STUDI E RICERCHE



LAVORI SCIENTIFICI RECENTI DI INTERESSE GENERALE

Di seguito potete trovare gli abstract di alcuni lavori pubblicati nel 2010 e nel 2011 su importanti riveste nazionali ed internazionali che sono legati pi o meno direttamente ai problemi allergo-pneumologici. Per questioni di copyright non possiamo presentare i lavori completi, ma in caso siate interessati vi sono le indicazioni per poterli reperire contattando la rivista, cercando su internet (si consiglia il sito www.pubmed.gov) o presso le biblioteche.

Total viable molds and fungal DNA in classrooms and association with respiratory health and pulmonary function of European schoolchildren

School air quality related to dry cough, rhinitis and nasal patency in children

Hyponatremia as a marker of invasiveness of pediatric respiratory tract infections

Differentiation of bacterial and viral community-acquired pneumonia in children

Transient hemi-diaphragmatic palsy following pleural empyema: a pediatric case report


Serologically verified human bocavirus pneumonia in children

 

Clicca qui per i lavori scientifici degli anni precedenti



Total viable molds and fungal DNA in classrooms and association with respiratory health and pulmonary function of European schoolchildren

Marzia Simoni, Gui-Hong Cai, Dan Norback, Isabella Annesi-Maesano, Francois Lavaud, Torben Sigsgaard, Gunilla Wieslander, Wenche Nystad, Mario Canciani, Giovanni Vieg & Piersante Sestini
Pediatr Allergy Immunol 2011: 22: 843–852.

Indoor molds are associated with adverse respiratory effects in children. Although schools are important exposure sources of molds, objective measurements were more often taken in homes. Our aim was to assess indoor molds in schools and related effects on schoolchildren health. The Health Effects of the School Environment study (HESE) included 21 schools (46 classrooms) in Italy, Denmark, Sweden, Norway, and France and 654 schoolchildren (mean age 10 yr). Information on schoolchildren was collected by standardized questionnaires. Measurements of total viable molds (VM, colony-forming units, cfu/m3) and total/specific fungal DNA (cell equivalents, CE/g dust) were taken inside all classrooms in the cold season during normal activities, using the same standardized methodology. Pulmonary function tests were performed on 244 pupils. VM (mean, 320 cfu/m3) and total fungal DNA (geometric mean, 2.2 105 2.1 CE/g dust) were detectable in all classrooms. The levels were significantly higher in buildings with mold/dampness problems. VM, but not fungal DNA, were inversely related to ventilation rate. VM exceeded the maximum standard of 300 cfu/m3 in 33% of the classrooms. In the past 12 months, dry cough at night (34%) and rhinitis (32%) were the mostly reported. Children exposed to VM levels ‡300 cfu/m3, compared with those exposed to lower levels, showed higher risk for past year dry cough at night (odds ratio, OR: 3.10, 95% confidence interval, CI: 1.61–5.98) and rhinitis (OR: 2.86, 95% CI: 1.65–4.95), as well as for persistent cough (OR: 3.79, 95% CI: 2.40–5.60). Aspergillus/Penicillium DNA was significantly positively associated with wheeze, and Aspergillus versicolor DNA with wheeze, rhinitis, and cough. There were significant inverse associations of Aspergillus versicolor DNA with forced vitality capacity (FVC) and Streptomyces DNA with both FEV1 and FVC. In conclusion, indoor VM and fungal DNA were commonly found in monitored European schools and adversely related to respiratory health. Schools should be routinely tested through both culturable and non-culturable methods for global indoor molds’ evaluation.



School air quality related to dry cough, rhinitis and nasal patency in children
M. Simoni, I. Annesi-Maesano, T. Sigsgaard, D. Norback, G. Wieslander, W. Nystad, M. Canciani, P. Sestini and G. Viegi
ERJ. April 1, 2010 - Vol. 35 N 4, 742-749

Controls for indoor air quality (IAQ) in schools are not usually performed throughout Europe. The aim of this study was to assess the effects of IAQ on respiratory health of schoolchildren living in Norway, Sweden, Denmark, France and Italy.
In the cross-sectional European Union-funded HESE (Health Effects of School Environment) Study, particulate matter with a 50% cut-off aerodynamic diameter of 10 m (PM10) and CO2 levels in a day of normal activity (full classroom) were related to wheezing, dry cough at night and rhinitis in 654 children (10 yrs) and to acoustic rhinometry in 193 children.
Schoolchildren exposed to PM10 >50 gm–3 and CO2 >1,000 ppm (standards for good IAQ) were 78% and 66%, respectively. All disorders were more prevalent in children from poorly ventilated classrooms. Schoolchildren exposed to CO2 levels >1,000 ppm showed a significantly higher risk for dry cough (OR 2.99, 95% CI 1.65–5.44) and rhinitis (OR 2.07, 95% CI 1.14–3.73). By two-level (child, classroom) hierarchical analyses, CO2 was significantly associated with dry cough (OR 1.06, 95% CI 1.00–1.13 per 100 ppm increment) and rhinitis (OR 1.06, 95% CI 1.00–1.11). Nasal patency was significantly lower in schoolchildren exposed to PM10 >50 gm–3 than in those exposed to lower levels.
A poor IAQ is frequent in European classrooms; it is related to respiratory disturbances and affects nasal patency.

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Hyponatremia as a marker of invasiveness of pediatric respiratory tract infections
Don M, Valerio G, Canciani M, Korppi M.
Lettera all’Editore in Pediatric Nephrology 2009;24(8):1597-1598

 
Dear Editor, the interesting observations of Kaneko and Kaneko on the association between the depth of respiratory tract infection (RTI) and hyponatremia (HN) markedly supplement our findings on HN in pediatric pneumonia. [1, 2] This association is in line with our finding for which the disease severity, assessed by fever and serum non-specific inflammatory markers, thus reflecting the invasiveness of infection, was associated with the occurrence of HN in children with pneumonia. In the study of Kaneko and Kaneko, [1] the prevalence of HN was 13.3% in upper (pharyngitis or laryngitis), 22.9% in middle (bronchiolitis or bronchitis) and 38.7% in lower (pneumonia) RTI..........

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Differentiation of bacterial and viral community-acquired pneumonia in children
Don M, Valent F, Korppi M, Canciani M.
Articolo originale in Pediatrics International 2009;51(1):91-96

 
Aim. Microbe-specific diagnosis of pediatric community-acquired pneumonia (CAP) and the distinction between typical-bacterial, atypical-bacterial and viral cases are difficult. Aim of the present paper was to evaluate the role of four serum non-specific inflammatory markers and their combinations, supplemented by chest radiological findings, in the screening of bacterial aetiology of paediatric CAP. Methods. Serum procalcitonin-PCT, serum C-reactive protein-CRP, blood erythrocyte sedimentation rate-ESR and white blood cell counts-WBC were determined in 101 children with CAP, all confirmed by chest radiograph. Evidence of aetiology was achieved in 68 (67%) patients mainly by a serologic test panel including 15 pathogens. Results. By the combination of CRP>100 mg/L, WBC>15x109/L, PCT>1.0 ng/mL and ESR>65 mm/h, the likelihood ratio for a positive test result (LR+) was 2.7 in the distinction between pneumococcal and viral CAP and 3.9 between atypical and viral CAP. If there was a higher value in one of these four parameters (CRP>200 mg/L, WBC>22x109/L, PCT>18 ng/mL or ESR>90 mm/h) LR+ changed to 3.4 or more, which means a significant increase from pre-test to post-test disease probability. An alveolar radiological infiltration was associated with higher values in non-specific inflammatory markers when compared with interstitial infiltrates, but there were no significant associations between radiological and etiological findings. Conclusions. CRP, WBC, PCT and ESR or their combinations have some but limited role in the screening between bacterial and viral pediatric CAP. If all or most of these markers are elevated, bacterial aetiology is highly probable, but low values do not rule bacterial aetiology out.

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Transient hemi-diaphragmatic palsy following pleural empyema: a pediatric case report
Don M, Russo V, Budai R, Canciani M.
Caso clinico in La Pediatria Medica e Chirurgica 2009;31(4):172-5
 
Phrenic nerve palsy generally is a jatrogenic damage of invasive neck and/or chest procedures in the pediatric age, but it does not represent a common complication of pleural empyema. One case of transient monolateral diaphragmatic paralysis following a decorticated pleural empyema is here reported. Common causes of the present disorder and its possible physiopathologic mechanisms are discussed, too.
 

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Serologically verified human bocavirus pneumonia in children
Don M, Sorelund-Venermo M, Valent F, Lahtinen A, Hedman L, Canciani M, Hedman K, Korppi M.
Articolo originale in Pediatric Pulmonology [in press]
 
Working hypothesis. Human bocavirus (HBoV) is a newly identified parvovirus frequently found in children suffering from acute respiratory and intestinal infections. The aim of the present study was to evaluate, by using a newly developed antibody assay, the role of HBoV in pediatric community-acquired pneumonia (CAP) and the seropositivity rate to HBoV in a prospective study in North-Italian children. Materials/patients and methods. During a 15-month study period, 124 children were admitted due to presumptive pneumonia, and in 101 of them, pneumonia was radiologically confirmed. The etiology of CAP was studied by antibody assays to 16 microbes, including the newly developed enzyme immunoassay for HBoV. Results. Serological evidence of acute HBoV infection was found in 12 (12%) children, being single in 7 and mixed in 5 cases (4 with other viruses and 3 with bacteria). IgM was positive in 11 cases. A diagnostic rise in IgG antibodies between paired sera was observed in 6 cases. HBoV was the second most common virus next to respiratory syncytial virus (17%). The seropositivity rate to HBoV increased with age, reaching nearly 100% before school age. Conclusions. The present results show that HBoV is able to induce significant antibody responses and suggest that HBoV may be a fairly common cause of pneumonia in children. Sero-conversion to HBoV in most children takes place in early childhood.

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