Spirometry-adjusted fraction of exhaled nitric oxide increases accuracy for assessment of asthma control in children

Spirometry and exhaled nitric oxide are two important complimentary tools to identify and assess asthma control in children. We aimed to determine the ability of a new suggested spirometry-adjusted fraction of exhaled nitric oxide (NO) index in doing that. A random sample of 1602 schoolchildren were screened by a health questionnaire, skin prick tests, spirometry with bronchodilation and exhaled NO. A total of 662 children were included with median (IQR) exhaled NO 11(14) ppb. Receiver operating characteristic (ROC) curves using exhaled NO equations from Malmberg, Kovesi and Buchvald, and spirometry-adjusted fraction of exhaled NO values were applied to identify asthmatic children and uncontrolled asthma. Receiver operating characteristic (ROC) curves failed to identify asthmatic children (all AUC < 0.700). Spirometry-adjusted fraction of exhaled NO/FEV1 (AUC = 0.712; P = .010) and NO/FEF25%-75% (AUC = 0.735 P = .004) had a fair and increased ability to identify uncontrolled disease compared with exhaled NO (AUC = 0.707; P = .011) or the Malmberg equation (AUC = 0.701; P = .014). Sensitivity and specificity identifying non-controlled asthma were 59% and 81%, respectively, for the cut-off value of 9.7 ppb/L for exhaled NO/FEV1 , and 40% and 100% for 15.7 ppb/L/s for exhaled NO/FEF25%-75% . Exhaled NO did not allow to identify childhood asthma. Spirometry-adjusted fraction of exhaled NO performed better-assessing asthma control in children. Thus, although more validation studies are needed, we suggest its use in epidemiological studies to assess asthma control.Health, Comfort and Energy in the Built Environment (HEBE), Grant/Award Number: NORTE-01-0145-FEDER-000010; Programa Operacional Regional do Norte, Grant/Award Number: NORTE2020; Fundo Europeu de Desenvolvimento Regional (FEDER); Foundation for Science and Technology schoolarships, Grant/Award Number: SFRH/BD/108605/2015 and SFRH/BD/112269/201

Comparative Antibiotic Resistance of Diarrheal Pathogens from Vietnam and Thailand, 1996-1999

Antimicrobial resistance rates for shigella, campylobacter, nontyphoidal salmonella, and enterotoxigenic Escherichia coli were compared for Vietnam and Thailand from 1996 to 1999. Resistance to trimethoprim-sulfamethoxazole, ampicillin, chloramphenicol, and tetracycline was common. Quinolone resistance remains low in both countries, except among campylobacter and salmonella organisms in Thailand. Nalidixic acid resistance among salmonellae has more than doubled since 1995 (to 21%) in Thailand but is not yet documented in Vietnam. Resistance to quinolones correlated with resistance to azithromycin in both campylobacter and salmonella in Thailand. This report describes the first identification of this correlation and its epidemiologic importance among clinical isolates. These data illustrate the growing magnitude of antibiotic resistance and important differences between countries in Southeast Asia

Longitudinal Evaluation of Humoral Immunity Following Vaccination With Six ZIKV Vaccines

The immunogenicity and efficacy of Zika virus (ZIKV) vaccines from our lab were successfully exhibited in both murine and non-human primate models. Long-term protection, a hallmark for vaccines, and the humoral immunity kinetics, though, have not yet been elucidated. Furthermore, a side-to-side comparison of ZIKV vaccines such as human adenovirus (Ad) serotypes 5, 26, rhesus adenovirus (RhAd) serotype 52, DNA vectors and purified inactivated virus (PIV) has not been done. The Ad-based vaccines, expressing viral membrane/envelope proteins, and PIV conferred durable protection against ZIKV challenge in mice. In contrast, the two DNA vaccines tested here were not as potent as the other four vaccines at inducing long-term protective humoral immunity. Determining the vaccine-induced antibody kinetics could provide details regarding the long-term protective efficacy of each vaccine. As several vaccines are moving forward into Phase I clinical trial, including some tested here, it is crucial to understand their capacity to generate long-term protection