scholarly journals Sputum Induction in Children and Adolescents with Problematic Severe Asthma: Success Rate, Safety and Tolerability

2015 ◽  
Vol 8 (1) ◽  
pp. 7-13
Author(s):  
Cristiane de Abreu T. Ricci ◽  
Laura Maria de Lima B. F. Lasmar ◽  
Paulo M. Pitrez ◽  
Raimundo F. Mascarenhas ◽  
Paulo A. M. Camargos

Background: In problematic severe asthma (PSA), inflammatory phenotypes can by identified by assessing cellularity in induced sputum (IS) samples. However, there have been few studies employing sputum induction (SI) in pediatric patients. Objectives: To assess the success rate, safety and tolerability of SI, as well as IS sample cellularity, in pediatric PSA patients. Methods: We conducted a cross-sectional study involving 44 pediatric PSA patients. We collected IS samples using inhalations of nebulized saline solution. On the basis of the post-bronchodilator forced expiratory volume in one second (FEV1, % of predicted), we administered nebulization with 4.5% hypertonic saline (for patients with an FEV1 ≥ 60%) or 0.9% isotonic saline (for those with an FEV1 < 60%). We classified IS samples as satisfactory if there was ≤ 20% squamous cell contamination and cell viability was > 50%. Results: The observed success rate was 75% (95% CI: 60-86). Most of the patients provided satisfactory samples, although multiple SI sessions were required in some cases (27%). In comparison with the IS samples containing > 20% squamous cells, those containing ≤ 20% showed significantly more neutrophils (P = 0.02) and eosinophils (P = 0.03). The most common adverse events were mild wheezing (in 14%) and salty taste (in 9%). In 8% of the sessions, there was a ≥ 20% decrease in FEV1. Conclusion: In our sample of pediatric patients with PSA, sputum induction was safe and generally well tolerated, suggesting that it could be useful in the assessment of inflammatory processes in such patients.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bingqing Shi ◽  
Wei Li ◽  
Hongna Dong ◽  
Mengting Xu ◽  
Yuqiu Hao ◽  
...  

Abstract Background The inflammatory phenotypes of asthma predict the treatment response and prognosis. The phenotype distributions differ depending on the geographical region. This study aimed to assess the distribution of different inflammatory phenotypes among asthma patients in Jilin Province, China. Methods A total of 255 patients with asthma were recruited from Jilin Province, China for this cross-sectional study. Each patient underwent sputum induction following clinical assessment and peripheral blood collection. Inflammatory phenotypes were classified according to the inflammatory cell counts in the sputum. Results Paucigranulocytic asthma (PGA) was the most common inflammatory phenotype (52.2%), followed by eosinophilic asthma (EA, 38.3%), mixed granulocytic asthma (MGA, 5.2%), and neutrophilic asthma (NA, 4.3%). NA was more common among patients over 45 years old and those who were treated with higher doses of inhaled corticosteroids (ICS), but was less common following antibiotics treatment (p < 0.05). The proportion of patients with EA decreased as the ICS treatment dose and time increased (p = 0.038). Patients with uncontrolled asthma had higher numbers of sputum eosinophils and neutrophils (p < 0.05). Patients with severe asthma had a higher percentage of sputum neutrophils (p < 0.05). A greater proportion of patients with NA had severe asthma (60%) compared to those with EA (18.2%) (p = 0.016). Conclusions The most common asthma inflammatory cell phenotype in Jilin Province, China is PGA, followed by EA, MGA, and NA. The low prevalence of NA in Jilin Province compared to other countries and also other regions in China might be due to excessive antibiotic use and irregular ICS treatment in this region.


2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Zaher Nazzal ◽  
Deema Odeh ◽  
Fatima Azahraa Haddad ◽  
Mohammad Berawi ◽  
Belal Rahhal ◽  
...  

Background. Waterpipe smoking in young individuals is increasing with limited studies addressing its respiratory health effects. The aim of the study was to determine the effect of waterpipe smoking on young adults’ lung functions. Spirometric parameters were compared between waterpipe smokers and nonsmokers. Methods. A comparative cross-sectional study of university students, including males and females, was conducted. An interviewer-administered questionnaire was used to record students’ characteristics. The spirometry test was performed to assess students’ lung functions; we recorded the forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, peak expiratory flow (PEF), and forced expiratory flow between 25 and 75% of FVC (FEF25–75%). Results. A total of 300 apparently healthy students (150 waterpipe smokers and 150 nonsmokers) were included in the study. Waterpipe smokers showed significantly lower values in FEV1, FEV1/FVC ratio, PEF, and FEF25–75% compared to the nonsmoker group (P<0.05 to P<0.001). The subgroup analysis on female students (50 WP smokers and 50 nonsmokers) showed a significant decrease in FEV1/FVC ratio, PEF, and FEF25–75% parameters (P<0.001). Conclusion. Waterpipe smoking is associated with reduced spirometric parameters in healthy young adults with relatively limited smoking years.


2021 ◽  
Vol 70 ◽  
pp. 102829
Author(s):  
Mohammad Al- zubi ◽  
Ammar Al Sleibi ◽  
Basel Mazen Elayan ◽  
Subhi Zahi Al-issawi ◽  
Morad Bani-hani ◽  
...  

2013 ◽  
Vol 17 (9) ◽  
pp. 2081-2086 ◽  
Author(s):  
Tze Pin Ng ◽  
Mathew Niti ◽  
Keng Bee Yap ◽  
Wan Cheng Tan

AbstractObjectiveA limited but growing body of evidence supports a significant role of antioxidant and anti-inflammatory micronutrients in pulmonary health. We investigated the associations of dietary and supplemental intakes of vitamins A, C, E and D, Se and n-3 PUFA with pulmonary function in a population-based study.DesignPopulation-based, cross-sectional study and data analysis of fruits and vegetables, dairy products and fish, vitamins A, C, E and D, Se and n-3 PUFA supplemental intakes, pulmonary risk factors and spirometry.SubjectsChinese older adults (n 2478) aged 55 years and above in the Singapore Longitudinal Ageing Studies.ResultsIn multiple regression models that controlled simultaneously for gender, age, height, smoking, occupational exposure and history of asthma/chronic obstructive pulmonary disease, BMI, physical activity, and in the presence of other nutrient variables, daily supplementary vitamins A/C/E (b = 0·044, se = 0·022, P = 0·04), dietary fish intake at least thrice weekly (b = 0·058, se = 0·016, P < 0·0001) and daily supplementary n-3 PUFA (b = 0·068, se = 0·032, P = 0·034) were individually associated with forced expiratory volume in the first second. Supplemental n-3 PUFA was also positively associated with forced vital capacity (b = 0·091, se = 0·045, P = 0·045). No significant association with daily dairy product intake, vitamin D or Se supplements was observed.ConclusionsThe findings support the roles of antioxidant vitamins and n-3 PUFA in the pulmonary health of older persons.


2018 ◽  
Vol 2018 ◽  
pp. 1-14 ◽  
Author(s):  
Zhiqiang Pang ◽  
Guoqiang Wang ◽  
Cuizhu Wang ◽  
Weijie Zhang ◽  
Jinping Liu ◽  
...  

Background and Objective. Asthma as a chronic heterogeneous disease seriously affects the quality of life. Incorrect identification for its clinical phenotypes lead to a huge waste of medical resources. Metabolomic technique as a novel approach to explore the pathogenesis of diseases have not been used to study asthma based on their clear defined inflammatory phenotypes. This study is aimed to distinguish the divergent metabolic profile in different asthma phenotypes and clarify the pathogenesis of them.Methods. Participants including eosinophilic asthmatics (EA, n=13), noneosinophilic asthmatics (NEA, n=16), and healthy controls (HC, n=15) were enrolled. A global profile of untargeted serum metabolomics was identified with Ultra Performance Liquid Chromatography–Mass Spectrometry technique.Results. Multivariate analysis was performed and showed a clear distinction between EA, NEA, and HC. A total of 18 different metabolites were recognized between the three groups based on OPLS-DA model and involved in 10 perturbed metabolic pathways. Glycerophospholipid metabolism, retinol metabolism, and sphingolipid metabolism were identified as the most significant changed three pathways (impact > 0.1 and -log(P) > 4) between the phenotypes.Conclusions. We showed that the different inflammatory phenotypes of asthma involve the immune regulation, energy, and nutrients metabolism. The clarified metabolic profile contributes to understanding the pathophysiology of asthma phenotypes and optimizing the therapeutic strategy against asthma heterogeneity.


2020 ◽  
Vol 58 (232) ◽  
Author(s):  
Meenakshi Basnet ◽  
Bibek Ghimire ◽  
Akriti Shrestha ◽  
Gyan Raj Aryal

Introduction: Epistaxis is a common medical emergency with 5% to 15% of patients admitted for epistaxis will require surgical management as nasal packing has high failure rates. A modern endoscopic technique like Endoscopic Sphenopalatine Artery Ligation has increased in popularity for managing intractable posterior epistaxis. It has less complication and a high success rate. The study conducted to estimate the success rate of Endoscopic Sphenopalatine Artery Ligation of refractory posterior epistaxis among admitted patients in a tertiary care hospital. Methods: This is a descriptive cross-sectional study conducted from June 2019 to June 2020 at the Department of Otorhinolaryngology, Nobel Medical College and Teaching Hospital among the patient with refractory posterior epistaxis with the help of retrospective data. A convenient sampling method was used. These patients underwent endoscopic sphenopalatine artery cauterization for recurrent/intractable posterior epistaxis. Ethical clearance was taken from the Institutional Review Board. Data were analyzed in Statistical Package for the Social Sciences. Results: Out of the total patient with refractory posterior epistaxis who underwent Endoscopic Sphenopalatine Artery Ligation, the overall success rate was 39 (95.12%). Among them, 25 (60.97%) males and 16 (39.02%) females underwent endoscopic sphenopalatine artery ligation. Twenty (48.78%) of them were unilateral whilst 21 (51.21%) were bilateral disease. About 2 (4.8%) cases had re-bleeding within 48 hours which was managed conservatively. Hypertension was found to be the most common comorbid condition followed by diabetes, chronic kidney. Conclusions: From our study, we conclude that the success rate for Endoscopic Sphenopalatine Artery Ligation in a patient with refractory posterior epistaxis was high.


Author(s):  
Gurmeet Kaur ◽  
Sandeep Kaur ◽  
Geetika Gupta ◽  
Rajneet Kaur

Background: Obesity has long been recognized to have significant effect on respiratory functions. Many studies have reported exponential decrease in pulmonary function test (PFT) with increasing body mass index (BMI), which is a crude indicator of obesity. Also, the relationship between BMI and PFTs varies with age, race, geographical region and the different obesity standards used. To the best of our knowledge, not many studies have been done to examine the relationship between obesity and lung volumes among adults in our region, Jammu. This cross-sectional study was carried out with the objective of evaluating the effect of obesity on lung function test in obese but otherwise healthy adults of Jammu region.Methods: This cross-sectional study was conducted in Jammu region on subjects selected randomly from different colleges in the age group of 18-40 years. The study involved 300 subjects; divided into three groups of 100 each, based on BMI into normal, overweight and obese groups. Four respiratory parameters viz. FVC (Forced Vital Capacity), FEV1 (Forced Expiratory Volume in 1 second), FEV3 (Forced Expiratory Volume in 3 seconds), and MVV (Maximum Voluntary Ventilation) were used to assess their lung functions.Results: All the respiratory parameters exhibited statistically significant decrease in obese groups as compared to normal and overweight groups.Conclusions: The present study suggests that obesity alters the respiratory physiology by producing a restrictive ventilatory pattern.


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