Mohammed Abdel Fattah Abdel Motey

This cross-sectional study included 41 children (age 2 mo-12 y)
with pneumonia and 40 healthy controls. Assay of serum
copeptin was done using ELISA. Median serum copeptin levels
were significantly higher (P=0.03) in children with pneumonia, and
in those who died (P=0.04). We conclude that serum copeptin
levels seem to be associated with poor outcome in pneumonia.

Atypical bacteria(Mycoplasma pneumoniae and Chlamydophila pneumoniae) are thought to be inflicted in the pathogenesis and precipitation of acute asthma. Past and current infections with these organisms were found more frequently in asthmatics compared to healthy controls. It was suggested that atypical infections could precipitate acute asthma attacks in previously healthy individuals. This has raised the question of whether or not to add antibiotics to the management, especially macrolides. This review highlights the natural history of these organisms and their role in acute asthma of children. The current literature about role of antibiotics in acute asthma is summarized.

ABSTRACT Background Exhaled nitric oxide is an easy noninvasive test, which is used for monitoring of different airway diseases. The aim of this study is to assess the usefulness of the fraction of exhaled nitric oxide (FeNO) in patients with chronic or recurrent coughing.

Methods In this cross-sectional case- controlled observational study; we measured the (FeNO) level among children suffering from different chronic airway diseases (Asthma and Bronchiectasis). The study was conducted on 40 patients (5 years and up, both males and females) diagnosed clinically and radiologically as bronchial asthma (n = 20) and lung bronchiectasis of different aetiology (n = 20) compared to 40 age-and sex-matched controls. FeNO was measured using NO breath® instrument (I. D. NBR022714, Bedfont Scientific Ltd, UK). It was significantly elevated in children with asthma compared to healthy controls (p < 0.001). FeNO was significantly lower in patients with bronchiectasis compared to healthy controls (p < 0.001). FeNO levels in primary ciliary dyskinesia (PCD) (n = 3) were very low whereas the differences between congenital bronchiectasis and cystic fibrosis levels were not significant.

Conclusion The study concluded that FeNO measurement is an important diagnostic test and screening biomarker for chronic paediatric airway diseases. Although FeNO can’t differentiate between causes of bronchiectasis, It can be used as a diagnostic test in PCD as it has significantly low levels.

Background: acute asthma is frequently encountered in children. Adrenomedullin (AM) was previously detected in lung tissue, but its pathophysiological significance in airway inflammation is still unclear. This study aimed at investigating the plasma levels of AM in a group of children with acute asthma.
Patients and Methods: This case - control study included 40 children as cases and 40 matched healthy children as controls. All candidates were subjected to a complete clinical study upon inclusion, with emphasis on symptoms and signs of acute asthma. A complete blood count (CBC) was withdrawn and plasma AM levels were assayed by a commercial enzyme-linked immunosorbent assay (ELISA).
Results: severity of acute asthma was mild in 27.5% of cases, moderate in 57.5% and severe in 15% of them. Plasma AM levels were significantly higher in acute asthmatics compared to normal controls (p < 0.001). Again, there was a significant direct correlation between plasma AM and severity of acute asthma (Spearman’s rho = 0.430, p = 0.006).
Conclusions: plasma AM was significantly elevated in acute asthmatic children with significant direct correlation with severity of acute attack. AM might have a role in the regulation of pediatric acute asthma.

Keywords: Asthma, children, adrenomedullin

Pleural effusion complicates community-acquired pneumonia (CAP). It is thought that it is due to increased vascular permeability. Vascular endothelial growth factor (VEGF) is a cytokine with an important role in angiogenesis and vascular permeability. A suggested active role for VEGF in development of pleural effusion has been postulated. This study investigated serum levels of VEGF in hospitalized pediatric patients with CAP with and without pleural effusion. Forty-one cases with CAP were enrolled in the study against 40 age- and sex- matched healthy controls. The following investigations were performed: complete blood counts, chest x- ray, quantitative C-reactive protein, erythrocytic sedimentation rate and assay of serum VEGF. Patients with effusion were significantly older (p = 0.001), and their ESR, CRP and total leucocytic levels were significantly higher (p = 0.006, 0.007 and 0.004, respectively). Serum VEGF was significantly higher in cases when compared to controls (1060.29 ± 67 vs. 686.11 ± 50 pg/ml respectively, 95% CI= [111; 638], p = 0.006). Serum VEGF was significantly higher in cases with effusion when compared to cases without effusion (1329 ± 66 vs. 829 ± 60 pg/ml respectively, 95% CI= [95; 905], p = 0.017). There was a significant direct correlation between serum VEGF and pleural effusion (Spearman’s rho = 0.492, p = 0.001). The study concluded that there were elevated serum VEGF levels in children with CAP especially when associated with pleural effusion, and that the significant positive correlation between serum VEGF and amount of effusion postulate that VEGF, a potent inducer of vascular permeability, plays a causal role in pleural fluid formation.

Key words: Pneumonia, effusion, VEGF, children