Диагностическая значимость оксида азота при проведении бронхиальных провокационных тестов

The reported practical work shows a significance of detection the exhaled fraction of nitric oxide (FENO) compared with bronchial challenge tests to diagnose the allergic inflammation and to determine the inflammatory activity in the airways. Methods: 30 bronchial challenge tests were performed in 24 children aged 5 to 16 yrs with different degrees of sensitization detected by the pricktest. The challenge tests were performed with various allergens, the lung function was examined by spirometry or pneumotachometry, the airway resistance was studied by impulse oscillometry. The FENO was measured using a chemiluminescent gas analyzer. The FENO levels obtained after the challenge tests allowed to divide the patients with positive test results in 2 groups and those with negative test results in 3 groups. Two negative and the positive groups had the similar FENO levels and only the third negative group had different FENO level. Therefore, the FENO allows detecting the allergy imflammation including its latent form even if the challenge test is negative.В проведенной практической работе при выполнении специфического бронхиального провокационного теста показано значение фракции выдыхаемого оксида азота (FENO), продуцируемого различными типами NO-синтаз, в диагностике аллергического воспаления и предполагаемой активности воспалительного процесса в дыхательных путях. Проведены 30 бронхиальных провокационных тестов 24 пациентам — детям в возрасте 5–16 лет с различным уровнем сенсибилизации, выявленным при помощи Prick-тестов. Бронхиальный провокационный тест проводился с различными аллергенами, оценка функции внешнего дыхания проводилась методом спирометрии / пневмотахометрии, сопротивление дыхательных путей определялось методом импульсной осциллометрии. Фракция оксида азота в выдыхаемом воздухе замерялась с помощью хемилюминесцентного газового анализатора. Полученные показатели уровня FENO после бронхиального провокационного теста позволили выделить среди пациентов, показавших положительный тест, 2 группы, а среди пациентов, показавших негативный тест, — 3 группы. Отмечено, что из 3 групп пациентов, имевших негативный бронхиальный тест, 2 группы реагировали по уровню FENO аналогично пациентам, имевшим положительный бронхиальный тест, и только 1 группа имела свои отличительные признаки. Заключение: Уровень FENO позволяет диагностировать наличие аллергической реакции, в т. ч. и латентной, даже при отрицательном провокационном бронхиальном тесте

Диагностическая значимость оксида азота при проведении бронхиальных провокационных тестов

The reported practical work shows a significance of detection the exhaled fraction of nitric oxide (FENO) compared with bronchial challenge tests to diagnose the allergic inflammation and to determine the inflammatory activity in the airways. Methods: 30 bronchial challenge tests were performed in 24 children aged 5 to 16 yrs with different degrees of sensitization detected by the prick-test. The challenge tests were performed with various allergens, the lung function was examined by spirometry or pneumotachometry, the airway resistance was studied by impulse oscillometry. The FENO was measured using a chemiluminescent gas analyzer. The FENO levels obtained after the challenge tests allowed to divide the patients with positive test results in 2 groups and those with negative test results in 3 groups. Two negative and the positive groups had the similar FENO levels and only the third negative group had different FENO level. Therefore, the FENO allows detecting the allergy imflammation including its latent form even if the challenge test is negative.В проведенной практической работе при выполнении специфического бронхиального провокационного теста показано значение фракции выдыхаемого оксида азота (FENO), продуцируемого различными типами NO-синтаз, в диагностике аллергического воспаления и предполагаемой активности воспалительного процесса в дыхательных путях. Проведено 30 бронхиальных провокационных тестов 24 пациентам — детям в возрасте 5–16 лет с различным уровнем сенсибилизации, выявленным при помощи Prick-тестов. Бронхиальный провокационный тест проводился с различными аллергенами, оценка функции внешнего дыхания проводилась методом спирометрии / пневмотахометрии, сопротивление дыхательных путей определялось методом импульсной осциллометрии. Фракция оксида азота в выдыхаемом воздухе замерялась с помощью хемилюминесцентного газового анализатора. Полученные показатели уровня FENO после бронхиального провокационного теста позволили выделить среди пациентов, показавших положительный тест, 2 группы, а среди пациентов, показавших негативный тест, — 3 группы. Отмечено, что из 3 групп пациентов, имевших негативный бронхиальный тест, 2 группы реагировали по уровню FENO аналогично пациентам, имевшим положительный бронхиальный тест, и только 1 группа имела свои отличительные признаки. Заключение: Уровень FENO позволяет диагностировать наличие аллергической реакции, в т. ч. и латентной, даже при отрицательном провокационном бронхиальном тесте

Why Give Birth in Health Facility? Users' and Providers' Accounts of Poor Quality of Birth Care in Tanzania.

In Tanzania, half of all pregnant women access a health facility for delivery. The proportion receiving skilled care at birth is even lower. In order to reduce maternal mortality and morbidity, the government has set out to increase health facility deliveries by skilled care. The aim of this study was to describe the weaknesses in the provision of acceptable and adequate quality care through the accounts of women who have suffered obstetric fistula, nurse-midwives at both BEmOC and CEmOC health facilities and local community members. Semi-structured interviews involving 16 women affected by obstetric fistula and five nurse-midwives at maternity wards at both BEmOC and CEmOC health facilities, and Focus Group Discussions with husbands and community members were conducted between October 2008 and February 2010 at Comprehensive Community Based Rehabilitation in Tanzania and Temeke hospitals in Dar es Salaam, and Mpwapwa district in Dodoma region. Health care users and health providers experienced poor quality caring and working environments in the health facilities. Women in labour lacked support, experienced neglect, as well as physical and verbal abuse. Nurse-midwives lacked supportive supervision, supplies and also seemed to lack motivation. There was a consensus among women who have suffered serious birth injuries and nurse midwives staffing both BEmOC and CEmOC maternity wards that the quality of care offered to women in birth was inadequate. While the birth accounts of women pointed to failure of care, the nurses described a situation of disempowerment. The bad birth care experiences of women undermine the reputation of the health care system, lower community expectations of facility birth, and sustain high rates of home deliveries. The only way to increase the rate of skilled attendance at birth in the current Tanzanian context is to make facility birth a safer alternative than home birth. The findings from this study indicate that there is a long way to go

A versatile synthesis method of dendrites-free segmented nanowires with a precise size control

We report an innovative strategy to obtain cylindrical nanowires combining well established and low-cost bottom-up methods such as template-assisted nanowires synthesis and electrodeposition process. This approach allows the growth of single-layer or multi-segmented nanowires with precise control over their length (from few nanometers to several micrometers). The employed techniques give rise to branched pores at the bottom of the templates and consequently dendrites at the end of the nanowires. With our method, these undesired features are easily removed from the nanowires by a selective chemical etching. This is crucial for magnetic characterizations where such non-homogeneous branches may introduce undesired features into the final magnetic response. The obtained structures show extremely narrow distributions in diameter and length, improved robustness and high-yield, making this versatile approach strongly compatible with large scale production at an industrial level. Finally, we show the possibility to tune accurately the size of the nanostructures and consequently provide an easy control over the magnetic properties of these nanostructures

Age of Child, More than HPV Type, Is Associated with Clinical Course in Recurrent Respiratory Papillomatosis

Background: RRP is a devastating disease in which papillomas in the airway cause hoarseness and breathing difficulty. The disease is caused by human papillomavirus (HPV), 6 or 11 and is very variable. Patients undergo multiple surgeries to maintain a patent airway and in order to communicate vocally. Several small studies have been published in which most have noted that HPV 11 is associated with a more aggressive course. Methodology/Principal Findings: Papilloma biopsies were taken from patients undergoing surgical treatment of RRP and were subjected to HPV typing. 118 patients with juvenile-onset RRP with a least 1 year of clinical data and infected with a single HPV type were analyzed. HPV 11 was encountered in 40% of the patients. By our definition, most of the patients in the sample (81%) had run an aggressive course. The odds of a patient with HPV 11 running an aggressive course were 3.9 times higher that that of patients with HPV 6 (Fisher's exact p=0.017). However, clinical course was more closely associated with age of the patient (at diagnosis and at the time of the current surgery) than with HPV type. Patients with HPV 11 were diagnosed at a younger age (2.4y) than were those with HPV 6 (3.4y) (p=0.014). Both by multiple linear regression and by multiple logistics regression HPV type was only weakly associated with metrics of disease course when simultaneously accounting for age. Conclusions/Significance Abstract: The course of RRP is variable and a quarter of the variability can be accounted for by the age of the patient. HPV 11 is more closely associated with a younger age at diagnosis than it is associated with an aggressive clinical course. These data suggest that there are factors other than HPV type and age of the patient that determine disease course. © 2008 Buchinsky et al

Public-private partnership for TB control in Bangladesh: Role of Private Medical Practitioners in the management of TB patients

Background: Despite enormous efforts, Bangladesh has one of the highest burdens of tuberculosis (TB) in the world. Treatment in the private sector is common and popular among TB patients in South-Asian countries, including Bangladesh, even though the quality of diagnosis and treatment of TB patients has been shown to be poor in several such countries. The Bangladesh National Tuberculosis Programme (NTP) has recently shown considerable interest in exploring policy options to address this problem. Consequently, the NTP and Non-Governmental Organisation (NGO) partners planned to develop a public-private partnership (PPP) model for effective involvement of private medical practitioners (PMPs) in TB control. However, there was a lack of solid data on TB case management practice by PMPs which was needed to appraise the potential role and contribution of PMPs in TB control. The purpose of the study is therefore to assess the knowledge, attitudes and practices of PMPs on TB control in an urban setting in Bangladesh in order to inform development of a public-private collaboration model