg), stratified as 0 to 4 per the hypertension criteria. The subjects were grouped according to hypertension burden scale 1 to 4: 20% (n=742 806), 19% (n=704 623), 19% (n=713 258), 21% (n=766 204), and 21% (n=799 281). Compared with normal people, subjects with hypertension burdens of 1, 2, 3, and 4 were associated with an 8%, 18%, 26%, and 27% increased risk of incident AF, respectively. On semiquantitative analyses with further stratification of stage 1 (systolic BP of 130–139 mm Hg or diastolic BP of 80–89 mm Hg) and stage 2 (systolic BP ≥140 mm Hg or diastolic BP ≥90 mm Hg) hypertension, the risk of AF increased with the hypertension burden by up to 71%. In this study, both a sustained exposure and the degree of increased BP were associated with an increased risk of incident AF. Tailored BP management should be emphasized to reduce the risk of AF.

scholarly journals EVALUATION OF INDUCED SPUTUM CYTOLOGY IN ASTHMATIC CHILDREN

2021 ◽  
Author(s):  
Debora Carla Chong-Silva ◽  
Adriana Nascimento ◽  
Roberta Cunha ◽  
Elessandra Bitencourt ◽  
Leticia Botelho ◽  
...  
Keyword(s):  
Asthma Control ◽  
Inhaled Corticosteroids ◽  
Pulmonary Function Tests ◽  
Sputum Cytology ◽  
Asthma Control Test ◽  
Sputum Induction ◽  
Hypertonic Saline Solution ◽  
Cross Sectional ◽  
Asthmatic Children ◽  
Children With Asthma

Objective: To evaluate the viability of sputum cytology in asthmatic children, recognizing inflammatory patterns and correlating them with clinical, epidemiological and functional variables of the disease. Methods: This was a cross-sectional and observational study of children with asthma who underwent sputum induction through increasing concentrations of nebulized hypertonic saline solution from 3% to 7%. The samples were processed according to the technique developed by Pizzichini et al. and the cytological pattern classified as pauci-granulocytic, neutrophilic, eosinophilic and mixed. Samples with cell viability> 50% were considered adequate. Asthma control was assessed using the asthma control test (ACT). Results: Seventy-nine children performed sputum induction. Thirty-three samples were excluded because they were not viable for analysis, resulting in 46 samples. The children’s average age was 9.4 (± 3) years. There was a predominance of eosinophilic (25/46, 54.3%), followed by mixed (13/46, 28.3%), pauci-granulocytic (7/46, 15.2%) and neutrophilic (1/46, 2.2%) pattern. Sixty-three percent of the children had severe asthma and 84.7% were treated with inhaled corticosteroids. The ACT showed that 25 (56.8%) patients had the disease under control. Forty-five children (97.8%) underwent pulmonary function tests (spirometry) and in 13 cases (28.9%) an obstructive ventilatory defect was found. Conclusions: The eosinophilic profile was predominant in the assessed asthmatic children. Non-eosinophilic phenotypes were found, but less frequently. There was no difference between the clinical variables and the sputum profile in this study group. Sputum induction in children with asthma is feasible and safe and can contribute to a specific and personalized approach to the disease.

scholarly journals Burden of diabetes and hypertension among people attending health camps in an urban area of Kancheepuram district

2017 ◽  
Vol 5 (1) ◽  
pp. 140 ◽  
Author(s):  
S. Hariharan ◽  
R. Umadevi ◽  
T. Stephen ◽  
S. Pradeep
Keyword(s):  
Blood Pressure ◽  
Blood Sugar ◽  
Urban Area ◽  
Blood Pressure Level ◽  
Pressure Level ◽  
Cross Sectional ◽  
Total Study Population ◽  
Random Blood Sugar ◽  
Cardiovascular Morbidity And Mortality ◽  
Study Population

Background: Diabetes and hypertension are among the most common non-communicable diseases affecting our population. They are the important risk factors for cardiovascular morbidity and mortality. The aims and objectives of the study were to determine the burden of diabetes and hypertension among people attending health camps in an urban area of Kancheepuram district. Formulation of suitable preventive measures based on the inferences from the study.Methods: A cross- sectional record based study was done on 825 people attending medical camps conducted by Sree Balaji Medical College & Hospital, in Anakaputhur area of Kancheepuram district. The data regarding Random Blood Sugar (RBS) level, blood pressure level, age, and gender were collected from the camp register (January and February, 2017). A random blood sugar (RBS) value of >200 mg/dl in a patient with classic symptoms of hyperglycaemia or hyperglycaemic crisis was defined as having diabetes. Blood pressure level equal to or greater than 140/90mm Hg was defined as having hypertension. Descriptive analysis and Chi square test was done to see the statistical association between various parameters. Results: Of the total study population of 825 people, 215 were males and 610 were females. The overall burden of diabetes and hypertension among the study population was 10.7% and 6.4% respectively. Co-existence of both diabetes and hypertension was seen in 5.7% of people. Conclusions: To reduce the disease burden due to diabetes and hypertension, primary prevention measures such as health education regarding adoption of healthy lifestyle should be instituted. Interventions such as screening and early initiation of treatment should also be made for controlling the diseases and preventing its complications. 

EFFECT OF MICROVASCULAR DECOMPRESSION IN TRIGEMINAL NEURALGIA PATIENTS WITH OR WITHOUT CONSTANT PAIN

Neurosurgery ◽  
2008 ◽  
Vol 63 (1) ◽  
pp. 93-100 ◽  
Author(s):  
Tiril Sandell ◽  
Per Kristian Eide
Keyword(s):  
Pain Relief ◽  
Trigeminal Neuralgia ◽  
Microvascular Decompression ◽  
Senior Author ◽  
Total Study Population ◽  
Significant Pain ◽  
Constant Pain ◽  
Study Population ◽  
First Time

ABSTRACT OBJECTIVE To study the effect of microvascular decompression (MVD) in trigeminal neuralgia (TN) patients with or without constant pain. METHODS The study includes all first-time MVDs for facial pain performed by the senior author (PKE) during the 6-year period from 1999 to 2005 in the Department of Neurosurgery at the National Hospital. At the time of follow-up, pain relief was assessed using a standard mail questionnaire; those patients still having residual pain were further examined in the outpatient clinic or interviewed by phone. RESULTS The total study population includes 135 patients who underwent initial MVDs (67% of MVDs for TN without constant pain and 33% of MVDs for TN with constant pain). At the time of follow-up, the response rate was 95%, which provided us with 128 patients. The median observation period was 38 months (range, 12–87 mo). For episodic pain, MVD caused complete (i.e., 100%) pain relief in 78% of TN patients without constant pain and in 77% of TN patients with constant pain before MVD, and a significant pain relief (i.e., worst pain marked as 0–3 cm on a 10-cm visual analog scale) in 85 and 81%, respectively. For constant pain, MVD caused complete pain relief in 70% of the TN patients with constant pain before MVD, and significant pain relief in 77%. CONCLUSION In TN patients with constant pain before MVD, significant relief of episodic and constant pain was observed in 81 and 77%, respectively. Hence, the presence of constant pain should not prevent TN patients from being offered MVD.

scholarly journals A virtual asthma clinic for children: fewer routine outpatient visits, same asthma control

2017 ◽  
Vol 50 (4) ◽  
pp. 1700471 ◽  
Author(s):  
Lara S. van den Wijngaart ◽  
Jolt Roukema ◽  
Annemie L.M. Boehmer ◽  
Marianne L. Brouwer ◽  
Cindy A.C. Hugen ◽  
...  
Keyword(s):  
Usual Care ◽  
Asthma Control ◽  
Outcome Measures ◽  
Hospital Admissions ◽  
Inhaled Corticosteroids ◽  
Controlled Trial ◽  
Asthma Control Test ◽  
Asthmatic Children ◽  
Outpatient Visits

eHealth is an appealing medium to improve healthcare and its value (in addition to standard care) has been assessed in previous studies. We aimed to assess whether an eHealth intervention could improve asthma control while reducing 50% of routine outpatient visits.In a multicentre, randomised controlled trial with a 16-month follow-up, asthmatic children (6–16 years) treated in eight Dutch hospitals were randomised to usual care (4-monthly outpatient visits) and online care using a virtual asthma clinic (VAC) (8-monthly outpatient visits with monthly web-based monitoring). Outcome measures were the number of symptom-free days in the last 4 weeks of the study, asthma control, forced expiratory volume in 1 s, exhaled nitric oxide fraction, asthma exacerbations, unscheduled outpatient visits, hospital admissions, daily dose of inhaled corticosteroids and courses of systemic corticosteroids.We included 210 children. After follow-up, symptom-free days differed statistically between the usual care and VAC groups (difference of 1.23 days, 95% CI 0.42–2.04; p=0.003) in favour of the VAC. In terms of asthma control, the Childhood Asthma Control Test improved more in the VAC group (difference of 1.17 points, 95% CI 0.09–2.25; p=0.03). No differences were found for other outcome measures.Routine outpatient visits can partly be replaced by monitoring asthmatic children via eHealth.

BCR Gene Breakpoint and Type of BCR/ABL-Transcript in Children with Chronic Myeloid Leukemia.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4863-4863
Author(s):  
Meinolf Suttorp ◽  
Susanne Viehmann ◽  
Alexander Claviez ◽  
Yvonne Martiniak ◽  
Jochen Harbott
Keyword(s):  
Chronic Myeloid Leukemia ◽  
Peripheral Blood ◽  
Myeloid Leukemia ◽  
Chronic Phase ◽  
Pediatric Leukemia ◽  
Total Study Population ◽  
Exon 2 ◽  
Study Population ◽  
The Impact

Abstract The hallmark of chronic myeloid leukemia (CML) is the reciprocal translocation t(9;22)(q34;q11) which creates a hybrid BCR/ABL gene that is transcribed into a chimeric mRNA. In the 8.5-kb mRNA either exon b2 or exon b3 of the major breakpoint cluster region (M-bcr) is coupled to C-ABL exon 2. These two junction variants (b2a2 or b3a2) differ in size by 75 nucleotides and can be selectively amplified by semi-nested PCR. A controversy exists whether or not the type of transcript and/or the breakpoint site exerts an influence on the clinical course of CML in adult patients (Mills KI 1991; Foiretos T 1993; Melo JV 1996). CML is a rare disease in childhood contributing only 2 – 3 % of all pediatric leukemia cases. This may be the reason why there are only scant data from small series of children with CML giving information on the transcript variant present at diagnosis. During an 11 year period (1995 – 2005) 203 pts younger than 19 years (median age: 11.4 yrs; 101 boys, 102 girls) with Philadelphia-chromosome positive CML were treated within the multicenter GPOH-trial “CML-paed”. 85% of the pts were diagnosed in chronic phase (CP). Treatment was performed by hydroxyurea +/− interferon and pts were scheduled for stem cell transplantation (SCT) from an HLA-matched family donor within 6 months after diagnosis and from an unrelated donor within 12 months. Bone marrow and/or peripheral blood specimen for molecular analysis were collected at diagnosis and during follow-up examinations at 3 – 6 months intervals. RT-PCR with analysis of the breakpoint and transcript type was performed in 154 pts (77.4 % of the total study population). 133 pts exhibited a Major-BCR rearrangement, 5 pts a minor-BCR rearrangement and in 16 pts both rearrangements were present. In pts with M-BCR either 55 pts expressed the b2a2 transcript (37 %) or the b3a2 transcript (37 %), respectively. Both types of transcripts were found either simultaneously or alternately during follow-up examinations in 38 pts (25 %). One pt showed an atypical rearrangement which is awaiting further classification. No statistical significant differences (p > 0.05) could be found with respect to hematological parameters at diagnosis (white cell count, platelets count, percentage of basophils in peripheral blood), clinical findings (liver size, spleen size) and disease status (CP versus advanced phase). The impact of either transcript upon the course of the disease (e.g. duration of chronic phase) was not analyzed because 70 % of the study population was transplanted early within 1 year after diagnosis. We conclude that in contrast to some reports in adults the type of BCR breakpoint seems to have no impact in pediatric pts with CML.

scholarly journals Abnormal Levels of Liver Enzymes and Hepatotoxicity in HIV-Positive, TB, and HIV/TB-Coinfected Patients on Treatment in Fako Division, Southwest Region of Cameroon

2020 ◽  
Vol 2020 ◽  
pp. 1-9 ◽  
Author(s):  
Jude Eteneneng Enoh ◽  
Frederick Nchang Cho ◽  
Faustin Pascal Manfo ◽  
Simon Eyongabane Ako ◽  
Eric Achidi Akum
Keyword(s):  
Risk Factors ◽  
Confidence Interval ◽  
Incidence Rate ◽  
Cumulative Incidence ◽  
Liver Enzymes ◽  
Hiv Positive ◽  
Total Study Population ◽  
Study Population ◽  
Hiv Aids

Hepatotoxicity is historically the 3rd most common reason for drug withdrawal and toxicity-related discontinuation of treatment. This study was aimed at determining the incidence and the onset of hepatotoxicity and at evaluating the relationship of some risk factors for hepatotoxicity among Human Immunodeficiency Virus- (HIV-) positive, tuberculosis (TB), and HIV/TB patients on treatment. This was a prospective follow-up study involving 125 participants from the HIV/AIDS and TB treatment centres in three hospitals in Fako Division of Cameroon. These TB and HIV patients were initiated on RHEZ (R = Rifampicin, H = Isoniazid, E = Ethambutol, and P = Pyrazinamide) and TELE (efavirenz/tenofovir/lamivudine), respectively, and followed up for 12 weeks between September 2018 and November 2019. The levels of liver enzymes (transaminases, gamma-glutamyltransferase, alkaline phosphatase, and unconjugated/total bilirubin) were measured spectrophotometrically using serum. The Chi-squared (χ2) test was used to assess the association between risk factors and hepatotoxicity, while the Kaplan-Meier survival analysis with the log-rank test was used to determine the occurrence of hepatotoxicity in the different groups. We followed the general study population for a total person time of 6580 person-days, with an incidence rate and cumulative incidence of 8 cases per 1000 person-days (53/6580 person-days) and 42.4% (53/125), respectively (95% confidence interval), recorded after 12 weeks of follow-up of all the participants. The onset of hepatotoxicity in the total study population was statistically significant (χ2=9.5334; p=0.022979; CI=95%), with the majority observed at week eight of follow-up. Also, the incidence rate and cumulative incidence of hepatotoxicity with respect to HIV/AIDS, TB, and HIV/TB patients, respectively, at 95% confidence interval were: 8 cases per 1000 person-days (32/3843 person-days) and 32/76 (42.1%), 6 cases per 1000 person-days (12/1932 person-days) and 12/32 (37.5%), and 11 cases per 1000 person-days (9/805 person-days) and 9/17 (52.9%). This study shows that the incidence rate and cumulative incidence of hepatotoxicity in HIV/AIDS, TB, and HIV/TB patients on treatment were high in Fako Division, Cameroon. Also, it is very important to check these patients’ liver function especially within the first 12 weeks of treatment.

Gene polymorphisms in VEGFA and COL2A1 are associated with response to inhaled corticosteroids in children with asthma

2019 ◽  
Vol 20 (13) ◽  
pp. 947-955 ◽  
Author(s):  
Zan Wan ◽  
Yongjun Tang ◽  
Qianqian Song ◽  
Jun Zhang ◽  
Wanying Xie ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Single Nucleotide Polymorphisms ◽  
Gene Polymorphisms ◽  
Inhaled Corticosteroids ◽  
Forced Expiratory Volume ◽  
Nucleotide Polymorphisms ◽  
Fractional Exhaled Nitric Oxide ◽  
Single Nucleotide ◽  
Asthmatic Children ◽  
Children With Asthma

Aim: The purpose of this study was to investigate the involvement of single-nucleotide polymorphisms in VEGFA, TBX21 and COL2A1 in the response to inhaled corticosteroids in asthmatic children. Subjects & methods: Children with mild-to-moderate asthma were enrolled in the study. The SEQUENOM MassARRAY method was used to sequence 27 SNP genotypes. By ranking the data from smallest to largest, we could infer whether the change in distribution of forced expiratory volume in one second/forced vital capcacity (FEV1/FVC) and fractional exhaled nitric oxide differed between genotype groups. Results: VEGFA rs3025039 T allele carriers had a smaller change in FEV1 than CC carriers (p = 0.040), and in COL2A1 rs3809324, the frequency of T allele carriers was lower than that of GG carriers (p = 0.048). rs3025039 was also associated with changes in FEV1/FVC (p = 0.016). Conclusion: VEGFA and COL2A1 polymorphisms are significantly associated with the response to inhaled corticosteroids in asthmatic children.

scholarly journals Total anti-SARS-CoV-2 antibodies measured 6 months after Pfizer-BioNTech COVID-19 vaccination in healthcare workers

2021 ◽  
Author(s):  
Giuseppe Lippi ◽  
Gian Luca Salvagno ◽  
Brandon Michael Henry ◽  
Laura Pighi ◽  
Simone De Nitto
Keyword(s):  
Healthcare Workers ◽  
Venous Blood ◽  
Vaccine Dose ◽  
Serum Levels ◽  
Gradual Decline ◽  
Post Vaccination ◽  
Median Serum ◽  
Study Population ◽  
Kinetics Of

Background: This study aimed at monitoring the kinetics of serum total anti-SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) antibodies in a cohort of healthcare workers after voluntary vaccination with Pfizer-BioNTech coronavirus disease 2019 (COVID-19).Methods: The study population consisted of 787 healthcare workers (mean age 44±12 years; 66% females), who received two 30 μg doses of Pfizer-BioNTech COVID-19 vaccine, 3 weeks apart. Venous blood was drawn before the first vaccine dose, immediately before the second vaccine dose, and then at 1, 3 and 6 months after the second vaccine dose. Serological testing employed the total anti-SARS-CoV-2 antibodies measurement with Roche Elecsys Anti-SARS-CoV-2 S chemiluminescent immunoassay.Results: The median serum levels of total anti-SARS-CoV-2 antibodies reached the peak (1762 KU/L) 1 month after the second vaccine dose, but tended to progressively decline at the 3-month (1086 KU/L) and 6-month (802 KU/L) follow-up points. Overall, the values after 3- and 6-months were 37% and 57% lower than the corresponding concentrations measured at the peak. No healthcare worker had total anti-SARS-CoV-2 antibodies below the method-dependent cut-off. The decline compared to the peak was more accentuated in baseline seropositive persons than in those who were baseline seronegative (74% vs. 52%) cohort. The 6-month post-vaccination anti-SARS-CoV-2 antibodies in subjects aged <65 years remained over 2-fold higher than that measured in those aged ≥65 years (813 vs. 343 KU/L). Conclusions: Gradual decline of total anti-SARS-CoV-2 antibodies occurred 6 months after Pfizer-BioNTech COVID-19 vaccination, though values remained higher than the method-dependent cut-off, with no case of seronegativization.

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