Evolution of airway inflammation in preschoolers with asthma : results of a two-year longitudinal study

Fractional exhaled nitric oxide (FeNO) is a non-invasive marker for eosinophilic airway inflammation and has been used for monitoring asthma. Here, we assess the characteristics of FeNO from preschool to school age, in parallel with asthma activity. A total of 167 asthmatic children and 66 healthy, age-matched controls were included in the 2-year prospective PreDicta study evaluating wheeze/asthma persistence in preschool-aged children. Information on asthma/rhinitis activity, infections and atopy was recorded at baseline. Follow-up visits were performed at 6-month intervals, as well as upon exacerbation/cold and 4-6 weeks later in the asthmatic group. We obtained 539 FeNO measurements from asthmatics and 42 from controls. At baseline, FeNO values did not differ between the two groups (median: 3.0 ppb vs. 2.0 ppb, respectively). FeNO values at 6, 12, 18 and 24 months (4.0, CI: 0.0-8.6; 6.0, CI: 2.8-12.0; 8.0, CI: 4.0-14.0; 8.5, CI: 4.4-14.5 ppb, respectively) increased with age (correlation p <= 0.001) and atopy (p = 0.03). FeNO was non-significantly increased from baseline to the symptomatic visit, while it decreased after convalescence (p = 0.007). Markers of disease activity, such as wheezing episodes and days with asthma were associated with increased FeNO values during the study (p < 0.05 for all). Age, atopy and disease activity were found to be important FeNO determinants in preschool children. Longitudinal and individualized FeNO assessment may be valuable in monitoring asthmatic children with recurrent wheezing or mild asthma

Evolution of Airway Inflammation in Preschoolers with Asthma-Results of a Two-Year Longitudinal Study

Fractional exhaled nitric oxide (FeNO) is a non-invasive marker for eosinophilic airway inflammation and has been used for monitoring asthma. Here, we assess the characteristics of FeNO from preschool to school age, in parallel with asthma activity. A total of 167 asthmatic children and 66 healthy, age-matched controls were included in the 2-year prospective PreDicta study evaluating wheeze/asthma persistence in preschool-aged children. Information on asthma/rhinitis activity, infections and atopy was recorded at baseline. Follow-up visits were performed at 6-month intervals, as well as upon exacerbation/cold and 4-6 weeks later in the asthmatic group. We obtained 539 FeNO measurements from asthmatics and 42 from controls. At baseline, FeNO values did not differ between the two groups (median: 3.0 ppb vs. 2.0 ppb, respectively). FeNO values at 6, 12, 18 and 24 months (4.0, CI: 0.0-8.6; 6.0, CI: 2.8-12.0; 8.0, CI: 4.0-14.0; 8.5, CI: 4.4-14.5 ppb, respectively) increased with age (correlation p <= 0.001) and atopy (p = 0.03). FeNO was non-significantly increased from baseline to the symptomatic visit, while it decreased after convalescence (p = 0.007). Markers of disease activity, such as wheezing episodes and days with asthma were associated with increased FeNO values during the study (p < 0.05 for all). Age, atopy and disease activity were found to be important FeNO determinants in preschool children. Longitudinal and individualized FeNO assessment may be valuable in monitoring asthmatic children with recurrent wheezing or mild asthma

Update on current views and advances on RSV infection (Review).

Respiratory syncytial virus (RSV) infection represents an excellent paradigm of precision medicine in modern paediatrics and several clinical trials are currently performed in the prevention and management of RSV infection. A new taxonomic terminology for RSV was recently adopted, while the diagnostic and omics techniques have revealed new modalities in the early identification of RSV infections and for better understanding of the disease pathogenesis. Coordinated clinical and research efforts constitute an important step in limiting RSV global predominance, improving epidemiological surveillance, and advancing neonatal and paediatric care. This review article presents the key messages of the plenary lectures, oral presentations and posters of the '5th workshop on paediatric virology' (Sparta, Greece, 12th October 2019) organized by the Paediatric Virology Study Group, focusing on recent advances in the epidemiology, pathogenesis, diagnosis, prognosis, clinical management and prevention of RSV infection in childhood

Conceptual design of multistep reaction processes

Many of the chemical routes that are proposed for making commodity and specialty chemicals are characterized by a large number of reaction steps with separations required between these steps. A hierarchical decision procedure has been developed for the conceptual design of multiple reaction step processes from the petrochemical, specialty chemical, and agrichemical industries. The major interactions among the individual plants within a process are identified at the higher abstraction levels of the procedure. Each plant in the process can have more than one supplier plant and can supply more than one plant. Alternative chemistry routes for the production of the desired product of the process or any of the plant intermediates can be integrated and compared within the same process. Balanced processes characterized by very tight interactions among the plants have also been examined. The procedure draws upon an extended set of heuristics that guide the decision-making. A new approach has been used for the calculation of the material balances for the overall process in terms of the dominant design variables, which are determined automatically. The raw material and waste treatment costs, the profits from valuable byproducts, and the costs of the reactor systems and gas compressors are incorporated in the economic evaluation of each process. The sensitivity of the economic potential on the design variables is investigated and the significant economic trade-offs are identified. Object-oriented and rule-based programming techniques have been used for the implementation of the procedure in PIP II, a computer program that allows a design engineer to rapidly generate potentially profitable process alternatives and estimate the optimum design conditions for each flowsheet. The hierarchical decomposition of the design problem and the systematic nature of the procedure considerably limit the number of alternatives that need to be examined and facilitate their screening. The procedure and PIP II have been successfully tested on the design of fifteen processes. Examples are: the production of vinyl chloride mononer via chlorination and oxychlorination of ethylene; the production of adipic acid from butadiene and methanol (BASF process); the production of adiponitrile by butadiene hydrocyanation (DuPont process) as well as via adipic acid

Φλεγμονή στη ρινίτιδα και το άσθμα. Συσχέτιση και κινητική

Το κλασματικό εκπνεόμενο μονοξείδιο του αζώτου (FeNO) είναι ένας μη επεμβατικός δείκτης της ηωσινοφιλικής φλεγμονής των αεραγωγών και έχει χρησιμοποιηθεί για την παρακολούθηση του άσθματος. Στην μελέτη αυτή αξιολογούμε τα χαρακτηριστικά της διακύμανσης του FeNO από την προσχολική έως τη σχολική ηλικία παράλληλα με τη δραστηριότητα της ρινίτιδας και του άσθματος. 167 παιδιά με άσθμα και 66 υγιείς μάρτυρες συμπεριελήφθησαν στη διετή προοπτική μελέτη του PreDicta που αξιολόγησε την επιμονή του συριγμού / άσθματος σε παιδιά προσχολικής ηλικίας. Πληροφορίες σχετικά με τη δραστηριότητα άσθματος / ρινίτιδας, λοιμώξεις και ατοπία καταγράφηκαν κατά την έναρξη. Οι επισκέψεις παρακολούθησης πραγματοποιήθηκαν σε διαστήματα 6 μηνών στην ομάδα των παιδιών με άσθμα καθώς και κατά την έξαρση συμπτωμάτων άσθματος / η κρυολογήματος όπως και 4-6 εβδομάδες αργότερα ,στην ανάρρωση. Λήφθηκαν 539 μετρήσεις FeNO στα παιδιά με άσθμα και 42 στην ομάδα ελέγχου. Κατά την έναρξη της μελέτης, το FeNO δεν διέφερε μεταξύ των ομάδων (διάμεσος αντίστοιχα, 3,0 έναντι 2,0 ppb). Οι τιμές FeNO στους 6, 12, 18 και 24 μήνες (αντίστοιχα 4.0 CI: 0.0-8.6, 6.0 CI: 2.8-12.0, 8.0 CI: 4.0-14.0, 8.5 CI: 4.4-14.5 ppb) αυξήθηκαν με την ηλικία &lt;0,001) και ατοπία (ρ = 0,03). Το FeNO δεν αυξήθηκε σημαντικά από την έναρξη μέχρι τη επίσκεψη επί συμπτωμάτων, ενώ μειώθηκε κατά την ανάρρωση (p = 0.007). Οι δείκτες της δραστηριότητας της νόσου, όπως τα επεισόδια συριγμού και οι ημέρες με άσθμα, συσχετίστηκαν με αυξημένες τιμές FeNO κατά τη διάρκεια της μελέτης (όλες οι τιμές p &lt;0,05). Η ηλικία, η ατοπία και η δραστηριότητα του άσθματος είναι σημαντικοί και καθοριστικοί παράγοντες του FeNO στα παιδιά προσχολικής ηλικίας. Η διαχρονική και εξατομικευμένη αξιολόγηση του FeNO μπορεί να είναι πολύτιμη για την παρακολούθηση των παιδιών με υποτροπιάζοντα συριγμό ή ήπιο άσθμα.Fractional exhaled nitric oxide (FeNO) is a non-invasive marker for eosinophilic airway inflammation and has been used for monitoring asthma. Here we assess the characteristics of FeNO from preschool to school age, in parallel to asthma and rhinitis activity.167 asthmatic children and 66 healthy age-matched were included in the 2-year prospective PreDicta study evaluating wheeze/asthma persistence in preschool-aged children. Information on asthma/rhinitis activity, infections and atopy were recorded at baseline. Follow up visits were performed at 6 months intervals in the asthmatic group, and on exacerbation/cold and 4-6 weeks later. We obtained 539 FeNO measurements in asthmatics and 42 in controls. At baseline, FeNO did not differ between groups (medians respectively, 3.0 vs 2.0 ppb). FeNO values at 6, 12, 18 and 24 months (respectively, 4.0 CI: 0.0-8.6, 6.0 CI: 2.8-12.0, 8.0 CI:4.0-14.0, 8.5 CI:4.4-14.5 ppb) increased with age (correlation p=&lt;0.001) and atopy (p=0.03). FeNO non-significantly increased from baseline to symptomatic visit, while decreased at convalescence (p=0.007). Markers of disease activity, such as wheeze episodes and days with asthma were associated with increased FeNO values during the study (all p&lt;0.05). Age, atopy and disease activity are important FeNO determinants in preschool children. Longitudinal and individualized FeNO assessment may be valuable in monitoring asthmatic children with recurrent wheezing or mild asthma

Association and kinetics of airway inflammation in rhinitis and asthma

Fractional exhaled nitric oxide (FeNO) is a non-invasive marker for eosinophilic airway inflammation and has been used for monitoring asthma. Here we assess the characteristics of FeNO from preschool to school age, in parallel to asthma activity. 167 asthmatic children and 66 healthy age-matched were included in the 2-year prospective PreDicta study evaluating wheeze/asthma persistence in preschool-aged children. Information on asthma/rhinitis activity, infections and atopy were recorded at baseline.Follow up visits were performed at 6 months intervals in the asthmatic group, and on exacerbation/cold and 4-6 weeks later. We obtained 539 FeNO measurements in asthmatics and 42 in controls. At baseline, FeNO did not differ between groups (medians respectively, 3.0 vs 2.0 ppb). FeNO values at 6, 12, 18 and 24 months (respectively, 4.0 CI: 0.0-8.6, 6.0 CI: 2.8-12.0, 8.0 CI:4.0-14.0, 8.5 CI:4.4-14.5 ppb) increased with age (correlation p=<0.001) and atopy (p=0.03). FeNO non-significantly increased from baseline to symptomatic visit, while decreased at convalescence (p=0.007). Markers of disease activity, such as wheeze episodes and days with asthma were associated with increased FeNO values during the study (all p<0.05). Age, atopy and disease activity are important FeNO determinants in preschool children. Longitudinal and individualized FeNO assessment may be valuable in monitoring asthmatic children with recurrent wheezing or mild asthma.Το κλασματικό εκπνεόμενο μονοξείδιο του αζώτου (FeNO) είναι ένας μη επεμβατικός δείκτης της ηωσινοφιλικής φλεγμονής των αεραγωγών και έχει χρησιμοποιηθεί για την παρακολούθηση του άσθματος. Στην μελέτη αυτή αξιολογούμε τα χαρακτηριστικά της διακύμανσης του FeNO από την προσχολική έως τη σχολική ηλικία παράλληλα με τη δραστηριότητα του άσθματος. 167 παιδιά με άσθμα και 66 υγιείς μάρτυρες συμπεριελήφθησαν στη διετή προοπτική μελέτη του PreDicta που αξιολόγησε την επιμονή του συριγμού / άσθματος σε παιδιά προσχολικής ηλικίας. Πληροφορίες σχετικά με τη δραστηριότητα άσθματος / ρινίτιδας, λοιμώξεις και ατοπία καταγράφηκαν κατά την έναρξη. Οι επισκέψεις παρακολούθησης πραγματοποιήθηκαν σε διαστήματα 6 μηνών στην ομάδα των παιδιών με άσθμα καθώς και κατά την έξαρση συμπτωμάτων άσθματος / η κρυολογήματος όπως και 4-6 εβδομάδες αργότερα ,στην ανάρρωση. Λήφθηκαν 539 μετρήσεις FeNO στα παιδιά με άσθμα και 42 στην ομάδα ελέγχου. Κατά την έναρξη της μελέτης, το FeNO δεν διέφερε μεταξύ των ομάδων (διάμεσος αντίστοιχα, 3,0 έναντι 2,0 ppb). Οι τιμές FeNO στους 6, 12, 18 και 24 μήνες (αντίστοιχα 4.0 CI: 0.0-8.6, 6.0 CI: 2.8-12.0, 8.0 CI: 4.0-14.0, 8.5 CI: 4.4-14.5 ppb) αυξήθηκαν με την ηλικία <0,001) και ατοπία (ρ = 0,03). Το FeNO δεν αυξήθηκε σημαντικά από την έναρξη μέχρι τη επίσκεψη επί συμπτωμάτων, ενώ μειώθηκε κατά την ανάρρωση (p = 0.007). Οι δείκτες της δραστηριότητας της νόσου, όπως τα επεισόδια συριγμού και οι ημέρες με άσθμα, συσχετίστηκαν με αυξημένες τιμές FeNO κατά τη διάρκεια της μελέτης (όλες οι τιμές p <0,05). Η ηλικία, η ατοπία και η δραστηριότητα του άσθματος είναι σημαντικοί και καθοριστικοί παράγοντες του FeNO στα παιδιά προσχολικής ηλικίας. Η διαχρονική και εξατομικευμένη αξιολόγηση του FeNO μπορεί να είναι πολύτιμη για την παρακολούθηση των παιδιών με υποτροπιάζοντα συριγμό ή ήπιο άσθμα

Invasive infection from Kingella kingae: Not only arthritis

Kingella kingae is a known pathogen for osteoarticular infections in young children. However other invasive infections such as pneumonia in immunocompetent patients are scarcely described in literature. We present an unusual case of bacteremia and lower respiratory tract infection in a previously healthy infant, the first one described in Greek pediatric population. The pathogen was identified using both culture and molecular technique