Displaying publications 1 - 20 of 69 in total

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  1. Gendeh BS, Gendeh HS, Purnima S, Comoretto RI, Gregori D, Gulati A
    Indian J Pediatr, 2019 Jan;86(Suppl 1):20-24.
    PMID: 30623311 DOI: 10.1007/s12098-018-2824-8
    Foreign body aspiration in children is a problem that can lead to several complications, including death. In this retrospective publication review from 1970 to 2015, there were altogether 42 Malaysian children below the age of 15 y reported with foreign body (FB) ingestion. There were 31 boys and 11 girls between 2 and 177 mo of age. The incidence of FB ingestion in children varied with dietary practices. Peanut was the most common food-related substance inhaled followed by watermelon seed and coconut kernel. The most common non-food related substances were metal objects (toys, springs, hair clips) and plastic objects (ballpoint tips, pencil caps and whistles). Successful removal of FB by bronchoscopy is achieved in the vast majority of cases except for a case of impacted whistle inhalation and a neglected laryngeal FB which required a tracheostomy. One child required thoracotomy for the removal of a peanut in the right bronchus. The incidence of food-related substance inhalation was more common than non-food related substance (30:7). From this review, the key messages are two: first, prevention can be achieved by educating parents not to allow access to small objects or dangerous foods to children below 3 y age; Second, emergency first aid home measures, in the combination form of back blows in the head down position and chest or abdominal thrusts, should be early performed according to the pediatric age group and can be quite effective.
    Matched MeSH terms: Respiratory System
  2. Muttalif AR, Presa JV, Haridy H, Gamil A, Serra LC, Cané A
    Infect Dis Ther, 2019 Dec;8(4):569-579.
    PMID: 31471813 DOI: 10.1007/s40121-019-00262-9
    INTRODUCTION: Mass gathering events involve close contact among large numbers of people in a specific location at the same time, an environment conducive to transmission of respiratory tract illnesses including invasive meningococcal disease (IMD). This report describes IMD incidence at mass gatherings over the past 10 years and discusses strategies to prevent IMD at such events.

    METHODS: A PubMed search was conducted in December 2018 using a search string intended to identify articles describing IMD at mass gatherings, including religious pilgrimages, sports events, jamborees, and refugee camps. The search was limited to articles in English published from 2008 to 2018. Articles were included if they described IMD incidence at a mass gathering event.

    RESULTS: A total of 127 articles were retrieved, of which 7 reported on IMD incidence at mass gatherings in the past 10 years. Specifically, in Saudi Arabia between 2002 and 2011, IMD occurred in 16 Hajj pilgrims and 1 Umrah pilgrim; serotypes involved were not reported. At a youth sports festival in Spain in 2008, 1 case of serogroup B IMD was reported among 1500 attendees. At the 2015 World Scout Jamboree in Japan, an outbreak of serogroup W IMD was identified in five scouts and one parent. At a refugee camp in Turkey, one case of serogroup B IMD was reported in a Syrian girl; four cases of serogroup X IMD occurred in an Italian refugee camp among refugees from Africa and Bangladesh. In 2017, a funeral in Liberia resulted in 13 identified cases of serogroup C IMD. Requiring meningococcal vaccination for mass gathering attendees and vaccinating refugees might have prevented these IMD cases.

    CONCLUSIONS: Mass gathering events increase IMD risk among attendees and their close contacts. Vaccines preventing IMD caused by serogroups ACWY and B are available and should be recommended for mass gathering attendees.

    FUNDING: Pfizer.

    Matched MeSH terms: Respiratory System
  3. Abdullah SF
    Med J Malaysia, 2021 03;76(2):177-182.
    PMID: 33742625
    INTRODUCTION: It is estimated that at least 30 to 40% of asthma attacks in adults are related to respiratory infections with viruses. The majority of asthma-related viruses include respiratory syncytial virus (RSV), rhinovirus, and parainfluenza. Inflammatory cytokines are supposed to play a vital role in causing inflammation of the respiratory tract as regulators of proliferation, chemotaxis, and activation of inflammatory cells.

    OBJECTIVES: The aim of this study is to assess the role of Granulocyte Macrophage-Colony Stimulating Factor (GMCSF) in asthmatic airway hyper-responsiveness associated with RSV infections.

    MATERIALS AND METHODS: Forty five asthmatic cases and 45 healthy individuals were studied in a cross-sectional design. All asthmatics underwent symptom score assessment.GMCSF concentrations in sputum and RSV-IgM/IgG in serum samples were measured for all participants by Enzyme Linked Immuno-Sorbent Assay (ELISA).

    RESULTS: The GM-CSF concentration level was significantly higher in asthmatics (270.27± 194.87pg/mL) especially among moderate and severe disease with mean concentration of 197.33±98.47 and 521.08± 310.04 respectively, compared to healthy controls (22.20±21.27 pg/ mL) (p =0.0001). The sputum level of GM-CSF in asthmatics is highly significant associated with positive anti-RSV IgG sera which represents 35/45(77.8%) with mean GM-CSF concentration of (276.99± 86.42) compared with controls at about 31/45 (68.9%) with GM-CSF mean concentration of (22.84±23.47). On the other hand, positive anti-RSV IgM in asthma cases was 8 out of 45(17.8 %) with GM-CSF mean concentration of (307.25± 306.65). Furthermore, GM-CSF sputum level was significantly correlated with eosinophil count especially in moderate and severe asthma.

    CONCLUSIONS: This study revealed that GM-CSF level is associated with eosinophilia and indicates asthma severity that might be evident during RSV infection .The distinctive GM-CSF features observed in the sputum from asthmatics with RSV may be useful as a diagnostic methods to help match patients with antibody therapy.

    Matched MeSH terms: Respiratory System
  4. Chua KB, Bellini WJ, Rota PA, Harcourt BH, Tamin A, Lam SK, et al.
    Science, 2000 May 26;288(5470):1432-5.
    PMID: 10827955
    A paramyxovirus virus termed Nipah virus has been identified as the etiologic agent of an outbreak of severe encephalitis in people with close contact exposure to pigs in Malaysia and Singapore. The outbreak was first noted in late September 1998 and by mid-June 1999, more than 265 encephalitis cases, including 105 deaths, had been reported in Malaysia, and 11 cases of encephalitis or respiratory illness with one death had been reported in Singapore. Electron microscopic, serologic, and genetic studies indicate that this virus belongs to the family Paramyxoviridae and is most closely related to the recently discovered Hendra virus. We suggest that these two viruses are representative of a new genus within the family Paramyxoviridae. Like Hendra virus, Nipah virus is unusual among the paramyxoviruses in its ability to infect and cause potentially fatal disease in a number of host species, including humans.
    Matched MeSH terms: Respiratory System/virology
  5. Blyth CC, Foo H, van Hal SJ, Hurt AC, Barr IG, McPhie K, et al.
    Emerg Infect Dis, 2010 May;16(5):809-15.
    PMID: 20409371 DOI: 10.3201/eid1605.091136
    Influenza outbreaks during mass gatherings have been rarely described, and detailed virologic assessment is lacking. An influenza outbreak occurred during World Youth Day in Sydney, Australia, July 2008 (WYD2008). We assessed epidemiologic data and respiratory samples collected from attendees who sought treatment for influenza-like illness at emergency clinics in Sydney during this outbreak. Isolated influenza viruses were compared with seasonal influenza viruses from the 2008 influenza season. From 100 infected attendees, numerous strains were identified: oseltamivir-resistant influenza A (H1N1) viruses, oseltamivir-sensitive influenza A (H1N1) viruses, influenza A (H3N2) viruses, and strains from both influenza B lineages (B/Florida/4/2006-like and B/Malaysia/2506/2004-like). Novel viruses were introduced, and pre-WYD2008 seasonal viruses were amplified. Viruses isolated at mass gatherings can have substantial, complex, and unpredictable effects on community influenza activity. Greater flexibility by public health authorities and hospitals is required to appropriately manage and contain these outbreaks.
    Matched MeSH terms: Respiratory System/virology
  6. Cleary DW, Morris DE, Anderson RA, Jones J, Alattraqchi AG, A Rahman NI, et al.
    NPJ Biofilms Microbiomes, 2021 01 05;7(1):1.
    PMID: 33402693 DOI: 10.1038/s41522-020-00173-5
    Much microbiome research has focused on populations that are predominantly of European descent, and from narrow demographics that do not capture the socio-economic and lifestyle differences which impact human health. Here we examined the airway microbiomes of the Orang Asli, the indigenous peoples of Malaysia. A total of 130 participants were recruited from two sites in the north-eastern state of Terengganu in Peninsular Malaysia. Using 16S rRNA sequencing, the nasal microbiome was significantly more diverse in those aged 5-17 years compared to 50+ years (p = 0.023) and clustered by age (PERMANOVA analysis of the Bray-Curtis distance, p = 0.001). Hierarchical clustering of Bray-Curtis dissimilarity scores revealed six microbiome clusters. The largest cluster (n = 28; 35.4%) had a marked abundance of Corynebacterium. In the oral microbiomes Streptococcus, Neisseria and Haemophilus were dominant. Using conventional microbiology, high levels of Staphylococcus aureus carriage were observed, particularly in the 18-65 age group (n = 17/36; 47.2% 95% CI: 30.9-63.5). The highest carriage of pneumococci was in the <5 and 5 to 17 year olds, with 57.1% (4/7) and 49.2% (30/61), respectively. Sixteen pneumococcal serotypes were identified, the most common being the nonvaccine-type 23A (14.6%) and the vaccine-type 6B (9.8%). The prevalence of pneumococcal serotypes covered by pneumococcal conjugate vaccines support introduction into a Malaysian national immunisation schedule. In addition, the dominance of Corynebacterium in the airway microbiomes is intriguing given their role as a potentially protective commensal with respect to acute infection and respiratory health.
    Matched MeSH terms: Respiratory System/microbiology*
  7. Ghani Siti-Ilyana, Koh, Yi-Ni, Embong Zunaina
    MyJurnal
    Toxoplasmic optic neuropathy is rare and usually occurs monoocularly. This case report demonstrates a rare presentation of bilateral
    juxtapapillary retinochoroiditis (Jensen disease) due to toxoplasma infection in
    a young healthy patient. A 20-year-old lady presented with bilateral painless
    blurring of central vision for 5 days duration. It was preceded by fever, upper
    respiratory tract symptoms and headache. There was no history of contact or
    being scratched by a cat. Visual acuity was counting fingers for the right eye
    and 6/45 for the left eye. There was presence of relative afferent pupillary
    defect in the right eye. Optic nerve functions were impaired bilaterally which
    was severe in the right eye. Both eyes showed the presence of mild anterior
    segment inflammation and vitritis. Fundus examination revealed juxtapapillary
    retinochoroiditis bilaterally with swollen optic disc. Optical coherence
    tomography (OCT) showed presence of intra-retinal and sub-retinal fluid at
    macular area bilaterally. Serology for anti-toxoplasma Immunoglobulin G (IgG)
    was positive with titre of 1450 IU/ml. Computed tomography scan (CT scan) of
    brain and orbit was normal. A diagnosis of bilateral juxtapapillary
    retinochoroiditis or Jensen disease was made. Oral azithromycin 500 mg daily
    and guttae prednisolone 4 hourly for 6 weeks was commenced. Oral
    prednisolone 50 mg daily (1 mg/kg/day) was added after completion of 1 week
    of antibiotic and was tapered down within 5 weeks. There was improvement of
    vision as early as 3 weeks post initiation of the treatment. Upon 6 weeks
    completing the treatment, her vision has improved to 6/7.5 on both eyes with
    resolution of optic disc swelling and sub-retinal fluid. Early recognition and
    initiation of treatment in toxoplasma infection associated with juxtapapillary
    retinochoroiditis usually result in good visual prognosis.
    Matched MeSH terms: Respiratory System
  8. Ong HK, Yong CY, Tan WS, Yeap SK, Omar AR, Razak MA, et al.
    Vaccines (Basel), 2019 08 19;7(3).
    PMID: 31430965 DOI: 10.3390/vaccines7030091
    Current seasonal influenza A virus (IAV) vaccines are strain-specific and require annual reconstitution to accommodate the viral mutations. Mismatches between the vaccines and circulating strains often lead to high morbidity. Hence, development of a universal influenza A vaccine targeting all IAV strains is urgently needed. In the present study, the protective efficacy and immune responses induced by the extracellular domain of Matrix 2 protein (M2e) displayed on the virus-like particles of Macrobrachium rosenbergii nodavirus (NvC-M2ex3) were investigated in BALB/c mice. NvC-M2ex3 was demonstrated to be highly immunogenic even in the absence of adjuvants. Higher anti-M2e antibody titers corresponded well with increased survival, reduced immunopathology, and morbidity of the infected BALB/c mice. The mice immunized with NvC-M2ex3 exhibited lower H1N1 and H3N2 virus replication in the respiratory tract and the vaccine activated the production of different antiviral cytokines when they were challenged with H1N1 and H3N2. Collectively, these results suggest that NvC-M2ex3 could be a potential universal influenza A vaccine.
    Matched MeSH terms: Respiratory System
  9. Nurul Ainun Hamzah, Shamsul Bahri Mohd Tamrin, Noor Hassim Ismail
    MyJurnal
    Air pollution in steel making operations effect to respiratory health. This study aimed to measure the dust exposure and evaluate the respiratory health among steel workers. A cross sectional study was conducted among 402 male workers. Respiratory symptoms using British Medical Research Council (BMRC) Questionnaire while lung function was measured The airborne dust [PM2.5, PM10, and Total Particulate Matter (TPM)] were monitored by Handheld 3016 Counter. All the parameters studied exceeded the limit of Malaysian guideline standard. Prevalence of chronic phlegm, chest of tightness, and shortness of breath were 35.8 %, 32.8 %, 23.4 %, and 22.4 %, respectively. significant differences between shortness of breath and work section (2=9.236, p=0.026) and %FEV1/FVC with work section [F (3, 3.98=3.194), p=0.025]. Smoking was associated with chronic cough (Adj OR =1.07, 95% CI: phlegm (Adj OR =1.05, 95% CI: 1.03 - 1.08), and shortness of breath (Adj OR = 1.05, 95% CI: 1.00 past respiratory illnesses was associated with chest tightness (Adj OR = 2.24, 95% CI: 1.04 - 4.84) and (Adj OR = 4.16, 95% CI: 1.92 - 9.92). Duration of employment was associated with FEV1 (β=-0.025, 0.020) while past respiratory illnesses was associated with %FEV1/FVC (β =-1.784, 95% CI: -3.017 workers are at risk of developing respiratory symptoms and lung function impairment.
    Matched MeSH terms: Respiratory System
  10. Shastri MD, Chong WC, Dua K, Peterson GM, Patel RP, Mahmood MQ, et al.
    Inflammopharmacology, 2021 Feb;29(1):15-33.
    PMID: 33152094 DOI: 10.1007/s10787-020-00770-y
    Asthma is a common, heterogeneous and serious disease, its prevalence has steadily risen in most parts of the world, and the condition is often inadequately controlled in many patients. Hence, there is a major need for new therapeutic approaches. Mild-to-moderate asthma is considered a T-helper cell type-2-mediated inflammatory disorder that develops due to abnormal immune responses to otherwise innocuous allergens. Prolonged exposure to allergens and persistent inflammation results in myofibroblast infiltration and airway remodelling with mucus hypersecretion, airway smooth muscle hypertrophy, and excess collagen deposition. The airways become hyper-responsive to provocation resulting in the characteristic wheezing and obstructed airflow experienced by patients. Extensive research has progressed the understanding of the underlying mechanisms and the development of new treatments for the management of asthma. Here, we review the basis of the disease, covering new areas such as the role of vascularisation and microRNAs, as well as associated potential therapeutic interventions utilising reports from animal and human studies. We also cover novel drug delivery strategies that are being developed to enhance therapeutic efficacy and patient compliance. Potential avenues to explore to improve the future of asthma management are highlighted.
    Matched MeSH terms: Respiratory System
  11. Ng KF, Kee Tan K, Chok MC, Zamil Mohd Muzzamil N, Choo P, Paramasivam U, et al.
    J Trop Pediatr, 2017 Dec 01;63(6):447-453.
    PMID: 28334949 DOI: 10.1093/tropej/fmx011
    This prospective observational study aims to determine the incidence, predictors and clinical features of Mycoplasma hominis (MH), Ureaplasma urealyticum (UU) and Chlamydia trachomatis (CT) respiratory colonization in infants <37 weeks of gestation. A total of 200 preterm newborns admitted to a tertiary center in Malaysia between 2013 and 2015 for increased breathing effort had their respiratory secretions tested for these bacteria by polymerase chain reaction. Fifteen of the 200 (7.5%) infants were detected to have these organisms in their respiratory tracts. Preterm prelabor rupture of membrane was associated with positive detection (odds ratio: 3.7; 95% confidence interval: 1.2-11.3). Seventy-three of the 200 (36.5%) infants were given macrolide for presumed infection but only 4.1% (3 of 73) were positive for these organisms. The incidence of UU respiratory colonization among preterm infants in our center is lower than other published reports, while the frequency of MH and CT isolation is comparable with many studies. There should be judicious use of empirical antibiotics for presumed UU, MH and CT infection in preterm infants.
    Matched MeSH terms: Respiratory System
  12. Zailina Hashim, Juliana Jalaludin, Norzila Muhamad Zainudin, Azizi Omar, Jamal H. Hashim
    MyJurnal
    A study on 30 asthmatic children was conducted in Kuala Lumpur. The objective of this study was to study the relationship between respirable particulate (PM10), sulphur dioxide, ozone and various meteorological factors such as humidity, level ofrainfall and temperature with asthma attacks. This study was conducted from 1st September to 31 December 1994. Patients were selected from the Paediatric Unit, Kuala Lumpur Hospital. Questionnaires were used to obtain information from their parents on the history and severity ofasthmatic attacks ofthese patients. Questionnaires were also used to determine if the indoor sources contributed to the attack. Diary cards were used to collect information on the frequency of asthmatic attacks. Each patient's progress was followed through every week during the study period and the attacks were recorded. The data on air quality on the PM10, sulphur dioxide, nitrogen dioxide, carbon monoxide and ozone were collected hourly using the microcomputer system of air monitoring unit from the Universiti Pertanian Malaysia air quality monitoring station located at the City Hall, Kuala Lumpur. The meteorological parameters such as temperature, relative humidity and rain-fall levels were also monitored daily. The asthmatic attack percentage was obtained by dividing the number of attacks in a day with the total number of sample and multiplying by a hundred. Statistical tests indicated that there was a significant correlation between asthmatic attacks and the PM10 concentrations (r=0.73), nitrogen dioxide (r=0.57) and.carbon monoxide (r=0.53) throughout the study period. During the haze episode, more significant correlations between asthmatic attacks, PM10 concentra-tions (0.86), carbon monoxide (0.79) and nitrogen oxide (0.53) were found. Multiple regression statistical test showed that PM10 had the greatest influence on the asthmatic attack rate. The minute respirable particulate which entered the respiratory system of the asthmatics triggered attacks on these patients.
    Matched MeSH terms: Respiratory System
  13. Sadiq, M.A., Zakaria, Z., Saharee, A.A., Abba, Y., Hassan, L.
    Jurnal Veterinar Malaysia, 2016;28(1):20-26.
    MyJurnal
    An adult female Elephant Trunk Snake (Acrochordus javanicus) was reported to have been weak and inappetent for five days. The following morning the snake found dead, while in the process of shedding its skin. On post mortem examination, there were multiple circumscribed caseous nodules of various sizes distributed all over the liver, along the respiratory tract and on the lungs. Bacteriological analysis of the lungs and liver swab samples yielded Burkholderia pseudomallei, which was confirmed by PCR amplification of specific 16S rRNA. The condition was diagnosed as melioidosis and the organism was genotypically characterized as sequence type 51, a genotype that has been previously characterized in humans in Malaysia. Antibiotic susceptibility by both Disc diffusion or Kirby Bauer and E-test minimum inhibitory concentration (MIC) showed that the organism exhibited susceptibility to meropenem, imipenem, ceftazidime, cotrimoxazole and co-amoxyclav; the antibiotics recommended in the treatment of melioidosis.
    Matched MeSH terms: Respiratory System
  14. Khan MF, Hamid AH, Bari MA, Tajudin ABA, Latif MT, Nadzir MSM, et al.
    Sci Total Environ, 2019 Feb 10;650(Pt 1):1195-1206.
    PMID: 30308807 DOI: 10.1016/j.scitotenv.2018.09.072
    Equatorial warming conditions in urban areas can influence the particle number concentrations (PNCs), but studies assessing such factors are limited. The aim of this study was to evaluate the level of size-resolved PNCs, their potential deposition rate in the human respiratory system, and probable local and transboundary inputs of PNCs in Kuala Lumpur. Particle size distributions of a 0.34 to 9.02 μm optical-equivalent size range were monitored at a frequency of 60 s between December 2016 and January 2017 using an optical-based compact scanning mobility particle sizer (SMPS). Diurnal and correlation analysis showed that traffic emissions and meteorological confounding factors were potential driving factors for changes in the PNCs (Dp ≤1 μm) at the modeling site. Trajectory modeling showed that a PNC <100/cm3 was influenced mainly by Indo-China region air masses. On the other hand, a PNC >100/cm3 was influenced by air masses originating from the Indian Ocean and Indochina regions. Receptor models extracted five potential sources of PNCs: industrial emissions, transportation, aged traffic emissions, miscellaneous sources, and a source of secondary origin coupled with meteorological factors. A respiratory deposition model for male and female receptors predicted that the deposition flux of PM1 (particle mass ≤1 μm) into the alveolar (AL) region was higher (0.30 and 0.25 μg/h, respectively) than the upper airway (UA) (0.29 and 0.24 μg/h, respectively) and tracheobronchial (TB) regions (0.02 μg/h for each). However, the PM2.5 deposition flux was higher in the UA (2.02 and 1.68 μg/h, respectively) than in the TB (0.18 and 0.15 μg/h, respectively) and the AL regions (1.09 and 0.91 μg/h, respectively); a similar pattern was also observed for PM10.
    Matched MeSH terms: Respiratory System
  15. Navaratnam V, Forrester DL, Eg KP, Chang AB
    Respirology, 2019 02;24(2):115-126.
    PMID: 30500093 DOI: 10.1111/resp.13451
    Bronchiectasis is a chronic lung disease associated with structurally abnormal bronchi, clinically manifested by a persistent wet/productive cough, airway infections and recurrent exacerbations. Early identification and treatment of acute exacerbations is an integral part of monitoring and annual review, in both adults and children, to minimize further damage due to infection and inflammation. Common modalities used to monitor disease progression include clinical signs and symptoms, frequency of exacerbations and/or number of hospital admissions, lung function (forced expiratory volume in 1 s (FEV1 )% predicted), imaging (radiological severity of disease) and sputum microbiology (chronic infection with Pseudomonas aeruginosa). There is good evidence that these monitoring tools can be used to accurately assess severity of disease and predict prognosis in terms of mortality and future hospitalization. Other tools that are currently used in research settings such as health-related quality of life (QoL) questionnaires, magnetic resonance imaging and lung clearance index can be burdensome and require additional expertise or resource, which limits their use in clinical practice. Studies have demonstrated that cross-infection, especially with P. aeruginosa between patients with bronchiectasis is possible but infrequent. This should not limit participation of patients in group activities such as pulmonary rehabilitation, and simple infection control measures should be carried out to limit the risk of cross-transmission. A multidisciplinary approach to care which includes respiratory physicians, chest physiotherapists, nurse specialists and other allied health professionals are vital in providing holistic care. Patient education and personalized self-management plans are also important despite limited evidence it improves QoL or frequency of exacerbations.
    Matched MeSH terms: Diagnostic Techniques, Respiratory System
  16. Zhang X, Deng T, Lu J, Zhao P, Chen L, Qian M, et al.
    Transbound Emerg Dis, 2020 May;67(3):1349-1355.
    PMID: 31943814 DOI: 10.1111/tbed.13477
    Infectious bronchitis virus (IBV), an ongoing emergence enveloped virus with a single-stranded positive-sense RNA genome, belongs to the Gammacoronavirus genus in the Coronaviridae family. IBV-associated tracheitis, nephritis, salpingitis, proventriculitis and egg drop have caused devastating economic losses to poultry industry worldwide. Since the end of 2018, a remarkably increasing number of commercial broilers and layers, vaccinated or not, were infected with IBV in China. Here, we described two IB outbreaks with severe respiratory system or kidney injury in IBV-vaccinated commercial poultry farms in central China. Other possible causative viral pathogens, including avian influenza virus (AIV), Newcastle disease virus (NDV) and Kedah fatal kidney syndrome virus (KFKSV), were excluded by reverse transcription-polymerase chain reaction (RT-PCR), and three virulent IBV strains, HeN-1/China/2019, HeN-2/China/2019 and HeN-101/China/2019, were identified. Although the gross pathologic appearance of these two IB outbreaks was different, the newly identified IBV strains were all closely related to the ck/China/I0529/17 strain and grouped into GI-19 genotype clade based on the sequencing and phylogenetic analysis of the complete S1 genes. Moreover, there are still some evolutionary distance between the newly identified IBV strains, HeN-101/China/2019 in particular, and other GI-19 strains, suggesting that Chinese IBV strains constantly emerge and evolve towards different directions. In conclusion, this study provided an insight of the recently emerging IBV outbreaks in IBV-vaccinated commercial poultry farms and identified the genetic characteristics of three virulent GI-19 IBV strains, which shows the need to carry out proper preventive measures and control strategies.
    Matched MeSH terms: Respiratory System
  17. Damiani LP, Berwanger O, Paisani D, Laranjeira LN, Suzumura EA, Amato MBP, et al.
    Rev Bras Ter Intensiva, 2017 Apr-Jun;29(2):142-153.
    PMID: 28977255 DOI: 10.5935/0103-507X.20170024
    BACKGROUND: The Alveolar Recruitment for Acute Respiratory Distress Syndrome Trial (ART) is an international multicenter randomized pragmatic controlled trial with allocation concealment involving 120 intensive care units in Brazil, Argentina, Colombia, Italy, Poland, Portugal, Malaysia, Spain, and Uruguay. The primary objective of ART is to determine whether maximum stepwise alveolar recruitment associated with PEEP titration, adjusted according to the static compliance of the respiratory system (ART strategy), is able to increase 28-day survival in patients with acute respiratory distress syndrome compared to conventional treatment (ARDSNet strategy).

    OBJECTIVE: To describe the data management process and statistical analysis plan.

    METHODS: The statistical analysis plan was designed by the trial executive committee and reviewed and approved by the trial steering committee. We provide an overview of the trial design with a special focus on describing the primary (28-day survival) and secondary outcomes. We describe our data management process, data monitoring committee, interim analyses, and sample size calculation. We describe our planned statistical analyses for primary and secondary outcomes as well as pre-specified subgroup analyses. We also provide details for presenting results, including mock tables for baseline characteristics, adherence to the protocol and effect on clinical outcomes.

    CONCLUSION: According to best trial practice, we report our statistical analysis plan and data management plan prior to locking the database and beginning analyses. We anticipate that this document will prevent analysis bias and enhance the utility of the reported results.

    TRIAL REGISTRATION: ClinicalTrials.gov number, NCT01374022.
    Matched MeSH terms: Respiratory System
  18. Tiew WT, Chen YC, Hsiao HL, Chen CL, Chen CJ, Chiu CH
    J Microbiol Immunol Infect, 2023 Aug;56(4):688-694.
    PMID: 36681556 DOI: 10.1016/j.jmii.2023.01.009
    BACKGROUND/PURPOSE: Precise detection of respiratory pathogens by molecular method potentially may shorten the time to diagnose and reduce unnecessary antibiotic use.

    METHODS: Medical records of hospitalized children from January 2020 to June 2021 with acute respiratory illness who received a FilmArray RP for respiratory pathogens were reviewed and compared with data from diagnosis-matched patients without receiving the test.

    RESULTS: In total, 283 patients and 150 diagnosis-matched controls were included. Single pathogen was detected in 84.3% (193/229) of the patients. The most common pathogen was human rhinovirus/enterovirus (31.6%, 84/266), followed by respiratory syncytial virus (18.8%, 50/266) and adenovirus (15%, 40/266). Although antimicrobial days of therapy (DOT) was significantly longer in FilmArray group than the control [7.1 ± 4.9 days vs 5.7 ± 2.7 days, P = 0.002], the former showed a higher intensive care unit (ICU) admission rate (3.9% vs 0%; P = 0.010). All ICU admissions were in FilmArray RP-positive group. There was no difference in antimicrobial DOT between FilmArray RP-positive and the negative groups, in all admissions, even after excluding ICU admissions. Antimicrobial DOT was shorter in the positive than negative group in patients with lower respiratory tract infections without admission to ICU [median (IQR): 6 (4-9) days vs 9 (4-12) days, P = 0.047].

    CONCLUSIONS: Shorter antimicrobial DOTs were identified in children with lower respiratory tract infection admitted to general pediatric ward and with an identifiable respiratory pathogen, indicating a role of the multiplex PCR in reducing antimicrobial use for children with respiratory tract infection.

    Matched MeSH terms: Respiratory System
  19. Fung SY, Tan NH, Sim SM
    Trop Biomed, 2010 Dec;27(3):366-72.
    PMID: 21399576 MyJurnal
    The protective effects of Mucuna pruriens seed extract (MPE) against the cardio-respiratory depressant and neuromuscular paralytic effects induced by injection of Calloselasma rhodostoma (Malayan pit viper) venom in anaesthetized rats were investigated. While MPE pretreatment did not reverse the inhibitory effect of the venom on the gastrocnemius muscle excitability, it significantly attenuated the venom-induced cardio-respiratory depressant effects (p < 0.05). The protection effects may have an immunological mechanism, as indicated by the presence of several proteins in the venom that are immunoreactive against anti-MPE. However, we cannot rule out the possibility that the pretreatment may exert a direct, non-immunological protective action against the venom.
    Matched MeSH terms: Respiratory System/drug effects
  20. Kim KT, Morton S, Howe S, Chiew YS, Knopp JL, Docherty P, et al.
    Trials, 2020 Feb 01;21(1):130.
    PMID: 32007099 DOI: 10.1186/s13063-019-4035-7
    BACKGROUND: Positive end-expiratory pressure (PEEP) at minimum respiratory elastance during mechanical ventilation (MV) in patients with acute respiratory distress syndrome (ARDS) may improve patient care and outcome. The Clinical utilisation of respiratory elastance (CURE) trial is a two-arm, randomised controlled trial (RCT) investigating the performance of PEEP selected at an objective, model-based minimal respiratory system elastance in patients with ARDS.

    METHODS AND DESIGN: The CURE RCT compares two groups of patients requiring invasive MV with a partial pressure of arterial oxygen/fraction of inspired oxygen (PaO2/FiO2) ratio ≤ 200; one criterion of the Berlin consensus definition of moderate (≤ 200) or severe (≤ 100) ARDS. All patients are ventilated using pressure controlled (bi-level) ventilation with tidal volume = 6-8 ml/kg. Patients randomised to the control group will have PEEP selected per standard practice (SPV). Patients randomised to the intervention will have PEEP selected based on a minimal elastance using a model-based computerised method. The CURE RCT is a single-centre trial in the intensive care unit (ICU) of Christchurch hospital, New Zealand, with a target sample size of 320 patients over a maximum of 3 years. The primary outcome is the area under the curve (AUC) ratio of arterial blood oxygenation to the fraction of inspired oxygen over time. Secondary outcomes include length of time of MV, ventilator-free days (VFD) up to 28 days, ICU and hospital length of stay, AUC of oxygen saturation (SpO2)/FiO2 during MV, number of desaturation events (SpO2 

    Matched MeSH terms: Respiratory System/physiopathology
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