OBJECTIVES: To investigate the influencing factors for asthma management and asthma control level in children. METHODS: A total of 202 children with a confirmed diagnosis of asthma were enrolled. The questionnaire of asthma control level and family management was used to investigate the influencing factors for asthma control level and the indicators of family management. The awareness of childhood asthma and its management was analyzed among the parents, as well as the influence on asthma control level in children, and the association between them was analyzed. RESULTS: Compared with the non-complete control group, the complete control group had significantly longer course of asthma and treatment time (P<0.05). The proportions of asthma attacks ≥3 times and aerosol treatment for asthma attacks >3 times in one year in the complete control group were significantly lower than those in the non-complete control group (P<0.05). The complete control group had a significantly lower proportion of children with frequent respiratory infection, wheezing during respiratory infection, or a family history of allergic diseases (P<0.05). The parents in the complete control group had significantly stronger awareness of short-term escalation to asthma medication after respiratory infection and significantly enhanced management of maintenance medication (P<0.05). Compared with the complete control group, the non-complete control group had a significantly higher proportion of children with abnormal pulmonary function at the initial stage (P<0.05). The level of asthma control in children was associated with short-term escalation to asthma medication during respiratory infection and initial lung function (P<0.05). CONCLUSIONS The level of asthma control in children is closely associated with the severity of asthma and the comprehensive management of childhood asthma. Early treatment and family management, especially escalation to asthma medication during the early stage of respiratory infection, are of great importance in asthma control. Citation:Chinese Journal of Contemporary Pediatrics, 2023, 25(1): 73-79.
Child ; Humans ; Asthma/diagnosis* ; Hypersensitivity/diagnosis* ; Lung ; Respiratory Tract Infections ; Parents ; Respiratory Sounds

Objective: To evaluate the recognition of acute respiratory infection (ARI) by a pretrained model based on electronic medical records (EMRs). Methods: 38 581 EMRs were obtained from Chongqing University Three Gorges Hospital in December 2021. Bidirectional encoder representation from transformers (BERT) pretrained model was used to identify ARI in EMRs. The results of medical professionals were considered as the gold standard to calculate the sensitivity, specificity, Kappa value, and area under the curve of the receiver operating characteristic (AUC). Results: There were 3 817 EMRs in the test set, with 1 200 ARIs. A total of 1 205 cases were determined as ARI by the model, with a sensitivity of 92.67% (1 112/1 200) and a specificity of 96.45% (2 524/2 617). The model identified ARI with similar accuracy in males and females (AUCs 0.95 and 0.94, respectively), and was more accurate in identifying ARI cases in those aged less than 18 than in adults 18-59 and adults 60 and older (AUCs 0.94, 0.89 and 0.94, respectively). The current model had a better identification of ARIs in outpatient patients than that in hospitalized patients, with AUCs of 0.74 and 0.95, respectively. Conclusion: The use of the BERT pretrained model based on EMRs has a good performance in the recognition of ARI cases, especially for the outpatients and juveniles. It shows a great potential to be applied to the monitoring of ARI cases in medical institutions.
Adult ; Male ; Female ; Humans ; Electronic Health Records ; Respiratory Tract Infections/diagnosis* ; Outpatients

Due to the wide variety of pathogens causing respiratory tract infection and the close symptoms, coronavirus disease 2019 (COVID-19) needs to be differentiated from other common infections. Early comprehensive detection and accurate identification of respiratory infection pathogens is of great value for early diagnosis, curative effect, as well as monitor of the diseases. Combined detection of multiple pathogens can quickly and accurately detect and distinguish the pathogens, then provide rapid and reliable laboratory diagnostic basis for further treatment. This article elaborates the application and development of multiplex detection assay in the diagnosis of COVID-19 according to the recent research.
Humans ; COVID-19/diagnosis* ; Respiratory Tract Infections/therapy* ; Sensitivity and Specificity

MicroRNAs (miRs) are single-stranded RNAs of 18-25 nucleotides. These molecules regulate gene expression at the post-transcriptional level; several of these are differentially expressed in asthma as well as in viral acute respiratory infections (ARIs), the main triggers of acute asthma exacerbations. In recent years, miRs have been studied in order to discover drug targets as well as biomarkers for diagnosis, disease severity and prognosis. We describe recent findings on miR expression and function in asthma and their role in the regulation of viral ARIs, according to cell tissue specificity and asthma severity. By combining the above information, we identify miRs that may be important in virus-induced asthma exacerbations. This is the first attempt to link miR profiles of asthmatic patients and ARI-induced miRs, addressing the question of whether there might be a specific miR deficit in asthmatic subjects that make them more susceptible and/or reactive to infection.
Asthma ; Biomarkers ; Diagnosis ; Disease Progression ; Gene Expression ; Humans ; Inflammation ; MicroRNAs ; Nucleotides ; Organ Specificity ; Prognosis ; Respiratory Tract Infections ; RNA

PURPOSE: Early detection of Mycoplasma pneumoniae is important for appropriate antimicrobial therapy in children with pneumonia. This study aimed to evaluate the diagnostic value of a rapid antigen test kit in detecting M. pneumoniae from respiratory specimens in children with lower respiratory tract infection (LRTI). METHODS: A total of 215 nasopharyngeal aspirates (NPAs) were selected from a pool of NPAs that had been obtained from children admitted for LRTI from August 2010 to August 2018. The specimens had been tested for M. pneumoniae by culture and stored at −70°C until use. Tests with Ribotest Mycoplasma® were performed and interpreted independently by two investigators who were blinded to the culture results. RESULTS: Among the 215 NPAs, 119 were culture positive for M. pneumoniae and 96 were culture negative. Of the culture-positive specimens, 74 (62.2%) were positive for M. pneumoniae by Ribotest Mycoplasma®, and 92 of the 96 (95.8%) culture-negative specimens were negative for M. pneumoniae by Ribotest Mycoplasma®. When culture was used as the standard test, the sensitivity and specificity of Ribotest Mycoplasma® were 62.2% and 95.8%, respectively. Additionally, the positive predictive value, negative predictive value, and overall agreement rates with Ribotest Mycoplasma® were 94.9%, 67.2%, and 77.2%, respectively. CONCLUSIONS: A positive test result of Ribotest Mycoplasma® suggests a high likelihood of culture-positive M. pneumoniae infection. However, a negative test result should be interpreted with caution because nearly one-third of negative test results reveal culture-positive M. pneumoniae infections.
Child ; Diagnosis ; Humans ; Immunochromatography ; Mycoplasma pneumoniae ; Mycoplasma ; Pneumonia ; Pneumonia, Mycoplasma ; Point-of-Care Systems ; Research Personnel ; Respiratory Tract Infections ; Sensitivity and Specificity

OBJECTIVE: Suicide is the leading cause of death in 10–39-year-olds in South Korea, and the second highest rate among the OECD countries. However, few studies have investigated the particularity of completed suicide in South Korea. METHODS: Study subjects consisted of 2,838 suicide cases and 56,758 age and sex matched living controls from a national representative sample of 1,025,340 South Koreans. They were obtained from the Korean National Health Insurance Service-National Sample Cohort (NHIS-NSC) with follow-up up to 12 years. We obtained information on primary diagnosis of any ICD-10 disorder along with suicide cases during their lifetime. RESULTS: Among ICD-10 disorders, depression was the most common disorder (19.10%, n=542), found in victims of completed suicides except for common medical disorders such as hypertensive crisis, respiratory tract infection or arthropathies. After adjusting for sex, age, economic status, disability, and disorders, schizophrenia showed the strongest association with suicide (AOR: 28.56, 95% CI: 19.58–41.66) among all ICD-10 disorders, followed by psoriasis, multiple body injury, epilepsy, sleep disorder, depression, and bipolar disorder. For age groups, ≤19 years was associated with anxiety disorder (AOR=80.65, 95% CI: 13.33–487.93), 20–34 years with epilepsy (AOR=134.92, 95% CI: 33.69–540.37), both 35–49 years (AOR=108.57, 95% CI: 37.17–317.09) and 50–65 years (AOR=189.41 95% CI: 26.59–1349.31), with schizophrenia, and >65 years (AOR=44.7, 95% CI: 8.93–223.63) with psoriasis. CONCLUSION: Psychiatric and physical disorders carried greatly increased risks and numbers of suicides in South Korea. Schizophrenia was the strongest risk factor, especially 35–65 years, and depression was the most common in suicide victims among ICD-10 disorders in South Korea.
Anxiety Disorders ; Bipolar Disorder ; Case-Control Studies ; Cause of Death ; Cohort Studies ; Depression ; Diagnosis ; Epilepsy ; Follow-Up Studies ; Humans ; Insurance, Health ; International Classification of Diseases ; Korea ; National Health Programs ; Organisation for Economic Co-Operation and Development ; Psoriasis ; Respiratory Tract Infections ; Risk Factors ; Schizophrenia ; Sleep Wake Disorders ; Suicide

BACKGROUND: Respiratory tract infections are major public health threats, and the identification of their causative microbes helps clinicians to initiate timely and appropriate antimicrobial therapy and prevent the secondary spread of infection. The main goal of this study was to compare two multiplex real-time polymerase chain reaction (PCR) assays used to detect respiratory viral pathogens in nasopharyngeal swab specimens. METHODS: Between September and October 2017, a total of 84 nasopharyngeal specimens were obtained consecutively from patients in a tertiary hospital using a flocked swab with 3 mL universal transport medium (COPAN Diagnostics, USA). A total of 64 positive and 20 negative sample results from the LG AdvanSure RV real-time RT-PCR kit (LG Life Sciences, Korea) were further retested using a new AdvanSure RV-plus a real-time RT-PCR kit to compare their performance. RESULTS: Statistical analysis of positive and negative agreement between the two different kits was conducted between the newly introduced AdvanSure RV-plus real-time RT-PCR kit and the AdvanSure RV real-time RT-PCR. The overall agreement was 96.4%, with positive agreement of 98.4% and negative agreement of 90%. The evaluated sensitivity and specificity of AdvanSure RV-plus real-time RT-PCR were 96.9% and 94.7%, respectively, with a kappa value of 0.9 (P<0.001). CONCLUSION: The performances of LG AdvanSure RV real-time RT-PCR and the new AdvanSure RV-plus real-time RT-PCR kit showed strong overall agreement. AdvanSure RV-plus real-time RT-PCR had a better detection rate and could detect coronavirus 229E and enterovirus, especially with a high detection rate in coinfection. AdvanSure RV-plus real-time RT-PCR can be considered a useful tool for respiratory virus diagnosis in clinical laboratories.
Biological Science Disciplines ; Coinfection ; Coronavirus ; Diagnosis ; Enterovirus ; Humans ; Multiplex Polymerase Chain Reaction ; Pneumonia ; Public Health ; Real-Time Polymerase Chain Reaction ; Respiratory Tract Infections ; Sensitivity and Specificity ; Tertiary Care Centers

Primary cardiac tumors are rare, with a prevalence of 0.001–0.2%. Among such tumors, cardiac hemangioendotheliomas are some of the most uncommon. In Korea, there have been no reports of hemangioendothelioma occurring in the heart of infants. We herein report a case of an infant that was admitted to our medical center and presented with cough and a runny nose. The initial diagnosis was acute bronchiolitis. Cardiomegaly was observed on chest radiography. Echocardiography revealed a tumor measuring 3.5×4.0 cm in the right atrium. The infant was transferred to a tertiary medical center for tumor excision. The excised lesion was 3.8×3×3.2 cm in size, and biopsy confirmed a diagnosis of hemangioendothelioma. In this case report, we describe our experience with a rare case involving cardiac tumor in an infant with an upper respiratory tract infection.
Biopsy ; Bronchiolitis ; Cardiomegaly ; Cough ; Diagnosis ; Echocardiography ; Heart ; Heart Atria ; Heart Neoplasms ; Hemangioendothelioma ; Humans ; Infant ; Korea ; Nose ; Prevalence ; Radiography ; Respiratory Tract Infections ; Thorax ; Twins

INTRODUCTION: Respiratory virus (RV) infections have been implicated in acute exacerbation cardiopulmunary conditions. This study aimed to determine the prevalence of RV infections in patients admitted to the cardiology unit with acute decompensated heart failure (ADHF) in a tertiary hospitals in Singapore. MATERIALS AND METHODS: This was a single-centre, prospective observational study. A total of 194 adults (aged >21) admitted to the Singapore General Hospital with ADHF were recruited. A nasopharyngeal swab was taken for multiplex polymerase chain reaction (PCR) detection of influenza virus, rhinovirus, parainfluenza virus (HPIV), human coronavirus (HcoV), adenoviurs, human bocavirus (HboV), human metapneumovirus (hMPV), and respiratory syncytial virus (RSV). RESULTS: Twenty-five (13%) had RVs detected by RV multiplex PCR. There comprised 9 rhinoviruses (36%), 4 influenza A viruses (16%), 3 HPIV (12%), 3 HCoV (12%), 2 adenoviruses (8%), 1 human HBoV (4%), 1 hMPV (4%), and 1 RSV (4%). Symptoms-wise, cough was significantly more common in the PCR-positive group (48% vs 24%, = 0.02). There were no statistically significant differences in laboratory investigations (haemoglobin, leukocytes, platelets, creatine kinase, creatine kinase-muscle/brain, troponin T), and radiology findings between RV PCR-positive and -negative groups. The PCR-positive group did not have increased mortality or length of hospital stay. CONCLUSION This study identified a considerable burden of RVs in our ADHF cohort, and highlights the need for prevention of RVs in this group of patients. We also recognised the difficulty with clinical diagnosis of RVs in ADHF patients.
Adult ; Comorbidity ; Diagnosis, Differential ; Female ; Heart Failure ; epidemiology ; physiopathology ; therapy ; Humans ; Length of Stay ; statistics & numerical data ; Male ; Nasopharynx ; virology ; Outcome Assessment (Health Care) ; Prospective Studies ; Respiratory Tract Infections ; epidemiology ; therapy ; virology ; Singapore ; epidemiology ; Survival Analysis ; Symptom Flare Up ; Viruses ; classification ; isolation & purification ; pathogenicity

Community-acquired pneumonia is common and important infectious disease in adults. This work represents an update to 2009 treatment guideline for community-acquired pneumonia in Korea. The present clinical practice guideline provides revised recommendations on the appropriate diagnosis, treatment, and prevention of community-acquired pneumonia in adults aged 19 years or older, taking into account the current situation regarding community-acquired pneumonia in Korea. This guideline may help reduce the difference in the level of treatment between medical institutions and medical staff, and enable efficient treatment. It may also reduce antibiotic resistance by preventing antibiotic misuse against acute lower respiratory tract infection in Korea.
Adult* ; Communicable Diseases ; Community-Acquired Infections ; Diagnosis ; Drug Resistance, Microbial ; Humans ; Korea ; Medical Staff ; Pneumonia* ; Respiratory Tract Infections