2% of exacerbated and in 13 0% of controlled asthma patients, but

2% of exacerbated and in 13.0% of controlled asthma patients, but with no significant difference (p = 0.27).31 Nasopharyngeal aspirate samples of 201 asthmatic children aged between 2and 15 years collected during episodes of exacerbation were referred for viral

identification by PCR. The positivity rate was 53.8%;the most frequently observed were hRV (41.0%), followed by hRSV buy CB-839 (9.0%). There was no association with exacerbation severity.32 A study compared the response to treatment with bronchodilators between exacerbated children with viral respiratory infection symptoms (n = 168) and a group without such symptoms (n = 50). The mean age was 6.6 years, and exacerbation severity did not differ between groups. Children with viral symptoms had poor response to bronchodilators, requiring more doses of beta-agonists after 6, 12, and

24 hours. The viral screening was conducted in 77.0% of cases; hRV was the most frequently found virus (61.4%).33 In another study, 78 exacerbated children were treated at the hospital and compared to 78 asymptomatic adults. Multiplex PCR reactions for eight respiratory viruses and monoplex PCT for Enterovirus, hRV, and Bocavirus detected the presence of respiratory viruses in 65.4% of cases; hRV was once again the most frequently observed virus (52.6%). Genotyping showed a higher frequency (56.0%) of type C hRV and association click here with type A showed a worse clinical outcome. 34 Asthma exacerbations have seasonal distribution, occurring cyclically in both adults and children, and can be explained by the viral circulation pattern or change in the level of pollutants and aeroallergens. One example is what occurs in temperate countries, where a higher rate of occurrence is more likely

to be observed in the fall and spring among schoolchildren.35 A combination of factors may explain this phenomenon, such as increased circulation of hRV in late summer and early autumn, increased circulation of pollutants and aeroallergens, Gemcitabine in vitro and the return to school after the summer vacations. The influence of the return to school activities may be explained by lower adherence to maintenance treatment during the vacation period. The circulation of other viruses has been reported in other countries in the northern hemisphere, especially hRSV during autumn-winter, Flu in winter, PIV- 1 and 2 in the fall, and PIV- 3 in the spring.36 and 37 In Brazil, data on viral circulation were collected from the Brazilian system of epidemiological surveillance on Flu viruses and their counterparts in the period between 2000 and 2010. Samples obtained from nasopharyngeal swabs of patients in different sentinel units distributed throughout the country were analyzed by immunofluorescence. They showed a predominance of FLUV and hRSV, with circulation throughout the year, with peaks for the latter between March and June, and between May and August for FLUV.38 No data were located concerning the movement of hRV in Brazil.

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