Association of sinusitis and upper respiratory tract diseases with incident rheumatoid arthritis: A case-control study

Objective We aimed to determine whether specific respiratory tract diseases are associated with increased rheumatoid arthritis (RA) risk. Methods This case-control study within the Mass General Brigham Biobank matched newly diagnosed RA cases to three controls on age, sex, and electronic health record history. We identified RA using a validated algorithm and confirmed by medical record review. Respiratory tract disease exposure required one inpatient or two outpatient codes at least two years before index date of RA clinical diagnosis or matched date. Logistic regression models calculated odds ratios (OR) for RA with 95% confidence intervals (CI), adjusting for confounders. We then stratified by serostatus ("seropositive" was positive rheumatoid factor and/or anti-citrullinated protein antibodies) and smoking. Results We identified 741 RA cases and 2,223 controls (both median age 55, 76% female). Acute sinusitis (OR 1.61, 95% CI:1.05,2.45), chronic sinusitis (OR 2.16, 95% CI:1.39,3.35), and asthma (OR 1.39, 95% CI:1.03,1.87) were associated with increased risk of RA. Acute respiratory tract disease burden during the pre-index exposure period was also associated with increased RA risk (OR 1.30 per 10 codes, 95% CI:1.08,1.55). Acute pharyngitis was associated with seronegative (OR 1.68, 95% CI:1.02,2.74) but not seropositive RA; chronic rhinitis/pharyngitis was associated with seropositive (OR 2.46, 95% CI:1.01,5.99) but not seronegative RA. Respiratory tract diseases tended towards higher associations in smokers, especially >10 packyears (OR 1.52, 95% CI:1.02,2.27; p=0.10 for interaction). Conclusion Acute/chronic sinusitis and pharyngitis and acute respiratory burden increased RA risk. The mucosal paradigm of RA pathogenesis may involve the upper respiratory tract.

Bronchus-Associated Lymphoid Tissue (BALT) Histology and Its Role in Various Pathologies

The lower respiratory tract is in direct communication with the external environment for gas exchange to occur. Therefore, it is constantly exposed to allergens, antigens, bacteria, viruses, and a wide variety of airborne foreign bodies. Bronchus-associated lymphoid tissue (BALT), which develops in response to these exposures and is one of the most prominent representatives of mucosa-associated lymphoid tissue (MALT), is important for generating rapid and specific bronchopulmonary adaptive immune responses. Therefore, this chapter focuses on the lymphoid architecture of BALT, which was first discovered in the bronchial wall of rabbits, its inducible form called inducible BALT (iBALT), its immunological response mechanisms, and its roles in certain pathologies including infectious and autoimmune diseases as well as in allergic and malignant conditions. In conclusion, it is hypothesized that BALT plays an important role in maintaining health and in the development of lower respiratory tract diseases; thanks to the pulmonary immune system in which it functions as a functional lymphoid tissue.

Self Medication Prevalence in Child’s who Consult for Respiratory Tract Diseases and Acute Diarrheal Disease to Clínica Universidad de la Sabana

Objetivo: Establecer la prevalencia de automedicación en niños de 0 a 15 años que consultan a un servicio de pediatría y explorar posibles factores de riesgo. Metodología: Estudio de corte transversal. Se incluyeron pacientes pediátricos con enfermedad respiratoria o enfermedad diarreica aguda. Se aplicó un instrumento para recolectar la información. Se exploraron posibles factores de riesgo asociadas con la automedicación. Se estimó, como medida de efecto, OR con su intervalo de confianza. Se estableció el valor de significancia estadística con un valor de p< 0,05. Resultados: Se incluyeron 300 menores. Se encontró una prevalencia de automedicación del 46%. Los medicamentos más usados fueron el acetaminofén (78%) y el ibuprofeno (15%). El 75% consideran que la automedicación es perjudicial para la salud. Se encontró posible asociación para la automedicación con el antecedente de previo de automedicación y la edad del niño. Conclusiones: La prevalencia de automedicación es alta y similar a la encontrada en la literatura. Los posibles factores de riesgo son la experiencia previa de automedicación y la edad del niño. Desde la atención primaria es adecuado realizar campañas educativas a la población de los riesgos de la automedicación.

ADHATODA VASICA (VASAPATRA): A REVIEW BASED UPON ITS MEDICINAL PROPERTIES

Adhatoda vasica (L.) Nees is also known as Justicia adhatoda L. belongs to the family Acanthaceae and is considered the most significant plant in the world. It is commonly known as Vasaka, Vasica, Adosa, Malbur nut and is distributed in various regions of India and throughout the world. It is a well-known plant in Ayurveda and Unani medicinal system. This plant has been used in the indigenous medicinal system of India for more than 2000 years. The plant has great medicinal importance and is used to treat various diseases and disorders mainly respiratory tract diseases like cough, symptoms of common cold, asthma, tuberculosis and chronic bronchitis. All the parts of the plant are used in medicines. Vasicine is the main chemical constituent present in this plant which possesses various medicinal properties and is used in different Ayurveda formulations. Also, it contains various reported pharmacological properties like antispasmodic, sedative, expectorant, antitussive, oxytocic, antibacterial, anti-diabetic, wound healing, abortifacient, antiasthma and anti-pyorrhea.

Intranasal Vaccine Delivery Technology for Respiratory Tract Disease Application with a Special Emphasis on Pneumococcal Disease

This mini-review will cover recent trends in intranasal (IN) vaccine delivery as it relates to applications for respiratory tract diseases. The logic and rationale for IN vaccine delivery will be compared to methods and applications accompanying this particular administration route. In addition, we will focus extended discussion on the potential role of IN vaccination in the context of respiratory tract diseases, with a special emphasis on pneumococcal disease. Here, elements of this disease, including its prevalence and impact upon the elderly population, will be viewed from the standpoint of improving health outcomes through vaccine design and delivery technology and how IN administration can play a role in such efforts.

Efficiency of elimination-irrigation therapy in children with allergic rhinitis and recurrent respiratory

Introduction. Despite new diagnostic methods contributing to an understanding of the etiopathogenesis of acute respiratory tract diseases and a variety of drugs for effective therapy, respiratory tract diseases continue to stand first in the overall morbidity profile in both children and adults. Frequently ill children are most susceptible to diseases, especially at the age of 3 to 6 years old, which accounts for up to 75% of all acute respiratory infection cases and shows no positive response to the medical-preventive activities. The article discusses the relationship between allergic rhinitis and recurrent respiratory diseases.Materials and methods. The possibility and effectiveness of complex treatment of allergic rhinitis in 65 frequently ill children aged 3 to 12 years are considered. The main group consisted of 35 children who were included in the traditional anti-allergic therapy with an isotonic solution of sea salt in an age-related dose for 10 days. The comparison group consisted of 30 children who received only traditional anti-allergic therapy, which was comparable in the compared groups. Patients underwent in-depth clinical and specific allergological examinations, as well as assessment of atopic response parameters of mucosal immunity, including determination of eosinophil levels, side, and Il-4 concentrations in nasal secretions.Results. Thus, the 12-month follow-up control over children with AR showed that the annual frequency of ARIs in the treatment group decreased by 1.4 times and, when averaged, was 5.2 cases, while in the comparison group it was 7.3 cases p < 0.05.Conclusions. In children with recurrent respiratory diseases, suffering from allergic rhinitis, the complex anti-allergic therapy, with the inclusion of elimination and irrigation therapy with a preparation based on isotonic sea salt solution, led to a decrease activity of markers of allergic inflammation in the nasal mucosa, which is confirmed by a decrease in the level of eosinophils, secretory IgE and IL-4 in nasal secretions against the background of a decrease in the frequency of acute respiratory diseases during follow-up for a year.

Extracellular Vesicles in Allergic Rhinitis and Asthma and Laboratory Possibilities for Their Assessment

Currently, extracellular vesicles (EVs) have been implicated in the etiopathogenesis of many diseases, including lung disorders, with the possibility of diagnostic and therapeutic applications. The analysis of EV in respiratory tract diseases faces many obstacles, including material collection from airways, standardization of isolation techniques, detection methods, the analysis of their content, etc. This review focuses on the role of extracellular vesicles in the pathogenesis of atopic respiratory diseases, especially asthma, with a special focus on their clinical applicability as a diagnostic tool. We also summarize available laboratory techniques that enable the detection of EVs in various biological materials, with particular emphasis on flow cytometry. The opportunities and limitations of detecting EV in bronchoalveolar lavage fluid (BALF) were also described.