Browsing by Subject "PNEUMONIA"

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  • Ranta, Jukka; Ilén, Elina; Palmu, Kirsi; Salama, Jonna; Roienko, Oleksii; Vanhatalo, Sampsa (2021)
    Aim To describe and test the accuracy of respiratory rate assessment in long-term surveillance using an open-source infant wearable, NAPping PAnts (NAPPA). Methods We recorded 24 infants aged 1-9 months using our newly developed infant wearable that is a diaper cover with an integrated programmable electronics with accelerometer and gyroscope sensors. The sensor collects child's respiration rate (RR), activity and body posture in 30-s epochs, to be downloaded afterwards into a mobile phone application. An automated RR quality measure was also implemented using autocorrelation function, and the accuracy of RR estimate was compared with a reference obtained from the simultaneously recorded capnography signal that was part of polysomnography recordings. Results Altogether 88 h 27 min of data were recorded, and 4147 epochs (39% of all data) were accepted after quality detection. The median of patient wise mean absolute errors in RR estimates was 1.5 breaths per minute (interquartile range 1.1-2.6 bpm), and the Blandt-Altman analysis indicated an RR bias of 0.0 bpm with the 95% limits of agreement of -5.7-5.7 bpm. Conclusion Long-term monitoring of RR and posture can be done with reasonable accuracy in out-of-hospital settings using NAPPA, an openly available infant wearable.
  • Hemilä, Harri (2007)
  • Broderick, David T. J.; Waite, David W.; Marsh, Robyn L.; Camargo, Carlos A.; Cardenas, Paul; Chang, Anne B.; Cookson, William O. C.; Cuthbertson, Leah; Dai, Wenkui; Everard, Mark L.; Gervaix, Alain; Harris, J. Kirk; Hasegawa, Kohei; Hoffman, Lucas R.; Hong, Soo-Jong; Josset, Laurence; Kelly, Matthew S.; Kim, Bong-Soo; Kong, Yong; Li, Shuai C.; Mansbach, Jonathan M.; Mejias, Asuncion; O'Toole, George A.; Paalanen, Laura; Perez-Losada, Marcos; Pettigrew, Melinda M.; Pichon, Maxime; Ramilo, Octavio; Ruokolainen, Lasse; Sakwinska, Olga; Seed, Patrick C.; van der Gast, Christopher J.; Wagner, Brandie D.; Yi, Hana; Zemanick, Edith T.; Zheng, Yuejie; Pillarisetti, Naveen; Taylor, Michael W. (2021)
    Introduction: The airway microbiota has been linked to specific paediatric respiratory diseases, but studies are often small. It remains unclear whether particular bacteria are associated with a given disease, or if a more general, non-specific microbiota association with disease exists, as suggested for the gut. We investigated overarching patterns of bacterial association with acute and chronic paediatric respiratory disease in an individual participant data (IPD) meta-analysis of 16S rRNA gene sequences from published respiratory microbiota studies.Methods: We obtained raw microbiota data from public repositories or via communication with corresponding authors. Cross-sectional analyses of the paediatric (10 case subjects were included. Sequence data were processed using a uniform bioinformatics pipeline, removing a potentially substantial source of variation. Microbiota differences across diagnoses were assessed using alpha- and beta-diversity approaches, machine learning, and biomarker analyses.Results: We ultimately included 20 studies containing individual data from 2624 children. Disease was associated with lower bacterial diversity in nasal and lower airway samples and higher relative abundances of specific nasal taxa including Streptococcus and Haemophilus. Machine learning success in assigning samples to diagnostic groupings varied with anatomical site, with positive predictive value and sensitivity ranging from 43 to 100 and 8 to 99%, respectively.Conclusion: IPD meta-analysis of the respiratory microbiota across multiple diseases allowed identification of a non-specific disease association which cannot be recognised by studying a single disease. Whilst imperfect, machine learning offers promise as a potential additional tool to aid clinical diagnosis.
  • Auvinen, Raija; Nohynek, Hanna; Syrjänen, Ritva; Ollgren, Jukka; Kerttula, Tuija; Mäntylä, Jarkko; Ikonen, Niina; Loginov, Raisa; Haveri, Anu; Kurkela, Satu; Skogberg, Kirsi (2021)
    Background We compared the clinical characteristics, findings, and outcomes of hospitalized patients with coronavirus disease 2019 (COVID-19) or influenza to detect relevant differences. Methods From December 2019 to April 2020, we recruited all eligible hospitalized adults with respiratory infection to a prospective observational study at a tertiary care hospital in Finland. Influenza and SARS-CoV-2 infections were confirmed by RT-PCR. Follow-up lasted for 3 months from admission. Results We included 61 patients, of whom 28 were COVID-19 and 33 influenza patients with median ages of 53 and 56 years. Majority of both COVID-19 and influenza patients were men (61% vs. 67%) and had at least one comorbidity (68% vs. 85%). Pulmonary diseases and current smoking were less common among COVID-19 than influenza patients (5 [18%] vs. 15 [45%], p=.03 and 1 [4%] vs. 10 [30%], p=.008). In chest X-ray at admission, ground-glass opacities (GGOs) and consolidations were more frequent among COVID-19 than influenza patients (19 [68%] and 7 [21%], p.001). Severe disease and intensive care unit (ICU) admission occurred more often among COVID-19 than influenza patients (26 [93%] vs. 19 [58%], p=.003 and 8 [29%] vs. 2 [6%], p=.034). COVID-19 patients were hospitalized longer than influenza patients (six days [IQR 4-21] vs. 3 [2-4], p.001). Conclusions Bilateral GGOs and consolidations in chest X-ray may help to differentiate COVID-19 from influenza. Hospitalized COVID-19 patients had more severe disease, required longer hospitalization and were admitted to ICU more often than influenza patients, which has important implications for public health policies.
  • Abdelrehiem, Dina Ahmed Mosselhy; Assad, Mhd Adel; Sironen, Tarja; Elbahri, Mady (2021)
    The COVID-19 pandemic is expanding worldwide. This pandemic associated with COVID-19 placed the spotlight on how bacterial (e.g., methicillin-resistant Staphylococcus aureus) co-infections may impact responses to coronavirus. In this review the ways in which nanoparticles can contain and rapidly diagnose COVID-19 under the umbrella of nanotheranostics (i.e., smart, single agents combining nanodiagnostics and nanotherapeutics) are elaborated. The present work provides new insights into the promising incorporation of antiviral nanotheranostics into nanostructured materials, including electrospun fibers with tailored pore sizes and hydrophobicity, namely "superhydrophobic self-disinfecting electrospun facemasks/fabrics (SSEF)." SSEFs are proposed as smart alternatives to address the drawbacks of N95 respirators. The challenges of coronavirus containment are underscored, literature is reviewed, and "top-five suggestions" for containing COVID-19 are offered, including: i) preventive appraisals-avoiding needless hospital admission and practicing frequent hand washing (from 20 to 60 s). ii) Diagnostics-highly recommending nanodiagnostics, detecting COVID-19 within 10 min. iii) Therapeutics-expanding nanotherapeutics to treat COVID-19 and bacterial co-infections after safety assessments and clinical trials. iv) Multipronged and multinational, including China, collaborative appraisals. v) Humanitarian compassion to traverse this pandemic in a united way.
  • Rossi, Heini; Raekallio, Marja; Määttä, Merita; Tapio, Heidi Anneli; Hanifeh, Mohsen; Junnila, Jouni; Rajamäki, Minna; Mykkänen, Anna (2019)
    Pneumonia is one of the potential complications of general anaesthesia in horses. Anaesthesia is known to increase neutrophils in bronchoalveolar lavage fluid (BALF) of horses after lateral recumbency, but studies after dorsal recumbency are lacking. Our primary aim was to determine when lung inflammation reaches its maximum and how rapidly BALF cytology returns to baseline after anaesthesia in dorsal recumbency. A secondary aim was to investigate the possible effect of vatinoxan, a novel drug, on the BALF cytology results. Six healthy experimental horses were enrolled in this observational crossover study. The horses were subject to repeated BALF and blood sampling for 7 days after general anaesthesia with two treatment protocols, and without anaesthesia (control). During the two treatments, the horses received either medetomidine-vatinoxan or medetomidine-placebo as premedication, and anaesthesia was induced with ketamine-midazolam and maintained with isoflurane for 1 h in dorsal recumbency. The differences in BALF and blood variables between the two anaesthesia protocols and control were analysed with repeated measures analysis of variance models. In this study, anaesthesia in dorsal recumbency resulted in no clinically relevant changes in airway cytology that could be differentiated from the effect of repeated BALF sampling. No differences in BALF matrix metalloproteinase gelatinolytic activity could be detected between the two treatments or the control series. Marked increase in serum amyloid A was detected in some animals. Vatinoxan as premedication did not consistently affect lung cytology or blood inflammatory markers after anaesthesia. (C) 2019 The Author(s). Published by Elsevier Ltd.
  • Halli, Outi; Haimi-Hakala, Minna; Oliviero, Claudio; Heinonen, Mari (2020)
    Background Chronic pleurisy is a common finding in slaughtered pigs in post-mortem meat inspection. The prevalence of pleurisy has been increasing during the last decade also in Finland. The aim of this prospective case-control study was to search for environmental, infectious and management-related herd-level risk factors for pleurisy in the slaughterhouse. Altogether 46 Finnish pig herds, including 25 control (low pleurisy prevalence in meat inspection) and 21 case (high pleurisy) herds, were enrolled in the study and visited during the tenth week of the rearing period of finishing pigs. Herd personnel were asked about basic herd information, management and environmental factors. Selected pigs were examined clinically, environmental parameters were measured and 15 blood samples per herd were taken during herd visits. Antibodies againstActinobacillus pleuropneumoniaserotype 2 (APP2) and ApxIV toxin and swine influenza virus were measured. After the slaughter of study pigs, meat inspection results of the batch were gathered from slaughterhouses. Multivariate logistic regression model was built to identify possible risk factors for a herd to be a case herd (i.e. having high pleurisy values). Results Finishing herd type and herd size were observed to act as risk factors. None of clinical signs of pigs, management-related factors or environmental measurements were associated with herd status. Conclusions As previously known, in endemic and subclinical infections such as APP, herd factors are important, but detailed risk factors seem to be difficult to identify.
  • Efraim Investigators; Nine-I Study Grp; Martin-Loeches, Ignacio; Valkonen, Miia; Azoulay, Elie (2019)
    BackgroundIt is unclear whether influenza infection and associated co-infection are associated with patient-important outcomes in critically ill immunocompromised patients with acute respiratory failure.MethodsPreplanned secondary analysis of EFRAIM, a prospective cohort study of 68 hospitals in 16 countries. We included 1611 patients aged 18years or older with non-AIDS-related immunocompromise, who were admitted to the ICU with acute hypoxemic respiratory failure. The main exposure of interest was influenza infection status. The primary outcome of interest was all-cause hospital mortality, and secondary outcomes ICU length of stay (LOS) and 90-day mortality.ResultsInfluenza infection status was categorized into four groups: patients with influenza alone (n=95, 5.8%), patients with influenza plus pulmonary co-infection (n=58, 3.6%), patients with non-influenza pulmonary infection (n=820, 50.9%), and patients without pulmonary infection (n=638, 39.6%). Influenza infection status was associated with a requirement for intubation and with LOS in ICU (P
  • GBD 2017 Influenza Collaborators (2019)
    Background Although the burden of influenza is often discussed in the context of historical pandemics and the threat of future pandemics, every year a substantial burden of lower respiratory tract infections (LRTIs) and other respiratory conditions (like chronic obstructive pulmonary disease) are attributable to seasonal influenza. The Global Burden of Disease Study (GBD) 2017 is a systematic scientific effort to quantify the health loss associated with a comprehensive set of diseases and disabilities. In this Article, we focus on LRTIs that can be attributed to influenza. Methods We modelled the LRTI incidence, hospitalisations, and mortality attributable to influenza for every country and selected subnational locations by age and year from 1990 to 2017 as part of GBD 2017. We used a counterfactual approach that first estimated the LRTI incidence, hospitalisations, and mortality and then attributed a fraction of those outcomes to influenza. Findings Influenza LRTI was responsible for an estimated 145 000 (95% uncertainty interval [UI] 99 000-200 000) deaths among all ages in 2017. The influenza LRTI mortality rate was highest among adults older than 70 years (16.4 deaths per 100 000 [95% UI 11.6-21.9]), and the highest rate among all ages was in eastern Europe (5.2 per 100 000 population [95% UI 3.5-7.2]). We estimated that influenza LRTIs accounted for 9 459 000 (95% UI 3 709 000-22 935 000) hospitalisations due to LRTIs and 81 536 000 hospital days (24 330 000-259 851 000). We estimated that 11.5% (95% UI 10.0-12.9) of LRTI episodes were attributable to influenza, corresponding to 54 481 000 (38 465 000-73 864 000) episodes and 8 172 000 severe episodes (5 000 000-13 296 000). Interpretation This comprehensive assessment of the burden of influenza LRTIs shows the substantial annual effect of influenza on global health. Although preparedness planning will be important for potential pandemics, health loss due to seasonal influenza LRTIs should not be overlooked, and vaccine use should be considered. Efforts to improve influenza prevention measures are needed. Copyright (c) 2018 The Author(s). Published by Elsevier Ltd.
  • GBD 2015 Eastern Mediterranean Reg; Mokdad, Ali H.; Weiderpass, Elisabete; Shiri, Rahman (2018)
    Although substantial reductions in under-5 mortality have been observed during the past 35 years, progress in the Eastern Mediterranean Region (EMR) has been uneven. This paper provides an overview of child mortality and morbidity in the EMR based on the Global Burden of Disease (GBD) study. We used GBD 2015 study results to explore under-5 mortality and morbidity in EMR countries. In 2015, 755,844 (95% uncertainty interval (UI) 712,064-801,565) children under 5 died in the EMR. In the early neonatal category, deaths in the EMR decreased by 22.4%, compared to 42.4% globally. The rate of years of life lost per 100,000 population under 5 decreased 54.38% from 177,537 (173,812-181,463) in 1990 to 80,985 (76,308-85,876) in 2015; the rate of years lived with disability decreased by 0.57% in the EMR compared to 9.97% globally. Our findings call for accelerated action to decrease child morbidity and mortality in the EMR. Governments and organizations should coordinate efforts to address this burden. Political commitment is needed to ensure that child health receives the resources needed to end preventable deaths.
  • Fu, Yu; Gaelings, Lana; Jalovaara, Petri; Kakkola, Laura; Kinnunen, Mervi T.; Kallio-Kokko, Hannimari; Valkonen, Miia; Kantele, Anu; Kainov, Denis E. (2016)
    Influenza A viruses (IAV) mutate rapidly and cause seasonal epidemics and occasional pandemics, which result in substantial number of patient visits to the doctors and even hospitalizations. We aimed here to identify inflammatory proteins, which levels correlated to clinical severity of the disease. For this we analysed 102 cytokines and growth factors in human nasopharyngeal aspirate (NPA) samples of 27 hospitalized and 27 outpatients diagnosed with influenza A(H1N1)pdm09 virus infection. We found that the relative levels of monocyte differentiation antigen CD14, lipocalin-2 (LCN2), C-C-motif chemokine 20 (CCL20), CD147, urokinase plasminogen activator surface receptor (uPAR), pro-epidermal growth factor (EGF), trefoil factor 3 (TFF3), and macrophage migration inhibitory factor (MIF) were significantly lower (p <0.008), whereas levels of retinol-binding protein 4 (RBP4), C-X-C motif chemokine 5 (CXCL5), interleukin-8 (IL-8), complement factor D (CFD), adiponectin, and chitinase-3-like 1 (CHI3L1) were significantly higher (p <0.008) in NPA samples of hospitalized than non-hospitalized patients. While changes in CD14, LCN2, CCL20, uPAR, EGF, MIF, CXCL5, IL-8, adiponectin and CHI3L1 levels have already been correlated with severity of IAV infection in mice and humans, our study is the first to describe association of CD147, RBP4, TFF3, and CFD with hospitalization of IAV-infected patients. Thus, we identified local innate immune profiles, which were associated with the clinical severity of influenza infections. (C) 2016 Elsevier Ltd. All rights reserved.
  • Määttä, O. L. M.; Laurila, H. P.; Holopainen, S.; Lilja-Maula, L.; Melamies, M.; Viitanen, S. J.; Johnson, L. R.; Koho, N.; Neuvonen, M.; Niemi, M.; Rajamäki, M. M. (2018)
    Background: Gastroesophageal reflux and microaspiration (MA) of gastric juice are associated with various human respiratory diseases but not in dogs. Objective: To detect the presence of bile acids in bronchoalveolar lavage fluid (BALF) of dogs with various respiratory diseases. Animals: Twenty-seven West Highland White Terriers (WHWTs) with canine idiopathic pulmonary fibrosis (CIPF), 11 dogs with bacterial pneumonia (BP), 13 with chronic bronchitis (CB), 9 with eosinophilic bronchopneumopathy (EBP), 19 with laryngeal dysfunction (LD), 8 Irish Wolfhounds (IWHs) with previous BPs, 13 healthy WHWTs, all privately owned dogs, and 6 healthy research colony Beagles Methods: Prospective cross-sectional observational study with convenience sampling of dogs. Bile acids were measured by mass spectrometry in BALF samples. Total bile acid (TBA) concentration was calculated as a sum of 17 different bile acids. Results: Concentrations of TBA were above the limit of quantification in 78% of CIPF, 45% of BP, 62% of CB, 44% of EBP, 68% of LD, and 13% of IWH dogs. In healthy dogs, bile acids were detected less commonly in Beagles (0/6) than in healthy WHWTs (10/13). Concentrations of TBA were significantly higher in CIPF (median 0.013 mu M, range not quantifiable [n.q.]-0.14 mu M, P <.001), healthy WHWTs (0.0052 mu M, n.q.-1.2 mu M, P = .003), LD (0.010 mu M, n.q.-2.3 mu M, P = .015), and CB (0.0078 mu M, n.q.-0.073 mu M, P = .018) groups compared to Beagles (0 mu M, n.q.). Conclusion and Clinical Importance: These results suggest that MA occurs in various respiratory diseases of dogs and also in healthy WHWTs.
  • HCA Lung Biological Network; Sungnak, Waradon; Horvarth, Peter (2020)
    We investigated SARS-CoV-2 potential tropism by surveying expression of viral entry-associated genes in single-cell RNA-sequencing data from multiple tissues from healthy human donors. We co-detected these transcripts in specific respiratory, corneal and intestinal epithelial cells, potentially explaining the high efficiency of SARS-CoV-2 transmission. These genes are co-expressed in nasal epithelial cells with genes involved in innate immunity, highlighting the cells' potential role in initial viral infection, spread and clearance. The study offers a useful resource for further lines of inquiry with valuable clinical samples from COVID-19 patients and we provide our data in a comprehensive, open and user-friendly fashion at
  • Ko, Meehyun; Chang, So Young; Byun, Soo Young; Ianevski, Aleksandr; Choi, Inhee; d'Orengiani, Anne-Laure Pham Hung d'Alexandry; Ravlo, Erlend; Wang, Wei; Bjoras, Magnar; Kainov, Denis E.; Shum, David; Min, Ji-Young; Windisch, Marc P. (2021)
    Therapeutic options for coronaviruses remain limited. To address this unmet medical need, we screened 5406 compounds, including United States Food and Drug Administration (FDA)-approved drugs and bioactives, for activity against a South Korean Middle East respiratory syndrome coronavirus (MERS-CoV) clinical isolate. Among 221 identified hits, 54 had therapeutic indexes (TI) greater than 6, representing effective drugs. The time-of-addition studies with selected drugs demonstrated eight and four FDA-approved drugs which acted on the early and late stages of the viral life cycle, respectively. Confirmed hits included several cardiotonic agents (TI > 100), atovaquone, an anti-malarial (TI > 34), and ciclesonide, an inhalable corticosteroid (TI > 6). Furthermore, utilizing the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), we tested combinations of remdesivir with selected drugs in Vero-E6 and Calu-3 cells, in lung organoids, and identified ciclesonide, nelfinavir, and camostat to be at least additive in vitro. Our results identify potential therapeutic options for MERS-CoV infections, and provide a basis to treat coronavirus disease 2019 (COVID-19) and other coronavirus-related illnesses.
  • EURODEM Study Grp; Karamercan, Mehmet Akif; Dundar, Zerrin Defne; Ergin, Mehmet; Harjola, Veli-Pekka; Laribi, Said (2020)
    Background/aim: To describe seasonal variations in epidemiology, management, and short-term outcomes of patients in Europe presenting to an emergency department (ED) with a main complaint of dyspnea. Materials and methods: An observational prospective cohort study was performed in 66 European EDs which included consecutive patients presenting to EDs with dyspnea as the main complaint during 3 72-h study periods. Data were collected on demographics, comorbidities, chronic treatment, prehospital treatment, mode of arrival of patient to ED, clinical signs at admission, treatment in the ED, ED diagnosis, discharge from El), and in-hospital outcome. Results: The study included 2524 patients with a median age of 69 (53-80) years old. Of the patients presented, 991 (39.3%) were in autumn, 849 (33.6%) were in spring, and 48 (27.1%) were in winter. The winter population was significantly older (P <0.001) and had a lower rate of ambulance arrival to ED (P <0.001). In the winter period, there was a higher rate for lower respiratory tract infection (35.1%), and patients were more hypertensive, more hypoxic, and more hyper/hypothermic compared to other seasons. The ED mortality was about 1% and, in hospital, mortality for admitted patients was 7.4%. Conclusion: The analytic method and the outcome of this study may help to guide the allocation of ED resources more efficiently and to recommend seasonal ED management protocols based on the seasonal trend of dyspneic patients.
  • Hemilä, Harri (2007)
    Moreira et al (2007) systematically reviewed the role of nutrition on exercise-induced immunodepression. However, their paper has several shortcomings. Moreira refers to Nieman’s ‘J’-curve hypothesis, which proposes that moderate exercise improves the immune system and reduces the risk of upper respiratory tract infections (URI), whereas excessive physical stress impairs the immune system and increases URI risk (Nieman, 1994). In a large cohort, we found that the risk of the common cold and pneumonia was not reduced with moderate physical activity, refuting the universal validity of the ‘J’-model (Hemila et al, 2003, 2006). There is strong evidence of positive effect of vitamin C on physically stressed people and there is no valid evidence that vitamin C would be harmful to ordinary people in doses of 1–2 g/day. Therefore, physically active people, who consider that they suffer from colds frequently, can use vitamin C, while at the same time, we hope that new trials would be carried out.
  • Hemilä, Harri; Louhiala, Pekka (2007)