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Breast milk fatty acid composition has a long-term effect on the risk of asthma, eczema, and sensitization.

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Breast milk fatty acid composition has a long-term effect on the risk of asthma, eczema, and sensitization.

Allergy. 2015 Jul 27;

Authors: van Elten TM, van Rossem L, Wijga AH, Brunekreef B, de Jongste JC, Koppelman GH, Smit HA

Abstract
BACKGROUND: Levels of n-3 polyunsaturated fatty acids (PUFAs) and n-6 PUFAs in breast milk are associated with development of allergic diseases up to school age. However, it is unknown if this relationship persists when the child becomes older. We therefore studied the association between levels of n-3 PUFAs and n-6 PUFAs in breast milk of allergic- and non-allergic mothers and asthma, eczema and sensitization up to the age of 14 years.
METHODS: The study was nested in the ongoing PIAMA birth cohort. At the child's age of 3 months, 276 mothers provided a breast milk sample. Asthma (Ntotal=269) and eczema (Ntotal=274) were self-reported up to the child's age of 14 years. Specific serum IgE levels were measured at the ages of 4, 8, and 12 years (Ntotal=216). Generalized estimating equations analyses were used to take account of repeated observations.
RESULTS: Asthma up to the age of 14 years is less prevalent in children of allergic mothers receiving breast milk with higher levels of n-3 long chain polyunsaturated (LCP) fatty acids (OR 0.50; 95% CI 0.31-0.79), and more prevalent in children of non-allergic mothers receiving breast milk with higher levels of n-6LCP (OR 1.86; 95% CI 1.14-3.03). Weaker associations in similar direction were observed for eczema and sensitization. Direction of associations were consistent and of similar magnitude throughout childhood.
CONCLUSION: The association between breast milk fatty acid composition and asthma, eczema, and sensitization persists up to the age of 14 years in children of both allergic and non-allergic mothers. This article is protected by copyright. All rights reserved.

PMID: 26214160 [PubMed - as supplied by publisher]

Newer Diagnostic Tests for Pulmonary Tuberculosis in Children.

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Newer Diagnostic Tests for Pulmonary Tuberculosis in Children.

Indian J Pediatr. 2015 Sep;82(9):827-32

Authors: Triasih R

Abstract
It has been well recognized that the diagnosis of pulmonary tuberculosis in children is often compromised by non-specific symptoms, paucibacillary nature of the disease, and the difficulty in collecting the specimen. Consequently, most tuberculosis cases in children are not confirmed, due to which the estimation of the global burden of tuberculosis in children may be inaccurate. There has also been a common misperception that diagnosis of tuberculosis and collecting respiratory specimen in children is always difficult. Because of this, microbiological confirmation of tuberculosis in young children is not routinely attempted in most endemic areas. With the emergence of HIV-related tuberculosis disease and drug-resistant tuberculosis, the availability of accurate, rapid and child friendly diagnostic tools to identify Mycobacterium tuberculosis in respiratory specimen are urgently required in endemic settings. There have been a large number of studies evaluating new diagnostic tests for tuberculosis in the past decade, but few have been evaluated in children. This review will address the developments in respiratory specimen collection and laboratory diagnostic tests of tuberculosis, with a focus on those that have been evaluated in children.

PMID: 26220244 [PubMed - in process]

Inflammation in venous thromboembolism: Cause or consequence?

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Inflammation in venous thromboembolism: Cause or consequence?

Int Immunopharmacol. 2015 Aug 4;28(1):655-665

Authors: Saghazadeh A, Hafizi S, Rezaei N

Abstract
Venous thromboembolism (VTE) which includes deep vein thrombosis (DVT) and pulmonary thromboembolism (PTE) is a moderately common disease especially in elderly population with high rate of recurrence and complications. Evidence is accumulating that VTE is not restricted to coagulation system and immune system appears to be involved in formation and resolution of thrombus. The present study was aimed at reviewing current evidences on immune system abnormalities such as alterations in cytokines, chemokines and immune cells. Also, current evidences suggest that; a, inflammation in general functions as a double-edged sword, b, inflammation can be both a cause and a consequence of VTE, and c, current anti-coagulation therapies are not well-equipped with the capacity to selectively inhibit inflammatory cells and pathways. Applying such inferences for selective pharmacological targeting of immune mediators in VTE and thereby for adoption of higher effective anti-thromboinflammatory strategies, either therapeutic or prophylactic, is henceforth to be considered as the line of research for future.

PMID: 26253657 [PubMed - as supplied by publisher]

Hospitalizations and outpatient visits for rhinovirus-associated acute respiratory illness in adults.

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BACKGROUND: Rhinovirus is linked to asthma exacerbations and chronic obstructive pulmonary disease exacerbations in adults. The severity and rates of rhinovirus acute respiratory illnesses (ARIs) in adults are uncertain.

OBJECTIVES: We sought to determine rhinovirus-associated ARI rates in adults presenting for care in multiple settings and identify factors associated with rhinovirus detection.

METHODS: This prospective, population-based cohort enrolled Tennessee residents 18 years or older in the emergency department (ED), outpatient clinics, or hospitalized for ARI from December 2008 to May 2010. Nasal/throat swabs were collected and tested for rhinovirus and other viruses by using RT-PCR. Rates of ED visits and hospitalizations were calculated and rhinovirus-positive and rhinovirus-negative patients were compared.

RESULTS: Among 2351 enrollees, rhinovirus was detected in 247 (11%). There were 7 rhinovirus-associated ED visits and 3 hospitalizations per 1000 adults annually. Patients with rhinovirus, compared with virus-negative ARI, were more likely to present with wheezing (odds ratio [OR], 1.7; 95% CI, 1.23-2.35; P < .001), to be a current smoker (OR, 2.31; 95% CI, 1.68-3.19) or live with a smoker (OR, 1.72; 95% CI, 1.10-2.67), have a history of chronic respiratory disease (OR, 1.61; 95% CI, 1.17-2.22), and were less likely to be hospitalized versus seen in the outpatient setting (OR, 0.58; 95% CI, 0.41-0.83).

CONCLUSIONS: Rhinovirus is associated with a substantial number of ED visits and hospitalizations for ARIs in adults. There may be modifiable factors that can reduce the likelihood of presenting with rhinovirus-associated ARIs.

Early Childhood Risk Factors for Decreased FEV1 at Age 6-7 Years in Young Children with Cystic Fibrosis.

There are limited objective measures of the severity of lung disease before children are able to routinely perform spirometry, generally at age 6 years. Identifying risk factors for reduced lung function at age 6 provides opportunities to intervene and slow the progression of cystic fibrosis (CF) lung disease.

OBJECTIVES: To evaluate early childhood predictors of lung function at age 6-7 in a large U.S. CF cohort in the current era of widespread early eradication therapy for Pseudomonas aeruginosa (Pa).

METHODS: Participants were children with CF enrolled before age 4 in the Early Pseudomonas Infection Control (EPIC) Observational Study, a multicenter, longitudinal study that enrolled Pa-negative children ≤12 years. Linear regression was used to estimate the association between potential early childhood risk factors and the best FEV1 % predicted at age 6-7 years.

MEASUREMENTS AND MAIN RESULTS: 484 children (out of 1,797 enrolled in the EPIC Observational Study) met the eligibility criteria for this analysis. Mean (SD) age at enrollment was 2.0 (1.3) years. In a multivariable model adjusted for age at enrollment, the following risk factors were significantly associated with lower mean (95% Confidence Interval) FEV1 % predicted at age 6-7: weight percentile < 10% during the year of enrollment [-5.3 (-9.1, -1.5)], Pa-positive during the year of enrollment [-2.8 (-5.7, 0.0)], crackles or wheeze during the year of enrollment [-5.7 (-9.4, -1.9)], mother's education high school or less [-4.2, (-7.3, -1.2)]; and mother smoked during pregnancy [-4.4, (-8.8, 0.1)].

CONCLUSIONS: In this large U.S. cohort, we identified several early childhood risk factors for lower FEV1 at age 6-7 years, most of which are modifiable. Clinical Trial registered at clinicaltrials.gov (NCT00097773).

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