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Intrauterine exposure to fine particulate matter as a risk factor for increased susceptibility to acute broncho-pulmonary infections in early childhood.

Intrauterine exposure to fine particulate matter as a risk factor for increased susceptibility to acute broncho-pulmonary infections in early childhood.

Int J Hyg Environ Health. 2013 Jan 16;

Authors: Jedrychowski WA, Perera FP, Spengler JD, Mroz E, Stigter L, Flak E, Majewska R, Klimaszewska-Rembiasz M, Jacek R

Abstract
Over the last decades many epidemiologic studies considered the morbidity patterns for respiratory diseases and lung function of children in the context of ambient air pollution usually measured in the postnatal period. The main purpose of this study is to assess the impact of prenatal exposure to fine particulate matter (PM(2.5)) on the recurrent broncho-pulmonary infections in early childhood. The study included 214 children who had measurements of personal prenatal PM(2.5) exposure and regularly collected data on the occurrence of acute bronchitis and pneumonia diagnosed by a physician from birth over the seven-year follow-up. The effect of prenatal exposure to PM(2.5) was adjusted in the multivariable logistic models for potential confounders, such as prenatal and postnatal ETS (environmental tobacco smoke), city residence area as a proxy of postnatal urban exposure, children's sensitization to domestic aeroallergens, and asthma. In the subgroup of children with available PM(2.5) indoor levels, the effect of prenatal exposure was additionally adjusted for indoor exposure as well. The adjusted odds ratio (OR) for incidence of recurrent broncho-pulmonary infections (five or more spells of bronchitis and/or pneumonia) recorded in the follow-up significantly correlated in a dose-response manner with the prenatal PM(2.5) level (OR=2.44, 95%CI: 1.12-5.36). In conclusion, the study suggests that prenatal exposure to PM(2.5) increases susceptibility to respiratory infections and may program respiratory morbidity in early childhood. The study also provides evidence that the target value of 20μg/m(3) for the 24-h mean level of PM(2.5) protects unborn babies better than earlier established EPA guidelines.

PMID: 23333083 [PubMed - as supplied by publisher]

Clinical significance of Pneumocystis jiroveci in patients with active tuberculosis.

Clinical significance of Pneumocystis jiroveci in patients with active tuberculosis.

Diagn Microbiol Infect Dis. 2013 Jan 16;

Authors: To KK, Hung IF, Xu T, Poon RW, Ip WC, Li PT, Li CP, Lau SK, Yam WC, Chan KH, Yuen KY

Abstract
Pneumocystis colonization has been associated with airway inflammation and obstruction. We conducted a retrospective cohort study to investigate the clinical significance of Pneumocystis in the airway of patients with active tuberculosis. Of the 108 respiratory specimens tested positive for M. tuberculosis by polymerase chain reaction (PCR), 11 (10.2%) were also positive for Pneumocystis by PCR. Compared with patients tested negative for Pneumocystis, those with Pneumocystis had a higher serum alanine transaminase level, a greater likelihood of requiring oxygen supplementation, and a worse 30-day mortality. The proportion of patients with chronic obstructive pulmonary disease was not significantly different between the 2 groups, but lung malignancy was more prevalent among patients with Pneumocystis. Multivariate analysis showed that Pneumocystis was independently associated with oxygen supplementation. Our study has shown an association between the detection of Pneumocystis in lower respiratory tract specimens and greater impairment of pulmonary function among patients with active tuberculosis.

PMID: 23333101 [PubMed - as supplied by publisher]

Obesity hypoventilation syndrome: an underdiagnosed and undertreated condition.

Authors: Pépin JL, Borel JC, Janssens JP PMID: 23250497 [PubMed - in process] (Source: American Journal of Respiratory and Critical Care Medicine)

Six Minute Walk Test in COPD: Minimal Clinically Important Difference for Death or Hospitalization.

CONCLUSIONS: A fall in the six minute walk distance of 30m or more is associated with increased risk of death but not hospitalization due to exacerbation in patients with chronic obstructive pulmonary disease and represents a clinically significant minimally important difference. PMID: 23262518 [PubMed - as supplied by publisher] (Source: American Journal of Respiratory and Critical Care Medicine)

Interferon Gamma Release Assays in the Diagnosis of Latent Tuberculosis Infection Among Immunocompromised Adults.

Authors: Redelman-Sidi G, Sepkowitz KA Abstract Immunocompromised persons with latent tuberculosis infection are at increased risk for tuberculosis reactivation compared to the general population. Tuberculin skin test, the traditional assay for diagnosing LTBI (latent tuberculosis infection), has reduced accuracy in immunocompromised patients. Interferon-gamma release assays (IGRAs) are in vitro blood tests that measure T-cell release of interferon-gamma following stimulation by antigens unique to Mycobacterium tuberculosis. Here we review the data for the use of QuantiFERON-TB Gold In-Tube (QFT-GIT) and T-SPOT.TB, the two currently available IGRAs, in immunocompromised adults, including persons infected with HIV, patients with immune-mediated inflammatory disorders, candidates for...

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