Urine Biomarkers Combined With Ultrasound for the Diagnosis of Obstruction in Pediatric Hydronephrosis

Introduction: To establish the efficacy of ultrasound (US) combined with urine biomarkers in differentiating patients who require surgical management from those who do not, avoiding invasive investigations.Materials and Methods: From February 2019 to February 2021, all pediatric patients who presented with hydronephrosis were selected for the study. All renal units (RU) were evaluated by US, and fresh frozen voided urine samples were collected at the time of inclusion. Hydronephrosis grade was evaluated by the Society for Fetal Urology (SFU) and an alternative grading system (AGS). Patients who had high-grade hydronephrosis on US were referred to renal scan (RS) or intervention, when there was an increase of dilatation in subsequent follow-up images. Fresh frozen urine from the control group with no history of renal diseases and no renal anomalies on US was collected. We compared differences of US parameters combined with urine biomarkers between surgically and non-surgically managed patients and between the groups of patients when they were stratified by different RS findings and analyzed whether urinary biomarkers give any additional value to US. Instead of the anterior–posterior diameter (APD), we used its ratio with mid-parenchymal thickness. The additional efficacy of biomarkers to US was calculated when the US component was derived to a cumulative APD/mid-parenchymal ratio.Results: Sixty-four patients with hydronephrosis were prospectively included in the study accounting for a total of 81 patient visits and 162 RUs evaluated. A control group of 26 patients was collected. The mean age at inclusion in the hydronephrosis group was 43.7(±45.5) months, and a mean age in a control group was 61.2(±41.3) months. The cumulative APD/mid-parenchymal ratio combined with urinary albumin, β2 microglobulin (β2-M), and urinary neutrophil gelatinase-associated lipocalcin may have a better performance in the prediction of surgical intervention than the cumulative APD/mid-parenchymal ratio alone (p = 0.1). The best performance to detect the increased tissue transit time and obstructive curve on RS was demonstrated by the β2-M creatinine ratio. An increased cumulative APD/mid-parenchymal ratio with biomarkers together had a fairly good sensitivity and specificity for detection of DRF < 40%.Conclusions: According to our data, the APD/mid-parenchymal ratio alone has good efficacy in prediction of surgery and abnormal RS findings especially when combined with urine biomarkers.

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Olfactory Dysfunction in β Thalassemia Major Patients Treated With Iron-Chelating Agents

Ear Nose & Throat Journal ◽

10.1177/0145561319840079 ◽

2019 ◽

Vol 98 (8) ◽

pp. NP125-NP130

Author(s):

Serhan Derin ◽

Selvet Erdogan ◽

Murat Sahan ◽

Mehmet Fatih Azik ◽

Hatice Derin ◽

...

Keyword(s):

Chelating Agents ◽

Thalassemia Major ◽

Olfactory Dysfunction ◽

Facial Trauma ◽

Control Group ◽

Control Groups ◽

History Of ◽

And Control ◽

Iron Chelating Agents

Ocular and ophthalmological adverse effects may be seen in β-thalassemia major (BTM) patients treated with regular blood transfusions and iron-chelating agents. We hypothesized that olfactory dysfunction may be present in this population. In this study, we aimed to investigate olfactory dysfunction in patients with BTM and determine the etiological factors. A total of 43 patients with BTM were included in the study. Forty-three patients without any nasal complaints, history of facial trauma, or nasal surgery were included as the controls. All participants had nasal endoscopy. The iron-chelating agents used, their duration of use, as well as hemoglobin and ferritin levels of the BTM patients were recorded. Sniffin’ Sticks test (SST) was used to assess olfactory functions, and BTM and control groups were compared for the results. The correlations of SST scores with the other study parameters were analyzed. Eight (18.6%) of 43 patients in the BTM group had hyposmia while none of the patients in the control group had hyposmia ( P < .001). Older age, low-hemoglobin level, and longer use of deferoxamine were found to be correlated with olfactory dysfunction. Olfactory dysfunction may be seen in BTM patients treated with iron-chelating agents. The results of this study suggest that screening for olfactory function may be needed in routine follow-up of BTM patients.

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Exploring the Neuropsychological Profile of a Clinically Referred Sample of Children in Mexico

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acz029.21 ◽

2019 ◽

Vol 34 (7) ◽

pp. 1254-1254

Author(s):

A Giudicessi ◽

V D Visconti ◽

A Zenit Aldana ◽

C Ibarra

Keyword(s):

Clinical Sample ◽

Control Group ◽

Master's Program ◽

Verbal Comprehension ◽

Clinically Referred ◽

Behavior Difficulties ◽

Neuropsychological Profile ◽

The Us ◽

History Of ◽

Perceptual Reasoning

Abstract Objective The Wechsler Scale of Intelligence for Children (WISC-IV) is one of the most commonly used intelligence tests for children. A Spanish version of the WISC-IV exists, but a limited amount of published information is available on its utility when assessing pediatric clinical populations. Furthermore, little published research utilizes the WISC-IV in Spanish speaking populations residing outside the US. This study seeks to present the neuropsychological profile of a clinically referred sample of children residing in Mexico. Participants and Method The present study included 35 participants (15 females and 20 males, M age of 9.26 years, SD = 1.69). Participants were referred to clinic sites affiliated with the neuropsychology master’s program at Benemérita Universidad Autónoma de Puebla (BUAP). Participants were referred for assessment due to persistent academic/behavior difficulties and were included in this study if they were between the ages of 7 and 12, with no history of a psychiatric disorder. All participants were administered the WISC-IV. Procedures were approved by the ethics committee at BUAP. Informed consent was obtained prior to evaluation. Results Descriptive statistics show a Full-Scale IQ average (FSIQ) mean of 75.40 (SD = 12.42). Highest index scores were on Perceptual Reasoning (PRI) (M = 84.94, SD = 16.22) and Processing Speed (PSI) (M = 81.34, SD = 12.96) and lowest index score were on working memory (WMI) (M = 76.97, SD = 14.64) and Verbal Comprehension (VCI) (M = 76.54, SD = 12.42). Independent T-Tests showed no significant differences between genders. Conclusions Our results show a low average IQ for the sample but also identifies strengths in certain indices and specific subtests within the WISC-IV that can add rich details in the comprehension of cognitive functioning in this sample. In the future, we plan to continue the growth of our study via the utilization of a control group to compare with the clinical sample.

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BCG In the treatment of recurrent. Genital condyloma accuminatum

Revista de Medicina ◽

10.11606/issn.1679-9836.v97i3p283-286 ◽

2018 ◽

Vol 97 (3) ◽

pp. 283-286

Author(s):

Chen Jen Shan ◽

Antonio Marmo Lucon ◽

Miguel Srougi

Keyword(s):

Control Group ◽

High Recurrence Rate ◽

Cure Rate ◽

Clinical Recurrence ◽

Collateral Effects ◽

Collateral Effect ◽

History Of ◽

Electro Coagulation ◽

And Control

Introduction: The Human Papilloma Virus (HPV) is the most prevalent sexually transmissible disease. The treatment of Condyloma Accuminatum is a great challenge because of the high recurrence rate and of the lack of any drug efficient in its elimination. Objective: To assess the efficacy of the treatment with Imuno BCG (Bacillus Calmette-Guérin) for bearers of condylomas recurrent for more than 2 years. Patients and Methods: Patients with age between 18 and 60 years, having a history of more than 2 years of genital warts, were included, attended as from 01-08-2011; bearers of serious diseases, immunodeficiency or users of immune-suppressors, being excluded. The procedure adopted began with a biopsy of the wart(s) with local anesthetic, followed by the electro-coagulation of all the warts and bases of the biopsies, a solution with 80 mg of Imuno BCG dissolved in 2 ml of saline solution 0.9% was applied to all the genital area, including the cauterized areas. The area was covered with plastic for 2 hours and afterwards washed with water. The local application of Imuno BCG was repeated for 8 consecutive weeks. At the end of the second month the cases were re-assessed. When there was clinical recurrence a new procedure with the same drug was undertaken, but with 3 weekly applications made by the patient himself for 8 weeks. Result: Sixteen patients completed 2-year follow-up. The cure rate was of 62.5%. Of the 10 patients cured, 6 (37.5%) used one series of Imuno BCG, 1 (6.25%) used 2 series, and 3 (18.75%) used 3 series. Of the 6 patients who were not cured, there was a reduction in the number of cauterizations from 5.5 times (over an average period of the disease of 51.6 months) to 2.4 cauterizations (over an average follow-up period of 52.3 months) after the use Imuno BCG. The collateral effects of the use of Imuno BCG were insignificant. Conclusion: Topical BCG is a good option for the treatment of recurrent condylomas, with minimal collateral effect. It may be used even on PPD-negative patients. However, this result must be confirmed with larger sample populations and control-group studies.

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Olfactory Dysfunction in β-Thalassemia Major Patients Treated with Iron-Chelating Agents

Ear Nose & Throat Journal ◽

10.1177/0145561317096010-1103 ◽

2017 ◽

Vol 96 (10-11) ◽

pp. E8-E12 ◽

Cited By ~ 1

Author(s):

Serhan Derin ◽

Selvet Erdogan ◽

Murat Sahan ◽

Mehmet Fatih Azik ◽

Hatice Derin ◽

...

Keyword(s):

Chelating Agents ◽

Thalassemia Major ◽

Olfactory Dysfunction ◽

Olfactory Function ◽

Facial Trauma ◽

Control Group ◽

History Of ◽

And Control ◽

Iron Chelating Agents

Ocular and ophthalmologic adverse effects may occur in patients with β-thalassemia major (BTM) treated regularly with blood transfusions and iron-chelating agents. We hypothesized that olfactory dysfunction may be present in this patient population. We aimed to investigate olfactory dysfunction in patients with BTM and to determine etiologic factors. A total of 43 patients with BTM were included in the study. Forty-three subjects without nasal complaints, history of facial trauma, or nasal surgery were included as the controls. All participants had nasal endoscopy. The use of iron-chelating agents by patients with BTM and their duration of use were recorded, as well as hemoglobin and ferritin levels. The Sniffin Sticks test (SST) was used to assess olfactory function, comparing results between the BTM and control groups. The correlations of SST scores with the other study parameters were analyzed. Eight (18.6%) of 43 patients in the BTM group and none of the subjects in the control group had hyposmia (p < 0.001). Older age, low hemoglobin level, and longer use of deferoxamine were found to be correlated with olfactory dysfunction. Olfactory dysfunction can occur in patients with BTM treated with iron-chelating agents. The results suggest that screening for olfactory function should be part of the routine follow-up of patients with BTM.

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Outcome of Kidney Transplantation in Patients with Antiphospholipid Antibodies: A Case Series

Blood ◽

10.1182/blood.v118.21.1230.1230 ◽

2011 ◽

Vol 118 (21) ◽

pp. 1230-1230

Author(s):

Karen A Breen ◽

Kaji Sritharan ◽

Jonathon Olsburgh ◽

Beverley J Hunt

Keyword(s):

Kidney Transplantation ◽

Antiphospholipid Antibodies ◽

Graft Failure ◽

Control Group ◽

Cardiolipin Antibodies ◽

Long Term Follow Up ◽

History Of ◽

Thrombotic Complications

Abstract Abstract 1230 Background: Thrombotic and obstetric complications occur in association with antiphospholipid antibodies (aPL), as do intrarenal vascular changes in primary and secondary APS. There are a limited number of studies reporting the outcome of patients with aPL receiving kidney allografts. Materials & Methods: A retrospective chart review of patients who underwent kidney transplantation in our institution between 2005 and 2010 (inclusive) was performed. Patients who had at least 1 positive aPL at the time of transplantation were identified, their demographic, immediate and long-term outcome details obtained including any aPL related complications (thrombotic episodes including intrarenal vascular complications). Comparison was made with a control group consisting of transplant recipients not known to have aPL, matched for age, sex, transplant type and year of transplant. Results: 884 patients underwent kidney transplantation between 2005 and 2010. 87 patients were screened for aPL(9.8%), 41 patients with aPL were identified(4.6%), 34 patients had a lupus anticoagulant, 1 had anti-cardiolipin antibodies and 6 both lupus anticoagulant and anti-cardiolipin antibodies. Long-term follow up was available for 31 patients. 25/31 patients were found to have persistent aPL (25/31 had repeated aPL screening). Patients included 17 males, 24 females, mean age 42 (range 19–61) years). 14 patients were known to have persistent aPL prior to transplantation and 5 of these were receiving long-term anticoagulation because of a history of thrombosis prior to renal transplant. 3 of the 27 patients not known to have persistent aPL prior to transplantation had a history of thrombosis prior to renal transplant; none of these were receiving long-term anticoagulation. 13 patients had aPL in association with other autoimmune disease (SLE). 30 patients had screening for other thrombophilic disorders performed. Other risk factors included hypercholesterolaemia, hypertension and cigarette smoking. The table below summarises short and long-term aPL related complications. 25 patients had a cadaveric transplant, 2 had live unrelated donor transplants and 14 had live-related donor kidney transplants. Immediate thrombotic complications in patients with aPL included 4 patients who had graft failure due to renal vessel thrombosis resulting in graft excision because of ischaemia of the transplanted organ and 2 had a lower limb DVT (receiving perioperative thromboprophylaxis with aspirin, n=6) compared to 1 patient in the control group who experienced a lower limb DVT(significantly higher in patients with aPL compared to controls p=0.03). Of the patients for whom long term follow up was available, long-term thrombotic complications were significantly higher in patients with aPL compared to controls (5/31 patients with aPL compared to 0/31 controls, p=0.02). Complications included fatal PE in 1 patient (on warfarin with subtherapeutic INR), bowel ischaemia secondary to mesenteric artery occlusion in another (on aspirin), and 1 patient had graft failure 9 months following transplant due to thrombotic microangiopathy (commenced on warfarin 6 months post transplant due to persistent aPL). Renal artery stenosis occurred in 2 patients (both receiving aspirin). Conclusions: There is a high risk of thrombotic complications in patients with aPL who are undergoing renal allograft. These patients should be considered for perioperative and longterm thromboprophylaxis. Disclosures: No relevant conflicts of interest to declare.

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Short-term skin problems in infants aged 0–3 months affect food allergies or atopic dermatitis until 2 years of age, among infants of the general population

Allergy Asthma & Clinical Immunology ◽

10.1186/s13223-019-0385-7 ◽

2019 ◽

Vol 15 (1) ◽

Cited By ~ 1

Author(s):

Kaori Yonezawa ◽

Megumi Haruna

Keyword(s):

Atopic Dermatitis ◽

Family History ◽

Food Allergies ◽

Control Group ◽

Short Term ◽

Skin Problem ◽

Significant Difference ◽

History Of

Abstract Background This study examined whether infants aged 0–3 months exhibited long-term effects of using a moisturizer skincare intervention and whether a short-term skin problem resulted in the subsequent development of food allergies or atopic dermatitis (AD) until the age of 2 years. Methods This study was a follow-up of a completed randomized control trial (RCT) of moisturizer skincare for infants aged 0–3 months. A self-reported questionnaire was mailed to the parents of children aged 1–2 years who had participated in the RCT. Data were analyzed using a Chi square test, by intention to treat analysis, and by multiple logistic regression. Results Of 155 infants, 22 (14.2%) and 28 (18.1%) had food allergies and AD/eczema until 2 years of age, respectively. No significant difference was seen in food allergies or AD between the group that received moisturizer skincare intervention and the control group. On the contrary, food allergies until 2 years of age were significantly associated with short-term (4–7 days) and long-term (more than 7 days) body skin problems occurring in the first 3 months of life, a family history of AD, and the time of starting complementary food. High value of face transepidermal water loss at 3 months of age was also associated with food allergies. Moreover, a short duration of severe diaper dermatitis during the first 3 months, a family history of AD, and being male were significantly associated with AD/eczema until the age of 2 years. Conclusions After adjusting for family history of AD, a short-term skin problem in the first 3 months of life was significantly associated with the development of food allergies or AD/eczema until the age of 2 years. Prevention or prompt treatment of skin problems in newborns is essential for preventing future allergic diseases. Trial registration This was a follow-up study conducted 2 years after the completed RCT of a moisturizer skincare intervention for early infants, which was registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN000013260)

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Evaluation of the increased risk of spine fracture in patients with mood disorder compared with matched controls: a longitudinal follow-up study using a national sample cohort in Korea

BMJ Open ◽

10.1136/bmjopen-2018-027581 ◽

2019 ◽

Vol 9 (11) ◽

pp. e027581

Author(s):

So Young Kim ◽

Chanyang Min ◽

Bumjung Park ◽

Miyoung Kim ◽

Hyo Geun Choi

Keyword(s):

Mood Disorder ◽

National Sample ◽

Spine Fracture ◽

Secondary Outcome ◽

Control Group ◽

Follow Up Study ◽

Increased Risk ◽

History Of ◽

Age And Sex

ObjectiveTo evaluate the risk of spine fracture in patients with mood disorder using a nationwide cohort.DesignA longitudinal follow-up study.SettingClaims data for the population ≥20 years of age were collected from 2002 to 2013 for the Korean National Health Insurance Service-National Sample Cohort.ParticipantsA total of 60 140 individuals with mood disorder were matched with 240 560 individuals (control group) for age, sex, income, region of residence and osteoporosis.InterventionsIn both the mood disorder and control groups, the history of spine fracture was evaluated. The International Classification of Diseases 10th Revision codes for mood disorder (F31–F39) and spine fracture (S220 and S320) were included.Primary and secondary outcome measuresThe univariable and multivariable HRs and 95% CIs of spine fracture for patients with mood disorder were analysed using a stratified Cox proportional hazards model. Subgroup analyses were conducted according to the history of osteoporosis, age and sex.ResultsApproximately 3.3% (2011/60 140) of patients in the mood disorder group and 2.8% (6795/240 560) of individuals in the control group had spine fracture (p<0.001). The mood disorder group demonstrated a higher adjusted HR for spine fracture than the control group (multivariable HR=1.10, 95% CI 1.04 to 1.15, p<0.001). The participants without osteoporosis showed a higher HR of mood disorder for spine fracture than the control participants (multivariable HR=1.25, 95% CI 1.14 to 1.37, p<0.001). According to age and sex, this result was consistent in subgroups of women aged 20–39 and 40–59 years and men aged ≥60 years.ConclusionThe risk of spine fracture was increased in patients with mood disorder. The potential risk of spine fracture needs to be evaluated when managing patients with mood disorder.

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OP0219 THE ASSOCIATION OF PSORIATIC ARTHRITIS WITH ALL-CAUSE MORTALITY AND LEADING CAUSES OF DEATH IN PSORIATIC ARTHRITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.1895 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 131.1-131

Author(s):

A. Haddad ◽

W. Saliba ◽

I. Lavi ◽

A. Batheesh ◽

S. Kasem ◽

...

Keyword(s):

Heart Disease ◽

Ischemic Heart Disease ◽

Causes Of Death ◽

Ischemic Heart ◽

Control Group ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

All Cause Mortality ◽

History Of

Background:Data on the association between PsA and mortality remains conflicting as it has been hampered by small sample size with few events and the potential for confounders of selection and severity biases from clinic-based studies.Objectives:To examine the association between PsA and all-cause mortality in a cohort of PsA patients and matched controls, using data from a population-based large medical record database.Methods:Patients with newly diagnosis of PsA between January 1st, 2003 and December 31st, 2018 from the Clalit Health database were identified. 4 controls without PsA were selected and matched to cases of PsA by age (within 1 year), sex, ethnicity (Jewish vs. non-Jewish), and index date. The two groups were followed from the index date until the first occurrence of death from any cause or end of follow-up (June 30, 2019). Data on mortality and on the immediate cause of death was based on the Notification of Death form legally required by the Israeli Ministry of the Interior for every deceased person in the country. Demographic data including age, sex, ethnicity (Jewish or Arab), and socioeconomic status (SES) at inception were retrieved from the CHS database. Data regarding tobacco use (ever), obesity, body mass index, diabetes mellitus, hyperlipidemia, hypertension, ischemic heart disease, prior cerebrovascular accident, congestive heart failure, chronic renal failure, chronic obstructive pulmonary disease, cirrhosis, prior malignancy, psoriasis, and the concomitant use of glucocorticosteroids, conventional and biologic disease-modifying anti-rheumatic drugs (cDMARDs and bDMARDs, respectively) were extracted from the database.We estimated the attributable fraction of the various causes of death in PsA patients and compared it to the proportionate mortality rate (PMR) of the leading causes of death in Israel during 2014-2016 based on a recently published report by the Central Bureau of Statistics. Cox proportional hazard regression models were used to estimate the crude and the multivariate adjusted hazard ratio (HR) for the association between PsA and all-cause mortality, as well as for factors associated with mortality within the PsA group.Results:A total of 5275 PsA patients were identified between 2003 and 2018 and where matched to 21,011 controls based on age, sex, and ethnicity. The mean age was 51.7 ± 15.4 years of whom 53% were females. More individuals in the PsA group were smokers, obese, with diabetes, hypertension, and dyslipidemia, as well as with a history of ischemic heart disease, cerebrovascular disease, congestive heart failure, chronic obstructive pulmonary disease, chronic renal failure and cirrhosis than patients in the control group, and 38.2% of PsA patients were on b-DMARDS. Overall 471 (8.9%) patients died in the PsA group compared to 1,668 (7.9%) in the control group during a mean follow-up of 7.2 ± 4.4 years. The crude HR for the association of PsA and all-cause mortality was 1.16 (95% CI, 1.042-1.29). However, the association was not significant on multivariate analysis with HR of 1.096 (95% CI, 0.977-1.229).In PsA patients, malignancy was the leading cause of death, constituting 26% of all deaths, followed by ischemic heart disease 15.8%, diabetes 6.2%, cerebrovascular diseases 5.5% and septicemia 5.5%, in keeping with the order of the leading causes of death in the general population of Israel during 2014-2016 as recently reported by the Central Bureau of Statistics.On multivariate model Cox regression analysis, male sex, increased body mass index, increased Charlson comorbidity index scores and history of hospitalization in a year prior to death were associated with higher mortality, whereas treatment bDMARDs and cDMARDs were associated with a lower relative risk of death.Conclusion:No clinically relevant increase in mortality rate was observed in PsA patients from the period 2003-2018. The most common causes of specific proportionate mortality rates in our cohort were similar to those in the general population.Disclosure of Interests:None declared

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Dementia Risk among Coronavirus Disease Survivors: A Nationwide Cohort Study in South Korea

Journal of Personalized Medicine ◽

10.3390/jpm11101015 ◽

2021 ◽

Vol 11 (10) ◽

pp. 1015

Author(s):

Hye-Yoon Park ◽

In-Ae Song ◽

Tak-Kyu Oh

Keyword(s):

Cohort Study ◽

Health Insurance ◽

South Korea ◽

Cox Regression ◽

Control Group ◽

Dementia Diagnosis ◽

Dementia Risk ◽

History Of ◽

New Onset

We aimed to investigate whether coronavirus disease (COVID-19) survivors were at a higher risk of dementia diagnosis compared to controls at 6 months follow-up. Data pertaining to the period between 1 January and 4 June 2020, were extracted from the National Health Insurance Service (NHIS)-COVID-19 database in South Korea. Data on adults (≥20 years old) with no history of dementia, obtained from the NHIS-COVID-19 database, were included in the study. The endpoint of this study was the development of dementia, which was evaluated from 1 January to 1 December 2020. A total of 306,577 adults were included in the analysis, comprising 7133 COVID-19 survivors and 299,444 individuals in the control group. Among the subjects, new-onset dementia diagnosed in 2020 was recorded in 1.2% (3546 of 306,577). In the covariate-adjusted multivariable Cox regression model, the incidence of dementia among COVID-19 survivors was 1.39-fold higher (hazard ratio: 1.39, 95% confidence interval: 1.05–1.85; p = 0.023) than that in the control group. At approximately 6 months of follow-up, COVID-19 survivors were at a higher risk of dementia compared to other populations in South Korea.

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A Multicentre Preliminary Study of the Effect of Recombinant Human Interferon α1b Treatment of Infants Hospitalized with Lower Respiratory Tract Infection on Subsequent Wheezing

10.21203/rs.3.rs-56752/v1 ◽

2020 ◽

Author(s):

Lihua Yang ◽

Guocheng Zhang ◽

Chengxiu Wang ◽

Yuanbin Shi ◽

Xiaoling Ren ◽

...

Keyword(s):

Logistic Regression ◽

Family History ◽

Respiratory Tract ◽

Family Environment ◽

Lower Respiratory Tract ◽

Human Interferon ◽

Control Group ◽

History Of ◽

Tract Infections

Abstract Background: To investigate the impact of recombinant human interferon α1b (rhIFNα1b) treatment of infants hospitalized with lower respiratory tract infections on subsequent wheezing.Methods: The clinical data of infants in 19 hospitals with viral pneumonia, wheezy bronchitis, or bronchiolitis were retrospectively reviewed from June 2009 to June 2015 (age, gender, diagnosis, the use of rhIFNα1b when in hospital). Age at follow-up, birth weight, gestation age, childhood and family history of allergy, feeding history, family environment, and the number of wheezing episodes within the last year were obtained by telephone and questionnaires. Based on the use of rhIFNα1b in hospital, the subjects were divided into two groups: the rhIFNα1b treatment group (253 cases) and the control group (287 cases). A comparison was made between the two groups in terms of wheezing episodes within the last year. Based on the number of wheezing episodes within the last year, the subjects were divided into two groups, the wheezing group (95 cases) and the non-wheezing group (445 cases). Comparisons were made between the 2 groups in terms of age, diagnosis, the use of rhIFNα1b in hospital, gender, age at follow-up, birth weight, gestation age, childhood and family history of allergy, feeding history, and family environment. If the result of single factor comparison showed that P was <0.05, the indicators were analysed by binary logistic regression. The receiver operator characteristic (ROC) curve was drawn to evaluate the prediction ability of logistic regression models.Results: (1) Of a total of 813 cases for which follow-up data were available, 273 cases were excluded because of incomplete questionnaires, a dosage of rhIFN a1 b < 1 ug/kg.d or a treatment duration < 3 days, a date in hospital beyond the scope of the follow-up, or because the patient’s age when in hospital was > 3 years old. Finally, 540 patients were included in the analysis.(2) A total of 95 (17.6%) out of 540 cases had experienced wheezing episodes within the last year; 35 (13.8%) out of 253 cases that were treated with rhIFN a1 b and 60 cases (20.9%) out of 287 cases without rhIFN a1 b treatment had wheezing episodes within the last year. The difference in wheezing episodes within the last year between the rhIFNα1b treatment group and the control group was statistically significant (P=0.031). (3)The result of single factor regression indicated that the differences between the two groups of wheezing and non-wheezing in terms of age, the use of rhIFNα1b in hospital, a childhood and family history of allergy, housing situation, and feeding history were all statistically significant (all P<0.05). The result of binary logistic regression showed that a childhood history of allergy (OR=2.14, P=0.004), no use of rhIFNα1b therapy (OR=1.70, P=0.028) and living in a crowded house (OR=1.92, P=0.012) were risk factors of subsequent wheezing. Breastfeeding (OR=0.44, P=0.008) and an age of £1year old at the time of hospitalization (OR=0.58, P=0.024) were protective factors. The area under the ROC curve was 0.68, P=0.00, which indicated that the regression model had greater than medium diagnostic accuracy. Conclusions: Early use of rhIFNα1b treatment for infants hospitalized with lower respiratory tract infections and breastfeeding could prevent subsequent wheezing. An atopic constitution and living in a crowded house could promote subsequent wheezing.

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