Allergic Rhinitis - Risk Factor for Bronchial Asthma in Children

In recent decades, both worldwide and in our country, there is a noticeable increase in allergic diseases, including those of respiratory system - bronchial asthma and allergic rhinitis. Epidemiological studies show that these conditions often coexist in the same patient. Allergen - specific sensitization is one of the major risk factors for the development of asthma in children. Allergic rhinitis usually precedes asthma. The premise `one respiratory system, one disease` marks a change in diagnostics and therapeutic treatment of respiratory allergies. Currently allergen-specific immunotherapy, administered in the early stage of the disease, is the only treatment that could have disease-modifying effect.The aim of this study is to analyze what proportion of children with asthma suffer from allergic rhinitis and what are the most common therapeutic schemes and practices used in the prophylaxis and treatment of the condition.For this purpose we conducted a survey among parents of children suffering from bronchial asthma on the territory of the city of Varna. Data were processes statistically based on respondent`s answers and were presented graphically. Results confirm that allergic rhinitis is a widespread disease among children with asthma and that is often neglected and not diagnosed and managed in time. Early diagnostics and adequate control of allergic rhinitis is crucial to stop the disease progression to asthma

Quality of Life in Patients with Bronchial Asthma in Childhood

Bronchial asthma is a major cause of morbidity in children in developed countries. In recent years, a large number of epidemiological studies have found an in- creased incidence of childhood asthma which makes this respiratory disorder the most frequent chronic dis- ease in childhood. Many factors are responsible for the huge incidence of asthma: triggering factors from the external environment, the use of inappropriate an- ti-inflammatory medication, lack of assistance with regard to therapeutic regimen, inadequate training of patient (family). The quality of life adolescents suffer- ing of bronchial asthma and their families often is ex- tremely deteriorated. Asthma may limit the ability of children to play, learn and sleep, to lead normal active life. Achieving disease control is the main goal of the treatment conducted. The Global initiative for asthma (GINA) defines control on asthma as minimal chron- ic symptoms, no emergency medical visits, no need of saving medication, normal daily activity, social adap- tation and school attendance.The aim of this study is to analyze the quality of life of children with asthma based on the achieved disease control. To achieve this goal a survey was conducted among parents and children of various ages in the city of Varna. Data from the surveys were processed using mathematical and statistical methods, and the results are presented by graphic images.Results show that in early childhood, when the treatment is performed under the supervision of par- ents, a well-controlled treatment is achieved compared to teenage years.Bronchial asthma is a chronic disease that is best affected in `therapeutic cooperation` between clini- cians, patients and their families. Implementation of training programs for children and parents will im- prove their compliance and execution of their indi- vidual treatment plan, and hence disease control and quality of life of patients

Streptococcus agalactiae clones infecting humans were selected and fixed through the extensive use of tetracycline

Streptococcus agalactiae (Group B Streptococcus, GBS) is a commensal of the digestive and genitourinary tracts of humans that emerged as the leading cause of bacterial neonatal infections in Europe and North America during the 1960s. Due to the lack of epidemiological and genomic data, the reasons for this emergence are unknown. Here we show by comparative genome analysis and phylogenetic reconstruction of 229 isolates that the rise of human GBS infections corresponds to the selection and worldwide dissemination of only a few clones. The parallel expansion of the clones is preceded by the insertion of integrative and conjugative elements conferring tetracycline resistance (TcR). Thus, we propose that the use of tetracycline from 1948 onwards led in humans to the complete replacement of a diverse GBS population by only few TcR clones particularly well adapted to their host, causing the observed emergence of GBS diseases in neonates. \ua9 2014 Macmillan Publishers Limited. All rights reserved

Meningococcal serogroups and surveillance: a systematic review and survey

Background: Meningococcal disease continues to be a global public health concern due to its epidemic potential, severity, and sequelae. The global epidemiological data on circulating meningococcal serogroups have never been reviewed concurrently with the laboratory capacity for meningococcal surveillance at the national level. We, therefore, aimed to conduct a country-level review of meningococcal surveillance, serogroup distribution, and vaccine use. Methods: We conducted a systematic literature review across six databases to identify studies (published January 1, 2010 to October 16, 2017) and grey literature reporting meningococcal serogroup data for the years 2010-2016. We performed independent random effects meta-analyses for serogroups A, B, C, W, X, Y, and other. We developed and circulated a questionnaire-based survey to surveillance focal points in countries (N = 95) with known regional bacterial meningitis surveillance programs to assess their surveillance capacity and summarized using descriptive methods. Results: We included 173 studies from 59 countries in the final analysis. The distribution of meningococcal serogroups differed markedly between countries and regions. Meningococcal serogroups C and W accounted for substantial proportions of meningococcal disease in most of Africa and Latin America. Serogroup B was the predominant cause of meningococcal disease in many locations in Europe, the Americas, and the Western Pacific. Serogroup Y also caused many cases of meningococcal disease in these regions, particularly in Nordic countries. Survey responses were received from 51 countries. All countries reported the ability to confirm the pathogen in-country, while approximately 30% either relied on reference laboratories for serogrouping (N = 10) or did not serogroup specimens (N = 5). Approximately half of countries did not utilize active laboratory-based surveillance system (N = 22). Nationwide use of a meningococcal vaccine varied, but most countries (N = 36) utilized a meningococcal vaccine at least for certain high-risk population groups, in private care, or during outbreaks. Conclusions: Due to the large geographical variations in circulating meningococcal serogroups, each country should continue to be monitored for changes in major disease-causing serogroups in order to inform vaccine and control policies. Similarly, laboratory capacity should be appropriately scaled up to more accurately understand local epidemiology and disease burden, as well as the impact of vaccination programs.Funding: This study was funded by Sanofi Pasteur. MHK and AM are employees of Sanofi Pasteur and had a role in study design, data interpretation, and preparation of the manuscript. YL is supported by a scholarship from the China Scholarship Council. l had no roThe China Scholarship Councile in study design, data interpretation, or preparation of the manuscript. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication.S