Marianna Ferrara

Recurrent wheezing 36 months after bronchiolitis is associated with rhinovirus infections and blood eosinophilia

Links between respiratory syncytial virus bronchiolitis and asthma are well known, but few studies have dealt with wheezing following bronchiolitis induced by other viruses. We assessed the risk factors for recurrent wheezing in infants hospitalised for acute viral bronchiolitis.

Bordetella pertussis in infants hospitalized for acute respiratory symptoms remains a concern

BackgroundPreliminary results suggest that pertussis infection might be considered in infants during a seasonal respiratory syncytial virus (RSV) outbreak.MethodsIn order to analyze clinical features and laboratory findings in infants with pertussis hospitalized for acute respiratory symptoms during a seasonal RSV outbreak, we conducted a retrospective single-center study on 19 infants with pertussis (6 boys; median age 72 days) and 19 matched controls (RSV-bronchiolitis), hospitalized from October 2008 to April 2010. B. pertussis and RSV were detected from nasopharyngeal washes with Real Time-PCR.ResultsInfants with pertussis were less often breastfeed than infants with RSV bronchiolitis (63.2% vs 89.5%; p <0.06). Clinically, significantly fewer infants with pertussis than controls had more episodes of whooping cough (63.2% vs 0.0%; p < 0.001) and also less frequently fever at admission (15.8% vs 68.4%; p <0.01), apnea (52.6% vs 10.5%; p <0.006), and cyanosis (52.6% vs 10.5%; p < 0.006). Infants with pertussis had more often no abnormal chest sounds on auscultation than infants with RSV bronchiolitis (0% vs 42,1%; p < 0.005). The absolute blood lymphocyte and eosinophil counts were higher in infants with B. pertussis than in controls with bronchiolitis (23886 ± 16945 vs 10725 ± 4126 cells/mm3, p < 0.0001 and 13.653 ± 10.430 vs 4.730 ± 2.400 cells/mm3, p < 0.001). The molecular analysis of 2 B. pertussis isolates for ptxA1, ptxP3, and prn2 genes showed the presence of gene variants.ConclusionsWhen infants are hospitalized for acute respiratory symptoms, physicians should suspect a pertussis infection, seek for specific clinical symptoms, investigate lymphocyte and eosinophil counts and thus diagnose infection early enough to allow treatment.

Viral Load in Infants Hospitalized for Respiratory Syncytial Virus Bronchiolitis Correlates with Recurrent Wheezing at Thirty-Six-Month Follow-Up.

The relationship between viral infection, host immune response in infants with respiratory syncytial virus (RSV) bronchiolitis and subsequent wheezing is discussed. We measured RSV-RNA load and interferon-&lgr;1–3 expression in the nasopharyngeal washings from 68 infants hospitalized for RSV bronchiolitis, and wheezing was assessed 36 months after the first episode of bronchiolitis. Higher RSV-RNA load and higher interferon-&lgr;2/3 levels were found in children with recurrent wheezing at 36-month follow-up.

Seven Percent Hypertonic Saline—0.1% Hyaluronic Acid in Infants With Mild-To-Moderate Bronchiolitis

Our study was aimed to evaluate the efficacy of 7% hypertonic saline and 0.1% hyaluronic acid (7% HS–HA) given by inhalation, in infants hospitalized for mild‐to‐moderate bronchiolitis.

Viral bronchiolitis in children: A common condition with few therapeutic options☆

Abstract Even though bronchiolitis is a disease that has been recognized for many years, there are still few therapeutic strategies beyond supportive therapies. Bronchiolitis is the most frequent cause of hospital admission in children less than 1 year of age. The incidence is estimated to be about 150° million cases a year worldwide, and 2–3% of these cases require hospitalization. It is acknowledged that viruses cause bronchiolitis, but most of the studies focus on RSV. The RSV causes a more severe form of bronchiolitis in children with risk factors including prematurity, cardiovascular disease and immunodeficiency. Other viruses involved in causing bronchiolitis include RV, hMPV, hBoV and co-infections. The RV seems to be associated with a less severe acute disease, but there is a correlation between the early infection and subsequent wheezing bronchitis and asthma in later childhood and adulthood. The supportive therapies used are intravenous fluids and oxygen supplement administered by nasal cannula or CPAP in most complicated patients. Additional pharmacological therapies include epinephrine, 3% hypertonic saline and corticosteroids. The Epinephrine seems to have the greatest short-term benefits and reduces the need of hospital admission, whereas hypertonic saline and corticosteroids seem to reduce the length of hospital stay. As bronchiolitis is such a prevalent disease in children and RV seems to play an important role, perhaps more studies should center around the RVs contribution to the initial disease and following pathology.

Sexuality as a promotion of Power: How the Chief Wife becomes a Means of Persuasion in the Vedic Rhetoric on Kingship

In the ancient South Asian texts about ritual known as Saṃhitā s and Brāhmaṇa s, the wives of the king play an interesting role in terms of bodily actions and ritual rhetoric. Especially the so-called “chief wife” ( mahi ṣ ī ) is described as a central and liminal player who serves as a sexual counterpart of the king at the main solemn rituals, i.e. Aśvamedha and Rājasūya, involving the travel of a horse in unconquered lands and the royal consecration, respectively. In this essay I suggest that the construction of female sexuality is a crucial point to fix the boundaries around the notion of authority, not only that of the king, but also that of his practitioner, i.e. the brāhmaṇa or purohita . From this starting point I suggest also that the chief wife of the king may be reconsidered as one of the most strategic actor on a ritual and political stage. I will try to show that the mahiṣī ’s sexual function in the ritual exegesis had gained value, in connection with the attempt to deify the human primus inter pares of the political organisation, i.e. the king. More specifically, I will deal with the ritual language and codification concerning the mahiṣī ’s sexuality in order to illustrate the formulation of her body in the rituals prescribed in the Brāhmaṇas about solemn rites. I will discuss how the persuasive force of description and prescription about her bodily actions served as a means of persuasion in displaying the king’s power. Finally, I suggest rethinking the role of gender in royal rituals from the perspective of literary criticism.