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Sample records for calculated respiratory tract

  1. Respiratory tract and mediastinum

    International Nuclear Information System (INIS)

    Respiratory tract problems originating in attempts to diagnose and treat illness are commonplace. They range from pharyngeal trauma during intubation to radiation-induced thyroid carcinoma. Occasionally, as with pulmonary hypervolemia accompanying drug-induced renal failure, they originate at a distance. Their actual number far exceeds those brought to clinical attention. Familiarity with the procedures which give rise to these complications is helpful in detecting and remedying them. It is important, therefore, to discuss their pathogenesis as well as their clinical and radiological findings

  2. Comparisons of calculated respiratory tract deposition of particles based on the NCRP/ITRI model and the new ICRP66 model

    Energy Technology Data Exchange (ETDEWEB)

    Yeh, Hsu-Chi; Phalen, R.F. [Univ. of California, Irvine, CA (United States); Chang, I. [Lovelace Inst., Albuquerque, NM (United States)] [and others

    1995-12-01

    The National Council on Radiation Protection and Measurements (NCRP) in the United States and the International Commission on Radiological Protection (ICRP) have been independently reviewing and revising respiratory tract dosimetry models for inhaled radioactive aerosols. The newly proposed NCRP respiratory tract dosimetry model represents a significant change in philosophy from the old ICRP Task Group model. The proposed NCRP model describes respiratory tract deposition, clearance, and dosimetry for radioactive substances inhaled by workers and the general public and is expected to be published soon. In support of the NCRP proposed model, ITRI staff members have been developing computer software. Although this software is still incomplete, the deposition portion has been completed and can be used to calculate inhaled particle deposition within the respiratory tract for particle sizes as small as radon and radon progeny ({approximately} 1 nm) to particles larger than 100 {mu}m. Recently, ICRP published their new dosimetric model for the respiratory tract, ICRP66. Based on ICRP66, the National Radiological Protection Board of the UK developed PC-based software, LUDEP, for calculating particle deposition and internal doses. The purpose of this report is to compare the calculated respiratory tract deposition of particles using the NCRP/ITRI model and the ICRP66 model, under the same particle size distribution and breathing conditions. In summary, the general trends of the deposition curves for the two models were similar.

  3. Respiratory tract infection during Hajj

    Directory of Open Access Journals (Sweden)

    Alzeer Abdulaziz

    2009-01-01

    Full Text Available Respiratory tract infection during Hajj (pilgrimage to Mecca is a common illness, and it is responsible for most of the hospital admissions. Influenza virus is the leading cause of upper respiratory tract infection during Hajj, and pneumonia can be serious. Taking into account the close contacts among the pilgrims, as well as the crowding, the potential for transmission of M. tuberculosis is expected to be high. These pilgrims can be a source for spreading infection on their return home. Although vaccination program for influenza is implemented, its efficacy is uncertain in this religious season. Future studies should concentrate on prevention and mitigation of these infections.

  4. Extensive upper respiratory tract sarcoidosis.

    Science.gov (United States)

    Soares, Mafalda Trindade; Sousa, Carolina; Garanito, Luísa; Freire, Filipe

    2016-04-18

    Sarcoidosis is a chronic granulomatous disease of unknown aetiology. It can affect any part of the organism, although the lung is the most frequently affected organ. Upper airway involvement is rare, particularly if isolated. Sarcoidosis is a diagnosis of exclusion, established by histological evidence of non-caseating granulomas and the absence of other granulomatous diseases. The authors report a case of a man with sarcoidosis manifesting as a chronic inflammatory stenotic condition of the upper respiratory tract and trachea.

  5. A model for calculating the aerosol deposition in the human respiratory tract, with particular regard to children and infants

    International Nuclear Information System (INIS)

    For this research project, the deposition of inhaled aerosols in the total lung of adults and also in lung compartments has been calculated as a function of particle diameter, applying various calculation models and the resulting equations. The models and equations that best described the experimental results have then be applied to calculate the deposition in infants and ten-year-old children. The results obtained show that for children and infants, radiation dose calculations for inhaled radioactive aerosols of an activity of 1 μm can be done using the values determined for the deposition in adults. In the case of larger particle diameters, with a median aerodynamic diameter of 8 μm for example, calculations for infants have to take into account the increased tracheobronchial deposition, and calculations for children have to consider increased pulmonary deposition. (orig./MG)

  6. Respiratory tract mortality in cement workers: a proportionate mortality study

    OpenAIRE

    Rachiotis George; Drivas Spyros; Kostikas Konstantinos; Makropoulos Vasilios; Hadjichristodoulou Christos

    2012-01-01

    Abstract Background The evidence regarding the association between lung cancer and occupational exposure to cement is controversial. This study investigated causes of deaths from cancer of respiratory tract among cement workers. Methods The deaths of the Greek Cement Workers Compensation Scheme were analyzed covering the period 1969-1998. All respiratory, lung, laryngeal and urinary bladder cancer proportionate mortality were calculated for cement production, maintenance, and office workers i...

  7. Cefotiam therapy of lower respiratory tract infections.

    Science.gov (United States)

    Polis, M A; Tuazon, C U

    1985-01-01

    Cefotiam, a new cephalosporin, was evaluated in the treatment of lower respiratory tract infections in 29 patients. The bacteria isolated from the sputum of these patients included Streptococcus pneumoniae (31%), Klebsiella pneumoniae (31%), and Haemophilus influenzae (28%). Satisfactory response was observed in 90% of the patients. There were three treatment failures, two superinfections, and four colonizations with gram-negative organisms resistant to the drug. Superficial phlebitis was noted in two patients. The results of this study suggest that cefotiam is an effective and well-tolerated antibiotic for the treatment of lower respiratory tract infections due to susceptible organisms. PMID:3865632

  8. Mechanisms of infection in the respiratory tract.

    Science.gov (United States)

    Baskerville, A

    1981-12-01

    Related to its potential vulnerability the respiratory tract has a very complex and effective defence apparatus. The interaction between these defence mechanisms and certain characteristics of aetiological agents results in a pattern in which initial infections by these agents tend to occur at specific sites in the tract. Infections in which the primary portal of entry is in the upper respiratory tract include Bordetella bronchiseptica and Haemophilus spp in pigs; Pasteurella spp in cattle, sheep, pigs; Mycoplasma spp in cattle, sheep, pigs and poultry; equine herpesvirus 1 in horses; infectious bovine rhinotracheitis in cattle; parainfluenza 3 in cattle and sheep; infectious laryngo-tracheitis and infectious bronchitis in poultry; feline viral rhinotracheitis and calicivirus in cats; Aujeszky's disease virus and swine influenza in pigs; and equine influenza in horses. Infections in which the primary portal of entry is in the lower respiratory tract include Aspergillus fumigatus in poultry and mammals, respiratory syncytial virus in cattle, distemper virus in dogs and adenovirus in cattle and dogs. A fuller understanding of the interactions between an agent and the host at the point of entry would make it much easier to develop effective vaccines and therapeutic agents. PMID:16030806

  9. Management of respiratory tract infections in children

    OpenAIRE

    PAUL, Siba Prosad

    2014-01-01

    Siba Prosad Paul,1 Rachel Wilkinson,2 Christine Routley3 1Southmead Hospital, Bristol, 2St Richard's Hospital, Chichester, 3Paediatric Services, Yeovil District Hospital, Yeovil, UK Abstract: Respiratory tract infections (RTIs) in children are one of the most common reasons for parents consulting health professionals. Most RTIs are self-limiting viral illnesses that will resolve with time and supportive management. However, it is important for the health professional to identify any ...

  10. Management of respiratory tract infections in children

    OpenAIRE

    Paul SP; Wilkinson R; Routley C

    2014-01-01

    Siba Prosad Paul,1 Rachel Wilkinson,2 Christine Routley3 1Southmead Hospital, Bristol, 2St Richard's Hospital, Chichester, 3Paediatric Services, Yeovil District Hospital, Yeovil, UK Abstract: Respiratory tract infections (RTIs) in children are one of the most common reasons for parents consulting health professionals. Most RTIs are self-limiting viral illnesses that will resolve with time and supportive management. However, it is important for the health professional to identify any RTI ...

  11. Software for the draft NCRP respiratory tract dosimetry model

    International Nuclear Information System (INIS)

    A task group of the National Council on Radiation Protection and Measurement (NCRP) is developing a new respiratory tract dosimetry model to update an earlier model developed by the International Commission on Radiological Protection (ICRP) Task Group on Lung Dynamics. To facilitate the use of the new model and model calculations, a menu-driven computer simulation package has been developed. The implementation and main features of the package are presented, including: (1) calculations of regional fractional deposition and clearance in the nasal, oral, tracheobronchial airways (16 generations), and pulmonary region; (2) scaling of respiratory tract airway size and breathing parameters for people of all sizes; and (3) incorporation of dissolution and mechanical clearance as two competing mechanisms. At present, the software package can be used to compute fractions of total inhaled radioactive material initially deposited and later retained in the respiratory tract regions. In the near future, the software will also make dosimetry calculations. This paper discusses mathematical formulations, computer languages, examples and future development associated with this package. (author)

  12. The Microbiome and the Respiratory Tract.

    Science.gov (United States)

    Dickson, Robert P; Erb-Downward, John R; Martinez, Fernando J; Huffnagle, Gary B

    2016-01-01

    Although the notion that "the normal lung is free from bacteria" remains common in textbooks, it is virtually always stated without citation or argument. The lungs are constantly exposed to diverse communities of microbes from the oropharynx and other sources, and over the past decade, novel culture-independent techniques of microbial identification have revealed that the lungs, previously considered sterile in health, harbor diverse communities of microbes. In this review, we describe the topography and population dynamics of the respiratory tract, both in health and as altered by acute and chronic lung disease. We provide a survey of current techniques of sampling, sequencing, and analysis of respiratory microbiota and review technical challenges and controversies in the field. We review and synthesize what is known about lung microbiota in various diseases and identify key lessons learned across disease states. PMID:26527186

  13. Microbial flora variations in the respiratory tract of mice

    OpenAIRE

    Cangemi de Gutierrez Rosa; Miguel de Nader Olga; Ruiz Holgado Aida Pesce de; Nader-Macias María Elena

    1999-01-01

    A stable microbial system in the respiratory tract acts as an important defense mechanism against pathogenic microorganisms. Perturbations in this system may allow pathogens to establish. In an ecological environment such as the respiratory tract, there are many diverse factors that play a role in the establishment of the indigenous flora. In the present work we studied the normal microbial flora of different areas of the respiratory tract of mice and their evolution from the time the mice we...

  14. The revised International Commission on Radiological Protection (ICRP) dosimetric model for the human respiratory tract

    Energy Technology Data Exchange (ETDEWEB)

    Bair, W.J.

    1992-05-01

    A task group has revised the dosimetric model of the respiratory tract used to calculate annual limits on intake of radionuclides. The revised model can be used to project respiratory tract doses for workers and members of the public from airborne radionuclides and to assess past exposures. Doses calculated for specific extrathoracic and thoracic tissues can be adjusted to account for differences in radiosensitivity and summed to yield two values of dose for the respiratory tract that are applicable to the ICRP tissue weighted dosimetry system.

  15. Defence System of Respiratory Tract and Clearence of Inhalation Agents

    OpenAIRE

    Nesrin Ocal

    2016-01-01

    It is well known that inhaled urban air contains many particles and gases. On the other hand, the anesthetic agents used in respiratory diseases comprise pharmaceutical particles. Deposition and cleaning processes of both the inhaled foreign particles and gases from room air, and inhalation agents from respiratory tract are very important clinically. These processes are carried out by the defense mechanisms of the respiratory system. In this review, the defence system of respiratory tract and...

  16. Management of respiratory tract infections in children

    Directory of Open Access Journals (Sweden)

    Paul SP

    2014-12-01

    Full Text Available Siba Prosad Paul,1 Rachel Wilkinson,2 Christine Routley3 1Southmead Hospital, Bristol, 2St Richard's Hospital, Chichester, 3Paediatric Services, Yeovil District Hospital, Yeovil, UK Abstract: Respiratory tract infections (RTIs in children are one of the most common reasons for parents consulting health professionals. Most RTIs are self-limiting viral illnesses that will resolve with time and supportive management. However, it is important for the health professional to identify any RTI that may have more serious implications for the child and require medical intervention. Diagnosis can usually be made from the history and presenting symptoms such as cough, wheeze, tachypnea, fever, or stridor. Exclusion of "red flag" symptoms will enable health professionals to appropriately reassure parents and advise symptomatic management with antipyretics and adequate fluid administration. With the expanding role of nurses in ambulatory settings, many children are now being seen by health professionals other than doctors, (eg, advanced nurse practitioners, some of whom are trained in pediatrics while others have limited knowledge of nursing sick children. It is therefore vital that these professionals remain aware of any risk factors and that they can recognize "red flags" in a sick child rapidly and escalate further management appropriately. Some children will require admission to hospital for respiratory support and other therapies, such as intravenous antibiotics and fluids. With advancement of the "non-medical prescriber" within the nursing profession, awareness of when to give or not give antibiotic therapy needs careful consideration, especially in light of the problems that may arise from overuse of antibiotic treatment. Nurses have a vital role, not only in administering medications and supporting other medical interventions, but also in supporting the child and family over the period of illness. The education of the parents and the child, in some

  17. The pressure gradient in the human respiratory tract

    Science.gov (United States)

    Chovancová, Michaela; Elcner, Jakub

    2014-03-01

    Respiratory airways cause resistance to air flow during inhalation and exhalation. The pressure gradient is necessary to transport the air from the mount (or nose) to pulmonary alveoli. The knowledge of pressure gradient (i.e. respiratory airways resistance) is also needed to solve the question of aerosol deposition in the human respiratory tract. The obtained data will be used as boundary conditions for CFD simulations of aerosol transport. Understanding of aerosol transport in the human lungs can help us to determine the health hazard of harmful particles. On the other hand it can be used to set the conditions for transport of medication to the desirable place. This article deals with the description of the mathematical equations defining the pressure gradient and resistance in the bronchial three and describes the geometry used in the calculation.

  18. Updating the ICRP human respiratory tract model

    International Nuclear Information System (INIS)

    The ICRP Task Group on Internal Dosimetry is developing new Occupational Intakes of Radionuclides (OIR) documents. Application of the Human Respiratory Tract Model (HRTM) requires a review of the lung-to-blood absorption characteristics of inhaled compounds of importance in radiological protection. Where appropriate, material-specific absorption parameter values will be given, and for other compounds, assignments to default Types will be made on current information. Publication of the OIR provides an opportunity for updating the HRTM in the light of experience and new information. The main possibilities under consideration relate to the two main clearance pathways. Recent studies provide important new data on rates of particle transport from the nasal passages, bronchial tree (slow phase) and alveolar region. The review of absorption rates provides a database of parameter values from which consideration can be given to deriving typical values for default Types F, M and S materials, and element-specific rapid dissolution rates. (authors)

  19. Deposition of inhaled particles in the respiratory tract as a function of age at exposure

    International Nuclear Information System (INIS)

    A respiratory tract deposition model was developed that would accommodate age 1 month to adulthood as an initial step in calculating radiation dose following inhalation during environmental exposures. The approach to changing respiratory tract and physiological parameters to be applicable to children was to derive an analytical function describing the ratio of the child value to the value for a reference adult with the desired characteristics. A computer program was written to carry out the tracing of airflow through the respiratory tract and deposition in each of the sections for monodispersed particles of known density and diameter. 7 references

  20. The Revised International Commission on Radiological Protection (ICRP) dosimetric model for the human respiratory tract

    Energy Technology Data Exchange (ETDEWEB)

    Bair, W.J.

    1991-09-01

    The new respiratory tract model is based on the premise that the large differences in radiation sensitivity of respiratory tract tissues, and the wide range of doses they receive, argue for calculating specific tissue doses rather than average lung doses for radiation protection purposes. The new model is more complex than the current lung model because it describes deposition of inhaled radioactive material in the clearance from several tissues and regions of the respiratory tract and is applicable to the worldwide population of both workers and the public. 2 refs., 2 figs.

  1. A new sampler for simulating aerosol deposition in the respiratory tract

    Institute of Scientific and Technical Information of China (English)

    LI Dehong; ZHUO Weihai; YI Yanling; CHEN Bo; LIU Haikuan

    2008-01-01

    Abstract For estimation of the deposition fractions of radon progeny in different regions of the respiratory tract, a new sampler consisting of three different configurations of sampling heads was developed. The deposition fractions of aerosols on the wire screens inside the sampling heads were calculated with the fan model of filtration theory. The deposition fractions of aerosols in different regions of the respiratory tract were calculated with the lung dose evaluation program (LUDEP (C)) developed by National Radiological Protection Board (NRPB) as References. In general indoor and mine environments, the deviation between the deposition fractions of attached aerosol on the wire screens designed in this study and its reference values in the respiratory tract is less than 5%. It is possible to accurately estimate the deposition fractions of radon progeny in different regions of the respiratory tract through mimic measurements of radon progeny collected with the new sampler.

  2. Fluorescence diagnosis of upper respiratory tract infections

    Science.gov (United States)

    Blanco, Kate C.; Inada, Natalia M.; Kurachi, Cristina; Bagnato, Vanderlei S.

    2015-06-01

    The pharyngitis and laryngitis are respiratory tract infections highly common. Pharyngitis can be accompanied by fever, especially if caused by a systemic infection. Laryngitis is an inflammation of your voice box (larynx) from irritation or infection. The conventional treatment is the antibiotics administration, which may be responsible by an increase of identification of bacterial strains resistant to drug. This fact associated to high incidence of these infections become important to develop new technologies for diagnosis. This study aims to evaluate the use of widefield fluorescence imaging for the characterization of oropharynx infections, in order to diagnose the bacteria colonization. The imaging system for wide field fluorescence visualization is Evince® (MMOptics, São Carlos, SP, Brazil) coupled to an Apple iPhone® cell phone device. The system consists of Light Emitting Diodes (LEDs) operating in the violet blue region centered at green-red spectrum 450 nm and optical filters that allow viewing of fluorescence. A tongue depressor was adapted to Evince® for mouth opening. The same images were captured with white light and fluorescence with an optical system. The red fluorescence may be a bacterial marker for physiological monitoring of oropharynx infection processes. The bacterial biofilm on tissue were assigned to the presence of protoporphyrin IX. This work indicates that the autofluorescence of the tissue may be used as a non-invasive technique to aid in the oropharynx infection diagnostic.

  3. Main features of the proposed NCRP respiratory tract model

    International Nuclear Information System (INIS)

    The proposed NCRP respiratory tract dosimetry model regions include the naso-oro-pharyngo-laryngeal (NOPL), the tracheobronchial (TB), the pulmonary (P), and the lymph nodes (LN). Input aerosol concentrations are derived from a consideration of particle-size-dependent inspirability. Particle deposition in the respiratory tract is modelled using the mechanisms of inertial impaction, sedimentation and diffusion. The rates of absorption of particles, and transport to the blood, have been derived from clearance data from people and laboratory animals. The effect of body growth on particle deposition is considered. Particle clearance rates are assumed to be independent of age. The proposed respiratory tract model differs significantly from the 1966 Task Group Model in that (1) inspirability is considered; (2) new sub-regions of the respiratory tract are considered; (3) absorption of materials by the blood is treated in a more sophisticated fashion; and (4) body size (and thus age) is taken into account. (author)

  4. Surveillance for outbreaks of respiratory tract infections in nursing homes

    OpenAIRE

    Loeb, M; McGeer, A; McArthur, M; Peeling, R. W.; Petric, M; Simor, A E

    2000-01-01

    BACKGROUND: Outbreaks of respiratory tract infections are common in long-term care facilities for older people. The objective of our study was to determine both the frequency of such outbreaks and their clinical and epidemiological features. METHODS: Prospective surveillance for outbreaks of respiratory tract infections and a retrospective audit of surveillance records were conducted in 5 nursing homes in metropolitan Toronto over 3 years. The clinical manifestations of infected residents wer...

  5. Responsible prescribing for upper respiratory tract infections.

    Science.gov (United States)

    Turnidge, J

    2001-01-01

    Upper respiratory tract infections (URTIs) are responsible for a large amount of community antibacterial use worldwide. Recent systematic reviews have demonstrated that most URTIs resolve naturally, even when bacteria are the cause. The high consumer expectation for antibacterials in URTIs requires intervention by the general practitioner and a number of useful strategies have been developed. Generic strategies, including eliciting patient expectations, avoiding the term 'just a virus', providing a value-for-money consultation, providing verbal and written information, empowering patients, conditional prescribing, directed education campaigns, and emphasis on symptomatic treatments, should be used as well as discussion of alternative medicines when relevant. The various conditions have differing rates of bacterial infection and require different approaches. For acute rhinitis, laryngitis and tracheitis, viruses are the only cause and, therefore, antibacterials are never required. In acute sore throat (pharyngitis) Streptococcus pyogenes is the only important bacterial cause. A scoring system can help to increase the likelihood of distinguishing a streptococcal as opposed to viral infection, or alternatively patients should be given antibacterials only if certain conditions are fulfilled. Strategies for treating acute otitis media vary in different countries. Most favour the strategy of prescribing antibacterials only when certain criteria are fulfilled, delaying antibacterial prescribing for at least 24 hours. In otitis media with effusion, on the other hand, there is no primary role for antibacterials, as the condition resolves naturally in almost all patients aged >3 months. Detailed strategies for acute sinusitis have not been worked out but restricting antibacterial prescribing to certain clinical complexes is currently recommended by several authorities because of the high natural resolution rate.

  6. Respiratory tract infections, reflex apnea and sudden infant death

    OpenAIRE

    Lindgren, Carl

    1996-01-01

    RESPIRATORY TRACT INFECTIONS, REFLEX APNEA AND SUDDEN INFANT DEATH. Experimental and epidemiological studies with special reference to Respiratory syncytial virus, Bordetella pertussis and sleep position. Carl Lindgren, Department of Women and Child Health, Karolinska Institute, Stockhohn, Sweden, and Department of Pediatrics, Division of Neonatology, Vanderbilt University, Nashville, Tennessee, USA. The seasonal distribution of Sudden infant death syndrome (SIDS) ...

  7. Antiviral effects of bovine interferons on bovine respiratory tract viruses.

    OpenAIRE

    Fulton, R W; Downing, M M; Cummins, J M

    1984-01-01

    The antiviral effects of bovine interferons on the replication of bovine respiratory tract viruses were studied. Bovine turbinate monolayer cultures were treated with bovine interferons and challenged with several bovine herpesvirus 1 strains, bovine viral diarrhea virus, parainfluenza type 3 virus, goat respiratory syncytial virus, bovine respiratory syncytial virus, bovine adenovirus type 7, or vesicular stomatitis virus. Treatment with bovine interferons reduced viral yield for each of the...

  8. Human metapneumovirus and respiratory syncytial virus in hospitalized danish children with acute respiratory tract infection

    DEFF Research Database (Denmark)

    von Linstow, Marie-Louise; Henrik Larsen, Hans; Koch, Anders;

    2004-01-01

    The newly discovered human metapneumovirus (hMPV) has been shown to be associated with respiratory illness. We determined the frequencies and clinical features of hMPV and respiratory syncytial virus (RSV) infections in 374 Danish children with 383 episodes of acute respiratory tract infection...

  9. Velocity profiles in idealized model of human respiratory tract

    Directory of Open Access Journals (Sweden)

    Jicha M.

    2013-04-01

    Full Text Available This article deals with numerical simulation focused on velocity profiles in idealized model of human upper airways during steady inspiration. Three r gimes of breathing were investigated: Resting condition, Deep breathing and Light activity which correspond to most common regimes used for experiments and simulations. Calculation was validated with experimental data given by Phase Doppler Anemometry performed on the model with same geometry. This comparison was made in multiple points which form one cross-section in trachea near first bifurcation of bronchial tree. Development of velocity profile in trachea during steady inspiration was discussed with respect for common phenomenon formed in trachea and for future research of transport of aerosol particles in human respiratory tract.

  10. Respiratory Syncytial Virus in Lower Respiratory Tract Infections

    OpenAIRE

    Anita Chakravarti; Bineeta Kashyap

    2007-01-01

    Objective: Acute lower respiratory infections lead to high morbidity and mortality rates in children from developing countries. The aim of this study was to look into the extent of respiratory syncytial virus infections in children with special reference to the role of specific immunoglobulins in protection against infection as well as the association with bacterial pathogens. Material & Methods: Nasopharyngeal aspirates were tested for respiratory syncytial virus antigen by enzyme immunoassa...

  11. Human respiratory tract model for radiological protection: A revision of the ICRP Dosimetric Model for the Respiratory System

    International Nuclear Information System (INIS)

    In 1984, the International Commission on Radiological Protection (ICRP) appointed a task group of Committee 2 to review and revise, as necessary, the ICRP Dosimetric Model for the Respiratory System. The model was originally published in 1966, modified slightly in Publication No. 19, and again in Publication No. 30 (in 1979). The task group concluded that research during the past 20 y suggested certain deficiencies in the ICRP Dosimetric Model for the Respiratory System. Research has also provided sufficient information for a revision of the model. The task group's approach has been to review, in depth, morphology and physiology of the respiratory tract; deposition of inhaled particles in the respiratory tract; clearance of deposited materials; and the nature and specific sites of damage to the respiratory tract caused by inhaled radioactive substances. This review has led to a redefinition of the regions of the respiratory tract for dosimetric purposes. The redefinition has a morphologic and physiological basis and is consistent with observed deposition and clearance of particles and with resultant pathology. Regions, as revised, are the extrathoracic (E-T) region, comprising the nasal and oral regions, the pharynx, larynx, and upper part of the trachea; the fast-clearing thoracic region (T[f]), comprising the remainder of the trachea and bronchi; and the slow-clearing thoracic region (T[s]), comprising the bronchioles, alveoli, and thoracic lymph nodes. A task group report will include models for calculating radiation doses to these regions of the respiratory tract following inhalation of representative alpha-, beta-, and gamma-emitting particulate and gaseous radionuclides. The models may be implemented as a package of computer codes available to a wide range of users

  12. Respiratory tract retention of inhaled particles in experimental animals

    International Nuclear Information System (INIS)

    A variety of inhalation studies have been reviewed to develop a model for describing the retention of particles in the respiratory tracts of several species of experimental animals. Presently, the respiratory tract clearance model receives the greatest use in the radiation protection field. This model has several disadvantages in its basic construction and in its application to radionuclide exposures of people to heterogeneous aerosolized substances. These are discussed and an alternative model is described. The alternative model uses time-varying solubility functions to described absorption of material from the lung and upper respiratory tract. The solubility functions can be determined from studies in experimental animals or can be approximated from in vitro chemical systems. Application of this model to data from several experimental studies is included

  13. Factors affecting on the particle deposition in the respiratory tract

    International Nuclear Information System (INIS)

    The deposition pattern of inhaled particles in the respiratory tracts is affected by anatomical structure of the respiratory tracts and respiratory pattern of animals, which are modified by many factors as animal species, physiological and psychological conditions, age, sex, smoking drug, lung diseases, etc. In human, studies have been focused on the initial lung deposition of particles and have made it clear that the respiratory pattern, gender, and diseases may have influence on the deposition pattern. On the other hand, there was little knowledge on the initial lung deposition of particles in laboratory animals. Recently, Raabe et al. have reported the initial lung deposition of 169Yb-aluminosilicate particles in mice, rats, hamsters, guinea pigs and rabbits. The authors have also investigated the lung deposition of latex particles with different sizes and 198Au-colloid in rats whose respiratory volumes during the inhalation were monitored by body plethysmography. These experiments indicated that the deposition of inhaled particles in distal lung e.g. small bronchiolar and alveolar region, was much lower in laboratory animals than that of human. This species difference may be due to smaller diameter of respiratory tract and/or shallower breathing and higher respiratory rate of laboratory animals. The experimental animals in which respiratory diseases were induced artificially have been used to investigate the modification factors on the deposition pattern of inhaled particles. As respiratory diseases, emphysema was induced in rats, hamsters, beagle dogs in some laboratories and pulmonary delayed type hypersensitivity reaction in rats was in our laboratory. The initial lung deposition of particles in these animals was consistently decreased in comparison with normals, regardless of the animal species and the type of disease. (author)

  14. Seasonality of long term wheezing following respiratory syncytial virus lower respiratory tract infection

    NARCIS (Netherlands)

    Bont, L; Steijn, M; van Aalderen, WMC; Brus, F; Draaisma, JMT; Van Diemen-Steenvoorde, RAAM; Pekelharing-Berghuis, M; Kimpen, JLL

    2004-01-01

    Background: It is well known that respiratory syncytial virus (RSV) lower respiratory tract infection (LRTI) is associated with subsequent wheezing episodes, but the precise natural course of wheezing following RSV LRTI is not known. This study aimed to determine the continuous development of wheezi

  15. Lower respiratory tract infection caused by respiratory syncytial virus : current management and new therapeutics

    NARCIS (Netherlands)

    Mazur, Natalie; Martinon-Torres, Federico; Baraldi, Eugenio; Fauroux, Brigitte; Greenough, Anne; Heikkinen, Terho; Manzoni, Paolo; Mejias, Asuncion; Nair, Harish; Papadopoulos, Nikolaos G.; Polack, Fernando P.; Ramilo, Octavio; Sharland, Mike; Stein, Renato; Madhi, Shabir A.; Bont, Louis

    2015-01-01

    Respiratory syncytial virus (RSV) is a major worldwide cause of morbidity and mortality in children under five years of age. Evidence-based management guidelines suggest that there is no effective treatment for RSV lower respiratory tract infection (LRTI) and that supportive care, ie, hydration and

  16. Estimates of committed effective dose and annual limit on intake for radioactive dusts using the new ICRP respiratory tract model

    Energy Technology Data Exchange (ETDEWEB)

    O`Brien, R.S. [Australian Radiation Lab., Melbourne, VIC (Australia)

    1996-01-01

    This paper discusses some of the implications of using the new ICRP 66 respiratory tract model for calculation of the committed effective dose(CED), for a period of 50 years post-intake, together with the annual limit on intake(ALI), for radioactive dusts encountered in the uranium and mineral sand mining and processing industries. Some of the differences between the old ICRP 30 respiratory tract model and the LUDEP 1.1 computer code, which is based on the new ICRP 66 respiratory tract model, are discussed and a comparison of values obtained using both models is given. 4 figs; 8 tabs; 16 refs.

  17. Microbial flora variations in the respiratory tract of mice

    Directory of Open Access Journals (Sweden)

    Rosa Cangemi de Gutierrez

    1999-09-01

    Full Text Available A stable microbial system in the respiratory tract acts as an important defense mechanism against pathogenic microorganisms. Perturbations in this system may allow pathogens to establish. In an ecological environment such as the respiratory tract, there are many diverse factors that play a role in the establishment of the indigenous flora. In the present work we studied the normal microbial flora of different areas of the respiratory tract of mice and their evolution from the time the mice were born. Our interest was to know which were the dominant groups of microorganisms in each area, which were the first capable of colonizing and which dominated over time to be used as probiotic microorganisms. Our results show that Gram negative facultatively anaerobic bacilli and strict anaerobic microorganisms were the last ones to appear in the bronchia, while aerobic and Gram positive cocci were present in all the areas of the respiratory tract. The number of facultative aerobes and strict anaerobes were similar in the nasal passage, pharynx instilled and trachea, but lower in bronchia. The dominant species were Streptococcus viridans and Staphylococcus saprophyticcus, followed by S. epidermidis, Lactobacilli and S. cohnii I which were present on every studied days but at different proportions. This paper is the first part of a research topic investigating the protective effect of the indigenous flora against pathogens using the mice as an experimental model.

  18. Dysbiosis of upper respiratory tract microbiota in elderly pneumonia patients

    NARCIS (Netherlands)

    Piters, Wouter A. A. de Steenhuijsen; Huijskens, Elisabeth G. W.; Wyllie, Anne L.; Biesbroek, Giske; van den Bergh, Menno R.; Veenhoven, Reinier H.; Wang, Xinhui; Trzcinski, Krzysztof; Bonten, Marc J.; Rossen, John W. A.; Sanders, Elisabeth A. M.; Bogaert, Debby

    2016-01-01

    Bacterial pneumonia is a major cause of morbidity and mortality in elderly. We hypothesize that dysbiosis between regular residents of the upper respiratory tract (URT) microbiome, that is balance between commensals and potential pathogens, is involved in pathogen overgrowth and consequently disease

  19. Enabling factors for antibiotic prescribing for upper respiratory tract infections

    DEFF Research Database (Denmark)

    Jaruseviciene, Lina; Radzeviciene Jurgute, Ruta; Bjerrum, Lars;

    2013-01-01

    Abstract Introduction. General practitioners (GPs) write about 80% of all antibiotic prescriptions, the greatest number of them for patients with respiratory tract infections. However, there is a lack of research targeting the influence of external factors on antibiotic prescribing by physicians....

  20. [Serum procalcitonin and respiratory tract infections].

    Science.gov (United States)

    Zarka, V; Valat, C; Lemarié, E; Boissinot, E; Carré, P; Besnard, J C; Diot, P

    1999-12-01

    The aim of our study was to evaluate the prognostic value of serum procalcitonine (PCT) assay in adult respiratory infections. Forty-nine patients admitted with pleurisy, community-acquired pneumonia, tuberculosis, infection were included in this prospective study. PCT was assayed on admission and discharge. Biological and clinical parameters of gravity were also evaluated. Twenty patients had elevated PCT of more than 0.50 ng/ml. In 29 patients, PCT was undetectable. The serum PCT level was normal in the patients with tuberculosis, infection, pneumocytosis. PCT did not correlate with the biological and clinical markers of the disease severity but the evolution of PCT correlated with the evolution of C-reactive-protein (r = 0.58, p < 0.05). PCT seems to be an early marker of the evolution of respiratory infections, but it does not help to establish prognosis. Further studies are necessary to assess the potential value of PCT in more severe respiratory infections requiring assisted ventilation. PMID:10685471

  1. Viral and bacterial interactions in the upper respiratory tract.

    Directory of Open Access Journals (Sweden)

    Astrid A T M Bosch

    2013-01-01

    Full Text Available Respiratory infectious diseases are mainly caused by viruses or bacteria that often interact with one another. Although their presence is a prerequisite for subsequent infections, viruses and bacteria may be present in the nasopharynx without causing any respiratory symptoms. The upper respiratory tract hosts a vast range of commensals and potential pathogenic bacteria, which form a complex microbial community. This community is assumed to be constantly subject to synergistic and competitive interspecies interactions. Disturbances in the equilibrium, for instance due to the acquisition of new bacteria or viruses, may lead to overgrowth and invasion. A better understanding of the dynamics between commensals and pathogens in the upper respiratory tract may provide better insight into the pathogenesis of respiratory diseases. Here we review the current knowledge regarding specific bacterial-bacterial and viral-bacterial interactions that occur in the upper respiratory niche, and discuss mechanisms by which these interactions might be mediated. Finally, we propose a theoretical model to summarize and illustrate these mechanisms.

  2. Risk factors for lower respiratory tract infections in children

    International Nuclear Information System (INIS)

    Objectives: Acute respiratory tract infections are divided into two groups as upper and lower respiratory tract infections. These are very common diseases in childhood. In this study, we aimed to determine risk factors for lower respiratory tract in this region. Methodology: Hospital were included in our study. Their examinations, backgrounds, family histories and information about environmental factors were recorded in questionnaire forms. Results: Lack of vaccination, duration of breast feeding, onset age of cow's milk, family history for asthma and food allergy, number of hospitalized people in the same room, number of people who live in same house and smoking around the children were evaluated for the presence of LRTI, and LRTI risks of these factors were respectively observed as 1.69, 1.71, 1.61, 1.69, 1.20, 1.47, 1.56 and 2.63 fold increased. Conclusion: Standardization of clinical diagnosis, accurate and realistic use of antibiotics, correction of nutrition, improvement of socio-economic situation and the elimination of Respiratory Infections. (author)

  3. Human metapneumovirus and respiratory syncytial virus in hospitalized danish children with acute respiratory tract infection

    DEFF Research Database (Denmark)

    von Linstow, Marie-Louise; Larsen, Hans Henrik; Eugen-Olsen, Jesper;

    2004-01-01

    The newly discovered human metapneumovirus (hMPV) has been shown to be associated with respiratory illness. We determined the frequencies and clinical features of hMPV and respiratory syncytial virus (RSV) infections in 374 Danish children with 383 episodes of acute respiratory tract infection...... children 1-6 months of age. Asthmatic bronchitis was diagnosed in 66.7% of hMPV and 10.6% of RSV-infected children (p respiratory support. hMPV is present in young...

  4. Do pollution and climate influence respiratory tract infections in children?

    Directory of Open Access Journals (Sweden)

    Saulo Duarte Passos

    2014-06-01

    Full Text Available To review if pollution and climate changes can influence respiratory tract infections in children. Data source: articles published on the subject in PubMed, SciELO, Bireme, EBSCO and UpTodate were reviewed. The following inclusion criteria were considered: scientific papers between 2002 and 2012, study design, the pediatric population, reference documents such as the CETESB and World Health Organization Summary of the data: We analyzed research that correlated respiratory viruses and climate and/or pollution changes. Respiratory syncytial virus has been the virus related most to changes in climate and humidity. Other "old and new" respiratory viruses such as Human Bocavirus, Metapneumovirus, Parechovirus and Parainfuenza would need to be investigated owing to their clinical importance. Although much has been studied with regard to the relationship between climate change and public health, specific studies about its influence on children's health remain scarce.

  5. Respiratory tract clearance model for dosimetry and bioassay of inhaled radionuclides

    Energy Technology Data Exchange (ETDEWEB)

    Bailey, M.R.; Birchall, A. (National Radiological Protection Board, Chilton (UK)); Cuddihy, R.G. (Inhalation Toxicology Research Inst., Albuquerque, NM (USA)); James, A.C. (Pacific Northwest Lab., Richland, WA (USA)); Roy, M. (CEA Centre d' Etudes Nucleaires de Fontenay-aux-Roses, 92 (France). Inst. de Protection et de Surete Nucleaire)

    1990-07-01

    The ICRP Task Group on Respiratory Tract Models is developing a model to describe the retention and clearance of deposited radionuclides for dose-intake calculations and interpretation of bioassay data. Clearance from each region is treated as competition between mechanical transport, which moves particles to the gastro-intestinal tract and lymph nodes, and the translocation of material to blood. It is assumed that mechanical transport rates are the same for all materials, and that rates of translocation to blood are the same in all regions. Time-dependent clearance is represented by combinations of compartments. Representative values of parameters to describe mechanical transport from the human respiratory tract have been estimated, and guidance is given on the determination of translocation rates. It is emphasized that the current version of the model described here is still provisional. 30 refs.

  6. Incense use and respiratory tract carcinomas: a prospective cohort study

    DEFF Research Database (Denmark)

    Yuan, J.M.; Wang, R.; Koh, W.P.;

    2008-01-01

    BACKGROUND: Incense use is an integral part of daily life in large parts of Asia. The burning of incense is a powerful producer of particulate matter and the smoke contains a multitude of well-characterized carcinogens. However, to the authors' knowledge, no convincing association has been reported...... between exposure to incense smoke and the development of cancer. Therefore, the relation between incense use and the risk of respiratory tract carcinomas was analyzed in a prospective cohort study. METHODS: Between 1993 and 1998, a population-based cohort of 61,320 Singapore Chinese who were free...... with incense use was estimated using a Cox proportional hazards model. RESULTS: A total of 325 upper respiratory tract (UPT) carcinomas and 821 lung carcinomas were observed during follow-up. Incense use was associated with a significantly increased risk of UPT carcinomas other than nasopharyngeal, whereas...

  7. Treatment of acute upper respiratory tract infections in children

    Directory of Open Access Journals (Sweden)

    Rončević-Babin Nevenka P.

    2002-01-01

    Full Text Available Introduction Acute respiratory tract infections are the most common diseases of childhood. A preschool child suffers up to 5-7 infections of upper airways during a year. Upper airway infections make 80 - 90% of all respiratory infections. Etiology and treatment In 75% of all cases respiratory infections are of viral etiology, 15% of bacterial and 10% are caused by mycoplasma, rickettsiae, fungi, parasites. The treatment of respiratory infections includes antimicrobial therapy (causal, relief of symptoms (symptomatic and application of general principles of child treatment. The choice of antimicrobial drug is based on the evidence of agents and their sensitivity to antimicrobial drugs, age, patient's condition, previous treatment and possible allergic reactions to the drug. In cases where adequate specimen cannot be obtained for microbiologic tests, when these tests do not reveal the agent, or therapy must start before evidence of the agent is available, we must decide about the therapy, taking in consideration the most frequent agents, and those that would cause the most devastating clinical picture. This therapy can be modified later, according to the isolated agent and its sensitivity to the drug. Considering the incidence and importance of respiratory infections in morbidity and mortality of children, the aim of this article was to present guidelines in treatment of respiratory infections. The main point remains that the treatment should take into consideration the individual patient before all.

  8. ASSOCIATION OF MYCOPLASMA PNEUMONIAE WITH RESPIRATORY TRACT INFECTIONS IN CHILDREN

    Directory of Open Access Journals (Sweden)

    Osama Mohammed Saed Abdul-Wahab

    2013-01-01

    Full Text Available Mycoplasma pneumoniae is one of four most common species of organisms that are responsible for most clinically significant infections in humans. It is a frequent cause of acute respiratory infections in both children and adults. The organism can cause pharyngitis, otitis, tracheobronchitis, or community-acquired pneumonia, but patients may also remain totally asymptomatic. Aim of this prospective study for children, was to investigate the association of M. pneumoniae with respiratory tract infections in a Saudi population. This study was designed as a case-control study in which 90 patients (Mean age of the patients in case group was 5.94±2.73 and in control group was 6.51±2.26 of either sexes were included. These patients were classified into two groups: first group (case group, included 45 patients who had been admitted in hospital with diagnosis of respiratory tract infections and the second group (control group, included 45 healthy patients who had no history of respiratory tract infections. Both the groups were age and sex matched. Presence of IgM antibodies to Mycoplasma pneumoniae was assessed by ELISA technique in both groups. In the case group, 4 (9% cases out of 45 children were positive for anti-mycoplasma antibody whereas in the control group, all children were negative. All positive case group patients had symptoms of acute pneumonia. 18 (40% of the patients were diagnosed with bronchial asthma (40% inclusive of all the four cases diagnosed with Mycoplasma pneumoniae infection. The relative risk for the occurrence of mycoplasma infection was estimated to be 9 (95%C.I = 0.49-162.43. However, on comparing the case and control groups, the result was not found to be statistically significant. (Fischer Exact Test p = 0.0583. Children in Saudi Arabia are at a relatively higher risk of developing Mycoplasma pneumoniae infection especially those predisposed with underlying chronic respiratory illnesses such as asthma. This is a first

  9. Treatment of acute lower respiratory tract infections in children

    Directory of Open Access Journals (Sweden)

    Rončević-Babin Nevenka P.

    2002-01-01

    Full Text Available Introduction Acute respiratory tract infections are the most common childhood diseases. A preschool child suffers up to 5-7 infections of upper airways during a year. Lower airway infections make 5-20% of all respiratory infections. Etiologic factors In developed countries, 75% of pneumonias in childhood are of viral etiology, in 15% of bacterial, and in 10% of some other causative agent (mycoplasma, rickettsiae, fungi, parasites. In developing countries, bacterial pneumonias are present in much higher percentages. Treatment Treatment of respiratory infections includes antimicrobial therapy (causal, relief of symptoms (symptomatic and conduction of general principles in child treatment. The choice of antimicrobial drug is based on evidence of agents and their sensitivity to antimicrobial drugs, age, patient's condition, previous treatment and possible allergic reactions to the drug. In cases where we cannot provide adequate specimen for microbiologic testing, when these tests do not reveal the agent, or when therapy must be started before the agent is available, we must decide about the therapy, taking in consideration the most frequent agents, and those that would cause the most devastating clinical picture. This therapy can later be modified according to the isolated agent and its sensitivity to the drug. Conclusion Having in mind the incidence and importance of respiratory infections in morbidity and mortality of children the aim of this article was to show guidelines in treatment of respiratory infections in children. The main point remains that we should take in consideration the individual patient before all.

  10. Clinical efficacy of ciprofloxacin in lower respiratory tract infections.

    Science.gov (United States)

    Pedersen, S S

    1989-01-01

    The sputum pharmacokinetics and clinical efficacy of ciprofloxacin in lower respiratory tract infections is reviewed. Following intravenous administration, ciprofloxacin penetrates rapidly into bronchial tissue; the elimination half life is between 3 and 4 h and a dose dependency is seen. Following oral intake, the time to reach maximal concentrations is approximately two hours and after a dose of 750 mg the concentration may reach 1.7 mg/l in patients without cystic fibrosis and range from 0.5 to 3.4 mg/l in cystic fibrosis patients. Coadministration of ciprofloxacin increases serum levels and decreases total body clearance of theophylline. In controlled comparative clinical trials, ciprofloxacin has been found to have similar clinical efficacy as amoxycillin, ampicillin, cefalexin, doxycycline, co-trimoxazole, imipenem-cilastatin and ceftazidime for the treatment of a range of lower respiratory tract infections. Ciprofloxacin has been found to be superior in clinical efficacy to cefaclor. Experimental animal models suggest a role for ciprofloxacin in infections caused by Legionella pneumophila and Mycoplasma pneumoniae. The clinical and bacteriological efficacy of ciprofloxacin is less pronounced in lung infections caused by Pseudomonas aeruginosa, but is comparable to the combination of beta-lactams and aminoglycosides. Development of resistance is frequently observed during ciprofloxacin treatment of Ps. aeruginosa. Because of the availability of other oral and effective agents, ciprofloxacin is not recommended for empirical treatment of community acquired lower respiratory infections, but should be reserved for infections caused by multiply resistant organisms. PMID:2667111

  11. Microbiological Study On Respiratory Tract Infections In Libya

    Directory of Open Access Journals (Sweden)

    *A. H. Eldeeb and **E.M. Khashan

    2006-09-01

    Full Text Available Introduction: Recent reports revealed that 10% of the worldwide burden of morbidity and mortality relates to respiratory tract infection. Patient and methods: Five hundreds and fifty nine clinical strains were isolated and identified from 322 patients suffering from respiratory tract infections. Patients represented different ages, sexes, and types of infections. Out of the 322 patients, 204 were suffering from upper respiratory tract infections and 118 patients were suffering from lower respiratory tract infections. Patients of upper respiratory tract infections were suffering from chronic suppurative otitis media (63 patients, tonsillitis (50 patients, pharyngitis (48 patients, and sinusitis (43 patients. Results: Out of the total isolates, Staphylococcus aureus was the most prevalent organism, followed by Streptococcus pyogenes and Klebsiella pneumoniae (17.71, 12.34, and 11.27% respectively. Pseudomonas aeruginosa represented 6.26%. Serratia marcescens and Morganella morganii were the least isolated organisms. The results revealed that 52.42% of the strains were isolated from males and 47.58% from females. Staphylococcus aureus was the most prevalent organism in males (21.16% while in females Strept. pyogenes was the most prevalent organism (14.29%. Also, the study revealed that Staphylococcus aureus was the most frequent isolate in age groups between 1-20, 21-40 and 41-60 years old (20.85%, 17.02% and 16.67% respectively. However, both Staphylococcus aureus and Klebsiella pneumoniae were isolated with equal incidences, 12% each, in elder patients (more than 60 years. The susceptibility pattern of the isolated bacteria to different antimicrobial agents was studied. Both levofloxacin and gatifloxacin showed the highest activity (100%, followed by ofloxacin and ciprofloxacin (96.44% and 93.39%, respectively. Those are followed by amikacin (91.86%, cefotaxime (89.31%, cefoperazone (86.26%, gentamicin (84.22%, ampicillin-sulbactam (70

  12. Antibiotic use in acute upper respiratory tract infections.

    Science.gov (United States)

    Zoorob, Roger; Sidani, Mohamad A; Fremont, Richard D; Kihlberg, Courtney

    2012-11-01

    Upper respiratory tract infections account for millions of visits to family physicians each year in the United States. Although warranted in some cases, antibiotics are greatly overused. This article outlines the guidelines and indications for appropriate antibiotic use for common upper respiratory infections. Early antibiotic treatment may be indicated in patients with acute otitis media, group A beta-hemolytic streptococcal pharyngitis, epiglottitis, or bronchitis caused by pertussis. Persistent cases of rhinosinusitis may necessitate the use of antibiotics if symptoms persist beyond a period of observation. Antibiotics should not be considered in patients with the common cold or laryngitis. Judicious, evidence-based use of antibiotics will help contain costs and prevent adverse effects and drug resistance.

  13. In vivo Measurement of Unattached Radon Progeny Deposited in the Human Respiratory Tract

    Energy Technology Data Exchange (ETDEWEB)

    Butterweck, G.; Vezzu, G.; Schuler, Ch.; Mueller, R.; Marsh, J.W.; Thrift, S.; Birchall, A

    2001-07-01

    Seven nose breathing and seven mouth breathing volunteers were exposed to atmospheres enriched with unattached radon progeny ({sup 218}Po, {sup 214}Pb and {sup 214}Bi). The activity of these radionuclides deposited in the respiratory track was measured in vivo after the exposures. The results of these measurements are in agreement with predictions calculated with the ICRP Publication 66 Human Respiratory Tract Model. Temporal analysis of the activity deposited in the heads of the volunteers leads to the conclusion that a significant amount of the deposited activity associated with particle diameters of about 1 nm is not subject to a fast transport to the gastrointestinal tract as generally reported for larger aerosol particles. (author)

  14. Absorbed fraction of electrons in human respiratory tract

    International Nuclear Information System (INIS)

    Absorbed fractions of electrons, defined as part of electron energy deposited in the target, were calculated for various combinations of source and targets in HRTM. In that propose source code for PENELOPE was developed while respirator tract was modeled according to ICRP66. Absorbed fractions were fitted with the function presented in the paper

  15. Low to medium WU-virus titers in young children with lower respiratory tract infections.

    Science.gov (United States)

    Kleines, Michael; Scheithauer, Simone; Hengst, Meike; Honnef, Dagmar; Ritter, Klaus; Mühler, Eberhard; Häusler, Martin; Rostamzadeh, Ayda

    2008-01-01

    The WU-virus (WUV), a novel polyomavirus, has recently been recovered from respiratory tract samples. Within a study collective of children with severe lower respiratory tract disease, 3% of the patients tested WUV positive. Viral loads ranged from 5 x 10(2) copies/ml to 1 x 10(4) copies/ml. The WUV genome-positive patients did not display specific clinical or radiological characteristics to be distinguished from other respiratory tract infections. PMID:19321930

  16. Proposed updating of the ICRP human respiratory tract model

    International Nuclear Information System (INIS)

    The ICRP Task Group on Internal Dosimetry is developing new Occupational Intakes of Radionuclides documents, which will include revised dose coefficients for inhalation of radionuclides by workers. Application of the ICRP Human Respiratory Tract Model requires a review of the lung-to-blood absorption characteristics of inhaled materials of importance in radiological protection. It is planned that, where appropriate, material-specific absorption parameter values will be given, and for other materials, assignments to default absorption Types will be made on the basis of current information. Publication of the Occupational Intakes of Radionuclides documents provides an opportunity for updating the Human Respiratory Tract Model in the light of experience and new information. The main possibilities under consideration relate to the two main clearance pathways: absorption to blood and particle transport. The review of absorption rates is providing a database of parameter values from which consideration can be given to deriving typical values for default Types F, M and S materials, and element-specific rapid dissolution rates. Important new data on rates of particle transport from the nasal passages, bronchial tree (slow phase) and alveolar-interstitial region have come from recent human studies, some of which were conducted to address uncertainties identified by development of the model. These new results, and others, are being reviewed alongside those available in 1993 when the model was finalised, to propose revisions based on the best currently-available information. This paper reports on the current status of this work. (author)

  17. Considering Respiratory Tract Infections and Antimicrobial Sensitivity: An Exploratory Analysis

    Directory of Open Access Journals (Sweden)

    Amin, R.

    2009-01-01

    Full Text Available This study was conducted to observe the sensitivity and resistance of status of antibiotics for respiratory tract infection (RTI. Throat swab culture and sensitivity report of 383 patients revealed sensitivity profiles were observed with amoxycillin (7.9%, penicillin (33.7%, ampicillin (36.6%, co-trimoxazole (46.5%, azithromycin (53.5%, erythromycin (57.4%, cephalexin (69.3%, gentamycin (78.2%, ciprofloxacin (80.2%, cephradine (81.2%, ceftazidime (93.1%, ceftriaxone (93.1%. Sensitivity to cefuroxime was reported 93.1% cases. Resistance was found with amoxycillin (90.1%, ampicillin (64.1%, penicillin (61.4%, co-trimoxazole (43.6%, erythromycin (39.6%, and azithromycin (34.7%. Cefuroxime demonstrates high level of sensitivity than other antibiotics and supports its consideration with patients with upper RTI.

  18. Relationship Between Upper Respiratory Tract Influenza Test Result and Clinical Outcomes Among Critically Ill Influenza Patients

    OpenAIRE

    Reddy, Krishna P.; Bajwa, Ednan K.; Parker, Robert A.; Andrew B Onderdonk; Walensky, Rochelle P.

    2016-01-01

    Among critically ill patients with lower respiratory tract (LRT)-confirmed influenza, we retrospectively observed worse 28-day clinical outcomes in upper respiratory tract (URT)-negative versus URT-positive subjects. This finding may reflect disease progression and highlights the need for influenza testing of both URT and LRT specimens to improve diagnostic yield and possibly inform prognosis.

  19. Lower Respiratory Tract Infections Due To Mycoplasma Pneumoniae: Report of Four Cases

    OpenAIRE

    Çetinkaya, Feyzullah; Göçmen, Ayhan; Ustaçelebi, Şemsettin

    1993-01-01

    Mycoplasma pnemoniae is one of the most important causes of lower respiratory tract infections in childhood In this study four cases diagnosed by complement fixation method are reported and the rilevant literature is reviewed Key words: Mycoplasma Pneumoniae Lower Respiratory Tract

  20. An association between Helicobacter pylori and upper respiratory tract disease: fact or fiction?

    Science.gov (United States)

    Kariya, Shin; Okano, Mitsuhiro; Nishizaki, Kazunori

    2014-02-14

    Helicobacter pylori (H. pylori) is a major cause of chronic gastritis and gastric ulcers and considerable evidence supports the notion that infection with this bacterium is also associated with gastric malignancy in addition to various other conditions including pulmonary, vascular and autoimmune disorders. Gastric juice infected with H. pylori might play an important role in upper respiratory tract infection. Although direct and/or indirect mechanisms might be involved in the association between H. pylori and upper respiratory tract diseases, the etiological role of H. pylori in upper respiratory tract disorders has not yet been fully elucidated. Although various studies over the past two decades have suggested a relationship between H. pylori and upper respiratory tract diseases, the findings are inconsistent. The present overview describes the outcomes of recent investigations into the impact of H. pylori on upper respiratory tract and adjacent lesions.

  1. Comparison of old and new ICRP models for respiratory tract dosimetry

    International Nuclear Information System (INIS)

    This paper examines the historical development and application of respiratory tract dosimetry models by the International Commission for Radiological Protection, ICRP, for health protection from inhaled radioactive aerosols. Three different models are discussed, those that were included in ICRP recommendations published in 1960 and 1979, and the new ICRP Publication 66. Basic features of these models are compared and contrasted. These features include model structure, sites and frequencies of particle deposition, processes and rates of clearance of the deposited material from the respiratory tract, and consideration of the parameters involved in these processes and how various factors can influence these parameters. All three models lead to the calculation of absorbed radiation doses with differing degrees of regional and local specificity. These calculations are achieved using different tools ranging from quick hand calculations to sophisticated computerized modeling approaches. A side-by-side review of these models indicates several important trends in respiratory tract dosimetry models, the most obvious of which is the increased complexity of each new model over the past 30+ years. These increases reflect both the increasing size of the knowledge base derived from studies in laboratory animals and in human subjects and the need for models more broadly applicable for both occupational and environmental exposures. It is likely that future research will be directed to those key aspects of the new model having the largest uncertainties. The detailed design of the new model and its associated software provide excellent means of identifying useful research areas and using the resulting new information in organized and productive ways

  2. Effectiveness of two types of intervention on antibiotic prescribing in respiratory tract infections in Primary Care in Spain

    DEFF Research Database (Denmark)

    Llor, Carles; Cots, Josep Maria; Hernández, Silvia;

    2014-01-01

    To evaluate the effectiveness of two types of intervention in reducing antibiotic prescribing in respiratory tract infections (RTI).......To evaluate the effectiveness of two types of intervention in reducing antibiotic prescribing in respiratory tract infections (RTI)....

  3. Dosimetry model for bronchial and extrathoracic tissues of the respiratory tract

    International Nuclear Information System (INIS)

    The Task Group to Review the Lung Model for the International Commission on Radiological Protection (ICRP) is proposing to revise the dosimetry model for the respiratory tract on the basis of the relative radiosensitivities of the various tissue components. The task group considers that if all tissues were to receive the same radiation dose, approximately 64% of fatal cancers would be likely to arise in the bronchi, about 12% in the bronchioles, about 20% in extrathoracic tissues (divided between the naso-- and oropharynx and larynx), and only about 4% in the alveolar-interstitial tissue, with a very small fraction of all cancers (less than 0.1%) in lymph nodes. A new and detailed treatment of dose received by epithelia in the tracheo-bronchiolar and extra-thoracic regions of the respiratory tract is therefore required. This paper describes the approach proposed by the task group to evaluate doses to presumed target cells in each of these tissues at risk in the respiratory tract from non-uniform irradiation by α-, β- and electron-emitters. The task group's approach takes into account the impact of observed phenomena that may cause long-lived radionuclides to be retained in epithelial tissues: the uptake of particles by the airway wall; the chemical binding of sparingly soluble nuclides in epithelial tissues; and, especially in the bronchi and bronchicles, the slow clearance of particles by mucus. Values of dose, weighted by the task group's proposed relative risk factors are calculated for several types of α- and β- emitters. These weighted doses are compared with the committed effective dose equivalent calculated using the current ICRP lung model, in which the simplifying assumption is made that all of the activity retained in the thorax uniformly irradiates the 1 kg mass of a ''composite'' lung. 11 refs., 14 figs., 7 tabs

  4. Dysbiosis of upper respiratory tract microbiota in elderly pneumonia patients.

    Science.gov (United States)

    de Steenhuijsen Piters, Wouter A A; Huijskens, Elisabeth G W; Wyllie, Anne L; Biesbroek, Giske; van den Bergh, Menno R; Veenhoven, Reinier H; Wang, Xinhui; Trzciński, Krzysztof; Bonten, Marc J; Rossen, John W A; Sanders, Elisabeth A M; Bogaert, Debby

    2016-01-01

    Bacterial pneumonia is a major cause of morbidity and mortality in elderly. We hypothesize that dysbiosis between regular residents of the upper respiratory tract (URT) microbiome, that is balance between commensals and potential pathogens, is involved in pathogen overgrowth and consequently disease. We compared oropharyngeal microbiota of elderly pneumonia patients (n=100) with healthy elderly (n=91) by 16S-rRNA-based sequencing and verified our findings in young adult pneumonia patients (n=27) and young healthy adults (n=187). Microbiota profiles differed significantly between elderly pneumonia patients and healthy elderly (PERMANOVA, Pdisease was less clear. A decision tree model based on the relative abundance of five bacterial community members in URT microbiota showed high specificity of 95% and sensitivity of 84% (89% and 73%, respectively, after cross-validation) for differentiating pneumonia patients from healthy individuals. These results suggest that pneumonia in elderly and young adults is associated with dysbiosis of the URT microbiome with bacterial overgrowth of single species and absence of distinct anaerobic bacteria. Whether the observed microbiome changes are a cause or a consequence of the development of pneumonia or merely coincide with disease status remains a question for future research.

  5. Inappropriate antibiotic prescription for respiratory tract indications : most prominent in adult patients

    NARCIS (Netherlands)

    Dekker, Anne R. J.; Verheij, Theo J. M.; van der Velden, Alike W.

    2015-01-01

    Background. Numerous studies suggest overprescribing of antibiotics for respiratory tract indications (RTIs), without really authenticating inappropriate prescription; the strict criteria of guideline recommendations were not taken into account as information on specific diagnoses, patient character

  6. Antibiotics for respiratory, ear and urinary tract disorders and consistency among GPs.

    NARCIS (Netherlands)

    Ong, D.S.Y.; Kuyvenhoven, M.M.; Dijk, L. van; Verheij, T.J.M.

    2008-01-01

    Objectives: To describe specific diagnoses for which systemic antibiotics are prescribed, to assess adherence of antibiotic choice to national guidelines and to assess consistency among general practitioners (GPs) in prescribed volumes of antibiotics for respiratory, ear and urinary tract disorders.

  7. Primary care management of respiratory tract infections in Dutch preschool children

    NARCIS (Netherlands)

    Jansen, Angelique G S C; Sanders, Elisabeth A M; Schilder, Anne G M; Hoes, Arno W; de Jong, Vanya F G M; Hak, Eelko

    2006-01-01

    OBJECTIVE: To determine age-specific antibiotic prescription and referral rates in preschool children diagnosed with acute respiratory tract infection (RTI) in primary care. DESIGN: Retrospective cohort study. SETTING: Research database of the Netherlands University Medical Center Utrecht Primary Ca

  8. Guidelines to rational use of antibiotics in acute upper respiratory tract infections in Chinese children

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@Acute respiratory tract infections (ARTIs) is the most common disease afflicting Chinese children and ranks first in numbers of outpatients, hospitalization and fatality rate. ARTI is also the most frequent reason that antibiotics are prescribed.

  9. Systematic review of the epidemiology literature on formaldehyde and cancers of the upper respiratory tract

    Science.gov (United States)

    Background: EPA is currently drafting a Toxicological Review of formaldehyde. As part of the comprehensive evaluation of potential hazards associated with exposure to formaldehyde, the potential hazards for cancers of the upper respiratory tract are being evaluated. We are aware ...

  10. Role of pneumococcal virulence genes in the etiology of respiratory tract infection and biofilm formation

    OpenAIRE

    Kurola, P. (Paula)

    2011-01-01

    Abstract Streptococcus pneumoniae, pneumococcus, is a common cause of respiratory tract infections and also a common inhabitant of the upper respiratory tract of healthy people. At present, 93 different polysaccharide types have been identified and in addition to them, unencapsulated pneumococci are found especially in healthy carriers. Pneumococci are usually identified by using a bacterial culture combined with biochemical or immunochemical tests. Recently, new DNA-based methods, such a...

  11. Atmospheric particulate matter and hospital admission due to lower respiratory tract infection: a case-cross study in Shijiazhuang, China

    Directory of Open Access Journals (Sweden)

    Zi-na BAI

    2016-03-01

    Full Text Available Objective  To explore the association between atmospheric particulate matter (PM10/PM2.5 levels and hospital admissions due to lower respiratory tract infection in Shijiazhuang. Methods  Data of air pollution, meteorologic data, and the data of patients admitted to hospital due to lower respiratory tract infection were retrospectively analyzed. Pearson's correlation coefficients were calculated to analyze correlations between atmospheric particulate matter and meteorologic factors. Data of hospital admission due to lower respiratory tract infection and of atmospheric air pollution levels in Shijiazhuang were obtained, a bidirectional case-crossover design was used to investigate the association between hospital admissions due to lower respiratory tract infection and levels of atmospheric particles. Stratified analyses of exposure based on age, gender, complications and season were performed to evaluate the effect. Results  Pearson's correlation analysis showed positive correlations among PM2.5, PM10, SO2, NO2 and CO. The concentration of all these five pollutants were negatively correlated with O3 and daily mean temperature, while a positive correlation was found between concentrations of the 5 pollutants and daily average temperature and O3. In single-pollutant model, every 10μg/m3 increase in PM2.5 and PM10 at lag5 brought the corresponding OR values (95%CI up to 1.010(1.005-1.015 and 1.006(1.003-1.009 respectively. In the multi-pollutant models, the observed effects of PM2.5 remained significant. Stratified analysis based on gender, age, season and comorbidities showed that the effect of PM2.5 exposure on lower respiratory tract infection admissions was stronger in males, persons younger than 60 years of age and persons without comorbidities, and even more stronger in cold season. The effect of PM10 exposure on lower respiratory tract infection admissions was stronger in females, persons older than 60 years of age and persons with

  12. On the behavior of particles in the human respiratory tract. Ueber das Verhalten von Aerosolteilchen im menschlichen Atemtrakt

    Energy Technology Data Exchange (ETDEWEB)

    Stahlhofen, W.; Scheuch, G. (Gesellschaft fuer Strahlen- und Umweltforschung mbH Muenchen, Neuherberg (Germany, F.R.))

    1989-01-01

    The results of a series of inhalation experiments (nose- as well as mouth-breathing) are the basis for an estimation of particle behavior in the whole human respiratory tract and in certain regions as extrathoracic, tracheobronchial and alveolar region. Particle behavior depends on the breathing parameters and on particle diameter. Additionally the clearance function of the tracheobronchial tract is given. The clearance is shown to be slowed down for particles being smaller than six micrometers. This fact cannot be neglected in case dosis effect relations are calculated. The corresponding consequences are discussed. (orig.).

  13. Viral and Bacterial Interactions in the Upper Respiratory Tract

    NARCIS (Netherlands)

    Bosch, Astrid A. T. M.; Biesbroek, Giske; Trzcinski, Krzysztof; Sanders, Elisabeth A. M.; Bogaert, Debby

    2013-01-01

    Respiratory infectious diseases are mainly caused by viruses or bacteria that often interact with one another. Although their presence is a prerequisite for subsequent infections, viruses and bacteria may be present in the nasopharynx without causing any respiratory symptoms. The upper respiratory t

  14. IRON AND IRON-RELATED PROTEINS IN THE LOWER RESPIRATORY TRACT OF ARDS PATIENTS

    Science.gov (United States)

    OBJECTIVE: An increased oxidative stress in the lower respiratory tract of individuals with acute respiratory distress syndrome is considered to be one mechanism of lung injury in these patients. Cell and tissue damage resulting from an oxidative stress can ultimately be the cons...

  15. Validation of a multiplex reverse transcriptase PCR ELISA for the detection of 19 respiratory tract pathogens

    NARCIS (Netherlands)

    Puppe, W.; Weigl, J.; Groendahl, B.; Knuf, M.; Rockahr, S.; von Bismarck, P.; Aron, G.; Niesters, H. G. M.; Osterhaus, A. D. M. E.; Schmitt, H. -J.

    2013-01-01

    Introduction Since acute respiratory tract infections inflict a high burden of disease in children worldwide, a multiplex reverse transcription polymerase chain reaction combined with a microwell hybridization assay (m-RT-PCR ELISA) to detect 19 different respiratory pathogens was developed and vali

  16. X-ray orbiscope physiological examination of the upper respiratory tract in newborn and infants using

    International Nuclear Information System (INIS)

    Physiological changes in the laryngotracheal axis were examined during the respiratory cycle by image inten fication with high image frequency (6 images/sec). This examination of movements appeared to be very useful in functional disturbances of the trachea for analyzing the symptoms of obstructive disturbances in the upper respiratory tract. (orig.)

  17. A preliminary approach to age-dependent deposition modeling for human respiratory tract

    International Nuclear Information System (INIS)

    Since the respiratory tract model, presented by the ICRP Task Group on Lung Dynamics, is limited to adult workers for determining internal radiation exposure from inhaled radionuclides, the development of the model for estimating radiation doses in the general public, including all age groups, from environmental radioactive materials is required. This paper provides background information in developing the age-dependent respiratory tract model. A way of obtaining deposition probability through major mechanisms, such as impaction, sedimentation, and diffusion, in the respiratory airways is given. A computer program for estimating the percent deposition of inhaled monodisperse particles is described. (Namekawa, K.)

  18. Assessment of a new algorithm in the management of acute respiratory tract infections in children

    Directory of Open Access Journals (Sweden)

    Seyed Ahmad Tabatabaei

    2012-01-01

    Full Text Available Objectives: To assess the practicability of a new algorithm in decreasing the rate of incorrect diagnoses and inappropriate antibiotic usage in pediatric Acute Respiratory Tract Infection (ARTI. Materials and Methods: Children between 1 month to15 years brought to outpatient clinics of a children′s hospital with acute respiratory symptoms were managed according to the steps recommended in the algorithm. Results: Upper Respiratory Tract Infection, Lower Respiratory Tract Infection, and undifferentiated ARTI accounted for 82%, 14.5%, and 3.5% of 1 209 cases, respectively. Antibiotics were prescribed in 33%; for: Common cold, 4.1%; Sinusitis, 85.7%; Otitis media, 96.9%; Pharyngotonsillitis, 63.3%; Croup, 6.5%; Bronchitis, 15.6%; Pertussis-like syndrome, 82.1%; Bronchiolitis, 4.1%; and Pneumonia, 50%. Conclusion: Implementation of the ARTIs algorithm is practicable and can help to reduce diagnostic errors and rate of antibiotic prescription in children with ARTIs.

  19. The effect of vitamin D on lower respiratory tract infections in children

    Science.gov (United States)

    Şişmanlar, Tuğba; Aslan, Ayşe Tana; Gülbahar, Özlem; Özkan, Seçil

    2016-01-01

    Aim: Lower respiratory tract infections including mainly pneumonia represent an important public health problem leading to high mortality and mobidity rates in children aged below five years in developing countries including our country. Vitamin D deficiency has been associated with increased risk of rickets/osteomalacia, various cancers, autoimmune diseases, hyperproliferative skin diseases, cardiovascular system diseases and infectious diseases. Vitamin D has an important role in cellular and humoral immunity and pulmonary functions. Vitamin D deficiency and lower respiratory tract infection are common health problems in children in our country and no clinical study investigating the relationship between these problems has been conducted so far. In this case-control study, we aimed to assess the association between vitamin D level and lower respiratory tract infection in children. Material and Methods: Sixty-three children aged between six months and five years with lower respiratory infections and 59 age-matched children who had no history of respiratory symptoms in the last month and no accompanying chronic disease were compared in terms of vitamin D levels. The children in the patient group were also evaluated by the clinical picture. Results: No significant correlation was found between vitamin D levels and lower respiratory tract infection in terms of disease and its severity. However, it was found that vitamin D deficiency/ insufficiency was observed with a high rate in all children included in the study. Conclusions: Although no correlation was found between vitamin D level and lower respiratory tract infection, it is recommended that vitamin D level should be measured in children with lower respiratory tract infection and vitamin D supplementation should be given to all children especially in winter months based on the fact that the level of vitamin D was lower than normal in approximately half of the children included in the study and considering the

  20. The upper respiratory tract microbiome and its potential role in bovine respiratory disease and otitis media

    Science.gov (United States)

    Lima, Svetlana F.; Teixeira, Andre Gustavo V.; Higgins, Catherine H.; Lima, Fabio S.; Bicalho, Rodrigo C.

    2016-01-01

    The upper respiratory tract (URT) hosts a complex microbial community of commensal microorganisms and potential pathogens. Analyzing the composition and nature of the healthy URT microbiota and how it changes over time will contribute to a better understanding of the pathogenesis of pneumonia and otitis. A longitudinal study was conducted including 174 Holstein calves that were divided in four groups: healthy calves, calves diagnosed with pneumonia, otitis or both diseases. Deep pharyngeal swabs were collected on days 3, 14, 28, and 35 of life, and next-generation sequencing of the 16S rRNA gene as well as quantitative PCR was performed. The URT of Holstein dairy calves aged 3 to 35 days revealed to host a highly diverse bacterial community. The relative abundances of the bacterial genera Mannheimia, Moraxella, and Mycoplasma were significantly higher in diseased versus healthy animals, and the total bacterial load of newborn calves at day 3 was higher for animals that developed pneumonia than for healthy animals. Our results corroborate the existing knowledge that species of Mannheimia and Mycoplasma are important pathogens in pneumonia and otitis. Furthermore, they suggest that species of Moraxella can potentially cause the same disorders (pneumonia and otitis), and that high neonatal bacterial load is a key contributor to the development of pneumonia. PMID:27363739

  1. EXPERIMENTAL INFECTION OF THE RESPIRATORY TRACT WITH MYCOPLASMA PNEUMONIAE

    Science.gov (United States)

    Mycoplasma pneumoniae, a common human respiratory pathogen, has been studied experimentally for years using intranasal inoculation of the golden Sytrian hamster. Because of recent evidence outlining the role in pulmonary immune development of particle size and depth of mycoplasma...

  2. Respiratory Tract Lung Geometry and Dosimetry Model for Male Sprague-Dawley Rats

    Energy Technology Data Exchange (ETDEWEB)

    Miller, Frederick J.; Asgharian, Bahman; Schroeter, Jeffry D.; Price, Owen; Corley, Richard A.; Einstein, Daniel R.; Jacob, Rick E.; Cox, Timothy C.; Kabilan, Senthil; Bentley, Timothy

    2015-07-24

    While inhalation toxicological studies of various compounds have been conducted using a number of different strains of rats, mechanistic dosimetry models have only had tracheobronchial (TB) structural data for Long-Evans rats, detailed morphometric data on the alveolar region of Sprague-Dawley rats and limited alveolar data on other strains. Based upon CT imaging data for two male Sprague-Dawley rats, a 15-generation, symmetric typical path model was developed for the TB region. Literature data for the alveolar region of Sprague-Dawley rats were analyzed to develop an eight-generation model, and the two regions were joined to provide a complete lower respiratory tract model for Sprague-Dawley rats. The resulting lung model was used to examine particle deposition in Sprague-Dawley rats and to compare these results with predicted deposition in Long-Evans rats. Relationships of various physiologic variables and lung volumes were either developed in this study or extracted from the literature to provide the necessary input data for examining particle deposition. While the lengths, diameters and branching angles of the TB airways differed between the two Sprague-Dawley rats, the predicted deposition patterns in the three major respiratory tract regions were very similar. Between Sprague-Dawley and Long-Evans rats, significant differences in TB and alveolar predicted deposition fractions were observed over a wide range of particle sizes, with TB deposition fractions being up to 3- to 4-fold greater in Sprague-Dawley rats and alveolar deposition being significantly greater in Long-Evans rats. Thus, strain-specific lung geometry models should be used for particle deposition calculations and interspecies dose comparisons.

  3. Radiologic findings of childhood lower respiratory tract infection by influenza virus

    Energy Technology Data Exchange (ETDEWEB)

    Song, Ho Taek; Park, Choong Ki; Shin, Hee Jung; Choi, Yo Won; Jeon, Seok Chol; Hahm, Chang Kok; Hern, Ahn You [Hanyang University College of Medicine, Seoul (Korea, Republic of)

    2002-08-01

    After the RS (respiratory syncytial) virus, the influenza virus is the most common cause of childhood lower respiratory tract infection. We assessed the radiologic findings of childhood lower respiratory tract infection by the influenza virus. A total of 105 pediatric patients (76 males and 29 females; mean age, 2.4 years) with symptoms of respiratory tract infection were examined between March 1997 and April 2000. Nasopharyngeal aspirates were obtained and influenza virus infection was confirmed by direct or indirect immunofluorescent assays. Peribronchial infiltration, hyperinflation, atelectasis, pulmonary consolidation, and hilar lymphadenopathy were evaluated retrospectively at simple chest radiography. Bilateral perihiler peribronchial infiltration was noted in 78.1% of patients (n=82), hyperinflation in 63.8% (n=67), atelectasis in 3.8% (n=4, segmental 50%, lobar 50%), and pulmonary consolidation in 16.2% [n=17; segmental 70.6% (n=12), lobar 29.4% (n=5)]. Hilar lymphadenopathy was noted in one patient in whom there was no pleural effusion, and subglottic airway narrowing in 12 of 14 in whom the croup symptom complex was present. The major radiologic findings of influenza virus infection were bilateral perihilar peribronchial infiltration and hyperinflation. In some patients, upper respiratory tract infection was combined with subgolttic airway narrowing. Atelectasis or pleural effusion was rare.

  4. Radiologic findings of childhood lower respiratory tract infection by influenza virus

    International Nuclear Information System (INIS)

    After the RS (respiratory syncytial) virus, the influenza virus is the most common cause of childhood lower respiratory tract infection. We assessed the radiologic findings of childhood lower respiratory tract infection by the influenza virus. A total of 105 pediatric patients (76 males and 29 females; mean age, 2.4 years) with symptoms of respiratory tract infection were examined between March 1997 and April 2000. Nasopharyngeal aspirates were obtained and influenza virus infection was confirmed by direct or indirect immunofluorescent assays. Peribronchial infiltration, hyperinflation, atelectasis, pulmonary consolidation, and hilar lymphadenopathy were evaluated retrospectively at simple chest radiography. Bilateral perihiler peribronchial infiltration was noted in 78.1% of patients (n=82), hyperinflation in 63.8% (n=67), atelectasis in 3.8% (n=4, segmental 50%, lobar 50%), and pulmonary consolidation in 16.2% [n=17; segmental 70.6% (n=12), lobar 29.4% (n=5)]. Hilar lymphadenopathy was noted in one patient in whom there was no pleural effusion, and subglottic airway narrowing in 12 of 14 in whom the croup symptom complex was present. The major radiologic findings of influenza virus infection were bilateral perihilar peribronchial infiltration and hyperinflation. In some patients, upper respiratory tract infection was combined with subgolttic airway narrowing. Atelectasis or pleural effusion was rare

  5. An epidemiological survey to assess the clinical use of cephalosporins in community-acquired respiratory tract infections

    Directory of Open Access Journals (Sweden)

    Vikram Sobti

    2015-06-01

    Conclusion: In-clinic use of cefpodoxime as monotherapy is preferred in upper respiratory tract infections. However, clinicians recommend a combination therapy of cefpodoxime and levofloxacin in lower respiratory tract infections. [Int J Basic Clin Pharmacol 2015; 4(3.000: 547-550

  6. Carriage of Mycoplasma pneumoniae in the Upper Respiratory Tract of Symptomatic and Asymptomatic Children : An Observational Study

    NARCIS (Netherlands)

    Spuesens, Emiel B. M.; Fraaij, Pieter L. A.; Visser, Eline G.; Hoogenboezem, Theo; Hop, Wim C. J.; van Adrichem, Leon N. A.; Weber, Frank; Moll, Henriette A.; Broekman, Berth; Berger, Marjolein Y.; van Rijsoort-Vos, Tineke; van Belkum, Alex; Schutten, Martin; Pas, Suzan D.; Osterhaus, Albert D. M. E.; Hartwig, Nico G.; Vink, Cornelis; van Rossum, Annemarie M. C.

    2013-01-01

    Background: Mycoplasma pneumoniae is thought to be a common cause of respiratory tract infections (RTIs) in children. The diagnosis of M. pneumoniae RTIs currently relies on serological methods and/or the detection of bacterial DNA in the upper respiratory tract (URT). It is conceivable, however, th

  7. Clinical relevance of prevention of respiratory syncytial virus lower respiratory tract infection in preterm infants born between 33 and 35 weeks gestational age

    NARCIS (Netherlands)

    Carbonell-Estrany, X.; Bont, L.; Doering, G.; Gouyon, J-B; Lanari, M.

    2008-01-01

    Premature infants are vulnerable to severe respiratory syncytial virus (RSV) lower respiratory tract infection (LRTI) resulting in hospitalisation and the potential for longer-term respiratory morbidity. Whilst the severity and consequence of RSV LRTI are generally accepted and recognised in infants

  8. Influenza A (H10N7) Virus Causes Respiratory Tract Disease in Harbor Seals and Ferrets.

    Science.gov (United States)

    van den Brand, Judith M A; Wohlsein, Peter; Herfst, Sander; Bodewes, Rogier; Pfankuche, Vanessa M; van de Bildt, Marco W G; Seehusen, Frauke; Puff, Christina; Richard, Mathilde; Siebert, Ursula; Lehnert, Kristina; Bestebroer, Theo; Lexmond, Pascal; Fouchier, Ron A M; Prenger-Berninghoff, Ellen; Herbst, Werner; Koopmans, Marion; Osterhaus, Albert D M E; Kuiken, Thijs; Baumgärtner, Wolfgang

    2016-01-01

    Avian influenza viruses sporadically cross the species barrier to mammals, including humans, in which they may cause epidemic disease. Recently such an epidemic occurred due to the emergence of avian influenza virus of the subtype H10N7 (Seal/H10N7) in harbor seals (Phoca vitulina). This epidemic caused high mortality in seals along the north-west coast of Europe and represented a potential risk for human health. To characterize the spectrum of lesions and to identify the target cells and viral distribution, findings in 16 harbor seals spontaneously infected with Seal/H10N7 are described. The seals had respiratory tract inflammation extending from the nasal cavity to bronchi associated with intralesional virus antigen in respiratory epithelial cells. Virus infection was restricted to the respiratory tract. The fatal outcome of the viral infection in seals was most likely caused by secondary bacterial infections. To investigate the pathogenic potential of H10N7 infection for humans, we inoculated the seal virus intratracheally into six ferrets and performed pathological and virological analyses at 3 and 7 days post inoculation. These experimentally inoculated ferrets displayed mild clinical signs, virus excretion from the pharynx and respiratory tract inflammation extending from bronchi to alveoli that was associated with virus antigen expression exclusively in the respiratory epithelium. Virus was isolated only from the respiratory tract. In conclusion, Seal/H10N7 infection in naturally infected harbor seals and experimentally infected ferrets shows that respiratory epithelial cells are the permissive cells for viral replication. Fatal outcome in seals was caused by secondary bacterial pneumonia similar to that in fatal human cases during influenza pandemics. Productive infection of ferrets indicates that seal/H10N7 may possess a zoonotic potential. This outbreak of LPAI from wild birds to seals demonstrates the risk of such occasions for mammals and thus humans

  9. Viral respiratory tract infections among patients with acute undifferentiated fever in Vietnam

    NARCIS (Netherlands)

    H.L. Phuong; T.T.T. Nga; G.J. van Doornum; J. Groen; T.Q. Binh; P.T. Giao; L.Q. Hung; N.V. Nams; P.A. Kager; P.J. de Vries

    2010-01-01

    To investigate the proportion of viral respiratory tract infections among acute undifferentiated fevers (AUFs) at primary health facilities in southern Vietnam during 2001-2005, patients with AUF not caused by malaria were enrolled at twelve primary health facilities and a clinic for malaria control

  10. [Probiotics as stimulators of immune response against pathogens in the respiratory tract].

    Science.gov (United States)

    Kalyuzhin, O V; Afanasyev, S S; Bykov, A S

    2016-01-01

    This review analyzes whether.it is expedient to use oral probiotics for the stimulation of immune response against pathogens in the respiratory tract. It considers a relationship between.mucosal microbial colonization in different biotopes of the body and mucosal.immunity in the respiratory tract. The principal and terminological controversial issues of colonic dysbiosis and the possibilities of using the medicines and products containing live commensals/symbionts to correct microbiota disturbances are examined. There are data on the degree of resistance and resilience of the colonic microbial community exposed to destabilizing factors, antibiotics in particular. The properties of probiotics that have been proven to enhance host response against pathogens and the phenomena that characterize these probiotics as immunomodifiers and distinguish them from other immunostimulating/immunomodulating agents are described. Criteria for choosing effective and safe oral probiotics to stimulate an immune response in the respiratory tract are formulated. Finally, we review the data on the clinical and immunomodulatory effects of dietary supplement containing a combination of three probiotic strains (Lactobacillus gasseri PA 16/8, Bifidobacterium bifidum MF 20/5 and Bifidobacterium longum SP 07/3) with vitamins and minerals as an agent to prevent and reduce the severity of acute and recurrent respiratory tract infections. PMID:27458629

  11. Acute bacterial infections of the lower respiratory tract in children from low-income countries

    NARCIS (Netherlands)

    Fleer, A; Wolf, B.H.M.

    2000-01-01

    Acute bacterial infection of the lower respiratory tract is a major cause of morbidity and mortality in children and is responsible for 4 million childhood deaths each year. Most of these deaths are caused by pneumonia and occur in the youngest children in the poorest parts of the world. Severe pneu

  12. Prognosis of primary care patients aged 80 years and older with lower respiratory tract infection

    NARCIS (Netherlands)

    van de Nadort, Christiana; Smeets, Hugo M; Bont, Jettie; Zuithoff, N Peter A; Hak, Eelko; Verheij, Theo J M

    2009-01-01

    BACKGROUND: Predictors for a complicated course of a lower respiratory tract infection (LRTI) episode among patients aged > or =80 years are unknown. AIM: To determine prognostic factors for hospital admission or death within 30 days after first onset of LRTI among primary care patients aged > or =8

  13. Effectiveness of adenoidectomy in children with recurrent upper respiratory tract infections

    NARCIS (Netherlands)

    van den Aardweg, M.T.A.

    2013-01-01

    This thesis focuses on the effects of adenoidectomy in children with recurrent upper respiratory tract infections (URTIs).Despite being one of the most frequent operations performed in children, evidence for the effectiveness of adenoidectomy is scarce and guidance in particular for children with re

  14. ACUPUNCTURE TREATMENT OF 42 CASES OF ACUTE UPPER RESPIRATORY TRACT INFECTION

    Institute of Scientific and Technical Information of China (English)

    ManWei; WangJinglan

    2000-01-01

    We made clinical observations on the therapeutic effect of acupuncture on acute upper respiratory tract infection and compared with the effect of paracetamol and Antondine, The result showed that acupuncture therapy could allay fever more rapidly than drugs, so long as the differentiation of syndromes is correct and the acupoint is selected properly.

  15. Cupping Therapy for 103 Cases of High Fever due to Infection of the Upper Respiratory Tract

    Institute of Scientific and Technical Information of China (English)

    刘颖东

    2002-01-01

    @@ The cupping therapy has remarkable antipyretic effect in the treatment of fever. In recent years, the author has treated 103 cases of high fever caused by infection of the upper respiratory tract and obtained quite satisfactory therapeutic results. A report follows.

  16. Illness behaviour and antibiotic prescription in patients with respiratory tract symptoms.

    NARCIS (Netherlands)

    Duijn, H.J. van; Kuyvenhoven, M.M.; Schellevis, F.G.; Verheij, T.J.M.

    2007-01-01

    BACKGROUND: Although the vast majority of respiratory tract symptoms are self-limiting, many patients visit their GP for these symptoms and antibiotics are over-prescribed. AIM: To explore determinants of patients visiting GPs for recent cough, sore throat, or earache; for being prescribed antibioti

  17. Views on respiratory tract symptoms and antibiotics of Dutch general practitioners, practice staff and patients

    NARCIS (Netherlands)

    van Duijn, HJ; Kuyvenhoven, MA; Schellevis, FG; Verheij, TJM

    2006-01-01

    Objectives: To explore views on respiratory tract symptoms (cough, sore throat and earache) and antibiotics of GPs, practice staff, and patients. Methods: In a nationwide study, 181 GPs, 204 practice staff members and 1250 patients from 90 practices participated by answering 14 items relating to vie

  18. Frequent respiratory tract infections in children. The role of environmental and genetic factors.

    NARCIS (Netherlands)

    Ruskamp, J.M.

    2009-01-01

    Respiratory tract infections (RTI), presenting as common cold, pharyngitis, tonsillitis, acute otitis media, bronchitis or pneumonia are a major health problem in children. In this thesis common environmental and host factors, as well as plausible genetic factors were evaluated in a large birth coho

  19. Selective media for recovery of Haemophilus influenzae from specimens contaminated with upper respiratory tract microbial flora.

    OpenAIRE

    Chapin, K. C.; Doern, G V

    1983-01-01

    Isolation of Haemophilus influenzae from specimens contaminated with upper respiratory tract microbial flora was attempted with three different media: enriched chocolate agar, chocolate agar plus vancomycin, and chocolate agar plus vancomycin, bacitracin, and clindamycin. Recovery rates of H. influenzae from 852 pediatric pharyngeal swab specimens were 6.0, 28.5, and 59.9%, respectively.

  20. CFD heat transfer simulation of the human upper respiratory tract for oronasal breathing condition

    Directory of Open Access Journals (Sweden)

    Kambiz Farahmand

    2012-01-01

    Full Text Available Injuries due to inhalation of hot gas are commonly encountered when dealing with fire and combustible material, which is harmful and threatens human life. In the literature, various studies have been conducted to investigate heat and mass transfer characteristics in the human respiratory tract (HRT. This study focuses on assessing the injury taking place in the upper human respiratory tract and identifying acute tissue damage, based on level of exposure. A three-dimensional heat transfer simulation is performed using Computational Fluid Dynamics (CFD software to study the temperature profile through the upper HRT consisting of the nasal cavity, oral cavity, trachea, and the first two generations of bronchi. The model developed is for the simultaneous oronasal breathing during the inspiration phase with a high volumetric flow rate of 90 liters/minute and the inspired air temperature of 100 degrees Celsius. The geometric model depicting the upper HRT is generated based on the data available and literature cited. The results of the simulation give the temperature distribution along the center and the surface tissue of the respiratory tract. This temperature distribution will help to assess the level of damage induced in the upper respiratory tract and appropriate treatment for the damage. A comparison of nasal breathing, oral breathing, and oronasal breathing is performed. Temperature distribution can be utilized in the design of the respirator systems where inlet temperature is regulated favoring the human body conditions.

  1. Diagnosis and treatment of community-acquired lower respiratory tract infections : Strategies for efficient management

    NARCIS (Netherlands)

    Oosterheert, J.J.

    2005-01-01

    Lower respiratory tract infections are an important cause for morbidity and mortality and associated with considerable costs and antibiotic consumption, especially in patients needing hospitalization. The aim of this thesis was to evaluate diagnostic and treatment strategies to decrease costs and co

  2. Neonatal total IgE and respiratory tract infections in children with intrauterine smoke exposure.

    NARCIS (Netherlands)

    Ruskamp, J.; Smit, H.; Rovers, M.M.; Hoekstra, M.O.; Schilder, A.G.M.; Brunekreef, B.; Wijga, A.; Kerkhof, M.; de Jongste, J.; Sanders, E.A.M.

    2010-01-01

    BACKGROUND: Exposure to environmental tobacco smoke (ETS) is known to increase the risk of respiratory tract infections (RTI). Some children, however, may be more susceptible to the harmful effects of ETS than others. We examined whether early atopic status (defined by elevated neonatal total IgE (t

  3. Neonatal total IgE and respiratory tract infections in children with intrauterine smoke exposure

    NARCIS (Netherlands)

    Ruskamp, Jopje; Smit, Henriette; Rovers, Maroeska; Hoekstra, Maarten; Schilder, Anne; Brunekreef, Bert; Wijga, Alet; Kerkhof, Marjan; de Jongste, Johan; Sanders, Elisabeth

    2010-01-01

    Background Exposure to environmental tobacco smoke (ETS) is known to increase the risk of respiratory tract infections (RTI). Some children, however, may be more susceptible to the harmful effects of ETS than others. We examined whether early atopic status (defined by elevated neonatal total IgE (tI

  4. Early adaptive immune responses in the respiratory tract of foot and mouth disease-infected cattle

    Science.gov (United States)

    Foot and mouth disease (FMD) is a highly contagious viral disease which affects both domestic and wildlife biungulate species. This acute disease, caused by the FMD virus (FMDV), usually includes an active replication phase in the respiratory tract up to 72 h post-infection followed by hematogenous ...

  5. Epidemiology of respiratory tract infections in Dutch general practice: a historical analysis.

    NARCIS (Netherlands)

    Schellevis, F.G.; Donker, G.

    2007-01-01

    Aims: To describe time trends in the incidence of respiratory tract infections in general practice in the Netherlands and its relation to sex and age. Design and Methods: Data will be presented from several morbidity surveys conducted in general practices in the Netherlands: the Intermittent Morbidi

  6. Validation study of a diary for use in acute lower respiratory tract infection

    NARCIS (Netherlands)

    Watson, L; Little, P; Moore, M; Warner, G; Williamson, [No Value

    2001-01-01

    Background. Despite lower respiratory tract infection (LRTi) being the most common illness treated by doctors, no validated outcome measure to assess symptom duration and severity has been developed for patient self-completion. Methods. As part of a randomized control trial researching management of

  7. Disordered microbial communities in the upper respiratory tract of cigarette smokers.

    Directory of Open Access Journals (Sweden)

    Emily S Charlson

    Full Text Available Cigarette smokers have an increased risk of infectious diseases involving the respiratory tract. Some effects of smoking on specific respiratory tract bacteria have been described, but the consequences for global airway microbial community composition have not been determined. Here, we used culture-independent high-density sequencing to analyze the microbiota from the right and left nasopharynx and oropharynx of 29 smoking and 33 nonsmoking healthy asymptomatic adults to assess microbial composition and effects of cigarette smoking. Bacterial communities were profiled using 454 pyrosequencing of 16S sequence tags (803,391 total reads, aligned to 16S rRNA databases, and communities compared using the UniFrac distance metric. A Random Forest machine-learning algorithm was used to predict smoking status and identify taxa that best distinguished between smokers and nonsmokers. Community composition was primarily determined by airway site, with individuals exhibiting minimal side-of-body or temporal variation. Within airway habitats, microbiota from smokers were significantly more diverse than nonsmokers and clustered separately. The distributions of several genera were systematically altered by smoking in both the oro- and nasopharynx, and there was an enrichment of anaerobic lineages associated with periodontal disease in the oropharynx. These results indicate that distinct regions of the human upper respiratory tract contain characteristic microbial communities that exhibit disordered patterns in cigarette smokers, both in individual components and global structure, which may contribute to the prevalence of respiratory tract complications in this population.

  8. Detection of viral acute lower respiratory tract infection in hospitalized infants using real-time PCR

    Directory of Open Access Journals (Sweden)

    Bassant Meligy

    2016-03-01

    Conclusions: RV was the most commonly detected virus in children under 3 years admitted with acute lower respiratory tract infections. Coinfection was present in the majority of our patients; however it was not related significantly to parameters of disease severity.

  9. A pilot study on respiratory and digestive tract cancer among woodworkers.

    Science.gov (United States)

    Esping, B; Axelson, O

    1980-09-01

    Cancer of the nose and paranasal sinuses is a known occupational hazard among workers in the furniture industry. An increased frequency of cancer at other sites has also been suggested to occur among different types of woodworkers in the United States, eg, cancer of the gastrointestinal tract and lung but also lymphatic and hematopoietic malignancies. This case-referent study is of a pilot character and was undertaken for the further elucidation of respiratory and digestive tract cancer among Swedish woodworkers. A four-fold excess of respiratory cancer, other than nasal cancer, was found, particularly in relation to furniture workers, whereas no definite excess of digestive tract cancer was indicated. Further studies seem worthwhile regarding cancer hazard in the woodworking industry.

  10. An unusual cause of epistaxis, anemia and upper respiratory tract obstruction, Leeches: Report of three cases

    Directory of Open Access Journals (Sweden)

    Engin Şengül

    2012-09-01

    Full Text Available The leech is an endoparasite for man and may cause lethal complications. In this article, we report two cases of 4 and 6-year-old who presented epistaxis due to leech infestasyon in nasopharynx and other case of 65-year-old adult with alzheimer who presented obstruction of upper respiratory tracks and anemia due to leech infestation in larynx. Especially in rural areas, it should always be borne in mind that leech might cause high mortality and morbidity due to serious complications such as anemia and obstruction of upper respiratory tracts and should be considered in evaluating the differential diagnosis of upper airway obstruction. J Clin Exp Invest 2012; 3 (3: 401-403Key words: Leech, epistaxis, anemia, obstruction of upper respiratory tract.

  11. Human bocavirus in children suffering from acute lower respiratory tract infection in Beijing Children's Hospital

    Institute of Scientific and Technical Information of China (English)

    ZHANG Li-li; XU Wen-bo; SHEN Kun-ling; TANG Liu-ying; XIE Zheng-de; TAN Xiao-juan; LI Chong-shan; CUI Ai-li; JI Yi-xin; XU Song-tao; MAO Nai-ying

    2008-01-01

    Background Human bocavirus(HBoV)is a parvovirus recently found to possibly cause respiratory tract disease in children and adults.This studV investigated HBoV infection and its clinical characte rist:ics in children younger than five years of age suffering from acute Iower respiratory tract infection in Beijing Children's Hospital.Methods Nasopharyngeal aspirates were collected from children suffering from acute Iower respiratory tract infection during the winters of 2004 to 2006 (from November through the following February).HBoV was detected by polymerase chain reaction amplification and virus isolation and the amplification products were sequenced for identification.Results HBoV jnfection was detected in 16 of 333 study subjects.Coinfections with respiratory syncytial virus were detected in 3 of 16 HBoV positive patients with acute lower respiratory tract infection.The median age for HBoV positive children was 8 months(mean age,17 months;range,3 to 57 months).Among the HBoV positive children,14 were younger than 3 years old.9 were younger than 1 year old and 7 were younger than 6 months.These 16 positive HBoV children exhibited coughing and abnormal chest radiography findings and more than 60%of these children had wheezing and fever.Ten children were clinically diagnosed with pneumonia,2 bronchiolitis,2 acute bronchitis and 2 asthma.One child died.Conclusions HBoV was detected in about 5%of children with acute Iower respiratory infection seen in Beijing Children's Hospital.Fudher investigations regarding clinical and epidemiologic charactedstics of HBoV infection are needed.

  12. Is there still room for novel viral pathogens in pediatric respiratory tract infections?

    Directory of Open Access Journals (Sweden)

    Blanca Taboada

    Full Text Available Viruses are the most frequent cause of respiratory disease in children. However, despite the advanced diagnostic methods currently in use, in 20 to 50% of respiratory samples a specific pathogen cannot be detected. In this work, we used a metagenomic approach and deep sequencing to examine respiratory samples from children with lower and upper respiratory tract infections that had been previously found negative for 6 bacteria and 15 respiratory viruses by PCR. Nasal washings from 25 children (out of 250 hospitalized with a diagnosis of pneumonia and nasopharyngeal swabs from 46 outpatient children (out of 526 were studied. DNA reads for at least one virus commonly associated to respiratory infections was found in 20 of 25 hospitalized patients, while reads for pathogenic respiratory bacteria were detected in the remaining 5 children. For outpatients, all the samples were pooled into 25 DNA libraries for sequencing. In this case, in 22 of the 25 sequenced libraries at least one respiratory virus was identified, while in all other, but one, pathogenic bacteria were detected. In both patient groups reads for respiratory syncytial virus, coronavirus-OC43, and rhinovirus were identified. In addition, viruses less frequently associated to respiratory infections were also found. Saffold virus was detected in outpatient but not in hospitalized children. Anellovirus, rotavirus, and astrovirus, as well as several animal and plant viruses were detected in both groups. No novel viruses were identified. Adding up the deep sequencing results to the PCR data, 79.2% of 250 hospitalized and 76.6% of 526 ambulatory patients were positive for viruses, and all other children, but one, had pathogenic respiratory bacteria identified. These results suggest that at least in the type of populations studied and with the sampling methods used the odds of finding novel, clinically relevant viruses, in pediatric respiratory infections are low.

  13. Is There Still Room for Novel Viral Pathogens in Pediatric Respiratory Tract Infections?

    Science.gov (United States)

    Taboada, Blanca; Espinoza, Marco A.; Isa, Pavel; Aponte, Fernando E.; Arias-Ortiz, María A.; Monge-Martínez, Jesús; Rodríguez-Vázquez, Rubén; Díaz-Hernández, Fidel; Zárate-Vidal, Fernando; Wong-Chew, Rosa María; Firo-Reyes, Verónica; del Río-Almendárez, Carlos N.; Gaitán-Meza, Jesús; Villaseñor-Sierra, Alberto; Martínez-Aguilar, Gerardo; Salas-Mier, Ma. del Carmen; Noyola, Daniel E.; Pérez-Gónzalez, Luis F.; López, Susana; Santos-Preciado, José I.; Arias, Carlos F.

    2014-01-01

    Viruses are the most frequent cause of respiratory disease in children. However, despite the advanced diagnostic methods currently in use, in 20 to 50% of respiratory samples a specific pathogen cannot be detected. In this work, we used a metagenomic approach and deep sequencing to examine respiratory samples from children with lower and upper respiratory tract infections that had been previously found negative for 6 bacteria and 15 respiratory viruses by PCR. Nasal washings from 25 children (out of 250) hospitalized with a diagnosis of pneumonia and nasopharyngeal swabs from 46 outpatient children (out of 526) were studied. DNA reads for at least one virus commonly associated to respiratory infections was found in 20 of 25 hospitalized patients, while reads for pathogenic respiratory bacteria were detected in the remaining 5 children. For outpatients, all the samples were pooled into 25 DNA libraries for sequencing. In this case, in 22 of the 25 sequenced libraries at least one respiratory virus was identified, while in all other, but one, pathogenic bacteria were detected. In both patient groups reads for respiratory syncytial virus, coronavirus-OC43, and rhinovirus were identified. In addition, viruses less frequently associated to respiratory infections were also found. Saffold virus was detected in outpatient but not in hospitalized children. Anellovirus, rotavirus, and astrovirus, as well as several animal and plant viruses were detected in both groups. No novel viruses were identified. Adding up the deep sequencing results to the PCR data, 79.2% of 250 hospitalized and 76.6% of 526 ambulatory patients were positive for viruses, and all other children, but one, had pathogenic respiratory bacteria identified. These results suggest that at least in the type of populations studied and with the sampling methods used the odds of finding novel, clinically relevant viruses, in pediatric respiratory infections are low. PMID:25412469

  14. [Proteolytic enzymes: potential allergens for the skin and respiratory tract?].

    Science.gov (United States)

    Wüthrich, B

    1985-03-01

    Proteolytic enzymes of animal, bacterial, mould or plant origin are used in many industrial processes, e.g. in the detergent, food and pharmaceutical industries as well as in medicine. The allergenic potency of these enzymes should not be underestimated, for they cause, in particular, IgE-mediated respiratory allergies. The risk of sensitization to enzymes due to inhalation as a result of occupational exposure is very high (up to 50%), and therapeutic applications are also not without risk. Therefore, the utmost care should be taken in the production and handling of pulverized enzymes and their inhalation should be avoided. Papain and Bromelain are used as tenderizers of meat and to clarify beer. Therefore, these enzymes are also potential ingestive allergens and may represent an unrecognized cause of an allergic reaction following a meal. As contact allergens the enzymes play a minor role; biodetergents in particular present no increased risk of skin damage for the user. PMID:3888919

  15. The Nucleus of the Solitary Tract and the coordination of respiratory and sympathetic activities

    Directory of Open Access Journals (Sweden)

    Daniel B. Zoccal

    2014-06-01

    Full Text Available It is well known that breathing introduces rhythmical oscillations in the heart rate and arterial pressure levels. Sympathetic oscillations coupled to the respiratory activity have been suggested as an important homeostatic mechanism optimizing tissue perfusion and blood gas uptake/delivery. This respiratory-sympathetic coupling is strengthened in conditions of blood gas challenges (hypoxia and hypercapnia as a result of the synchronized activation of brainstem respiratory and sympathetic neurons, culminating with the emergence of entrained cardiovascular and respiratory reflex responses. Studies have proposed that the ventrolateral region of the medulla oblongata is a major site of synaptic interaction between respiratory and sympathetic neurons. However, other brainstem regions also play a relevant role in the patterning of respiratory and sympathetic motor outputs. Recent findings suggest that the neurons of the nucleus of the solitary tract (NTS, in the dorsal medulla, are essential for the processing and coordination of respiratory and sympathetic responses to hypoxia. The NTS is the first synaptic station of the cardiorespiratory afferent inputs, including peripheral chemoreceptors, baroreceptors and pulmonary stretch receptors. The synaptic profile of the NTS neurons receiving the excitatory drive from afferent inputs is complex and involves distinct neurotransmitters, including glutamate, ATP and acetylcholine. In the present review we discuss the role of the NTS circuitry in coordinating sympathetic and respiratory reflex responses. We also analyze the neuroplasticity of NTS neurons and their contribution for the development of cardiorespiratory dysfunctions, as observed in neurogenic hypertension, obstructive sleep apnea and metabolic disorders.

  16. Experimentally determined human respiratory tract deposition of airborne particles at a busy street

    DEFF Research Database (Denmark)

    Löndahl, Jakob; Massling, Andreas; Swietlicki, Erik;

    2009-01-01

    Traffic is one of the major sources of harmful airborne particles worldwide. To relate exposure to adverse health effects it is important to determine the deposition probability of the inhaled particles in the human respiratory tract. The size-dependent deposition of 12-580 nm particles was measu......Traffic is one of the major sources of harmful airborne particles worldwide. To relate exposure to adverse health effects it is important to determine the deposition probability of the inhaled particles in the human respiratory tract. The size-dependent deposition of 12-580 nm particles...... was measured with a novel setup in 9 healthy subjects breathing by mouth on the windward side of a busy street in Copenhagen, Denmark. The aerosol was characterized both at the curbside and, to obtain the background concentration, at rooftop level. Particle hygroscopicity, a key parameter affecting respiratory...... investigated previously (equal inhaled mass concentrations). This was because the traffic exhaust particles had both a higher deposition probability and a higher number and surface area concentration per unit mass. To validate the results, the respiratory tract deposition was estimated by using the well...

  17. The role and regulation of catalase in respiratory tract opportunistic bacterial pathogens.

    Science.gov (United States)

    Eason, Mia M; Fan, Xin

    2014-09-01

    Respiratory tract bacterial pathogens are the etiologic agents of a variety of illnesses. The ability of these bacteria to cause disease is imparted through survival within the host and avoidance of pathogen clearance by the immune system. Respiratory tract pathogens are continually bombarded by reactive oxygen species (ROS), which may be produced by competing bacteria, normal metabolic function, or host immunological responses. In order to survive and proliferate, bacteria have adapted defense mechanisms to circumvent the effects of ROS. Bacteria employ the use of anti-oxidant enzymes, catalases and catalase-peroxidases, to relieve the effects of the oxidative stressors to which they are continually exposed. The decomposition of ROS has been shown to provide favorable conditions in which respiratory tract opportunistic bacterial pathogens such as Haemophilus influenzae, Mycobacterium tuberculosis, Legionella pneumophila, and Neisseria meningitidis are able to withstand exposure to highly reactive molecules and yet survive. Bacteria possessing mutations in the catalase gene have a decreased survival rate, yet may be able to compensate for the lack of catalatic activity if peroxidatic activity is present. An incomplete knowledge of the mechanisms by which catalase and catalase-peroxidases are regulated still persists, however, in some bacterial species, a regulatory factor known as OxyR has been shown to either up-regulate or down-regulate catalase gene expression. Yet, more research is still needed to increase the knowledge base in relation to this enzyme class. As with this review, we focus on major respiratory tract opportunistic bacterial pathogens in order to elucidate the function and regulation of catalases. The importance of the research could lead to the development of novel treatments against respiratory bacterial infections.

  18. Community Respiratory Viruses as a Cause of Lower Respiratory Tract Infections Following Suppressive Chemotherapy in Cancer Patients

    International Nuclear Information System (INIS)

    Community respiratory viruses are an important cause of respiratory disease in the immunocompromised patients with cancer. To evaluate the occurrence and clinical significance of respiratory virus infections in hospitalized cancer patients at National Cancer Institute, Cairo University, during anticancer treatment, we studied cases that developed episodes of lower respiratory tract infections (LRTI). Patients and Methods: Thirty patients with LRTI were studied clinically, radiologically, and microbiologically. Sputum cultures were done and an immunofluorescence search for IgM antibodies of influenza A and B, parainfluenza serotypes 1,2 and 3, adenovirus, respiratory syncytial virus, Legionella pneumophila, Coxiella burnettii, Chlamydia pneumoniae, and Mycoplasma pneumoniae were performed on serum samples of patients. The main presenting symptom was cough and expectoration. Hematologic malignancy was the underlying disease in 86.6% of cases. Blood cultures were positive in II patients (36.6%) only. Sputum cultures revealed a bacterial pathogen in [3 cases and fungi in 3; whereas viral and atypical bacterial lgM antibodies were detected in 13 and 4 patients; respectively. Influenza virus was the commonest virus detected, being of type B in 4 cases, type A in one case and mixed A and B in another 5 cases; followed by RSV in 5 patients. Taken together, bacteria were identified as a single cause of LRTI in 10 cases, viruses in 6, fungi in 3 and mixed causes in 7. Still, there were 4 undiagnosed cases. This study showed that respiratory viruses are common in LRTI, either as a single cause or mixed with bacterial pathogens. in hospitalized cancer patients receiving chemotherapy. Diagnostic tests for respiratory viruses should be incorporated in the routine diagnostic study of patients with hematologic malignancies. Also, it must be emphasized that early CT chest is crucial as a base-line prior to initiation of anti-fungal or anti-viral therapy. In cancer patients with a

  19. Diagnosis of Upper and Lower Respiratory Tract Bacterial Infections with the Use of Multiplex PCR Assays

    Directory of Open Access Journals (Sweden)

    Jenny Kourea-Kremastinou

    2013-03-01

    Full Text Available The investigation of respiratory infections by molecular techniques provides important information about the epidemiology of respiratory disease, especially during the post-vaccination era. The objective of the present study was the detection of bacterial pathogens directly in clinical samples from patients with upper and lower respiratory tract infections using multiplex polymerase chain reaction (PCR assays developed in our laboratory. Clinical samples taken over a three-year period (2007–2009 and obtained from 349 patients (adults (n = 66; children (n = 283 with signs and symptoms of certain upper or lower respiratory tract infections, consisted of: bronchoalveolar lavages (BAL, n = 83, pleural fluids (n = 29, and middle-ear aspirates (n = 237. Overall, 212 samples (61% were confirmed by culture and/or PCR. Among the positive samples, Streptococcus pneumoniae (mainly serotype 3 was predominant (104/212; 49.0%, followed by non-typable Haemophilus influenzae (NTHi 59/212; 27.8% and Streptococcus pyogenes (47/212; 22%. Haemophilus influenzae type b was detected in only three samples. The underlying microbiology of respiratory infections is gradually changing in response to various selective pressures, such as vaccine use and antibiotic consumption. The application of multiplex PCR (mPCR assays is particularly useful since it successfully identified the microorganisms implicated in acute otitis media or lower respiratory tract infections in nearly 75% of patients with a positive result compared to conventional cultures. Non-culture identification of the implicated pneumococcal serotypes is also an important issue for monitoring pneumococcal infections in the era of conjugate pneumococcal vaccines.

  20. [The curative action of Monticelli Term's water in upper respiratory tract diseases (author's transl)].

    Science.gov (United States)

    Turchi, R; Jemmi, G; Barani, B

    1976-01-01

    The Authors study the action of the sodio bromide-iodic water of Monticelli Terme in upper respiratory tract disease and particularly assert that is not to neglect the organic ground on which establishes mucosa's disease. Therman treatment gives the best therapeutic results in every patient presenting chronic inflammatory processes of the upper respiratory trach alternating periods of quiescency and of activity, and poor therapeutic action in patients presenting chronic inveterate diseases with great alterations in vascular and glandular components of the mucosa. PMID:1021139

  1. Clinical characteristics and risk factors of severe respiratory syncytial virus-associated acute lower respiratory tract infections in hospitalized infants

    Institute of Scientific and Technical Information of China (English)

    Xiao-Bo Zhang; Li-Juan Liu; Li-Ling Qian; Gao-Li Jiang; Chuan-Kai Wang; Pin Jia; Peng Shi; Jin Xu; Li-Bo Wang

    2014-01-01

    Background: To investigate the clinical characteristics and analyze risk factors for severe respiratory syncytial virus (RSV) infection in hospitalized infants with acute lower respiratory tract infections (ALRIs). Methods: A retrospective review of the medical records of infants with RSV-associated ALRIs between March 1st, 2011 and February 29th, 2012 was conducted. Subjects were followed up over the phone or by outpatient visit six and twelve months after discharge. Results: Among 913 RSV-associated ALRIs infants, 288 (31.5%) had severe infections, which accounted for 4.2% of hospitalized children. The hospital RSV mortality rate was 1.0%. The proportions of cases with tachypnea, apnea, cyanosis, and fine rales were significantly higher in the severe ALRIs group (all P Conclusions: Younger age, low birth weight and underlying disease are associated with severe RSVassociated ALRIs. Furthermore, severe RSV infections may be associated with a higher frequency of subsequent bronchitis, pneumonia and re-hospitalization in the following year.

  2. Application of the physiological and morphological parameters of the brazilian population sample to the mathematical model of the human respiratory tract

    International Nuclear Information System (INIS)

    The Human Respiratory Tract Model proposed by the ICRP Publication 66 accounts for the morphology and physiology of the respiratory tract. The characteristics of air drawn into the lungs and exhaled are greatly influenced by the morphology of the respiratory tract, which causes numerous changes in pressure, flow rate, direction and humidity as air moves into and out of the lungs. Concerning the respiratory physiological parameters the breathing characteristics influence the volume, the inhalation rate of air and the portion that enters through the nose and the mouth. These characteristics are important to determine the fractional deposition. The model uses morphological and physiological parameters from the Caucasian man to establish deposition fractions in the respiratory tract regions. It is known that the morphology and physiology are influenced by environmental, occupational and economic conditions. The ICRP recommends, for a reliable evaluation of the regional deposition, the use of parameters from a local population when information is available. The main purpose of this study is to verify the influence in using the morphology and physiology parameters representative of a sample of the Brazilian population on the deposition model of the ICRP Publication 66. The morphological and physiological data were obtained from the literature. The software EXCEL for Windows (version 2000) was used in order to implement the deposition model and also to allow the changes in parameters of interest. Initially, the implemented model was checked using the parameters defined by the ICRP and the results of the fraction deposition in the respiratory tract compartments were compared. Finally, morphological and physiological parameters from Brazilian adult male were applied and the fractional deposition calculated. The results suggest a significant variation in fractional deposition when Brazilian parameters are applied in the model. (author)

  3. [Mucolytics in acute and chronic respiratory tract disorders. I. Pathophysiology and mechanisms of action].

    Science.gov (United States)

    Kupczyk, Maciej; Kuna, Piotr

    2002-03-01

    Mucus hypersecretion is a cardinal sign of both acute and chronic pulmonary diseases. Normally, mucus protects respiratory tract, but its overproduction leads to airway obstruction and promotes bacterial colonization. In the first part of our review we outlined the possible factors responsible for mucus hypersecretion and clinical consequences of this process. Mucolytic agents such as Ambroxol and N-acetylcysteine are able to alter the secretion of mucus and its physical properties which results in improvement of mucociliary clearance. Mechanisms of action and indications for use of mucolytics are presented. Mucolytics have been shown to have a role in improving lung functions and patients' quality of life. Undoubtedly they are useful as an adjunctive therapy of respiratory tract disorders. PMID:12053600

  4. Sarcoid-like lymphocytosis of the lower respiratory tract in patients with active Crohn's disease.

    Science.gov (United States)

    Smiéjan, J M; Cosnes, J; Chollet-Martin, S; Soler, P; Basset, F M; Le Quintrec, Y; Hance, A J

    1986-01-01

    To re-evaluate the relationship between Crohn's disease and sarcoidosis, we compared the numbers and types of cells recovered by bronchoalveolar lavage from normal volunteers and patients with Crohn's disease, with other forms of inflammatory bowel disease, and with sarcoidosis. Patients with Crohn's disease, but not patients with other inflammatory bowel disorders, had an increase in the number of T lymphocytes on the surface of the lower respiratory tract similar to that seen in patients with sarcoidosis. As in sarcoidosis, this lymphocytosis results from an expansion of the T4+ T-lymphocyte subset, is characteristic of patients with active disease only, and is not associated with similar abnormalities in the peripheral blood. Thus, patients with apparently localized Crohn's disease have sarcoid-like lymphocytosis of the lower respiratory tract, a finding that emphasizes the systemic nature of Crohn's disease and the disorder's close relationship to sarcoidosis. PMID:3940500

  5. Airway CD8(+) T Cells Are Associated with Lung Injury during Infant Viral Respiratory Tract Infection.

    Science.gov (United States)

    Connors, Thomas J; Ravindranath, Thyyar M; Bickham, Kara L; Gordon, Claire L; Zhang, Feifan; Levin, Bruce; Baird, John S; Farber, Donna L

    2016-06-01

    Infants and young children are disproportionately susceptible to severe complications from respiratory viruses, although the underlying mechanisms remain unknown. Recent studies show that the T cell response in the lung is important for protective responses to respiratory infections, although details on the infant/pediatric respiratory immune response remain sparse. The objectives of the present study were to characterize the local versus systemic immune response in infants and young children with respiratory failure from viral respiratory tract infections and its association to disease severity. Daily airway secretions were sampled from infants and children 4 years of age and younger receiving mechanical ventilation owing to respiratory failure from viral infection or noninfectious causes. Samples were examined for immune cell composition and markers of T cell activation. These parameters were then correlated with clinical disease severity. Innate immune cells and total CD3(+) T cells were present in similar proportions in airway aspirates derived from infected and uninfected groups; however, the CD8:CD4 T cell ratio was markedly increased in the airways of patients with viral infection compared with uninfected patients, and specifically in infected infants with acute lung injury. T cells in the airways were phenotypically and functionally distinct from those in blood with activated/memory phenotypes and increased cytotoxic capacity. We identified a significant increase in airway cytotoxic CD8(+) T cells in infants with lung injury from viral respiratory tract infection that was distinct from the T cell profile in circulation and associated with increasing disease severity. Airway sampling could therefore be diagnostically informative for assessing immune responses and lung damage. PMID:26618559

  6. Upper Respiratory Tract Disease in the Gopher Tortoise Is Caused by Mycoplasma agassizii†

    OpenAIRE

    Brown, M B; McLaughlin, G. S.; Klein, P A; Crenshaw, B. C.; Schumacher, I M; Brown, D R; Jacobson, E R

    1999-01-01

    Upper respiratory tract disease (URTD) has been observed in a number of tortoise species, including the desert tortoise (Gopherus agassizii) and the gopher tortoise (Gopherus polyphemus). Clinical signs of URTD in gopher tortoises are similar to those in desert tortoises and include serous, mucoid, or purulent discharge from the nares, excessive tearing to purulent ocular discharge, conjunctivitis, and edema of the eyelids and ocular glands. The objectives of the present study were to determi...

  7. The Efficacy of Systemic Corticosteroids in Treatment of Respiratory Tract Infections During Hajj 2012

    OpenAIRE

    Tabatabaei, Aminreza; Heidarzadeh, Abbas; Shamspour, Navvab; Kolivand, Pirhosein

    2015-01-01

    Background: Diagnosis and treatment of respiratory tract infections (RTI) in a mass-gathering situation such as hajj is a medical challenge that requires quick decision-making and considerable knowledge about its etiology and treatment methods. High prevalence of RTI during Hajj and tendency of caravan physicians to treat of patients quickly in such situation lead to prescription of parenteral steroids. Nonetheless, no study has focused on the short-term and long-term effects of systemic ster...

  8. Antibiotic prescribing patterns for upper respiratory tract infections in rural Western China

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    Objective To explore the prescribing patterns of outpatients receiving antibiotics for upper respiratory tract infections(URTIs)in rural Western China and to identify the correlation in terms of doctors and patients characteristics.Methods Totally 7 678 prescriptions for URTIs were collected from 680 primary health village clinics of 40 counties across 10 provinces of Western China.Two outcome variables were used in the analysis:the occurrence of prescribing at least one antibiotic drug for an URTI and the ...

  9. Prognostic value of procalcitonin in hospitalized patients with lower respiratory tract infections

    OpenAIRE

    NOBRE Vandack; Borges, Isabela

    2016-01-01

    Lower respiratory tract infections are common and potentially lethal conditions and are a major cause of inadequate antibiotic prescriptions. Characterization of disease severity and prognostic prediction in affected patients can aid disease management and can increase accuracy in determining the need for and place of hospitalization. The inclusion of biomarkers, particularly procalcitonin, in the decision taken process is a promising strategy. This study aims to present a narrative review of...

  10. Mycoplasmas isolated from the respiratory tract of cattle in Bosnia and Herzegovina

    OpenAIRE

    Zinka, Maksimović; Maid, Rifatbegović

    2012-01-01

    This study represents Mycoplasma species isolated from the respiratory tract of cattle in Bosnia and Herzegovina between 2002 and 2010. A total of 328 nasal swabs and 59 lung samples were submitted for isolation of mycoplasmas. Mycoplasmas were isolated from 27 samples (6.9%). M. bovis was recovered from eight nasal swabs and two lungs, while M. bovirhinis (n=4) and Acholeplasma sp. (n=1) were detected only in nasal swabs. Twelve mycoplasma isolates were unidentified (44.4%).

  11. Macrolide overuse for treatment of respiratory tract infections in general practice

    DEFF Research Database (Denmark)

    Hinnerskov, Mette; Therkildsen, Julie Maria; Cordoba, Gloria;

    2011-01-01

    High consumption of macrolides has been linked to increased macrolide resistance in the common pathogens of respiratory tract infections (RTIs). According to Danish recommendations, penicillin is the first-choice treatment for RTIs and macrolides should only be prescribed when a patient is allergic...... to penicillin or for treatment of mycoplasma pneumonias. The aim of the present study was to explore the prescription of macrolides for different RTIs to patients without penicillin allergy in general practice in Denmark....

  12. Hemoglobin level as a risk factor for lower respiratory tract infections in Lebanese children

    Directory of Open Access Journals (Sweden)

    Sawsan Mourad

    2010-10-01

    Full Text Available Background: Pneumonia is the biggest single cause of childhood death under the age of 5 years, and anemia affects approximately 30% of infants and children all over the world. Aim: Determination of the relationship between anemia and lower respiratory tract infection as a risk factor in Lebanese children. Patients and Methods A total number of two hundred infants and children aged nine months to twelve years were included; One hundred cases were hospitalized for lower respiratory tract infection in Department of Pediatrics, Makassed General Hospital, and one hundred healthy, age and sex matched controls, were selected from outpatient department. Complete blood count, iron level, ferritin level, and total iron binding capacity were taken if hemoglobin level less than eleven gram per deci-liter. In addition peripheral blood smear, chest radiograph and C-reactive protein were done to hospitalized cases. Definition of iron deficiency anemia and normal laboratory values were predetermined. Results: Anemia was found in 32% of hospitalized cases and 16% of healthy controls. Mean hemoglobin level was 9.99 ± 0.62 gram per deci-liter and 11.99 ± 0.92 gram per deci-liter in anemic and non-anemic group respectively with a significant P-value of 0.001. C-reactive protein levels and number hospitalization days were similar among the anemic and non-anemic group. History of recurrent chest infections was significantly higher in both anemic group and hospitalized cases compared to non-anemic group and healthy controls. Low hemoglobin level was a risk factor for lower respiratory tract infection with a P-value of 0.008. Conclusion: Anemic children were two times more susceptible to lower respiratory tract infection compared to the control group, and iron deficiency anemia was predominating. Accurate diagnosis and prevention of anemia, whatever its etiology, is essential.

  13. Hemoglobin level as a risk factor for lower respiratory tract infections in Lebanese children

    Directory of Open Access Journals (Sweden)

    Sawsan Mourad

    2010-01-01

    Full Text Available Background: Pneumonia is the biggest single cause of childhood death under the age of 5 years, and anemia affects approximately 30% of infants and children all over the world. Aim: Determination of the relationship between anemia and lower respiratory tract infection as a risk factor in Lebanese children. Patients and Methods A total number of two hundred infants and children aged nine months to twelve years were included; One hundred cases were hospitalized for lower respiratory tract infection in Department of Pediatrics, Makassed General Hospital, and one hundred healthy, age and sex matched controls, were selected from outpatient department. Complete blood count, iron level, ferritin level, and total iron binding capacity were taken if hemoglobin level less than eleven gram per deci-liter. In addition peripheral blood smear, chest radiograph and C-reactive protein were done to hospitalized cases. Definition of iron deficiency anemia and normal laboratory values were predetermined. Results: Anemia was found in 32% of hospitalized cases and 16% of healthy controls. Mean hemoglobin level was 9.99 ΁ 0.62 gram per deci-liter and 11.99 ΁ 0.92 gram per deci-liter in anemic and non-anemic group respectively with a significant P-value of 0.001. C-reactive protein levels and number hospitalization days were similar among the anemic and non-anemic group. History of recurrent chest infections was significantly higher in both anemic group and hospitalized cases compared to non-anemic group and healthy controls. Low hemoglobin level was a risk factor for lower respiratory tract infection with a P-value of 0.008. Conclusion: Anemic children were two times more susceptible to lower respiratory tract infection compared to the control group, and iron deficiency anemia was predominating. Accurate diagnosis and prevention of anemia, whatever its etiology, is essential.

  14. Association of residential dampness and mold with respiratory tract infections and bronchitis: a meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Fisk, William J.; Eliseeva, Ekaterina A.; Mendell, Mark J.

    2010-11-15

    Dampness and mold have been shown in qualitative reviews to be associated with a variety of adverse respiratory health effects, including respiratory tract infections. Several published meta-analyses have provided quantitative summaries for some of these associations, but not for respiratory infections. Demonstrating a causal relationship between dampness-related agents, which are preventable exposures, and respiratory tract infections would suggest important new public health strategies. We report the results of quantitative meta-analyses of published studies that examined the association of dampness or mold in homes with respiratory infections and bronchitis. For primary studies meeting eligibility criteria, we transformed reported odds ratios (ORs) and confidence intervals (CIs) to the log scale. Both fixed and random effects models were applied to the log ORs and their variances. Most studies contained multiple estimated ORs. Models accounted for the correlation between multiple results within the studies analyzed. One set of analyses was performed with all eligible studies, and another set restricted to studies that controlled for age, gender, smoking, and socioeconomic status. Subgroups of studies were assessed to explore heterogeneity. Funnel plots were used to assess publication bias. The resulting summary estimates of ORs from random effects models based on all studies ranged from 1.38 to 1.50, with 95% CIs excluding the null in all cases. Use of different analysis models and restricting analyses based on control of multiple confounding variables changed findings only slightly. ORs (95% CIs) from random effects models using studies adjusting for major confounding variables were, for bronchitis, 1.45 (1.32-1.59); for respiratory infections, 1.44 (1.31-1.59); for respiratory infections excluding nonspecific upper respiratory infections, 1.50 (1.32-1.70), and for respiratory infections in children or infants, 1.48 (1.33-1.65). Little effect of publication

  15. Azithromycin does not improve disease course in hospitalized infants with respiratory syncytial virus (RSV) lower respiratory tract disease : A randomized equivalence trial

    NARCIS (Netherlands)

    Kneyber, Martin C. J.; van Woensel, Job B. M.; Uijtendaal, Esther; Uiterwaal, Cuno S. P. M.; Kimpen, Jan L. L.

    2008-01-01

    Background: Nearly halt of all hospitalized infants with respiratory syncytial virus (RSV) lower respiratory tract disease (LRTD) are treated with (parenteral) antibiotics. The present study was designed to test our hypothesis that the use of antibiotics would not lead to a reduced duration of hospi

  16. Change of immune indexes and oxidative stress state of children with recurrent respiratory tract infection

    Institute of Scientific and Technical Information of China (English)

    Wei-Qing Wu; Shu-Ping Liao; Xiao-Lan Lin; Qiong-Fang Huang

    2015-01-01

    Objective:To observe and analyze the change situation of immune indexes and oxidative stress state of children with recurrent respiratory tract infection.Methods:75 children with recurrent respiratory tract infection in our hospital from January 2014 to June 2015 were selected as observation group, 75 healthy children with health examination at the same time were selected as control group, then the immune indexes and oxidative stress state related serum indexes of two groups were detected,and the detection results of observation group with boys and girls, mild, moderate and severe disease were compared.Results: The cellular immune and erythrocyte immune and oxidative stress state related serum indexes of observation group were all worse than those of control group,and the detection results of observation group with mild, moderate and severe disease had obvious differences too, allP0.05.Conclusion:The change of immune indexes and oxidative stress state of children with recurrent respiratory tract infection are obvious,and the differences of children with mild, moderate and severe disease are obvious too,while the differences of boys and girls are not obvious.

  17. Impact of chest radiography for children with lower respiratory tract infection: a propensity score approach.

    Directory of Open Access Journals (Sweden)

    Emmanuelle Ecochard-Dugelay

    Full Text Available BACKGROUND: Management of acute respiratory tract infection varies substantially despite this being a condition frequently encountered in pediatric emergency departments. Previous studies have suggested that the use of antibiotics was higher when chest radiography was performed. However none of these analyses had considered the inherent indication bias of observational studies. OBJECTIVE: The aim of this work was to assess the relationship between performing chest radiography and prescribing antibiotics using a propensity score analysis to address the indication bias due to non-random radiography assignment. METHODS: We conducted a prospective study of 697 children younger than 2 years of age who presented during the winter months of 2006-2007 for suspicion of respiratory tract infection at the Pediatric Emergency Department of an urban general hospital in France (Paris suburb. We first determined the individual propensity score (probability of having a chest radiography according to baseline characteristics. Then we assessed the relation between radiography and antibiotic prescription using two methods: adjustment and matching on the propensity score. RESULTS: We found that performing a chest radiography lead to more frequent antibiotic prescription that may be expressed as OR = 2.3, CI [1.3-4.1], or as an increased use of antibiotics of 18.6% [0.08-0.29] in the group undergoing chest radiography. CONCLUSION: Chest radiography has a significant impact on the management of infants admitted for suspicion of respiratory tract infection in a pediatric emergency department and may lead to unnecessary administration of antibiotics.

  18. Respiratory and allergic diseases: from upper respiratory tract infections to asthma.

    Science.gov (United States)

    Jaber, Raja

    2002-06-01

    patient, mind-body interventions such as yoga, hypnosis, and biofeedback-assisted relaxation and breathing exercises are beneficial for stress reduction in general and may be helpful in further controlling asthma. Encouraging parents to learn how to massage their asthmatic children may appeal to some parents and provide benefits for parents and children alike. Acupuncture and chiropractic treatment cannot be recommended at this time, although some patients may derive benefit because of the placebo effect. For patients with allergic rhinitis, there are no good clinical research data on the use of quercetin and vitamin C. Similarly, freeze-dried stinging nettle leaves may be tried, but the applicable research evidence also is poor. Further studies are needed to assess the efficacy of these supplements and herbs. Homeopathic remedies based on extreme dilutions of the allergen may be beneficial in allergic rhinitis but require collaboration with an experienced homeopath. There are no research data on constitutional homeopathic approaches to asthma and allergic rhinitis. Patients with COPD are helped by exercise, pulmonary rehabilitation, and increased caloric protein and fat intake. Vitamin C and n-3 supplements are safe and reasonable; however, studies are needed to establish their efficacy in COPD. On the other hand, there are convincing data in favor of N-acetyl-cysteine supplementation for the patient with COPD at doses ranging between 400 and 1200 mg daily. Red blood cell magnesium levels may guide the use of magnesium replacement. The use of L-carnitine and coenzyme Q10 in patients with COPD needs further study. The addition of essential oils to the dietary regimen of patients with chronic bronchitis is worth exploring. Patients with upper respiratory tract infections can expect a shorter duration of symptoms by taking high doses of vitamin C (2 g) with zinc supplements, preferably the nasal zinc gel, at the onset of their symptoms. Adding an herb such as echinacea or

  19. Treatment of 31 Cases of Infant Respiratory Tract Infection by Health-care Tuina plus Medicated Bath

    Institute of Scientific and Technical Information of China (English)

    LI Jie; WU Xue-fei

    2003-01-01

    Thirty-one cases of infant respiratory tract infection were treated by no-pain health-care Tuina plus medicated bath. Since the therapeutic effects were satisfactory, so parents and infants are willing to accept.

  20. Continued high rates of antibiotic prescribing to adults with respiratory tract infection : survey of 568 UK general practices

    NARCIS (Netherlands)

    Gulliford, Martin C; Dregan, Alex; Moore, Michael V; Ashworth, Mark; Staa, Tjeerd van; McCann, Gerard; Charlton, Judith; Yardley, Lucy; Little, Paul; McDermott, Lisa

    2014-01-01

    OBJECTIVES: Overutilisation of antibiotics may contribute to the emergence of antimicrobial drug resistance, a growing international concern. This study aimed to analyse the performance of UK general practices with respect to antibiotic prescribing for respiratory tract infections (RTIs) among young

  1. Antimicrobial susceptibility of communityacquired respiratory tract pathogens isolated from patients in primary hospitals in Shanghai from 2007 to 2010

    Institute of Scientific and Technical Information of China (English)

    周春妹

    2013-01-01

    Objective To investigate the etiology of communityacquired respiratory tract infections (CARTI) and the antimicrobial resistance of the major pathogens in primary hospitals in Shanghai.Methods Patients with CARTI were prospectively recruited from 30 primary hospitals

  2. Effects of Acetaminophen on Oxidant and Irritant Respiratory Tract Responses to Environmental Tobacco Smoke in Female Mice

    OpenAIRE

    Smith, Gregory J.; Cichocki, Joseph A.; Doughty, Bennett J.; Manautou, Jose E.; Jordt, Sven-Eric; Morris, John B.

    2015-01-01

    Background: Although it is known that acetaminophen causes oxidative injury in the liver, it is not known whether it causes oxidative stress in the respiratory tract. If so, this widely used analgesic may potentiate the adverse effects of oxidant air pollutants. Objectives: The goal of this study was to determine if acetaminophen induces respiratory tract oxidative stress and/or potentiates the oxidative stress and irritant responses to an inhaled oxidant: environmental tobacco smoke (ETS). M...

  3. Mammalian Cell-Derived Respiratory Syncytial Virus-Like Particles Protect the Lower as well as the Upper Respiratory Tract.

    Directory of Open Access Journals (Sweden)

    Pramila Walpita

    Full Text Available Globally, Respiratory Syncytial Virus (RSV is a leading cause of bronchiolitis and pneumonia in children less than one year of age and in USA alone, between 85,000 and 144,000 infants are hospitalized every year. To date, there is no licensed vaccine. We have evaluated vaccine potential of mammalian cell-derived native RSV virus-like particles (RSV VLPs composed of the two surface glycoproteins G and F, and the matrix protein M. Results of in vitro testing showed that the VLPs were functionally assembled and immunoreactive, and that the recombinantly expressed F protein was cleaved intracellularly similarly to the virus-synthesized F protein to produce the F1 and F2 subunits; the presence of the F1 fragment is critical for vaccine development since all the neutralizing epitopes present in the F protein are embedded in this fragment. Additional in vitro testing in human macrophage cell line THP-1 showed that both virus and the VLPs were sensed by TLR-4 and induced a Th1-biased cytokine response. Cotton rats vaccinated with RSV VLPs adjuvanted with alum and monophosphoryl lipid A induced potent neutralizing antibody response, and conferred protection in the lower as well as the upper respiratory tract based on substantial virus clearance from these sites. To the best of our knowledge, this is the first VLP/virosome vaccine study reporting protection of the lower as well as the upper respiratory tract: Prevention from replication in the nose is an important consideration if the target population is infants < 6 months of age. This is because continued virus replication in the nose results in nasal congestion and babies at this age are obligate nose breathers. In conclusion, these results taken together suggest that our VLPs show promise to be a safe and effective vaccine for RSV.

  4. Cefditoren in upper and lower community-acquired respiratory tract infections

    Directory of Open Access Journals (Sweden)

    Francisco Soriano

    2011-02-01

    Full Text Available Francisco Soriano1, María-José Giménez1,2, Lorenzo Aguilar1,21PRISM-AG, Madrid, Spain; 2Microbiology Department, School of Medicine, University Complutense, Madrid, SpainAbstract: This article reviews and updates published data on cefditoren in the evolving scenario of resistance among the most prevalent isolates from respiratory tract infections in the community (Streptococcus pyogenes, Haemophilus influenzae, and Streptococcus pneumoniae. By relating the in vitro activity of cefditoren (in national and multinational surveillance and against isolates with emerging resistant genotypes/phenotypes to its pharmacokinetics, the cefditoren pharmacodynamic activity predicting efficacy (in humans, animal models, and in vitro simulations is analyzed prior to reviewing clinical studies (tonsillopharyngitis, sinusitis, acute exacerbations of chronic bronchitis, and community-acquired pneumonia and the relationship between bacterial eradication and clinical efficacy. The high in vitro activity of cefditoren against the most prevalent respiratory isolates in the community, together with its pharmacokinetics (enabling a twice daily regimen leading to adequate pharmacodynamic indexes covering all S. pyogenes, H. influenzae, and at least 95% S. pneumoniae isolates, makes cefditoren an antibiotic that will play a significant role in the treatment of respiratory tract infections in the community. In the clinical setting, studies carried out with cefditoren showed that treatments with the 400 mg twice daily regimen were associated with high rates of bacteriological response, even against penicillin-nonsusceptible S. pneumoniae, with good correlation between bacteriological efficacy/response and clinical outcome.Keywords: cefditoren, Streptococcus pyogenes, Haemophilus influenzae, Streptococcus pneumoniae, community-acquired respiratory tract infections

  5. Multidrug resistant Gram-negative bacilli in lower respiratory tract infections.

    Directory of Open Access Journals (Sweden)

    Shashidhar Vishwanath

    2013-12-01

    Full Text Available Lower respiratory tract infections are among important causes of morbidity and mortality for all age groups. The emergence of multidrug resistant Gram-negative bacilli is an issue of increasing concern.A retrospective study including respiratory specimens (sputum and BAL was conducted in our tertiary care centre. Samples were processed for microscopy, culture and susceptibility testing following standard methods. Multidrug resistant Gram-negative bacilli causing lower respiratory tract infections were studied for their causation of disease. The effect of appropriate treatment on clinical outcome was observed.A total of 472 Gram-negative pathogens were isolated from sputum and broncho-alveolar lavage fluid specimens during the study period. Among these Gram-negative pathogens 175 (37% were found to be multidrug resistant. Klebsiella pneumoniae 85 (48.6% and Acinetobacter spp. 59 (33.7% were the predominant multidrug resistant Gram-negative bacilli isolated. Based on clinico-microbiological correlation, 138 (78.9% multidrug resistant isolates were found to be pathogenic and the rest 37 (21.1% were considered as colonizers. After initiating appropriate antibiotic therapy, clinical improvement was seen in 110 (79.7% patients. In the patients who showed improvement, amikacin (34.3% and cefoperazone-sulbactum (21.8% were found to be the most effective drugs.A large majority of the isolated multidrug resistant Gram-negative bacilli were found to be pathogenic. Regular surveillance which directs appropriate empirical therapy; and good clinic-microbiological workup of each case of lower respiratory tract infection can reduce the morbidity and mortality associated with multidrug resistant organisms.

  6. [Pharmacological effects of N-acetyl-L-cysteine on the respiratory tract. (I). Quantitative and qualitative changes in respiratory tract fluid and sputum (author's transl)].

    Science.gov (United States)

    Kogi, K; Saito, T; Kasé, Y; Hitoshi, T

    1981-06-01

    The following three experiments were performed to determine the effects of N-acetyl-L-cysteine (NAC) on the quantity and quality of respiratory tract fluid (RTF) and sputum. All drugs used were administered into the stomach through a gastric tube. 1) Indirect measurement of bronchial secretion in rats, which was expressed by the amounts of dye excreted into the respiratory tract, was carried out according the the Sakuno's method, with some modification. Some expectorants of the secretomotor type, such as bromhexine and pilocarpine, significantly increased the secretion, even at low doses. On the other hand, mucolytic agents such as NAC augmented the secretion only in doses of 500 to 1500 mg/kg. 2)As a direct method of measurements, Kasé's modification of Perry and Boyd's method was used to collect RTF, quantitatively, from rabbits. The RTF of healthy rabbits was colorless and watery. The administration of NAC in doses of 500 to 1500 mg/kg augmented the output volume and RTF became slightly turbid, probably due to an increase in the viscous mucus. 3) Rabbits with subacute bronchitis were prepared by long-term exposure to air contaminated with SO2 gas and sputa were collected before and after administration of NAC, respectively, according to the Kase's method. The sputa were opalescent and viscous gel included nodular masses. The administration of NAC, 1000 and 1500 mg/kg resulted in a dose dependent decrease in the relative viscosity. The percent-decreased in viscosity with NAC was statistically correlated with that in amounts of dry matter, those in protein and polysaccharide in the sputa. From the results described above, it was concluded that NAC given into the stomach can liquefy sputum by splitting mucoprotein disulphide linkages, that is, altering the rheological characteristics of sputum to facilitate expectoration.

  7. [Pharmacological effects of N-acetyl-L-cysteine on the respiratory tract. (I). Quantitative and qualitative changes in respiratory tract fluid and sputum (author's transl)].

    Science.gov (United States)

    Kogi, K; Saito, T; Kasé, Y; Hitoshi, T

    1981-06-01

    The following three experiments were performed to determine the effects of N-acetyl-L-cysteine (NAC) on the quantity and quality of respiratory tract fluid (RTF) and sputum. All drugs used were administered into the stomach through a gastric tube. 1) Indirect measurement of bronchial secretion in rats, which was expressed by the amounts of dye excreted into the respiratory tract, was carried out according the the Sakuno's method, with some modification. Some expectorants of the secretomotor type, such as bromhexine and pilocarpine, significantly increased the secretion, even at low doses. On the other hand, mucolytic agents such as NAC augmented the secretion only in doses of 500 to 1500 mg/kg. 2)As a direct method of measurements, Kasé's modification of Perry and Boyd's method was used to collect RTF, quantitatively, from rabbits. The RTF of healthy rabbits was colorless and watery. The administration of NAC in doses of 500 to 1500 mg/kg augmented the output volume and RTF became slightly turbid, probably due to an increase in the viscous mucus. 3) Rabbits with subacute bronchitis were prepared by long-term exposure to air contaminated with SO2 gas and sputa were collected before and after administration of NAC, respectively, according to the Kase's method. The sputa were opalescent and viscous gel included nodular masses. The administration of NAC, 1000 and 1500 mg/kg resulted in a dose dependent decrease in the relative viscosity. The percent-decreased in viscosity with NAC was statistically correlated with that in amounts of dry matter, those in protein and polysaccharide in the sputa. From the results described above, it was concluded that NAC given into the stomach can liquefy sputum by splitting mucoprotein disulphide linkages, that is, altering the rheological characteristics of sputum to facilitate expectoration. PMID:7286849

  8. Experimental determination of the regional deposition of aerosol particles in the human respiratory tract

    Energy Technology Data Exchange (ETDEWEB)

    Stahlhofen, W.; Gebhart, J.; Heyder, J.

    1980-06-01

    The experimental techniques and the results of inhalation studies with radioaerosols on normal non-smokers for mouth-breathing are described and discussed. Monodisperse iron oxide particles tagged with /sup 198/Au are produced with a spinning top generator in the aerodynamic size range between 1 to 10 ..mu..m. An aerosol inhalation apparatus enables the subjects to breathe under standardized conditions with respect to tidal volume and breathing frequency. The calculation of total deposition is based upon measurements of the number of in- and exhaled particles per breath by means of photometric methods and pneumotachography. The retention of the radioactive particles present in the body after aerosol administration is measured with a body counter designed and constructed for these experiments. Retention measurements as functions of time after inhalation are carried out in extrathoracic-, chest- and stomach-position. The body counter consists of four shielded NaF(Tl)-dectors. Characteristic feature of the body counter is its low sensitivity to neighboring organs and to neighboring regions within the respiratory tract. For the evaluation of extrathoracic deposition, the activity measured in the stomach immediately after inhalation is added to extrathoracic activity. The elimination of material from the chest is found to be much slower for the material deposited in the alveolar region than for the amount deposited in the tracheobronchial tree. This allows the intrathoracic deposition to be divided into tracheolbronchial and alveolar deposition by means of the different slopes of the normalized chest retention function. Different normalized chest retention functions are presented and analyzed with respect to their different elimination rats belonging to the tracheobronchial and alveolar region. Total, tracheobronchial, alveolar and extrathoracic deposition data are reported in the aerodynamic diameter range between 1 and 10 ..mu..m.

  9. Fungal contamination of the respiratory tract and associated respiratory impairment among sawmill workers in India

    Directory of Open Access Journals (Sweden)

    Asit Adhikari

    2015-10-01

    Full Text Available Wood processing workers are exposed to wood-associated microbiological contaminants, including fungi. Our aim was to study the potential association between sputum fungus and adverse respiratory effects in such workers. In a group of sawmill workers, we administered a respiratory questionnaire, performed lung function testing and quantified the proportions of leukocytes in spontaneously expectorated sputum samples. We identified fungal species by DNA sequencing. Of 54 sawmill workers, 19 yielded fungal positive sputum samples (mean age 42.5±10.4 years and 35 were negative for fungus (mean age 36.9±5.2 years. The fungus was identified as Candida sp. in all samples. Those with fungal-positive sputum, compared to others, reported more cough (26% versus 63% and haemoptysis (6% versus 37% (both p<0.05, manifested reduced forced midexpiratory flow rates (FEF25–75% (82.3±4.5 versus 69.2±9.9% predicted, p<0.001, and had higher sputum eosinophil counts (median 9.25 versus 3.25%, p<0.01. Reduction of FEF25–75% was associated both with fungus detection in sputum (−12.7%, 95% CI−8.5– −16.9% and sputum eosinophils (−2.1% per 1% increase in eosinophils, 95% CI −1.5– −2.8% (both p<0.001. In sawmill workers, Candida sp. detectable in sputum was associated with respiratory symptoms, sputum eosinophilia and reduced FEF25–75%.

  10. Viral-bacterial interactions and risk of acute otitis media complicating upper respiratory tract infection.

    Science.gov (United States)

    Pettigrew, Melinda M; Gent, Janneane F; Pyles, Richard B; Miller, Aaron L; Nokso-Koivisto, Johanna; Chonmaitree, Tasnee

    2011-11-01

    Acute otitis media (AOM) is a common complication of upper respiratory tract infection whose pathogenesis involves both viruses and bacteria. We examined risks of acute otitis media associated with specific combinations of respiratory viruses and acute otitis media bacterial pathogens. Data were from a prospective study of children ages 6 to 36 months and included viral and bacterial culture and quantitative PCR for respiratory syncytial virus (RSV), human bocavirus, and human metapneumovirus. Repeated-measure logistic regression was used to assess the relationship between specific viruses, bacteria, and the risk of acute otitis media complicating upper respiratory tract infection. In unadjusted analyses of data from 194 children, adenovirus, bocavirus, Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis were significantly associated with AOM (P virus loads (≥3.16 × 10(7) copies/ml) experienced increased acute otitis media risk. Higher viral loads of bocavirus and metapneumovirus were not significantly associated with acute otitis media. In adjusted models controlling for the presence of key viruses, bacteria, and acute otitis media risk factors, acute otitis media risk was independently associated with high RSV viral load with Streptococcus pneumoniae (odds ratio [OR], 4.40; 95% confidence interval [CI], 1.90 and 10.19) and Haemophilus influenzae (OR, 2.04; 95% CI, 1.38 and 3.02). The risk was higher for the presence of bocavirus and H. influenzae together (OR, 3.61; 95% CI, 1.90 and 6.86). Acute otitis media risk differs by the specific viruses and bacteria involved. Acute otitis media prevention efforts should consider methods for reducing infections caused by respiratory syncytial virus, bocavirus, and adenovirus in addition to acute otitis media bacterial pathogens.

  11. Caudal Nuclei Of The Rat Nucleus Of The Solitary Tract Differentially Innervate Respiratory Compartments Within The Ventrolateral Medulla

    OpenAIRE

    Alheid, George F.; Jiao, Weijie; McCrimmon, Donald R.

    2011-01-01

    A substantial array of respiratory, cardiovascular, visceral and somatic afferents are relayed via the nucleus of the solitary tract (NTS) to the brainstem (and forebrain). Despite some degree of overlap within the NTS, specificity is maintained in central respiratory reflexes driven by 2nd order afferent relay neurons in the NTS. While the topographical arrangement of respiratory-related afferents targeting the NTS has been extensively investigated, their higher order brainstem targets beyon...

  12. Human Pharyngeal Microbiome May Play A Protective Role in Respiratory Tract Infections

    Institute of Scientific and Technical Information of China (English)

    Zhancheng Gao; Yu Kang; Jun Yu; Lufeng Ren

    2014-01-01

    The human pharyngeal microbiome, which resides at the juncture of digestive and respi-ratory tracts, may have an active role in the prevention of respiratory tract infections, similar to the actions of the intestinal microbiome against enteric infections. Recent studies have demonstrated that the pharyngeal microbiome comprises an abundance of bacterial species that interacts with the local epithelial and immune cells, and together, they form a unique micro-ecological system. Most of the microbial species in microbiomes are obligate symbionts constantly adapting to their unique surroundings. Indigenous commensal species are capable of both maintaining dominance and evoking host immune responses to eliminate invading species. Temporary damage to the pha-ryngeal microbiome due to the impaired local epithelia is also considered an important predisposing risk factor for infections. Therefore, reinforcement of microbiome homeostasis to prevent invasion of infection-prone species would provide a novel treatment strategy in addition to antibiotic treat-ment and vaccination. Hence continued research efforts on evaluating probiotic treatment and developing appropriate procedures are necessary to both prevent and treat respiratory infections.

  13. The development of lavage procedures for the upper and lower respiratory tract of the cat

    International Nuclear Information System (INIS)

    New techniques for routine bronchopulmonary lavage (BPL) and nasal flushing in the anaesthetized cat which are safe, reproducible and simple to use have been developed. Five adult mixed-breed cats from a specific pathogen-free colony were selected, fasted overnight and weighed. The feeding tube was passed through the endotracheal tube and down the trachea until it became wedged in the bronchus. Nasal flushing was then immediately carried out after the BPL with the endotracheal tube in position. Radiological and fluoroscopic examinations were carried out to determine the position of the feeding tube in the lung. Lateral and dorsoventral views of the thorax of each cat were taken. These examinations identified the tube most frequently in the caudal lobe of the lung. The lavage techniques described provide a definite procedure for investigating the cellular and humoral mechanisms operating in the upper and lower respiratory tract of the cat. These methods can be used to sample directly the cellular and humoral constituents contributing to defence mechanisms in the feline respiratory tract and to monitor the local changes accompanying respiratory disease

  14. Calculating the respiratory flow velocity fluctuations in pericardial diseases.

    Science.gov (United States)

    Siniorakis, Eftychios; Arvanitakis, Spyridon; Zarreas, Elias; Barlagiannis, Dimitris; Skandalakis, Nikos; Karidis, Constantinos

    2010-11-01

    An excessive respiratory fluctuation (RTFV) in transmitral early diastolic velocity E is a pivotal Doppler echocardiographic sign of haemodynamic compromise, in constrictive pericardial diseases. RTFV is expressed as a percentage and 25% is considered a threshold value. Unfortunately there is no unanimity in calculating RTFV. Sometimes it is expressed as a percentage of expiratory E velocity, while others of inspiratory E velocity. This disparity has led to gross misinterpretations in medical literature. Here we emphasize the importance of a rational procedure calculating RTFV and we propose the appropriate mathematical model.

  15. Patterns Of Antimicrobial Use For Respiratory Tract Infections In Elderly Patients

    International Nuclear Information System (INIS)

    Background: Elderly patients are prone to respiratory tract infections (RTIs) both; acute bronchitis and pneumonia. A large proportion of the antibiotics prescribed are unlikely to provide clinical benefit to patients. There is an increased need to decrease excess antibiotic use in elderly to minimize antibiotic resistance. Objective: To describe patterns of antimicrobial use for respiratory tract infections (RTIs) among elderly Patients and methods: A cross sectional study was conducted on one hundred elderly patients, aged > 60 years, both males and females to describe patterns of antimicrobial use for respiratory tract infections (RTIs) among elderly patients. RTIs, categorized as acute bronchitis, and pneumonia, were studied for appropriateness of antimicrobial use, type of antibiotics used, and factors associated with their use. We rated antibiotic use as appropriate (when an effective drug was used), inappropriate (when a more effective drug was indicated), or unjustified (when use of any antimicrobial was not indicated). Results: Of 100 patients with RTI, overall treatment was appropriate in 79% of episodes, inappropriate in 9%, and unjustified in 12%. For acute bronchitis, treatment was appropriate in 85% and unjustified in 15% of cases. For pneumonia, treatment was appropriate in 55% of episodes. Among the most commonly used antimicrobials, B.Lactam + macrolides their use were unjustified in 41% of cases. There were statistical significant differences in the patterns of antibiotic use when stratified by age, gender, and co- morbid conditions including chronic obstructive pulmonary disease. Conclusion: Antimicrobials are unjustifiably used for 12% of RTIs and 15% of cases of acute bronchitis, thus suggesting a need for programs to improve antibiotic prescribing at hospitals.

  16. Drug resistance in community-acquired respiratory tract infections: role for an emerging antibacterial

    Directory of Open Access Journals (Sweden)

    Lorenzo Aguilar

    2010-06-01

    Full Text Available Lorenzo Aguilar1, María-José Giménez1, José Barberán21Microbiology Department, School of Medicine, University Complutense, Madrid; 2Infectious Diseases Department, Hospital Central de la Defensa Gomez Ulla, Madrid, SpainAbstract: The nasopharynx is the ecological niche where evolution towards resistance occurs in respiratory tract isolates. Dynamics of different bacterial populations in antibiotic-free multibacterial niches are the baseline that antibiotic treatments can alter by shifting the competitive balance in favor of resistant populations. For this reason, antibiotic resistance is increasingly being considered to be an ecological problem. Traditionally, resistance has implied the need for development of new antibiotics for which basic efficacy and safety data are required prior to licensing. Antibiotic development is mainly focused on demonstrating clinical efficacy and setting susceptibility breakpoints for efficacy prediction. However, additional information on pharmacodynamic data predicting absence of selection of resistance and of resistant subpopulations, and specific surveillance on resistance to core antibiotics (to detect emerging resistances and its link with antibiotic consumption in the community are valuable data in defining the role of a new antibiotic, not only from the perspective of its therapeutic potential but also from the ecologic perspective (countering resistances to core antibiotics in the community. The documented information on cefditoren gleaned from published studies in recent years is an example of the role for an emerging oral antibacterial facing current antibiotic resistance in community-acquired respiratory tract infections.Keywords: respiratory tract infection, antibiotic resistance, cefditoren, community

  17. An investigation into the role of Chlamydophila spp. in bovine upper respiratory tract disease.

    Science.gov (United States)

    Twomey, D F; Griffiths, P C; Horigan, M W; Hignett, B C; Martin, T P

    2006-05-01

    An outbreak of upper respiratory tract disease was investigated in a group of 17 housed home-bred calves on a mixed dairy, beef and sheep farm in Devon. Conjunctival swabs were collected and tested for Chlamydophila spp. DNA using a PCR test that detects Chlamydophila abortus and Chlamydophila psittaci. Six of the calves tested gave a positive result. Further epidemiological observations and laboratory testing indicated that the adult dairy cows, from which the affected calves originated, were the most likely source of infection.

  18. Influences of parameter uncertainties within the ICRP 66 respiratory tract model: particle deposition.

    Science.gov (United States)

    Bolch, W E; Farfán, E B; Huh, C; Huston, T E; Bolch, W E

    2001-10-01

    Risk assessment associated with the inhalation of radioactive aerosols requires as an initial step the determination of particle deposition within the various anatomic regions of the respiratory tract. The model outlined in ICRP Publication 66 represents to date one of the most complete overall descriptions of not only particle deposition, but of particle clearance and local radiation dosimetry of lung tissues. In this study, a systematic review of the deposition component within the ICRP 66 respiratory tract model was conducted in which probability density functions were assigned to all input parameters. These distributions were subsequently incorporated within a computer code LUDUC (LUng Dose Uncertainty Code) in which Latin hypercube sampling techniques are used to generate multiple (e.g., 1,000) sets of input vectors (i.e., trials) for all of the model parameters needed to assess particle deposition within the extrathoracic (anterior and posterior), bronchial, bronchiolar, and alveolar-interstitial regions of the ICRP 66 respiratory tract model. Particle deposition values for the various trial simulations were shown to be well described by lognormal probability distributions. Geometric mean deposition fractions from LUDUC were found to be within approximately +/- 10% of the single-value estimates from the LUDEP computer code for each anatomic region and for particle diameters ranging from 0.001 to 50 microm. In all regions of the respiratory tract, LUDUC simulations for an adult male at light exertion show that uncertainties in particle deposition fractions are distributed only over a range of about a factor of approximately 2-4 for particle sizes between 0.005 to 0.2 microm. Below 0.005 microm, uncertainties increase only for deposition within the alveolar region. At particle sizes exceeding 1 microm, uncertainties in the deposition fraction within the extrathoracic regions are relatively small, but approach a factor of 20 for deposition in the bronchial

  19. Anaerobic bacteria in upper respiratory tract and head and neck infections: microbiology and treatment.

    Science.gov (United States)

    Brook, Itzhak

    2012-04-01

    Anaerobes are the predominant components of oropharyngeal mucous membranes bacterial flora, and are therefore a common cause of bacterial infections of endogenous origin of upper respiratory tract and head and neck. This review summarizes the aerobic and anaerobic microbiology and antimicrobials therapy of these infections. These include acute and chronic otitis media, mastoiditis and sinusitis, pharyngo-tonsillitis, peritonsillar, retropharyngeal and parapharyngeal abscesses, suppurative thyroiditis, cervical lymphadenitis, parotitis, siliadenitis, and deep neck infections including Lemierre Syndrome. The recovery from these infections depends on prompt and proper medical and when indicated also surgical management.

  20. Interventions to improve adherence to first-line antibiotics in respiratory tract infections

    DEFF Research Database (Denmark)

    Llor, Carl; Monedero, María José; García, Guillermo;

    2015-01-01

    intervention (II), aimed to improve the adherence to recommendations on first-line antibiotics in patients with respiratory tract infections (RTIs). Methods: General practitioners (GPs) from different regions of Spain were offered two different interventions on antibiotic prescribing. They registered all...... included training and access to point-of-care tests in practice. Results: The GPs registered 15 073 RTIs before the intervention and 12 760 RTIs after. The antibiotic prescribing rate reduced from 27.7% to 19.8%. Prescribing of first-choice antibiotics increased after the intervention in both groups...

  1. Quality indicators for treatment of respiratory tract infections? An assessment by Danish general practitioners

    DEFF Research Database (Denmark)

    Hansen, Malene Plejdrup; Bjerrum, Lars; Gahrn-Hansen, Bente;

    2013-01-01

    Background: In 2008, a set of 41 quality indicators for antibiotic treatment of respiratory tract infections (RTIs) in general practice were developed in an international setting as part of the European project HAPPY AUDIT. Objectives: To investigate Danish general practitioners' (GPs') assessment...... of 62 (61%) responded. Quality indicators focusing on the frequency of prescribing of narrow-spectrum penicillin were rated as suitable by more than 80% of the Danish GPs, while quality indicators concerning cephalosporins or quinolones were rated suitable by less than half of the GPs. The antibiotic...... treatment of RTIs, only a few of them were rated suitable by the GPs, who are supposed to use them....

  2. Primary pneumocystis infection in infants hospitalized with acute respiratory tract infection

    DEFF Research Database (Denmark)

    Larsen, Hans Henrik; von Linstow, Marie-Louise; Lundgren, Bettina;

    2007-01-01

    Acquisition of Pneumocystis jirovecii infection early in life has been confirmed by serologic studies. However, no evidence of clinical illness correlated with the primary infection has been found in immunocompetent children. We analyzed 458 nasopharyngeal aspirates from 422 patients hospitalized...... with 431 episodes of acute respiratory tract infection (RTI) by using a real-time PCR assay. In 68 episodes in 67 infants, P. jirovecii was identified. The odds ratio (95% confidence interval) of a positive signal compared with the first quartile of age (7-49 days) was 47.4 (11.0-203), 8.7 (1...

  3. European H16N3 gull influenza virus attaches to the human respiratory tract and eye.

    Directory of Open Access Journals (Sweden)

    Cecilia Lindskog

    Full Text Available We explored the attachment of an H16N3 influenza virus to human, mallard, and gull tissues using virus histochemistry applied to tissue microarrays and employing human and mallard viruses as references. Of the viruses tested, the H16N3 gull virus most readily attached to the human respiratory tract and eye. These results underscore the need to assess the potential for gull influenza viruses to replicate in human tissues and further investigate the role of gulls in influenza virus ecology.

  4. ROLE OF IMUNOMET IN UPPER RESPIRATORY TRACT DISORDERS: A RANDOMIZED DOUBLE BLIND PLACEBO CONTROLLED CLINICAL TRIAL

    Directory of Open Access Journals (Sweden)

    Adhikari Anjan

    2012-08-01

    Full Text Available Upper respiratory tract disorders comprise 87.5% of total acute respiratory morbidity in India in children. This has become a major community health problem. The symptoms are often self limiting and many a time caused by viruses, however, recurrent attacks may lead to distinct morbidity. This study was conducted in hospital outpatient department on children who have been attending at frequent interval with complaints of sore throat, pharyngitis and tonsillitis. They were administered Imunomet syrup or tablet for a period of 8 weeks. At the end of the treatment, about 84% patients responded well to treatment and 16% patients had fair response to treatment. None of the patients showed any adverse reaction to treatment. The syrup was found to be palatable.

  5. Insights into the respiratory tract microbiota of patients with cystic fibrosis during early Pseudomonas aeruginosa colonization

    Energy Technology Data Exchange (ETDEWEB)

    Keravec, Marlene; Mounier, Jerome; Prestat , Emmanuel; Vallet, Sophie; Jansson, Janet K.; Bergaud , Gaetaqn; Rosec, Silvain; Gourious, Stephanie; Rault, Gilles; Coton, Emmanuel; Barbier, George; Hery-Arnaud, Geneveieve

    2015-08-09

    Abstract Pseudomonas aeruginosa plays a major role in cystic fibrosis (CF) progression. Therefore, it is important to understand the initial steps of P. aeruginosa infection. The structure and dynamics of CF respiratory tract microbial communities during the early stages of P. aeruginosa colonization were characterized by pyrosequencing and cloning-sequencing. The respiratory microbiota showed high diversity, related to the young age of the CF cohort (mean age 10 years). Wide inter- and intra-individual variations were revealed. A common core microbiota of 5 phyla and 13 predominant genera was found, the majority of which were obligate anaerobes. A few genera were significantly more prevalent in patients never infected by P. aeruginosa. Persistence of an anaerobic core microbiota regardless of P. aeruginosa status suggests a major role of certain anaerobes in the pathophysiology of lung infections in CF. Some genera may be potential biomarkers of pulmonary infection state.

  6. Atypical presentation of human bocavirus: Severe respiratory tract infection complicated with encephalopathy.

    Science.gov (United States)

    Akturk, Hacer; Sık, Guntulu; Salman, Nuran; Sutcu, Murat; Tatli, Burak; Ciblak, Meral Akcay; Erol, Oguz Bulent; Torun, Selda Hancerli; Citak, Agop; Somer, Ayper

    2015-11-01

    Human bocavirus (HBOV) has been reported as a worldwide distributed respiratory pathogen. It has also been associated with encephalitis recently by detection of the virus in cerebrospinal fluid (CSF) of patients presented with encephalitis. This retrospective study aimed to present clinical features of HBOV infections in children with respiratory symptoms and describe unexplained encephalopathy in a subgroup of these patients. Results of 1,143 pediatric nasal samples from mid-December 2013 to July 2014 were reviewed for detection of HBOV. A multiplex real time polymerase chain reaction assay was used for viral detection. Medical records of the patients were retrospectively analyzed. HBOV was detected in 30 patients (2.6%). Median age was 14 months (5-80). Clinical diagnoses were upper respiratory tract infection (n = 10), bronchopneumonia (n = 9), acute bronchiolitis (n = 5), pneumonia (n = 4), acute bronchitis (n = 1), and asthma execarbation (n = 1). Hospitalization was required in 16 (53.3%) patients and 10 (62.5%) of them admitted to pediatric intensive care unit (PICU). Noninvasive mechanical ventilation modalities was applied to four patients and mechanical ventilation to four patients. Intractable seizures developed in four patients while mechanically ventilated on the 2nd-3rd days of PICU admission. No specific reason for encephalopathy was found after a thorough investigation. No mortality was observed, but two patients were discharged with neurological sequela. HBOV may lead to respiratory infections in a wide spectrum of severity. This report indicates its potential to cause severe respiratory infections requiring PICU admission and highlights possible clinical association of HBOV and encephalopathy, which developed during severe respiratory infection. PMID:25966820

  7. Clinical characteristics of acute lower respiratory tract infections due to 13 respiratory viruses detected by multiplex PCR in children

    Directory of Open Access Journals (Sweden)

    Jeong-Sook Lim

    2010-03-01

    Full Text Available Purpose : This study was performed to investigate the epidemiologic and clinical features of 13 respiratory viruses in children with acute lower respiratory tract infections (ALRIs. Methods : Nasopharyngeal aspirates were prospectively obtained from 325 children aged 15 years or less from May 2008 to April 2009 and were tested for the presence of 13 respiratory viruses by multiplex real-time-polymerase chain reaction (RT-PCR. Results : Viruses were identified in 270 children (83.1%. Co-infections with ?#242; viruses were observed in 71 patients (26.3 %. Respiratory syncytial virus (RSV was the most common virus detected (33.2%, followed by human rhinovirus (hRV (19.1%, influenza virus (Flu A (16.9%, human metapneumovirus (hMPV (15.4%, parainfluenza viruses (PIVs (8.3%, human bocavirus (hBoV (8.0%, adenovirus (ADV (5.8%, and human coronavirus (hCoV (2.2%. Clinical diagnoses of viral ALRIs were bronchiolitis (37.5%, pneumonia (34.5%, asthma exacerbation (20.9%, and croup (7.1%. Clinical diagnoses of viral bronchiolitis and pneumonia were frequently demonstrated in patients who tested positive for RSV, hRV, hMPV, or Flu A. Flu A and hRV were most commonly identified in children older than 3 years and were the 2 leading causes of asthma exacerbation. hRV C was detected in 14 (4.3% children, who were significantly older than those infected with hRV A (mean±SD, 4.1±3.5 years vs. 1.7±2.3 years; P=0.009. hBoV was usually detected in young children (2.3±3.4 years with bronchiolitis and pneumonia. Conclusion : This study described the features of ALRI associated with 13 respiratory viruses in Korean children. Additional investigations are required to define the roles of newly identified viruses in children with ALRIs.

  8. Procalcitonin guided antibiotic therapy and hospitalization in patients with lower respiratory tract infections: a prospective, multicenter, randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Henzen Christoph

    2007-07-01

    Full Text Available Abstract Background: Lower respiratory tract infections like acute bronchitis, exacerbated chronic obstructive pulmonary disease and community-acquired pneumonia are often unnecessarily treated with antibiotics, mainly because of physicians' difficulties to distinguish viral from bacterial cause and to estimate disease-severity. The goal of this trial is to compare medical outcomes, use of antibiotics and hospital resources in a strategy based on enforced evidence-based guidelines versus procalcitonin guided antibiotic therapy in patients with lower respiratory tract infections. Methods and design: We describe a prospective randomized controlled non-inferiority trial with an open intervention. We aim to randomize over a fixed recruitment period of 18 months a minimal number of 1002 patients from 6 hospitals in Switzerland. Patients must be >18 years of age with a lower respiratory tract infections Discussion: Use of and prolonged exposure to antibiotics in lower respiratory tract infections is high. The proposed trial investigates whether procalcitonin-guidance may safely reduce antibiotic consumption along with reductions in hospitalization costs and antibiotic resistance. It will additionally generate insights for improved prognostic assessment of patients with lower respiratory tract infections. Trial registration: ISRCTN95122877

  9. How often do general practitioners prescribe antibiotics for otitis media and the most common respiratory tract infections?

    Directory of Open Access Journals (Sweden)

    Jørund Straand

    2009-11-01

    Full Text Available  ABSTRACTObjective:  Design:  Setting:  Material:  Results:  Conclusion:  Key words:  Antibiotics, general practice, diagnoses, respiratory tract infections, otitis media, pharmacoepidemiologyExcept for upper respiratory tract infection, antibiotic treatment is the rule not an exception, forall the diagnoses studied. In general practice, improved communication- and prescribing-skills are probablyessentials for implementing a more evidence based treatment of otitis media, and the common respiratorytract infections. The significance of patient related factors for seeing a GP (or not and for (not expectingantibiotics for otitis media and the common respiratory tract infections should be explored in future research.Antibiotics were issued during 57% of all contacts for the included diagnoses, ranging from 22%(upper respiratory tract infection to 91% (tonsillitis. All patients who had first time office consultations fortonsillitis, acute bronchitis and pneumonia, were prescribed antibiotics. One out of three patients who consultedthe doctor on the telephone for these diagnoses, were also prescribed an antibiotic.8610 physician-patient contacts, and 4909 antibiotic prescriptions for otitis media, upper respiratorytract infection, tonsillitis, sinusitis, acute bronchitis, and pneumonia.Cross sectional, multipractice study.GPs in the Norwegian county of Møre & Romsdal. Data were recorded during two months.To examine how frequently general practitioners actually prescribe antibiotics for patientscontacting them for otitis media, and the most common respiratory tract infection diagnoses, – by the type ofdoctor-patient contact during prescribing, and patients' age and sex.

  10. Acute lower respiratory tract infection due to respiratory syncytial virus in a group of Egyptian children under 5 years of age

    OpenAIRE

    El-kholy Amany A; El-anany Mervat G; Mansi Yasmeen A; Fattouh Aya M; El-karaksy Hanaa M

    2011-01-01

    Abstract Background and aim Respiratory syncytial virus (RSV) is one of the most important causes of acute lower respiratory tract infections (ALRTI) in infants and young children. This study was conducted to describe the epidemiology of ALRTI associated with RSV among children ≤ 5 years old in Egypt. Patients and Methods We enrolled 427 children ≤ 5 years old diagnosed with ALRTI attending the outpatient clinic or Emergency Department (ED) of Children Hospital, Cairo University during a one-...

  11. Perioperative respiratory adverse events in children with active upper respiratory tract infection who received general anesthesia through an orotracheal tube and inhalation agents

    OpenAIRE

    Kim, So Yeon; Kim, Jeong Min; Lee, Jae Hoon; Kang, Young Ran; Jeong, Seung Ho; Koo, Bon-Nyeo

    2013-01-01

    Background Active upper respiratory tract infection (URI), orotracheal intubation and use of inhalation anesthetics are known risk factors for perioperative respiratory adverse events (RAE). This study investigated the risk factors of perioperative RAE in children with these risk factors. Methods The records of 159 children who underwent general anesthesia with an orotracheal tube and inhalation were reviewed. These patients also had at least one of the following URI symptoms on the day of su...

  12. Prevalence and emerging resistance of Moraxella catarrhalis in lower respiratory tract infections in Karachi

    International Nuclear Information System (INIS)

    Objective: To determine the prevalence of Moraxella catarrhalis in sputum cultures from patients with lower respiratory tract infection and their antimicrobial sensitivity profiles. Methods: The study comprised sputum specimens of 776 patients at various branches of Dr Essa's Diagnostic Lab, Karachi. The specimens were cultured on blood, chocolate, and eosin methylene blue agars between October 2010 and October 2011. The isolates were identified by conventional methods and anti-biograms were determined by the Kirby-Bauer Agar Disc Diffusion Method. Results: Moraxella catarrhalis was isolated from 39 (5.02%) sputa of which 18 (46.15%) belonged to males. The bimodal age prevalence was 238 (30.7%) in age group 20-29 years, and 180 (23.1%) in 70 years and above. Amoxicillin/clavulanate, cefotaxime, and ceftriaxone were most effective (100%). Very high resistance was seen with amikacin (92.3%), cefixime (92.3%), fosfomycin (84.6%), cefuroxime (84.6%), erythromycin and amoxicillin (76.9%), cotrimoxazole (90%) and doxycycline (76.9%). Conclusions: The incidence of Moraxella catarrhalis in sputum encourages routine culture and sensitivity of sputa from patients suffering from lower respiratory tract infection, especially the elderly and immunocompromised, for tailored drug prescription. (author)

  13. [Mucolytics in acute and chronic respiratory tract disorders. II. Uses for treatment and antioxidant properties].

    Science.gov (United States)

    Kupczyk, Maciej; Kuna, Piotr

    2002-03-01

    In the first part of our editorial we reviewed the possible factors responsible for mucus hypersecretion in acute and chronic pulmonary diseases. The present paper presents the results of studies proving, that mucolytics are useful in adjunctive therapy of respiratory tract disorders. Mucolytic agents such as Ambroxol and N-acetylcysteine are able to alter the secretion of mucus and its physical properties which results in improvement of mucociliary clearance. Current evidence indicate, that these drugs are effective, especially in chronic obstructive pulmonary disease, asthma and acute bronchitis. They produce a modest improvement in symptom control and lung function. It has been demonstrated that there is a synergism between mucolytics and antibiotics in the treatment of exacerbation of chronic bronchitis. Moreover, they act as scavengers of reactive oxygen species. Ambroxol is able to inhibit mediator release involved in the pathogenesis of allergic inflammation. As mucolytics are cheap and well-tolerated they are beneficial in the therapy of patients suffering from respiratory tract disorders. PMID:12053601

  14. Carboxylesterases in the respiratory tracts of rabbits, rats and Syrian hamsters.

    Science.gov (United States)

    Dahl, A R; Miller, S C; Petridou-Fischer, J

    1987-04-01

    Esters are a widespread class of organic compounds found both in industry and the environment. Because esters are often volatile and, therefore, readily inhaled, the capacity of respiratory tract tissues as well as liver S-9 homogenates from rats, rabbits, and Syrian hamsters to hydrolyze a variety of esters was investigated. A new technique to determine hydrolysis rates by measuring carboxylic acid residues using ion chromatography was proven effective. The results indicated that esters, including potentially carcinogenic beta-lactones, are readily hydrolyzed by respiratory tract enzymes. Species and tissue differences were apparent. The nasal ethmoturbinates had especially high levels of esterase activity with tissue weight-normalized activities from rabbits and hamsters for most substrates exceeding all other tissues tested, including liver. Phenyl acetate was the most rapidly hydrolyzed by ethmoturbinate tissue of the esters tested. Among straight chain aliphatic alcohol acetates, hydrolysis rates increased with carbon number up to pentyl alcohol and then decreased. Branched 4-carbon alcohol acetates were less rapidly hydrolyzed than n-butyl acetate. Correlation of hydrophobicity constants with hydrolysis rates indicated that, for the straight chain aliphatic acetates, a bilinear model best fit the data. PMID:3576643

  15. Viral Co-Infections in Pediatric Patients Hospitalized with Lower Tract Acute Respiratory Infections

    Science.gov (United States)

    Cebey-López, Miriam; Herberg, Jethro; Pardo-Seco, Jacobo; Gómez-Carballa, Alberto; Martinón-Torres, Nazareth; Salas, Antonio; Martinón-Sánchez, José María; Gormley, Stuart; Sumner, Edward; Fink, Colin; Martinón-Torres, Federico

    2015-01-01

    Background Molecular techniques can often reveal a broader range of pathogens in respiratory infections. We aim to investigate the prevalence and age pattern of viral co-infection in children hospitalized with lower tract acute respiratory infection (LT-ARI), using molecular techniques. Methods A nested polymerase chain reaction approach was used to detect Influenza (A, B), metapneumovirus, respiratory syncytial virus (RSV), parainfluenza (1–4), rhinovirus, adenovirus (A—F), bocavirus and coronaviruses (NL63, 229E, OC43) in respiratory samples of children with acute respiratory infection prospectively admitted to any of the GENDRES network hospitals between 2011–2013. The results were corroborated in an independent cohort collected in the UK. Results A total of 204 and 97 nasopharyngeal samples were collected in the GENDRES and UK cohorts, respectively. In both cohorts, RSV was the most frequent pathogen (52.9% and 36.1% of the cohorts, respectively). Co-infection with multiple viruses was found in 92 samples (45.1%) and 29 samples (29.9%), respectively; this was most frequent in the 12–24 months age group. The most frequently observed co-infection patterns were RSV—Rhinovirus (23 patients, 11.3%, GENDRES cohort) and RSV—bocavirus / bocavirus—influenza (5 patients, 5.2%, UK cohort). Conclusion The presence of more than one virus in pediatric patients admitted to hospital with LT-ARI is very frequent and seems to peak at 12–24 months of age. The clinical significance of these findings is unclear but should warrant further analysis. PMID:26332375

  16. Candelabra aloe (Aloe arborescens) in the therapy and prophylaxis of upper respiratory tract infections: traditional use and recent research results.

    Science.gov (United States)

    Bastian, Petra; Fal, Andrzej M; Jambor, Jerzy; Michalak, Anna; Noster, Britta; Sievers, Hartwig; Steuber, Anke; Walas-Marcinek, Natalia

    2013-02-01

    Aloe arborescens (Candelabra Aloe) has been used in the treatment of upper respiratory tract infections in Central and Eastern European countries for many decades. Originally introduced to support the healing and recovery in cornea transplant patients, aqueous A. arborescens extracts soon became popular in the treatment of upper respiratory tract infections with a focus on toddlers and children. Recent preclinical and clinical data show that immunomodulatory, antiinflammatory, and antiviral effects contribute to its therapeutic efficacy. Based on its well documented, longstanding traditional use and its excellent safety and tolerability, A. arborescens may be considered a valuable addition to the spectrum of herbal medicinal products for the treatment and prophylaxis of upper respiratory tract infections, in particular common cold, in adults and children. PMID:23361849

  17. Systematic Review of Factors Associated with Antibiotic Prescribing for Respiratory Tract Infections.

    Science.gov (United States)

    McKay, Rachel; Mah, Allison; Law, Michael R; McGrail, Kimberlyn; Patrick, David M

    2016-07-01

    Antibiotic use is a modifiable driver of antibiotic resistance. In many circumstances, antibiotic use is overly broad or unnecessary. We systematically assessed factors associated with antibiotic prescribing for respiratory tract infections (RTI). Studies were included if they used actual (not self-reported or intended) prescribing data, assessed factors associated with antibiotic prescribing for RTIs, and performed multivariable analysis of associations. We searched Medline, Embase, and International Pharmaceutical Abstracts using keyword and MeSH (medical subject headings) search terms. Two authors reviewed each abstract and independently appraised all included texts. Data on factors affecting antibiotic prescribing were extracted. Our searches retrieved a total of 2,848 abstracts, with 97 included in full-text review and 28 meeting full inclusion criteria. Compared to other factors, diagnosis of acute bronchitis was associated with increased antibiotic prescribing (range of adjusted odds ratios [aOR], 1.56 to 15.9). Features on physical exam, such as fever, purulent sputum, abnormal respiratory exam, and tonsillar exudate, were also associated with higher odds of antibiotic prescribing. Patient desire for an antibiotic was not associated or was modestly associated with prescription (range of aORs, 0.61 to 9.87), in contrast to physician perception of patient desire for antibiotics, which showed a stronger association (range of aORs, 2.11 to 23.3). Physician's perception of patient desire for antibiotics was strongly associated with antibiotic prescribing. Antimicrobial stewardship programs should continue to expand in the outpatient setting and should emphasize clear and direct communication between patients and physicians, as well as signs and symptoms that do and do not predict bacterial etiology of upper respiratory tract infections. PMID:27139474

  18. CLINICAL PROFILE OF ACUTE LOWER RESPIRATORY TRACT INFECTIONS IN CHILDREN BETWEEN 2MONTHS TO 5 YEARS

    Directory of Open Access Journals (Sweden)

    Amitoj Singh Chhina

    2015-08-01

    Full Text Available BACKGROUND : Acute respiratory infections are a leading cause of morbidity and mortality in under - five children in developing countries. Hence, the present study was undertaken to study the various risk factors, clinical profile and outcome of acute lower respiratory tract infections (ALRI in children aged 2 month to 5 years. OBJECTIVE : clinical features, laborato ry assessment and morbidity and mortality pattern associated with acute lower respiratory tract infections in children aged 2 months to 5 years. METHODS: 100 ALRI cases fulfilling WHO criteria for pneumonia, in the age group of 2 month to 5 years were evaluated for clinical profile as per a predesigned proforma in a rural medical college. RESULTS : Of cases 61% were infants and remaining 39%12 - 60 months age group, males outnumbered females with sex ratio of 1.3;1. Elevated total leukocyte counts for age were observed in only 22% of cases, of these 3% were having pneumonia, 9% severe pneumonia and 10% very severe pneumonia. Significant association was found between leukocytosis and ALRI severity (p= 0.0001 Positive blood culture was obtained in 8% of cases and was significantly associated with ALRI severity (p=. 0.027. Among the ALRI cases, 84% required oxygen supplementation at any time during the hospital stay and 8% required mechanical ventilation. The mortality rate was 1%; with 99% of cases recovering and getting discharged uneventfully. CONCLUSION : Among the clinical variables, the signs and symptoms of ALRI as per the WHO ARI Control Programme were found in almost all cases. Regarding the laboratory profile, leukocytosis and blood culture positivity w ere observed in a small percentage, but significant association with ALRI severity was observed for both. Thus, clinical signs, and not invasive blood tests are a better diagnostic tools, though the latter may provide additional therapeutic and prognostic information in severe disease

  19. Recurrent lower respiratory tract infections in children: a practical approach to diagnosis.

    Science.gov (United States)

    Patria, Maria Francesca; Esposito, Susanna

    2013-03-01

    Many children are affected by recurrent lower respiratory tract infections (LRTIs), but the majority of them do not suffer from serious lung or extrapulmonary disease. The challenge for clinicians is to distinguish the recurrent RTIs with self-limiting or minor problems from those with underlying disease. The aim of this review is to describe a practical approach to children with recurrent LRTIs that limits unnecessary, expensive and time-consuming investigations. The children can be divided into three groups on the basis of their personal and family history and clinical findings: 1) otherwise healthy children who do not need further investigations; 2) those with risk factors for respiratory infections for whom a wait-and-see approach can be recommended; and 3) those in whom further investigations are mandatory. However, regardless of the origin of the recurrent LRTIs, it is important to remember that prevention by means of vaccines against respiratory pathogens (i.e. type b Haemophilus influenzae, pertussis, pneumococcal and influenza vaccines) can play a key role.

  20. The use of household cleaning products during pregnancy and lower respiratory tract infections and wheezing during early life.

    OpenAIRE

    Casas, L.; Zock, J. P.; Carsin, A.E.; Fernández-Somoano, A.; A.Esplugues; Santa-Marina, L.; Tardón, A.; Ballester, F; Basterrechea, M.; Sunyer, J.

    2013-01-01

    To evaluate the effects of household use of cleaning products during pregnancy on infant wheezing and lower respiratory tract infections (LRTI). In four prospective Spanish birth cohorts (n = 2,292), pregnant women reported the use of household cleaning products. When infants were 12-18 months old, current cleaning product use and infant's wheezing and LRTI were reported. Cohort-specific associations between the use of specific products and respiratory outcomes were evaluated using multivaria...

  1. Lactobacillus fermentum (PCC®) supplementation and gastrointestinal and respiratory-tract illness symptoms: a randomised control trial in athletes

    OpenAIRE

    Hopkins William G; Cripps Allan W; Pyne David B; West Nicholas P; Eskesen Dorte C; Jairath Ashok; Christophersen Claus T; Conlon Michael A; Fricker Peter A

    2011-01-01

    Abstract Background Probiotics purportedly reduce symptoms of gastrointestinal and upper respiratory-tract illness by modulating commensal microflora. Preventing and reducing symptoms of respiratory and gastrointestinal illness are the primary reason that dietary supplementation with probiotics are becoming increasingly popular with healthy active individuals. There is a paucity of data regarding the effectiveness of probiotics in this cohort. The aim of this study was to evaluate the effecti...

  2. Immune parameters, symptoms of upper respiratory tract infections, and training-load indicators in volleyball athletes

    Directory of Open Access Journals (Sweden)

    Dias R

    2011-12-01

    Full Text Available Rodrigo Dias1, Anelena Bueno Frollini1, Diego Trevisan Brunelli1, André Katayama Yamada1, Richard Diego Leite4, Ricardo Adamoli Simões1, Guilherme Souza Lobo Salles1, Débora Trevisan1, Idico Luiz Pellegrinotti1, Marcelo de Castro César1, Silvia Cristina Crepaldi Alves1, Rozangela Verlengia1, João Paulo Borin2, Jonato Prestes2,3, Claudia Regina Cavaglieri21Núcleo de Performance Humana, Mestrado em Educação Física, Faculdade de Ciências da Saúde, Universidade Metodista de Piracicaba, São Paulo, Brasil; 2Faculdade de Educação Física (FEF Universidade Estadual de Campinas – UNICAMP, Campinas, Brasil; 3Programa de Mestrado e Doutorado em Educação Física, Universidade Católica de Brasília, Brasília, Brasil; 4Laboratório de Pesquisa Clínica e Experimental em Biologia Vascular (BioVasc, Departamento de Ciências Fisiológicas, Universidade Estadual do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, BrasilBackground: The control of immunological alterations becomes important during in-season training, as a result of increased incidence of infectious diseases, and may assist in avoiding interruptions to training due to illness.Objective: The aim of the present study was to evaluate 28 weeks of chronic immune modulations in female volleyball athletes.Methods: The sample was composed of twelve athletes aged 19.47 ± 2.49 years, height 1.78 ± 0.08 cm, and body mass 66.77 ± 7.8 kg. Leukocytes, individual immune cell count, interleukin (IL-2, IL-6, and tumor necrosis factor (TNF-α plasma cytokines were measured during the competitive period.Results: Results revealed that immune variables were correlated with symptoms of upper respiratory tract infections and training-load indicators, indicating a possible marker of immune status. There was a statistically significant increase in total leukocytes, neutrophils, and monocyte count, a decrease in lymphocytes, and an increase in upper respiratory tract infection symptoms, with no change

  3. Innovative characteristics of the new dosimetric model for the human respiratory tract studied by the ICRP appointed Task Group of Committee 2

    International Nuclear Information System (INIS)

    In 1984, the ICRP appointed a Task Group of Committee 2 to review and revise, as necessary, the current lung dosimetric model. On the basis of the knowledge acquired during the past 20 years, the Task Group's approach has been to review, in depth, the morphology and physiology of the human respiratory tract, inspirability of aerosols and regional deposition of inhaled particles as functions of aerosol size and breathing parameters, clearance of deposited materials, nature and specific sites of damage to the respiratory system caused by inhaled radioactive substances. In the proposed model, clearance from the three regions of the respiratory tract (extrathoracic ET, fast-clearing thoracic Tf and slow-clearing thoracic Ts, comprising lymph nodes) is described in terms of competition between the mechanical processes moving particles, which do not depend on the substances, and those of absorption into the blood, determined solely by the material. A Task Group report will also include models for calculating radiation doses to tissues of the respiratory system following inhalation of α, β and γ emitting particulate and gaseous radionuclides. (author)

  4. ATP-Binding Cassette (ABC) Transporters of the Human Respiratory Tract Pathogen, Moraxella catarrhalis: Role in Virulence.

    Science.gov (United States)

    Murphy, Timothy F; Brauer, Aimee L; Johnson, Antoinette; Kirkham, Charmaine

    2016-01-01

    Moraxella catarrhalis is a human respiratory tract pathogen that causes otitis media (middle ear infections) in children and respiratory tract infections in adults with chronic obstructive pulmonary disease. In view of the huge global burden of disease caused by M. catarrhalis, the development of vaccines to prevent these infections and better approaches to treatment have become priorities. In previous work, we used a genome mining approach that identified three substrate binding proteins (SBPs) of ATP-binding cassette (ABC) transporters as promising candidate vaccine antigens. In the present study, we performed a comprehensive assessment of 19 SBPs of 15 ABC transporter systems in the M. catarrhalis genome by engineering knockout mutants and studying their role in assays that assess mechanisms of infection. The capacity of M. catarrhalis to survive and grow in the nutrient-limited and hostile environment of the human respiratory tract, including intracellular growth, account in part for its virulence. The results show that ABC transporters that mediate uptake of peptides, amino acids, cations and anions play important roles in pathogenesis by enabling M. catarrhalis to 1) grow in nutrient-limited conditions, 2) invade and survive in human respiratory epithelial cells and 3) persist in the lungs in a murine pulmonary clearance model. The knockout mutants of SBPs and ABC transporters showed different patterns of activity in the assay systems, supporting the conclusion that different SBPs and ABC transporters function at different stages in the pathogenesis of infection. These results indicate that ABC transporters are nutritional virulence factors, functioning to enable the survival of M catarrhalis in the diverse microenvironments of the respiratory tract. Based on the role of ABC transporters as virulence factors of M. catarrhalis, these molecules represent potential drug targets to eradicate the organism from the human respiratory tract. PMID:27391026

  5. Assessment of mucous transport in the respiratory tract by radioisotopic techniques

    International Nuclear Information System (INIS)

    One of the body's major defense mechanisms is the mucociliary transport system of the respiratory tract. The function of this system is to remove secretions and trapped inhaled biological and nonbiological particles-including, for example, viruses, bacteria, industrial dusts, and aspirated material-from the lung, thus keeping the airway surface clean and sterile. This cleansing process is accomplished by the action of vigorously beating cilia in the airway epithelium on secretions lining the surface of the airways, which entrap the inhaled foreign materials to be removed from the lung. In this way, normal secretions are moved progressively upward toward the pharynx to be swallowed or, if secretions are produced to excess, expectorated

  6. Intensified microbiological investigations in adult patients admitted to hospital with lower respiratory tract infections

    DEFF Research Database (Denmark)

    Korsgaard, Jens; Rasmussen, TR; Sommer, T;

    2002-01-01

    The objective of this study was to investigate the diagnostic yield of a programme with intensified microbiological investigations in immunocompetent adult patients with lower respiratory tract infections (LRTI). Patients in the study group were included prospectively and consecutively from...... lavage (BAL). Only 7% in the historic control group were discharged with an aetiological diagnosis of their infections; while the diagnostic yield in the study group increased to 51% of patients. In the study group the presence of new infiltrates on chest X-ray increased the detection...... of a microbiological aetiology from 37% with no infiltrates to 62% with infiltrates and recent antibiotic therapy reduced the detection of a microbiological cause of infection from 61% in 36 patients who had not received antibiotic therapy to 39% in 31 patients who had received recent antibiotic therapy prior...

  7. Effects of air pollution on daily clinic visits for lower respiratory tract illness.

    Science.gov (United States)

    Hwang, Jing-Shiang; Chan, Chang-Chuan

    2002-01-01

    The authors used data obtained from clinic records and environmental monitoring stations in Taiwan during 1998 to estimate the association between air pollution and daily numbers of clinic visits for lower respiratory tract illness. A small-area design and hierarchical modeling were used for the analysis. Rates of daily clinic visits were associated with current-day concentrations of nitrogen dioxide, carbon monoxide, sulfur dioxide, and particulate matter less than or equal to 10 microm in aerometric diameter. People over age 65 years were the most susceptible, and estimated pollution effects decreased as the exposure time lag increased. The analysis also suggested that several community-specific variables, such as a community's population density and yearly air pollution levels, modified the effects of air pollution. In this paper, the authors demonstrate the use of a small-area design to assess acute health effects of air pollution.

  8. [Cefditoren pivoxil: A new oral cephalosporin for skin, soft tissue and respiratory tract infections].

    Science.gov (United States)

    Hernández-Martin, J; Romá, E; Salavert, M; Doménech, L; Poveda, J L

    2006-09-01

    Cefditoren pivoxil, a new-third generation cephalosporin antibiotic that has recently been granted approval in Spain, shows important activity over a large part of the pathogens causing skin, soft tissue and respiratory tract infections, including Gram-negative and Gram-positive bacteria. Cefditoren has also been shown to be stable against hydrolysis by many common beta-lactamases. Data from in vitro studies and clinical trials show this antibiotic as an oral formulation with an intrinsic activity against Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pneumoniae equivalent to that of other third-generation cephalosporins administered via parenteral, like cefotaxime or ceftriaxone, thereby placing its maximal benefits mainly in the treatment of ambulatory infections. This paper reviews the main characteristics of cefditoren pivoxil (spectrum of activity, chemical structure, mechanism of action, pharmacokinetics, adverse effects and clinical efficacy) and attempts to find its place in current antibiotic therapeutics.

  9. Aetiology and prediction of pneumonia in lower respiratory tract infection in primary care

    DEFF Research Database (Denmark)

    Holm, Anette; Nexoe, Joergen; Bistrup, Lene A;

    2007-01-01

    BACKGROUND: Knowledge of predominant pathogens and their association with outcome are of importance for the management of lower respiratory tract infection (LRTI). As antibiotic therapy is indicated in pneumonia and not in acute bronchitis, a predictor of pneumonia is needed. AIM: To describe...... the aetiology and outcome of LRTI in adults with pneumonic and adults with non-pneumonic LRTI treated in general practice and to identify predictors of radiographic pneumonia. DESIGN OF STUDY: Prospective, observational study. SETTING: Forty-two general practices and an outpatient clinic at the Department....... Primary outcome measure was hospitalisation within 4 weeks. RESULTS: Pneumonia was radiographically verified in 48 of 364 patients (13%). Bacterial infection was seen more often in patients with pneumonia (33% versus 17%, P

  10. Lower respiratory tract infection and rapid expansion of an abdominal aortic aneurysm: a case report

    Directory of Open Access Journals (Sweden)

    Puppala Sapna

    2010-10-01

    Full Text Available Abstract Introduction The rate of abdominal aortic aneurysm expansion is related to multiple factors. There is some evidence that inflammation can accelerate aneurysm expansion. However, the association between pulmonary sepsis and rapid abdominal aortic aneurysm expansion is rarely reported. Case presentation Here we present a case of a rapidly expanding abdominal aortic aneurysm in a 68-year-old Caucasian man with a concomitant lower respiratory tract infection and systemic sepsis requiring intensive monitoring and urgent endovascular intervention. Our patient had an uncomplicated post-operative recovery and a follow-up computed tomography scan at one month demonstrated no evidence of an endoleak. Conclusion This case highlights the potential association between pulmonary sepsis and rapid abdominal aortic aneurysm expansion. In such cases, a policy of frequent monitoring should be adopted to identify those patients requiring definitive management.

  11. The comparison and characterisation of glycolytic mycoplasmas isolated from the respiratory tract of sheep.

    Science.gov (United States)

    Jones, G E; Foggie, A; Mould, D L; Livitt, S

    1976-02-01

    Nine strains of glycolytic mycoplasmas isolated from the respiratory tract of apparently healthy sheep, pneumonic sheep and sheep with pulmonary adenomatosis (SPA) were compared with a Queensland strain (Y98) of Mycoplasma ovipneumoniae. All strains were very similar in their reactions in 14 biochemical tests and in their sensitivities to optochin, digitonin, sodium polyanethol sulphonate, and 11 antibiotics. Polyacrylamide-gel electrophoresis and serological cross-reactions by the agar-gel double diffusion, metabolic inhibition (MI) and growht-inhibition (GI) tests also showed that all strains could be classified as M. ovipneumoniae. The MI and GI tests, however, showed considerable intraspecific differences among strains, with apparent polarisation of SPA strains and non-SPA strains at opposite ends of the antigenic spectrum. Two representative strains were tested by the MI test against antisera to 39 mycoplasma species or serogroups, with negative results.

  12. Pteropine orthoreovirus infection among out-patients with acute upper respiratory tract infection in Malaysia.

    Science.gov (United States)

    Voon, Kenny; Tan, Yeh Fong; Leong, Pooi Pooi; Teng, Cheong Lieng; Gunnasekaran, Rajasekaran; Ujang, Kamsiah; Chua, Kaw Bing; Wang, Lin-Fa

    2015-12-01

    This study aims to assess the incidence rate of Pteropine orthreovirus (PRV) infection in patients with acute upper respiratory tract infection (URTI) in a suburban setting in Malaysia, where bats are known to be present in the neighborhood. Using molecular detection of PRVs directly from oropharyngeal swabs, our study demonstrates that PRV is among one of the common causative agents of acute URTI with cough and sore throat as the commonest presenting clinical features. Phylogenetic analysis on partial major outer and inner capsid proteins shows that these PRV strains are closely related to Melaka and Kampar viruses previously isolated in Malaysia. Further study is required to determine the public health significance of PRV infection in Southeast Asia, especially in cases where co-infection with other pathogens may potentially lead to different clinical outcomes. PMID:26106066

  13. Compliance with Recommendations on Outpatient Antibiotic Prescribing for Respiratory Tract Infections

    DEFF Research Database (Denmark)

    Malo, Sara; Bjerrum, Lars; Feja, Cristina;

    2015-01-01

    Inappropriate antibiotic use in primary care, such as in Respiratory Tract Infections (RTIs), is an important cause of bacterial resistance. This study aimed at describing the current pattern of outpatient antibiotic use in acute RTIs in Spain and evaluating adherence to national recommendations......, and adherence to recommendations for antibiotic prescribing was assessed. One third of patients with a RTI were prescribed an antibiotic, with young adults (aged 15-64 years) being the most treated. High prescribing rates were observed in patients with acute otitis, sinusitis and acute tonsillitis (about 70......%), whereas low rates were found in acute bronchitis (50%) and non-specific upper RTIs (24%) episodes. A high prescription of broad-spectrum agents and antibiotics not recommended as first choice was observed. In accordance with Spanish guidelines, there exists a potential over-prescribing of antibiotics...

  14. Antibiotic prescriptions for suspected respiratory tract infection in primary care in South America

    DEFF Research Database (Denmark)

    Cordoba, Gloria; Caballero, Lidia; Sandholdt, Håkon;

    2016-01-01

    OBJECTIVES: To describe and compare antibiotic prescribing patterns for primary care patients with respiratory tract infections (RTIs) in four South American countries. METHODS: This was a prospective observational study. General practitioners (GPs) from Argentina, Bolivia, Paraguay and Uruguay......%) of these received an antibiotic prescription. There was a wide variation across countries in the use and selection of antibiotics. For example, 94% of patients with acute bronchitis were prescribed antibiotics in Bolivia, while in Uruguay only 21% received antibiotics. Amoxicillin was the most commonly prescribed...... antibiotic across countries, but prescription rates varied between 45% in Bolivia and 69% in Uruguay. Compared with the overall mean prescribing rate, and after adjusting for clinical presentation and demographics, prescribing of antibiotics varied by a factor of 6, the OR ranging from 0.37 (95% CI = 0...

  15. Antibiotic prescriptions for suspected respiratory tract infection in primary care in South America

    DEFF Research Database (Denmark)

    Cordoba Currea, Gloria Cristina

    2016-01-01

    Objective: To describe and compare antibiotic prescribing patterns for primary care patients with respiratory tract infections (RTIs) in four South American countries. Methods: Prospective observational study. General practitioners (GPs) from Argentina, Bolivia, Paraguay and Uruguay registered data...... an antibiotic prescription. There was a wide variation across countries in the use and selection of antibiotics. For example, 94% of patients with acute bronchitis were prescribed antibiotics in Bolivia, while in Uruguay only 21% received antibiotics. Amoxicillin was the most commonly prescribed antibiotic...... across countries, but prescription rates varied between 45% in Bolivia and 69% in Uruguay. Compared with the overall mean prescribing rate and after adjusting for clinical presentation and demographics, prescribing of antibiotics varied by a factor of 6, the odds ratio ranging from 0.37 (95% CI 0.21; 0...

  16. Behavioral Effects of Upper Respiratory Tract Illnesses: A Consideration of Possible Underlying Cognitive Mechanisms

    Directory of Open Access Journals (Sweden)

    Andrew P. Smith

    2012-03-01

    Full Text Available Previous research has shown that both experimentally induced upper respiratory tract illnesses (URTIs and naturally occurring URTIs influence mood and performance. The present study investigated possible cognitive mechanisms underlying the URTI-performance changes. Those who developed a cold (N = 47 had significantly faster, but less accurate, performance than those who remained healthy (N = 54. Illness had no effect on manipulations designed to influence encoding, response organisation (stimulus-response compatilibility or response preparation. Similarly, there was no evidence that different components of working memory were impaired. Overall, the present research confirms that URTIs can have an effect on performance efficiency. Further research is required to identify the physiological and behavioral mechanisms underlying these effects.

  17. Morphologic observations on respiratory tracts of chickens after hatchery infectious bronchitis vaccination and formaldehyde fumigation.

    Science.gov (United States)

    Di Matteo, A M; Soñez, M C; Plano, C M; von Lawzewitsch, I

    2000-01-01

    The histologic changes in the respiratory tracts of chickens were evaluated after hatchery fumigation with 40% formaldehyde vapors and vaccination against infectious bronchitis virus with live attenuated vaccine (Massachusetts serotype). One-day-old chickens were housed in four isolation units in controlled environmental conditions, fed and watered ad libitum, and separated into four groups: 1) fumigated and vaccinated birds (FV group); 2) nonfumigated and vaccinated birds (NFV group); 3) fumigated and nonvaccinated birds (FNV group); and 4) control group (C group). All birds were tested to be free from Mycoplasma gallisepticum and Mycoplasma synoviae. After necropsy on the first, eighth, and twenty-sixth days after birth, samples from tracheal upper portion and lungs were conventionally processed for light, scanning, and transmission electron microscopy. Tissue response was monitored by microscopic examination of trachea and lung. On the first day of observation, fumigated and vaccinated birds (FV group) showed extensively damaged tracheal epithelium with exfoliated areas and some active glands with electrodense granules, and in the lung, the primary bronchi epithelium had disorganized cilia and abundant lymphocytes, with emphysematous areas in tertiary bronchus. On day 8 after vaccination, cubical and cylindrical tracheal cell proliferation was observed, and on day 26, ciliated columnar epithelium was almost regenerated with heterophil corion infiltration, and hyaline cartilage nodules appeared in parabronchi. The nonfumigated and vaccinated birds (NFV) revealed less injury on the epithelial surface and a more rapid response to epithelial regeneration than the in only fumigated animals (FNV). The control group did not show remarkable morphologic changes. Postvaccinal and fumigation effects on the upper respiratory tract were temporary, whereas in lungs, increased emphysema, cartilage nodules in the interchange zone, and general lymphocyte infiltration had caused

  18. Aminomethyl spectinomycins as therapeutics for drug-resistant respiratory tract and sexually transmitted bacterial infections.

    Science.gov (United States)

    Bruhn, David F; Waidyarachchi, Samanthi L; Madhura, Dora B; Shcherbakov, Dimitri; Zheng, Zhong; Liu, Jiuyu; Abdelrahman, Yasser M; Singh, Aman P; Duscha, Stefan; Rathi, Chetan; Lee, Robin B; Belland, Robert J; Meibohm, Bernd; Rosch, Jason W; Böttger, Erik C; Lee, Richard E

    2015-05-20

    The antibiotic spectinomycin is a potent inhibitor of bacterial protein synthesis with a unique mechanism of action and an excellent safety index, but it lacks antibacterial activity against most clinically important pathogens. A series of N-benzyl-substituted 3'-(R)-3'-aminomethyl-3'-hydroxy spectinomycins was developed on the basis of a computational analysis of the aminomethyl spectinomycin binding site and structure-guided synthesis. These compounds had ribosomal inhibition values comparable to spectinomycin but showed increased potency against the common respiratory tract pathogens Streptococcus pneumoniae, Haemophilus influenzae, Legionella pneumophila, and Moraxella catarrhalis, as well as the sexually transmitted bacteria Neisseria gonorrhoeae and Chlamydia trachomatis. Non-ribosome-binding 3'-(S) isomers of the lead compounds demonstrated weak inhibitory activity in in vitro protein translation assays and poor antibacterial activity, indicating that the antibacterial activity of the series remains on target against the ribosome. Compounds also demonstrated no mammalian cytotoxicity, improved microsomal stability, and favorable pharmacokinetic properties in rats. The lead compound from the series exhibited excellent chemical stability superior to spectinomycin; no interaction with a panel of human receptors and drug metabolism enzymes, suggesting low potential for adverse reactions or drug-drug interactions in vivo; activity in vitro against a panel of penicillin-, macrolide-, and cephalosporin-resistant S. pneumoniae clinical isolates; and the ability to cure mice of fatal pneumococcal pneumonia and sepsis at a dose of 5 mg/kg. Together, these studies indicate that N-benzyl aminomethyl spectinomycins are suitable for further development to treat drug-resistant respiratory tract and sexually transmitted bacterial infections. PMID:25995221

  19. Clinical Observation on 46 Cases of Infantile Repeated Respiratory Tract Infection Treated by Mild-Moxibustion over Acupoints on Back

    Institute of Scientific and Technical Information of China (English)

    龙训; 常奇; 寿琼

    2001-01-01

    @@Repeated respiratory tract infection is a frequently-occurring disease during childhood. At present, western medicine doctors generally adopt anti-infectives and immunomodulators to treat the disease, while traditional Chinese medicine doctors mainly administer decoction of Chinese herbs. The authors treated 46 cases of repeated respiratory tract infection from March 1990 to April 1996 by applying mild-moxibustion over points on the back with satisfactory therapeutic results. A report follows. Clinical Data All the 86 cases were outpatients in our hospital with duration of common cold for over 10 days and characterized by relapse of respiratory tract infection. There were over 7-time relapse of respiratory tract infection on each case within a year. Eighty-six cases were randomly divided into treatment group (46 cases) and control group (40 cases). Of the 46 cases in the treatment group, 22 were boys and 24 girls. 17 cases (36.9%) were 6 months to 4 years old, 18 (39.1%) 4 to 6 years, and 11 (23.9%) 6 to 12 years. Among the 40 cases in the control group, 19 cases were boys and 21 girls.

  20. Determinants of prescribing of second-choice antibiotics for upper and lower respiratory tract in Dutch general practice.

    NARCIS (Netherlands)

    Duijn, H.J. van; Kuyvenhoven, M.M.; Schellevis, F.; Verheij, T.J.M.

    2005-01-01

    Objectives: The aim of this study was to assess the association between general practitioners' (GPs') characteristics and the volume of second-choice antibiotics for acute respiratory tract (RT) episodes by GPs. Methods: Morbidity and antibiotic prescription data originated from the Second Dutch Nat

  1. Quality indicators for diagnosis and treatment of respiratory tract infections in general practice

    DEFF Research Database (Denmark)

    Plejdrup, Malene; Bjerrum, Lars; Gahrn-Hansen, Bente;

    Objective: To develop a set of quality indicators focusing on the diagnosis and treatment of respiratory tract infections in general practice.  Material and methods: A modified 2-round Delphi study was conducted from April to July 2008. A panel of 27 experts (13 countries) comprising mainly general...

  2. The use of household cleaning products during pregnancy and lower respiratory tract infections and wheezing during early life.

    NARCIS (Netherlands)

    Casas, L.; Zock, J.P.; Carsin, A.E.; Fernández-Somoano, A.; Esplugues, A.; Santa-Marina, L.; Tardón, A.; Ballester, F.; Basterrechea, M.; Sunyer, J.

    2013-01-01

    To evaluate the effects of household use of cleaning products during pregnancy on infant wheezing and lower respiratory tract infections (LRTI). In four prospective Spanish birth cohorts (n = 2,292), pregnant women reported the use of household cleaning products. When infants were 12-18 months old,

  3. Matrix metalloproteinases (MMPs) and tissue inhibitors of MMPs in the respiratory tract: Potential implications in asthma and other lung diseases

    OpenAIRE

    Guéders, Maud; Foidart, Jean-Michel; Noël, Agnès; Cataldo, Didier

    2006-01-01

    In healthy lung, Matrix Metalloproteinases (MMPs) and their physiological inhibitors, tissue inhibitors of matrix metalloproteinases (TIMPs), are produced in the respiratory tract by a panel of different structural cells. These activities are mandatory for many physiological processes including development, wound healing and cell trafficking. Deregulation of proteolytic-antiproteolytic network and inappropriate secretion of various MMPs by stimulated structural or inflammatory cells is though...

  4. Phenotypic and genetic characterization of NAD-dependent Pasteurellaceae from the respiratory tract of pigs and their possible pathogenetic importance

    DEFF Research Database (Denmark)

    Kielstein, P.; Wuthe, H.H.; Angen, Øystein;

    2001-01-01

    . In the present study, 107 of these NAD-dependent isolates from the porcine respiratory tract, primarily from lungs with pathological changes, were investigated. On the basis of phenotypic criteria, such as haemolysis, urease, catalase, and indole formation as well as other fermentative activities, 50...

  5. College Students, Shared Decision Making, and the Appropriate Use of Antibiotics for Respiratory Tract Infections: A Systematic Literature Review

    Science.gov (United States)

    Blyer, Kristina; Hulton, Linda

    2016-01-01

    Objective: This systematic review examines shared decision making to promote the appropriate use of antibiotics for college students with respiratory tract infections. Participants/Methods: CINAL, Cochrane, PubMed, EBSCO, and PsycNET were searched in October 2014 using the following criteria: English language, human subjects, peer-reviewed, shared…

  6. The upper respiratory tract microbiome of hospitalised patients with community-acquired pneumonia of unknown aetiology: a pilot study

    Directory of Open Access Journals (Sweden)

    Timothy L Wiemken

    2015-01-01

    Full Text Available   The composition of the upper respiratory tract microbiome may play an important role in the development of lower respiratory tract infections. Here, we characterised the microbiome of the nasopharynx and oropharynx of hospitalised patients with community-acquired pneumonia (CAP with unknown aetiology in an attempt to obtain insight into the aetiology of CAP. A random sample of 10 patients hospitalised with CAP previously enrolled in a separate clinical trial (ClinicalTrials.gov registry, Study ID: NCT01248715 in which a complete microbiological workup was not able to define an aetiology were analysed in this pilot study. This larger trial (n = 1,221 enrolled patients from 9 adult hospitals in Louisville, Kentucky, USA. Nasopharyngeal and oropharyngeal swabs were obtained for metagenomic analysis. Polymerase chain reaction (PCR for Streptococcus pneumoniae was performed in all patients. One patient had a distinct nasophararyngeal microbiome consisting largely of Haemophilus influenzae. This was the only patient with a negative PCR for S. pneumoniae in both nasophararyngeal and oropharyngeal specimens. Overall, substantial differences were found between nasophararyngeal and oropharyngeal microbiomes. The upper respiratory tract microbiome of only one patient suggested H. influenzae as a probable aetiology of CAP. Although this was a pilot study of only 10 patients, the presence of S. pneumoniae in the upper respiratory tract of the other 9 patients warrants further investigation.

  7. Intervention with educational outreach at large scale to reduce antibiotics for respiratory tract infections : a controlled before and after study

    NARCIS (Netherlands)

    Smeets, H. M.; Kuyvenhoven, M. M.; Akkerman, A. E.; Welschen, I.; van Essen, G. A.; Verheij, T. J. M.; Schouten, G.P.

    2009-01-01

    Background. A multiple intervention targeted to reduce antibiotic prescribing with an educational outreach programme had proven to be effective in a randomized controlled trial in 12 peer review groups, demonstrating 12% less prescriptions for respiratory tract infections. Objective. To assess the e

  8. Serologic study on the outbreak of acute upper respiratory tract Infections caused by adenovirus 3

    Institute of Scientific and Technical Information of China (English)

    JIANG Lufang; JU Liwen; JIANG Renjie; LIN Yuzun; ZHOU Liandi; YU Shunzhang; JIANG Qingwu

    2007-01-01

    From April to June,2004,an outbreak of acute upper respiratory tract infections(AURTI)occurred in the north area of Jiangsu Province,China.Twenty throat swabs were collected with 13 of them presenting an adenovirus (Ad)-like cytopathogenic effect on HEp-2.These were verified as Ad by the electron microscope,direct immunofluorescence assay and Ad primer-mediated PCR.Moreover,they were identified as adenovirus type 3(Ad3)by type-specific PCR and sequencing of the amplification products.Subsequent serologic studies were carried out to finally diagnose and document the outbreak.The neutralization test of paired serum of six in nine cases show obviously increased antibodies titers.The positive rate of IgM,IgG and recovery phase neutralization antibodies of the cases were 3.7%,44.4%and 59.5%respectively while those of the controls were 0%,8.3%and 33.3%respectively.The Pvalues of Chi-Square were 0.510,0.018 and 0.226 respectively.The concordance between IgG detected by ELISA and neutralization antibodies detected by the neutralization test was 61.4%and the Pvalue of Kappa was 0.070.By the serologic study,we can definitively diagnose that this outbreak of acute respiratory infections was caused by Adenovirus 3.

  9. The respiratory tract deposition model proposed by the ICRP Task Group

    International Nuclear Information System (INIS)

    The Task Group has developed a new model of the deposition of inhaled aerosols in each anatomical region of the respiratory tract. The model is used to evaluate the fraction of airborne activity that is deposited in respiratory regions having distinct retention characteristics and clearance pathways, and/or tissue sensitivity: the extrathoracic airways of the naso- and oropharynx and larynx, the bronchi, the bronchioles, and the alveolated airways of the lung. Drawn from experimental data on total and regional deposition in human subjects, the model is based on extrapolation of these data by means of a detailed theoretical model of aerosol transport and deposition within the lung. The Task Group model applies to all practical conditions, and for aerosol particles and vapours from atomic size up to very coarse aerosols with an activity median aerodynamic diameter of 100 μm. The model is designed to predict regional deposition in different subjects, including adults of either sex, children of various ages, and infants, and also to account for anatomical differences among Caucasian and non-Caucasian subjects. The Task Group model represents aerosol inhalability and regional deposition in different subjects by algebraic expressions of aerosol size, breathing rates, standard lung volumes, and scaling factors for airway dimensions. It is emphasised that the current version of the model described here is still provisional. (author)

  10. The respiratory tract deposition model proposed by the ICRP Task Group

    Energy Technology Data Exchange (ETDEWEB)

    James, A.C.; Briant, J.K. (Pacific Northwest Lab., Richland, WA (USA)); Stahlhofen, W.; Rudolf, G. (Gesellschaft fuer Strahlen- und Umweltforschung mbH Muenchen, Frankfurt am Main (Germany, F.R.). Abt. fuer Biophysikalische Strahlenforschung); Egan, M.J.; Nixon, W. (AEA Safety and Reliability, Culcheth (UK)); Gehr, P. (Bern Univ. (Switzerland). Anatomisches Inst.)

    1990-11-01

    The Task Group has developed a new model of the deposition of inhaled aerosols in each anatomical region of the respiratory tract. The model is used to evaluate the fraction of airborne activity that is deposited in respiratory regions having distinct retention characteristics and clearance pathways: the anterior nares, the extrathoracic airways of the naso- and oropharynx and larynx, the bronchi, the bronchioles, and the alveolated airways of the lung. Drawn from experimental data on total and regional deposition in human subjects, the model is based on extrapolation of these data by means of a detailed theoretical model of aerosol transport and deposition within the lung. The Task Group model applies to all practical conditions, and for aerosol particles and vapors from atomic size up to very coarse aerosols with an activity median aerodynamic diameter of 100 {mu}m. The model is designed to predict regional deposition in different subjects, including adults of either sex, children of various ages, and infants, and also to account for anatomical differences among Caucasian and non-Caucasian subjects. The Task Group model represents aerosol inhalability and regional deposition in different subjects by algebraic expressions of aerosol size, breathing rates, standard lung volumes, and scaling factors for airway dimensions. 35 refs., 13 figs., 2 tabs.

  11. Treatment of Upper Respiratory Tract Infections in Primary Care: A Randomized Study Using Aromatic Herbs

    Directory of Open Access Journals (Sweden)

    Eran Ben-Arye

    2011-01-01

    Full Text Available This study is a prospective randomized double-blind controlled trial whose aim was to investigate the clinical effects of aromatic essential oils in patients with upper respiratory tract infections. The trial was conducted in six primary care clinics in northern Israel. A spray containing aromatic essential oils of five plants (Eucalyptus citriodora, Eucalyptus globulus, Mentha piperita, Origanum syriacum, and Rosmarinus officinalisas applied 5 times a day for 3 days and compared with a placebo spray. The main outcome measure was patient assessment of the change in severity of the most debilitating symptom (sore throat, hoarseness or cough. Sixty patients participated in the study (26 in the study group and 34 in the control group. Intention-to-treat analysis showed that 20 minutes following the spray use, participants in the study group reported a greater improvement in symptom severity compared to participants in the placebo group (=.019. There was no difference in symptom severity between the two groups after 3 days of treatment (=.042. In conclusion, spray application of five aromatic plants reported in this study brings about significant and immediate improvement in symptoms of upper respiratory ailment. This effect is not significant after 3 days of treatment.

  12. Impacts of upper respiratory tract disease on olfactory behavior of the Mojave desert tortoise

    Science.gov (United States)

    Germano, Jennifer; Van Zerr, Vanessa E.; Esque, Todd C.; Nussear, Ken E.; Lamberski, Nadine

    2014-01-01

    Upper respiratory tract disease (URTD) caused by Mycoplasma agassizii is considered a threat to desert tortoise populations that should be addressed as part of the recovery of the species. Clinical signs can be intermittent and include serous or mucoid nasal discharge and respiratory difficulty when nares are occluded. This nasal congestion may result in a loss of the olfactory sense. Turtles are known to use olfaction to identify food items, predators, and conspecifics; therefore, it is likely that URTD affects not only their physical well-being but also their behavior and ability to perform necessary functions in the wild. To determine more specifically the impact nasal discharge might have on free-ranging tortoises (Gopherus agassizii), we compared the responses of tortoises with and without nasal discharge and both positive and negative for M. agassizii antibodies to a visually hidden olfactory food stimulus and an empty control. We found that nasal discharge did reduce sense of smell and hence the ability to locate food. Our study also showed that moderate chronic nasal discharge in the absence of other clinical signs did not affect appetite in desert tortoises.

  13. Treatment of upper respiratory tract infections in primary care: a randomized study using aromatic herbs.

    Science.gov (United States)

    Ben-Arye, Eran; Dudai, Nativ; Eini, Anat; Torem, Moshe; Schiff, Elad; Rakover, Yoseph

    2011-01-01

    This study is a prospective randomized double-blind controlled trial whose aim was to investigate the clinical effects of aromatic essential oils in patients with upper respiratory tract infections. The trial was conducted in six primary care clinics in northern Israel. A spray containing aromatic essential oils of five plants (Eucalyptus citriodora, Eucalyptus globulus, Mentha piperita, Origanum syriacum, and Rosmarinus officinalis) as applied 5 times a day for 3 days and compared with a placebo spray. The main outcome measure was patient assessment of the change in severity of the most debilitating symptom (sore throat, hoarseness or cough). Sixty patients participated in the study (26 in the study group and 34 in the control group). Intention-to-treat analysis showed that 20 minutes following the spray use, participants in the study group reported a greater improvement in symptom severity compared to participants in the placebo group (P = .019). There was no difference in symptom severity between the two groups after 3 days of treatment (P = .042). In conclusion, spray application of five aromatic plants reported in this study brings about significant and immediate improvement in symptoms of upper respiratory ailment. This effect is not significant after 3 days of treatment. PMID:21052500

  14. Treatment of Upper Respiratory Tract Infections in Primary Care: A Randomized Study Using Aromatic Herbs

    Science.gov (United States)

    Ben-Arye, Eran; Dudai, Nativ; Eini, Anat; Torem, Moshe; Schiff, Elad; Rakover, Yoseph

    2011-01-01

    This study is a prospective randomized double-blind controlled trial whose aim was to investigate the clinical effects of aromatic essential oils in patients with upper respiratory tract infections. The trial was conducted in six primary care clinics in northern Israel. A spray containing aromatic essential oils of five plants (Eucalyptus citriodora, Eucalyptus globulus, Mentha piperita, Origanum syriacum, and Rosmarinus officinalis) as applied 5 times a day for 3 days and compared with a placebo spray. The main outcome measure was patient assessment of the change in severity of the most debilitating symptom (sore throat, hoarseness or cough). Sixty patients participated in the study (26 in the study group and 34 in the control group). Intention-to-treat analysis showed that 20 minutes following the spray use, participants in the study group reported a greater improvement in symptom severity compared to participants in the placebo group (P = .019). There was no difference in symptom severity between the two groups after 3 days of treatment (P = .042). In conclusion, spray application of five aromatic plants reported in this study brings about significant and immediate improvement in symptoms of upper respiratory ailment. This effect is not significant after 3 days of treatment. PMID:21052500

  15. Procalcitonin-guided antibiotic treatment of respiratory tract infections in a primary care setting

    DEFF Research Database (Denmark)

    Aabenhus, Rune; Jensen, Jens Ulrik Stæhr

    2011-01-01

    Clinical signs of infection do not allow for correct identification of bacterial and viral aetiology in acute respiratory infections. A valid tool to assist the clinician in identifying patients who will benefit from antibiotic therapy, as well as patients with a potentially serious infection, co...... are likely to benefit from antibiotic treatment and to rule out serious infections, and comments on further research to determine a future role for procalcitonin in primary care......., could greatly improve patient care and limit excessive antibiotic prescriptions. Procalcitonin is a new marker of suspected bacterial infection that has shown promise in guiding antibiotic therapy in acute respiratory tract infections in hospitals without compromising patient safety. Procalcitonin...... concentrations in primary care are low and can be used primarily to rule out serious infection. However, procalcitonin measurement should not be used as the sole basis for clinical decisions; clinical skills are prerequisites for the correct use of this new tool in practice. At present there is no point-of-care...

  16. The respiratory tract deposition model proposed by the ICRP Task Group

    International Nuclear Information System (INIS)

    The Task Group has developed a new model of the deposition of inhaled aerosols in each anatomical region of the respiratory tract. The model is used to evaluate the fraction of airborne activity that is deposited in respiratory regions having distinct retention characteristics and clearance pathways: the anterior nares, the extrathoracic airways of the naso- and oropharynx and larynx, the bronchi, the bronchioles, and the alveolated airways of the lung. Drawn from experimental data on total and regional deposition in human subjects, the model is based on extrapolation of these data by means of a detailed theoretical model of aerosol transport and deposition within the lung. The Task Group model applies to all practical conditions, and for aerosol particles and vapors from atomic size up to very coarse aerosols with an activity median aerodynamic diameter of 100 μm. The model is designed to predict regional deposition in different subjects, including adults of either sex, children of various ages, and infants, and also to account for anatomical differences among Caucasian and non-Caucasian subjects. The Task Group model represents aerosol inhalability and regional deposition in different subjects by algebraic expressions of aerosol size, breathing rates, standard lung volumes, and scaling factors for airway dimensions. 35 refs., 13 figs., 2 tabs

  17. An analysis of the pharmacological management of respiratory tract infections in pediatric in-patients at a tertiary care teaching hospital

    Directory of Open Access Journals (Sweden)

    Geetha S Iyer

    2013-07-01

    Full Text Available Objectives: To analyze the pharmacological management of respiratory tract infections in hospitalized pediatric patients. The economic burden of the disease and the adverse drug reactions occurring during the course of treatment have also been studied. Materials and Methods: It was a prospective, longitudinal, and observational study, carried out over a period of one-and-a-half years. The patients, aged one month to twelve years, diagnosed with respiratory tract infections (RTI, as confirmed by a pediatrician, were enrolled. Modified Kunin's criteria along with the guidelines set by the Indian Academy of Pediatrics (IAP were followed for assessing the appropriateness of the antibacterials prescribed. The adverse drug reactions occurring during the course of the treatment were noted and the economic burden of the disease was calculated as direct and indirect costs. Results: A total of 201 patients were enrolled, of whom 46% were in the age group of one month to one year. The most common diagnosis was pneumonia (76%. The number of drugs and antibacterials prescribed per patient were 4.88 ± 1.57 and 1.85 ± 0.86, respectively. Antibacterials (37.7%, intravenous fluids (17.2%, respiratory medicines (16.6%, and analgesic/antipyretics (16.5% were the common drug groups prescribed. Among the antibacterials, amoxicillin with clavulanic acid (47% and cefotaxime (22% were frequently prescribed. Appropriate antibacterial therapy was given in 42% of the cases. Salbutamol and a combination of Levosalbutamol and Ipratropium Bromide were the commonly prescribed respiratory medicines. Three adverse drug reactions (ADRs were observed in indoor patients, all due to antibacterials. The economic burden of the disease was calculated to be Rs. 4925.14 or US$ 109.9 per patient. Conclusion: An overuse of antibacterials and respiratory medicines was seen in the study. Emphasis on proper diagnosis and treatment, education and availability of locally effective guidelines

  18. Some viral and bacterial respiratory tract infections of dairy cattle during the summer season

    Directory of Open Access Journals (Sweden)

    Kale M.

    2013-01-01

    Full Text Available In this research, dairy cattle with respiratory system problems that were brought to a private slaughterhouse in Burdur province were investigated for viral and bacterial infections present in the summer season. The blood samples were collected from 56 animals. The samples were tested for antibodies against bovine herpesvirus 1 (BoHV-1, bovine viral diarrhea virus (BVDV, bovine respiratory syncytial virus (BRSV, bovine parainfluenza virus 3 (BPIV-3 and bovine adenovirus 3 (BAV-3 by ELISA. Bacteriological cultivation was carried out from lung samples taken after cutting the same animals. The seropositivity rates which were determined for 5 viruses in cattle (BoHV- 1, BVDV, BRSV, BPIV-3 and BAV-3 were 7.14%, 50%, 94.64%, 94.64% and 82.14% respectively. The presence of antibodies against the viruses was as follows; 5.36% of cattle had antibodies against only one virus, 14.29% against two, 30.36% against three, 44.64% against four and 5.36% against five viruses. A total of 36 bacterial agents were isolated from 30 out of 56 lung samples. From the lung samples, only one bacterium was isolated from 39.3% (22/56 samples, and more than one bacterium from 14.3% (8/56. Escherichia coli, Staphylococcus aureus and Streptococcus spp. were detected as the most often isolated agents. Compared to bacteria, the rates of viral infections associated with Escherichia coli (BRSV+BPIV-3+BAV- 3+Escherichia coli; 8.92% and BRSV+BPIV-3+Escherichia coli; 5.35% were higher. As a consequence, it was thought that primary agents which were the viruses and bacteria may have attended as secondary factors in respiratory tract infections of dairy cattle.

  19. Prevalence of Human Papillomavirus (HPV in upper respiratory tract mucosa in a group of pre-school children

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    Jaroslaw Szydłowski

    2014-11-01

    Full Text Available [b]introduction[/b]. Human Papillomavirus (HPV is a group of DNA viruses which is an etiological factor of many benign and malignant diseases of the upper respiratory tract mucosa, female genital tract and the skin. HPV infection is considered a sexually-transmitted infection, but can also be transmitted by non-sexual routes, including perinatal vertical transmission, physical contact, iatrogenic infection and autoinoculation. Recurrent Respiratory Papillomatosis (RRP in children is connected with HPV infection transmitted vertically from mother to child during the passage of the foetus through an infected birth canal. [b]objective. [/b]The aim of this study was to establish the level of Human Papillomaviruses carrier state in upper respiratory tract mucosa in healthy pre-school children, and to identify potential risk factors for HPV infection. [b]materials and method[/b]. After obtaining consent from their parents, 97 pre-school children were examined – 51 girls and 46 boys between the ages of 3 – 5 years; average age – 4 years and 5 months. 68 children were urban dwellers and 29 came from a rural environment. A questionnaire with detailed history was taken including parents’ and child`s personal data, as well as perinatal risk factors in pregnancy. Socio-demographic information was also obtained, including the standard of living, and chosen environmental factors. Routine ENT examination was performed. Exfoliated oral squamous cells were collected from swabs and analysed for the presence of DNA papillomaviruses by polymerase chain reaction. [b]results.[/b] The presence of HPV in the respiratory tract in children was detected in 19.6% cases. ‘High oncogenic potential’ HPVs, such as HPV-16 and HPV-18, were not observed in squamous cell mucosa of the respiratory tract in the children. No significant differences were observed between the HPV carrier state in urban and rural inhabitants.

  20. Silicone Modeling of the Interior Spaces of Hollow Organs: Use in Dog and Manatee Respiratory Tract and in a Beef Heart

    OpenAIRE

    Charles J. Grossman; Richard Hamilton; Lisa A. Close-Jacob; Martine D. Wit; Jeffery Werwa

    2011-01-01

    Problem statement: The mechanism, by which the Florida manatee (Trichechus manatus latirostris) vocalizes, remains unknown because the manatee larynx does not contain true vocal cords. Since sound can be generated when air passes through a narrow respiratory structure we needed to visualize the internal anatomy of manatee respiratory tract to locate any candidate regions for study. Approach: To visualize the internal anatomy of upper and lower manatee respiratory tract we ...

  1. Intravenous moxifloxacin in routine hospital treatment of respiratory tract infections in China: results of a multicenter, noninterventional study

    Directory of Open Access Journals (Sweden)

    Chen R

    2011-04-01

    Full Text Available Rongchang Chen1, Wenjiang Ma2, Xuezhong Yu3, Xinmin Liu4, Jihong Zhu5, Hong Liang6, Xiaomei Wu7, Tao Guo81State Key Laboratory of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, China; 2Respiratory Department, The First Affiliated Hospital of Medical School of Zhejiang University, China; 3Emergency Department, Peking Union Medical College Hospital, China; 4Geriatric Department, Peking University First Hospital, China; 5Emergency Department, Peking University People's Hospital, China; 6Respiratory Department, Huadong Hospital Affiliated to Fudan University, China; 7Respiratory Department, The Second Affiliated Hospital of Harbin Medical University, China; 8Hematology Department, Wuhan Union Hospital, ChinaObjective: To investigate the effectiveness, safety, and tolerability of moxifloxacin (MXF (intravenous [IV] or sequential therapy [IV followed by oral] under daily treatment conditions in a large number of patients with respiratory tract infections.Design: Patients with a diagnosis of respiratory tract infection should be treated with MXF IV and/or tablets 400 mg once daily for a duration at the physician's discretion. For each patient, the physician documented data at an initial visit and at the end of therapy (EOT visit and/or, in the case of sequential therapy, an interim visit when the patient switched to oral treatment.Results: A total of 1953 patients treated with MXF were documented and were valid for an effectiveness and safety evaluation. An improvement was observed in 98.1% (n = 1911/1949 of patients treated with MXF. Recovery was documented in 89.9% (n = 1754/1951 of the patients. At the EOT visit, severity of infection was assessed to be "relieved" or at least "improved" in 96.5% (n = 1873/1940 of the patients. Physicians assessed overall effectiveness as "good" or "very good" in 93.3% (n = 1822/1953 of all patients. The physicians' overall tolerability rating was "very good" or "good" in 93.5% (n

  2. Airflow and Aerosol-Drug Delivery in a CT Scan based Human Respiratory Tract with Tumor using CFD

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    Vivek K.Srivastav

    2014-01-01

    Full Text Available This paper is focused on to study the effect of a tumor present in the respiratory tract (in trachea on airflow pattern and aerosol-drug deposition. A realistic model of human respiratory tract was constructed from spiral computed tomography (CT scan data and a bifocal tumor (Glomus tumor was constructed in the tract. The inspiratory flow characteristics of the realistic human airway models (with and without tumor was numerically solved using the realizable k turbulence model for airflow and Shear Stress Transport (SST k-ω turbulence model for two-phase flow. The velocity (contours and vector plots, wall shear stress and deposition efficiency of aerosol were obtained at different locations to the upstream and downstream region of the bifocal tumor in respiratory tract. The flow pattern shows that the maximum flow disturbance occurs around the tumor and at downstream of the flow. Magnitude and location of maximum wall shear stress in the presence of the tumor helps in identifying the extent and probable location of the wall injury during the normal and heavy breathing conditions. Deposition efficiency of aerosol-drug on tumor location will be useful for designing the efficient targeted drug delivery system.

  3. Distribution patterns of influenza virus receptors and viral attachment patterns in the respiratory and intestinal tracts of seven avian species

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    Costa Taiana

    2012-04-01

    Full Text Available Abstract This study assessed the presence of sialic acid α-2,3 and α-2,6 linked glycan receptors in seven avian species. The respiratory and intestinal tracts of the chicken, common quail, red-legged partridge, turkey, golden pheasant, ostrich, and mallard were tested by means of lectin histochemistry, using the lectins Maackia amurensis agglutinin II and Sambucus nigra agglutinin, which show affinity for α-2,3 and α-2,6 receptors, respectively. Additionally, the pattern of virus attachment (PVA was evaluated with virus histochemistry, using an avian-origin H4N5 virus and a human-origin seasonal H1N1 virus. There was a great variation of receptor distribution among the tissues and avian species studied. Both α-2,3 and α-2,6 receptors were present in the respiratory and intestinal tracts of the chicken, common quail, red-legged partridge, turkey, and golden pheasant. In ostriches, the expression of the receptor was basically restricted to α-2,3 in both the respiratory and intestinal tracts and in mallards the α-2,6 receptors were absent from the intestinal tract. The results obtained with the lectin histochemistry were, in general, in agreement with the PVA. The differential expression and distribution of α-2,3 and α-2,6 receptors among various avian species might reflect a potentially decisive factor in the emergence of new viral strains.

  4. Determining the basic characteristics of aerosols suitable for studies of deposition in the respiratory tract.

    Science.gov (United States)

    Legáth, L; Naus, A; Halík, J

    1988-01-01

    Studies of aerosol particle deposition in the respiratory tract requires experimental inhalation of artificial model aerosols. The paper formulates some of the most important requirements for the properties of such aerosols. Several suitable fractions were prepared as part of a research project dealing with the use of microporous polymers for diagnostic purposes. 5 fractions of the polymer designated G-gel 60 with the particle size as stated by the manufacturer, ranging from 3 to 7 micron were evaluated using a 16-channel particle dispersity analyzer HIAC/ROYCO MT 3210 with the sensor 1200 and operated by a microprocessor, the equipment being coupled to an APPLE IIe computer. G-gel 60 particles introduced into the aerosol were characterized by the parameters CMAD, MMAD and sg both numerically and graphically. The measurement procedure was found to be very sensitive with respect to all fractions in evaluating the subtile differences between different lot numbers of the aerosol. G-gel 60 fractions characterized both numerically and graphically were compared with the known aerosols from paraffin oil and atmospheric air. The equipment MT 3210 enables prompt determination of the percentages of aerosol particles distribution by size class. The authors conclude that the procedure, both in its numerical and graphical versions, is particularly suitable for the diagnosis of aerosol particles deposition in the respiratory tract, offering a new application for HIAC/ROYCO in the field of medicine. In evaluating atmospheric aerosol in exhaled air, the number of particles was found to be below that in inhaled air, the difference being dependent on the choice of investigation methods. Percentual distribution of deposited particles following one minute ventilation proved to be at its maximum, as regards atmospheric aerosol, in the 0.30-0.50 micron range. The deposition curve was similar to already published curves, being characterized by an S-shaped pattern with maximum deposition

  5. Human respiratory tract model for radiological protection - a revision of the ICRP dosimetric model for the respiratory system

    International Nuclear Information System (INIS)

    The need for standardized values for various parameters describing the inhalation, deposition, retention and translocation of airborne radionuclides in workers for the purpose of deriving exposure limits was addressed in Tripartite Conferences on Radiation Protection from 1949 to 1953. At conferences held at Chalk River, Canada, September 29-30, 1949, and at Arden House in Harriman, New York, March 30-April 1, 1953, agreement was reached on a model for calculating radiation doses resulting from inhalation of radioactive aerosols when specific data were not available. This model was used in the 1959 report of the ICRP Committee II on Permissible Dose for Internal Radiation (ICRP 1959). This simple model of deposition, retention and clearance of inhaled aerosols was the basis for the limits for exposure to radionuclides for calculations of doses to exposed individuals for both assessment and predictive purposes until ICRP Publication 30 appeared in 1979, using much more sophisticated dosimetric and metabolic models (ICRP 1979). The model made possible consideration of both particle size of inspired aerosols and respiratory rate with respect to fraction deposited in each region: nasal, bronchial and pulmonary

  6. Infants with recurrent lower respiratory tract symptoms – who benefits of extensive investigations?

    Directory of Open Access Journals (Sweden)

    Anne Kotaniemi-Syrjänen

    2008-04-01

    Full Text Available There is limited information on lung function and exhaled nitric oxide fraction (FeNO in infants with recurrent lower respiratory tract symptoms. In 2000–2003, 201 recurrently symptomatic infants were referred to a tertiary center for further investigation. As part of the clinical investigation, whole-body plethysmography, tidal FeNO measurements, and skin prick tests were performed. In addition, 77 (38% of the children underwent bronchoscopy. Increased work of breathing in clinical examination (in 22%, and abnormal chest radiograph (in 30%, were associated with decreased airway conductance (sGaw z-score –1.65 (p<0.001 and p = 0.048, respectively and hyperinflation of the lungs (FRC z-score 1.65(p = 0.004 and p = 0.038, respectively. Exposure to environmental tobacco smoke (ETS was associated with FeNO 40 ppb (p = 0.009. Increased work of breathing, sGaw z-score –1.65, and FRC z-score 1.65, were associated with low FeNO (p = 0.002, p = 0.005, p = 0.026, respectively. A definitive diagnosis was made in 184 (92% children; asthma was diagnosed in 149 (74%, infection in 23 (11%, and a structural abnormality in 12 (6%. Abnormal findings in clinical examination predicted the diagnosis of asthma or a structural abnormality in 96% of cases, whereas in children with underlying respiratory infection or no definitive diagnosis, clinical examination was normal in 92% (p<0.001. In conclusion, clinical findings of bronchial obstruction predict well lung function and the diagnosis of asthma in recurrently symptomatic infants. FeNO is affected by ETS exposure, clinical state of the child, and the used methods, and the information obtained should be interpreted with care.

  7. BACTERIAL PROFILE, ANTIBIOTIC SENSITIVITY AND RESISTANCE OF LOWER RESPIRATORY TRACT INFECTIONS IN UPPER EGYPT

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    Gamal Agmy

    2013-09-01

    Full Text Available BACKGROUND: Lower respiratory tract infections (LRTI account for a considerable proportion of morbidity and antibiotic use. We aimed to identify the causative bacteria, antibiotic sensitivity and resistance of hospitalized adult patients due to LRTI in Upper Egypt. METHODS: A multicentre prospective study was performed at 3 University Hospitals for 3 years. Samples included sputum or bronchoalveolar lavage (BAL for staining and culture, and serum for serology. Samples were cultured on 3 bacteriological media (Nutrient, Chocolate ,MacConkey's agars.Colonies were identified via MicroScan WalkAway-96. Pneumoslide IgM kit was used for detection of atypical pathogens via indirect immunofluorescent assay. RESULTS: The predominant isolates in 360 patients with CAP were S.pneumoniae (36%, C. pneumoniae (18%, and M. pneumoniae (12%. A higher sensitivity was recorded for moxifloxacin, levofloxacin, macrolides, and cefepime. A higher of resistance was recorded for doxycycline, cephalosporins, and β-lactam-β-lactamase inhibitors. The predominant isolates in 318 patients with HAP were, methicillin-resistant Staphylococcus aureus; MRSA (23%, K. pneumoniae (14%, and polymicrobial in 12%. A higher sensitivity was recorded for vancomycin, ciprofloxacin, and moxifloxacin. Very high resistance was recorded for β-lactam-β-lactamase inhibitors and cephalosporins. The predominant organisms in 376 patients with acute exacerbation of chronic obstructive pulmonary diseases (AECOPD were H. influnzae (30%, S. pneumoniae (25%, and M. catarrhalis(18%. A higher sensitivity was recorded for moxifloxacin, macrolides and cefepime. A higher rate of resistance was recorded for aminoglycosides and cephalosporins CONCLUSIONS: The most predominant bacteria for CAP in Upper Egypt are S. pneumoniae and atypical organisms, while that for HAP are MRSA and Gram negative bacteria. For acute exacerbation of COPD,H.influnzae was the commonest organism. Respiratory quinolones

  8. A linear, time-varying simulation of the respiratory tract system

    Energy Technology Data Exchange (ETDEWEB)

    Hernandez, O.

    1992-11-01

    These results show that regional deposition efficiencies of inhaled particles are highly dependent on the level of physical activity in all the spectrum of thermodynamic and aerodynamic aerosol particle sizes; also it was shown that for particles in the aerodynamic size range, the values of regional deposition efficiencies at the inner regions of the lung are highly dependent on age. In addition, the shape of regional deposition efficiency curves as a function of particle size have a similar behavior for all ages; thus, any variation of the airway geometry and respiratory physiological parameters such as tidal volumes and breathing frequencies due to age difference do not cause a change in the fundamental mechanisms of deposition. Thus, for all the cases of physical activity and age dependency, the deposition of ultrafine aerosol particles is highly enhanced by diffusive processes in all regions of the respiratory tract, and for very large aerosol size particles this behavior is repeated again due to impaction and sedimentation mechanisms. Although the results presented at this work, are the result of computer simulations based on different sources of experimental data, the structure of the computer simulation code BIODEP is flexible enough to the acquisition of any kind of new experimental information in terms of biokinetic analysis and regional deposition parameters. In addition, since the design of BIODEP was intended for easy access to the users, then with exception of the subroutine DIVPAG, at this moment, the modular design of BIODEP using FORTRAN 77 allows the implementation of all the subroutines of BIODEP to be used in a interactive mode with any microcomputer.

  9. The impact of passive smoking on the development of lower respiratory tract infections in children.

    Science.gov (United States)

    Keskinoglu, Pembe; Cimrin, Dilek; Aksakoglu, Gazanfer

    2007-10-01

    Environmental tobacco smoke is an important public health problem. The objective of this study was to evaluate the effect of passive smoking on lower respiratory tract infections (LRTIs) in children aged 2-12 years. A case-control study was conducted on matched-pair design. One-hundred and fifty children with LRTIs and 150 healthy children were included in the study. Data were collected through questionnaire and urine samples for the determination of cotinine levels, and were analysed by McNemar chi-square, paired t-test and Pearson correlation tests. The prevalence of parental self-reported, indoor smoking was 71.3% in children with LRTI and 72.0% in healthy children. Employing 30 ng mg(-1), the cut-off level of urinary cotinine/creatinine as commonly accepted, 87.3% of the children with LRTIs and 84.7% of healthy children were found to be passive smokers (p = 0.61, odds ratio (OR) = 0.93; confidence interval (CI) = 0.34-2.53). If 60 ng mg(-1) of urinary cotinine/creatinine was accepted as a cut-off level, it was observed that the rates of passive smoking were 76.7% and 50.7%, respectively (p = 0.000, OR = 4.72; 95% CI = 2.62-8.52). Dose-dependent exposure to environmental tobacco smoke was found to be associated with the incidence of LRTI. PMID:17517813

  10. Modeling micro-particle deposition in human upper respiratory tract under steady inhalation

    Institute of Scientific and Technical Information of China (English)

    Jianhua Huang; Lianzhong Zhang; Suyuan Yu

    2011-01-01

    A representative human upper respiratory tract (URT) with idealized oral region and asymmetric tracheobronchial (TB) airway has been modeled,and laminar-to-turbulent airflow for typical inhalation modes as well as micro-particle transport and deposition has been simulated using CFX10.0 software from Ansys Inc. on a personal computer. The asymmetric TB airway could not be replaced by an extended straight tube as outlet of the oral region while investigating the tracheal airflow field and particle deposition.Compared to an idealized oral airway with an extended straight tube,several differences could be noted:(i) The laryngeal jet extends further down the trachea and inclines towards the anterior wall: (ii) the turbulence level in trachea is less and decays more quickly: (iii) three recirculation zones are visible with intense adverse current after the glottis; (iv) deposition of small particles in trachea is reduced due to lower turbulence. Refined unstructured mesh with densified boundary layer mesh could be a proper substitute for the structured mesh in the human URT model with asymmetric TB airway. Based on the refined unstructured mesh,the physiological structure of uvula in the soft palate is properly simulated in the present human URT model.

  11. Pulmonary radiographic findings and mortality in hospitalized patients with lower respiratory tract infections

    International Nuclear Information System (INIS)

    Lower respiratory tract infections (LRTIs) remain a widespread problem and have a significant impact on primary healthcare resources. Previous studies have reported conflicting results on whether pulmonary radiographic findings at presentation predict lethality for patients with LRTIs. The aim of this study was to determine if the pulmonary radiographic findings at the third day of hospitalisation were independently associated with lethality in patients with LRTIs. A total of 616 patients with LRTIs, admitted to our hospital, were evaluated with regard to radiographic data. The prognostic analysis included an univariate approach of the following radiographic findings: focal alveolar infiltrates in one or more segments, focal alveolar infiltrates in one or more lobes, cavitations, diffuse infiltrates, solitary or multiple nodules, pleural effusion and fibrosis. Of the 616 patients, 560 patients (90.0%) had at least one pulmonary radiographic finding confirmed by a panel of radiologists. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) for Windows. Eleven independent radiographic variables were examined for association with lethality. Overall lethality was 10.2% (553 survivors, 63 non-survivors). The only parameter found to be significantly different between survivors and non-survivors was cavitations on chest radiograph (p-value: 0.047). In conclusion, the presence of cavitations on chest radiograph at third day of hospitalisation can help physicians' assessment of prognosis in patients with LRTIs, as it is an independent predictor of lethality

  12. Pulmonary radiographic findings and mortality in hospitalized patients with lower respiratory tract infections

    Energy Technology Data Exchange (ETDEWEB)

    Trakada, G. [Division of Pulmonology, Department of Internal Medicine, University Hospital of Patras Medical School, Patras 26500 (Greece)]. E-mail: gtrakada@hotmail.com; Pouli, A. [Agios Savas Hospital, Athens (Greece); Goumas, P. [Department of ORL, University Hospital of Patras Medical School, Patras (Greece)

    2006-02-15

    Lower respiratory tract infections (LRTIs) remain a widespread problem and have a significant impact on primary healthcare resources. Previous studies have reported conflicting results on whether pulmonary radiographic findings at presentation predict lethality for patients with LRTIs. The aim of this study was to determine if the pulmonary radiographic findings at the third day of hospitalisation were independently associated with lethality in patients with LRTIs. A total of 616 patients with LRTIs, admitted to our hospital, were evaluated with regard to radiographic data. The prognostic analysis included an univariate approach of the following radiographic findings: focal alveolar infiltrates in one or more segments, focal alveolar infiltrates in one or more lobes, cavitations, diffuse infiltrates, solitary or multiple nodules, pleural effusion and fibrosis. Of the 616 patients, 560 patients (90.0%) had at least one pulmonary radiographic finding confirmed by a panel of radiologists. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) for Windows. Eleven independent radiographic variables were examined for association with lethality. Overall lethality was 10.2% (553 survivors, 63 non-survivors). The only parameter found to be significantly different between survivors and non-survivors was cavitations on chest radiograph (p-value: 0.047). In conclusion, the presence of cavitations on chest radiograph at third day of hospitalisation can help physicians' assessment of prognosis in patients with LRTIs, as it is an independent predictor of lethality.

  13. Diagnosis and Management of Recurrent Respiratory Tract Infections in Children: A Practical Guide

    Directory of Open Access Journals (Sweden)

    Schaad

    2015-12-01

    Full Text Available Context Respiratory tract infections (RTIs affect children all over the world and are associated with significant morbidity and mortality. RTIs are usually triggered by viruses, though bacterial infections are also common. Results Children are particularly susceptible to RTIs due to the relative immaturity of their immune systems, and genetic factors (such as family history of atopy and/or environmental factors (such as exposure to pollution and pathogens also render certain populations more vulnerable to infection. Furthermore, RTIs tend to be recurrent and can result in multiple infections per year. The management of recurrent RTIs poses a tremendous challenge for physicians, who have a limited armamentarium with which to alleviate patients’ symptoms, treat their disease, and prevent recurrences. Conclusions Though antibiotics are rarely indicated, they are often still used to treat RTIs. The resulting increase in bacterial resistance, the lack of treatment efficacy, and drug-related side effects all underscore the need for alternative strategies to manage recurrent RTIs. This article uses a typical pediatric case study to review central issues in the diagnosis and management of recurrent RTIs in children, with an emphasis on the role of immunomodulation as a preventive strategy.

  14. Characterisation of Candida within the Mycobiome/Microbiome of the Lower Respiratory Tract of ICU Patients.

    Directory of Open Access Journals (Sweden)

    Robert Krause

    Full Text Available Whether the presence of Candida spp. in lower respiratory tract (LRT secretions is a marker of underlying disease, intensive care unit (ICU treatment and antibiotic therapy or contributes to poor clinical outcome is unclear. We investigated healthy controls, patients with proposed risk factors for Candida growth in LRT (antibiotic therapy, ICU treatment with and without antibiotic therapy, ICU patients with pneumonia and antibiotic therapy and candidemic patients (for comparison of truly invasive and colonizing Candida spp.. Fungal patterns were determined by conventional culture based microbiology combined with molecular approaches (next generation sequencing, multilocus sequence typing for description of fungal and concommitant bacterial microbiota in LRT, and host and fungal biomarkes were investigated. Admission to and treatment on ICUs shifted LRT fungal microbiota to Candida spp. dominated fungal profiles but antibiotic therapy did not. Compared to controls, Candida was part of fungal microbiota in LRT of ICU patients without pneumonia with and without antibiotic therapy (63% and 50% of total fungal genera and of ICU patients with pneumonia with antibiotic therapy (73% (p<0.05. No case of invasive candidiasis originating from Candida in the LRT was detected. There was no common bacterial microbiota profile associated or dissociated with Candida spp. in LRT. Colonizing and invasive Candida strains (from candidemic patients did not match to certain clades withdrawing the presence of a particular pathogenic and invasive clade. The presence of Candida spp. in the LRT rather reflected rapidly occurring LRT dysbiosis driven by ICU related factors than was associated with invasive candidiasis.

  15. Aspergillus thyroiditis: a complication of respiratory tract infection in an immunocompromised patient.

    Science.gov (United States)

    Alvi, Madiha M; Meyer, David S; Hardin, Nicholas J; Dekay, James G; Marney, Annis M; Gilbert, Matthew P

    2013-01-01

    A 59-year-old male with past medical history significant for non-Hodgkin's lymphoma status after chemotherapy presented with acute onset of neck pain, odynophagia, and dysphagia associated with subjective fever, chills, and dyspnea. Physical findings included a temperature of 38.4°C, hypertension, and tachycardia. Patient was found to have anterior neck tenderness. Laboratory evaluation revealed neutropenia. The patient was started on empiric antibacterial and antiviral therapy and continued on home prophylactic antifungal treatment. Thyroid function tests revealed overt hyperthyroidism. A thyroid ultrasound showed heterogeneous echotexture without discrete nodules. Subacute thyroiditis was treated with methylprednisolone, metoprolol, and opiate analgesics. Patient's antibacterial, antifungal, and antiviral treatments were broadened. A fine needle aspiration was not conducted. The patient's condition deteriorated rapidly over his brief hospital course and he expired. Autopsy showed fungal thyroiditis secondary to disseminated invasive Aspergillus. This report describes the presentation of fungal thyroiditis secondary to disseminated invasive Aspergillus originating from the respiratory tract. The authors review the diagnostic challenges, pathophysiology, and treatment of this condition. PMID:24455333

  16. Drug Utilization Study on Antibiotics Use in Lower Respiratory Tract Infection

    Directory of Open Access Journals (Sweden)

    Harish Govind Naik

    2013-08-01

    Full Text Available ABSTRACT Antibiotics are commonly prescribed for the lower respiratory tract infection. But if antibiotics are not used rationally then there will be increase chances of resistance of bacteria as well as increase in the total cost of treatment. This study was conducted to see the antibiotics utilization pattern. Aim: This drug utilization study was conducted to evaluate the pattern of antibiotics use in Medicine Department of a Krishna Hospital, Karad, Maharashtra, India. 96 case records were examined, of which 46.87% were LRTI (nonspecific LRTI and acute bronchitis and 51% were pneumonia. Female accounted for 53.12% and male for 46.87 % of total cases. The World Health Organization (WHO indicators (utilization in defined daily doses (DDD; DDD/1000inhibitant/day were used and the ATC/DDD method was implemented. The most frequently prescribed antibiotic was ceftriaxone, followed by Azithromycin. The DDD/1000inhibitant/day of Azithromycin was the highest (5.74. Average treatment period was found to be 5.42 and 6.52 for LRTI (nonspecific LRTI and Acute Bronchitis and pneumonia respectively. A total of 96 cases studied; in which 33 cases had mono-antibiotic therapy (33.37% and rest contained poly-antibiotics therapy (66.63%. Prescribing by generic names has to be encouraged. [Natl J Med Res 2013; 3(4.000: 324-327

  17. Mycoplasmas isolated from the respiratory tract of cattle and goats in Tanzania.

    Science.gov (United States)

    Kusiluka, L J; Ojeniyi, B; Friis, N F; Kazwala, R R; Kokotovic, B

    2000-01-01

    A microbiological study of the mycoplasma flora in the respiratory tracts of cattle and goats in selected regions of Tanzania is described. In the examination of cattle, mycoplasmas were isolated from 60 (17.8%) of the 338 examined lung samples, 8 (47.1%) of the 17 lymph nodes, 4 (13.3%) of the 30 pleural fluid samples and 4 (3.9%) of the 103 nasal swabs examined. All the isolates were identified as Mycoplasma mycoides subsp. mycoides, Small Colony type except for one isolate from pleural fluid which was identified as Mycoplasma arginini. M. mycoides subsp. mycoides, Small Colony type was isolated from samples originating from Dodoma, Iringa, Mbeya, Morogoro and Shinyanga regions where outbreaks of contagious bovine pleuropneumonia had been reported. In the examination of goats, mycoplasmas were isolated from 54 (34.0%) of the 159 examined lung samples, 41 (18.1%) of the 226 nasal swabs and 4 (40.0%) of the 10 pleural fluid samples. The species demonstrated were Mycoplasma capricolum subsp. capripneumoniae, M. mycoides subsp. mycoides, Small Colony type Mycoplasma ovipneumoniae and M. Capricolum subsp. arginini. The isolation of M. capripneumoniae in the Coast and Morogoro regions confirmed the presence of contagious caprine pleuropneumonia in the regions.

  18. Immunohistochemical Analysis of Leucocyte Subsets in the Sinonasal Mucosa of Cats with Upper Respiratory Tract Aspergillosis.

    Science.gov (United States)

    Whitney, J L; Krockenberger, M B; Day, M J; Beatty, J A; Dhand, N K; Barrs, V R

    2016-01-01

    Leucocyte populations in the sinonasal mucosa of cats with and without upper respiratory tract aspergillosis were compared using immunohistochemistry and computer-aided morphometry. Inflammation was identified in the nasal mucosa of all affected cats, comprising predominantly of lymphoplasmacytic infiltration of the lamina propria associated with epithelial proliferation and degeneration. There was intense and diffuse expression of class II antigens of the major histocompatibility complex, associated with sites of hyphal invasion with hyperplasia and ulceration of the epithelium adjacent to fungal elements. Significantly more CD79b(+) cells, total lymphocytes, immunoglobulin (Ig)-expressing cells and MAC387(+) cells infiltrated the epithelium and more IgG(+) cells and total Ig-expressing cells infiltrated the lamina propria in affected cats compared with controls. Importantly, the inflammatory profile in affected cats was not consistent with the T helper (Th)1 and Th17 cell-mediated response that confers protective acquired immunity against invasive aspergillosis in dogs and people and in murine models of the infection. This finding may help to explain the development of invasive aspergillosis in systemically immunocompetent cats. PMID:27576043

  19. Characteristics of Streptococcus pneumoniae Strains Colonizing Upper Respiratory Tract of Healthy Preschool Children in Poland

    Directory of Open Access Journals (Sweden)

    Izabela Korona-Glowniak

    2012-01-01

    Full Text Available Antibiotic resistant and invasive pneumococci may spread temporally and locally in day care centers (DCCs. We examined 267 children attending four DCCs located in the same city and 70 children staying at home in three seasons (autumn, winter, and spring to determine prevalence, serotype distribution, antibiotic resistance patterns, and transmission of pneumococcal strains colonizing upper respiratory tract of healthy children without antipneumococcal vaccination. By pheno- and genotyping, we determined clonality of pneumococci, including drug-resistant strains. The average carriage of pneumococci in three seasons was 38.2%. 73.4% and 80.4% of the isolates belonged to serotypes present in 10- and 13-valent conjugate vaccine, respectively. Among the pneumococcal strains, 33.3% were susceptible to all antimicrobial tested and 39.2% had decreased susceptibility to penicillin. Multidrug resistance was common (35.7%; 97.5% of drug-resistant isolates represented serotypes included to 10- and 13-valent conjugate vaccine. According to BOX-PCR, clonality definitely was observed only in case of serotype 14. Multivariate analysis determined DCC attendance as strongly related to pneumococcal colonization in all three seasons, but important seasonal differences were demonstrated. In children attending DCCs, we observed dynamic turnover of pneumococcal strains, especially penicillin nonsusceptible and multidrug resistant, which were mostly distributed among serotypes included to available pneumococcal conjugate vaccines.

  20. Morphology of respiratory tract lesions in rats exposed to radon progeny

    Energy Technology Data Exchange (ETDEWEB)

    Dagle, G.E.; Cross, F.T.; Gies, R.A. [Pacific Northwest Lab., Richland, WA (United States)

    1992-12-31

    We will discuss the morphologic features of lesions in the respiratory tract of rats exposed to radon and radon progeny. Groups of male Wister rats were exposed to from 10 to 1000 working levels (WL) of radon progeny in the presence of less than 1 to about 15 mg m{sup {minus}3} uranium ore dust. Cumulative exposures ranged from 20 to approximately 10,000 working level months (WLM). Higher exposure levels produced radiation pneumonitis characterized by interstitial fibrosis, associated with alveolar epithelial cell hyperplasia and accumulations of alveolar macrophages containing phagocytosed uranium ore dust. Nodular fibrosis and alveolar proteinosis were correlated with deposits of uranium ore dust. Vesicular emphysema also occurred at higher exposure levels. Pulmonary adenomatosis appeared to be a preneoplastic lesion; it was composed of nodular proliferation of bronchioloalveolar epithelium without disruption of the general architecture of the parenchyma. At exposure levels where rats lived longer than 1 y, lung tumors and a few tumors of the nasal cavity developed. The principal lung tumors were pulmonary adenomas, bronchioloalveolar carcinomas, papillary adenocarcinomas, epidermoid carcinomas, and adenosquamous carcinomas. Occasionally, malignant mesotheliomas and sarcomas were also present. The malignant lung tumors were characterized by invasion and occasionally metastasized to regional lymph nodes. Lower exposure rates produced more tumors, generally of different histologic types, and more fatal tumors than higher exposure rates. The similarity to relationships of human radon progeny exposure as far as incidence and types of lung tumors establish the validity of this animal model for studying radon carcinogenesis in humans.

  1. A Computer Model for the Simulation of Nonspherical Particle Dynamics in the Human Respiratory Tract

    Directory of Open Access Journals (Sweden)

    Robert Sturm

    2012-01-01

    Full Text Available In the study presented here deposition of spheres and nonspherical particles with various aspect ratios (0.01–100 in the human respiratory tract was theoretically modeled. Shape of the nonspherical particles was considered by the application of the latest aerodynamic diameter concepts. Particle deposition was predicted by using a stochastic model of the lung geometry and simulating particle transport trajectories according to the random-walk algorithm. Concerning fibers total deposition is significantly enhanced with respect to that of spheres for μm-sized particles, whereby at normal breathing conditions peripheral lung compartments serve as primary deposition targets. In the case of oblate disks, total deposition becomes mostly remarkable for submicron particles, with the bronchioli and alveoli being targeted to a high extent. Enhancement of the aerodynamic diameter and/or flow rate generally causes a displacement of deposition maxima from peripheral to more proximal lung regions. From these findings, it can be concluded that these particle classes may represent tremendous occupational hazards, especially if they are attached with radioactive elements or heavy metals.

  2. Respiratory tract exacerbations revisited: ventilation, inflammation, perfusion, and structure (VIPS) monitoring to redefine treatment.

    Science.gov (United States)

    Tiddens, Harm A W M; Stick, Stephen M; Wild, Jim M; Ciet, Pierluigi; Parker, Geoffrey J M; Koch, Armin; Vogel-Claussen, Jens

    2015-10-01

    For cystic fibrosis (CF) patients older than 6 years there are convincing data that suggest respiratory tract exacerbations (RTE) play an important role in the progressive loss of functional lung tissue. There is a poor understanding of the pathobiology of RTE and whether specific treatment of RTE reduces lung damage in the long term. In addition, there are limited tools available to measure the various components of CF lung disease and responses to therapy. Therefore, in order to better understand the impact of RTE on CF lung disease we need to develop sensitive measures to characterize RTE and responses to treatment; and improve our understanding of structure-function changes during treatment of RTE. In this paper we review our current knowledge of the impact of RTE on the progression of lung disease and identify strategies to improve our understanding of the pathobiology of RTE. By improving our knowledge regarding RTE in CF we will be better positioned to develop approaches to treatment that are individualized and that can prevent permanent structural damage. We suggest the development of a ventilation, perfusion, inflammation and structure (VIPS)-MRI suite that supplies the clinician with data on ventilation, inflammation, perfusion, and structure in one MRI session. VIPS-MRI could be an important step to better understand the factors that contribute to and limit treatment efficacy of RTE.

  3. Mycoplasmosis and upper respiratory tract disease of tortoises: a review and update

    Science.gov (United States)

    Jacobson, Elliott R.; Brown, Mary B.; Wendland, Lori; Brown, Daniel R.; Klein, Paul A.; Christopher, Mary M.; Berry, Kristin H.

    2014-01-01

    Tortoise mycoplasmosis is one of the most extensively characterized infectious diseases of chelonians. A 1989 outbreak of upper respiratory tract disease (URTD) in free-ranging Agassiz's desert tortoises (Gopherus agassizii) brought together an investigative team of researchers, diagnosticians, pathologists, immunologists and clinicians from multiple institutions and agencies. Electron microscopic studies of affected tortoises revealed a microorganism in close association with the nasal mucosa that subsequently was identified as a new species, Mycoplasma agassizii. Over the next 24 years, a second causative agent, Mycoplasma testudineum, was discovered, the geographic distribution and host range of tortoise mycoplasmosis were expanded, diagnostic tests were developed and refined for antibody and pathogen detection, transmission studies confirmed the pathogenicity of the original M. agassizii isolate, clinical (and subclinical) disease and laboratory abnormalities were characterized, many extrinsic and predisposing factors were found to play a role in morbidity and mortality associated with mycoplasmal infection, and social behavior was implicated in disease transmission. The translation of scientific research into management decisions has sometimes led to undesirable outcomes, such as euthanasia of clinically healthy tortoises. In this article, we review and assess current research on tortoise mycoplasmosis, arguably the most important chronic infectious disease of wild and captive North American and European tortoises, and update the implications for management and conservation of tortoises in the wild.

  4. Maternal agency influences the prevalence of diarrhea and acute respiratory tract infections among young Indonesian children.

    Science.gov (United States)

    Agustina, Rina; Shankar, Anita V; Ayuningtyas, Azalea; Achadi, Endang L; Shankar, Anuraj H

    2015-05-01

    To examine the relationship between measures of mother's caretaking, practice and individual agency on acute diarrhea and respiratory tract infections (ARTIs) of Indonesian children. Using population-based household data from the Indonesian Demographic Health Surveys for 2002-2003 (n = 9,151 children) and 2007 (n = 9,714 children), we selected 28 indicators related to mother' caretaking, and applied principal component analysis to derive indices for access to care, practice and experience, and agency. The association between index quartiles (level 1-4) and the prevalence of diarrhea and ARTIs in the youngest child family size, child's age and sex, immunization status and received vitamin A supplementation. Moderate levels (level 3) of practice and experience were associated with decreased diarrheal risk (adjusted OR 0.86, 95 % CI 0.75-0.98), but not for ARTIs. Children of mothers with higher levels (level 4) of agency were protected against both diarrhea (adjusted OR 0.68, 95 % CI 0.60-0.77) and ARTIs (adjusted OR 0.77, 95 % CI 0.66-0.91). Stratified analyses with child's age and mother's education, and tests of interaction, showed that agency had a stronger effect on diarrhea and ARTIs prevalence in children child health. PMID:25108503

  5. Morphology of respiratory tract lesions in rats exposed to radon progeny

    International Nuclear Information System (INIS)

    We will discuss the morphologic features of lesions in the respiratory tract of rats exposed to radon and radon progeny. Groups of male Wister rats were exposed to from 10 to 1000 working levels (WL) of radon progeny in the presence of less than 1 to about 15 mg m-3 uranium ore dust. Cumulative exposures ranged from 20 to approximately 10,000 working level months (WLM). Higher exposure levels produced radiation pneumonitis characterized by interstitial fibrosis, associated with alveolar epithelial cell hyperplasia and accumulations of alveolar macrophages containing phagocytosed uranium ore dust. Nodular fibrosis and alveolar proteinosis were correlated with deposits of uranium ore dust. Vesicular emphysema also occurred at higher exposure levels. Pulmonary adenomatosis appeared to be a preneoplastic lesion; it was composed of nodular proliferation of bronchioloalveolar epithelium without disruption of the general architecture of the parenchyma. At exposure levels where rats lived longer than 1 y, lung tumors and a few tumors of the nasal cavity developed. The principal lung tumors were pulmonary adenomas, bronchioloalveolar carcinomas, papillary adenocarcinomas, epidermoid carcinomas, and adenosquamous carcinomas. Occasionally, malignant mesotheliomas and sarcomas were also present. The malignant lung tumors were characterized by invasion and occasionally metastasized to regional lymph nodes. Lower exposure rates produced more tumors, generally of different histologic types, and more fatal tumors than higher exposure rates. The similarity to relationships of human radon progeny exposure as far as incidence and types of lung tumors establish the validity of this animal model for studying radon carcinogenesis in humans

  6. Application of the physiological and morphological parameters of the brazilian population sample to the mathematical model of the human respiratory tract; Aplicacao dos parametros fisiologicos e morfologicos de uma amostra da populacao brasileira no modelo matematico do trato respiratorio humano

    Energy Technology Data Exchange (ETDEWEB)

    Reis, Arlene Alves dos

    2005-07-01

    The Human Respiratory Tract Model proposed by the ICRP Publication 66 accounts for the morphology and physiology of the respiratory tract. The characteristics of air drawn into the lungs and exhaled are greatly influenced by the morphology of the respiratory tract, which causes numerous changes in pressure, flow rate, direction and humidity as air moves into and out of the lungs. Concerning the respiratory physiological parameters the breathing characteristics influence the volume, the inhalation rate of air and the portion that enters through the nose and the mouth. These characteristics are important to determine the fractional deposition. The model uses morphological and physiological parameters from the Caucasian man to establish deposition fractions in the respiratory tract regions. It is known that the morphology and physiology are influenced by environmental, occupational and economic conditions. The ICRP recommends, for a reliable evaluation of the regional deposition, the use of parameters from a local population when information is available. The main purpose of this study is to verify the influence in using the morphology and physiology parameters representative of a sample of the Brazilian population on the deposition model of the ICRP Publication 66. The morphological and physiological data were obtained from the literature. The software EXCEL for Windows (version 2000) was used in order to implement the deposition model and also to allow the changes in parameters of interest. Initially, the implemented model was checked using the parameters defined by the ICRP and the results of the fraction deposition in the respiratory tract compartments were compared. Finally, morphological and physiological parameters from Brazilian adult male were applied and the fractional deposition calculated. The results suggest a significant variation in fractional deposition when Brazilian parameters are applied in the model. (author)

  7. Measurement of the deposited activity of the short-lived radon progeny in the human respiratory tract

    Energy Technology Data Exchange (ETDEWEB)

    Vezzu, G.; Butterweck-Dempewolf, G.; Schuler, C. [Paul Scherrer Inst., Villigen (Switzerland). Div. for Radiation Protection and Waste Management

    1998-12-31

    Volunteers were exposed in the radon chamber at Paul Scherrer Institut to an atmosphere enriched with highly unattached radon progeny. The deposited radon progeny activity in the respiratory tract of the volunteers was determined using a low level in-vivo counter. The detector arrangement and its calibration for the measurement of deposited radon progeny activity is described and the results for a mouth and a nose breathing volunteer are presented. For the nose breathing volunteer 55% of the deposited radon progeny activity was located in the head and the remaining 45% in the chest whereas for the mouth breathing volunteer 25% was located in the head and the remaining 75% in the chest. A mean clearance half-life for the deposited radon progeny from the respiratory tract of (2{+-}1) h was obtained from the analyses of the temporal behaviour of the deposited radon progeny activity in the head. (orig.)

  8. The possibility of evaluation on inflammatory change at respiratory tract in chronic bronchial asthma using 67Ga scintigraphy

    International Nuclear Information System (INIS)

    67Ga scintigraphy was performed in 17 patients with chronic bronchial asthma to grasp the inflammatory change of respiratory tract. On 67Ga scintigraphy, abnormal accumulations were detected on lung fields in 6 cases (35.3%) of 17 cases. In 5 cases of these 6 cases, the defect areas which were pointed out on 81mKr ventilation scintigraphy were matched to the abnormal accumulation areas which were pointed out on 67Ga scintigraphy. In dynamics, the abnormal accumulation areas which were pointed out on 67Ga scintigraphy were matched to the defect areas which had been at all times pointed out on 81mKr ventilation scintigraphy. 67Ga scintigraphy was expected to be one of index to grasp the inflammatory change of respiratory tract in patients with chronic bronchial asthma. (author)

  9. Quality indicators for diagnosis and treatment of respiratory tract infections in general practice: a modified Delphi study

    DEFF Research Database (Denmark)

    Hansen, Malene Plejdrup; Bjerrum, Lars; Gahrn-Hansen, Bente;

    2010-01-01

    , clinical microbiologists, and clinical pharmacologists were asked to rate the relevance of 59 quality indicators for diagnosis and treatment of respiratory tract infections with regard to reducing antimicrobial resistance and improving patient health. A thorough literature review was carried out to ensure...... was achieved in both Delphi rounds. A total of 41 of the proposed 59 quality indicators attained consensus. None of the quality indicators focusing on the diagnostic process achieved consensus. Consensus was attained for 14 quality indicators focusing on the decision regarding antibiotic treatment and for 27...... quality indicators focusing on the choice of antibiotics. CONCLUSION: This study resulted in a final set of 41 quality indicators concerning respiratory tract infections in general practice. These quality indicators may be used to strengthen general practitioners' focus on their management of patients...

  10. Detection of antibodies to a pathogenic mycoplasma in desert tortoises (Gopherus agassizii) with upper respiratory tract disease.

    OpenAIRE

    Schumacher, I M; Brown, M B; Jacobson, E R; Collins, B R; Klein, P A

    1993-01-01

    Mycoplasma agassizii (proposed species novum) is the etiologic agent of an upper respiratory tract disease in the desert tortoise (Gopherus agassizii), which is threatened in most of its range. An enzyme-linked immunosorbent assay (ELISA) for the detection of M. agassizii-specific antibodies in desert tortoises was developed with a monoclonal antibody with specificity for desert tortoise immunoglobulin light chain. Plasma samples from one group of tortoises were tested immediately before and ...

  11. Infection biomarkers in primary care patients with acute respiratory tract infections–comparison of Procalcitonin and C-reactive protein

    OpenAIRE

    Meili, Marc; Kutz, Alexander; Briel, Matthias; Christ-Crain, Mirjam; Bucher, Heiner C.; Mueller, Beat; Schuetz, Philipp

    2016-01-01

    Background There is a lack of studies comparing the utility of C-reactive protein (CRP) with Procalcitonin (PCT) for the management of patients with acute respiratory tract infections (ARI) in primary care. Our aim was to study the correlation between these markers and to compare their predictive accuracy in regard to clinical outcome prediction. Methods This is a secondary analysis using clinical and biomarker data of 458 primary care patients with pneumonic and non-pneumonic ARI. We used co...

  12. PspA Family Distribution, Antimicrobial Resistance and Serotype of Streptococcus pneumoniae Isolated from Upper Respiratory Tract Infections in Japan

    OpenAIRE

    Muneki Hotomi; Akihisa Togawa; Masamitsu Kono; Yorihiko Ikeda; Shin Takei; Hollingshead, Susan K.; Briles, David E.; Kenji Suzuki; Noboru Yamanaka

    2013-01-01

    BACKGROUND: The protection against pneumococcal infections provided by currently available pneumococcal polysaccharide conjugate vaccines are restricted to the limited number of the serotypes included in the vaccine. In the present study, we evaluated the distribution of the pneumococcal capsular type and surface protein A (PspA) family of pneumococcal isolates from upper respiratory tract infections in Japan. METHODS: A total of 251 S. pneumoniae isolates from patients seeking treatment for ...

  13. Inhibitory substances produced by Streptococcus salivarius and colonization of the upper respiratory tract with group A streptococci.

    Science.gov (United States)

    Huskins, W. C.; Kaplan, E. L.

    1989-01-01

    It has been proposed that inhibitory substances produced by viridans streptococci colonizing the upper respiratory tract aid in eradication of established group A streptococcal colonization of that site. We studied the prevalence of inhibitory-substance producing strains of Streptococcus salivarius in throat cultures from three groups of children: 16 children with persistently positive throat cultures for group A streptococci despite receiving recommended therapeutic courses of antibiotics (group I), 26 children from whom group A streptococci were eradicated from the upper respiratory tract by antibiotic therapy (group II), and 18 children who never harboured group A streptococci in their upper respiratory tract during the study period (group III). An in vitro deferred antagonism method was employed to detect inhibitory substances; 5233 strains of S. salivarius were examined. Strains of S. salivarius producing inhibitory substances were isolated from 76-88% of the children in each group on at least one occasion. However, only a small percentage of subjects in each group harboured strains producing these substances in every throat culture. The mean total percentage of S. salivarius strains producing inhibitory substances was 21.8% in children in group I, 22.4% in children in group II, and 16.4% in children in group III; these percentages were not statistically different (P greater than 0.1). In this study, we could not confirm a significant role for inhibitory substances produced by S. salivarius in the eradication of group A streptococci from the upper respiratory tract of colonized individuals. Images Fig. 1 Fig. 2 PMID:2500355

  14. Metagenomic Analysis of Respiratory Tract DNA Viral Communities in Cystic Fibrosis and Non-Cystic Fibrosis Individuals

    OpenAIRE

    Willner, Dana; Furlan, Mike; Haynes, Matthew; Schmieder, Robert; Angly, Florent E.; Silva, Joas; Tammadoni, Sassan; Nosrat, Bahador; Conrad, Douglas; Rohwer, Forest

    2009-01-01

    The human respiratory tract is constantly exposed to a wide variety of viruses, microbes and inorganic particulates from environmental air, water and food. Physical characteristics of inhaled particles and airway mucosal immunity determine which viruses and microbes will persist in the airways. Here we present the first metagenomic study of DNA viral communities in the airways of diseased and non-diseased individuals. We obtained sequences from sputum DNA viral communities in 5 individuals wi...

  15. Probiotics and vitamin C for the prevention of respiratory tract infections in children attending preschool: a randomised controlled pilot study

    OpenAIRE

    Garaiova, I.; Muchová, J; Nagyová, Z; Wang, D; Li, J. V.; Országhová, Z; Michael, D R; Plummer, S F; Ďuračková, Z

    2014-01-01

    Background: This pilot study investigates the efficacy of a probiotic consortium (Lab4) in combination with vitamin C on the prevention of respiratory tract infections in children attending preschool facilities. Subjects/methods: In a double-blind, randomised, placebo-controlled pilot study with children aged 3–6 years, 57 received 1.25 × 1010 colony-forming units of Lactobacillus acidophilus CUL21 (NCIMB 30156), Lactobacillus acidophilus CUL60 (NCIMB 30157), Bifidobacterium bifidum CUL20 (NC...

  16. Systematic Review of Clinical Trials Assessing the Effectiveness of Ivy Leaf (Hedera Helix) for Acute Upper Respiratory Tract Infections

    OpenAIRE

    Holzinger, Felix; Chenot, Jean-François

    2011-01-01

    Introduction. Among nonantibiotic cough remedies, herbal preparations containing extracts from leaves of ivy (Hedera helix) enjoy great popularity. Objective. A systematic review to assess the effectiveness and tolerability of ivy for acute upper respiratory tract infections (URTIs). Methods. We searched for randomized controlled trials (RCTs), nonrandomized controlled clinical trials and observational studies evaluating the efficacy of ivy preparations for acute URTIs. Study quality was asse...

  17. Systematic Review of Clinical Trials Assessing the Effectiveness of Ivy Leaf (Hedera Helix) for Acute Upper Respiratory Tract Infections

    OpenAIRE

    Holzinger, Felix; Chenot, Jean-François

    2010-01-01

    Introduction. Among nonantibiotic cough remedies, herbal preparations containing extracts from leaves of ivy (Hedera helix) enjoy great popularity. Objective. A systematic review to assess the effectiveness and tolerability of ivy for acute upper respiratory tract infections (URTIs). Methods. We searched for randomized controlled trials (RCTs), nonrandomized controlled clinical trials and observational studies evaluating the efficacy of ivy preparations for acute URTIs. Study quality was asse...

  18. Novel avian-origin influenza A (H7N9) virus attachment to the respiratory tract of five animal models

    NARCIS (Netherlands)

    J.Y. Siegers (Jurre); K.R. Short (Kirsty); L.M.E. Leijten (Lonneke); M.T. de Graaf (Marieke); M.I. Spronken (Monique); E.J.A. Schrauwen (Eefje); N. Marshall (Nicolle); A.C. Lowen (Anice); G. Gabriel (Gülsah); A.D.M.E. Osterhaus (Albert); T. Kuiken (Thijs); D.A.J. van Riel (Debby)

    2014-01-01

    textabstractWe determined the pattern of attachment of the avian-origin H7N9 influenza viruses A/Anhui/1/2013 and A/Shanghai/1/2013 to the respiratory tract in ferrets, macaques, mice, pigs, and guinea pigs and compared it to that in humans. The H7N9 attachment pattern in macaques, mice, and to a le

  19. Association between respiratory tract diseases and secondhand smoke exposure among never smoking flight attendants: a cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Murawski Judith

    2007-09-01

    Full Text Available Abstract Background Little is known about long-term adverse health consequences experienced by flight attendants exposed to secondhand smoke (SHS during the time smoking was allowed on airplanes. We undertook this study to evaluate the association between accumulated flight time in smoky airplane cabins and respiratory tract diseases in a cohort of never smoking flight attendants. Methods We conducted a mailed survey in a cohort of flight attendants. Of 15,000 mailed questionnaires, 2053 (14% were completed and returned. We excluded respondents with a personal history of smoking (n = 748 and non smokers with a history of respiratory tract diseases before the age of 18 years (n = 298. The remaining 1007 respondents form the study sample. Results The overall study sample was predominantly white (86% and female (89%, with a mean age of 54 years. Overall, 69.7% of the respondents were diagnosed with at least one respiratory tract disease. Among these respondents, 43.4% reported a diagnosis of sinusitis, 40.3% allergies, 30.8% bronchitis, 23.2% middle ear infections, 13.6% asthma, 13.4% hay fever, 12.5% pneumonia, and 2.0% chronic obstructive pulmonary disease. More hours in a smoky cabin were observed to be significantly associated with sinusitis (OR = 1.21; p = 0.024, middle ear infections (OR = 1.30; p = 0.006, and asthma (OR = 1.26; p = 0.042. Conclusion We observed a significant association between hours of smoky cabin exposure and self-reported reported sinusitis, middle ear infections, and asthma. Our findings suggest a dose-response between duration of SHS exposure and diseases of the respiratory tract. Our findings add additional evidence to the growing body of knowledge supporting the need for widespread implementation of clean indoor air policies to decrease the risk of adverse health consequences experienced by never smokers exposed to SHS.

  20. Effect of Carbon Dioxide on Testing of Susceptibilities of Respiratory Tract Pathogens to Macrolide and Azalide Antimicrobial Agents

    OpenAIRE

    Johnson, M M; Hill, S. L.; Piddock, Laura J. V.

    1999-01-01

    The in vitro activities of erythromycin, azithromycin, and clarithromycin against 178 clinical isolates from the lower respiratory tract of patients with chronic obstructive pulmonary disease were determined by an agar dilution method. The plates were incubated in air alone or in 5% carbon dioxide. The MICs measured in air alone were lower for most isolates than those measured in 5% carbon dioxide, illustrating the “pH effect” of incubation in carbon dioxide. Testing of isolates in 5% carbon ...

  1. In utero exposure to 25(OH) D and risk of childhood asthma, wheeze and respiratory tract infections

    DEFF Research Database (Denmark)

    Feng, Haixia; Xun, Pengcheng; Pike, Katharine;

    2016-01-01

    BACKGROUND: Studies of the associations between in utero 25-hydroxyvitamin D [25(OH) D] exposure and childhood asthma risk, wheeze and respiratory tract infections are inconsistent and inconclusive. OBJECTIVES: To assess the associations between 25(OH) D levels in cord blood or maternal venous bl...... associated with the risk of asthma and wheeze during childhood. These findings are in keeping with the results of two recently published randomized clinical trials of vitamin D supplementation during pregnancy.......BACKGROUND: Studies of the associations between in utero 25-hydroxyvitamin D [25(OH) D] exposure and childhood asthma risk, wheeze and respiratory tract infections are inconsistent and inconclusive. OBJECTIVES: To assess the associations between 25(OH) D levels in cord blood or maternal venous...... blood and risk of offspring's asthma, wheeze and respiratory tract infections. METHODS: Data were derived from PubMed, EMBASE, Google Scholar, references from relevant articles, and de novo results from published studies until December, 2015. Random-effects meta-analysis was conducted among 16 birth...

  2. Seasonal behavior of radon decay products in indoor air and resulting radiation dose to human respiratory tract

    Directory of Open Access Journals (Sweden)

    A.M.A. Mostafa

    2015-01-01

    Full Text Available Most of radiation hazard of indoor radon is largely due to the radon progenies, which are inhaled and deposited in the human respiratory tract. It is essential to evaluate aerodynamic characteristics of the radon progenies, which are either attached or unattached to aerosol particles, because the dose is strongly dependent on the location of deposition in respiratory tract and hence on the aerodynamic characteristics of the aerosol particles. This paper presents the seasonal behavior of radon decay products in indoor air under domestic conditions at Nagoya University, Japan. A low pressure cascade impactor as an instrument for classifying aerosol sizes and imaging plate as a radiation detector have been employed to characterize the activity size distribution of short-lived radon decay products. In parallel, radon and its progenies concentrations were measured. Taking into account the progeny characteristics, the inhalation dose in the different seasons was also estimated based on a lung dose model with the structure that is related to the ICRP66 respiratory tract model. The result evident that, the highest dose 0.22 mSvy−1 was observed during the winter where the highest value of equilibrium equivalent concentration of radon (EEC and lowest value of the activity median aerodynamic diameter (AMAD were found in this season; whereas, the dose in spring appeared to be lowest 0.02 mSvy−1.

  3. Treatment of adults with community-acquired respiratory tract infections: results of a multicentric clinical trial with gatifloxacin

    Directory of Open Access Journals (Sweden)

    Medeiros Eduardo Alexandrino Servolo

    2002-01-01

    Full Text Available Respiratory tract infections have an important clinical and economic impact and they are the most common indication for antibiotic use in outpatient practice. This prospective, multicenter non-controlled trial assessed the efficacy and safety of gatifloxacin in the treatment of community-acquired respiratory tract infections. Patients were treated with a daily oral dose of gatifloxacin 400 mg for 7-14 days. The diagnosis of respiratory infection was made based on the clinical condition and/or radiologic findings. A total of 5,044 adult patients with community-acquired respiratory infections was treated with gatifloxacin in different centers in Brazil between March 1, 2001, and October 31, 2001. Among the 5,044 patients treated, 1,501 patients (29.76% had community-acquired pneumonia, 756 (14.99% had acute exacerbation of chronic bronchitis and 2,787 (55.25% had acute sinusitis. Of the total of patients treated, 3,607 (71.51% were considered cured, 1,261 (25% progressed with some clinical improvement, 28 (0.56% presented a relapse, 56 (1.11% failed to treatment and 92 (1.82% were unable to be evaluated. Adverse events were described in 634 (12.57% patients. The most common adverse events were: nausea (2.24%; dyspepsia (1.86%; diarrhea (0.79%; change in taste (0.46%; insomnia and irritability (0.22%; dizziness (0.77%; headache (0.42%; allergic reaction (0.18%; Central Nervous System alterations - insomnia, agitation, anxiety - (0.46%. This study showed that the treatment of respiratory tract infections with gatifloxacin was safe and efficient and had a low incidence of adverse events.

  4. [Assessment of chronic glucose metabolism disorders coexisting with respiratory failure in non-critical ill patients hospitalized with lower respiratory tract infections].

    Science.gov (United States)

    Sobocińska, Magdalena Barbara; Loba, Jerzy

    2015-01-01

    Lungs are the target organ in chronic hyperglycemia, but its large reserves causes a subclinical course of these changes. Given the results of other researchers indicating reduced active surface of gas exchange and pulmonary capillary damage, it can be assumed that diabetes and other hyperglycemic states diminish these reserves and impair effectiveness of respiratory gas exchange during pneumonia. So it is plausible to observe coexistence of glucose metabolism disorders and respiratory failure in patients hospitalized with lower respiratory tract infection. An observational study was conducted on 130 patients hospitalized with bacteriologically confirmed pneumonia. 63 patients suffering from chronic glucose metabolism disorders (A) and 67 randomly selected patients in control group (B) were observed on laboratory and clinical findings. There was no significant difference in prevalence of acute respiratory failure, although in the study group a slightly greater number of patients diagnosed with acute respiratory failure was observed. There was a significantly greater number of patients with previously confirmed chronic respiratory failure using long-term oxygen theraphy in A group (p = 0.029). The B patients with average blood glucose level > 108 mg/dl had significantly lower partial pressure of oxygen (PaO2)(gIc ≤ 108: 58.6 +/- 9.8; glc > 108: 51.7 +/- 11.1; p = 0.042). There was a statistically significant negative correlation of the average blood glucose level and PaO2 in the control group (p = 0.0152) and a significant inverse association between the average blood glucose level and the partial pressure of oxygen in patients without COPD belonging to the control group (p = 0.049). Respiratory failure is frequent in patients hospitalized with pneumonia. In patients without chronic glucose metabolism disorders with blood glucose level rising the oxygen tension decreases The association is stronger in patients without COPD.

  5. Chemical exposure-response relationship between air pollutants and reactive oxygen species in the human respiratory tract

    Science.gov (United States)

    Lakey, Pascale S. J.; Berkemeier, Thomas; Tong, Haijie; Arangio, Andrea M.; Lucas, Kurt; Pöschl, Ulrich; Shiraiwa, Manabu

    2016-09-01

    Air pollution can cause oxidative stress and adverse health effects such as asthma and other respiratory diseases, but the underlying chemical processes are not well characterized. Here we present chemical exposure-response relations between ambient concentrations of air pollutants and the production rates and concentrations of reactive oxygen species (ROS) in the epithelial lining fluid (ELF) of the human respiratory tract. In highly polluted environments, fine particulate matter (PM2.5) containing redox-active transition metals, quinones, and secondary organic aerosols can increase ROS concentrations in the ELF to levels characteristic for respiratory diseases. Ambient ozone readily saturates the ELF and can enhance oxidative stress by depleting antioxidants and surfactants. Chemical exposure-response relations provide a quantitative basis for assessing the relative importance of specific air pollutants in different regions of the world, showing that aerosol-induced epithelial ROS levels in polluted megacity air can be several orders of magnitude higher than in pristine rainforest air.

  6. Chemical exposure-response relationship between air pollutants and reactive oxygen species in the human respiratory tract.

    Science.gov (United States)

    Lakey, Pascale S J; Berkemeier, Thomas; Tong, Haijie; Arangio, Andrea M; Lucas, Kurt; Pöschl, Ulrich; Shiraiwa, Manabu

    2016-01-01

    Air pollution can cause oxidative stress and adverse health effects such as asthma and other respiratory diseases, but the underlying chemical processes are not well characterized. Here we present chemical exposure-response relations between ambient concentrations of air pollutants and the production rates and concentrations of reactive oxygen species (ROS) in the epithelial lining fluid (ELF) of the human respiratory tract. In highly polluted environments, fine particulate matter (PM2.5) containing redox-active transition metals, quinones, and secondary organic aerosols can increase ROS concentrations in the ELF to levels characteristic for respiratory diseases. Ambient ozone readily saturates the ELF and can enhance oxidative stress by depleting antioxidants and surfactants. Chemical exposure-response relations provide a quantitative basis for assessing the relative importance of specific air pollutants in different regions of the world, showing that aerosol-induced epithelial ROS levels in polluted megacity air can be several orders of magnitude higher than in pristine rainforest air. PMID:27605301

  7. Chemical exposure-response relationship between air pollutants and reactive oxygen species in the human respiratory tract

    Science.gov (United States)

    Lakey, Pascale S. J.; Berkemeier, Thomas; Tong, Haijie; Arangio, Andrea M.; Lucas, Kurt; Pöschl, Ulrich; Shiraiwa, Manabu

    2016-01-01

    Air pollution can cause oxidative stress and adverse health effects such as asthma and other respiratory diseases, but the underlying chemical processes are not well characterized. Here we present chemical exposure-response relations between ambient concentrations of air pollutants and the production rates and concentrations of reactive oxygen species (ROS) in the epithelial lining fluid (ELF) of the human respiratory tract. In highly polluted environments, fine particulate matter (PM2.5) containing redox-active transition metals, quinones, and secondary organic aerosols can increase ROS concentrations in the ELF to levels characteristic for respiratory diseases. Ambient ozone readily saturates the ELF and can enhance oxidative stress by depleting antioxidants and surfactants. Chemical exposure-response relations provide a quantitative basis for assessing the relative importance of specific air pollutants in different regions of the world, showing that aerosol-induced epithelial ROS levels in polluted megacity air can be several orders of magnitude higher than in pristine rainforest air. PMID:27605301

  8. Associations of hand-washing frequency with incidence of acute respiratory tract infection and influenza-like illness in adults: a population-based study in Sweden

    OpenAIRE

    Merk, Hanna; Kühlmann-Berenzon, Sharon; Linde, Annika; Nyrén, Olof

    2014-01-01

    Background Frequent hand-washing is standard advice for avoidance of respiratory tract infections, but the evidence for a preventive effect in a general community setting is sparse. We therefore set out to quantify, in a population-based adult general population cohort, the possible protection against acute respiratory tract infections (ARIs) conferred by a person’s self-perceived hand-washing frequency. Methods During the pandemic influenza season from September 2009 through May 2010, a coho...

  9. Simptomi in znaki s področja spodnjih dihal v ambulanti družinskega zdravnika: Lower respiratory tract symptoms in family practice:

    OpenAIRE

    Kopčavar Guček, Nena; Mazej Poredoš, Barbara

    2012-01-01

    Cough, dyspnea.chest pain, wheezing, hemoptysis, hemoptoe, abnormal breathing patterns and sputum are the main symptoms of lower respiratory tract disease, which can easily be recognized via a thorough examination of medical history in a family practice. The specificity of the symptoms varies greatly. While cough can indicate the involvement of several organs, wheezing is highly indicative of lower respiratory tract disease. This article discusses some of the lung symptoms and signs, their ch...

  10. Effect of vitamin D supplementation on prevention of upper respiratory tract infections : a systematic review of randomized controlled trials / y Guo Jing

    OpenAIRE

    Guo, Jing; 郭婧

    2013-01-01

    Background The prevention of chronic diseases has always been a major focus in the medical field as a measure to improve public health. As a potential prevention to one of the most common chronic diseases, vitamin D was previously reported to show some signs of positive effect on the prevention of upper respiratory tract infections. Although trials were performed to demonstrate the association between the effectiveness of vitamin D and upper respiratory tract infections in the past few yea...

  11. Four country healthcare-associated infection prevalence survey: pneumonia and lower respiratory tract infections.

    LENUS (Irish Health Repository)

    Humphreys, H

    2010-03-01

    In 2006, the Hospital Infection Society was funded by the respective health services in England, Wales, Northern Ireland and the Republic of Ireland to conduct a prevalence survey of healthcare-associated infection (HCAI). Here, we report the prevalence of pneumonia and lower respiratory tract infection other than pneumonia (LRTIOP) in these four countries. The prevalence of all HCAIs was 7.59% (5743 out of 75 694). Nine hundred (15.7%) of these infections were pneumonia, and 402 (7.0%) were LRTIOP. The prevalence of both infections was higher for males than for females, and increased threefold from those aged <35 to those aged >85 years (P<0.001). At the time of the survey or in the preceding seven days, 23.7% and 18.2% of patients with pneumonia and LRTIOP, respectively, were mechanically ventilated compared to 5.2% of patients in the whole study population. Meticillin-resistant Staphylococcus aureus (MRSA) was the cause of pneumonia and LRTIOP in 7.6% and 18.1% of patients, respectively (P<0.001). More patients with LRTIOP (4.2%) had concurrent diarrhoea due to Clostridium difficile compared to patients with pneumonia (2.4%), but this did not reach statistical significance. Other HCAIs were present in 137 (15.2%) of patients with pneumonia and 66 (16.4%) of those with LRTIOP. The results suggest that reducing instrumentation, such as mechanical ventilation where possible, should help reduce infection. The higher prevalence of MRSA as a cause of LRTIOP suggests a lack of specificity in identifying the microbial cause and the association with C. difficile emphasises the need for better use of antibiotics.

  12. Alternative Treatment Applications in Children with Respiratory Tract Infections in the West of Turkey

    Directory of Open Access Journals (Sweden)

    Naci Topaloğlu

    2013-04-01

    Full Text Available Introduction: It is known that the trend toward alternative treatments is increasing each day regardless of the differences between communities. We aimed to detect alternative treatments in our region and to determine the thoughts of families about these treatments. Materials and Methods: A total of 214 patients presenting to General Pediatrics Outpatient Clinics of Çanakkale Onsekiz Mart University Teaching and Research Hospital between October 2012 and February 2012 with fever, coughs, sore throat, wheezing and diagnosed as upper or lower respiratory tract infection and their parents are included in the study. Results: A total of 93.7% of parents were using non-drug applications with varying frequencies. Alternative practices are being used prior to drug treatment (62.7%, with drugs (28.7%, when there is no response to drugs (6.7% or never (1.9%. Most common used applications to reduce cough was to give pure honey (30.6% and the most common application to lower the fever was to use warm shower (48.1%. Most common source of information for these applications was relatives and family members. It was shown that the most requested resources to get information were doctors, nurses and other health care professionals with 84.5%. There was statistically significant correlation between educational status and frequency of usage of non-drug applications. However, requested source of information did not change according to the educational status. Conclusions: As a result we thought that doctors and nurses dealing with child health and disease should obtain information about alternative treatments and help the parents about logical managements. (Journal of Current Pediatrics 2013; 11: 23-6

  13. Upper respiratory tract bacteria in Influenza-like illness cases in Indonesia using multiplex PCR method

    Directory of Open Access Journals (Sweden)

    Vivi Setiawaty

    2014-02-01

    Full Text Available AbstrakLatar belakang: Walaupun surveilans ILI di Indonesia sudah berlangsung sejak tahun 2006, namun belum diketahui data mengenai bakteri-bakteri yang dapat dideteksi dari kasus ILI dan kemungkinan menyebabkan ILI.Metode: Penelitian dilakukan pada bulan Maret – Desember tahun 2012, laboratorium Virologi Pusat Biomedis dan Teknologi Dasar Kesehatan menerima spesimen apus tenggorokan dan apus hidung dari 9 puskesmas yang menjadi sentinel surveilan ILI. Spesimen diperiksa menggunakan multipleks PCR untuk mendeteksi 6 panel bakteri.Hasil:Sebanyak 175 spesimen kasus ILI bakteri yang paling banyak ditemukan pada spesimen ini adalah Streptococcus pneumoniae (n=163, Haemophilus influenzae (n=146 dan Legionella pneumophila (41.Kesimpulan:Pada pasien ILI bakteri yang biasa terdeteksi pada saluran pernapasan bagian atas adalah Streptococcus  pneumoniae, Haemophilus  influenzae  dan  Legionella  pneumophila.  (Health Science Indones 2013;2:83-6Kata kunci:infeksi bakteri, ILI, PCR multipleksAbstractBackground: ILI surveillance in Indonesia has been conducted since 2006, but no data on the bacteria can be detected and caused ILI has been obtained. Method: From March to December 2012, Center for Research on Biomedic and Basic Health Technology’s laboratory was receiving throat and nose swab specimens from nine Public Health Centers appointed as the sentinels for ILI surveillance. These specimens were analyzed using multiplex PCR method, which detected six panels of bacteria. Results: 175 specimens taken from ILI patients contained three most frequently found species of bacteria: Streptococcus pneumoniae (n=163, Haemophilus influenzae (n=146 andLegionella pneumophila (41. Conclusion: In ILI patients, there are several bacteria most frequently detected in upper respiratory tract such as Streptococcus pneumoniae, Haemophilus influenzae and Legionella pneumophila. (Health Science Indonesia 2013;2:83-6Key words:bacterial infection, ILI, multiplex PCR

  14. Respiratory tract infection is the major cause of the ambulatory visits in children

    Directory of Open Access Journals (Sweden)

    Lue KoHuang

    2011-09-01

    Full Text Available Abstract Background As children represent the future, ensuring that they receive proper health care should be a primary concern of our societies. Epidemiological research underpins the importance of effective child health care strategies, and highlights the need for accurate data collection; such surveys are currently lacking in Taiwan. In our descriptive studies, we compared the differences of the ten most common diseases in the year 2000 and 2009 among Taiwanese children. Methods Data for a total of 174,651 and 142,200 visits under eighteen years old were collected from the National Health Insurance Research Database in year 2000 and 2009. A maximum of three outpatient diagnostic codes (the International Classification of Disease [ICD], ninth revision could be listed for every visit. Data were categorized according to the principal diagnoses, age and different specialties of physicians. Results Respiratory tract infection was the most common disease (58.21% to 44.77%. Teeth (4.90% to 5.16% and eye (2.52% to 3.15% problems were the also in the list of top ten diseases. In year 2009, the rate of allergic rhinitis was 2.87% in 7-18 years old group. Pediatricians were the first option for consultation, followed by ear, nose and throat specialists and family physicians. However, for the school age children group, the role of pediatricians with regards to children's health care showed a decrease in its importance. Conclusions The amount of information relevant to child health care is rapidly expanding. The ten most common diseases of the present analysis may serve as baseline data for future evaluations of the changes of type of diseases among children.

  15. Microbiology of lower respiratory tract infection in workers of garment industry of Kathmandu

    Directory of Open Access Journals (Sweden)

    S Pant

    2015-06-01

    Full Text Available OBJECTIVES This study was designed with the objectives of describing the distribution pattern of microorganisms responsible for causing LRTI in the workers of garment industries. MATERIALS AND METHODS A total of 198 cases of suspected person of Lower Respiratory Tract infection (LRTI LRTI were included in this study. This study was conducted between November 2009 to April 2010. Specimen for the study was expectorated sputum. Gram-stain, Ziehl-Neelsen stains and culture were performed. RESULTS On direct microscopic examination, 20.51% were Gram positive bacteria, 79.48% were Gram negative bacteria and 4% were smear positive AFB. On culture sensitivity examination, 22% percent showed growth of different bacteria in different culture media. The bacteria isolated from the samples included Klebsiella pneumoniae (15.38%, Proteus mirabilis (15.38% and Citrobacterfruendii (15.38%. Gram Negative bacteria were found most susceptible to Ciprofloxacin (92.30%, 24/26 and Amikacin (92.30%, 24/26. Similarly, Gram Positive bacteria were found most susceptible to Ciprofloxacin (100%, 8/8 followed by Cloxacillin and Cephalexin (87.5%, 7/8. Smear positive AFB was significantly associated with not using the protective measures (mask by workers and presence of symptoms (cough for more than two weeks, night sweat, hemoptysis and anorexia (p=0.031. Culture positivity was significantly associated with symptoms like production of purulent sputum (p=0.045. CONCLUSION There was insignificant association between LRTI and risk factors present in working room of garment industries. Most of the isolates were sensitive to Ciprofloxacin and resistance to Ampicillin and Cephalexin.DOI: http://dx.doi.org/10.3126/jcmsn.v10i3.12772 Journal of College of Medical Sciences-Nepal, 2014, Vol-10, No-3, 14-22

  16. Maternal agency influences the prevalence of diarrhea and acute respiratory tract infections among young Indonesian children.

    Science.gov (United States)

    Agustina, Rina; Shankar, Anita V; Ayuningtyas, Azalea; Achadi, Endang L; Shankar, Anuraj H

    2015-05-01

    To examine the relationship between measures of mother's caretaking, practice and individual agency on acute diarrhea and respiratory tract infections (ARTIs) of Indonesian children. Using population-based household data from the Indonesian Demographic Health Surveys for 2002-2003 (n = 9,151 children) and 2007 (n = 9,714 children), we selected 28 indicators related to mother' caretaking, and applied principal component analysis to derive indices for access to care, practice and experience, and agency. The association between index quartiles (level 1-4) and the prevalence of diarrhea and ARTIs in the youngest child <5 years of age was assessed with multivariate logistic regression adjusting for socioeconomic status, residence type, mother's age and education, family size, child's age and sex, immunization status and received vitamin A supplementation. Moderate levels (level 3) of practice and experience were associated with decreased diarrheal risk (adjusted OR 0.86, 95 % CI 0.75-0.98), but not for ARTIs. Children of mothers with higher levels (level 4) of agency were protected against both diarrhea (adjusted OR 0.68, 95 % CI 0.60-0.77) and ARTIs (adjusted OR 0.77, 95 % CI 0.66-0.91). Stratified analyses with child's age and mother's education, and tests of interaction, showed that agency had a stronger effect on diarrhea and ARTIs prevalence in children <2 years of age. Maternal caretaking, especially agency, is strongly associated with lower prevalence of diarrhea and ARTIs in younger children. Interventions specifically designed to promote maternal autonomy and decision-making may lead to improved child health.

  17. Drugs in upper respiratory tract infections in paediatric patients in North Trinidad

    Directory of Open Access Journals (Sweden)

    Thurston P

    2009-03-01

    Full Text Available Objective: We explored the prescribing patterns of physicians in North Trinidad in treating upper respiratory tract infections (URTI in paediatric patients and the appropriateness of drugs prescribed.Methods: A retrospective observational study was conducted, with a sample size of 523 paediatric patients, diagnosed with an URTI during the period of June 2003 to 22 June 2005. The study was conducted at five Primary Health Care Facilities in North Trinidad.Results: The three most frequent URTIs diagnosed were non-specific URTI, common cold, and acute tonsillitis in rank order. Four patterns of prescribing were identified, (1 no drug therapy [1.9%]; (2 antibiotic therapy alone [6.1%]; (3 antibiotic and symptomatic therapy [53.0%]; and (4 symptomatic therapy alone [39.0%]. The, most frequently prescribed antibiotics were penicillins (amoxicillin [46.3%] and amoxicillin/clavulanate [5.3%] and a macrolide (erythromycin [6.1%]. The three symptomatic agents most frequently prescribed were paracetamol [40.1%]; diphenhydramine [29.1%]; and normal saline nasal drops [14.2%]. In 112 cases with swab analyses done, of these, 98.2% revealed a growth of commensals only, while 1.8% grew pathogenic micro-organisms. Of the cases showing commensal growth only, 84.6% were treated with an antibiotic, 14.5% were treated with symptomatic agents alone and 0.9% received no drug therapy at all. Conclusions: A large proportion of paediatric patients diagnosed with an URTI in North Trinidad was prescribed antibiotics although not indicated The inappropriate use of antibiotics can potentiate the worldwide trend of antimicrobial resistance.

  18. Micromachined polymerase chain reaction system for multiple DNA amplification of upper respiratory tract infectious diseases.

    Science.gov (United States)

    Liao, Chia-Sheng; Lee, Gwo-Bin; Wu, Jiunn-Jong; Chang, Chih-Ching; Hsieh, Tsung-Min; Huang, Fu-Chun; Luo, Ching-Hsing

    2005-01-15

    This paper presents a micro polymerase chain reaction (PCR) chip for the DNA-based diagnosis of microorganism genes and the detection of their corresponding antibiotic-resistant genes. The micro PCR chip comprises cheap biocompatible soda-lime glass substrates with integrated thin-film platinum resistors as heating/sensing elements, and is fabricated using micro-electro-mechanical-system (MEMS) techniques in a reliable batch-fabrication process. The heating and temperature sensing elements are made of the same material and are located inside the reaction chamber in order to ensure a uniform temperature distribution. This study performs the detection of several genes associated with upper respiratory tract infection microorganisms, i.e. Streptococcus pneumoniae, Haemopilus influenze, Staphylococcu aureus, Streptococcus pyogenes, and Neisseria meningitides, together with their corresponding antibiotic-resistant genes. The lower thermal inertia of the proposed micro PCR chip relative to conventional bench-top PCR systems enables a more rapid detection operation with reduced sample and reagent consumption. The experimental data reveal that the high heating and cooling rates of the system (20 and 10 degrees C/s, respectively) permit successful DNA amplification within 15 min. The micro PCR chip is also capable of performing multiple DNA amplification, i.e. the simultaneous duplication of multiple genes under different conditions in separate reaction wells. Compared with the large-scale PCR system, it is greatly advantageous for fast diagnosis of multiple infectious diseases. Multiplex PCR amplification of two DNA segments in the same well is also feasible using the proposed micro device. The developed micro PCR chip provides a crucial tool for genetic analysis, molecular biology, infectious disease detection, and many other biomedical applications. PMID:15590288

  19. Impact of symptomatic upper respiratory tract infections on insulin absorption and action of Technosphere inhaled insulin

    Science.gov (United States)

    Levin, Philip A; Heinemann, Lutz; Boss, Anders; Rosenblit, Paul D

    2016-01-01

    Objective Uncomplicated, acute upper respiratory tract infections (URTIs) occur in patients with diabetes at a similar frequency to the general population. This study (NCT00642681) investigated the effect of URTIs on the pharmacokinetic (PK) and pharmacodynamic (PD) properties of Technosphere inhaled insulin (TI) in patients with type 1 or type 2 diabetes. Research design and methods This was a phase 2 study conducted in patients who developed a URTI while being treated with TI in a phase 3 study (N=20, mean age 50 years, 60% men). Patients underwent two 4-hour meal challenges, during which blood samples were drawn to measure serum fumaryl diketopiperazine (FDKP; the excipient representing an essential part of TI), serum insulin, serum C-peptide, and plasma glucose. The primary outcome was the ratio of serum FDKP area under the concentration–time curve from 0 to 240 min (AUC0–240 min) during URTI and after clinical resolution of URTI symptoms (≥15 to ≤45 days). Results No significant differences in PK parameters were seen during URTI versus post-URTI for FDKP. The ratio of serum FDKP AUC0–240 min during URTI and post-URTI was 1.1 (SD 0.6), p=0.4462. Plasma glucose concentrations during each 4-hour meal challenge were similar, showing small non-significant differences. No adverse events, including hypoglycemia, occurred during meal challenge visits. Conclusions Development of an active, symptomatic URTI during treatment with TI had no significant impact on the PK/PD properties of TI, suggesting that no adjustment in prandial insulin dosing is needed. However, if patients are unable to conduct proper inhalation, they should administer their prandial insulin subcutaneously. Trial registration number NCT00642681; Results. PMID:27648286

  20. Antibiotic sensitivity pattern of gram negative bacilli isolated from the lower respiratory tract of ventilated patients in the intensive care unit

    Directory of Open Access Journals (Sweden)

    Goel Nidhi

    2009-01-01

    Full Text Available Background: Lower respiratory tract infections (LRTIs are the most frequent infections among patients in Intensive care units (ICUs. Aims: To know the bacterial profile and determine the antibiotic susceptibility pattern of the lower respiratory tract isolates from patients admitted to the ICU. Settings and Design: Tertiary care hospital, retrospective study. Materials and Methods: Transtracheal or bronchial aspirates from 207 patients admitted to the ICU were cultured, identified, and antibiotic sensitivity was performed by standard methods. Statistical Analysis Used: SPSS software was used for calculation of % R of 95% confidence interval (CI. Results: Of 207 specimens, 144 (69.5% were culture positive and 63 (30.4% showed no growth. From 144 culture positives, 161 isolates were recovered, of which 154 (95.6% were Gram negative bacilli (GNB. In 17 (11.0% patients, two isolates per specimen were recovered. The most common GNB in order of frequency were Pseudomonas aeruginosa (35%, Acinetobacter baumannii (23.6%, and Klebsiella pneumoniae (13.6%. A very high rate of resistance (80-100% was observed among predominant GNB to ciprofloxacin, ceftazidime, co-trimoxazole, and amoxycillin/clavulanic acid combination. Least resistance was noted to meropenem and doxycycline. Conclusion: Nonfermenters are the most common etiological agents of LRTIs in ICU. There is an alarmingly high rate of resistance to cephalosporin and β-lactam-β-lactamase inhibitor group of drugs. Meropenem was found to be the most sensitive drug against all GNB. Acinetobacter and Klebsiella spp. showed good sensitivity to doxycycline.

  1. Incidence of GP-diagnosed respiratory tract infections according to age, gender and high-risk co-morbidity: the Second Dutch National Survey of General Practice.

    NARCIS (Netherlands)

    Hak, E.; Rovers, M.M.; Kuyvenhoven, M.M.; Schellevis, F.G.; Verheij, T.J.M.

    2006-01-01

    Background. Figures on GP-diagnosed respiratory tract infections (RTI) are outdated because of demographic changes and increase in co-morbid conditions, respiratory vaccination programmes and change in illness behaviour. Objective. To determine the incidence of RTI in patients presenting to the GP a

  2. Incidence of GP-diagnosed respiratory tract infections according to age, gender and high-risk co-morbidity : the Second Dutch National Survey of General Practice

    NARCIS (Netherlands)

    Hak, E; Rovers, M M; Kuyvenhoven, M M; Schellevis, F G; Verheij, T J M

    2006-01-01

    BACKGROUND: Figures on GP-diagnosed respiratory tract infections (RTI) are outdated because of demographic changes and increase in co-morbid conditions, respiratory vaccination programmes and change in illness behaviour. OBJECTIVE: To determine the incidence of RTI in patients presenting to the GP a

  3. Diagnostic value of real-time polymerase chain reaction to detect viruses in young children admitted to the paediatric intensive care unit with lower respiratory tract infection

    NARCIS (Netherlands)

    van de Pol, Alma C; Wolfs, Tom F W; Jansen, Nicolaas J G; van Loon, Anton M; Rossen, John W A

    2006-01-01

    INTRODUCTION: The aetiology of lower respiratory tract infections in young children admitted to the paediatric intensive care unit (PICU) is often difficult to establish. However, most infections are believed to be caused by respiratory viruses. A diagnostic study was performed to compare convention

  4. Analysis of antibiotic consumption for treating respiratory tract infections in children and compliance with the national clinical guidelines

    Directory of Open Access Journals (Sweden)

    Lakić Dragana

    2014-01-01

    Full Text Available Introduction. Respiratory infections are the most common infections in children. The aims of the study were to analyze the use of antibiotics for respiratory infections in the period 2008 - 2010 in children’s population in region of Niš and to estimate the rational use of antibiotics in relation to the recommendations of the National Guidelines for physicians in primary care. Material and methods. Data source was a Pharmacy Niš database. Antibiotics prescriptions were selected for the following diagnoses: H65-H75 (acute otitis media, mastoiditis, J01 (acute sinusitis, J02-J03 (tonsillopharyngitis, J12-J18 (community acquired pneumonia, J20 (acute bronchitis, J32 (chronic sinusitis, J42 (chronic bronchitis. Antibiotic consumption was expressed in defined daily dose/1000 inhabitants/day. Results. The most widely prescribed antibiotic for the treatment of upper respiratory tract infections in children during the three years was amoxicillin (34.63; 32.50 and 31.00 defined daily dose/1000 inhabitants/day in 2008, 2009 and 2010, respectively. In the treatment of infections of the middle ear and mastoid, the combination of amoxicillin and clavulanic acid, was the most prescribed antibiotics (60% of total consumption of antibiotics for this indication. Azithromycin was the most widely prescribed antibiotic for the treatment of lower respiratory tract infections in children during the observed period (6.92; 8.20 and 7.18 defined daily dose/1000 inhabitans/day in 2008, 2009 and 2010, respectively. Conclusion. Recommendations of national guidelines are not complied with the treatment of upper and lower respiratory infections in the children population in region of Niš. This could be a sign of potentially irrational use of antibiotics that need to be further examined. Education of physicians can influence irrational use of antibiotics.

  5. Effect of Antimicrobial Consumption and Production Type on Antibacterial Resistance in the Bovine Respiratory and Digestive Tract.

    Directory of Open Access Journals (Sweden)

    Boudewijn Catry

    Full Text Available The aim of this study was to investigate the relationship between antimicrobial use and the occurrence of antimicrobial resistance in the digestive and respiratory tract in three different production systems of food producing animals. A longitudinal study was set up in 25 Belgian bovine herds (10 dairy, 10 beef, and 5 veal herds for a 2 year monitoring of antimicrobial susceptibilities in E. coli and Pasteurellaceae retrieved from the rectum and the nasal cavity, respectively. During the first year of observation, the antimicrobial use was prospectively recorded on 15 of these farms (5 of each production type and transformed into the treatment incidences according to the (animal defined daily dose (TIADD and (actually used daily dose (TIUDD. Antimicrobial resistance rates of 4,174 E. coli (all herds and 474 Pasteurellaceae (beef and veal herds only isolates for 12 antimicrobial agents demonstrated large differences between intensively reared veal calves (abundant and inconstant and more extensively reared dairy and beef cattle (sparse and relatively stable. Using linear mixed effect models, a strong relation was found between antimicrobial treatment incidences and resistance profiles of 1,639 E. coli strains (p<0.0001 and 309 Pasteurellaceae (p≤0.012. These results indicate that a high antimicrobial selection pressure, here found to be represented by low dosages of oral prophylactic and therapeutic group medication, converts not only the commensal microbiota from the digestive tract but also the opportunistic pathogenic bacteria in the respiratory tract into reservoirs of multi-resistance.

  6. Effect of Antimicrobial Consumption and Production Type on Antibacterial Resistance in the Bovine Respiratory and Digestive Tract.

    Science.gov (United States)

    Catry, Boudewijn; Dewulf, Jeroen; Maes, Dominiek; Pardon, Bart; Callens, Benedicte; Vanrobaeys, Mia; Opsomer, Geert; de Kruif, Aart; Haesebrouck, Freddy

    2016-01-01

    The aim of this study was to investigate the relationship between antimicrobial use and the occurrence of antimicrobial resistance in the digestive and respiratory tract in three different production systems of food producing animals. A longitudinal study was set up in 25 Belgian bovine herds (10 dairy, 10 beef, and 5 veal herds) for a 2 year monitoring of antimicrobial susceptibilities in E. coli and Pasteurellaceae retrieved from the rectum and the nasal cavity, respectively. During the first year of observation, the antimicrobial use was prospectively recorded on 15 of these farms (5 of each production type) and transformed into the treatment incidences according to the (animal) defined daily dose (TIADD) and (actually) used daily dose (TIUDD). Antimicrobial resistance rates of 4,174 E. coli (all herds) and 474 Pasteurellaceae (beef and veal herds only) isolates for 12 antimicrobial agents demonstrated large differences between intensively reared veal calves (abundant and inconstant) and more extensively reared dairy and beef cattle (sparse and relatively stable). Using linear mixed effect models, a strong relation was found between antimicrobial treatment incidences and resistance profiles of 1,639 E. coli strains (p<0.0001) and 309 Pasteurellaceae (p≤0.012). These results indicate that a high antimicrobial selection pressure, here found to be represented by low dosages of oral prophylactic and therapeutic group medication, converts not only the commensal microbiota from the digestive tract but also the opportunistic pathogenic bacteria in the respiratory tract into reservoirs of multi-resistance. PMID:26820134

  7. The development and validation of a multidimensional sum-scaling questionnaire to measure patient-reported outcomes in acute respiratory tract infections in primary care: the Acute Respiratory Tract Infection Questionnaire: ARTIQ

    DEFF Research Database (Denmark)

    Aabenhus, R.; Thorsen, H.; Siersma, V.;

    2013-01-01

    to test dimensionality, objectivity, and reliability of items. Test of known groups' validity was conducted by comparing participants with and without an ARTI. RESULTS: The final version of the ARTIQ consisted of 38 items covering five dimensions (Physical-upper, Physical-lower, Psychological, Sleep...... interviews and field testing among adults with an ARTI were conducted to ascertain a high degree of face and content validity of the questionnaire. Subsequently, a draft version of the Acute Respiratory Tract Infection Questionnaire (ARTIQ) was statistically validated by using the partial credit Rasch model...

  8. Respiratory disease in young adults: influence of early childhood lower respiratory tract illness, social class, air pollution, and smoking

    Energy Technology Data Exchange (ETDEWEB)

    Colley, J.R.T.; Douglas, J.W.B.; Reid, D.D.

    1973-01-01

    Of the factors examined, smoking and, to a lesser extent, lower respiratory illness prior to age 2, were found to have the greatest effect on prevalence of cough in a group of 3,899 20-yr-olds. Social class of father and air pollution had little effect in this cohort.

  9. Drug-resistant genes carried by Acinetobacter baumanii isolated from patients with lower respiratory tract infection

    Institute of Scientific and Technical Information of China (English)

    DAI Ning; ZHANG Wei; LI Jia-shu; YU Qin; WAN Huan-ying; MU Lan; ZHONG Xiao-ning; WEI Li-ping; MA Jian-jun; WANG Qiu-yue; HU Ke; LI De-zhi; TIAN Gui-zhen; CAI Shao-xi; WANG Rui-qin; HE Bei; WANG Si-qin; WANG Zhan-wei; ZHAO Su-rui; GAO Zhan-cheng; CHEN Ji-chao; CHEN Yu-sheng; GENG Rong; HU Ying-hui; YANG Jing-ping; DU Juan; HU Cheng-ping

    2010-01-01

    Background Acinetobacter baumanii (A. baumanii) remains an important microbial pathogen resulting in nosocomial acquired infections with significant morbidity and mortality. The mechanism by which nosocomial bacteria, like A.baumanii, attain multidrug resistance to antibiotics is of considerable interest. The aim in this study was to investigate the spread status of antibiotic resistance genes, such as multiple β-lactamase genes and aminoglycoside-modifying enzyme genes, from A. baumanii strains isolated from patients with lower respiratory tract infections (LRTIs).Methods Two thousand six hundred and ninety-eight sputum or the bronchoalveolar lavage samples from inpatients with LRTIs were collected in 21 hospitals in the mainland of China from November 2007 to February 2009. All samples were routinely inoculated. The isolated bacterial strains and their susceptibility were analyzed via VITEK-2 expert system.Several kinds of antibiotic resistant genes were further differentiated via polymerase chain reaction and sequencing methods.Results Totally, 39 A. baumanii strains were isolated from 2698 sputum or bronchoalveolar lavage samples. There was not only a high resistant rate of the isolated A. baumanii strains to ampicillin and first- and second-generation cephalosporins (94.87%, 100% and 97.44%, respectively), but also to the third-generation cephalosporins (ceftriaxone at 92.31%, ceftazidine at 51.28%) and imipenem (43.59%) as well. The lowest antibiotic resistance rate of 20.51% was found to amikacin. The OXA-23 gene was identified in 17 strains of A. baumanii, and the AmpC gene in 23 strains. The TEM-1 gene was carried in 15 strains. PER-1 and SHV-2 genes were detected in two different strains.Aminoglycoside-modifying enzyme gene aac-3-la was found in 23 strains, and the aac-6'-lb gene in 19 strains, aac-3-la and aac-6'-lb genes hibernated in three A. baumanii strains that showed no drug-resistant phenotype.Conclusions A. baumaniican carry multiple drug

  10. [Bacteriological and virological status in upper respiratory tract infections of cats (cat common cold complex)].

    Science.gov (United States)

    Adler, Kerstin; Radeloff, Isabel; Stephan, Bernd; Greife, Heinrich; Hellmann, Klaus

    2007-01-01

    Between October 2002 and January 2005,460 bacteriological samples from cats with an acute upper respiratory tract infection were analysed in clinical field studies in two accredited laboratories in Germany. Oropharyngeal swabs were taken from these cats and sent to the laboratories for routine diagnostics. In the swab samples of 460 cats 382 bacteria strains were isolated. The following bacteria were isolated most frequently: Pasteurella spp. (32.5 %), Staphylococcus spp. (18.5 %), Escherichia coli (17.0 %), Streptococcus spp. (9.1 %), Pseudomonas spp. (6.9 %) and Klebsiella spp. (3.0 %). Bordetella bronchiseptica was found in 0.4 % of the animals To evaluate possible regional and time influences, the animals were split into three populations: 1: Germany, laboratory A; 2: Germany, laboratory B; 3: France and Belgium, laboratory B. In population 1 an 2 Pasteurella spp. were found most frequently with 42.2 % and 36.5 %, respectively. The second most frequently isolated bacterial species were Staphylococcus spp. with 14.1 % and 21.4 % and E. coli with 13.6 % and 17.5 % respectively. In population 3 Staphylococcus spp., E. coli (20 % each) and Pasteurella spp. (18.5 %) were isolated at almost the same frequency. Virological parameter were additionally analysed in 328 cats (population 2 and 3). Serum samples were analysed for antibodies specific for Feline Calicivirus (FCV) and Feline Immunodeficiency Virus (FIV) and for Feline Leukaemia Virus (FeLV) antigen. Oropharyngeal swabs were analysed for Feline Herpesvirus (FHV) by using PCR. Calicivirus-specific antibodies were found in 99.6 % of the cats of population 2 and in 100 % of the animals in population 3. Herpesvirus was detected in 15.3 % and 23.3 % of the cats, respectively. FeLV-Antigen was found in 0.4 % of the animals in population 2 and in 10.1 % of the cats in population 3, while FIV-antibodies were identified in 8.7 % of the animals of population 2 and in 6.1 % of the cats of population 3. In total FHV was

  11. Molecular Epidemiology of Streptococcus pneumoniae Isolates from Children with Recurrent Upper Respiratory Tract Infections.

    Science.gov (United States)

    Korona-Glowniak, Izabela; Maj, Maciej; Siwiec, Radosław; Niedzielski, Artur; Malm, Anna

    2016-01-01

    A total of 125 isolates were recovered from adenoids and/or nasopharynx of 170 children aged 2 to 5 from south-east Poland; they had undergone adenoidectomy for recurrent and/or persistent symptoms of upper respiratory tract infections. Pneumococcal isolates were analyzed by phenotyping (serotyping and antimicrobial resistance tests) and genotyping together with the clonality of the pneumococcal isolates based on resistance determinants, transposon distribution and multilocus sequence typing (MLST). Serotypes 19F, 6B and 23F constituted 44.8% of the isolates. Among all of the strains, 44.8% showed decreased susceptibility to penicillin and resistance to co-trimoxazole (52.8%), tetracycline (38.4%), erythromycin (53.6%), clindamycin (52.8%) and chloramphenicol (27.2%) was observed. Tn6002 was found in 34.8% of erythromycin-resistant isolates while composite Tn2010-in 16.7% of erm(B)-carrying isolates that harboured also mef(E) gene. Tn3872-related elements were detected in 27.3% of erythromycin-resistant strains. In the majority of chloramphenicol-resistant catpC194-carrying isolates (79.4%), ICESp23FST81-family elements were detected. The genotyping showed that pneumococcal population was very heterogeneous; 82 sequence types (STs) were identified, and the most frequent contributed to not more than 8% of the isolates. Nearly 44% STs were novel, each of them was recovered only from one child. Four STs belonged to one of the 43 worldwide spread resistant pneumococcal clones currently accepted by Pneumococcal Molecular Epidemiology Network (PMEN), i.e. Spain 9V-3, Spain 23F-1, Norway NT-42 and Poland 6B-20, accounting for 12 (16.7%) of the 75 nonususceptible isolates, and five STs were single-locus variants of PMEN resistant clones (England 14-9, Spain 9V-3, Spain 23F-1, Greece 21-30, Denmark 14-32), accounting 9 (12%) of nonsusceptible isolates. A few MDR clones belonging to 6B and 19F serotypes found among preschool children emphasizes rather the role of clonal

  12. Efficacy and Safety of Procalcitonin-Guided Antibiotic Therapy in Lower Respiratory Tract Infections

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    Werner C. Albrich

    2013-01-01

    Full Text Available Background: In 14 randomized controlled studies to date, a procalcitonin (PCT-based algorithm has been proven to markedly reduce the use of antibiotics along with an unimpaired high safety and low complication rates in patients with lower respiratory tract infections (LRTIs. However, compliance with the algorithm and safety out of controlled study conditions has not yet been sufficiently investigated. Methods: We performed a prospective international multicenter observational post-study surveillance of consecutive adults with community-acquired LRTI in 14 centers (Switzerland (n = 10, France (n = 3 and the United States (n = 1. Results: Between September 2009 and November 2010, 1,759 patients were enrolled (median age 71; female sex 44.4%. 1,520 (86.4% patients had a final diagnosis of LRTI (community-acquired pneumonia (CAP, 53.7%; acute exacerbation of chronic obstructive pulmonary disease (AECOPD, 17.1%; and acute bronchitis, 14.4%. Compliance with the PCT-guided therapy (overall 68.2% was highest in patients with bronchitis (81.0% vs. AECOPD, 70.1%; CAP, 63.7%; p < 0.001, outpatients (86.1% vs. inpatients, 65.9%; p < 0.001 and algorithm-experienced centers (82.5% vs. algorithm-naive, 60.1%; p < 0.001 and showed significant geographical differences. The initial decision about the antibiotic therapy was based on PCT value in 72.4%. In another 8.6% of patients, antibiotics were administered despite low PCT values but according to predefined criteria. Thus, the algorithm was followed in 81.0% of patients. In a multivariable Cox hazard ratio model, longer antibiotic therapy duration was associated with algorithm-non-compliance, country, hospitalization, CAP vs. bronchitis, renal failure and algorithm-naïvety of the study center. In a multivariable logistic regression complications (death, empyema, ICU treatment, mechanical ventilation, relapse, and antibiotic-associated side effects were significantly associated with increasing CURB65-Score, CAP

  13. Molecular Epidemiology of Streptococcus pneumoniae Isolates from Children with Recurrent Upper Respiratory Tract Infections.

    Science.gov (United States)

    Korona-Glowniak, Izabela; Maj, Maciej; Siwiec, Radosław; Niedzielski, Artur; Malm, Anna

    2016-01-01

    A total of 125 isolates were recovered from adenoids and/or nasopharynx of 170 children aged 2 to 5 from south-east Poland; they had undergone adenoidectomy for recurrent and/or persistent symptoms of upper respiratory tract infections. Pneumococcal isolates were analyzed by phenotyping (serotyping and antimicrobial resistance tests) and genotyping together with the clonality of the pneumococcal isolates based on resistance determinants, transposon distribution and multilocus sequence typing (MLST). Serotypes 19F, 6B and 23F constituted 44.8% of the isolates. Among all of the strains, 44.8% showed decreased susceptibility to penicillin and resistance to co-trimoxazole (52.8%), tetracycline (38.4%), erythromycin (53.6%), clindamycin (52.8%) and chloramphenicol (27.2%) was observed. Tn6002 was found in 34.8% of erythromycin-resistant isolates while composite Tn2010-in 16.7% of erm(B)-carrying isolates that harboured also mef(E) gene. Tn3872-related elements were detected in 27.3% of erythromycin-resistant strains. In the majority of chloramphenicol-resistant catpC194-carrying isolates (79.4%), ICESp23FST81-family elements were detected. The genotyping showed that pneumococcal population was very heterogeneous; 82 sequence types (STs) were identified, and the most frequent contributed to not more than 8% of the isolates. Nearly 44% STs were novel, each of them was recovered only from one child. Four STs belonged to one of the 43 worldwide spread resistant pneumococcal clones currently accepted by Pneumococcal Molecular Epidemiology Network (PMEN), i.e. Spain 9V-3, Spain 23F-1, Norway NT-42 and Poland 6B-20, accounting for 12 (16.7%) of the 75 nonususceptible isolates, and five STs were single-locus variants of PMEN resistant clones (England 14-9, Spain 9V-3, Spain 23F-1, Greece 21-30, Denmark 14-32), accounting 9 (12%) of nonsusceptible isolates. A few MDR clones belonging to 6B and 19F serotypes found among preschool children emphasizes rather the role of clonal

  14. Use and feasibility of delayed prescribing for respiratory tract infections: A questionnaire survey

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    Lindbæk Morten

    2011-05-01

    Full Text Available Abstract Background Delayed prescribing of antibiotics for respiratory tract infections (RTIs lowers the amount of antibiotics consumed. Several national treatment guidelines on RTIs recommend the strategy. When advocating treatment innovations, the feasibility and credibility of the innovation must be taken into account. The objective of this study was to explore GPs use and patients uptake of wait-and-see prescriptions for RTIs, and to investigate the feasibility of the strategy from GPs' and patients' perspectives. Methods Questionnaire survey among Norwegian GPs issuing and patients receiving a wait-and-see-prescription for RTIs. Patients reported symptoms, confidence and antibiotics consumption, GPs reported diagnoses, reason for issuing a wait-and-see-prescription and their opinion about the method. Results 304 response pairs from consultations with 49 GPs were received. The patient response rate was 80%. The most common diagnosis for the GPs to issue a wait-and-see prescription was sinusitis (33% and otitis (21%. 46% of the patients reported to consume the antibiotics. When adjusted for other factors, the diagnosis did not predict antibiotic consumption, but both being 16 years or more (p = 0,006 and reporting to have a fever (p = 0,012 doubled the odds of antibiotic consumption, while feeling very ill more than quadrupled the odds (p = 0,002. In 210 cases (69%, the GP found delayed prescribing a very reasonable strategy, and 270 patients (89% would prefer to receive a wait-and-see prescription in a similar situation in the future. The GPs found delayed prescribing very reasonable most frequently in cases of sinusitis (79%, p = 0,007 and least frequently in cases of lower RTIs (49%, p = 0,002. Conclusion Most patients and GPs are satisfied with the delayed prescribing strategy. The patients' age, symptoms and malaise are more important than the diagnosis in predicting antibiotic consumption. The GP's view of the method as a reasonable

  15. Cost-effectiveness of gargling for the prevention of upper respiratory tract infections

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    Kitamura Tetsuhisa

    2008-12-01

    Full Text Available Abstract Background In Japan, gargling is a generally accepted way of preventing upper respiratory tract infection (URTI. The effectiveness of gargling for preventing URTI has been shown in a randomized controlled trial that compared incidences of URTI between gargling and control groups. From the perspective of the third-party payer, gargling is dominant due to the fact that the costs of gargling are borne by the participant. However, the cost-effectiveness of gargling from a societal perspective should be considered. In this study, economic evaluation alongside a randomized controlled trial was performed to evaluate the cost-effectiveness of gargling for preventing URTI from a societal perspective. Methods Among participants in the gargling trial, 122 water-gargling and 130 control subjects were involved in the economic analysis. Sixty-day cumulative follow-up costs and effectiveness measured by quality-adjusted life days (QALD were compared between groups on an intention-to-treat basis. Incremental cost-effectiveness ratio (ICER was converted to dollars per quality-adjusted life years (QALY. The 95% confidence interval (95%CI and probability of gargling being cost-effective were estimated by bootstrapping. Results After 60 days, QALD was increased by 0.43 and costs were $37.1 higher in the gargling group than in the control group. ICER of the gargling group was $31,800/QALY (95%CI, $1,900–$248,100. Although this resembles many acceptable forms of medical intervention, including URTI preventive measures such as influenza vaccination, the broad confidence interval indicates uncertainty surrounding our results. In addition, one-way sensitivity analysis also indicated that careful evaluation is required for the cost of gargling and the utility of moderate URTI. The major limitation of this study was that this trial was conducted in winter, at a time when URTI is prevalent. Care must be taken when applying the results to a season when URTI is

  16. Application of computational fluid dynamics to regional dosimetry of inhaled chemicals in the upper respiratory tract of the rat.

    Science.gov (United States)

    Kimbell, J S; Gross, E A; Joyner, D R; Godo, M N; Morgan, K T

    1993-08-01

    For certain inhaled air pollutants, such as reactive, water soluble gases, the distribution of nasal lesions observed in F344 rats may be closely related to regional gas uptake patterns in the nose. These uptake patterns can be influenced by the currents of air flowing through the upper respiratory tract during the breathing cycle. Since data on respiratory tract lesions in F344 rats are extrapolated to humans to make predictions of risk to human health, a better understanding of the factors affecting these responses is needed. To assess potential effects of nasal airflow on lesion location and severity, a methodology was developed for creation of computer simulations of steady-state airflow and gas transport using a three-dimensional finite element grid reconstructed from serial step-sections of the nasal passages of a male F344 rat. Simulations on a supercomputer used the computational fluid dynamics package FIDAP (FDI, Evanston, IL). Distinct streams of bulk flow evident in the simulations matched inspiratory streams reported for the F344 rat. Moreover, simulated regional flow velocities matched measured velocities in concurrent laboratory experiments with a hollow nasal mold. Computer-predicted flows were used in simulations of gas transport to nasal passage walls, with formaldehyde as a test case. Results from the uptake simulations were compared with the reported distribution of formaldehyde-induced nasal lesions observed in the F344 rat, and indicated that airflow-driven uptake patterns probably play an important role in determining the location of certain nasal lesions induced by formaldehyde. This work demonstrated the feasibility of applying computational fluid dynamics to airflow-driven dosimetry of inhaled chemicals in the upper respiratory tract.

  17. The Nucleus of the Solitary Tract and the coordination of respiratory and sympathetic activities

    OpenAIRE

    DanielB.Zoccal

    2014-01-01

    It is well known that breathing introduces rhythmical oscillations in the heart rate and arterial pressure levels. Sympathetic oscillations coupled to the respiratory activity have been suggested as an important homeostatic mechanism optimizing tissue perfusion and blood gas uptake/delivery. This respiratory-sympathetic coupling is strengthened in conditions of blood gas challenges (hypoxia and hypercapnia) as a result of the synchronized activation of brainstem respiratory and sympathetic ne...

  18. The nucleus of the solitary tract and the coordination of respiratory and sympathetic activities

    OpenAIRE

    Zoccal, Daniel B.; Furuya, Werner I.; Bassi, Mirian; Colombari, Débora S. A.; Colombari, Eduardo

    2014-01-01

    It is well known that breathing introduces rhythmical oscillations in the heart rate and arterial pressure levels. Sympathetic oscillations coupled to the respiratory activity have been suggested as an important homeostatic mechanism optimizing tissue perfusion and blood gas uptake/delivery. This respiratory-sympathetic coupling is strengthened in conditions of blood gas challenges (hypoxia and hypercapnia) as a result of the synchronized activation of brainstem respiratory and sympathetic ne...

  19. Recurrent lower respiratory tract infections in a 14-year-old boy with tracheobronchomegaly (Mounier-Kuhn syndrome).

    Science.gov (United States)

    Benesch, M; Eber, E; Pfleger, A; Zach, M S

    2000-06-01

    Tracheobronchomegaly (Mounier-Kuhn syndrome) is characterized by dilatation of the central airways, tracheobronchial outpouchings, and chronic tracheobronchitis. Most cases are diagnosed in adulthood. We report the clinical, radiographic, and bronchoscopic findings in a 14-year-old boy with tracheobronchomegaly, ptosis of the right eyelid, and redundant skin and mucosa of the upper lip, who presented with a 2-year history of recurrent lower respiratory tract infections. Pediatricians should be aware of the possibility that tracheobronchomegaly may cause clinical symptoms in childhood and adolescence. Pediatr Pulmonol. 2000; 29: 476-479. PMID:10821730

  20. Human LPLUNC1 is a secreted product of goblet cells and minor glands of the respiratory and upper aerodigestive tracts

    OpenAIRE

    Bingle, CD; Wilson, K.; Lunn, H.; Barnes, FA; High, AS; Wallace, WA; Rassl, D; Campos, MA; Ribeiro, M; Bingle, L.

    2010-01-01

    Long PLUNC1 (LPLUNC1, C20orf114) is a member of a family of poorly described proteins (PLUNCS) expressed in the upper respiratory tract and oral cavity, which may function in host defence. Although it is one of the most highly expressed genes in the upper airways and has been identified in sputum and nasal secretions by proteomic studies, localisation of LPLUNC1 protein has not yet been described. We developed affinity purified antibodies and localised the protein in tissues of the human resp...

  1. Extracellular DNA is essential for maintaining Bordetella biofilm integrity on abiotic surfaces and in the upper respiratory tract of mice.

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    Matt S Conover

    Full Text Available Bacteria form complex and highly elaborate surface adherent communities known as biofilms which are held together by a self-produced extracellular matrix. We have previously shown that by adopting a biofilm mode of existence in vivo, the gram negative bacterial pathogens Bordetella bronchiseptica and Bordetella pertussis are able to efficiently colonize and persist in the mammalian respiratory tract. In general, the bacterial biofilm matrix includes polysaccharides, proteins and extracellular DNA (eDNA. In this report, we investigated the function of DNA in Bordetella biofilm development. We show that DNA is a significant component of Bordetella biofilm matrix. Addition of DNase I at the initiation of biofilm growth inhibited biofilm formation. Treatment of pre-established mature biofilms formed under both static and flow conditions with DNase I led to a disruption of the biofilm biomass. We next investigated whether eDNA played a role in biofilms formed in the mouse respiratory tract. DNase I treatment of nasal biofilms caused considerable dissolution of the biofilm biomass. In conclusion, these results suggest that eDNA is a crucial structural matrix component of both in vitro and in vivo formed Bordetella biofilms. This is the first evidence for the ability of DNase I to disrupt bacterial biofilms formed on host organs.

  2. Detection of human bocavirus from children and adults with acute respiratory tract illness in Guangzhou, southern China

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    Liu Wen-Kuan

    2011-12-01

    Full Text Available Abstract Background Human bocavirus (HBoV is a newly discovered parvovirus associated with acute respiratory tract illness (ARTI and gastrointestinal illness. Our study is the first to analyze the characteristics of HBoV-positive samples from ARTI patients with a wide age distribution from Guangzhou, southern China. Methods Throat swabs (n=2811 were collected and analyzed from children and adults with ARTI over a 13-month period. The HBoV complete genome from a 60 year-old female patient isolate was also determined. Results HBoV DNA was detected in 65/2811 (2.3% samples, of which 61/1797 were from children (Mycoplasma pneumoniae had the highest frequency of 16.9% (11/65. Upper and lower respiratory tract illness were common symptoms, with 19/65 (29.2% patients diagnosed with pneumonia by chest radiography. All four adult patients had systemic influenza-like symptoms. Phylogenetic analysis of the complete genome revealed a close relationship with other HBoVs, and a more distant relationship with HBoV2 and HBoV3. Conclusions HBoV was detected from children and adults with ARTI from Guangzhou, southern China. Elderly people were also susceptive to HBoV. A single lineage of HBoV was detected among a wide age distribution of patients with ARTI.

  3. Particle deposition in a child respiratory tract model: in vivo regional deposition of fine and ultrafine aerosols in baboons.

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    Iolanda Albuquerque-Silva

    Full Text Available To relate exposure to adverse health effects, it is necessary to know where particles in the submicron range deposit in the respiratory tract. The possibly higher vulnerability of children requires specific inhalation studies. However, radio-aerosol deposition experiments involving children are rare because of ethical restrictions related to radiation exposure. Thus, an in vivo study was conducted using three baboons as a child respiratory tract model to assess regional deposition patterns (thoracic region vs. extrathoracic region of radioactive polydisperse aerosols ([d16-d84], equal to [0.15 µm-0.5 µm], [0.25 µm-1 µm], or [1 µm-9 µm]. Results clearly demonstrated that aerosol deposition within the thoracic region and the extrathoraic region varied substantially according to particle size. High deposition in the extrathoracic region was observed for the [1 µm-9 µm] aerosol (72% ± 17%. The [0.15 µm-0.5 µm] aerosol was associated almost exclusively with thoracic region deposition (84% ± 4%. Airborne particles in the range of [0.25 µm-1 µm] showed an intermediate deposition pattern, with 49% ± 8% in the extrathoracic region and 51% ± 8% in the thoracic region. Finally, comparison of baboon and human inhalation experiments for the [1 µm-9 µm] aerosol showed similar regional deposition, leading to the conclusion that regional deposition is species-independent for this airborne particle sizes.

  4. Numerical simulation of micro-particle deposition in a realistic human upper respiratory tract model during transient breathing cycle

    Institute of Scientific and Technical Information of China (English)

    Jian hua Huang; Lian zhong Zhang

    2011-01-01

    An more reliable human upper respiratory tract model that consisted of an oropharynx and four generations of asymmetric tracheo-bronchial (TB) airways has been constructed to investigate the micro-particle deposition pattern and mass distribution in five lobes under steady inspiratory condition in former work by Huang and Zhang (2011 ).In the present work,transient airflow patterns and particle deposition during both inspiratory and expiratory processes were numerically simulated in the realistic human upper respiratory tract model with 14 cartilaginous rings (CRs) in the tracheal tube.The present model was validated under steady inspiratory flow rates by comparing current results with the theoretical models and published experimental data.The transient deposition fraction was found to strongly depend on breathing flow rate and particle diameter but slightly on turbulence intensity.Particles were mainly distributed in the high axial speed zones and traveled basically following the secondary flow.“Hot spots” of deposition were found in the lower portion of mouth cavity and posterior wall of pharynx/larynx during inspiration,but transferred to upper portion of mouth and interior wall of pharynx/larynx during expiration.The deposition fraction in the trachea during expiration was found to be much higher than that during inspiration because of the stronger secondary flow.

  5. Respiratory tract changes in guinea pigs, rats, and mice following a single six-hour exposure to methyl isocyanate vapor

    Energy Technology Data Exchange (ETDEWEB)

    Fowler, E.H.; Dodd, D.E.

    1987-06-01

    Groups of male and female Fischer 344 rats, B6C3F1 mice, and Hartley guinea pigs were exposed once for 6 hr to mean concentrations of 10.5, 5.4, 2.4, 1.0, or 0 (control) ppm of methyl isocyanate (MIC) vapor. Rats and mice were also exposed to 20.4 ppm of MIC. The majority of deaths occurred during postexposure days 1 through 3. The 6-hr LC/sub 50/ values were 6.1 ppm for rats, 12.2 ppm for mice, and 5.4 ppm for guinea pigs. Notable clinical observations during and immediately following MIC exposure were lacrimation, perinasal/perioral wetness, respiratory difficulty (e.g., mouth breathing), decreased activity, ataxia, and hypothermia. Body weight losses were common in all species following MIC exposures of 2.4 ppm or greater. Microscopic lesions included acute necrosis of the epithelial lining throughout the respiratory tract in animals that died shortly after exposure, coupled with congestion, edema, and inflammation. A microscopic lesion that appeared unique to guinea pigs was bronchiolitis obliterans. Additional microscopic lesions observed in some animals that died or were sacrificed at the end of the study (postexposure day 14) consisted of squamous metaplasia of respiratory epithelium in the nasal cavity, which extended into the larynx, trachea, and in some cases, the bronchi. In addition, epithelial regeneration throughout the tract and submucosal fibroplasia in the trachea, bronchi, and bronchioles were observed, the latter lesion being primarily confined to rodents. Only in guinea pigs were there lesions in the 1.0 ppm group attributed to MIC exposure. In conclusion, guinea pigs were more sensitive to the MIC vapor than were rats, which were in turn more sensitive than mice.

  6. Surveillance data on micro-organisms in respiratory tract infections at a tertiary care teaching hospital in South India

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    Sriram Shanmugam

    2015-09-01

    Full Text Available Background: Respiratory tract infections are the leading cause of infections and associated hospitalizations in India. Generally, there is little control on the use of antibiotics. Community awareness of the issues involved in antibiotic therapy is poor and this is compounded by over-the-counter availability. The main aim was to compare the resistance developed by respiratory microbes. Methods: A retrospective and prospective study was designed and conducted to compare the pattern of resistance developed by microorganisms affecting the respiratory tract. Results: The sensitivity of K. pneumoniae to cefepime/tazobactum has decreased from 91.9% to 47.6% and S. aureus to Linezolid has decreased from 93.4% to 80% and S. pyogenes to azithromycin from 51.4% to 24.8%. Whereas sensitivity pattern of S. pneumoniae to amoxicillin/clavulanate is increased from 65.6% to 82.3%. The prevalence of Klebsiella pneumoniae was increased 19% to 25.2% whereas the prevalence of S. pneumoniae was decreased from 66.8% to 65.2%. Our study suggests that all microorganisms isolated are susceptible to carbapenems and cefepime/tazobactum in the cephalosporin class. Conclusions: There is major shift in the sensitivity pattern of microorganisms towards antibiotics. Therefore, these results must be kept in mind by the practitioners in the study site, prior to making decisions over a medication regimen empirically for patients and also to maximize the output of medications by rational prescribing and dosing. [Int J Res Med Sci 2015; 3(9.000: 2366-2375

  7. Lower respiratory tract infection hospitalizations among American Indian/Alaska Native children and the general United States child population

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    Eric M. Foote

    2015-11-01

    Full Text Available Background: The lower respiratory tract infection (LRTI-associated hospitalization rate in American Indian and Alaska Native (AI/AN children aged <5 years declined during 1998–2008, yet remained 1.6 times higher than the general US child population in 2006–2008. Purpose: Describe the change in LRTI-associated hospitalization rates for AI/AN children and for the general US child population aged <5 years. Methods: A retrospective analysis of hospitalizations with discharge ICD-9-CM codes for LRTI for AI/AN children and for the general US child population <5 years during 2009–2011 was conducted using Indian Health Service direct and contract care inpatient data and the Nationwide Inpatient Sample, respectively. We calculated hospitalization rates and made comparisons to previously published 1998–1999 rates prior to pneumococcal conjugate vaccine introduction. Results: The average annual LRTI-associated hospitalization rate declined from 1998–1999 to 2009–2011 in AI/AN (35%, p<0.01 and the general US child population (19%, SE: 4.5%, p<0.01. The 2009–2011 AI/AN child average annual LRTI-associated hospitalization rate was 20.7 per 1,000, 1.5 times higher than the US child rate (13.7 95% CI: 12.6–14.8. The Alaska (38.9 and Southwest regions (27.3 had the highest rates. The disparity was greatest for infant (<1 year pneumonia-associated and 2009–2010 H1N1 influenza-associated hospitalizations. Conclusions: Although the LRTI-associated hospitalization rate declined, the 2009–2011 AI/AN child rate remained higher than the US child rate, especially in the Alaska and Southwest regions. The residual disparity is likely multi-factorial and partly related to household crowding, indoor smoke exposure, lack of piped water and poverty. Implementation of interventions proven to reduce LRTI is needed among AI/AN children.

  8. In Vitro susceptibility of Gram-positive cocci isolated from skin and respiratory tract to azithromycin and twelve other antimicrobial agents

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    Caio M. F. Mendes

    2001-10-01

    Full Text Available This study was conducted to evaluate the activity of azithromycin in comparison to 12 other antibacterial agents against recent isolates obtained consecutively from patients with respiratory tract or skin infections, from January to July, 2000. A total of 717 Gram-positive cocci were analyzed in this study and the following species were studied: Staphylococcus aureus (n=576, beta-hemolytic streptococci ( n=115, and Streptococcus pneumoniae (n=26. Susceptibility testing was carried out by the disk diffusion method and interpreted according to NCCLS breakpoints. The activity of azithromycin was compared to erythromycin, clindamycin, chloramphenicol, ciprofloxacin, ofloxacin, oxacillin, penicillin, ceftriaxone, tetracycline, trimethoprim/sulfamethoxazole, teicoplanin, and vancomycin. Of the 26 S. pneumoniae isolates recovered from the respiratory tract, 5 (19.2% were intermediate resistant to penicillin. All of these strains were susceptible to chloramphenicol, ofloxacin, and vancomycin, and 24 (92% were also susceptible to azithromycin, clindamycin, and erythromycin. Among the 67 beta-hemolytic streptococci strains isolated from the respiratory tract, 66 (99% were susceptible to azithromycin, erythromycin, clindamycin, and ofloxacin. All 48 beta-hemolytic streptococci strains isolated from skin were susceptible to azithromycin and clindamycin, 47 (98% were susceptible to erythromycin, and 46 (96% were susceptible to ofloxacin. Of the 576 strains of S. aureus, 253 (43.9% were isolated from the respiratory tract and 323 (56.1% from skin. Among S. aureus isolates from the respiratory tract and skin, 46 (18% and 78 (24%, respectively were resistant to oxacillin. Isolates from the respiratory tract and skin showed the same percentage of resistance (36% to azithromycin. These in vitro results suggest that azithromycin can be a therapeutic option for treatment of infections caused by these bacteria since the newer macrolides have several distinct

  9. The associations of humorous coping styles, affective states, job demands and job control with the frequency of upper respiratory tract infection

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    Sibe Doosje

    2011-05-01

    Full Text Available Orientation: There is some evidence that job demands and job resources such as job control and humorous coping may contribute to the risk of upper respiratory tract infections (URTI.Research purpose: The purpose of this study was to test a model including these variables as well as job-related affect, in order to explore their role in the explanation of the frequency of upper respiratory tract infection.Motivation of the study: This study has been conducted in order to extend our understanding of the role of traditional variables like job demands and job control with humorous coping styles and affective variables with regard to the explanation of the frequency of URTI.Research design, approach and method: A sample of 2094 employees filled out questionnaires assessing job demands, job control, generic (MSHS-C, antecedent-focused and responsefocused humorous coping (QOHC and job-related affect (JAWS.Main findings: Job demands were indirectly related to the frequency of upper respiratory tract infections, mediated by their relationships with job control and negative job-related affect. Generic and response-focused humorous coping were less relevant for the explanation of the frequency of upper respiratory tract infections than the presumably ‘healthy’ antecedentfocused humorous coping style. The latter showed a negative association with negative jobrelated affect. The frequency of upper respiratory tract infections was better predicted by job control and negative job-related affect than by humorous coping, in the expected directions.Practical/managerial implication: These findings may have practical relevance for the improvement of stress management interventions in organisations.Contribution/value-add: Although it was shown that healthy humorous coping does contribute to decreases in upper respiratory tract infection, job demands, job resources and negative affective state seem the most important predictors.

  10. Radiological features of viral infection of lower respiratory tract in infants and children : infection by common virus other than RS virus

    International Nuclear Information System (INIS)

    There have been report on radiological features of lower respiratory track infection in infants and children caused by RSV(respiratory syncytial virus) in KOREA. The aims of this study were to summarize radiological features of lower respiratory tract infection caused by common viral agents other than RSV and to find any specific radiological features which might provide clue to the etiologic diagnosis. We retrospectively analyzed radiological features in 51 children with symptoms of lower respiratory tract infection and identification of viral agents(except RSV). They included parainfluenza (n=22), adenovirus(n=16), influenza A(n=11), influenza 8(n=2) virus infections. The mean age of the patients was 23 months. Major radiological findings of viral lower respiratory tract infection were bilateral parahilar peribronchial infiltration(62%), bilateral overaeration(60%), atelectasis(59%)(segmental or subsegmental atelectasis(43%), lobar atelectasis(16%)) and patchy or confluent consolidation(20%). Pleural effusion was seen in only one case and hilar adenopathy was not observed in any of them. In the cares of adeno virus, consolidation was seen in 5 cases(31%) including 3 cases(19%) of extensive confluent consolidations and overaerations were less frequent findings(44%) than in other viruses. In 24 patients with radiological follow up for more than 1 week, consolidation improved most rapidly, while was persistent atelectasis. The major radiologic features in viral lower respiratory tract infection(except RSV) were overinflation, bilateral peribronchial infiltration and atelectasis. In adenoviral infection, confluent consolidations which are usually seen in bacterial pneumonia were more common findings than in other viral lower respiratory tract infections

  11. The associations of humorous coping styles, affective states, job demands and job control with the frequency of upper respiratory tract infection

    OpenAIRE

    Sibe Doosje; Martijn P.M. de Goede; Lorenz J.P. van Doornen; Rens van de Schoot

    2011-01-01

    Orientation: There is some evidence that job demands and job resources such as job control and humorous coping may contribute to the risk of upper respiratory tract infections (URTI).Research purpose: The purpose of this study was to test a model including these variables as well as job-related affect, in order to explore their role in the explanation of the frequency of upper respiratory tract infection.Motivation of the study: This study has been conducted in order to extend our understandi...

  12. Mycoplasma agassizii sp., nov., isolated from the upper respiratory tract of the desert tortoise (Gopherus agassizii) and the gopher tortoise (Gopherus polyphemus).

    Science.gov (United States)

    Brown, Mary E.; Brown, D.R.; Kelin, P.A.; McLaughlin, G.S.; Schumacher, I.M.; Jacobson, E.R.; Adams, H.P.; Tully, J.G.

    2001-01-01

    Biochemical, serological and molecular genetic studies were performed on seven mycoplasma isolates that were recovered from the upper respiratory tract of clinically ill desert tortoises. The isolates were serologically related to each other but serologically distinct from previously described species. Unique mycoplasma species-specific 16S rRNA nucleotide sequences were found in the proposed type strain. The name Mycoplasma agassizii is proposed for these isolates. The type strain is PS6T (=ATCC 700616T) which caused upper respiratory tract disease (URTD) in experimentally infected tortoises.

  13. CT-assisted versus silicone rubber cast morphometry of the lower respiratory tract in healthy amazons (genus Amazona) and grey parrots (genus Psittacus)

    International Nuclear Information System (INIS)

    The objective of this study was to examine the normal respiratory tract of grey parrots and amazons by using two different methods. The lower respiratory tract of five amazons and four grey parrots, all healthy, were investigated applying computerised tomography (CT). Volumes and densities of the body, the body cavities, the normal lungs, and the airsacs in the living animals were defined as reference values of healthy birds to give a basis for future CT-diagnosis of respiratory diseases and their precise locations in parrots. In a parallel study, the lung and air sac volumes of six amazons and two grey parrots were measured using silicone rubber casts produced after the method described byH.-R. Duncker. Values for identical respiratory structures gained by these different methods were compared

  14. Acute lower respiratory tract infection due to respiratory syncytial virus in a group of Egyptian children under 5 years of age

    Directory of Open Access Journals (Sweden)

    El-kholy Amany A

    2011-04-01

    Full Text Available Abstract Background and aim Respiratory syncytial virus (RSV is one of the most important causes of acute lower respiratory tract infections (ALRTI in infants and young children. This study was conducted to describe the epidemiology of ALRTI associated with RSV among children ≤ 5 years old in Egypt. Patients and Methods We enrolled 427 children ≤ 5 years old diagnosed with ALRTI attending the outpatient clinic or Emergency Department (ED of Children Hospital, Cairo University during a one- year period. Nasopharyngeal aspirates were obtained from the patients, kept on ice and processed within 2 hours of collection. Immunoflourescent assay (IFA for RSV was performed. Results 91 cases (21.3% had viral etiology with RSV antigens detected in 70 cases (16.4%. The RSV positive cases were significantly younger than other non-RSV cases (mean age 8.2 months versus 14.2 months, p Conclusion RSV is the most common viral etiology of ALRTI in children below 5 years of age, especially in young infants below 6 months of age. It is more prevalent in winter and tends to cause severe infection.

  15. ACUPUNCTURE TREATMENT OF 42 CASES OF ACUTE UPPER RESPIRATORY TRACT INFECTION

    Institute of Scientific and Technical Information of China (English)

    满伟; 王敬兰

    2000-01-01

    We made clinical observations on the therapeutic effect of acupuncture on acute upperr espiratory tract infection and compared with the effect of paracetamol and Antondine, The result showed that acupuncture therapy could allay fever more rapidly than drugs, so long as the differentiation of syndromes is correct and the acupoint is selected properly.

  16. Epidemiology of respiratory syncytial virus in children ≤2 years of age hospitalized with lower respiratory tract infections in the Russian Federation: a prospective, multicenter study

    Directory of Open Access Journals (Sweden)

    Vladimir Tatochenko

    2010-09-01

    Full Text Available Vladimir Tatochenko1, Vasily Uchaikin2, Aleksandr Gorelov3, Konstantin Gudkov4, Andrew Campbell5, Gregory Schulz5, Rebecca Prahl5, Gerard Notario51Scientific Centre of Children’s Health, Russian Academy of Medical Sciences, Lomonosovskiy Prospect, Moscow, Russia; 2Russian State Medical University of Roszdrav, Moscow, Russia; 3Central Scientific Research Institution of Epidemiology, Moscow, Russia; 4Abbott Laboratories LLC, Khimki, Moscow, Russia; 5Abbott Laboratories, Abbott Park, IL, USABackground: Respiratory syncytial virus (RSV is the leading cause of severe lower respiratory tract infections among infants and young children, and is responsible for an estimated four million deaths per year globally. A monthly injection of palivizumab has been used for prophylaxis of serious RSV infections among high-risk children in 71 countries since 1998 and approval for use in the Russian Federation was obtained in February 2010. A recommendation for RSV prophylaxis in the Russian Federation would require knowledge of the prevalence and seasonality of RSV in that country.Methods: In a prospective, multicenter, epidemiological study of the prevalence, seasonality, and peak occurrence of RSV infection, children aged ≤2 years hospitalized for lower respiratory tract infections in three regions of the Russian Federation, from September 2008 through April 2009, were screened and tested for RSV using rapid immunochromatography of nasopharyngeal lavage. For subjects who were tested positive, hospitalization data were collected.Results: Of 519 children aged ≤2 years enrolled from September 11, 2008 through April 26, 2009, 197 tested positive for RSV (38.0%, 95% CI: 33.8, 42.3. The onset of the 2008–2009 RSV season in the Russian Federation occurred in late October 2008, similar to what is observed in other northern temperate zones. Peak activity occurred in early April 2009, when 62% of children enrolled tested positive for RSV.Conclusion: The prevalence

  17. The role of neutrophils in the upper and lower respiratory tract during influenza virus infection of mice

    Directory of Open Access Journals (Sweden)

    Reading Patrick C

    2008-08-01

    Full Text Available Abstract Background Neutrophils have been shown to play a role in host defence against highly virulent and mouse-adapted strains of influenza virus, however it is not clear if an effective neutrophil response is an important factor moderating disease severity during infection with other virus strains. In this study, we have examined the role of neutrophils during infection of mice with influenza virus strain HKx31, a virus strain of the H3N2 subtype and of moderate virulence for mice, to determine the role of neutrophils in the early phase of infection and in clearance of influenza virus from the respiratory tract during the later phase of infection. Methods The anti-Gr-1 monoclonal antibody (mAb RB6-8C5 was used to (i identify neutrophils in the upper (nasal tissues and lower (lung respiratory tract of uninfected and influenza virus-infected mice, and (ii deplete neutrophils prior to and during influenza virus infection of mice. Results Neutrophils were rapidly recruited to the upper and lower airways following influenza virus infection. We demonstrated that use of mAb RB6-8C5 to deplete C57BL/6 (B6 mice of neutrophils is complicated by the ability of this mAb to bind directly to virus-specific CD8+ T cells. Thus, we investigated the role of neutrophils in both the early and later phases of infection using CD8+ T cell-deficient B6.TAP-/- mice. Infection of B6.TAP-/- mice with a low dose of influenza virus did not induce clinical disease in control animals, however RB6-8C5 treatment led to profound weight loss, severe clinical disease and enhanced virus replication throughout the respiratory tract. Conclusion Neutrophils play a critical role in limiting influenza virus replication during the early and later phases of infection. Furthermore, a virus strain of moderate virulence can induce severe clinical disease in the absence of an effective neutrophil response.

  18. Coordinated Research Project: Relationship between recurrent lower respiratory tract infection, bronchial asthma and gastroesophageal reflux in children

    International Nuclear Information System (INIS)

    Gastroesophageal reflux may cause or contribute to different respiratory problems such as bronchial asthma (BA), recurrent lower respiratory tract infection (rLRTI), among others. There is no clear cut explanation of mechanisms responsible for the respiratory symptoms in children with recurrent GER, and how beneficial GER treatment could be in the management of this children. The aim of this prospective coordinate research project was to evaluated the presence of GER, esophageal transit (ET) abnormalities and lung aspiration (LA) in children with recurrent respiratory symptoms. So far we had evaluated 309 children; 173 boys and 136 girls, between 15 days and 15 years old of age. Under standard and protocolized procedures all children underwent gastroesophageal scintigraphic study. Esophageal transit scintigraphy (ETS) was performed in 127 and LA scintigraphy in 205. The scintigraphic study was positive for GER in 160/309 (51.8%) of the total group. We found an abnormal ETS in 13.4% and a LA scintigraphy positive for aspiration of gastric content in 3.9% of the studied patients. According to clinical features, 75% of asthmatic children with persistent symptoms had GER and 30.7% of children with rLRTI. Follow-up studies were performed in 85 children after treatment of GER and there was a normalization of the scintigraphic study, associated with clinical improvement in 69.4% of them. These results show that GER prevalence in children with BA and rLRTI is higher than the reported normal prevalence in infancy, specially in the group of asthmatic patients. In our group, we do not find a significant presence of ET abnormalities neither LA of gastric content. The diagnosis and treatment of GER is mandatory in children with rLRTI or persistent BA. In asthmatic patients the recognition of gastric abnormalities is highly relevant for therapeutic problems when GER is in a sub-clinical stage

  19. Effect of aerial ammonia on porcine infection of the respiratory tract with toxigenic Pasteurella multocida

    DEFF Research Database (Denmark)

    Andreasen, Morten; Bækbo, P.; Nielsen, J.P.

    1999-01-01

    The objective of the experimental study was to examine whether aerial ammonia alone could predispose the respiratory system of pigs to infection with toxigenic Pasteurella multocida type A. Two groups of 5 pigs each were continuously exposed to 50 ppm ammonia and less than 5 ppm ammonia, respecti...

  20. Silicone Modeling of the Interior Spaces of Hollow Organs: Use in Dog and Manatee Respiratory Tract and in a Beef Heart

    Directory of Open Access Journals (Sweden)

    Charles J. Grossman

    2011-01-01

    Full Text Available Problem statement: The mechanism, by which the Florida manatee (Trichechus manatus latirostris vocalizes, remains unknown because the manatee larynx does not contain true vocal cords. Since sound can be generated when air passes through a narrow respiratory structure we needed to visualize the internal anatomy of manatee respiratory tract to locate any candidate regions for study. Approach: To visualize the internal anatomy of upper and lower manatee respiratory tract we have developed a rapid but accurate method of modeling these structures using liquid silicone. We first tested this technique on the respiratory structure of a cadaver dog and then applied it to two small manatees which had died through natural causes. Incisions were made in the trachea of both dog and manatees and commercially available liquid silicone was then forced into the upper and lower respiratory tracts used a slightly modified common automobile grease gun. The animals were then refrigerated overnight and the silicone was allowed to cure for a period of 24 h. Results: In dog, we removed cured silicone model by applying mild force to it after surgically opening the nasal cavity. In the manatees some dissection was necessary for release of mold from the upper nasal cavity, but only mild force was necessary with no dissection to release silicone model from the lower tract. Because the models created exhibited great accuracy and fine structure, including presence of tertiary bronchi in the manatee respiratory tract, we realized that the technique was applicable for use in other hollow organs. We applied this method to the visualization of internal structure of a fresh beef heart and were pleased with the accuracy and detail of model produced. Conclusion: We suggest that this technique can be adopted for three-dimensional visualization of the internal structure and volume estimation of many hollow organs in a wide variety of organisms with both minimal

  1. Health Alliance for Prudent Prescribing, Yield and Use of Antimicrobial Drugs in the Treatment of Respiratory Tract Infections (HAPPY AUDIT)

    DEFF Research Database (Denmark)

    Bjerrum, Lars; Munck, Anders; Gahrn-Hansen, Bente;

    2010-01-01

    with a low prevalence. Therefore, bacterial resistance is an important issue with a potential serious impact on all countries. The majority of respiratory tract infections (RTIs) are treated in general practice. Most infections are caused by virus and antibiotics are therefore unlikely to have any clinical...... with different practice setting. The aim of this study is to evaluate the impact of a multifaceted intervention targeting general practitioners (GPs) and patients in six countries with different prevalence of antibiotic resistance: Two Nordic countries (Denmark and Sweden), two Baltic Countries (Lithuania......'surgeries. To ensure public awareness of the risk of resistant bacteria, media campaigns targeting both professionals and the public will be developed and the results will be published and widely disseminated at a Working Conference hosted by the World Association of Family Doctors (WONCA-Europe) at the end...

  2. Procalcitonin versus C-reactive protein for predicting pneumonia in adults with lower respiratory tract infection in primary care

    DEFF Research Database (Denmark)

    Holm, Anette; Pedersen, Svend S; Nexoe, Joergen;

    2007-01-01

    BACKGROUND: The role of procalcitonin in diagnosing bacterial infection has mainly been studied in patients with severe infections. There is no study on the value of procalcitonin measurements in adults with lower respiratory tract infection (LRTI) treated in primary care. AIM: To evaluate the...... accuracy of plasma procalcitonin in predicting radiographic pneumonia, bacterial infection, and adverse outcome in a population of adults with LRTI treated in primary care. DESIGN OF STUDY: Prospective, observational study. SETTING: Forty-two general practices and an outpatient clinic at the Department of...... Infectious Diseases, Odense University Hospital, Denmark. METHOD: A total of 364 patients with LRTI were prospectively enrolled from 42 general practices. Patients were examined with chest radiography, microbiological analyses, and measurements of C-reactive protein (CRP) and procalcitonin. The outcome...

  3. Modeling the deposition of bioaerosols with variable size and shape in the human respiratory tract – A review

    Directory of Open Access Journals (Sweden)

    R. Sturm

    2012-10-01

    Full Text Available The behavior of bioaerosol particles with various size and shape in the human respiratory tract was simulated by using a probabilistic model of the lung and an almost realistic mathematical approach to particle deposition. Results obtained from the theoretical computations clearly show that biogenic particle deposition in different lung compartments does not only depend on physical particle properties, but also on breathing mode (nose or mouth breathing and inhalative flow rate (=tidal volume × breathing frequency/30. Whilst ultrafine (5 μm particles tend to accumulate in the extrathoracic region and the uppermost airways of the tracheobronchial tree, particles with intermediate size are characterized by higher penetration depth, leading to their possible accumulation in the lung alveoli. Due to their deposition in deep lung regions and insufficient clearance, some bioaerosol particles may induce severe lung diseases ranging from infections, allergies, and toxic reactions to cancer.

  4. Different Cell Types In the Lower Respiratory Tract of the Reindeer (Rangifer tarandus tarandus L. - A Transmission Electron Microscopical Study

    Directory of Open Access Journals (Sweden)

    Seppo A.m. Saari

    1997-02-01

    Full Text Available The epithelium of the trachea and distal airways of 12 healthy adult reindeer were studied with transmission electron microscopy. The ultrastructure of the reindeer respiratory tract corresponded to the findings of previous investigators studying other mammalian species. The epithelium of the trachea and bronchi, down to the level of the distal bronchioli, was composed of three main types of cell: ciliated, goblet, and basal. In the distal brochioli, non-ciliated cells similar to those known as Clara cells were predominant. Numerous electron-dense granules and the cell organelle pattern resembled the Clara cell type observed in laboratory rodents, rabbit, sheep, pig, horse, and llama. Pneumocyte 1 and pneumocyte 2 cells were readily identified in the alveoli. The pneumocyte 2 cells possessed short microvilli and granules with lamellar content. Micropinocytotic vesicles were very numerous in the alveolar wall, and a small number of alveolar macrophages occasionally seen in the alveolar lumen.

  5. Health-related quality of life among children with recurrent respiratory tract infections in Xi'an, China.

    Directory of Open Access Journals (Sweden)

    Xun Jiang

    Full Text Available OBJECTIVE: The aim of this study was to investigate the health-related quality of life (HRQOL in 2-7-year-old children diagnosed with recurrent respiratory tract infections (RRTIs and the impact of RRTIs on affected families. METHODS: This was a cross-sectional case-control study evaluating 2-7-year-old children with RRTIs (n = 352, 2-7-year-old healthy children (n = 376, and associated caregivers (parents and/or grandparents. A Chinese version of the PedsQL™ 4.0 Generic Core Scale was used to assess childhood HRQOL, and a Chinese version of the Family Impact Module (FIM was used to assess the impact of RRTIs on family members. HRQOL scores were compared between children with RRTIs and healthy children. In addition, a multiple step-wise regression with demographic variables of children and their caregivers, family economic status, and caregiver's HRQOL as independent variables determined factors that influenced HRQOL in children with RRTIs. RESULTS: Children with RRTIs showed significantly lower physical, emotional, social, and school functioning scores than healthy children (p<0.05. Caregivers for children with RRTIs also scored significantly lower than caregivers for healthy children on physical, emotional, social, cognitive, and communication functioning (p<0.05. Caregivers for RRTIs affected children also reported significantly higher levels of worry. Multivariate analyses showed that children's age, children's relation with caregivers, the frequency of respiratory tract infections in the preceding year, caregiver's educational level, and caregiver's own HRQOL influenced HRQOL in children with RRTIs. CONCLUSIONS: The current data demonstrated that RRTIs were associated with lower HRQOL in both children and their caregivers and negatively influenced family functioning. In addition, caregivers' social characteristics also significantly affected HRQOL in children with RRTIs.

  6. PspA family distribution, antimicrobial resistance and serotype of Streptococcus pneumoniae isolated from upper respiratory tract infections in Japan.

    Directory of Open Access Journals (Sweden)

    Muneki Hotomi

    Full Text Available BACKGROUND: The protection against pneumococcal infections provided by currently available pneumococcal polysaccharide conjugate vaccines are restricted to the limited number of the serotypes included in the vaccine. In the present study, we evaluated the distribution of the pneumococcal capsular type and surface protein A (PspA family of pneumococcal isolates from upper respiratory tract infections in Japan. METHODS: A total of 251 S. pneumoniae isolates from patients seeking treatment for upper respiratory tract infections were characterized for PspA family, antibiotic resistance and capsular type. RESULTS: Among the 251 pneumococci studied, the majority (49.4% was identified as belonging to PspA family 2, while most of the remaining isolates (44.6% belonged to family 1. There were no significant differences between the distributions of PspA1 versus PspA2 isolates based on the age or gender of the patient, source of the isolates or the isolates' susceptibilities to penicillin G. In contrast, the frequency of the mefA gene presence and of serotypes 15B and 19F were statistically more common among PspA2 strains. CONCLUSION: The vast majority of pneumococci isolated from the middle ear fluids, nasal discharges/sinus aspirates or pharyngeal secretions represented PspA families 1 and 2. Capsular serotypes were generally not exclusively associated with certain PspA families, although some capsular types showed a much higher proportion of either PspA1 or PspA2. A PspA-containing vaccine would potentially provide high coverage against pneumococcal infectious diseases because it would be cross-protective versus invasive disease with the majority of pneumococci infecting children and adults.

  7. Isolation of human β-defensin-4 in lung tissue and its increase in lower respiratory tract infection

    Directory of Open Access Journals (Sweden)

    Mukae Hiroshi

    2005-11-01

    Full Text Available Abstract Background Human β-defensin-4 (hBD-4, a new member of the β-defensin family, was discovered by an analysis of the genomic sequence. The objective of this study was to clarify hBD-4 expression in human lung tissue, along with the inducible expression in response to infectious stimuli, localization, and antimicrobial activities of hBD-4 peptides. We also investigated the participation of hBD-4 in chronic lower respiratory tract infections (LRTI by measuring the concentrations of hBD-4 peptides in human bronchial epithelial lining fluid (ELF. Methods The antimicrobial activity of synthetic hBD-4 peptides against E. coli and P. aeruginosa was measured by radial diffusion and colony count assays. We identified hBD-4 in homogenated human lung tissue by reverse-phase high-performance liquid chromatography coupled with a radioimmunoassay (RIA. Localization of hBD-4 was studied through immunohistochemical analysis (IHC. We investigated the effects of lipopolysaccharide (LPS on hBD-4 expression and its release from small airway epithelial cells (SAEC. We collected ELF from patients with chronic LRTI using bronchoscopic microsampling to measure hBD-4 concentrations by RIA. Results hBD-4 exhibited salt-sensitive antimicrobial activity against P. aeruginosa. We detected the presence of hBD-4 peptides in human lung tissue. IHC demonstrated the localization of hBD-4-producing cells in bronchial and bronchiolar epithelium. The levels of hBD-4 peptides released from LPS-treated SAECs were higher than those of untreated control cells. ELF hBD-4 was detectable in 4 of 6 patients with chronic LRTI, while the amounts in controls were all below the detectable level. Conclusion This study suggested that hBD-4 plays a significant role in the innate immunity of the lower respiratory tract.

  8. Progress in pediatrics in 2011. Choices in endocrinology, gastroenterology, hemato-oncology, infectious diseases, otolaryngology, pharmacotherapy and respiratory tract illnesses.

    Science.gov (United States)

    Caffarelli, Carlo; Santamaria, Francesca; Cesari, Silvia; Di Giorgio, Angela; Bernasconi, Sergio

    2012-06-08

    Main progresses in endocrinology, gastroenterology, hemato-oncology, infectious diseases, otolaryngology, pharmacotherapy, and respiratory tract illnesses selected from articles published in The Italian Journal of Pediatrics in 2011 were reviewed. Risk factors for gastroenteritis and appendicitis in developing countries may be useful in improving our understanding of these diseases. Childhood hearing impairment is a world-wide problem which continues to have an high prevalence in newborns. Among the mechanisms of diseases, obese children often have asthma and high hepcidin levels that may reduce serum iron concentrations. In cystic fibrosis, 18q distal deletion has been described as a novel mutation. Hypothyroidism in children with central nervous system infections may increase mortality rates. Infrared tympanic thermometer (IRTT) in oral mode for the measurement of body temperature may be useful in fever screening in a busy setup. In newborns, the transmission of CMV infection through breast milk may be prevented through freezing or pasteurization. Recent advances in treatment of constipation, urinary tract infections, leukemia, pain in children with cancer, neonates with sepsis or difficult weaning from mechanical ventilation will likely contribute towards optimizing management of these common disorders. The work of the Family Pediatricians Medicines for Children Research Network aims to develop competence, infrastructure, networking and education for pediatric clinical trials.

  9. Progress in pediatrics in 2011. Choices in endocrinology, gastroenterology, hemato-oncology, infectious diseases, otolaryngology, pharmacotherapy and respiratory tract illnesses

    Directory of Open Access Journals (Sweden)

    Caffarelli Carlo

    2012-06-01

    Full Text Available Abstract Main progresses in endocrinology, gastroenterology, hemato-oncology, infectious diseases, otolaryngology, pharmacotherapy, and respiratory tract illnesses selected from articles published in The Italian Journal of Pediatrics in 2011 were reviewed. Risk factors for gastroenteritis and appendicitis in developing countries may be useful in improving our understanding of these diseases. Childhood hearing impairment is a world-wide problem which continues to have an high prevalence in newborns. Among the mechanisms of diseases, obese children often have asthma and high hepcidin levels that may reduce serum iron concentrations. In cystic fibrosis, 18q distal deletion has been described as a novel mutation. Hypothyroidism in children with central nervous system infections may increase mortality rates. Infrared tympanic thermometer (IRTT in oral mode for the measurement of body temperature may be useful in fever screening in a busy setup. In newborns, the transmission of CMV infection through breast milk may be prevented through freezing or pasteurization. Recent advances in treatment of constipation, urinary tract infections, leukemia, pain in children with cancer, neonates with sepsis or difficult weaning from mechanical ventilation will likely contribute towards optimizing management of these common disorders. The work of the Family Pediatricians Medicines for Children Research Network aims to develop competence, infrastructure, networking and education for pediatric clinical trials.

  10. New insight into the pathogenesis of minimal change nephrotic syndrome: Role of the persistence of respiratory tract virus in immune disorders.

    Science.gov (United States)

    Zhang, Hui; Wang, Zheng; Dong, Liqun; Guo, Yannan; Wu, Jin; Zhai, Songhui

    2016-07-01

    The pathogenesis of minimal change nephrotic syndrome (MCNS) is a complex clinical problem which, unfortunately, has been in need of significant breakthroughs for decades. Improved understanding of the mechanisms is important to develop effective treatment strategies. To our knowledge, the pathogenesis of MCNS is multifactorial, involving both intrinsic and extrinsic factors, reasonable to be regarded as a "long chain" cascade reaction. Current studies implicating that the disease could probably be caused by immune disorders, however, have focused merely on the middle or terminal of this "long chain". It remains unclear what really triggers the immune disorders. It is noteworthy that the close association of respiratory tract infection with the occurrence, relapse and aggravation of nephrotic syndrome has been confirmed for over two decades. Derived from what we demonstrated in earlier studies, that the persistence of respiratory tract virus may contribute to the onset and development of MCNS, this review summarizes current evidence investigating the possible mechanisms of viral persistence, and discusses the role of viral persistence in the pathogenesis of MCNS. The key point is: whether the persistence of respiratory tract virus results in immune disorders. The available evidence under review also highlight the fact that the background of genetic susceptibility to the disease was found in many patients, which could be triggered by extrinsic factors, e.g. by the infection of respiratory tract virus.

  11. High prevalence of acute respiratory tract infections among Warao Amerindian children in Venezuela in relation to low immunization coverage and chronic malnutrition.

    NARCIS (Netherlands)

    Verhagen, L.M.; Warris, A.; Hermans, P.W.M.; Nogal, B. del; Groot, R. de; Waard, J.H. de

    2012-01-01

    BACKGROUND: Higher prevalence rates of acute respiratory tract infections (ARTIs) have been described in Australian and Canadian indigenous populations than in nonindigenous age-matched counterparts. Few studies on ARTIs in South American indigenous populations have been published. We performed a cr

  12. Impact of positive chest X-ray findings and blood cultures on adverse outcomes following hospitalized pneumococcal lower respiratory tract infection

    DEFF Research Database (Denmark)

    Skovgaard, Marlene; Schønheyder, Henrik C; Benfield, Thomas Lars Vibe;

    2013-01-01

    Little is known about the clinical presentation and outcome of pneumococcal lower respiratory tract infection (LRTI) without positive chest X-ray findings and blood cultures. We investigated the prognostic impact of a pulmonary infiltrate and bacteraemia on the clinical course of hospitalized...... patients with confirmed pneumococcal LRTI....

  13. Detection of Mycoplasma pneumoniae by two polymerase chain reactions and role of M. pneumoniae in acute respiratory tract infections in pediatric patients

    NARCIS (Netherlands)

    Ieven, M; Ursi, D; Van Bever, H; Quint, W; Niesters, H G; Goossens, H

    1996-01-01

    Mycoplasma pneumoniae and viruses in acute respiratory tract infections in children were studied during the winter of 1992-1993 in Antwerp, Belgium. M. pneumoniae was diagnosed in nasopharyngeal aspirates by culture and polymerase chain reaction (PCR). For this, amplification of a fragment of the PI

  14. Prognostic factors for serious morbidity and mortality from community-acquired lower respiratory tract infections among the elderly in primary care

    NARCIS (Netherlands)

    Hak, E; Bont, J; Hoes, A W; Verheij, T J M

    2005-01-01

    BACKGROUND: Uncertainty about the prognosis of lower respiratory tract infections (LRTI) hinders optimal management in primary care. OBJECTIVE: We determined prognostic factors for a severe complicated course of LRTI among elderly patients in primary care. METHODS: In a retrospective clinical databa

  15. Impact of rapid detection of viral and atypical bacterial pathogens by real-time polymerase chain reaction for patients with lower respiratory tract infection

    NARCIS (Netherlands)

    Oosterheert, Jan Jelrik; van Loon, Anton M; Schuurman, Rob; Hoepelman, Andy I M; Hak, Eelko; Thijsen, Steven; Nossent, George; Schneider, Margriet M E; Hustinx, Willem M N; Bonten, Marc J M

    2005-01-01

    BACKGROUND: Rapid diagnostic tests with a high sensitivity for lower respiratory tract infection (LRTI) could lead to improved patient care and reduce unnecessary antibiotic use and associated costs. Diagnostic yields, feasibility, and costs of real-time polymerase chain reaction (PCR) of nasopharyn

  16. Oxidative stress and antioxidants at biosurfaces: plants, skin, and respiratory tract surfaces.

    OpenAIRE

    Cross, C. E.; van Vliet, A.; Louie, S.; Thiele, J J; Halliwell, B

    1998-01-01

    Atmospheric pollutants represent an important source of oxidative and nitrosative stress to both terrestrial plants and to animals. The exposed biosurfaces of plants and animals are directly exposed to these pollutant stresses. Not surprisingly, living organisms have developed complex integrated extracellular and intracellular defense systems against stresses related to reactive oxygen and nitrogen species (ROS, RNS), including O3 and NO2. Plant and animal epithelial surfaces and respiratory ...

  17. Revised dose limits and new respiratory tract model and their implications for annual limits of intake of radioactive materials - A review of recent ICRP publications

    International Nuclear Information System (INIS)

    Ionizing radiation may cause immediate and/or delayed biological damages to the body of the exposed person and/or his/her progeny. The exposure may be caused by an external source or may arise due to internal contamination by a radioactive material. In order to prevent such exposure, or to reduce the probability that it will occur, national authorities and international organizations that are engaged in radiation safety and protection have set limits for the exposure to ionizing radiation from either source. The sensitivity of the body to ionizing radiation usually decreases with age. For this reason and due to the limited possibilities to control the exposure of the general public, different limits have been set for for occupational exposure and for the exposure of members of the public of different age groups. The general principles of these limits and guidelines for their calculations are set by the International Commission on Radiological Protection (ICRP) and published in the Annals of the ICRP. The basic philosophy of the Commission, which includes the principles of justification, optimization and dose limits, the basic radiobiological models, and the distinction between stochastic and non-stochastic effects has been presented in its publication no. 26 . Based on this philosophy, the Commission issued between 1979 and 1988 a series of publications followed by annexes and addenda known as publication no. 30 . This series presented models describing the metabolism of radioactive materials which enter the body by inhalation and ingestion, the transfer of such materials from the respiratory tract and the gastrointestinal tract to the blood, and from there to the body organs and the excretion of the material from the body. This series presented also values for biokinetic parameters of these systems and transfer paths, and methods for calculating limits on intake which ensure that the exposure from internal contamination will not exceed the dose limits set by the

  18. The Effectiveness and Safety of a Homeopathic Medicinal Product in Pediatric Upper Respiratory Tract Infections With Fever

    Directory of Open Access Journals (Sweden)

    Robert van Haselen MSc

    2016-06-01

    Full Text Available We investigated the clinical effectiveness of a homeopathic add-on therapy in a pediatric subpopulation with upper respiratory tract infections (URTI in a randomized, controlled, multinational clinical trial. Patients received either on-demand symptomatic standard treatment (ST-group or the same ST plus a homeopathic medication (Influcid; IFC-group for 7 days. Outcome assessment was based on symptom and fever resolution and the Wisconsin Upper Respiratory Symptom Survey–21 (WURSS-21. A total of 261 pediatric (<12 years patients (130 IFC-group; 131 ST-group were recruited in Germany and the Ukraine. The IFC-group used less symptomatic medication, symptoms resolved significantly earlier (P = .0001, had higher proportions of fever-free children from day 3 onwards, and the WURSS-assessed global disease severity was significantly less (P < .0001 during the entire URTI episode. One adverse event (vomiting was possibly related to IFC. IFC as add-on treatment in pediatric URTI reduced global disease severity, shortened symptom resolution, and was safe in use.

  19. The Effectiveness and Safety of a Homeopathic Medicinal Product in Pediatric Upper Respiratory Tract Infections With Fever

    Science.gov (United States)

    van Haselen, Robert; Thinesse-Mallwitz, Manuela; Maidannyk, Vitaliy; Buskin, Stephen L.; Weber, Stephan; Keller, Thomas; Burkart, Julia; Klement, Petra

    2016-01-01

    We investigated the clinical effectiveness of a homeopathic add-on therapy in a pediatric subpopulation with upper respiratory tract infections (URTI) in a randomized, controlled, multinational clinical trial. Patients received either on-demand symptomatic standard treatment (ST-group) or the same ST plus a homeopathic medication (Influcid; IFC-group) for 7 days. Outcome assessment was based on symptom and fever resolution and the Wisconsin Upper Respiratory Symptom Survey–21 (WURSS-21). A total of 261 pediatric (<12 years) patients (130 IFC-group; 131 ST-group) were recruited in Germany and the Ukraine. The IFC-group used less symptomatic medication, symptoms resolved significantly earlier (P = .0001), had higher proportions of fever-free children from day 3 onwards, and the WURSS-assessed global disease severity was significantly less (P < .0001) during the entire URTI episode. One adverse event (vomiting) was possibly related to IFC. IFC as add-on treatment in pediatric URTI reduced global disease severity, shortened symptom resolution, and was safe in use. PMID:27493984

  20. Prescriber and Patient Responsibilities in Treatment of Acute Respiratory Tract Infections — Essential for Conservation of Antibiotics

    Directory of Open Access Journals (Sweden)

    Antonio C. Pignatari

    2013-06-01

    Full Text Available Inappropriate antibiotic use in normally self-limiting acute respiratory tract infections (RTIs, such as sore throat and the common cold, is a global problem and an important factor for increasing levels of antibiotic resistance. A new group of international experts—the Global Respiratory Infection Partnership (GRIP—is committed to addressing this issue, with the interface between primary care practitioners and their patients as their core focus. To combat the overuse of antibiotics in the community, and facilitate a change from prescribing empiric antibiotic treatment towards cautious deferment combined with symptomatic relief, there is a need to introduce and enhance evidence-based dialogue between primary care practitioners and their patients. Communication with patients should focus on the de-medicalisation of self-limiting viral infections, which can be achieved via a coherent globally endorsed framework outlining the rationale for appropriate antibiotic use in acute RTIs in the context of antibiotic stewardship and conservancy. The planned framework is intended to be adaptable at a country level to reflect local behaviours, cultures and healthcare systems, and has the potential to serve as a model for change in other therapeutic areas.

  1. Procalcitonin-guided antibiotic treatment of respiratory tract infections in a primary care setting: are we there yet?

    DEFF Research Database (Denmark)

    Aabenhus, R.; Jensen, J.U.

    2011-01-01

    Clinical signs of infection do not allow for correct identification of bacterial and viral aetiology in acute respiratory infections. A valid tool to assist the clinician in identifying patients who will benefit from antibiotic therapy, as well as patients with a potentially serious infection, co...... are likely to benefit from antibiotic treatment and to rule out serious infections, and comments on further research to determine a future role for procalcitonin in primary care......, could greatly improve patient care and limit excessive antibiotic prescriptions. Procalcitonin is a new marker of suspected bacterial infection that has shown promise in guiding antibiotic therapy in acute respiratory tract infections in hospitals without compromising patient safety. Procalcitonin...... concentrations in primary care are low and can be used primarily to rule out serious infection. However, procalcitonin measurement should not be used as the sole basis for clinical decisions; clinical skills are prerequisites for the correct use of this new tool in practice. At present there is no point-of-care...

  2. MUCOSAL MICROFLORA AND INNATE IMMUNITY OF UPPER RESPIRATORY TRACT IN INTRAUTERINE FOETAL INFECTION AND PNEUMONIA OF NEONATES

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    O. A. Svitich

    2016-01-01

    Full Text Available Specific perinatal infections make about 30% in causal structure of infant mortality. Among the respiratory diseases of perinatal period, pneumonias take a special place, due to higher frequency, severity, complications and adverse outcomes. The aim of this work was to study microflora and factors of innate immunity (TLR2, TLR4, HBD-1, HBD-2, TNFα and NF-kB at the level of the mucous membranes of the upper respiratory tract during intrauterine infection of fetus and perinatal pneumonia. Causal structure of ventilator-associated pneumonias at the intensive care unit represents a broad spectrum of pathogens with high resistance to antibiotics. Changes of immunological parameters (recognizing structures, i.e., TLR2, TLR4, HBD-1; HBD-2 defensins; proinflammatory TNFα cytokine and NF-kB transcription factor in patients with intrauterine infections and pneumonia are ambiguous. Decreased expression of TLR2, TLR4 genes, along with increased of TNFα and NF-kB gene expression. These changes correlate with type of infectious pathogen, thus allowing us to assume that the pathogen, due to pathogenicity factors, may directly affect innate immunity mechanisms.

  3. The effect of using an interactive booklet on childhood respiratory tract infections in consultations: Study protocol for a cluster randomised controlled trial in primary care

    Directory of Open Access Journals (Sweden)

    Nuttall Jacqueline

    2008-04-01

    Full Text Available Abstract Background Respiratory tract infections in children result in more primary care consultations than any other acute condition, and are the most common reason for prescribing antibiotics (which are largely unnecessary. About a fifth of children consult again for the same illness episode. Providing parents with written information on respiratory tract infections may result in a reduction in re-consultation rates and antibiotic prescribing for these illnesses. Asking clinicians to provide and discuss the information during the consultation may enhance effectiveness. This paper outlines the protocol for a study designed to evaluate the use of a booklet on respiratory tract infections in children within primary care consultations. Methods/Design This will be a cluster randomised controlled trial. General practices will be randomised to provide parents consulting because their child has an acute respiratory tract infection with either an interactive booklet, or usual care. The booklet provides information on the expected duration of their child's illness, the likely benefits of various treatment options, signs and symptoms that should prompt re-consultation, and symptomatic treatment advice. It has been designed for use within the consultation and aims to enhance communication through the use of specific prompts. Clinicians randomised to using the interactive booklet will receive online training in its use. Outcomes will be assessed via a telephone interview with the parent two weeks after first consulting. The primary outcome will be the proportion of children who re-consult for the same illness episode. Secondary outcomes include: antibiotic use, parental satisfaction and enablement, and illness costs. Consultation rates for respiratory tract infections for the subsequent year will be assessed by a review of practice notes. Discussion Previous studies in adults and children have shown that educational interventions can result in reductions

  4. Innovative characteristics of the new dosimetric model for the human respiratory tract studied by the ICRP appointed Task Group of Committee 2

    CERN Document Server

    Melandri, C; Tarroni, G

    1991-01-01

    In 1984, the ICRP appointed a Task Group of Committee 2 to review and revise, as necessary, the current lung dosimetric model. On the basis of the knowledge acquired during the past 20 years, the Task Group's approach has been to review, in depth, the morphology and physiology of the human respiratory tract, inspirability of aerosols and regional deposition of inhaled particles as functions of aerosol size and breathing parameters, clearance of deposited materials, nature and specific sites of damage to the respiratory system caused by inhaled radioactive substances. In the proposed model, clearance from the three regions of the respiratory tract (extrathoracic ET, fast-clearing thoracic T sub f and slow-clearing thoracic T sub s , comprising lymph nodes) is described in terms of competition between the mechanical processes moving particles, which do not depend on the substances, and those of absorption into the blood, determined solely by the material. A Task Group report will also include models for calcula...

  5. Respiratory influence on left atrial volume calculation with 3D-echocardiography

    DEFF Research Database (Denmark)

    Sørgaard, Mathias; Linde, Jesper J; Ismail, Hafsa;

    2016-01-01

    BACKGROUND: Left atrial volume (LAV) estimation with 3D echocardiography has been shown to be more accurate than 2D volume calculation. However, little is known about the possible effect of respiratory movements on the accuracy of the measurement. METHODS: 100 consecutive patients admitted...... with chest pain were examined with 3D echocardiography and LAV was quantified during inspiratory breath hold, expiratory breath hold and during free breathing. RESULTS: Of the 100 patients, only 65 had an echocardiographic window that allowed for 3D echocardiography in the entire respiratory cycle. Mean...

  6. Improved detection of Pneumocystis jirovecii in upper and lower respiratory tract specimens from children with suspected pneumocystis pneumonia using real-time PCR: a prospective study

    Directory of Open Access Journals (Sweden)

    Samuel Catherine M

    2011-11-01

    Full Text Available Abstract Background Pneumocystis pneumonia (PCP is a major cause of hospitalization and mortality in HIV-infected African children. Microbiologic diagnosis relies predominantly on silver or immunofluorescent staining of a lower respiratory tract (LRT specimens which are difficult to obtain in children. Diagnosis on upper respiratory tract (URT specimens using PCR has been reported useful in adults, but data in children are limited. The main objectives of the study was (1 to compare the diagnostic yield of PCR with immunofluorescence (IF and (2 to investigate the usefulness of upper compared to lower respiratory tract samples for diagnosing PCP in children. Methods Children hospitalised at an academic hospital with suspected PCP were prospectively enrolled. An upper respiratory sample (nasopharyngeal aspirate, NPA and a lower respiratory sample (induced sputum, IS or bronchoalveolar lavage, BAL were submitted for real-time PCR and direct IF for the detection of Pneumocystis jirovecii. A control group of children with viral lower respiratory tract infections were investigated with PCR for PCP. Results 202 children (median age 3.3 [inter-quartile range, IQR 2.2 - 4.6] months were enrolled. The overall detection rate by PCR was higher than by IF [180/349 (52% vs. 26/349 (7% respectively; p Conclusion Real-time PCR is more sensitive than IF for the detection of P. jirovecii in children with PCP. NPA samples may be used for diagnostic purposes when PCR is utilised. Wider implementation of PCR on NPA samples is warranted for diagnosing PCP in children.

  7. Comparative estimated effectiveness of antibiotic classes as initial and secondary treatments of respiratory tract infections: longitudinal analysis of routine data from UK primary care 1991-2012.

    Science.gov (United States)

    Berni, Ellen; Butler, Chris C; Jenkins-Jones, Sara; de Voogd, Hanka; Ouwens, Mario; Morgan, Christopher Ll; Currie, Craig J

    2016-06-01

    Purpose To compare the estimated effectiveness of seven frequently prescribed antibiotic classes as initial and secondary treatments of upper respiratory tract infections (URTIs) and lower respiratory tract infections (LRTIs) 1991-2012. The main outcome measure was a surrogate for estimated antibiotic effectiveness. Methods Routine, primary care data from the UK Clinical Practice Research Datalink (CPRD) were used. Having established standardized criteria representing antibiotic treatment failure, estimated treatment effectiveness rates were calculated as one minus the treatment failure rate. For each year from 1991 to 2012, estimated effectiveness rates by treatment line, indication, and sub-indication were calculated. These were presented by antibiotic class, with a sub-analysis for the macrolide clarithromycin. Findings From approximately 58 million antibiotic prescriptions in CPRD, we analyzed 8,654,734 courses of antibiotic monotherapy: 4,825,422 courses (56%) were associated with URTI; 3,829,312 (44%) were associated with LRTI. Amino-penicillins (4,148,729 [56%]), penicillins (1,304,561 [18%]), and macrolides (944,622 [13%]) predominated as initial treatments; macrolides (375,903 [32%]), aminopenicillins (275,866 [23%]), and cephalosporins (159,954 [14%]) as secondary treatments. Macrolides and aminopenicillins had estimated effectiveness rates ≥80% across the study period as initial treatments of URTI and LRTI. In secondary use, only macrolides maintained these rates: 80.7% vs. 79.8% in LRTI, 85.1% vs. 84.5% in throat infections, 80.7% vs. 82.3% in nasal infections, 83.5% vs. 83.8% in unspecified URTI in 1991 and 2012, respectively. Implications After more than two decades, macrolides remained amongst the most effective antibiotic classes for both URTI and LRTI in initial and secondary antibiotic treatment when a further antibiotic course was prescribed. Limitations Antibiotic treatments were classified as intention to treat. It is unknown whether the

  8. Identification of upper respiratory tract pathogens using electrochemical detection on an oligonucleotide microarray.

    Directory of Open Access Journals (Sweden)

    Michael J Lodes

    Full Text Available Bacterial and viral upper respiratory infections (URI produce highly variable clinical symptoms that cannot be used to identify the etiologic agent. Proper treatment, however, depends on correct identification of the pathogen involved as antibiotics provide little or no benefit with viral infections. Here we describe a rapid and sensitive genotyping assay and microarray for URI identification using standard amplification and hybridization techniques, with electrochemical detection (ECD on a semiconductor-based oligonucleotide microarray. The assay was developed to detect four bacterial pathogens (Bordetella pertussis, Streptococcus pyogenes, Chlamydia pneumoniae and Mycoplasma pneumoniae and 9 viral pathogens (adenovirus 4, coronavirus OC43, 229E and HK, influenza A and B, parainfluenza types 1, 2, and 3 and respiratory syncytial virus. This new platform forms the basis for a fully automated diagnostics system that is very flexible and can be customized to suit different or additional pathogens. Multiple probes on a flexible platform allow one to test probes empirically and then select highly reactive probes for further iterative evaluation. Because ECD uses an enzymatic reaction to create electrical signals that can be read directly from the array, there is no need for image analysis or for expensive and delicate optical scanning equipment. We show assay sensitivity and specificity that are excellent for a multiplexed format.

  9. Antiadhesive and antibiofilm activity of hyaluronic acid against bacteria responsible for respiratory tract infections.

    Science.gov (United States)

    Drago, Lorenzo; Cappelletti, Laura; De Vecchi, Elena; Pignataro, Lorenzo; Torretta, Sara; Mattina, Roberto

    2014-10-01

    To address the problem of limited efficacy of existing antibiotics in the treatment of bacterial biofilm, it is necessary to find alternative remedies. One candidate could be hyaluronic acid; this study therefore aimed to evaluate the in vitro antiadhesive and antibiofilm activity of hyaluronic acid toward bacterial species commonly isolated from respiratory infections. Interference exerted on bacterial adhesion was evaluated by using Hep-2 cells, while the antibiofilm activity was assessed by means of spectrophotometry after incubation of biofilm with hyaluronic acid and staining with crystal violet. Our data suggest that hyaluronic acid is able to interfere with bacterial adhesion to a cellular substrate in a concentration-dependent manner, being notably active when assessed as pure substance. Moreover, we found that Staphylococcus aureus biofilm was more sensitive to the action of hyaluronic acid than biofilm produced by Haemophilus influenzae and Moraxella catarrhalis. In conclusion, hyaluronic acid is characterized by notable antiadhesive properties, while it shows a moderate activity against bacterial biofilm. As bacterial adhesion to oral cells is the first step for colonization, these results further sustain the role of hyaluronic acid in prevention of respiratory infections. PMID:24698341

  10. Antibiotic resistance of streptococcus pneumoniae and haemophilus influenzae isolated from respiratory tract specimens

    Directory of Open Access Journals (Sweden)

    Hikmet Eda Aliskan

    2016-06-01

    Full Text Available Purpose: Streptococcus pneumoniae and Haemophilus influenzae are two of the major pathogens in respiratory infections, treatment is usually started empirically. The aim of this study was to detect in vitro resistance rates of S. pneumoniae and H. influenzae strains isolated from different lower respiratory clinical samples to the antibotics which are used for therapy of infections due to these pathogens. Material and Methods: Seventy seven S.pneumoniae and 117 H.influenzae strains, isolated from patients were included in the study. S.pneumoniae isolates which gave an inhibition zone diameter of >20 mm for oxacillin were considered susceptible for penicilin. For the isolates which had an oxacillin zone diameter of 2 mg/l and 31.1 % were intermediately resistant to parenteral penicillin. Resistance rates to antibiotics were as follows: erythromycin 40 %, trimethoprim/sulphametoxazole (TMP/SMX 54.5 % and ofloxacin 6.4%. beta-lactamases were detected in 15.6% of the H.influenzae isolates by nitrocefin positivity. Conclusion: H.influenzae strains (8.6% were identified as beta-lactamase negative ampicillin resistant (BLNAR strains. Resistance rates for other antibiotics were as follows: ampicillin 28.6%, cefaclor 36.5% , cefuroxime 30.1%, clarithromycin 9.6%, cloramphenicol 7% and TMP-SMX 43.9%. [Cukurova Med J 2016; 41(2.000: 201-207

  11. New Epidemiological and Clinical Signatures of 18 Pathogens from Respiratory Tract Infections Based on a 5-Year Study.

    Directory of Open Access Journals (Sweden)

    Xiaohong Liao

    Full Text Available Respiratory tract infections (RTIs are a heavy burden on society. However, due to the complex etiology of RTIs, the clinical diagnosis, treatment, and prevention of these infections remain challenging, especially in developing countries.To determine the epidemiological and clinical characteristics of 18 respiratory pathogens, we analyzed 12,502 patients with acute respiratory infections (ARIs by performing polymerase chain reaction (PCR on patient pharyngeal swabs.Samples positive for at least 1 pathogen were obtained from 48.42% of the total patients. Of these pathogen-positive patients, 17.99% were infected with more than 1 pathogen. Of the 18 pathogens analyzed, four were detected with a positive detection rate (PDR > 5%: influenza A virus (IAV > respiratory syncytial virus (RSV >Mycoplasma pneumoniae (MP > human coronavirus (HCoV. The pathogens with the 4 highest co-infection rates (CIRs were as follows: HCoV > human bocavirus (HBoV > enterovirus (EV > parainfluenza virus (PIV. The overall positive detection rate (PDR varied significantly according to patient age, the season and year of detection, and the disease subgroup, but not according to patient sex. The individual PDRs of the pathogens followed 3 types of distributions for patient sex, 4 types of distributions for patient age, 4 types of seasonal distributions, 2 types of seasonal epidemic trends, 4 types of yearly epidemic trends, and different susceptibility distributions in the disease subgroups. Additionally, the overall CIR showed significantly different distributions according to patient sex, patient age, and the disease subgroup, whereas the CIRs of individual pathogens suggested significant preference characteristics.IAV remains the most common pathogen among the pathogens analyzed. More effort should be directed toward the prevention and control of pathogens that show a trend of increasing incidence such as HCoV, human adenovirus (ADV, and RSV. Although clinically

  12. Bacterial Respiratory Tract Infections are Promoted by Systemic Hyperglycemia after Severe Burn Injury in Pediatric Patients

    Science.gov (United States)

    Kraft, Robert; Herndon, David N; Mlcak, Ronald P; Finnerty, Celeste C; Cox, Robert A; Williams, Felicia N; Jeschke, Marc G

    2014-01-01

    Background Burn injuries are associated with hyperglycemia leading to increased incidence of infections with pneumonia being one of the most prominent and adverse complication. Recently, various studies in critically ill patients indicated that increased pulmonary glucose levels with airway/blood glucose threshold over 150 mg/dl lead to an overwhelming growth of bacteria in the broncho-pulmonary system, subsequently resulting in an increased risk of pulmonary infections. The aim of the present study was to determine whether a similar cutoff value exists for severely burned pediatric patients. Methods One-hundred six severely burned pediatric patients were enrolled in the study. Patients were divided in two groups: high (H) defined as daily average glucose levels >75% of LOS >150 mg/dl), and low (L) with daily average glucose levels >75% of the LOS <150 mg/dl). Incidences of pneumonia, atelectasis, and acute respiratory distress syndrome (ARDS) were assessed. Incidence of infections, sepsis, and respiratory parameters were recorded. Blood was analyzed for glucose and insulin levels. Statistical analysis was performed using Student’s t-test and chi-square test. Significance was set at p<0.05. Results Patient groups were similar in demographics and injury characteristics. Pneumonia in patients on the mechanical ventilation (L: 21% H: 32%) and off mechanical ventilation (L: 5% H: 15%), as well as ARDS were significantly higher in the high group (L: 3% H: 19%), p<0.05, while atelectasis was not different. Patients in the high group required significantly longer ventilation compared to low patients (p<0.05). Furthermore, incidence of infection and sepsis were significantly higher in the high group, p<0.05. Conclusion Our results indicate that systemic glucose levels over 150 mg/dl are associated with a higher incidence of pneumonia confirming the previous studies in critically ill patients. PMID:24074819

  13. Investigation on the carcinogenic effects of coal tar pitch in rat respiratory tract by intratracheal instillations.

    Science.gov (United States)

    Chang, F; Wang, L; Zhao, Q; Zhu, Q; Wu, Y; Chen, C; Syrjänen, S; Syrjänen, K

    1992-02-01

    The effects of coal tar pitch (CTP) on the tracheobronchial mucosa of Wistar rats were studied. Three groups of animals received 10 weekly intratracheal instillations of CTP at the cumulative doses of 6.48, 136.56 and 200 mg respectively. The control group of rats received 10 weekly intratracheal instillations of charcoal powder at a cumulative dose of 20 mg. The study in which the animals were killed serially revealed that CTP had conspicuous damage on the respiratory system of rats, especially on the bronchiolo-alveolar areas. The lesions induced by CTP ranged from hyperplastic, metaplastic and dysplastic changes to extensive cancers. These lesions were usually multifocal, and were more severe in the rats receiving higher dosages of CTP. The deposition of CTP particles within or adjacent to these lesions could be readily identified. Lung cancers occurred in 12.5% (4/32) and 25% (10/40) of the rats treated with 136.56 and 200 mg of CTP, whereas no tumors were found in control rats and the rats that received 6.48 mg of CTP. The overall cancer incidence significantly related to the cumulative dose of CTP. The histological types of lung cancers consisted of squamous cell carcinomas (10 out of the 14 lung cancers), adenocarcinoma (1/14), and combined squamous and adenocarcinomas (3/14). The development of CTP-induced rat lung cancers appears to derive from the hyperplasias of bronchiolo-alveolar epithelium, and processing stages of squamous metaplasias and/or dysplasias to carcinomas. The present results confirmed the carcinogenic effects of CTP on the respiratory system of rats, and provided experimental evidence for human lung carcinogenesis, particularly in those occupationally exposed to coal tars or tar products.

  14. Bone marrow stem cells do not repopulate the healthy upper respiratory tract.

    Science.gov (United States)

    Davies, Jane C; Potter, Mike; Bush, Andrew; Rosenthal, Mark; Geddes, Duncan M; Alton, Eric W F W

    2002-10-01

    Recent studies reported differentiation of both bone marrow and tissue-specific stem cells into cells of other organs. The demonstration that bone marrow stem cells differentiate into human hepatocytes in vivo has raised the possibility of new therapeutic approaches for liver disease. For diseases such as cystic fibrosis (CF), correction of the respiratory epithelium is being attempted by gene therapy. Differentiation of bone marrow stem cells into epithelium of the lung and airway was recently reported in an animal model, and would provide an alternative approach. We examined the nasal epithelium of female patients up to 15 years after gender-mismatched bone marrow transplantation. Donor-derived epithelial cells were sought with a combination of Y-chromosome fluorescence in situ hybridization and anti-cytokeratin antibody. In nasal brushing samples from 6 transplant-recipients, a median of 2.5% (range, 0.7-18.1%) of nuclei was male and identified as being of donor-origin. However, a complete absence of staining with anti-cytokeratin antibodies confirmed that these were not epithelial cells, but were likely to be either intraepithelial lymphocytes or mesenchymal cells. Following whole bone marrow transplantation, bone marrow progenitor cells do not differentiate into respiratory epithelium of the healthy upper airway. The differences between this and other studies could relate to the cells transplanted, to differential rates of turnover, or to the requirement for specific triggers to stimulate migration and differentiation. In the absence of such conditions, whole bone marrow transplantation is unlikely to provide a route for correction of the CF airway. PMID:12205565

  15. Therapy and Progress on Clearance of Respiratory Tract Retention Content%呼吸道潴留物的清除治疗及其研究进展

    Institute of Scientific and Technical Information of China (English)

    何明欣; 唐娟; 陈贵华

    2015-01-01

    目的:总结目前临床常用呼吸道潴留物清除疗法的主要特点及应用概况,评价其有效性和安全性。方法收集国内外文献进行分析对比。结果与结论呼吸道潴留物是引起患者病情加重的重要原因,目前常用的清除方法包括药物祛痰、体位引流、机械辅助、气道吸引术等,各有优缺点,规范化利用其特点和应用适应证,有利于临床工作中更有效地廓清患者的呼吸道。%Objective Summarize the clinical characteristics and applications of the respiratory tract retention content, evaluate its efficacy and safety. Methods The literature from home and abroad were collected for analysis. Results ann Conclusion Respiratory tract reten-tion content is a common clinical reason of hypoxia, how to clear it becomes the most important tract to alleviate hypoxia. These meth-ods include machine, postural drainage, assistant machine and airway aspiration, both have advantages and shortcomings. This article re-views the methods of clearing respiratory tract retention content and progress.

  16. The HMW1 and HMW2 Adhesins Enhance the Ability of Nontypeable Haemophilus influenzae To Colonize the Upper Respiratory Tract of Rhesus Macaques.

    Science.gov (United States)

    Rempe, Katherine A; Porsch, Eric A; Wilson, Jolaine M; St Geme, Joseph W

    2016-10-01

    Nontypeable Haemophilus influenzae (NTHi) initiates infection by colonizing the upper respiratory tract and is a common cause of localized respiratory tract disease. Previous work has established that the NTHi HMW1 and HMW2 proteins are potent adhesins that mediate efficient in vitro adherence to cultured human respiratory epithelial cells. In this study, we used a rhesus macaque model to assess the contributions of HMW1 and HMW2 to in vivo colonization. In experiments involving inoculation of individual isogenic derivatives of NTHi strain 12, the parent strain expressing both HMW1 and HMW2 and the mutant strains expressing either HMW1 or HMW2 were able to colonize more frequently than the double mutant strain lacking HMW1 and HMW2. In competition experiments, the parent strain efficiently outcompeted the double mutant lacking HMW1 and HMW2. Colonization with strains expressing HMW2 resulted in development of antibody against HMW2 in a number of the animals, demonstrating that colonization can stimulate an antibody response. In conclusion, we have established that the HMW1 and HMW2 adhesins play a major role in facilitating colonization of the upper respiratory tract of rhesus macaques, in some cases associated with stimulation of an immune response.

  17. CLINICAL PROFILE OF CHILDREN IN THE AGE GROUP 6 MONTHS TO 60 MONTHS WITH LOWER RESPIRATORY TRACT INFECTION

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    Bharath Kumar

    2015-05-01

    Full Text Available CONTEXT : Infections of the respiratory tract are perhaps the most common human ailments. Acute Respiratory Infections (ARI has quite a high morbidity and mortality in children in developing countries 1 ARI is responsible for about 30 - 50 percent of visits to health facilities and for about 20 - 40 percent of hospital admissions. Pneumonia is a leading cause of mortality in children worldwide. Because mortality due to pneumonia in developing countries is attributable mainly to bacterial etiology , IM NCI strategy recommends the use of antibiotics when a child presented with tachypnea as defined previously . AIMS : To re - define or refine tachypnea as a specific indicator of bacterial pneumonia. To identify other clinical predictors for identifying bacteri al pneumonia. DESIGNS : The study was designed to be done in two phases . In the first phase it is to be carried out as a descriptive study of children presenting with fever and respiratory distress in the OPD to identify the specific markers for bacterial p neumonia. In the second phase presenting clinical features in children with radiological pneumonia will be analysed to validate the findings from Phase I. MATERIALS AND METHODS : This was a hospital based study and was conducted in Sri Manakula V inayagar Me dical College and Hospital , Puducherry . The study included 100 Children in the age group 6 months to 5 years presenting in the out patients department with fever and respiratory distress Children attending the out - patient department on a fixed day of the w eek (Monday and who come under this study population during the study period were admitted and recruited in the study and informed verbal consent for participation was taken from the parents. Their clinical profiles were recorded as in phase I. All childr en coming under this study population were given antibiotics and supportive treatment. The cases were monitored for any worsening or improvement every 6 th hourly on day 1 and

  18. Association between air pollution and general outpatient clinic consultations for upper respiratory tract infections in Hong Kong.

    Directory of Open Access Journals (Sweden)

    Wilson W S Tam

    Full Text Available BACKGROUND AND OBJECTIVES: Many studies have shown the adverse effects of air pollution on respiratory health, but few have examined the effects of air pollution on service utilisation in the primary care setting. The aim of this study was to examine the association between air pollution and the daily number of consultations due to upper respiratory tract infections (URTIs in general outpatient clinics (GOPCs in Hong Kong. METHODS: Daily data on the numbers of consultations due to URTIs in GOPCs, the concentrations of major air pollutants, and the mean values of metrological variables were retrospectively collected over a 3-year period (2008-2010, inclusive. Generalised additive models were constructed to examine the association between air pollution and the daily number of consultations, and to derive the relative risks and 95% confidence intervals (95% CI of GOPC consultations for a unit increase in the concentrations of air pollutants. RESULTS: The mean daily consultations due to URTIs in GOPCs ranged from 68.4 to 253.0 over the study period. The summary relative risks (and 95% CI of daily consultations in all GOPCs for the air pollutants PM10, NO2, O3, and SO2 were 1.005 (1.002, 1.009, 1.010 (1.006, 1.013, 1.009 (1.006, 1.012, and 1.004 (1.000, 1.008 respectively, per 10 µg/m(3 increase in the concentration of each pollutant. CONCLUSION: Significant associations were found between the daily number of consultations due to URTIs in GOPCs and the concentrations of air pollutants, implying that air pollution incurs a substantial morbidity and increases the burden of primary health care services.

  19. Prevalence and correlation of infectious agents in hospitalized children with acute respiratory tract infections in Central China.

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    Jia Liu

    Full Text Available Acute respiratory tract infections (ARTIs are associated with significant morbidity and mortality worldwide, especially in children under the age of 5 years. Almost 2 million children die from ARTIs each year, and most of them are from developing countries. The prevalence and correlation of pathogens in ARTIs are poorly understood, but are critical for improving case prevention, treatment, and management. In this study, we investigated the prevalence and correlation of infectious agents in children with ARTIs. A total of 39,756 children with one or more symptoms, including fever, cough, sore throat, tonsillitis, pharyngitis, herpangina, pneumonia, and bronchiolitis, were enrolled in the study. All patients were hospitalized in Wuhan Children's Hospital between October 1, 2010 and September 30, 2012, and were evaluated for infectious agents. Pathogens, including Mycoplasma pneumoniae, influenza A virus, influenza B virus, adenoviruses, respiratory syncytial virus, parainfluenza virus, Legionella pneumophila, Chlamydophila pneumoniae, and Coxiella burnetii, were screened simultaneously in patient blood samples using anti-pathogen IgM tests. Regression analysis was used to reveal correlations among the pathogens. Our results showed that one or more pathogens were identified in 10,206 patients, and that Mycoplasma pneumoniae, adenoviruses, and influenza B virus were the leading infectious agents. Mixed-infections of pathogens were detected in 2,391 cases, with Mycoplasma pneumoniae as the most frequent pathogen. The most common agents in the co-infections were Mycoplasma pneumoniae and influenza B virus. Regression analysis revealed a linear correlation between the proportion of mixed infections and the incidence of multi-pathogen infections. The prevalence of infectious agents in children with ARTIs was determined. Equations were established to estimate multiple infections by single-pathogen detection. This revealed a linear correlation for

  20. Experimental studies on the pathogenicity of Mycoplasma ovipneumoniae and Mycoplasma arginini for the respiratory tract of goats.

    Science.gov (United States)

    Goltz, J P; Rosendal, S; McCraw, B M; Ruhnke, H L

    1986-01-01

    Mycoplasma ovipneumoniae and Mycoplasma arginini were the species of Mollicutes most commonly isolated from 175 goats with respiratory disease in Ontario. The pathogenicity of M. ovipneumoniae, strain B321B and M. arginini, strain D53e, was assessed in goats following endobronchial inoculation. One out of three two year old goats developed fever after inoculation with a pure culture of strain B321B, and it had extensive subacute fibrinous pleuritis when necropsied three weeks later. Neither of the remaining goats had lesions in the respiratory tract. Mycoplasma ovipneumoniae was recovered from one of the animals four days after inoculation, but not at necropsy from any of the goats, at which time a marked humoral immune response with growth inhibiting antibodies was detected. In a second experiment three four to five week old goats were inoculated with the same strain and three other goats were given placebo treatment. One experimental goat developed fever and coughing, and it had extensive subacute fibrinous pleuritis in the right side and pneumonia. Another goat had focal pneumonia in the left diaphragmatic lobe. Microscopically there was subacute hyperplastic suppurative bronchiolitis, atelectasis and nonsuppurative alveolitis. The infected animals did not clear the mycoplasma and not all of them produced antibodies. Mycoplasma arginini, strain D53e, did not induce lesions in any of four goat kids within 14 days after inoculation but did cause transient elevations in rectal temperature, circulating monocytes, circulating neutrophils and blood fibrinogen. Mycoplasma arginini was infective and immunogenic for all inoculated animals and showed a particular affinity for the tonsil. Thus, this study provides the first evidence that M. ovipneumoniae is pathogenic for goats causing pneumonia and pleuritis.(ABSTRACT TRUNCATED AT 250 WORDS)

  1. Metagenomic analysis of respiratory tract DNA viral communities in cystic fibrosis and non-cystic fibrosis individuals.

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    Dana Willner

    Full Text Available The human respiratory tract is constantly exposed to a wide variety of viruses, microbes and inorganic particulates from environmental air, water and food. Physical characteristics of inhaled particles and airway mucosal immunity determine which viruses and microbes will persist in the airways. Here we present the first metagenomic study of DNA viral communities in the airways of diseased and non-diseased individuals. We obtained sequences from sputum DNA viral communities in 5 individuals with cystic fibrosis (CF and 5 individuals without the disease. Overall, diversity of viruses in the airways was low, with an average richness of 175 distinct viral genotypes. The majority of viral diversity was uncharacterized. CF phage communities were highly similar to each other, whereas Non-CF individuals had more distinct phage communities, which may reflect organisms in inhaled air. CF eukaryotic viral communities were dominated by a few viruses, including human herpesviruses and retroviruses. Functional metagenomics showed that all Non-CF viromes were similar, and that CF viromes were enriched in aromatic amino acid metabolism. The CF metagenomes occupied two different metabolic states, probably reflecting different disease states. There was one outlying CF virome which was characterized by an over-representation of Guanosine-5'-triphosphate,3'-diphosphate pyrophosphatase, an enzyme involved in the bacterial stringent response. Unique environments like the CF airway can drive functional adaptations, leading to shifts in metabolic profiles. These results have important clinical implications for CF, indicating that therapeutic measures may be more effective if used to change the respiratory environment, as opposed to shifting the taxonomic composition of resident microbiota.

  2. Is quantitative PCR for the pneumolysin (ply) gene useful for detection of pneumococcal lower respiratory tract infection?

    Science.gov (United States)

    Abdeldaim, G; Herrmann, B; Korsgaard, J; Olcén, P; Blomberg, J; Strålin, K

    2009-06-01

    The pneumolysin (ply) gene is widely used as a target in PCR assays for Streptococcus pneumoniae in respiratory secretions. However, false-positive results with conventional ply-based PCR have been reported. The aim here was to study the performance of a quantitative ply-based PCR for the identification of pneumococcal lower respiratory tract infection (LRTI). In a prospective study, fibreoptic bronchoscopy was performed in 156 hospitalized adult patients with LRTI and 31 controls who underwent bronchoscopy because of suspicion of malignancy. Among the LRTI patients and controls, the quantitative ply-based PCR applied to bronchoalveolar lavage (BAL) fluid was positive at >or=10(3) genome copies/mL in 61% and 71% of the subjects, at >or=10(5) genome copies/mL in 40% and 58% of the subjects, and at >or=10(7) genome copies/mL in 15% and 3.2% of the subjects, respectively. Using BAL fluid culture, blood culture, and/or a urinary antigen test, S. pneumoniae was identified in 19 LRTI patients. As compared with these diagnostic methods used in combination, quantitative ply-based PCR showed sensitivities and specificities of 89% and 43% at a cut-off of 10(3) genome copies/mL, of 84% and 66% at a cut-off of 10(5) genome copies/mL, and of 53% and 90% at a cut-off of 10(7) genome copies/mL, respectively. In conclusion, a high cut-off with the quantitative ply-based PCR was required to reach acceptable specificity. However, as a high cut-off resulted in low sensitivity, quantitative ply-based PCR does not appear to be clinically useful. Quantitative PCR methods for S. pneumoniae using alternative gene targets should be evaluated.

  3. Electronic ventilator temperature sensors as a potential source of respiratory tract colonization with Stenotrophomonas maltophilia.

    Science.gov (United States)

    Rogues, A M; Maugein, J; Allery, A; Fleureau, C; Boulestreau, H; Surcin, S; Bebear, C; Janvier, G; Gachie, J P

    2001-12-01

    Stenotrophomonas maltophilia (S. maltophilia) is an important cause of nosocomial infection among ventilated and immunocompromised patients, and among patients receiving broad-spectrum antimicrobials. We report a cluster of patients in a surgical intensive care unit who were colonized or infected with S. maltophilia. An epidemiological investigation was initiated after surveillance data revealed that eight patients were culture-positive from sputum for S. maltophilia in the preceding month. Review of respiratory care procedures revealed that when mechanical ventilators were serviced between patients, the electronic temperature probes used with servo-controlled humidifiers were wiped with inadequate disinfection. We collected cultures of case-patient room surfaces, sinks and ventilator equipment. S. maltophilia was recovered from room surfaces, ventilator expiratory circuits and a temperature sensor which had been kept in ambient air after disinfection. Patients and environmental isolates were examined by RAPD-PCR. Three clinical isolates and one environmental isolate had the same profile, which suggests cross-contamination or common source exposure. The outbreak was controlled by adequate disinfection of the temperature sensors. No single epidemic strain was identified but several observations support the conclusion that the temperature probes contributed to the outbreak.

  4. Differentiation by random amplified polymorphic DNA-polymerase chain reaction (RAPD-PCR) of Candida albicans isolated from upper respiratory tract in patients with non-small cell lung cancer.

    Science.gov (United States)

    Biernasiuk, Anna; Korona-Głowniak, Izabela; Grzegorczyk, Agnieszka; Malm, Anna

    2014-01-01

    Cancer patients are predisposed to fungal infections caused by Candida albicans, especially to oral or respiratory tract candidiasis. The aim of this study was to estimate genetic diversity by RAPD-PCR (random amplified polymorphic DNA-polymerase chain reaction) of C. albicans isolated from upper respiratory tract of 100 patients with non-small cell lung cancer. Among 52 strains, 34 genotypes were defined. 10 clusters comprising 28 (53.85%) isolates with similarity coefficient ≥ 80% were formed. The remaining 24 (46.15%) isolates represented individual genotypes. The RAPD-PCR technique revealed genomic variability within C. albicans isolated from upper respiratory tract of the cancer patients. PMID:25371918

  5. Lactobacillus fermentum (PCC® supplementation and gastrointestinal and respiratory-tract illness symptoms: a randomised control trial in athletes

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    Hopkins William G

    2011-04-01

    Full Text Available Abstract Background Probiotics purportedly reduce symptoms of gastrointestinal and upper respiratory-tract illness by modulating commensal microflora. Preventing and reducing symptoms of respiratory and gastrointestinal illness are the primary reason that dietary supplementation with probiotics are becoming increasingly popular with healthy active individuals. There is a paucity of data regarding the effectiveness of probiotics in this cohort. The aim of this study was to evaluate the effectiveness of a probiotic on faecal microbiology, self-reported illness symptoms and immunity in healthy well trained individuals. Methods Competitive cyclists (64 males and 35 females; age 35 ± 9 and 36 ± 9 y, VO2max 56 ± 6 and 52 ± 6 ml.kg-1.min-1, mean ± SD were randomised to either probiotic (minimum 1 × 109 Lactobacillus fermentum (PCC® per day or placebo treatment for 11 weeks in a double-blind, randomised, controlled trial. The outcome measures were faecal L. fermentum counts, self-reported symptoms of illness and serum cytokines. Results Lactobacillus numbers increased 7.7-fold (90% confidence limits 2.1- to 28-fold more in males on the probiotic, while there was an unclear 2.2-fold (0.2- to 18-fold increase in females taking the probiotic. The number and duration of mild gastrointestinal symptoms were ~2-fold greater in the probiotic group. However, there was a substantial 0.7 (0.2 to 1.2 of a scale step reduction in the severity of gastrointestinal illness at the mean training load in males, which became more pronounced as training load increased. The load (duration×severity of lower respiratory illness symptoms was less by a factor of 0.31 (99%CI; 0.07 to 0.96 in males taking the probiotic compared with placebo but increased by a factor of 2.2 (0.41 to 27 in females. Differences in use of cold and flu medication mirrored these symptoms. The observed effects on URTI had too much uncertainty for a decisive outcome. There were clear reductions in

  6. Progress in pediatrics in 2013: choices in allergology, endocrinology, gastroenterology, hypertension, infectious diseases, neonatology, neurology, nutrition and respiratory tract illnesses.

    Science.gov (United States)

    Caffarelli, Carlo; Santamaria, Francesca; Vottero, Alessandra; Dascola, Carlotta Povesi; Mirra, Virginia; Sperli, Francesco; Bernasconi, Sergio

    2014-07-12

    This review will provide new information related to pathophysiology and management of specific diseases that have been addressed by selected articles published in the Italian Journal of Pediatrics in 2013, focusing on allergology, endocrinology, gastroenterology, hypertension, infectious diseases, neonatology, neurology, nutrition and respiratory tract illnesses in children. Recommendations for interpretation of skin prick test to foods in atopic eczema, management of allergic conjunctivitis, hypertension and breastfeeding in women treated with antiepileptic drugs and healthy breakfast have been reported. Epidemiological studies have given emphasis to high incidence of autoimmune disorders in patients with Turner syndrome, increasing prevalence of celiac disease, frequency of hypertension in adolescents, incidence and risk factor for retinopathy of prematurity. Advances in prevention include elucidation of the role of probiotics in reducing occurrence of allergies and feeding intolerance, and events of foetal life that influence later onset of diseases. Mechanistic studies suggested a role for vitamin D deficiency in asthma and type 1 diabetes and for reactivation of Varicella-Zoster virus in aseptic meningitis. Regarding diagnosis, a new mean for the diagnosis of hyperbilirubinaemia in newborns, a score for recognition of impaired nutritional status and growth and criteria for early Dyke-Davidoff-Masson Syndrome have been suggested. New therapeutic approaches consist of use of etanercept for reducing insulin dose in type 1 diabetes, probiotics in atopic eczema, and melatonin in viral infections.

  7. Thermal water applications in the treatment of upper respiratory tract diseases: a systematic review and meta-analysis.

    Science.gov (United States)

    Keller, Sarah; König, Volker; Mösges, Ralph

    2014-01-01

    Background. Thermal water inhalations and irrigations have a long tradition in the treatment of airway diseases. Currently there exists no systematic review or meta-analysis on the effectiveness of thermal water treatment in upper respiratory tract diseases. Methods. A systematic search in the databases of MEDLINE, EMBASE, CENTRAL, ISI Web of Science, and MedPilot was accomplished. Results. Eight evaluable outcome parameters from 13 prospective clinical studies were identified for 840 patients. Mucociliary clearance time improves significantly (P thermal water subgroup and the sulphurous subgroup after 2 weeks (-6.69/minutes) and after 90 days (-8.33/minutes), not for isotonic sodium chloride solution (ISCS). Nasal resistance improved significantly after 2 weeks (Radon, ISCS, and placebo), after 30 days (sulphur and ISCS), and after 90 days (sulphur). Nasal flow improved significantly with the pooled thermal water, radon alone, and ISCS subgroups. For the IgE parameter only sulphurous thermal water (P 0.01) were analyzable. Adverse events of minor character were only reported for sulphurous treatment (19/370). Conclusion. Thermal water applications with radon or sulphur can be recommended as additional nonpharmacological treatment in upper airway diseases. Also in comparison to isotonic saline solution it shows significant improvements and should be investigated further.

  8. Indoor air quality and risk of severe lower respiratory tract infection in Inuit infants in Baffin Region, Nunavut

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    Kovesi, T. [Children' s Hospital of Easterrn Ontario, Ottawa, ON (Canada)

    2008-07-01

    This paper discussed the indoor air quality in the houses of Inuit infants in Nunavut and the health implications. Inuit infants in the Baffin (Qikiqtani) Region of Nunavut have the highest reported rate in the world of severe lower respiratory tract infection (LRTI) including bronchiolitis and pneumonia requiring hospitalization. This population also has a high rate of long-term complications after severe LRTI. The houses in the region are small and crowded and tend to be kept warm and humid. Although the homes are heated with low-sulphur Arctic diesel, there is no evidence of leakage from furnaces, as nitrogen dioxide concentrations are low. Houses are generally clean, with very low levels of dust mites and generally low levels of indoor mould. However, indoor smoking is prevalent. According to measured ventilation of indoor carbon dioxide (CO{sub 2}) concentrations, most houses have ventilation rates below recommended standards. A controlled trial of installing heat recovery ventilators (HRVs) in the homes of the 68 young Inuit children in 3 communities in the Baffin Region has shown that active HRVs can significantly reduce mean indoor CO{sub 2} concentrations and increase occupant comfort. Health outcomes are currently undergoing analysis. 11 refs.

  9. Meta-analysis of Zn, Cu and Fe in the hair of Chinese children with recurrent respiratory tract infection.

    Science.gov (United States)

    Mao, Song; Zhang, Aihua; Huang, Songming

    2014-10-01

    Trace elements play an important role in maintaining the normal metabolic and immune function. The onset of recurrent respiratory tract infection (RRI) is associated with the immune function, genetic factors and nutritional status. However, the association between the levels of trace elements and RRI remains inconclusive. We aimed to investigate the alterations of hair levels of zinc (Zn), copper (Cu) and iron (Fe) in Chinese children with RRI by performing a meta-analysis. A predefined electronic databases search was performed to identify eligible studies for the analysis of hair Zn, Cu or Fe levels in Chinese children with RRI. Thirteen studies were included. RRI patients displayed significantly lower levels of hair Zn (13 studies, random effects SMD: - 1.215, 95% CI: - 1.704 to - 0.725, p < 0.0001), Cu (11 studies, random effects SMD: - 0.384, 95% CI: - 0.717 to - 0.052, p = 0.023) and Fe (12 studies, random effects SMD: - 0.569, 95% CI: - 0.827 to - 0.312, p < 0.0001) compared with controls. No evidence of publication bias was observed. Sensitivity analysis did not change the results significantly. In conclusion, the deficiency of Zn, Cu and Fe may be contributing factors for the susceptibility of RRI in Chinese children. However, more studies in different ethnicities should be performed in the future.

  10. Coal Mine Air Pollution and Number of Children Hospitalizations because of Respiratory Tract Infection: A Time Series Analysis

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    Yonglin Liu

    2015-01-01

    Full Text Available To analyze the relationship between levels of air pollution and number of children hospitalizations because of respiratory tract infection in Shenmu County, the data regarding meteorological factors, environmental pollutants, that is SO2 and NO2, Particulate Matter 10 (PM10, and hospitalizations of children less than 16 years of age was collected during the time duration of November 2009 to October 2012. Using SAS 9.3, descriptive data analysis for meteorological and environmental factors and hospital admissions were performed along with main air pollutants determination. Using the statistical software R 3.0.1, a generalized additive Poisson regression model was established, the linear fitting models of the air pollutant concentrations and meteorological factors were introduced considering the lag effect, and the relative risk of the main atmospheric pollutants on children hospitalization was evaluated. The results showed that the primary air pollutant in Shenmu County is PM10 and its Pearson correlation coefficient with Air Pollution Index (API is 0.917. After control of long term climate trend, “week day effect,” meteorological factors, and impact of other contaminants, it was found that, on the same day and during the lag of 1 to 10 days, PM10 concentrations had no significant effect on children hospitalization rate.

  11. Difficult identification of Haemophilus influenzae, a typical cause of upper respiratory tract infections, in the microbiological diagnostic routine.

    Science.gov (United States)

    Hinz, Rebecca; Zautner, Andreas Erich; Hagen, Ralf Matthias; Frickmann, Hagen

    2015-03-01

    Haemophilus influenzae is a key pathogen of upper respiratory tract infections. Its reliable discrimination from nonpathogenic Haemophilus spp. is necessary because merely colonizing bacteria are frequent at primarily unsterile sites. Due to close phylogenetic relationship, it is not easy to discriminate H. influenzae from the colonizer Haemophilus haemolyticus. The frequency of H. haemolyticus isolations depends on factors like sampling site, patient condition, and geographic region. Biochemical discrimination has been shown to be nonreliable. Multiplex PCR including marker genes like sodC, fucK, and hpd or sequencing of the 16S rRNA gene, the P6 gene, or multilocus-sequence-typing is more promising. For the diagnostic routine, such techniques are too expensive and laborious. If available, matrix-assisted laser-desorption-ionization time-of-flight mass spectrometry is a routine-compatible option and should be used in the first line. However, the used database should contain well-defined reference spectra, and the spectral difference between H. influenzae and H. haemolyticus is small. Fluorescence in-situ hybridization is an option for less well-equipped laboratories, but the available protocol will not lead to conclusive results in all instances. It can be used as a second line approach. Occasional ambiguous results have to be resolved by alternative molecular methods like 16S rRNA gene sequencing. PMID:25883794

  12. The efficacy of Pelargonium sidoides in the treatment of upper respiratory tract infections in children with transient hypogammaglobulinemia of infancy.

    Science.gov (United States)

    Patiroglu, Turkan; Tunc, Aydin; Eke Gungor, Hatice; Unal, Ekrem

    2012-08-15

    Transient hypogammaglobulinemia of infancy (THI), defined as prolongation of physiological hypogammaglobulinemia normally seen between the initial 3rd and 6th months of life, is one of the most common immune deficiencies of childhood. Recurrent upper respiratory tract infections (URTI) are rather common in this group of patients, and generally, antibiotic treatment is the usual choice, although viruses involved in most cases. Pelargonium sidoides extract a herbal drug with known immunmodulator, antiviral and antibacterial effects. In this randomized, placebo controlled, prospective, monocentric pilot study, 14 of 28 patients with a diagnosed THI, were given Pelargonium sidoides, while 14 were given placebo during the period of URTI. Before and after the treatment period of one week, complete blood count, prothrombin time, activated prothromboplastin time, serum alanine aminotransferase, aspartate aminotransferase, gamma glutamyl transpeptidase, total and direct bilirubin levels were measured. Mothers were asked to fill in a questionnaire for the recovery of the clinical symptoms during the treatment. The results were evaluated and compared in both group to assess the effect of Pelargonium sidoides. As a conclusion, the Pelargonium sidoides group showed increased appetite. The Pelargonium sidoides were found to beneficial for the nasal congestion, recovery of daily and nocturnal cough but not found be significant. Further studies with large number of participants are necessary to highlight the effect of Pelargonium sidoides in children with transient hypogammaglobulinemia of infancy.

  13. Systematic Review of Clinical Trials Assessing the Effectiveness of Ivy Leaf (Hedera Helix for Acute Upper Respiratory Tract Infections

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    Felix Holzinger

    2011-01-01

    Full Text Available Introduction. Among nonantibiotic cough remedies, herbal preparations containing extracts from leaves of ivy (Hedera helix enjoy great popularity. Objective. A systematic review to assess the effectiveness and tolerability of ivy for acute upper respiratory tract infections (URTIs. Methods. We searched for randomized controlled trials (RCTs, nonrandomized controlled clinical trials and observational studies evaluating the efficacy of ivy preparations for acute URTIs. Study quality was assessed by the Jadad score or the EPHPP tool. Results. 10 eligible studies were identified reporting on 17463 subjects. Studies were heterogeneous in design and conduct; 2 were RCTs. Three studies evaluated a combination of ivy and thyme, 7 studies investigated monopreparations of ivy. Only one RCT (=360 investigating an ivy/thyme combination used a placebo control and showed statistically significant superiority in reducing the frequency and duration of cough. All other studies lack a placebo control and show serious methodological flaws. They all conclude that ivy extracts are effective for reducing symptoms of URTI. Conclusion. Although all studies report that ivy extracts are effective to reduce symptoms of URTI, there is no convincing evidence due to serious methodological flaws and lack of placebo controls. The combination of ivy and thyme might be more effective but needs confirmation.

  14. Local IL-17A potentiates early neutrophil recruitment to the respiratory tract during severe RSV infection.

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    Arie Jan Stoppelenburg

    Full Text Available Respiratory syncytial virus (RSV bronchiolitis triggers a strong innate immune response characterized by excessive neutrophil infiltration which contributes to RSV induced pathology. The cytokine IL-17A enhances neutrophil infiltration into virus infected lungs. IL-17A is however best known as an effector of adaptive immune responses. The role of IL-17A in early immune modulation in RSV infection is unknown. We aimed to elucidate whether local IL-17A facilitates the innate neutrophil infiltration into RSV infected lungs prior to adaptive immunity. To this end, we studied IL-17A production in newborns that were hospitalized for severe RSV bronchiolitis. In tracheal aspirates we measured IL-17A concentration and neutrophil counts. We utilized cultured human epithelial cells to test if IL-17A regulates RSV infection-induced IL-8 release as mediator of neutrophil recruitment. In mice we investigated the cell types that are responsible for early innate IL-17A production during RSV infection. Using IL-17A neutralizing antibodies we tested if IL-17A is responsible for innate neutrophil infiltration in mice. Our data show that increased IL-17A production in newborn RSV patient lungs correlates with subsequent neutrophil counts recruited to the lungs. IL-17A potentiates RSV-induced production of the neutrophil-attracting chemokine IL-8 by airway epithelial cells in vitro. Various lung-resident lymphocytes produced IL-17A during early RSV infection in Balb/c mice, of which a local population of CD4 T cells stood out as the predominant RSV-induced cell type. By removing IL-17A during early RSV infection in mice we showed that IL-17A is responsible for enhanced innate neutrophil infiltration in vivo. Using patient material, in vitro studies, and an animal model of RSV infection, we thus show that early local IL-17A production in the airways during RSV bronchiolitis facilitates neutrophil recruitment with pathologic consequences to infant lungs.

  15. Biological fractionation of lead isotopes in Sprague-Dawley rats lead poisoned via the respiratory tract.

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    Jing Wu

    Full Text Available OBJECTIVES: It was considered that lead isotope ratios did not change during physical, chemical, or biological processes. Thus, lead isotope ratios have been used as fingerprints to identify possible lead sources. However, recent evidence has shown that the lead isotope ratios among different biological samples in human are not always identical from its lead origins in vitro. An animal experiment was conducted to explore the biological fractionation of lead isotopes in biological systems. METHODS: 24 male Sprague-Dawley (SD rats were divided into groups that received acute lead exposure (0, 0.02, 0.2, or 2 mg/kg body weight of lead acetate via the respiratory route every day for 5 days. Biological samples (i.e., blood, urine, and feces were collected for comparison with the lead acetate (test substance and the low-lead animal feed (diet administered to the rats. The lead isotope ratios were determined by inductively coupled plasma mass spectrometry (ICP-MS. RESULTS: There are significant differences (p<0.05 in lead isotope ratios between blood, urine, and feces. Moreover, a nonlinear relationship between the blood lead concentration and the blood lead isotope ratios was observed. There is also a threshold effect to the fractionation function. Only the blood isotope ratio of (204Pb/(206Pb matches the test substance well. As for feces, when (204Pb/(206Pb ratio is considered, there is no significant difference between feces-test substance pairs in medium and high dose group. CONCLUSIONS: The biological fractionation of lead isotopes in SD rats was observed. Moreover, there might be a threshold for the biological fractionation of lead isotopes which is depending on whole blood lead level. It is considered to be more reliable that we compared the isotope ratios of potential lead hazards with both blood and feces lead fingerprints especially for (204Pb/(206Pb ratio under high-dose exposure.

  16. 2014年乐从镇346例登革热患者合并呼吸道感染的情况分析%346 patients with dengue complicated with respiratory tract infection at Lecong town in 2014

    Institute of Scientific and Technical Information of China (English)

    黎教武; 黄金华; 李明霞

    2015-01-01

    Objective To improve the level of differential diagnosis for dengue and respiratory tract infection analyzing the status of 346 patients with dengue complicated with respiratory tract infection at Lecong town from September to December,2014.Methods 346 patients confirmed with dengue and admitted into our hospital from September to December,2014 were chosen.Among which,164(47.4%) wer male and 182 (52.6%) female.They were 1-87 years old,with an average age of (40.7±16.9) years.The peak of attack occurred from September to October,2014.The dengue patients complicated with respiratory tract infection or with respiratory symptoms or misdiagnosed with respiratory tract infection at the outpatient department were calculated and analyzed.Results 43 patients(12.4%) complicated with respiratory tract infection;among which,2(4.6%) suffered from acute upper respiratory infection,19(44.2%) acute tracheobronchitis,and 22(51.2%) pneumonia.69 patients(19.9%) had respiratory symptom but no respiratory tract infection;among which,27(39.1%) had expectoration,32(46.4%) cough,and 41(59.4%) pharyngalgia.40 patients (11.6%) were misdiagnosed with respiratory tract infection.Conclusions Dengue patients complicated with respiratory tract infection easily.Clinician should avoid misdiagnosis and enhance the level of differential diagnosis for dengue and respiratory tract infection according to epidemiology,clinical features,blood routine test,dengue virus antigen screening,imaging examination,and so on.%目的 分析2014年9月至2014年12月乐从镇346例登革热患者合并呼吸道感染的情况,提高登革热与呼吸道感染鉴别诊断水平.方法 选择2014年9月至2014年12月佛山市顺德区乐从医院收治的346例登革热确诊病例,男164例(47.4%),女182例(52.6%),年龄1~ 87岁,平均(40.7±16.9)岁,9~ 10月为发病高峰;统计登革热合并呼吸道感染病例、伴有呼吸道症状的登革热病例、门诊误诊为呼吸道

  17. Lower respiratory tract infection caused by respiratory syncytial virus in infants: the role played by specific antibodies Infecção por virus sincicial respiratório: o papel dos anticorpos séricos específicos

    OpenAIRE

    Vieira, Sandra E; Alfredo E. Gilio; Durigon, Edison L.; Bernardo Ejzenberg

    2007-01-01

    INTRODUCTION: Respiratory syncytial virus (RSV) is a major etiological agent of lower respiratory tract infection in infants. Genotypes of this virus and the role of the infants' serum antibodies have yet to be fully clarified. This knowledge is important for the development of effective therapeutic and prophylactic measures. OBJECTIVES: To evaluate the types and genotypes of RSV causing respiratory tract infection in infants, to analyze the association of subtype-specific serum antibodies wi...

  18. A comparison of nimesulide and paracetamol in the treatment of fever due to inflammatory diseases of the upper respiratory tract in children.

    Science.gov (United States)

    Polidori, G; Titti, G; Pieragostini, P; Comito, A; Scaricabarozzi, I

    1993-01-01

    The efficacy and tolerability of nimesulide were compared with those of paracetamol in a nonblind randomised study that recruited 110 children (64 males, 46 females; aged 3 to 6 years) with inflammation of the upper respiratory tract and fever. Nimesulide suspension (1.5 mg/kg 3 times daily) or paracetamol syrup (10 mg/kg 4 times daily) were administered orally until fever resolved. Body temperature was recorded and local pain and general discomfort assessed. Three patients treated with nimesulide and 6 patients treated with paracetamol withdrew from the study as a result of adverse events, and 1 paracetamol-treated patient discontinued because of a requirement for therapy with steroids. Nimesulide was as effective as paracetamol in reducing fever, local pain, and general discomfort. Nimesulide therefore appears to be at least as effective as paracetamol in terms of antipyretic and anti-inflammatory activity in children with inflammation of the upper respiratory tract and fever. PMID:7506180

  19. Airway biofilms: implications for pathogenesis and therapy of respiratory tract infections.

    Science.gov (United States)

    Kobayashi, Hiroyuki

    2005-01-01

    The differentiation of bacterial biofilms in the airway environment, the pathogenesis of airway biofilm, and possible therapeutic methods are discussed. Biofilm diseases that characteristically involve the respiratory system include cystic fibrosis (CF), diffuse panbronchiolitis (DPB), and bronchiectasia with Pseudomonas aeruginosa (P. aeruginosa) infection. There is evidence to suggest that almost all strains of P. aeruginosa have the genetic capacity to synthesize alginate, a main matrix of biofilms, when ecological conditions are unfavorable for their survival. The bacteria inside the mature biofilm show increased resistance to both antibacterials and phagocytic cells, express fewer virulence factors because of their stationary state of growth, and are less stimulatory to the mucosa because of the 'sandwich binding'. These factors facilitate both the colonization of bacteria and their extended survival even under unfavorable conditions. Since the biofilm limits colonization to a latent form, the clinical symptoms in this situation are unremarkable. However, the clinical progression of both CF and DPB proceeds in two characteristic directions. The first is an acute exacerbation caused by planktonic bacteria that have germinated from the biofilm. The second is a slow progression of disease that is induced by harmful immune reactions. The harmful reactions are mediated by alginate, which induces antigen antibody reactions around the airways, as well as formation of circulating immune complexes that are deposited on lung tissue. Furthermore, the highest titer of bacterial permeability increasing anti-neutrophil cytoplasmic autoantibodies (BPI-ANCA) is observed in association with highly impaired pulmonary function in patients with CF and DPB, as well as in patients with a lengthy period of colonization with P. aeruginosa. BPI-ANCA subsequently makes chronic airway infection even more intractable. The long-term use of 14- or 15-ring membered macrolides results in a

  20. High prevalence of Streptococcus pneumoniae in adenoids and nasopharynx in preschool children with recurrent upper respiratory tract infections in Poland – distribution of serotypes and drug resistance patterns

    OpenAIRE

    Niedzielski, Artur; Korona-Glowniak, Izabela; Malm, Anna

    2013-01-01

    Background Streptococcus pneumoniae is one of the major bacterial pathogens colonizing nasopharynx, and often causes upper respiratory tract infections in children. We investigated the prevalence of S. pneumoniae in nasopharynx and adenoid core in 57 children aged 2–5 years who underwent adenoidectomy for recurrent pharyngotonsillitis, and we determined serotypes and antibiotic resistance patterns of the isolated pneumococci. Material/Methods The nasopharyngeal specimens obtained before adeno...

  1. Attributable costs of ventilator-associated lower respiratory tract infection (LRTI) acquired on intensive care units: a retrospectively matched cohort study

    OpenAIRE

    Leistner, Rasmus; Kankura, Linda; Bloch, Andy; Sohr, Dorit; Gastmeier, Petra; Geffers, Christine

    2013-01-01

    Background Lower respiratory tract infections (LRTI) are the most common hospital-acquired infections on ICUs. They have not only an impact on each patient’s individual health but also result in a considerable financial burden for the healthcare system. Our aim was to determine the costs and the length of stay of patients with ICU-acquired LRTI. Methods We used a retrospectively matched cohort design, comparing patients with ICU-acquired LRTI and ICU patients without LRTI. LRTI was diagnosed ...

  2. Population diversity and dynamics of Streptococcus mitis, Streptococcus oralis, and Streptococcus infantis in the upper respiratory tracts of adults, determined by a nonculture strategy

    DEFF Research Database (Denmark)

    Bek-Thomsen, Malene; Tettelin, H; Hance, I;

    2008-01-01

    We reinvestigated the clonal diversity and dynamics of Streptococcus mitis and two other abundant members of the commensal microbiota of the upper respiratory tract, Streptococcus oralis and Streptococcus infantis, to obtain information about the origin of frequently emerging clones in this habitat...... with loss and acquisition from contacts. These findings provide a platform for understanding the mechanisms that govern the balance within the complex microbiota at mucosal sites and between the microbiota and the mucosal immune system of the host....

  3. Acquisition of pneumococci specific effector and regulatory Cd4+ T cells localising within human upper respiratory-tract mucosal lymphoid tissue.

    OpenAIRE

    Jeffrey Pido-Lopez; Kwok, William W.; Timothy J Mitchell; Heyderman, Robert S.; Neil A Williams

    2011-01-01

    The upper respiratory tract mucosa is the location for commensal Streptococcus (S.) pneumoniae colonization and therefore represents a major site of contact between host and bacteria. The CD4(+) T cell response to pneumococcus is increasingly recognised as an important mediator of immunity that protects against invasive disease, with data suggesting a critical role for Th17 cells in mucosal clearance. By assessing CD4 T cell proliferative responses we demonstrate age-related sequestration of ...

  4. A method of calculating total respiratory system compliance from resonant frequency: validity in a rabbit model.

    Science.gov (United States)

    Schulze, A; Schaller, P; Dinger, J; Winkler, U; Gmyrek, D

    1990-12-01

    Ten anesthetized, tracheotomized, adult rabbits were used to test the validity of a method for calculation of total respiratory system compliance from resonant frequency (Cr). Reference values were obtained during constant flow inflation of the relaxed respiratory system by dividing the volume gain by the related difference in pressure at the airway opening (inflation method compliance, Ci). The animals were connected to a new type of servo-controlled infant ventilator. Besides volume-controlled mechanical ventilation at constant inspiratory flow rate and intermittent mandatory ventilation, there is a negative ventilator resistance mode integrated in this device for resistive unloading (Schulze A, Schaller P, Gehrhardt B, Mädler H-J, Gmyrek D: Pediatr Res 28:79-82, 1990). To measure resonant frequency (fr), the respiratory system was totally unloaded for a short period by a negative ventilator resistance exceeding the combined resistances of the endotracheal tube and airways. This evoked a continuous oscillation at fr. By analogy with electrical circuit theory, Cr was calculated according to C = 1/(4 pi 2.I.fr2) where C is compliance and I is inertance. The inertance of the endotracheal tube is given and that of the bronchial tree was ignored assuming a much greater total cross-sectional area and therefore much lower inertance when compared with the endotracheal tube. Three pairs of Ci - Cr values were obtained from each animal: 1) during intact respiratory muscle activity; 2) after pancuronium relaxation, and 3) after surfactant depletion by saline washout.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2284157

  5. The effects of anatomic resolution, respiratory variations and dose calculation methods on lung dosimetry

    Science.gov (United States)

    Babcock, Kerry Kent Ronald

    2009-04-01

    The goal of this thesis was to explore the effects of dose resolution, respiratory variation and dose calculation method on dose accuracy. To achieve this, two models of lung were created. The first model, called TISSUE, approximated the connective alveolar tissues of the lung. The second model, called BRANCH, approximated the lungs bronchial, arterial and venous branching networks. Both models were varied to represent the full inhalation, full exhalation and midbreath phases of the respiration cycle. To explore the effects of dose resolution and respiratory variation on dose accuracy, each model was converted into a CT dataset and imported into a Monte Carlo simulation. The resulting dose distributions were compared and contrasted against dose distributions from Monte Carlo simulations which included the explicit model geometries. It was concluded that, regardless of respiratory phase, the exclusion of the connective tissue structures in the CT representation did not significantly effect the accuracy of dose calculations. However, the exclusion of the BRANCH structures resulted in dose underestimations as high as 14% local to the branching structures. As lung density decreased, the overall dose accuracy marginally decreased. To explore the effects of dose calculation method on dose accuracy, CT representations of the lung models were imported into the Pinnacle 3 treatment planning system. Dose distributions were calculated using the collapsed cone convolution method and compared to those derived using the Monte Carlo method. For both lung models, it was concluded that the accuracy of the collapsed cone algorithm decreased with decreasing density. At full inhalation lung density, the collapsed cone algorithm underestimated dose by as much as 15%. Also, the accuracy of the CCC method decreased with decreasing field size. Further work is needed to determine the source of the discrepancy.

  6. Antimicrobial susceptibility monitoring of bacterial pathogens isolated from respiratory tract infections in dogs and cats across Europe: ComPath results.

    Science.gov (United States)

    Morrissey, Ian; Moyaert, Hilde; de Jong, Anno; El Garch, Farid; Klein, Ulrich; Ludwig, Carolin; Thiry, Julien; Youala, Myriam

    2016-08-15

    ComPath is a pan-European resistance monitoring programme collecting bacterial pathogens from dogs and cats. We present data for respiratory tract infection (RTI) isolates collected between 2008 and 2010. Antimicrobial minimal inhibitory concentrations (MICs) were determined and susceptibility calculated following Clinical Laboratory Standards Institute (CLSI) standards for veterinary medicine. The main pathogen from dogs was Staphylococcus intermedius Group (49/215, 22.8%) which was >90% susceptible to most antimicrobials (including oxacillin - 93.9%; 3 isolates confirmed mecA-positive) but only 59.2%, 73.5% and 87.8% susceptible to tetracycline, chloramphenicol and penicillin. Bordetella bronchiseptica (48/215, 22.3%), streptococci (36/215, 16.7%), Escherichia coli (24/215, 11.2%) and Pasteurella multocida (23/215, 10.7%) were also found in dog RTI. There are no breakpoints for Bordetella bronchiseptica. Most streptococci were penicillin- chloramphenicol-, ampicillin- and pradofloxacin-susceptible. None were enrofloxacin-resistant but 6 isolates (16.7%) were of intermediate susceptibility. The least active agent against streptococci was tetracycline (47.2% susceptible). For E. coli, 37.5% were ampicillin-susceptible but 83.3% were amoxicillin/clavulanic acid-susceptible. Only chloramphenicol showed susceptibility>90% against E. coli, with 66.7% tetracycline-susceptible and 79.2% to 87.5% susceptibility to enrofloxacin, trimethoprim-sulfamethoxazole or pradofloxacin. P. multocida were susceptible to pradofloxacin (no other breakpoints are available). The main pathogen from cats was P. multocida (82/186, 44.1%), where only pradofloxacin has breakpoints (100% susceptible). Streptococci were also collected from cats (25/186, 13.4%) and were >90% susceptible to all antimicrobials except tetracycline (36% susceptible). Most susceptibility was calculated with human-derived breakpoints and some antimicrobials had no breakpoints. Therefore predictions of clinical utility

  7. Risk factors for recurrent lower respiratory tract infections in infants%幼儿反复下呼吸道感染危险因素分析

    Institute of Scientific and Technical Information of China (English)

    孙光辉; 李敏; 多力坤·木扎帕尔; 张季红

    2014-01-01

    目的:分析幼儿反复下呼吸道感染(RLRTI)的危险因素。方法选择新疆医科大学第一附属医院儿科收治的123例反复下呼吸道感染幼儿为 RLRTI组,取同期117例非反复呼吸道感染幼儿作为对照组,对可能影响反复下呼吸道感染的因素进行单因素分析和 Logistic回归分析。结果单因素分析显示 IgA、IgG、营养不良、过敏体质、合并基础疾病及非正规治疗6个因素与幼儿反复下呼吸道感染相关(P <0.05);Logistic回归分析显示IgA、营养不良、过敏体质及合并基础疾病是幼儿反复下呼吸道感染的独立危险因素(P <0.05)。结论提高幼儿免疫力、合理膳食加强营养、减少与过敏物质接触并及早治疗基础疾病可减少幼儿反复下呼吸道感染的发生。%Objective To analyze the risk factors of recurrent lower respiratory tract infections in infants. Methods 123 infants with recurrent lower respiratory tract infections were analyzed retrospectively.117 patients with other diseases of respiratory tract infections were compared.Independent variables were ana-lyzed by univariate analysis and logistic regression to screen out the risk factors.Results Single factor a-nalysis was conducted for 6 risk factors.IgA,IgG,malnutrition,allergy,with basic diseases and Informal treatment were considered statistically significant (P <0.05).Logistic regression model analysis showed that IgA,malnutrition,allergy,and with basic diseases were the independent risk factors of recurrent lower respiratory tract infections (P <0.05).Conclusion Improving immunity in infants,suppling nutri-tious food,reducing the chance to contact allergies,and curing the basic diseases can decrease the incidence of recurrent lower respiratory tract infections.

  8. Interleukin-6 G-174C gene polymorphism and susceptibility to upper respiratory tract infection among endurance athletes

    Directory of Open Access Journals (Sweden)

    Farzad Zehsaz

    2014-06-01

    Full Text Available The aim of this study was to investigate the influence of interleukin (IL-6 gene polymorphisms on upper respiratory tract infection (URTI incidence. To this end, 100 healthy elite male athletes participating in the study were classified as either healthy or prone to frequent URTI. Blood samples and DNA isolation, multiplex polymerase chain reaction, and Taqman real-time polymerase chain reaction were carried out. Genomic DNA was extracted from peripheral leukocytes of whole blood samples using the QIAmp DNA Blood Mini Kit according to the manufacturer's protocols. For comparison of the distribution of genotypes between the two groups and for estimating odds ratios for URTI susceptibility in relation to the IL-6 polymorphism, Pearson's χ2 and logistic regression methods were used, respectively. The IL-6-174 genotype distribution differed between athletes with URTI and healthy athletes (χ2 = 11.68, p = 0.003. The IL-6 low-expression genotype (CC, relative to the other two genotypes combined (GC + GG, was associated with a tendency for an increased likelihood of frequent URTI (odds ratio: 3.33, 95% confidence interval: 1.40–7.92; p = 0.006. In conclusion, findings from this study have identified a potential role of genetic variation in influencing the risk for URTI in athletic populations and single nucleotide polymorphisms in the IL-6 genes were associated with an altered risk profile. These measures may have a predictive value in the identification of individuals who are more likely to experience recurrent infections when exposed to high physical stress in the areas of athletic endeavor.

  9. Antibiotic prescribing of village doctors for children under 15 years with upper respiratory tract infections in rural China

    Science.gov (United States)

    Zhang, Zhixia; Zhan, Xingxin; Zhou, Hongjun; Sun, Fang; Zhang, Heng; Zwarenstein, Merrick; Liu, Qian; Li, Yingxue; Yan, Weirong

    2016-01-01

    Abstract The aim of this study was to explore the knowledge, attitudes, and practices of village doctors regarding the prescribing of antibiotics for children under 15 years with upper respiratory tract infections (URTIs) in rural China. Twelve focus group discussions (FGDs) were conducted in Xianning, a prefecture-level city in rural China, during December 2014. We conducted 6 FGDs with 35 village doctors, 3 with 13 primary caregivers (11 parents), and 3 with 17 directors of township hospitals, county-level health bureaus, county-level Centers for Disease Control and Prevention, or county-level Chinese Food and Drug Administration offices. Audio records of the interviews were transcribed verbatim and analyzed using the thematic analysis approach. Participants believed that unnecessary antibiotic prescribing for children under 15 years with The occurrence of URTIs was a problem in village clinics in rural China. The discussions revealed that most of the village doctors had inadequate knowledge and misconceptions about antibiotic use, which was an important factor in the unnecessary prescribing. Village doctors and directors reported that the doctors’ fear of complications, the primary caregivers’ pressure for antibiotic treatment, and the financial considerations of patient retention were the main factors influencing the decision to prescribe antibiotics. Most of the primary caregivers insisted on antibiotics, even when the village doctors were reluctant to prescribe them, and they preferred to go to see those village doctors who prescribed antibiotics. The interviewees also gave their opinions on what would be the most effective measures for optimizing antibiotic prescriptions; these included educational/training campaigns, strict regulations on antibiotic prescription, and improved supervision. Findings emphasized the need to improve the dissemination of information and training/education, and implement legislation on the rational use of antibiotics. And it

  10. Molecular identification of adenovirus causing respiratory tract infection in pediatric patients at the University of Malaya Medical Center

    Directory of Open Access Journals (Sweden)

    AbuBakar Sazaly

    2010-07-01

    Full Text Available Abstract Background There are at least 51 adenovirus serotypes (AdV known to cause human infections. The prevalence of the different human AdV (HAdV serotypes varies among different regions. Presently, there are no reports of the prevalent HAdV types found in Malaysia. The present study was undertaken to identify the HAdV types associated primarily with respiratory tract infections (RTI of young children in Malaysia. Methods Archived HAdV isolates from pediatric patients with RTI seen at the University of Malaya Medical Center (UMMC, Kuala Lumpur, Malaysia from 1999 to 2005 were used. Virus isolates were inoculated into cell culture and DNA was extracted when cells showed significant cytopathic effects. AdV partial hexon gene was amplified and the sequences together with other known HAdV hexon gene sequences were used to build phylogenetic trees. Identification of HAdV types found among young children in Malaysia was inferred from the phylograms. Results At least 2,583 pediatric patients with RTI sought consultation and treatment at the UMMC from 1999 to 2005. Among these patients, 48 ( Conclusions HAdV-1 and HAdV-2 were the most common HAdV isolated from pediatric patients who sought treatment for RTI at the UMMC from 1999 to 2005. HAdV-B, mainly HAdV-3, was recovered from ~22% of the patients. These findings provide a benchmark for future studies on the prevalence and epidemiology of HAdV types in Malaysia and in the region.

  11. Systematic review of evidence-based guidelines on medication therapy for upper respiratory tract infection in children with AGREE instrument.

    Directory of Open Access Journals (Sweden)

    Linan Zeng

    Full Text Available OBJECTIVES: To summarize recommendations of existing guidelines on the treatment of upper respiratory tract infections (URTIs in children, and to assess the methodological quality of these guidelines. METHODS: We searched seven databases and web sites of relevant academic agencies. Evidence-based guidelines on pediatric URTIs were included. AGREE II was used to assess the quality of these guidelines. Two researchers selected guidelines independently and extracted information on publication years, institutions, target populations, recommendations, quality of evidence, and strength of recommendations. We compared the similarities and differences of recommendations and their strength. We also analyzed the reasons for variation. RESULTS: Thirteen guidelines meeting our inclusion criteria were included. Huge differences existed among these 13 guidelines concerning the categorization of evidence and recommendations. Nearly all of these guidelines lacked the sufficient involvement of stake holders. Further, the applicability of these guidelines still needs to be improved. In terms of recommendations, penicillin and amoxicillin were suggested for group A streptococcal pharyngitis. Amoxicillin and amoxicillin-clavulanate were recommended for acute bacterial rhinosinusitis (ABRS. An observation of 2-3 days prior to antibiotic therapy initiation for mild acute otitis media (AOM was recommended with amoxicillin as the suggested first choice agent. Direct evidence to support strong recommendations on the therapy for influenza is still lacking. In addition, the antimicrobial durations for pharyngitis and ABRS were still controversial. No consensus was reached for the onset of antibiotics for ABRS in children. CONCLUSIONS: Future guidelines should use a consistent grading system for the quality of evidence and strength of recommendations. More effort needs to be paid to seek the preference of stake holders and to improve the applicability of guidelines

  12. Public beliefs on antibiotics and symptoms of respiratory tract infections among rural and urban population in Poland: a questionnaire study.

    Directory of Open Access Journals (Sweden)

    Maciek Godycki-Cwirko

    Full Text Available General public views and expectations around the use of antibiotics can influence general practitioners' antibiotic prescribing decisions. We set out to describe the knowledge, attitudes and beliefs about the use of antibiotics for respiratory tract infections in adults in Poland, and explore differences according to where people live in an urban-rural continuum.Face to face survey among a stratified random sample of adults from the general population.1,210 adults completed the questionnaire (87% response rate; 44.3% were rural; 57.9% were women. 49.4% of rural respondents and 44.4% of urban respondents had used an antibiotic in the last 2 years. Rural participants were less likely to agree with the statement "usually I know when I need an antibiotic," (53.5% vs. 61.3% respectively; p = 0.015 and reported that they would consult with a physician for a cough with yellow/green phlegm (69.2% vs. 74.9% respectively; p = 0.004, and were more likely to state that they would leave the decision about antibiotic prescribing to their doctor (87.5% vs. 85.6% respectively; p = 0.026. However, rural participants were more likely to believe that antibiotics accelerate recovery from sore throat (45.7% vs. 37.1% respectively; p = 0.017. Use of antibiotic in the last 2 years, level of education, number of children and awareness of the problem of developing antimicrobial resistance predicted accurate knowledge about antibiotic effectiveness.There were no major differences in beliefs about antibiotics between urban and rural responders, although rural responders were slightly less confident in their knowledge about antibiotics and self-reported greater use of antibiotics. Despite differences in the level of education between rural and urban responders, there were no significant differences in their knowledge about antibiotic effectiveness.

  13. Antimicrobial characterisation of CEM-101 activity against respiratory tract pathogens, including multidrug-resistant pneumococcal serogroup 19A isolates.

    Science.gov (United States)

    Farrell, David J; Sader, Helio S; Castanheira, Mariana; Biedenbach, Douglas J; Rhomberg, Paul R; Jones, Ronald N

    2010-06-01

    CEM-101 is a novel fluorinated macrolide-ketolide with potent activity against bacterial pathogens that are susceptible or resistant to other macrolide-lincosamide-streptogramin B (MLS(B))-ketolide agents. CEM-101 is being developed for oral and parenteral use in moderate to moderately severe community-acquired bacterial pneumonia. The objective of this study was to assess the activity of CEM-101 and comparators against contemporary respiratory tract infection (RTI) isolates. A worldwide sample of organisms was used, including Streptococcus pneumoniae [n=168; 59.3% erythromycin-resistant and 18 multidrug-resistant (MDR) serogroup 19A strains], Moraxella catarrhalis (n=21; 11 beta-lactamase positive), Haemophilus influenzae (n=100; 48 beta-lactamase positive), Haemophilus parainfluenzae and Haemophilus haemolyticus (n=12), and Legionella pneumophila (n=30). Testing and interpretation were performed using reference Clinical and Laboratory Standards Institute methods. CEM-101 was very potent against S. pneumoniae [minimum inhibitory concentration for 90% of the organisms (MIC90)=0.25 mg/L; highest MIC at 0.5 mg/L] and was 2- and > or =32-fold more active than telithromycin and clindamycin, respectively. CEM-101 also demonstrated potent activity against S. pneumoniae MDR-19A strains (MIC90=0.5 mg/L). CEM-101 was the most potent antimicrobial agent tested against L. pneumophila, with all MIC values at or = 2 mg/L. CEM-101 exhibited the greatest potency and widest spectrum of activity against RTI pathogens among the tested MLS(B)-ketolide agents (azithromycin, clarithromycin, erythromycin, telithromycin, clindamycin and quinupristin/dalfopristin) and was comparable overall with levofloxacin. PMID:20211548

  14. G-scores: a method for identifying disease-causing pathogens with application to lower respiratory tract infections.

    Science.gov (United States)

    Zhang, Peng; Peng, Peichao; Wang, Lu; Kang, Yu

    2014-07-20

    Lower respiratory tract infections (LRTIs) are well known for the lack of a good diagnostic method. The main difficulty lies in the fact that there are a variety of pathogens causing LRTIs, and their management and treatment are quite different. The development of quantitative real-time loop-mediated isothermal amplification (qrt-LAMP) made it possible to rapidly amplify and quantify multiple pathogens simultaneously. The question that remains to be answered is how accurate and reliable is this method? More importantly, how are qrt-LAMP measurements utilized to inform/suggest medical decisions? When does a pathogen start to grow out of control and cause infection? Answers to these questions are crucial to advise treatment guidance for LRTIs and also helpful to design phase I/II trials or adaptive treatment strategies. In this article, our main contributions include the following two aspects. First, we utilize zero-inflated mixture models to provide statistical evidence for the validity of qrt-LAMP being used in detecting pathogens for LRTIs without the presence of a gold standard test. Our results on qrt-LAMP suggest that it provides reliable measurements on pathogens of interest. Second, we propose a novel statistical approach to identify disease-causing pathogens, that is, distinguish the pathogens that colonize without causing problems from those that rapidly grow and cause infection. We achieve this by combining information from absolute quantities of pathogens and their symbiosis information to form G-scores. Change-point detection methods are utilized on these G-scores to detect the three phases of bacterial growth-lag phase, log phase, and stationary phase. PMID:24599506

  15. Physician behaviour for antimicrobial prescribing for paediatric upper respiratory tract infections: a survey in general practice in Trinidad, West Indies

    Directory of Open Access Journals (Sweden)

    Ramdhanie Joseph

    2004-06-01

    Full Text Available Abstract Background Upper respiratory tract infections (URTIs are among the most frequent reasons for physician office visits in paediatrics. Despite their predominant viral aetiology, URTIs continue to be treated with antimicrobials. We explored general practitioners' (GPs prescribing behaviour for antimicrobials in children (≤ 16 years with URTIs in Trinidad, using the guidelines from the Centers for Disease Control and Prevention (CDC as a reference. Methods A cross-sectional study was conducted on 92 consenting GPs from the 109 contacted in Central and East Trinidad, between January to June 2003. Using a pilot-tested questionnaire, GPs identified the 5 most frequent URTIs they see in office and reported on their antimicrobial prescribing practices for these URTIs to trained research students. Results The 5 most frequent URTIs presenting in children in general practice, are the common cold, pharyngitis, tonsillitis, sinusitis and acute otitis media (AOM in rank order. GPs prescribe at least 25 different antibiotics for these URTIs with significant associations for amoxicillin, co-amoxiclav, cefaclor, cefuroxime, erythromycin, clarithromycin and azithromycin (p 30 years were more likely to prescribe antibiotics for the common cold (p = 0.014. Severity (95.7% and duration of illness (82.5% influenced doctors' prescribing and over prescribing in general practice was attributed to parent demands (75% and concern for secondary bacterial infections (70%. Physicians do not request laboratory investigations primarily because they are unnecessary (86% and the waiting time for results is too long (51%. Conclusions Antibiotics are over prescribed for paediatric URTIs in Trinidad and amoxicillin with co-amoxiclav were preferentially prescribed. Except for AOM, GPs' prescribing varied from the CDC guidelines for drug and duration. Physicians recognise antibiotics are overused and consider parents expecting antibiotics and a concern for secondary

  16. Clinical Analysis of Children with Recurrent Respiratory Tract Infection%儿童反复呼吸道感染病因分析

    Institute of Scientific and Technical Information of China (English)

    严春梅; 刘伟英; 吴锦珍

    2013-01-01

    目的:讨论引起儿童呼吸道反复感染的相关因素,为临床治疗提供相关依据。方法:选取2012年2月-2013年2月于本院接受治疗的反复呼吸道感染患儿206例作为观察组,并以同期入院体检的206例非呼吸道感染儿童作为对照组,对两组患儿的临床资料进行详细比较和统计学分析。结果:单因素考察结果显示:营养不良、缺铁性贫血、维生素缺乏、微量元素缺乏、先天性心脏病、胃食道反流、支气管哮喘、慢性肺炎、鼻炎、扁桃体炎及过敏史为发生反复呼吸道感染的重要影响因素(P<0.05);Logistic回归分析结果显示:其中营养不良、胃食道反流、支气管哮喘、慢性炎症、鼻炎、扁桃体炎及过敏史7项指标为反复上呼吸道感染的独立危险因素(P<0.05)。结论:儿童为反复呼吸道感染的高发群体,且存在致病因素复杂的典型特点。明确呼吸道感染反复发作的主要病因是保障患儿临床治疗水平和预后生活质量的根本措施。%Objective:To discuss the related factors causing children repeated respiratory tract infection in order to provide evidence for clinical treatment.Method:Two hundred and six children with repeated respiratory tract infection accepted by our hospital from February 2010 to February 2012 were researched as the observation group,while the other 206 children without repeated respiratory tract infection were researched as the control group, which clinical data were retrospectively analyzed.Result:Single factor investigation showed that the factors of poor nutrition,lack of iron deficiency anemia,vitamin deficiency,trace element deficiency,congenital heart disease,gastroesophageal reflux,bronchial asthma,chronic pneumonia, coryza,amygdalitis and allergies played important roles for recurrent respiratory tract infections(P<0.05);and Logistic regression analysis showed that 7 factors including malnutrition

  17. Sources of multidrug-resistant Acinetobacter baumannii and its role in respiratory tract colonization and nosocomial pneumonia in intensive care unit patients

    Institute of Scientific and Technical Information of China (English)

    HUANG Jie; CHEN Er-zhen; QU Hong-ping; MAO En-qiang; ZHU Zheng-gang; NI Yu-xing; HAN Li-zhong

    2013-01-01

    Background Multidrug-resistant Acinetobacter baumannii (MDRAB) is an important and emerging hospital-acquired pathogen worldwide.This study was conducted to identify the sources of MDRAB and its role in respiratory tract colonization and nosocomial pneumonia in intensive care unit (ICU) patients.Methods We conducted a prospective active surveillance study of MDRAB in three ICUs at a Chinese Hospital from April to August 2011,to identify the sources of MDRAB and its role in respiratory tract colonization and nosocomial pneumonia.Results One hundred and fourteen (13.0%) MDRAB isolates were detected from 876 specimens,with a sensitivity of 11.6% (55/474) in screening of the pharyngeal and tracheal swabs,and 14.7% (59/402) of the sputum/endotracheal aspirates.MDRAB colonization/infection was found in 34 (26.8%) of 127 patients,including 16 (12.6%) cases of pure colonization and 18 (14.2%) cases of pneumonia (two pre-ICU-acquired cases of pneumonia and 16 ICU-acquired cases of pneumonia).Previous respiratory tract MDRAB colonization was found in 22 (17.3%) patients:eight (6.3%)were pre-ICU-acquired colonization and 14 (11.0%) ICU-acquired colonization.Of eight pre-ICU-colonized patients,five were transferred from other wards or hospitals with hospitalization >72 hours,and three came from the community with no previous hospitalization.Overall,6/22 colonized patients presented with secondary pneumonia; only two (9.1%) colonized MDRAB strains were associated with secondary infections.Respiratory tract MDRAB colonization had no significant relationship with nosocomial pneumonia (P=-0.725).In addition,acute respiratory failure,mechanical ventilation,renal failure,and prior carbapenem use were risk factors for MDRAB colonization/infection.Conclusions A high proportion of cases of MDRAB colonization/infection in ICU patients were detected through screening cultures.About one-third were acquired from general wards and the community before ICU admission

  18. Sialic acid receptor detection in the human respiratory tract: evidence for widespread distribution of potential binding sites for human and avian influenza viruses

    Directory of Open Access Journals (Sweden)

    Guan Yi

    2007-10-01

    Full Text Available Abstract Background Influenza virus binds to cell receptors via sialic acid (SA linked glycoproteins. They recognize SA on host cells through their haemagglutinins (H. The distribution of SA on cell surfaces is one determinant of host tropism and understanding its expression on human cells and tissues is important for understanding influenza pathogenesis. The objective of this study therefore was to optimize the detection of α2,3-linked and α2,6-linked SA by lectin histochemistry by investigating the binding of Sambucus nigra agglutinin (SNA for SAα2,6Gal and Maackia amurensis agglutinin (MAA for SAα2,3Gal in the respiratory tract of normal adults and children. Methods We used fluorescent and biotinylated SNA and MAA from different suppliers on archived and prospectively collected biopsy and autopsy specimens from the nasopharynx, trachea, bronchus and lungs of fetuses, infants and adults. We compared different methods of unmasking for tissue sections to determine if these would affect lectin binding. Using serial sections we then compared the lectin binding of MAA from different suppliers. Results We found that unmasking using microwave treatment in citrate buffer produced increased lectin binding to the ciliated and glandular epithelium of the respiratory tract. In addition we found that there were differences in tissue distribution of the α2,3 linked SA when 2 different isoforms of MAA (MAA1 and MAA2 lectin were used. MAA1 had widespread binding throughout the upper and lower respiratory tract and showed more binding to the respiratory epithelium of children than in adults. By comparison, MAA2 binding was mainly restricted to the alveolar epithelial cells of the lung with weak binding to goblet cells. SNA binding was detected in bronchial and alveolar epithelial cells and binding of this lectin was stronger to the paediatric epithelium compared to adult epithelium. Furthermore, the MAA lectins from 2 suppliers (Roche and EY Labs tended

  19. Respiratory tract tamor

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008295 Analysis of RASSF1A promoter hypermethylation in serum DNA of non-small cell lung cancer patients. YU Zhen(于正洪), et al. Dept Med Oncol, Nanjing General Hosp, Nanjing Milit Command, PLA, Nanjing 210002. Chin J Oncol 2008;30(4):284-287.Objective To detect the hypermethylation status of RASSF1A promoter in serum DNAof non-small cell lung cancer(NSCLC)patient and evaluate its correlation with

  20. Respiratory tract tumor

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    2010336 Study on the association between DNA double-strand break repair gene NBS1 polymorphisms and susceptibility on lung cancer. FAN Lihui(樊丽辉),et al. Dept Epidemiol,Public Health Sch,Fujian Med Univ,Fuzhou 350004.Chin J Epidemiol 2010;31(2):213-217.

  1. Respiratory tract tumor

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930513 MRI sequences evaluation in examiningpatients with bronchiogenic carcinoma.ZHANSonghua(詹松华),et al.Dept Radiol,HuashanHosp,Shanghai Med Univ,Shanghai,200040.Chin J Radiol 1993;27(3):165—168.Different tissues in thorax have different T1and T2 values and proton densities.The more ap-propriate MRI sequences are selected,the betterMRI images can be obtained with high signal-to

  2. Respiratory tract tumor

    Institute of Scientific and Technical Information of China (English)

    1995-01-01

    950309 The result of re-resection for lung cancer.GAO Wen(高文),et al.Dept Thoracic Surg,Shang-hai 1st Pulmon Hosp,Shanghai,200433.Chin J Oncol1995;17(1):30-32.In 38 cases of primary lung cancer with postopera-tive recurrence and metastasis or second primary lungcancer,re-resection was performed.The time intervalbetween the first operation and re-resection was 2

  3. Respiratory tract tumor

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008053 Expression of PTEN gene in non-small cell lung cancer. HONG Zheng(洪征),et al. Dept Thoracic Surg, Thoracic Tumor & Tuberc Res Instit , Beijing 101149. Chin J Clin Oncol Rehabil 2007;14(6):487-490. Objective To investigate the expression of PTEN gene in non-small cell lung cancer (NSCLC) and analyze the role of PTEN gene in lung tumorigenesis. Methods Immunohistochemical stain was used to determine the expression of PTEN in

  4. Mechanisms of probiotic treatment of recurrent respiratory tract infections%益生菌治疗反复呼吸道感染的相关机制

    Institute of Scientific and Technical Information of China (English)

    陈汝文; 杨静; 薛辉

    2012-01-01

    Recurrent respiratory tract infection (RRTI) is a common chronic respiratory disease of children.The pathogenesis is complex,etiology and treatment methods are varied.Probiotics are immune modulators with extensive clinical application.This paper reviewed the changes of intestinal microflora in children with recurrent respiratory tract infection and the mechanisms of probiotic treatment including intestinal flora regulation,intestinal mucosal barrier,stimulation of the growth of intestinal mucosa and immune regulation.%反复呼吸道感染是儿童常见的慢性呼吸道疾病,发病机制复杂,病因及治疗方法较多.益生菌是近年来临床应用较多的免疫调节剂之一,本文综述了反复呼吸道感染患儿肠道菌群的变化,并从调节肠道菌群、增强肠黏膜屏障、刺激肠道黏膜生长、调节机体免疫等方面阐述了益生菌治疗反复呼吸道感染的相关机制.

  5. Viral Respiratory Tract Infections in Adult Patients Attending Outpatient and Emergency Departments, Taiwan, 2012-2013: A PCR/Electrospray Ionization Mass Spectrometry Study.

    Science.gov (United States)

    Shih, Hsin-I; Wang, Hsuan-Chen; Su, Ih-Jen; Hsu, Hsiang-Chin; Wang, Jen-Ren; Sun, Hsiao Fang Sunny; Chou, Chien-Hsuan; Ko, Wen-Chien; Hsieh, Ming-I; Wu, Chi-Jung

    2015-09-01

    Viral etiologies of respiratory tract infections (RTIs) have been less studied in adult than in pediatric populations. Furthermore, the ability of PCR/electrospray ionization mass spectrometry (PCR/ESI-MS) to detect enteroviruses and rhinoviruses in respiratory samples has not been well evaluated. We sought to use PCR/ESI-MS to comprehensively investigate the viral epidemiology of adult RTIs, including testing for rhinoviruses and enteroviruses. Nasopharyngeal or throat swabs from 267 adults with acute RTIs (212 upper RTIs and 55 lower RTIs) who visited a local clinic or the outpatient or emergency departments of a medical center in Taiwan between October 2012 and June 2013 were tested for respiratory viruses by both virus isolation and PCR/ESI-MS. Throat swabs from 15 patients with bacterial infections and 27 individuals without active infections were included as control samples. Respiratory viruses were found in 23.6%, 47.2%, and 47.9% of the 267 cases by virus isolation, PCR/ESI-MS, and both methods, respectively. When both methods were used, the influenza A virus (24.3%) and rhinoviruses (9.4%) were the most frequently identified viruses, whereas human coronaviruses, human metapneumovirus (hMPV), enteroviruses, adenoviruses, respiratory syncytial virus, and parainfluenza viruses were identified in small proportions of cases (old age, and immunosuppression were independently associated with lower RTIs. In conclusion, PCR/ESI-MS improved the diagnostic yield for viral RTIs. Non-influenza respiratory virus infections were associated with patients with comorbidities and with lower RTIs. Additional studies that delineate the clinical need for including non-influenza respiratory viruses in the diagnostic work-up in these populations are warranted. PMID:26402811

  6. Progress in Pediatrics in 2012: choices in allergy, endocrinology, gastroenterology, hematology, infectious diseases, neurology, nutrition and respiratory tract illnesses.

    Science.gov (United States)

    Caffarelli, Carlo; Santamaria, Francesca; Vottero, Alessandra; Bernasconi, Sergio

    2013-05-08

    In this review, we summarize the progresses in allergy, endocrinology, gastroenterology, hematology, infectious diseases, neurology, nutrition and respiratory tract illnesses that have been published in The Italian Journal of Pediatrics in 2012. The induction of Treg activity by probiotics might be effective for promoting tolerance towards food allergens. Nasal cytology is useful in patients with rhinitis for diagnosing chronic non-allergic non-infectious diseases. Atopic eczema is associated both with an aberrant skin matrix and impaired systemic immune response. Therefore, isolated topical treatment may have suboptimal effect. Diagnostic work-up of exercise-induced anaphylaxis, including exercise challenge test, is necessary to reach a diagnosis. Studies may support a role for nutrition on prevention of asthma and cardiovascular diseases. Clinicians need to early identify adolescent menstrual abnormalities to minimize sequelae, and to promote health information. In Multiple Endocrine Neoplasia type 2B investigations include acetylcholinesterase study of rectal mucosa followed by the molecular analysis of RET mutation. Low adherence to gluten-free diet and osteopenia are common problems in children with diabetes mellitus type 1 and celiac disease. In infantile colic, laboratory tests are usually unnecessary and the treatment is based on reassurance. Prevalence of obesity and stunting is elucidated by several studies. Evidences are growing that dietetic measures are needed to prevent obesity in children with acute leukemia. Treatment studies for infectious diseases show promise for probiotics along with standard triple therapy in children with Helicobacter pilori infection, while zinc has no effect on pneumonia. Educational programs about the proper management of the febrile child are warranted. A new hour-specific total serum bilirubin nomogram has been shown to be able to predict newborns without hyperbilirubinemia after 48 to 72 hours of life. Newborns with

  7. Preliminary molecular epidemiology of the Staphylococcus aureus in lower respiratory tract infections: a multicenter study in China

    Institute of Scientific and Technical Information of China (English)

    LI De-zhi; HU Ke; CAI Shao-xi; WAN Huan-ying; WANG Qiu-yue; WEI Li-ping; DU Juan; YU Qin; ZHONG Xiao-ning; WANG Rui-qin; MA Jian-jun; CHEN Yu-sheng; TIAN Gui-zhen; WANG Si-qin; GAO Zhan-cheng; YANG Jing-ping; ZHANG Wei; HU Cheng-ping; LI Jia-shu; MU Lan; HU Ying-hui; GENG Rong

    2011-01-01

    Background Staphylococcus aureus (S.aureus) remains as an important microbial pathogen resulting in community and nosocomial acquired infections with significant morbidity and mortality. Few reports for S. aureus in lower respiratory tract infections (LRTIs) have been documented. The aim of this study was to explore the molecular epidemiology of S.aureus in LRTIs in China.Methods A multicenter study of the molecular epidemiology of S. aureus in LRTIs was conducted in 21 hospitals in Beijing, Shanghai and twelve other provinces from November 2007 to February 2009. All the collected S. aureus strains were classified as minimum inhibitory concentration (MIC), mecA gene, virulence genes Panton-Valentine Leukocidin (PVL)and y-hemolysin (hlg), staphylococcal cassette chromosome mec (SCCmec) type, agr type, and Multilocus Sequence Typing (MLST).Results Totally, nine methicillin-sensitive S. aureus (MSSA) and 29 methicillin-resistant S. aureus (MRSA) strains were isolated after culture from a total of 2829 sputums or bronchoalveolar lavages. The majority of MRSA strains (22/29) had a MIC value of ≥512 μg/ml for cefoxitin. The mecA gene acting as the conservative gene was carried by all MRSA strains.PVL genes were detected in only one S. aureus strain (2.63%, 1/38). The hlg gene was detected in almost the all S.aureus (100% in MSSA and 96.56% in MRSA strains). About 75.86% of MRSA strains carried SCCmec Ⅲ. Agr type 1 was predominant (78.95%) among the identified three agr types (agr types 1,2, and 3). Totally, ten sequence type (ST) of S. aureus strains were detected. A new sequence type (ST1445) was found besides confirming ST239 as the major sequence type (60.53%). A dendrogram generated from our own MLST database showed all the bootstrap values≤50%.Conclusion Our preliminary epidemiology data show SCCmec Ⅲ, ST239 and agr type 1 of S. aureus as the predominant strains in LRTIs in Mainland of China.

  8. Health Alliance for Prudent Prescribing, Yield and Use of Antimicrobial Drugs in the Treatment of Respiratory Tract Infections (HAPPY AUDIT

    Directory of Open Access Journals (Sweden)

    Reutskiy Anatoliy

    2010-04-01

    Full Text Available Abstract Background Excessive and inappropriate use of antibiotics is considered to be the most important reason for development of bacterial resistance to antibiotics. As antibiotic resistance may spread across borders, high prevalence countries may serve as a source of bacterial resistance for countries with a low prevalence. Therefore, bacterial resistance is an important issue with a potential serious impact on all countries. The majority of respiratory tract infections (RTIs are treated in general practice. Most infections are caused by virus and antibiotics are therefore unlikely to have any clinical benefit. Several intervention initiatives have been taken to reduce the inappropriate use of antibiotics in primary health care, but the effectiveness of these interventions is only modest. Only few studies have been designed to determine the effectiveness of multifaceted strategies in countries with different practice setting. The aim of this study is to evaluate the impact of a multifaceted intervention targeting general practitioners (GPs and patients in six countries with different prevalence of antibiotic resistance: Two Nordic countries (Denmark and Sweden, two Baltic Countries (Lithuania and Kaliningrad-Russia and two Hispano-American countries (Spain and Argentina. Methods/Design HAPPY AUDIT was initiated in 2008 and the project is still ongoing. The project includes 15 partners from 9 countries. GPs participating in HAPPY AUDIT will be audited by the Audit Project Odense (APO method. The APO method will be used at a multinational level involving GPs from six countries with different cultural background and different organisation of primary health care. Research on the effect of the intervention will be performed by analysing audit registrations carried out before and after the intervention. The intervention includes training courses on management of RTIs, dissemination of clinical guidelines with recommendations for diagnosis and

  9. Influence of patient symptoms and physical findings on general practitioners' treatment of respiratory tract infections: a direct observation study

    Directory of Open Access Journals (Sweden)

    Kochen Michael M

    2005-02-01

    Full Text Available Abstract Background The high rate of antibiotic prescriptions general practitioners (GPs make for respiratory tract infections (RTI are often explained by non-medical reasons e.g. an effort to meet patient expectations. Additionally, it is known that GPs to some extent believe in the necessity of antibiotic treatment in patients with assumed bacterial infections and therefore attempt to distinguish between viral and bacterial infections by history taking and physical examination. The influence of patient complaints and physical examination findings on GPs' prescribing behaviour was mostly investigated by indirect methods such as questionnaires. Methods Direct, structured observation during a winter "cough an cold period" in 30 (single handed general practices. All 273 patients with symptoms of RTI (age above 14, median 37 years, 51% female were included. Results The most frequent diagnoses were 'uncomplicated upper RTI/common cold' (43% followed by 'bronchitis' (26%. On average, 1.8 (95%-confidence interval (CI: 1.7–2.0 medicines per patient were prescribed (cough-and-cold preparations in 88% of the patients, antibiotics in 49%. Medical predictors of antibiotic prescribing were pathological findings in physical examination such as coated tonsils (odds ratio (OR 15.4, 95%-CI: 3.6–66.2 and unspecific symptoms like fatigue (OR 3.1, 95%-CI 1.4–6.7, fever (OR 2.2, 95%-CI: 1.1–4.5 and yellow sputum (OR 2.1, 95%-CI: 1.1–4.1. Analysed predictors explained 70% of the variance of antibiotic prescribing (R2 = 0,696. Efforts to reduce antibiotic prescribing, e.g. recommendations for self-medication, counselling on home remedies or delayed antibiotic prescribing were rare. Conclusions Patient complaints and pathological results in physical examination were strong predictors of antibiotic prescribing. Efforts to reduce antibiotic prescribing should account for GPs' beliefs in those (non evidence based predictors. The method of direct observation was

  10. Impact on respiratory tract infections of heptavalent pneumococcal conjugate vaccine administered at 3, 5 and 11 months of age

    Directory of Open Access Journals (Sweden)

    Cesati Laura

    2007-02-01

    Full Text Available Abstract Background Medical and public health importance of pneumococcal infections justifies the implementation of measures capable of reducing their incidence and severity, and explains why the recently marketed heptavalent pneumococcal conjugate vaccine (PCV-7 has been widely studied by pediatricians. This study was designed to evaluate the impact of PCV-7 administered at 3, 5 and 11 months of age on respiratory tract infections in very young children. Methods A total of 1,571 healthy infants (910 males aged 75–105 days (median 82 days were enrolled in this prospective cohort trial to receive a hexavalent vaccine (DTaP/IPV/HBV/Hib and PCV-7 (n = 819 or the hexavalent vaccine alone (n = 752 at 3, 5 and 11 months of age. Morbidity was recorded for the 24 months following the second dose by monthly telephone interviews conducted by investigators blinded to the study treatment assignment using standardised questionnaires. During these interviews, the caregivers and the children's pediatricians were questioned about illnesses and the use of antibiotics since the previous telephone call. All of the data were analysed using SAS Windows v.12. Results Among the 1,555 subjects (98.9% who completed the study, analysis of the data by the periods of follow-up demonstrated that radiologically confirmed community-acquired pneumonia (CAP was significantly less frequent in the PCV-7 group during the follow-up as a whole and during the last period of follow-up. Moreover, there were statistically significant between-group differences in the incidence of acute otitis media (AOM in each half-year period of follow-up except the first, with significantly lower number of episodes in children receiving PCV-7 than in controls. Furthermore, the antibiotic prescription data showed that the probability of receiving an antibiotic course was significantly lower in the PCV-7 group than in the control group. Conclusion Our findings show the effectiveness of the simplified

  11. Functional, radiological and biological markers of alveolitis and infections of the lower respiratory tract in patients with systemic sclerosis

    Directory of Open Access Journals (Sweden)

    Danza Francesco

    2005-08-01

    would be necessary to detect any infections of the lower respiratory tract that may cause further deterioration in lung function.

  12. Characterization and sensitivity to antibiotics of bacteria isolated from the lower respiratory tract of ventilated patients hospitalized in intensive care units

    Directory of Open Access Journals (Sweden)

    Manuel Medell

    2012-02-01

    Full Text Available OBJECTIVE: This observational study described the characterization of bacteria isolated from the lower respiratory tract of ventilated patients hospitalized in intensive care units. The demonstration of isolated microorganism resistance to antibiotics and a time-trend analysis of infection comparing a 48-month period were also other objectives. METHOD: Semi-quantitative assays of 1254 samples taken from 741 ventilated patients were performed, while pathogens were identified using the Enterotube II assay and VITEK 2 Compact equipment. Bacterial resistance to antibiotics was assessed by the Kirby-Bauer disc diffusion method and time-trend analysis of infection was based on data recorded by hospital microbiology laboratories. RESULTS: The most prevalent isolated bacteria from the patient's lower respiratory tract were with Gram-negative bacteria (67.8% mostly represented by: Acinetobacter spp. (25.2%, Pseudomonas spp. (18.3% and Klebsiellas spp. (9.4%. Acinetobacter spp. showed moderate high to very high resistance to ceftriaxone (CRO, gentamicin (CN, amikacin (AK, meropenem (MRP, aztreonam (ATM and piperacillin/tazobactam (TZP. Some isolates of Acinetobacter spp. resistant to colistin (CS were identified in this patient population. Pseudomonas spp. and Klebsiella spp. were very highly resistant to ampicillin/sublactam (AMS and with moderate or low resistance to CRO, ATM, MRP, AK, CN and TZP. A decrease in the Pseudomonas spp. prevalence rate was observed, whereas an increase in Acinetobacter spp. and Klebsiella spp. prevalence rates were observed in a 48-month period. CONCLUSION: This research corroborated that these nosocomial infections are a relevant medical problem in our context. The most prevalent bacterial infections in the lower respiratory tract of ventilated patients were by Acinetobacter spp., Pseudomonas spp. and Klebsiella spp. The panel of antibiotics used as preventive therapy was not the solution of infections and probably induced

  13. Towards evidence based emergency medicine: Best BETs from the Manchester Royal Infirmary. Bet 3. Honey for the symptomatic relief of cough in children with upper respiratory tract infections.

    Science.gov (United States)

    Heppermann, Beth

    2009-07-01

    A short-cut review was carried out to establish whether honey provides significant symptom relief of cough in children with an upper respiratory tract infection (URTI). Only one paper presented a trial addressing the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of this paper are shown in table 1. The clinical bottom line is that honey does appear to be effective in relieving some of the symptoms of URTI. PMID:19546278

  14. Pneumonia and empyema caused by Streptococcus intermedius that shows the diagnostic importance of evaluating the microbiota in the lower respiratory tract.

    Science.gov (United States)

    Noguchi, Shingo; Yatera, Kazuhiro; Kawanami, Toshinori; Yamasaki, Kei; Fukuda, Kazumasa; Naito, Keisuke; Akata, Kentarou; Nagata, Shuya; Ishimoto, Hiroshi; Taniguchi, Hatsumi; Mukae, Hiroshi

    2014-01-01

    The bacterial species in the Streptococcus anginosus group (S. constellatus, S. anginosus, S. intermedius) are important causative pathogens of bacterial pneumonia, pulmonary abscesses and empyema. However, the bacteria in this group are primarily oral resident bacteria and unable to grow significantly on ordinary aerobic culture media. We experienced a case of pneumonia and empyema caused by Streptococcus intermedius detected using a 16S rRNA gene sequencing analysis of bronchoalveolar lavage fluid and pleural effusion, but not sputum. Even when applying the molecular method, sputum samples are occasionally unsuitable for identifying the causative pathogens of lower respiratory tract infections.

  15. Effect of recombinant human interleukin-2 on the course of experimental chronic respiratory tract infection caused by Klebsiella pneumoniae in mice.

    OpenAIRE

    Iizawa, Y; Nishi, T; Kondo, M.; Tsuchiya, K.; Imada, A

    1988-01-01

    The effect of recombinant human interleukin-2 (rIL-2) on the course of experimental chronic respiratory tract infection caused by Klebsiella pneumoniae in mice was examined. rIL-2 was administered subcutaneously once a day for 7 or 14 days, starting 2 weeks after the mice were infected. Administration of 2 or 20 micrograms of rIL-2 per mouse daily for 7 days reduced bacterial counts in the lungs dose dependently. At a dose of 0.2 microgram per day, proliferation of bacteria in the lungs was s...

  16. Information density of hemato-immune system parameters for integral estimate of insulating properties of protection equipment for upper respiratory tract of exclusion zone workers

    International Nuclear Information System (INIS)

    A possibility of integral estimation of insulating properties of protection equipment (based on Petryanov cloth) for upper respiratory tract in conditions of its application in 30-km Exclusion Zone ('Ukryttia' Object and State Specialized Plant 'Complex') through hemato-immune system parameters are discussed. As a result of researches, the attributes of adaptive potential decrease,especially for the workers of Ukrytie Activity Suppression Shop and SSP Complex' Equipment and Vehicles Decontamination Department, are detected. They indicate to a high risk of radionuclide inhalations,throw discredit upon sufficient reliability of protective properties of applicable respirators,and enforce checking the correctness of this conclusion for adequate model systems

  17. Access to Point-of-Care Tests Reduces the Prescription of Antibiotics Among Antibiotic-Requesting Subjects With Respiratory Tract Infections

    DEFF Research Database (Denmark)

    Llor, Carl; Bjerrum, Lars; Munck, Anders;

    2014-01-01

    BACKGROUND: General practitioners (GPs) often feel uncomfortable when patients request an antibiotic when there is likely little benefit. This study evaluates the effect of access to point-of-care tests on decreasing the prescription of antibiotics in respiratory tract infections in subjects who...... of interventions were performed: the full intervention group received prescriber feedback with discussion of the results of the first registry, courses for GPs, guidelines, patient information leaflets, workshops, and access to point-of-care tests (rapid streptococcal antigen detection test and C-reactive protein...... test); and the partial intervention group underwent all of the above interventions except for the workshop and access to point-of-care tests. RESULTS: A total of 210 GPs were assigned to the full intervention group and 71 to the partial intervention group. A total of 25,479 subjects with respiratory...

  18. Influences of parameter uncertainties within the ICRP-66 respiratory tract model: regional tissue doses for 239PuO2 and 238UO2/238U3O8.

    Science.gov (United States)

    Farfán, Eduardo B; Huston, Thomas E; Bolch, W Emmett; Vernetson, William G; Bolch, Wesley E

    2003-04-01

    This paper extends an examination of the influence of parameter uncertainties on regional doses to respiratory tract tissues for short-ranged alpha particles using the ICRP-66 respiratory tract model. Previous papers examined uncertainties in the deposition and clearance aspects of the model. The critical parameters examined in this study included target tissue depths, thicknesses, and masses, particularly within the thoracic or lung regions of the respiratory tract. Probability density functions were assigned for the parameters based on published data. The probabilistic computer code LUDUC (Lung Dose Uncertainty Code) was used to assess regional and total lung doses from inhaled aerosols of 239PuO2 and 238UO2/238U3O8. Dose uncertainty was noted to depend on the particle aerodynamic diameter. Additionally, dose distributions were found to follow a lognormal distribution pattern. For 239PuO2 and 238UO2/238U3O8, this study showed that the uncertainty in lung dose increases by factors of approximately 50 and approximately 70 for plutonium and uranium oxides, respectively, over the particle size range from 0.1 to 20 microm. For typical exposure scenarios involving both radionuclides, the ratio of the 95% dose fractile to the 5% dose fractile ranged from approximately 8-10 (corresponding to a geometric standard deviation, or GSD, of about 1.7-2) for particle diameters of 0.1 to 1 microm. This ratio increased to about 370 for plutonium oxide (GSD approximately 4.5) and to about 600 for uranium oxide (GSD approximately 5) as the particle diameter approached 20 microm. However, thoracic tissue doses were quite low at larger particle sizes because most of the deposition occurred in the extrathoracic airways. For 239PuO2, median doses from LUDUC were found be in general agreement with those for Reference Man (via deterministic LUDEP 2.0 calculations) in the particle range of 0.1 to 5 microm. However, median doses to the basal cell nuclei of the bronchial airways (BB

  19. Applying psychological theories to evidence-based clinical practice: Identifying factors predictive of managing upper respiratory tract infections without antibiotics

    Directory of Open Access Journals (Sweden)

    Glidewell Elizabeth

    2007-08-01

    Full Text Available Abstract Background Psychological models can be used to understand and predict behaviour in a wide range of settings. However, they have not been consistently applied to health professional behaviours, and the contribution of differing theories is not clear. The aim of this study was to explore the usefulness of a range of psychological theories to predict health professional behaviour relating to management of upper respiratory tract infections (URTIs without antibiotics. Methods Psychological measures were collected by postal questionnaire survey from a random sample of general practitioners (GPs in Scotland. The outcome measures were clinical behaviour (using antibiotic prescription rates as a proxy indicator, behavioural simulation (scenario-based decisions to managing URTI with or without antibiotics and behavioural intention (general intention to managing URTI without antibiotics. Explanatory variables were the constructs within the following theories: Theory of Planned Behaviour (TPB, Social Cognitive Theory (SCT, Common Sense Self-Regulation Model (CS-SRM, Operant Learning Theory (OLT, Implementation Intention (II, Stage Model (SM, and knowledge (a non-theoretical construct. For each outcome measure, multiple regression analysis was used to examine the predictive value of each theoretical model individually. Following this 'theory level' analysis, a 'cross theory' analysis was conducted to investigate the combined predictive value of all significant individual constructs across theories. Results All theories were tested, but only significant results are presented. When predicting behaviour, at the theory level, OLT explained 6% of the variance and, in a cross theory analysis, OLT 'evidence of habitual behaviour' also explained 6%. When predicting behavioural simulation, at the theory level, the proportion of variance explained was: TPB, 31%; SCT, 26%; II, 6%; OLT, 24%. GPs who reported having already decided to change their management to

  20. Reducing general practice trainees' antibiotic prescribing for respiratory tract infections: an evaluation of a combined face-to-face workshop and online educational intervention.

    Science.gov (United States)

    Magin, Parker J; Morgan, Simon; Tapley, Amanda; Davis, Joshua S; McArthur, Lawrie; Henderson, Kim M; Mulquiney, Katie J; Dallas, Anthea; Davey, Andrew R; Scott, John; van Driel, Mieke L

    2016-03-01

    Over-prescription of antibiotics for non-pneumonia respiratory tract infections (RTIs) is a major concern in general practice. Australian general practice registrars (trainees) have inappropriately high rates of prescription of antibiotics for RTIs. The 'apprenticeship' educational model and the trainee-trainer relationship are drivers of this inappropriate prescribing. We aimed to reduce registrars' non-pneumonia RTI antibiotic prescribing via an educational intervention (a 90-min face-to-face workshop supported by online modules), complemented by delivery of the same intervention, separately, to their trainers. We conducted a pre- and post-intervention comparison of the registrars' intention to prescribe antibiotics for common RTIs using McNemar's test. We similarly tested changes in supervisors' intended prescribing. Prescribing intentions were elicited by responses to six written clinical vignettes (upper respiratory tract infection, otitis media, sore throat and three acute bronchitis vignettes). We found that, for registrars, there were statistically significant reductions in antibiotic prescribing for the sore throat (24.0% absolute reduction), otitis media (17.5% absolute reduction) and two of the three acute bronchitis (12.0% and 18.0% absolute reduction) vignettes. There were significant reductions in supervisors' antibiotic prescribing intentions for the same four vignettes. We conclude that our intervention produced a significant change in registrars' intention to prescribe antibiotics for non-pneumonia RTIs. PMID:27005837

  1. Reducing general practice trainees' antibiotic prescribing for respiratory tract infections: an evaluation of a combined face-to-face workshop and online educational intervention.

    Science.gov (United States)

    Magin, Parker J; Morgan, Simon; Tapley, Amanda; Davis, Joshua S; McArthur, Lawrie; Henderson, Kim M; Mulquiney, Katie J; Dallas, Anthea; Davey, Andrew R; Scott, John; van Driel, Mieke L

    2016-03-01

    Over-prescription of antibiotics for non-pneumonia respiratory tract infections (RTIs) is a major concern in general practice. Australian general practice registrars (trainees) have inappropriately high rates of prescription of antibiotics for RTIs. The 'apprenticeship' educational model and the trainee-trainer relationship are drivers of this inappropriate prescribing. We aimed to reduce registrars' non-pneumonia RTI antibiotic prescribing via an educational intervention (a 90-min face-to-face workshop supported by online modules), complemented by delivery of the same intervention, separately, to their trainers. We conducted a pre- and post-intervention comparison of the registrars' intention to prescribe antibiotics for common RTIs using McNemar's test. We similarly tested changes in supervisors' intended prescribing. Prescribing intentions were elicited by responses to six written clinical vignettes (upper respiratory tract infection, otitis media, sore throat and three acute bronchitis vignettes). We found that, for registrars, there were statistically significant reductions in antibiotic prescribing for the sore throat (24.0% absolute reduction), otitis media (17.5% absolute reduction) and two of the three acute bronchitis (12.0% and 18.0% absolute reduction) vignettes. There were significant reductions in supervisors' antibiotic prescribing intentions for the same four vignettes. We conclude that our intervention produced a significant change in registrars' intention to prescribe antibiotics for non-pneumonia RTIs.

  2. A chicken influenza virus recognizes fucosylated α2,3 sialoglycan receptors on the epithelial cells lining upper respiratory tracts of chickens.

    Science.gov (United States)

    Hiono, Takahiro; Okamatsu, Masatoshi; Nishihara, Shoko; Takase-Yoden, Sayaka; Sakoda, Yoshihiro; Kida, Hiroshi

    2014-05-01

    Influenza viruses recognize sialoglycans as receptors. Although viruses isolated form chickens preferentially bind to sialic acid α2,3 galactose (SAα2,3Gal) glycans as do those of ducks, chickens were not experimentally infected with viruses isolated from ducks. A chicken influenza virus, A/chicken/Ibaraki/1/2005 (H5N2) (Ck/IBR) bound to fucose-branched SAα2,3Gal glycans, whereas the binding towards linear SAα2,3Gal glycans was weak. On the epithelial cells of the upper respiratory tracts of chickens, fucose-branched SAα2,3Gal glycans were detected, but not linear SAα2,3Gal glycans. The growth of Ck/IBR in MDCK-FUT cells, which were genetically prepared to express fucose-branched SAα2,3Gal glycans, was significantly higher than that in the parental MDCK cells. The present results indicate that fucose-branched SAα2,3Gal glycans existing on the epithelial cells lining the upper respiratory tracts of chickens are critical for recognition by Ck/IBR.

  3. Expression of SCGB1C1 gene as a potential marker of susceptibility to upper respiratory tract infections in elite athletes - a pilot study.

    Science.gov (United States)

    Orysiak, J; Malczewska-Lenczowska, J; Bik-Multanowski, M

    2016-06-01

    High levels of exercise in athletes result in temporary immunosuppression, which could increase the susceptibility to upper respiratory tract infections. Understanding of immunological mechanisms responsible for this phenomenon could enable optimization of training schemes for elite athletes and avoidance of infection-related episodes of absence during sports championships. The aim of this study was to detect genes that may be responsible for modulation of individual susceptibility to infections. The blood and saliva samples were collected from 10 healthy, medically examined kayakers (4 females and 6 males) aged 24.7 ± 2.3 years. All samples were taken in the morning, after overnight fasting, in a seated position. The ELISA method was used to determine the levels of secretory immunoglobulin A (sIgA) and interleukin 5 (IL-5). Whole genome expression in blood was assessed using microarrays. The study did not reveal any significant correlation between genome expression and sIgA concentration. However, low expression of a gene involved in protection against the common cold - secretoglobin 1C1 (SCGB1C1) - was detected in athletes with high IL-5 concentrations (corrected p = 0.00065; fold change = 3.17). Our results suggest that blood expression of the SCGB1C1 gene might be a marker of susceptibility to upper respiratory tract infections in athletes. PMID:27274102

  4. Exposure to environmental tobacco smoke and respiratory tract infections in pre-school children – a cross-sectional study in Poland

    Directory of Open Access Journals (Sweden)

    Dorota Emilia Bielska

    2015-09-01

    Full Text Available [b][/b]Introduction and objective. Knowledge of the harmful influence of environmental tobacco smoke (ETS has a positive impact on changing social behaviours worldwide. In many homes smoking is totally prohibited; in some others, partial limitations of tobacco consumption have been introduced. Objective. To study the correlation between the adopted rules of tobacco use in homes of 3-year-olds, and the kind and frequency of acute respiratory system infections within a 6-month period of attending pre-schools. Materials and methods. The study was performed among children attending municipal pre-schools in Białystok, Poland. The data was collected by anonymous questionnaires completed by the parents of 302 children aged 3 years chosen randomly from 1,200 children attending 51 pre-schools. The exposure of children to tobacco smoke was measured by determining cotinine to creatinine ratio (CCR in urine. Results. In the 150 families of children who were surveyed, 210 were smokers. Every day, the smokers consisted of fathers (37.3% and mothers (23.6%. The 3-year-old children were divided into 3 groups according to smoking habits in their homes: 28.5% of the children under examination came from homes where tobacco smoking was forbidden (mean CCR – 15.21ng/mg, SD=11.86, 26.2% came from homes where tobacco was smoked in separate rooms (mean CCR – 65.75 ng/ml, SD=81.51, 45.4% lived in homes where no rules connected with smoking had been established (mean CCR – 61.75 ng/ml, SD= 70.29. During the analyzed period of 6 months, 85% of the children had at least 1 respiratory tract infection (60% – upper, 16.9% – lower, 16.5% – upper and lower, 7.1% – otitis media. Conclusions. The majority of the 3-year-old children who had lower respiratory tract infections required antibiotics and hospitalization. Living in a home where no tobacco rules were established may cause an increase of respiratory tract infections.

  5. Randomized trial of a fixed combination (KanJang) of herbal extracts containing Adhatoda vasica, Echinacea purpurea and Eleutherococcus senticosus in patients with upper respiratory tract infections.

    Science.gov (United States)

    Narimanian, M; Badalyan, M; Panosyan, V; Gabrielyan, E; Panossian, A; Wikman, G; Wagner, H

    2005-08-01

    The clinical efficacy of KanJang oral solution, a fixed combination of standardised extracts of Echinacea purpurea, Adhatoda vasica and Eleutherococcus senticosus, was compared with the combined extracts of Echinacea purpurea and Eleutherococcus senticosus alone (Echinacea mixture) in a controlled, double blind, randomized trial, and with Bromhexine (a standard treatment) in a controlled, open, randomized clinical trial on patients with non-complicated acute respiratory tract infections. Many of the parameters evaluated, such as severity of coughing, frequency of coughing, efficacy of mucus discharge in the respiratory tract, nasal congestion and a general feeling of sickness, showed significantly greater improvement in patients treated with KanJang compared with those receiving the standard treatment. However, no significant differences in the improvement of these symptoms (except in a reduced frequency of coughing) were observed between patients treated with the Echinacea mixture and those receiving the standard treatment. The only explanation is that the lack of extract of A. vasica in the Echinacea mixture reduces its efficacy compared with the complete KanJang oral solution even though direct double-blind comparison yielded no significant differences between these two groups of patients. The recovery time of patients being treated with KanJang or Echinacea mixture was 2 days shorter than that of patients receiving the standard treatment. None of the patients completing the study reported adverse reactions to the medication taken. The significance of the results obtained in this study is discussed with respect to the efficacy of KanJang in the treatment of acute respiratory infection and to the concept that multi-drug therapy offers higher efficacy compared with mono-drug treatment of such infections. PMID:16121513

  6. Detection of Aspergillus-specific antibodies by agar gel double immunodiffusion and IgG ELISA in feline upper respiratory tract aspergillosis.

    Science.gov (United States)

    Barrs, V R; Ujvari, B; Dhand, N K; Peters, I R; Talbot, J; Johnson, L R; Billen, F; Martin, P; Beatty, J A; Belov, K

    2015-03-01

    Feline upper respiratory tract aspergillosis (URTA) is an emerging infectious disease. The aims of this study were: (1) to assess the diagnostic value of detection of Aspergillus-specific antibodies using an agar gel double immunodiffusion (AGID) assay and an indirect immunoglobulin G (IgG) ELISA; and (2) to determine if an aspergillin derived from mycelia of Aspergillus fumigatus, Aspergillus niger and Aspergillus flavus can be used to detect serum antibodies against cryptic Aspergillus spp. in Aspergillus section Fumigati. Sera from cats with URTA (group 1: n = 21) and two control groups (group 2: cats with other upper respiratory tract diseases, n = 25; group 3: healthy cats and cats with non-respiratory, non-fungal illness, n = 84) were tested. Isolates from cats with URTA comprised A. fumigatus (n = 5), A. flavus (n = 1) and four cryptic species: Aspergillus felis (n = 12), Aspergillus thermomutatus (Neosartorya pseudofischeri, n = 1), Aspergillus lentulus (n = 1) and Aspergillus udagawae (n = 1). Brachycephalic purebred cats were significantly more likely to develop URTA than other breeds (P = 0.013). The sensitivity (Se) of the AGID was 43% and the specificity (Sp) was 100%. At a cut-off value of 6 ELISA units/mL, the Se of the IgG ELISA was 95.2% and the Sp was 92% and 92.9% for groups 2 and 3 cats, respectively. Aspergillus-specific antibodies against all four cryptic species were detected in one or both assays. Assay Se was not associated with species identity. Detection of Aspergillus-specific antibodies by IgG ELISA has high Se and Sp for diagnosis of feline URTA.

  7. PICU危重患儿呼吸道感染调查分析%Investigation of respiratory tract infections in PICU critically ill children

    Institute of Scientific and Technical Information of China (English)

    陈洋; 蔡小芳; 张隆; 贾德胜; 蓝莹

    2016-01-01

    OBJECTIVETo explore the respiratory tract infections in PICU children patients and to provide evidence for the treatment of respiratory tract infections in children .METHODSA total of 1000 cases of critically ill children treated in PICU from Jan .2011 to Dec .2014 in our hospital .According to children ages ,they were divided into two groups :≤6-month old group (n=538) and >6-month old group (n=462) .The incidence of respiratory tract infections in the two groups were compared ,and the distribution and drug resistance of pathogenic bacteria in children with respiratory tract infection were analyzed using VITEK‐AMS32 automatic bacterial identification , susceptibility analyzers ,matching identification card and Minka drug identification .Respiratory infections in chil‐dren and antibiotic resistance were analyzed . The results were statistically analyzed by software SPSS 17 .0 . RESULTSThere were 38 cases of respiratory tract infections in the 1000 cases of critically ill children with an infec‐tion rate of 3 .8% .The respiratory tract infection rate of patients in >6-month old group was 2 .2% which was significantly lower than that of ≤6-month old group with an infection rate of 5 .2% .The difference has statisti‐cal significance (P<0 .05) .A total of 45 strains of pathogenic bacteria were isolated from the infected children :25 strains of gram‐negative bacteria accounting for 55 .6% ,11 strains of gram‐positive bacteria accounting for 24 .4%and 9 strains of fungi and accounting for 20 .0% .Pathogenic bacteria mainly contained K lebsiellapneumoniae , Pseudomonas aeruginosa , Staphylococcus aureus and Candida albicans respectively accounting for 20 .0% , 13 .3% ,17 .8% and 15 .6% .Gram‐negative bacteria were more sensitive to commonly used antimicrobial drugs such as imipenem ,ciprofloxacin ,amikacin ,kanamycin ,gentamycin and levofloxacin .Staphylococcus aureus were more sensitive to linezolid and vancomycin . C .albicans were sensitive to

  8. Prophylactic antibody treatment and intramuscular immunization reduce infectious human rhinovirus 16 load in the lower respiratory tract of challenged cotton rats

    Directory of Open Access Journals (Sweden)

    Jorge C.G. Blanco

    2014-01-01

    Full Text Available Human rhinoviruses (HRV represent the single most important etiological agents of the common cold and are the most frequent cause of acute respiratory infections in humans. Currently the performance of available animal models for immunization studies using HRV challenge is very limited. The cotton rat (Sigmodon hispidus is a well-recognized model for the study of human respiratory viral infections. In this work we show that, without requiring any genetic modification of either the host or the virus, intranasal infection of cotton rats with HRV16 resulted in measurable isolation of infective virus, lower respiratory tract pathology, mucus production, and expression of interferon-activated genes. Intramuscular immunization with live HRV16 generated robust protective immunity that correlated with high serum levels of neutralizing antibodies. In addition, cotton rats treated prophylactically with hyperimmune anti-HRV16 serum were protected against HRV16 intranasal challenge. Finally, protection by immunization was efficiently transferred from mothers to newborn animals resulting in a substantial reduction of infectious virus loads in the lung following intranasal challenge. Overall, our results demonstrate that the cotton rat provides valuable additional model development options for testing vaccines and prophylactic therapies against rhinovirus infection.

  9. Clinical and epidemiological aspects related to the detection of adenovirus or respiratory syncytial virus in infants hospitalized for acute lower respiratory tract infection

    Directory of Open Access Journals (Sweden)

    Eduardo A. Ferone

    2014-01-01

    Full Text Available OBJECTIVE: To characterize and compare clinical, epidemiological, and laboratory aspects ofinfants with acute lower respiratory infection (ALRI associated with the detection of adenovirus(ADV or respiratory syncytial virus (RSV. METHODS: A preliminary respiratory infection surveillance study collected samples of nasopharyngeal aspirate (NPA for viral research, linked to the completion of a standard protocol, from children younger than two years admitted to a university hospital with ALRI, between March of 2008 and August of 2011. Polymerase chain reaction (PCR was used for eight viruses: ADV, RSV, metapneumovirus, Parainfluenza 1, 2, and 3, and Influenza A and B. Cases with NPA collectedduring the first 24 hours of admission, negative results of blood culture, and exclusive detection of ADV (Gadv group or RSV (Grsv group were selected for comparisons. RESULTS: The preliminary study included collection of 1,121 samples of NPA, 813 collected in thefirst 24 hours of admission, of which 50.3% were positive for at least one virus; RSV was identifiedin 27.3% of cases surveyed, and ADV was identified in 15.8%. Among the aspects analyzed inthe Gadv (n = 58 and Grsv (n = 134 groups, the following are noteworthy: the higher meanage, more frequent prescription of antibiotics, and the highest median of total white blood cellcount and C-reactive protein values in Gadv. CONCLUSIONS: PCR can detect persistent/latent forms of ADV, an aspect to be considered wheninterpreting results. Additional studies with quantitative diagnostic techniques could elucidatethe importance of the high frequency observed.

  10. Predictors of severe disease in a hospitalized population of children with acute viral lower respiratory tract infections.

    Science.gov (United States)

    Pedraza-Bernal, Angela M; Rodriguez-Martinez, Carlos E; Acuña-Cordero, Ranniery

    2016-05-01

    Although predictors of severe viral acute lower respiratory infections (ALRIs) in children have been reported, there have been few research studies performed in low- and middle-income countries (LMIC). The aim of the present study was to determine predictors of disease severity in a population of Colombian children disease conditions and the infecting respiratory viruses as predictor variables of severe disease. We defined severe disease as the necessity of pediatric intensive care unit admission. Of a total of 1,180 patients admitted with a diagnosis of ALRI, 416 (35.3%) were included because they were positive for any kind of respiratory virus. After controlling for potential confounders, it was found that a history of pulmonary hypertension (RR 3.62; CI 95% 2.38-5.52; P disease. The present study shows that respiratory viruses are significant causes of ALRI in infants and young children in Colombia, a typical tropical LMIC, especially during the rainy season. Additionally, the results of the present study show that clinical variables such as a history of pulmonary hypertension and a history of recurrent wheezing are more relevant for predicting ALRI severity than the infecting respiratory viruses.

  11. IL-2 and IL-10 gene polymorphisms are associated with respiratory tract infection and may modulate the effect of vitamin E on lower respiratory tract infections in elderly nursing home residents

    Science.gov (United States)

    Vitamin E supplementation has been suggested as a potential strategy to prevent respiratory infections (RI) in the elderly. Previously, we showed that vitamin E reduced RI in some but not all nursing home residents. The efficacy of vitamin E supplementation may depend on individual factors including...

  12. Evaluation of antibacterial agents applying in outpatient's respiratory tract infection%门诊患者呼吸道感染抗菌药物使用评价

    Institute of Scientific and Technical Information of China (English)

    崔伟堂

    2015-01-01

    Objective To explore the main distributions of pathogenic bacteria in outpatient’s respiratory tract infection and application of common antimicrobial agents. Methods 829 outpatients with respiratory tract infection from January 2010 to January 2014 in outpatient clinic were selected as the research object,the mucosa of respiratory tract as speci-mens were separated,cultured and identified,then tested for sensitivity of antibacterial agents by Kirby-Bauer (KB) method. Results There were 1651 sputum and throat swab specimens from 829 patients with respiratory tract infection treated by antibacterial agents.568 strains of bacteria were separated and cultured,and the positive rate was 30.3%. There were Gram-negative bacteria in 469 strains accounting for 81.1%, 67 strains of Gram-positive bacteria for 11.8%,and 42 strains of fungi accounting for 7.4%.The positive rate of pathogenic bacterium was 34.4%.829 partici-pants had medical history of using antibacterial drugs,cephalosporins were used in 368 cases (44.39%),aminoglycosides were used in 278 csaes(33.53%),macrolides were used in 66 csaes(6.51%).There were 276 patients using two kinds of antimicrobial agents and took the percentage of 33.29% in all patients with acute respiratory tract infection.There were 69 patients using 3 kinds of antimicrobial agents accounting for 8.32%in all patients with acute respiratory tract infec-tion.The average time of using antibacterial agents lasted 2.74 d.The drug resistant rates of Pseudomonas aeruginosa on ciprofloxacin and ciprofloxacin was relatively low,the drug resistant rates of Klebsiella pneumonia on cefotaxime and cefoperazone was relatively low, the drug resistant rates of Escherichia coli on ceftriaxone and cefoperazone was rela-tively low,the drug resistant rates of Staphylococcus aureus on cefazolin and levofloxacin was relatively low. Conclusion The main pathogenic bacteria of outpatient’s respiratory tract infection have different drug-resistance on some common

  13. Low prevalence of Chlamydia pneumoniae and Mycoplasma pneumoniae among patients with symptoms of respiratory tract infections in Dutch general practices.

    NARCIS (Netherlands)

    Meijer, A.; Dagnelie, C.F.; Jong, J.C. de; Vries, A. de; Besteboer, T.M.; Loon, A.M. van; Bartelds, A.I.M.; Ossewaarde, J.M.

    2000-01-01

    Acute respiratory disease is one of the most common reasons to consult a general practitioner. A substantial part of these diseases cannot be explained by an infection with a virus or a common pathogenic bacterium. To study this diagnostic deficit, the prevalence of Chlamydia pneumoniae and Mycoplas

  14. Antibiotic treatment interruption of suspected lower respiratory tract infections based on a single procalcitonin measurement at hospital admission-a randomized trial

    DEFF Research Database (Denmark)

    Kristoffersen, K B; Schmeltz Søgaard, Ole; Wejse, Christian;

    2009-01-01

    on antibiotic use in suspected lower respiratory tract infections (LRTIs) in a Danish hospital setting. In a randomized, controlled intervention study, 223 adult patients admitted to the hospital because of suspicion of LRTI were included with 210 patients available for analysis. Patients were randomized......Recent studies have suggested that procalcitonin (PCT) is a safe marker for the discrimination between bacterial and viral infection, and that PCT-guided treatment may lead to substantial reductions in antibiotic use. The present objective was to evaluate the effect of a single PCT measurement...... to either PCT-guided treatment or standard treatment. Antibiotic treatment duration in the PCT group was based on the serum PCT value at admission. The cut-off point for recommending antibiotic treatment was PCT >/=0.25 mug/L. Physicians could overrule treatment guidelines. The mean duration of hospital...

  15. 神经内科下呼吸道感染危险因素研究%Risk factors for lower respiratory tract infections in a neurology department

    Institute of Scientific and Technical Information of China (English)

    张希玉

    2013-01-01

    目的 探讨神经内科下呼吸道感染患者的相关危险因素,为预防医院感染提供依据.方法 对2010~2012年医院神经内科住院患者1 415例临床资料进行回顾性分析.结果 共调查病例1 415例,其中发生医院感染167例,感染率11.80%,其中下呼吸道感染97例,感染率6.86%,占医院感染的58.08%.脑血管病患者感染率相对较高,均超过7%,缺血性卒中和出血性卒中患者下呼吸道感染69例,占总感染例数的71.14%.97例下呼吸道感染者中,分离病原菌102株,以革兰阴性菌为主,共71株,占69.61%.年龄>60岁、住院时间>20 d、有糖尿病史、合并慢性基础疾病、接受侵入性操作、意识障碍的患者感染率相对较高,是院内感染的危险因素.结论 神经内科下呼吸道感染多见于脑血管病患者,临床应健全医院感染管理制度,针对感染危险因素积极采取预防措施,减少医院感染的发生.%Objective To examine risk factors for lower respiratory tract infections in a neurology department in order to provide evidence for prevention of nosocomial infections.Methods Clinical data from 1,415 patients seen by Neurology from 2010 to 2012 were retrospectively analyzed.Results Data from a total of 1,415 patients was studied.Of these patients,167 had a nosocomial infection for an infection rate of 11.80 %.Ninety-seven patients had a lower respiratory tract infection,accounting for 58.08% of all infections,and the rate of infection was 6.86%.Patients with cerebrovascular disease had a relatively high rate of infection above 7 %.Patients suffering an ischemic stroke or hemorrhagic stroke and a lower respiratory tract infection accounted for 71.14 % of all patients with infections.Pathogens responsible for infection were mainly Gram-negative bacteria (69.61%).Patients over the age of 60,patients who were hospitalized longer than 20 days,patients with a history of diabetes,patients with a chronic

  16. Analysis on Lymphocyte Subsets in Children with Acute Respiratory Syncytial Virus Lower Respiratory Tract Infection%急性下呼吸道合胞病毒感染190例的淋巴细胞亚群分析

    Institute of Scientific and Technical Information of China (English)

    戴银芳; 郝创利; 陶慧; 杨晓蕴; 周菁; 孙惠泉; 陆燕红

    2013-01-01

    目的:分析急性下呼吸道合胞病毒感染患儿的外周血淋巴细胞亚群的变化,为临床免疫调节治疗提供依据。方法对小于6个月急性下呼吸道感染住院患儿行痰病原学检测,明确为呼吸道合胞病毒为感染组。选择门诊体检儿童为对照组。同时两组病例抽外周血采用流式细胞仪检测淋巴细胞亚群值。结果感染组CD3+、CD3+CD8+低于对照组,差异有统计学意义(P<0.05);CD3-CD19+、CD19+CD23+、CD4+/CD8+、CD3+CD25+高于对照组,差异有统计学意义(P<0.05)。感染组与对照组CD3+CD4+、CD16+CD56+差异无统计学意义(P>0.05)。结论急性下呼吸道合胞病毒感染患儿的细胞免疫功能紊乱:T淋巴细胞受到全面抑制,B淋巴细胞激活参与病毒的清除,NK细胞比例变化不显著。%Objective To analyze the changes of lymphocyte subsets in children with acute respiratory syncytial virus lower respiratory tract infection. Methods Multi-pathogen detection using direct fluorescence antibody test(DFA), clear etiology diagnosis. Lymphocyte subsets in peripheral blood in part of patients(0.05). Conclusion Cellular immunity function is in disorder in children with acute respiratory syncytial virus lower respiratory tract infection. T lymphocytes are extensively depressed early in the course;B lymphocytes are involved in the virus clearance;NK cells have no signiifcant change with those critical cases.

  17. Evaluation of intranasal vaccine administration and high-dose interferon- α2b therapy for treatment of chronic upper respiratory tract infections in shelter cats.

    Science.gov (United States)

    Fenimore, Audra; Carter, Kasey; Fankhauser, Jeffrey; Hawley, Jennifer R; Lappin, Michael R

    2016-08-01

    Clinical signs of upper respiratory tract infection can be hard to manage in cats, particularly those in shelters. In this study, clinical data were collected from chronically ill (3-4 weeks' duration) cats with suspected feline herpesvirus-1 (FHV-1) or feline calicivirus (FCV) infections after administration of one of two novel therapies. Group A cats were administered a commercially available formulation of human interferon-α2b at 10,000 U/kg subcutaneously for 14 days, and group B cats were administered one dose of a FHV-1 and FCV intranasal vaccine. Molecular assays for FHV-1 and FCV were performed on pharyngeal samples, and a number of cytokines were measured in the blood of some cats. A clinical score was determined daily for 14 days, with cats that developed an acceptable response by day 14 returning to the shelter for adoption. Those failing the first treatment protocol were entered into the alternate treatment group. During the first treatment period, 8/13 cats in group A (61.5%) and all 12 cats in group B (100%) had apparent responses. The seven cats positive for nucleic acids of FHV-1 or FCV responded favorably, independent of the treatment group. There were no differences in cytokine levels between cats that responded to therapy or failed therapy. Either protocol assessed here may be beneficial in alleviating chronic clinical signs of suspected feline viral upper respiratory tract disease in some cats that have failed other, more conventional, therapies. The results of this study warrant additional research involving these protocols. PMID:26269455

  18. Spectrum and potency of ceftaroline against leading pathogens causing community-acquired respiratory tract and skin and soft tissue infections in Latin America, 2010

    Directory of Open Access Journals (Sweden)

    Robert K. Flamm

    2013-10-01

    Full Text Available Ceftaroline, the active metabolite of the prodrug ceftaroline fosamil, is a cephalosporin with in vitro bactericidal activity against Gram-positive organisms, including methicillinsusceptible and -resistant Staphylococcus aureus, β-haemolytic and viridans group streptococci, and Streptococcus pneumoniae, as well as common Gram-negative organisms. In this study a total of 986 isolates collected in 2010 from patients in 15 medical centers in five Latin American countries from the Assessing Worldwide Antimicrobial Resistance Evaluation Program were identified as community-acquired respiratory tract or skin and soft tissue infection pathogens. Ceftaroline was the most potent agent tested against S. pneumoniae with a MIC90 value (0.12 µg/mL that was eight-fold lower than ceftriaxone, levofloxacin, and linezolid. Its spectrum of coverage (100.0% susceptible was similar to tigecycline, linezolid, levofloxacin and vancomycin. Against Haemophilus influenzae and Moraxella catarrhalis, ceftaroline was the most active agent tested. The activity of ceftaroline against S. aureus (including MRSA was similar to that of vancomycin and tetracycline (MIC90,1 µg/mL and linezolid (MIC90,2 Jg/mL. The 1-haemolytic streptococci exhibited 100.0% susceptibility to ceftaroline. Ceftaroline activity against Escherichia coli, Klebsiella spp., and Enterobacter spp. was similar to that of ceftriaxone and ceftazidime. These parenteral cephalosporin agents have potent activity against non-extended-spectrum These parenteral cephalosporin agents have potent activity against non-extended-spectrum-lactamase-phenotype strains, but are not active against extended-spectrum β-lactamase-phenotype strains. These results confirm the in vitro activity of ceftaroline against pathogens common in communityacquired respiratory tract and skin and soft tissue infection in Latin America, and suggest that ceftaroline fosamil could be an important therapeutic option for these infections.

  19. Is 'shared decision-making' feasible in consultations for upper respiratory tract infections? Assessing the influence of antibiotic expectations using discourse analysis.

    Science.gov (United States)

    Elwyn, Glyn; Gwyn, Richard; Edwards, Adrian; Grol, Richard

    1999-05-01

    OBJECTIVES: To examine the discourse of consultations in which conflict occurs between parents and clinicians about the necessity of antibiotics to treat an upper respiratory tract infection. To appraise the feasibility of shared decision-making in such consultations. DESIGN: A qualitative study using discourse analysis techniques. SETTING: A general practice with 12 500 patients in an urban area of Cardiff, Wales. PARTICIPANTS: Two consultations were purposively selected from a number of audiotaped sessions. The consultations took place during normal clinics in which appointments are booked at 7-minute intervals. The practitioner is known to be interested in involving patients in treatment decisions. METHOD: Discourse analysis was employed to examine the consultation transcripts. This analysis was then compared with the theoretical competencies proposed for 'shared decision-making'. RESULTS: The consultations exhibit less rational strategies than those suggested by the shared decision-making model. Strong parental views are expressed (overtly and covertly) which seem derived from prior experiences of similar illnesses and prescribing behaviours. The clinician responds by emphasizing the 'normality' of upper respiratory tract infections and their recurrence, accompanied by expressions that antibiotic treatment is ineffective in 'viral' illness - the suggested diagnosis. The competencies of 'shared decision-making' are not exhibited. CONCLUSIONS: The current understanding of shared decision-making needs to be developed for those situations where there are dis-agreements due to the strongly held views of the participants. Clinicians have limited strategies in situations where patient treatment preferences are opposed to professional views. Dispelling 'misconceptions' by sharing information and negotiating agreed management plans are recommended. But it seems that communication skills, information content and consultation length have to receive attention if such

  20. Epidemiological pattern of community-acquired respiratory tract infections of the conscripts in the North Fleet during a vaccine-challenged period

    Directory of Open Access Journals (Sweden)

    Yu. V. Lobzin

    2011-01-01

    Full Text Available The formation of the new military units in the North fleet is accompanied by vaccination using Exhausted diphtheria tetanus vaccine, modified. The accination coincides with periods of a rising number of army conscripts being taken ill with community-acquired infection of respiratory tracts: acute tonsillitis, acute bronchitis and community-acquired pneumonia. We need to study is to ascertain whether there is the correlation between the periods of the increase in the number of ervicemen fallen ill with community-acquired infection of respiratory tracts and the diphtheria and tetanus vaccination. The study was carried out on the North fleet conscripts who were drawn blood samples from the ulnar vein before and after the vaccination using Exhausted diphtheria tetanus vaccine, modified. The blood was examined for the presence of antibodies to diphtheria and tetanus using direct hemagglutination test. The health status of the vaccinated conscripts was under observation for 4 months, during which acute illnesses (acute tonsillitis, acute bronchitis and community-acquired pneumonia were registered. Serologic testing demonstrated a high rate of immunological protection against diphtheria and tetanus before vaccination. After the diphtheria and tetanus vaccination, the number of conscripts, who were taken ill in the first month, was significantly higher compared to the following months. The conscripts, who fell ill, had high antibody titers against diphtheria and tetanus in the vaccine-challenged period. Vaccination of the servicemen using Exhausted diphtheria tetanus vaccine, modified, is serologically unfounded; it leads to complications such as acute tonsillitis, acute bronchitis and community-acquired pneumonia during the vaccinechallenged period especially during the first month and less considerably during the following months.

  1. Influenza and SARS-coronavirus activating proteases TMPRSS2 and HAT are expressed at multiple sites in human respiratory and gastrointestinal tracts.

    Directory of Open Access Journals (Sweden)

    Stephanie Bertram

    Full Text Available The type II transmembrane serine proteases TMPRSS2 and HAT activate influenza viruses and the SARS-coronavirus (TMPRSS2 in cell culture and may play an important role in viral spread and pathogenesis in the infected host. However, it is at present largely unclear to what extent these proteases are expressed in viral target cells in human tissues. Here, we show that both HAT and TMPRSS2 are coexpressed with 2,6-linked sialic acids, the major receptor determinant of human influenza viruses, throughout the human respiratory tract. Similarly, coexpression of ACE2, the SARS-coronavirus receptor, and TMPRSS2 was frequently found in the upper and lower aerodigestive tract, with the exception of the vocal folds, epiglottis and trachea. Finally, activation of influenza virus was conserved between human, avian and porcine TMPRSS2, suggesting that this protease might activate influenza virus in reservoir-, intermediate- and human hosts. In sum, our results show that TMPRSS2 and HAT are expressed by important influenza and SARS-coronavirus target cells and could thus support viral spread in the human host.

  2. DETERMINATION OF THE EFFECTS OF MATERIAL FROM ALTERNATE ENERGY SOURCES ON THE UPPER RESPIRATORY TRACT CLEARANCE MECHANISM. PART I: IN VITRO EXPOSURE TO PARTICULATE POLLUTANTS. PART II: IN VIVO EXPOSURE TO OZONE

    Science.gov (United States)

    Studies were conducted to measure the toxic effects of a variety of substances from the environment on the clearance mechanism of the upper respiratory tract using an in vitro hamster model system. Studies using hamsters for in vivo exposures to ozone were also conducted to deter...

  3. Acute effects of low-level sulphur dioxide and nitrogen dioxide exposures on the respiratory tract of susceptible subjects in cold environments

    Energy Technology Data Exchange (ETDEWEB)

    Salonen, R.O.; Randell, J.T.; Haelinen, A.I.; Pennanen, A.S. [National Public Health Inst., Kuopio (Finland). Div. of Environmental Health; Kosma, V.M. [Kuopio Univ. (Finland). Dept. of Pathology; Pekkarinen, H. [Kuopio Univ. (Finland). Dept. of Physiology; Ruuskanen, J. [Kuopio Univ. (Finland). Dept. of Environmental Sciences; Tukiainen, H. [Kuopio Univ. (Finland). Dept. of Pulmonary Diseases

    1995-12-31

    Several recent epidemiological studies from Finland have suggested that sulphur dioxide (SO{sub 2}) and nitrogen dioxide (NO{sub 2}) cause adverse health effects in susceptible population groups, such as children and asthmatic patients, at much smaller concentrations than the present guideline values of the World Health Organization. One possible explanation of these findings is that the relatively long winter-time increases the sensitivity of the respiratory tract to irritant pollutants. This hypothesis is supported by experimental human and animal studies, which have shown obstruction and inflammatory changes in the conducting airways after ventilation of cold and dry air. Asthmatic patients are much more sensitive than healthy subjects to the irritating effects of cold and dry air and of air pollutants. The airways of many non-asthmatic a topic subjects are also sensitive to cold air, but these subjects are poorly defined as a potential susceptible population group to air pollutants. The aims of this project are: (1) to construct experimental human and animal facilities and protocols for short-term studies on SO{sub 2} and NO{sub 2} exposures at subfreezing temperatures, (2) to apply advanced lung function methodologies and symptom assessment for characterisation of short-term respiratory responses of asthmatic and a topic subjects to these exposures, (3) to apply well-established pulmonary physiological, cytological and morphological methods for characterisation of short-term responses to and mechanisms of these exposures in the guinea-pig lower airways. (author)

  4. Advances in pediatrics in 2014: current practices and challenges in allergy, gastroenterology, infectious diseases, neonatology, nutrition, oncology and respiratory tract illnesses.

    Science.gov (United States)

    Caffarelli, Carlo; Santamaria, Francesca; Cesari, Silvia; Sciorio, Elisa; Povesi-Dascola, Carlotta; Bernasconi, Sergio

    2015-01-01

    Major advances in the conduct of pediatric practice have been reported in the Italian Journal of Pediatrics in 2014. This review highlights developments in allergy, gastroenterology, infectious diseases, neonatology, nutrition, oncology and respiratory tract illnesses. Investigations endorse a need to better educate guardians and improve nutritional management in food allergy. Management of hyperbilirubinemia in neonates and of bronchiolitis have been improved by position statements of scientific societies. Novel treatments for infant colic and inflammatory bowel diseases have emerged. Studies suggest the diagnostic utility of ultrasonography in diagnosing community-acquired pneumonia. Progress in infectious diseases should include the universal varicella vaccination of children. Recommendations on asphyxia and respiratory distress syndrome have been highlighted in neonatology. Studies have evidenced that malnutrition remains a common underestimated problem in developing countries, while exposure to cancer risk factors in children is not negligible in Western countries. Advances in our understanding of less common diseases such as cystic fibrosis, plastic bronchitis, idiopathic pulmonary hemosiderosis facilitate diagnosis and management. Researches have led to new therapeutic approaches in patent ductus arteriosus and pediatric malignancies.

  5. Gastroesophageal reflux and respiratory tract infection in tube-fed elderly patients. A comparison between scintigraphy and 24-h pH monitoring

    Energy Technology Data Exchange (ETDEWEB)

    Ogawa, Shigehiko; Koichi, Katsuyuki; Tofuku, Yohei [Ishikawa-Ken Saiseikai Kanazawa Hospital (Japan)

    1994-11-01

    Aspiration pneumonia in patients who received enteral feeding via a nasogastric tube may result from retrograde colonization from the stomach, and this may be more likely when the gastroesophageal reflux is severe and the gastric pH is relative high. We investigated 11 elderly patients fed via nasogastric tube with suspected recurrent aspiration pneumonia by means of esophageal scintigraphy, 24-h pH monitoring, gastric pH and concentrations of gram-negative bacilli in gastric aspirates. The grade of respiratory tract infection (RTI) was evaluated by the frequency of episodes of fever with respiratory symptoms. The correlation between the grade of RTI and reflux index by scintigraphy was statistically significant (p<0.05), but the correlation between the grade of RTI and reflux rate by 24-h pH monitoring was not statistically significant. Although the correlation between gastric pH and log (base 10) concentration of gram-negative bacilli/ml of gastric aspirates was statistically significant (p<0.001), the correlation between the grade of RTI and gastric pH was not statistically significant. Scintigraphy was superior for evaluation of gastroesophageal reflux resulting in aspiration pneumonia in the tube-fed elderly patients. (author).

  6. The Effectiveness and Safety of a Homeopathic Medicinal Product in Pediatric Upper Respiratory Tract Infections With Fever: A Randomized Controlled Trial.

    Science.gov (United States)

    van Haselen, Robert; Thinesse-Mallwitz, Manuela; Maidannyk, Vitaliy; Buskin, Stephen L; Weber, Stephan; Keller, Thomas; Burkart, Julia; Klement, Petra

    2016-01-01

    We investigated the clinical effectiveness of a homeopathic add-on therapy in a pediatric subpopulation with upper respiratory tract infections (URTI) in a randomized, controlled, multinational clinical trial. Patients received either on-demand symptomatic standard treatment (ST-group) or the same ST plus a homeopathic medication (Influcid; IFC-group) for 7 days. Outcome assessment was based on symptom and fever resolution and the Wisconsin Upper Respiratory Symptom Survey-21 (WURSS-21). A total of 261 pediatric (<12 years) patients (130 IFC-group; 131 ST-group) were recruited in Germany and the Ukraine. The IFC-group used less symptomatic medication, symptoms resolved significantly earlier (P = .0001), had higher proportions of fever-free children from day 3 onwards, and the WURSS-assessed global disease severity was significantly less (P < .0001) during the entire URTI episode. One adverse event (vomiting) was possibly related to IFC. IFC as add-on treatment in pediatric URTI reduced global disease severity, shortened symptom resolution, and was safe in use.

  7. Clinical risk factors for life-threatening lower respiratory tract infections in children: a retrospective study in an urban city in Malaysia.

    Directory of Open Access Journals (Sweden)

    Anna Marie Nathan

    Full Text Available AIM: Lower respiratory tract infections (LRTIs are an important cause of morbidity and mortality, especially in low income countries. The aim of this study was to determine risk factors of life-threatening LRTIs in hospitalised children in Malaysia. METHODS: This retrospective study included children aged less than 18 years admitted for LRTIs over 13 months in a tertiary referral centre in Kuala Lumpur, Malaysia. Neonates, children with asthma and those with either no or a normal chest radiograph were excluded. Life-threatening infection was defined as that needing non-invasive ventilation or admission to the paediatric intensive care unit. Routine blood investigations and nasopharyngeal secretion results (bacterial and viral were obtained. Chest radiographs were reviewed by a designated radiologist. Environmental data (rainfall, particulate matter ≤ 10 µm [PM10] and air pollution index [API] was obtained from the respective government departments. RESULTS: Three hundred and ninety-one episodes of LRTIs were included. Viruses were implicated in 48.5% of LRTIs, with respiratory syncytial virus (RSV being detected in 44% of viral LRTIs. Forty-six (11.8% children had life-threatening disease and the overall mortality rate was 1.3% (5 children. RSV was detected in 26% of children with life-threatening LRTIs. In multivariate logistic regression, chronic lung disease, presenting history of apnoea and signs of hypoxia, was associated with life threatening LRTIs. Increased LRTI admissions were associated with low rainfall but not PM10 nor API. Of those on follow-up, 39% had persistent respiratory symptoms. CONCLUSION: One in nine children admitted with LRTI had a life-threatening LRTI. The aetiology was viral in almost half of admitted children. RSV was detected in a quarter of children with life-threatening LRTIs. Children who present with LRTIs and either have chronic lung disease, presenting history of apnoea or signs of hypoxia, should be

  8. Patient-reported outcomes to assess the efficacy of extended-release guaifenesin for the treatment of acute respiratory tract infection symptoms

    Directory of Open Access Journals (Sweden)

    Albrecht Helmut

    2012-12-01

    Full Text Available Abstract Background Guaifenesin is a component of medicines used to improve symptoms associated with upper respiratory tract infections. Patient-reported outcome instruments are valuable for evaluating symptom improvements; however, a validated tool to assess efficacy of mucoactive drugs does not exist. We compared the efficacy of extended-release guaifenesin with placebo for treatment of symptoms of upper respiratory tract infection using subjective efficacy assessments in a pilot study and confirmed precision of assessments in a validation study. Methods The pilot study was a randomized, double-blind study where patients were dosed with either 1200 mg extended-release guaifenesin (n = 188 or placebo (n = 190, every 12 hours for 7 days. Efficacy was assessed using subjective measures including the Daily Cough and Phlegm Diary, the Spontaneous Symptom Severity Assessment and the Wisconsin Upper Respiratory Symptom Survey. End-of-study assessments were completed by patients and investigator. The validation study consisted of two phases. In Phase I, subjects completed interviews to gather evidence to support the content validity of the Daily Cough and Phlegm Diary, the Spontaneous Symptom Severity Assessment and Patient’s End-of-Treatment Assessment. Phase II examined the psychometric properties of assessments evaluated in Phase I of the validation study using data from the pilot study. Results Subjective measures of efficacy at Day 4 showed the most prominent difference between treatment groups, in favor of guaifenesin. The 8-symptom related questions (SUM8 in the Daily Cough and Phlegm Diary, analyzed as a composite score appeared to be the strongest candidate endpoint for further evaluation. Results from the interviews in Phase I supported the content of the assessments which were validated during Phase II. Treatments were well tolerated. Conclusions Results from the clinical pilot and validation studies showed that the SUM8 diary

  9. 手术患者下呼吸道感染临床分析%Clinical analysis of lower respiratory tract infections after anesthesia

    Institute of Scientific and Technical Information of China (English)

    王浩; 李淑艳; 王慧

    2015-01-01

    目的:分析手术患者麻醉后下呼吸道感染的病原菌及其耐药性,对临床预防和治疗麻醉后下呼吸道感染提供参考依据。方法选取2010年3月-2013年11月麻醉后发生下呼吸道感染的患者共122例,取其深部痰液标本,进行分离培养,并利用K‐B琼脂法对病原菌的耐药性进行药敏试验,数据采用SPSS 17.0软件进行统计处理。结果122例发生麻醉后下呼吸道感染的患者中以采用全麻导致感染为主,共48例占39.34%;共分离革兰阳性菌56株占43.75%,革兰阴性菌72株占56.25%;感染主要革兰阳性菌对利奈唑胺、多西环素和加替沙星的耐药率较低,均<10.00%;麻醉后下呼吸道感染的主要革兰阴性菌对亚胺培南、多黏菌素和替考拉宁的耐药率较低,均<10.00%。结论患者麻醉后下呼吸道感染的病原菌多具有耐药性,临床发生麻醉后下呼吸道感染时,应先分离培养病原菌并进行耐药试验,选择耐药率低的抗菌药物进行治疗。%OBJECTIVE To analyze the pathogenic bacteria and their drug resistance in patients with lower respira‐tory tract infections after anesthesia ,and provide some reference for prevention and treatment of lower respiratory tract infections after anesthesia .METHODS Totally 122 cases of patients with lower respiratory tract infections af‐ter anesthesia were chosen ,pathogenic bacteria were isolated and cultured from sputum specimens collected from the deep section ,drug resistance test was performed by K‐B test .Data were statistically analyzed by the software SPSS17 .0 .RESULTS General anesthesia in 48 patients accounted for 39 .34% ,being the largest proportion of 122 patients with lower respiratory tract infections after anesthesia .Totally 56 strains of gram‐positive bacteria were detected ,accounting for 43 .75% and 72 strains of gram‐negative bacteria were detected ,accounting for 56 .25% . Gram

  10. Clinical and Experimental Study on Shuanghua Aerosol (双花喷雾剂) in Treating Infantile Upper Respiratory Tract Infection

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    [1]WU RP, HU YM, JIANG ZF. ZHU Fu-tang Practical Pediatrics. Beijing: People's Health Publishing House, 1997∶1132-1135.[2]Ministry of Health, P.R.C. Standard for Diagnosis and Therapeutic Effect Evaluation of TCM Diseases and Syndromes. Nanjing: Publishing House of Nanjing University, 1994∶76.[3]XU SY. Methodology of Pharmacological Experiment. Beijing: People's Health Publishing House, 1994∶1410-1411.[4]ZHANG ZJ. Infantile Viral Respiratory Infection and Viral Pneumonia. Beijing: Chinese Publishing House of Medical Sciences and Techniques, 1998∶8.

  11. A Distinct Lung-Interstitium-Resident Memory CD8+ T Cell Subset Confers Enhanced Protection to Lower Respiratory Tract Infection

    Directory of Open Access Journals (Sweden)

    Pavlo Gilchuk

    2016-08-01

    Full Text Available The nature and anatomic location of the protective memory CD8+ T cell subset induced by intranasal vaccination remain poorly understood. We developed a vaccination model to assess the anatomic location of protective memory CD8+ T cells and their role in lower airway infections. Memory CD8+ T cells elicited by local intranasal, but not systemic, vaccination with an engineered non-replicative CD8+ T cell-targeted antigen confer enhanced protection to a lethal respiratory viral challenge. This protection depends on a distinct CXCR3LO resident memory CD8+ T (Trm cell population that preferentially localizes to the pulmonary interstitium. Because they are positioned close to the mucosa, where infection occurs, interstitial Trm cells act before inflammation can recruit circulating memory CD8+ T cells into the lung tissue. This results in a local protective immune response as early as 1 day post-infection. Hence, vaccine strategies that induce lung interstitial Trm cells may confer better protection against respiratory pathogens.

  12. A multi-compartment model for slow bronchial clearance of insoluble particles - Extension of the ICRP human respiratory tract models

    International Nuclear Information System (INIS)

    To incorporate the various mechanisms that are presently assumed to be responsible for the experimentally observed slow bronchial clearance into the HRTM, a multi-compartment model was developed to simulate the clearance of insoluble particles in the tracheobronchial tree of the human lung. The new model considers specific mass transfer paths that may play an important role for slow bronchial clearance. These include the accumulation of particulate mass in the peri-ciliary sol layer, phagocytosis of stored particles by airway macrophages and uptake of deposited mass by epithelial cells. Besides the gel layer representing fast mucociliary clearance, all cellular and non-cellular units involved in the slow clearance process are described by respective compartments that are connected by specific transfer rates. The gastrointestinal tract and lymph nodes are included into the model as final accumulation compartments, to which mass is transferred via the airway route and the transepithelial path. Predicted retention curves correspond well with previously published data. (authors)

  13. The relationship between putative periodontopathic bacteria and lower respiratory tract infection%牙周可疑致病菌与下呼吸道感染的关系

    Institute of Scientific and Technical Information of China (English)

    谭丽思; 潘亚萍

    2011-01-01

    The biofilm of dental plaque is the initiation factor of periodontitis.It is known to all that there are relationships between periodontitis and many multi-organ or systemic diseases, such as cardiovascular and cerebrovascular diseases, diabetes mellitus, alimentary tract and respiratory tract disease.Recently, people pay close attention to the relationship between putative periodontopathic bacteria and the respiratory tract disease, and this review will summarize the path and the role of the putative periodontopathic bacteria infecting the lower respiratory tract.%牙菌斑生物膜是牙周炎的始动因子.研究发现,牙周炎与全身多器官或系统的感染性疾病有关,如心脑血管疾病、糖尿病、消化道和呼吸道疾病.近年来,牙周炎与呼吸道疾病之间的关系备受关注,本文将近期对牙周可疑致病菌感染下呼吸道的途径及其作用研究做简要综述.

  14. A pilot study of the use of near-patient C-Reactive Protein testing in the treatment of adult respiratory tract infections in one Irish general practice.

    LENUS (Irish Health Repository)

    Kavanagh, Kim E

    2011-08-31

    Abstract Background New approaches are being sought to safely reduce community antibiotic prescribing. A recent study demonstrated that CRP testing resulted in decreased antibiotic prescribing for lower respiratory tract infection in primary care. There is little other published primary care data available evaluating CRP in the treatment of lower respiratory tract infections in routine clinical practice. This pilot study aims to describe the performance of near-patient CRP testing, in a mixed payments health system. Specific areas to be reviewed included the integrity of the study protocol, testing of data collection forma and acceptability of the intervention. Patients Patients over the age of 18 years, with acute cough and\\/or sore throat with a duration of one month or less, in routine clinical practice. Method Design: A pilot with a cross-sectional design. The first 60 recruited patients were treated with routine clinical management, and GP\\'s had no access to a CRP test. For the subsequent 60 patients, access to CRP testing was available. Participants: 3 GP\\'s in one Irish primary care practice recruited 120 patients, fulfilling the above criteria over five months, from January 1 to May 31, 2010. Main outcome measures: The primary outcome was antibiotic prescription at the index consultation. Secondary outcomes were the numbers of delayed prescriptions issued, patient satisfaction immediately after consultation and re-consultations and antibiotic prescriptions during 28 days follow-up. Results The protocol and data collection forms worked well and the intervention of CRP testing appeared acceptable. Thirty-five (58%) patients in the no-test group received antibiotic prescriptions compared to 27 (45%) in the test group. Both groups demonstrated similarly high level of patient satisfaction (85%). Fourteen (23%) patients in the CRP test group re-attended within 28 days compared to 9 (15%) in the no-CRP test group. Conclusion This pilot study confirms the

  15. Developing the content of two behavioural interventions: Using theory-based interventions to promote GP management of upper respiratory tract infection without prescribing antibiotics #1

    Directory of Open Access Journals (Sweden)

    Kaner Eileen FS

    2008-01-01

    Full Text Available Abstract Background Evidence shows that antibiotics have limited effectiveness in the management of upper respiratory tract infection (URTI yet GPs continue to prescribe antibiotics. Implementation research does not currently provide a strong evidence base to guide the choice of interventions to promote the uptake of such evidence-based practice by health professionals. While systematic reviews demonstrate that interventions to change clinical practice can be effective, heterogeneity between studies hinders generalisation to routine practice. Psychological models of behaviour change that have been used successfully to predict variation in behaviour in the general population can also predict the clinical behaviour of healthcare professionals. The purpose of this study was to design two theoretically-based interventions to promote the management of upper respiratory tract infection (URTI without prescribing antibiotics. Method Interventions were developed using a systematic, empirically informed approach in which we: selected theoretical frameworks; identified modifiable behavioural antecedents that predicted GPs intended and actual management of URTI; mapped these target antecedents on to evidence-based behaviour change techniques; and operationalised intervention components in a format suitable for delivery by postal questionnaire. Results We identified two psychological constructs that predicted GP management of URTI: "Self-efficacy," representing belief in one's capabilities, and "Anticipated consequences," representing beliefs about the consequences of one's actions. Behavioural techniques known to be effective in changing these beliefs were used in the design of two paper-based, interactive interventions. Intervention 1 targeted self-efficacy and required GPs to consider progressively more difficult situations in a "graded task" and to develop an "action plan" of what to do when next presented with one of these situations. Intervention 2

  16. 儿童反复呼吸道感染影响因素研究%Study on influence factors of recurrent respiratory tract infections in children

    Institute of Scientific and Technical Information of China (English)

    刘少强

    2015-01-01

    Objective To explore the influence factors of recurrent respiratory tract infections (RRTIs) in children,and to provide the basis for scientific prevention and treatment.Methods 108 children with RRTIs were selected as case group,and 108 children without RRTIs were selected as control group according to 1∶1 matching principle.The case-control study was carried out to study influence factors.Results Multivariate logistic regression analysis indicated that entry kindergarten,passive smoking and use of antibiotics ≥ 3 times in the recent 1 year were risk factors for children RRTIs (OR=2.80,1.82,1.75);ingestion of animal liver or blood more than 5 times/week was protection factor (OR=0.40).Conclusion RRTIs in children was affected by many factors.We can reduce the incidence of children RRTIs by reducing passive smoking and the abuse of antibiotics,and increasing the ingestion of animal liver or blood.%目的 探讨儿童反复呼吸道感染(recurrent respiratory tract infections,RRTIs)的影响因素,为科学防治提供依据.方法 以108名RRTIs儿童为病例组,按照1∶1匹配的原则选取108名非RRTIs儿童为对照组,通过病例-对照研究探讨危险因素.结果 多因素logistic回归分析发现,儿童入托入园(OR=2.80)、被动吸烟(OR=1.82)和近1年来使用抗生素≥3次(OR=1.75)是儿童RRTIs的危险因素;每周摄入动物肝脏、血≥5次(OR=0.40)是其保护性因素.结论 儿童RRTIs受多种因素的影响,通过减少被动吸烟、减少抗生素滥用和增加动物肝脏、血的摄入可减少该病的发生.

  17. Cigarette smoke induced genotoxicity and respiratory tract pathology: evidence to support reduced exposure time and animal numbers in tobacco product testing.

    Science.gov (United States)

    Dalrymple, Annette; Ordoñez, Patricia; Thorne, David; Walker, David; Camacho, Oscar M; Büttner, Ansgar; Dillon, Debbie; Meredith, Clive

    2016-06-01

    Many laboratories are working to develop in vitro models that will replace in vivo tests, but occasionally there remains a regulatory expectation of some in vivo testing. Historically, cigarettes have been tested in vivo for 90 days. Recently, methods to reduce and refine animal use have been explored. This study investigated the potential of reducing animal cigarette smoke (CS) exposure to 3 or 6 weeks, and the feasibility of separate lung lobes for histopathology or the Comet assay. Rats were exposed to sham air or CS (1 or 2 h) for 3 or 6 weeks. Respiratory tissues were processed for histopathological evaluation, and Alveolar type II cells (AEC II) isolated for the Comet assay. Blood was collected for Pig-a and micronucleus quantification. Histopathological analyses demonstrated exposure effects, which were generally dependent on CS dose (1 or 2 h, 5 days/week). Comet analysis identified that DNA damage increased in AEC II following 3 or 6 weeks CS exposure, and the level at 6 weeks was higher than 3 weeks. Pig-a mutation or micronucleus levels were not increased. In conclusion, this study showed that 3 weeks of CS exposure was sufficient to observe respiratory tract pathology and DNA damage in isolated AEC II. Differences between the 3 and 6 week data imply that DNA damage in the lung is cumulative. Reducing exposure time, plus analyzing separate lung lobes for DNA damage or histopathology, supports a strategy to reduce and refine animal use in tobacco product testing and is aligned to the 3Rs (replacement, reduction and refinement).

  18. Detection of pathogenic genes in Neisseria spp causing respiratory tract infections%呼吸道感染患者奈瑟菌属致病性相关基因的检测

    Institute of Scientific and Technical Information of China (English)

    罗振华; 王和; 易旭; 佘晓玲; 王涛; 王艳; 叶长芸

    2012-01-01

    目的 检测呼吸道感染患者分离奈瑟菌属的致病性相关基因,探讨非淋病奈瑟菌、非脑膜炎奈瑟菌的致病性.方法 采用PCR扩增和序列分析技术,对慢性呼吸道感染患者下呼吸道分离奈瑟菌属致病性相关基因orf1与nspA进行检测.结果 从呼吸道感染患者标本分离的230株奈瑟菌属,orf1基因阳性35株,序列比对与淋病奈瑟菌TCDC-NG08107 orf1序列同源性达95.0%~99.0%;nspA无阳性反应.结论 人体上呼吸道正常菌群奈瑟菌属缺乏nspA基因,少数菌株可具有淋病奈瑟菌及脑膜炎奈瑟菌致病性相关基因orf1,提示该基因并不是人体上呼吸道正常菌群奈瑟菌属致病性和引起呼吸道继发性感染的毒力因素%OBJECTIVE To detect the pathogenic genes of Neisseria spp. isolated from patients with respiratory tract infections and probe the pathogenicity of non-gonococci and non-meningitidis Neisseria species. METHODS The virulence-associated genes or/1 and nspA in Neisseria species isolated from the patients with chronic respiratory tract infections were detected and analyzed by PCR and nucleotide sequencing. RESULTS Of the 230 strains of Neisseria species isolated from patients with chronic respiratory tract infections, totally 35 strains showed or/1 positive, as compared with the sequence of TCDC-NG08107 orfl of N. g9norrhoeae? the sequence homology reaching to 95. 0% - 99. 0% , and there was no positive reaction of nspA. CONCLUSION The species of Neisseria spp. which are the normal flora of upper respiratory tract of human lack nspA, the pathogenic gene or/1 of N. gonorrhoeae and N. meningitides can be found only in few strains, which indicate that the genes are not the important virulence factors for the normal flora Neisseria species living the upper respiratory tract of human that causing the secondary respiratory tract infections.

  19. Calculation of the Respiratory Modulation of the Photoplethysmogram (DPOP) Incorporating a Correction for Low Perfusion

    OpenAIRE

    Addison, Paul S.; Wang, Rui; McGonigle, Scott J.; Uribe, Alberto A.; Bergese, Sergio D.

    2014-01-01

    DPOP quantifies respiratory modulations in the photoplethysmogram. It has been proposed as a noninvasive surrogate for pulse pressure variation (PPV) used in the prediction of the response to volume expansion in hypovolemic patients. The correlation between DPOP and PPV may degrade due to low perfusion effects. We implemented an automated DPOP algorithm with an optional correction for low perfusion. These two algorithm variants (DPOPa and DPOPb) were tested on data from 20 mechanically ventil...

  20. Increasing signal processing sophistication in the calculation of the respiratory modulation of the photoplethysmogram (DPOP)

    OpenAIRE

    Addison, Paul S.; Wang, Rui; Uribe, Alberto A.; Bergese, Sergio D.

    2014-01-01

    DPOP (∆POP or Delta-POP) is a non-invasive parameter which measures the strength of respiratory modulations present in the pulse oximetry photoplethysmogram (pleth) waveform. It has been proposed as a non-invasive surrogate parameter for pulse pressure variation (PPV) used in the prediction of the response to volume expansion in hypovolemic patients. Many groups have reported on the DPOP parameter and its correlation with PPV using various semi-automated algorithmic implementations. The study...

  1. Temporal and spatial expression of Muc2 and Muc5ac mucins during rat respiratory and digestive tracts development.

    Science.gov (United States)

    Ferretti, V A; Segal-Eiras, A; Barbeito, C G; Croce, M V

    2016-02-01

    Secreted mucins constitute a crucial part of the gel that protects respiratory and digestive epithelia, being MUC2/Muc2 the predominant gel-forming mucin of the intestine while MUC5AC/Muc5ac is one of the gel-forming mucins most expressed at the airways. In this study, we have analyzed Muc2 and Muc5ac during rat development by using immunohistochemistry, Western blotting and RT-PCR. We demonstrated that rat Muc2 was expressed in fetal intestinal goblet cells of surface epithelium of villi and developing Lieberkühn crypts. In neonates and adults, Muc2 was expressed at luminal goblet cells of small and large intestine and at gastric mucous and glandular cells. Muc5ac protein was observed in embryonic gastric and lung samples; expression increased during development and postnatal and adult life. After birth, a low reaction was detected at the tracheal surface epithelium and glands, which increased in adults. PMID:26850552

  2. The impact of photon dose calculation algorithms on expected dose distributions in lungs under different respiratory phases

    International Nuclear Information System (INIS)

    A planning study was carried out on a cohort of CT datasets from breast patients scanned during different respiratory phases. The aim of the study was to investigate the influence of different air filling in lungs on the calculation accuracy of photon dose algorithms and to identify potential patterns of failure with clinical implications. Selected respiratory phases were free breathing (FB), representative of typical end expiration, and deep inspiration breath hold (DIBH), a typical condition for clinical treatment with respiratory gating. Algorithms investigated were the pencil beam (PBC), the anisotropic analytical algorithm (AAA) and the collapsed cone (CC) from the Varian Eclipse or Philips Pinnacle planning system. Reference benchmark calculations were performed with the Voxel Monte Carlo (VMC++). An analysis was performed in terms of physical quantities inspecting either dose-volume or dose-mass histograms and in terms of an extension to three dimensions of the γ index of Low. Results were stratified according to a breathing phase and algorithm. Collectives acquired in FB or DIBH showed well-separated average lung density distributions with mean densities of 0.27 ± 0.04 and 0.16 ± 0.02 g cm-3, respectively, and average peak densities of 0.17 ± 0.03 and 0.09 ± 0.02 g cm-3. Analysis of volume-dose or mass-dose histograms proved the expected deviations on PBC results due to the missing lateral transport of electrons with underestimations in the low dose region and overestimations in the high dose region. From the γ analysis, it resulted that PBC is systematically defective compared to VMC++ over the entire range of lung densities and dose levels with severe violations in both respiratory phases. The fraction of lung voxels with γ > 1 for PBC reached 25% in DIBH and about 15% in FB. CC and AAA performed, in contrast, similarly and with fractions of lung voxels with γ > 1 in average inferior to 2% in FB and 4-5% (AAA) or 6-8% (CC) in DIBH. In summary, PBC

  3. The impact of photon dose calculation algorithms on expected dose distributions in lungs under different respiratory phases

    Energy Technology Data Exchange (ETDEWEB)

    Fogliata, Antonella; Nicolini, Giorgia; Vanetti, Eugenio; Clivio, Alessandro; Cozzi, Luca [Oncology Institute of Southern Switzerland, Medical Physics Unit, 6504 Bellinzona (Switzerland); Winkler, Peter [Department of Therapeutic Radiology and Oncology, University Hospital Graz (Austria)], E-mail: lucozzi@iosi.ch

    2008-05-07

    A planning study was carried out on a cohort of CT datasets from breast patients scanned during different respiratory phases. The aim of the study was to investigate the influence of different air filling in lungs on the calculation accuracy of photon dose algorithms and to identify potential patterns of failure with clinical implications. Selected respiratory phases were free breathing (FB), representative of typical end expiration, and deep inspiration breath hold (DIBH), a typical condition for clinical treatment with respiratory gating. Algorithms investigated were the pencil beam (PBC), the anisotropic analytical algorithm (AAA) and the collapsed cone (CC) from the Varian Eclipse or Philips Pinnacle planning system. Reference benchmark calculations were performed with the Voxel Monte Carlo (VMC++). An analysis was performed in terms of physical quantities inspecting either dose-volume or dose-mass histograms and in terms of an extension to three dimensions of the {gamma} index of Low. Results were stratified according to a breathing phase and algorithm. Collectives acquired in FB or DIBH showed well-separated average lung density distributions with mean densities of 0.27 {+-} 0.04 and 0.16 {+-} 0.02 g cm{sup -3}, respectively, and average peak densities of 0.17 {+-} 0.03 and 0.09 {+-} 0.02 g cm{sup -3}. Analysis of volume-dose or mass-dose histograms proved the expected deviations on PBC results due to the missing lateral transport of electrons with underestimations in the low dose region and overestimations in the high dose region. From the {gamma} analysis, it resulted that PBC is systematically defective compared to VMC++ over the entire range of lung densities and dose levels with severe violations in both respiratory phases. The fraction of lung voxels with {gamma} > 1 for PBC reached 25% in DIBH and about 15% in FB. CC and AAA performed, in contrast, similarly and with fractions of lung voxels with {gamma} > 1 in average inferior to 2% in FB and 4

  4. The impact of photon dose calculation algorithms on expected dose distributions in lungs under different respiratory phases

    Science.gov (United States)

    Fogliata, Antonella; Nicolini, Giorgia; Vanetti, Eugenio; Clivio, Alessandro; Winkler, Peter; Cozzi, Luca

    2008-05-01

    A planning study was carried out on a cohort of CT datasets from breast patients scanned during different respiratory phases. The aim of the study was to investigate the influence of different air filling in lungs on the calculation accuracy of photon dose algorithms and to identify potential patterns of failure with clinical implications. Selected respiratory phases were free breathing (FB), representative of typical end expiration, and deep inspiration breath hold (DIBH), a typical condition for clinical treatment with respiratory gating. Algorithms investigated were the pencil beam (PBC), the anisotropic analytical algorithm (AAA) and the collapsed cone (CC) from the Varian Eclipse or Philips Pinnacle planning system. Reference benchmark calculations were performed with the Voxel Monte Carlo (VMC++). An analysis was performed in terms of physical quantities inspecting either dose-volume or dose-mass histograms and in terms of an extension to three dimensions of the γ index of Low. Results were stratified according to a breathing phase and algorithm. Collectives acquired in FB or DIBH showed well-separated average lung density distributions with mean densities of 0.27 ± 0.04 and 0.16 ± 0.02 g cm-3, respectively, and average peak densities of 0.17 ± 0.03 and 0.09 ± 0.02 g cm-3. Analysis of volume-dose or mass-dose histograms proved the expected deviations on PBC results due to the missing lateral transport of electrons with underestimations in the low dose region and overestimations in the high dose region. From the γ analysis, it resulted that PBC is systematically defective compared to VMC++ over the entire range of lung densities and dose levels with severe violations in both respiratory phases. The fraction of lung voxels with γ > 1 for PBC reached 25% in DIBH and about 15% in FB. CC and AAA performed, in contrast, similarly and with fractions of lung voxels with γ > 1 in average inferior to 2% in FB and 4-5% (AAA) or 6-8% (CC) in DIBH. In summary, PBC

  5. Descriptive Study on Parents’ Knowledge, Attitudes and Practices on Antibiotic Use and Misuse in Children with Upper Respiratory Tract Infections in Cyprus

    Directory of Open Access Journals (Sweden)

    Christos Hadjichristodoulou

    2011-08-01

    Full Text Available Upper respiratory tract infections (URTIs are common in children and represent a significant cause of antibiotic abuse which contributes to the development of antibiotic resistance. A survey was conducted in Cyprus in 2006 to assess parents’ and pediatricians’ Knowledge, Attitude and Practices (KAP concerning the role of antibiotics in children with URTIs. A school-based stratified geographic clustering sampling was used and a pre-tested KAP questionnaire was distributed. A different questionnaire was distributed to paediatricians. Demographic factors associated with antibiotic misuse were identified by backward logistic regression analysis. The parental overall response rate was 69.3%. Parents (N = 1,462 follow pediatricians advice and rarely administer antibiotics acquired over the counter. Although a third expects an antibiotic prescription for URTI symptoms, most deny pressuring their doctors. Low parental education was the most important independent risk factor positively related to antibiotic misuse (OR = 2.88, 95%CI 2.02 to 4.12, p < 0.001. Pediatricians (N = 33 denied prescribing antibiotics after parental pressure but admit that parents ask for antibiotics and believe they expect antibiotic prescriptions even when not needed. In conclusion, Cypriotic parents trust their primary care providers. Although it appears that antibiotic misuse is not driven by parental pressure, the pediatricians’ view differs.

  6. Acquisition of pneumococci specific effector and regulatory Cd4+ T cells localising within human upper respiratory-tract mucosal lymphoid tissue.

    Directory of Open Access Journals (Sweden)

    Jeffrey Pido-Lopez

    2011-12-01

    Full Text Available The upper respiratory tract mucosa is the location for commensal Streptococcus (S. pneumoniae colonization and therefore represents a major site of contact between host and bacteria. The CD4(+ T cell response to pneumococcus is increasingly recognised as an important mediator of immunity that protects against invasive disease, with data suggesting a critical role for Th17 cells in mucosal clearance. By assessing CD4 T cell proliferative responses we demonstrate age-related sequestration of Th1 and Th17 CD4(+ T cells reactive to pneumococcal protein antigens within mucosal lymphoid tissue. CD25(hi T cell depletion and utilisation of pneumococcal specific MHCII tetramers revealed the presence of antigen specific Tregs that utilised CTLA-4 and PDL-1 surface molecules to suppress these responses. The balance between mucosal effector and regulatory CD4(+ T cell immunity is likely to be critical to pneumococcal commensalism and the prevention of unwanted pathology associated with carriage. However, if dysregulated, such responses may render the host more susceptible to invasive pneumococcal infection and adversely affect the successful implementation of both polysaccharide-conjugate and novel protein-based pneumococcal vaccines.

  7. Deep, respiratory tract and ear infections caused by Pseudallescheria (Scedosporium) and Microascus (Scopulariopsis) in Finland. A 10-year retrospective multi-center study.

    Science.gov (United States)

    Issakainen, J; Salonen, J H; Anttila, V-J; Koukila-Kähkölä, P; Castrén, M; Liimatainen, O; Vuento, R; Ojanen, T; Koivula, I; Koskela, M; Meurman, O

    2010-05-01

    Deep, respiratory tract and ear infections due to Microascaceae (Pseudallescheria, Scedosporium, Microascus or Scopulariopsis) were studied nationwide in Finland during 1993-2002. The data were based on 52,000 fungal cultures that represented about 50% of all such specimens in Finland and included all Finnish cases of profound immunosuppression. There were 39 cases that were re-evaluated as clinically significant, i.e., three pneumonias, two deep pedal infections and five wound infections, 11 sinusitis and 18 ear infections. The pedal infections and most pneumonias occurred in immunocompromised patients. Most cases, except the ear infections, were due to Pseudallescheria boydii. Two patients had lethal P. boydii pneumonia and a deep P. boydii infection of the foot contributed to a third lethal case. Two of the patients with lethal outcomes had received an allogeneic haematopoietic stem cell transplantation (AHSCT). Two patients with haematological malignancies were cured of deep site infections by a prolonged course of itraconazole. Wound, sinus and ear infections were cured or improved by local surgery or topical therapy. There were 0.8-1.7 cases of any type of infection per million inhabitants per year (MY) and 3.4 cases/1000 AHSCT. Mortality associated with Microascaceae in any type of patient was 0.06-0.12 MY. PMID:19672782

  8. Study on antitussive effects of eprazinone dihydrochloride on radiation induced inflammation of upper respiratory tract due to postoperative irradiation of breast cancer

    International Nuclear Information System (INIS)

    Discussion was made of antitussive effects of Eprazinone hydrochloride (Resplen) on radiation induced inflammation of the upper respiratory tract in 15 cases irradiated after an operation of breast cancer. Depth dose at 3 cm was 200 rads/day, and 5000 rad/25 times/5 weeks was irradiated with telecobalt. Mainly abnormal sensation and pain in the throat and cough appeared and patients complained of suffering from a common cold, because a part of irradiation field included the throat, trachea, and esophagus. At the same time as manifestation of symptoms, 120 mg/day of Eprazinone Dihydrochloride was administered. In 8 cases, other drugs were added to, or irradiation schedule was changed because the symptoms were not improved or were exaggerated. The symptoms disappeared up to 5000 rad irradiation in one case, up to 4000 - 5000 rad irradiation in 4 cases, and up to 4000 rad irradiation in 2 cases. It is impossible to decide effective rate of this drug because of shortage of clinical cases, but it is suggested that there is a significance to increase cases treated successively with this drug in future. (Tsunoda, M.)

  9. Homeopathic medicine for acute cough in upper respiratory tract infections and acute bronchitis: a randomized, double-blind, placebo-controlled trial.

    Science.gov (United States)

    Zanasi, Alessandro; Mazzolini, Massimiliano; Tursi, Francesco; Morselli-Labate, Antonio Maria; Paccapelo, Alexandro; Lecchi, Marzia

    2014-02-01

    Cough is a frequent symptom associated to upper respiratory tract infections (URTIs) and, although being self-limiting, it might deeply affect the quality of life. Homeopathic products are often employed by patients to treat cough, but the evidence on their efficacy is scarce. Thus, we tested the efficacy of a homeopathic syrup in treating cough arising from URTIs with a randomized, double blind, placebo controlled clinical trial. Patients were treated with either the homeopathic syrup or a placebo for a week, and recorded cough severity in a diary by means of a verbal category-descriptive score for two weeks. Sputum viscosity was assessed with a viscosimeter before and after 4 days of treatment; patients were also asked to provide a subjective evaluation of viscosity. Eighty patients were randomized to receive placebo (n = 40) or the homeopathic syrup (n = 40). All patients completed the study. In each group cough scores decreased over time, however, after 4 and 7 days of treatment, cough severity was significantly lower in the homeopathic group than in the placebo one (p syrup employed in the study was able to effectively reduce cough severity and sputum viscosity, thereby representing a valid remedy for the management of acute cough induced by URTIs. PMID:23714686

  10. Manifestation of the Se, Cd and Mo levels in different components of the peripheral blood of Sprague-Dawley rats poisoned via the respiratory tract.

    Science.gov (United States)

    Wang, Dong-Fang; Sun, Xuan; Cao, Bing; Wen, Hua; Zhang, Yu; Liu, Duo-Jian; Yan, Lai-Lai; Liu, Ya-Qiong; Lu, Qing-Bin; Wang, Jing-Yu

    2015-01-01

    This study aimed to explore the effects of exogenous element exposure via the respiratory tract on the Se, Cd and Mo concentrations in different components of the peripheral blood in rats as well as to determine the correlations of the three trace elements concentrations among the components. The Sprague-Dawley rats were randomly divided into a control group and several experimental groups treated with different doses. The rats were exposed to a mixed trace element solution through 10 days of intratracheal instillation. The whole blood of all rats was collected and separated into three parts with Percoll density gradient centrifugation. The Se, Cd and Mo levels in whole blood, plasma, red blood cells (RBCs) and peripheral blood mononuclear cells (PBMCs) were determined by inductively coupled plasma mass spectrometry. The concentrations of the three trace elements increased together with the increase of the given doses (Pblood (r, 0.806-0.934). The correlation coefficients were higher (0.842-0.962) among the whole blood, plasma and RBCs than between PBMCs and other components, such as Se (0.376-0.529), Cd (0.495-0.604) and, especially, Mo (0.160-0.257). In conclusion, PBMCs might provide information about endogenous factors, and whole blood could more accurately reflect the effects of exogenous factors compared to other blood components. PMID:26770359

  11. Impact of selective digestive decontamination on respiratory tract Candida among patients with suspected ventilator-associated pneumonia. A meta-analysis.

    Science.gov (United States)

    Hurley, J C

    2016-07-01

    The purpose here is to establish the incidence of respiratory tract colonization with Candida (RT Candida) among ICU patients receiving mechanical ventilation within studies in the literature. Also of interest is its relationship with candidemia and the relative importance of topical antibiotic (TA) use as within studies of selective digestive decontamination (SDD) versus other candidate risk factors towards it. The incidence of RT Candida was extracted from component (control and intervention) groups decanted from studies of various TA and non-TA ICU infection prevention methods with summary estimates derived using random effects. A benchmark RT Candida incidence to provide overarching calibration was derived using (observational) groups from studies without any prevention method under study. A multi-level regression model of group level data was undertaken using generalized estimating equation (GEE) methods. RT Candida data were sourced from 113 studies. The benchmark RT Candida incidence is 1.3; 0.9-1.8 % (mean and 95 % confidence intervals). Membership of a concurrent control group of a study of SDD (p = 0.02), the group-wide presence of candidemia risk factors (p Candida incidence. RT Candida and candidemia incidences are correlated. RT Candida incidence can serve as a basis for benchmarking. Several relationships have been identified. The increased incidence among concurrent control groups of SDD studies cannot be appreciated in any single study examined in isolation. PMID:27116009

  12. Predominant characteristics of CTX-M-producing Klebsiella pneumoniae isolates from patients with lower respiratory tract infection in multiple medical centers in China.

    Science.gov (United States)

    An, Shuchang; Chen, Jichao; Wang, Zhanwei; Wang, Xiaorong; Yan, Xixin; Li, Jihong; Chen, Yusheng; Wang, Qi; Xu, Xiaoling; Li, Jiabin; Yang, Jingping; Wang, Hui; Gao, Zhancheng

    2012-07-01

    From February 2010 to July 2011, 183 of 416 presumptive Klebsiella pneumoniae isolates with reduced susceptibility to third-generation cephalosporins from patients with lower respiratory tract infection were collected from seven tertiary hospitals in China. Phenotypic and genotypic methods were employed to characterize 158 extended-spectrum β-lactamase (ESBL)-producers. Among the 158 isolates analyzed, 134 (84.8%) harbored bla(CTX-M) , within which the most predominant ESBL gene was CTX-M-14 (49.4%), followed by CTX-M-15 (12.0%) and CTX-M-27 (10.8%). Also, 120 (75.9%) harbored bla(SHV) . One novel SHV variant, bla(SHV -142) with T18A and L35Q substitutions, was identified. Ninety-one isolates carried bla(TEM-1). An isolate containing bla(TEM-135) was first identified in Klebsiella spp. bla(KPC)-2) was detected in 5 isolates. More than one ESBL combination was detected in 18 isolates (11.4%). Fifty-four (34.2%) isolates demonstrated the multidrug resistant (MDR) phenotype. Seventy-four sequence types (STs) were identified, which showed large genetic background diversity in ESBL-producing K. pneumoniae isolates from the six areas. This is the first report on the high prevalence of CTX-M-27 in China with the possible transmission of a single clone (ST48). The correlated surveillance of organisms with MDR phenotype should be investigated in future. PMID:22537112

  13. Microdistribution and long-term retention of 239Pu (NO3)4 in the respiratory tracts of an acutely exposed plutonium worker and experimental beagle dogs.

    Science.gov (United States)

    Nielsen, Christopher E; Wilson, Dulaney A; Brooks, Antone L; McCord, Stacey L; Dagle, Gerald E; James, Anthony C; Tolmachev, Sergei Y; Thrall, Brian D; Morgan, William F

    2012-11-01

    The long-term retention of inhaled soluble forms of plutonium raises concerns as to the potential health effects in persons working in nuclear energy or the nuclear weapons program. The distributions of long-term retained inhaled plutonium-nitrate [(239)Pu (NO(3))(4)] deposited in the lungs of an accidentally exposed nuclear worker (Human Case 0269) and in the lungs of experimentally exposed beagle dogs with varying initial lung depositions were determined via autoradiographs of selected histologic lung, lymph node, trachea, and nasal turbinate tissue sections. These studies showed that both the human and dogs had a nonuniform distribution of plutonium throughout the lung tissue. Fibrotic scar tissue effectively encapsulated a portion of the plutonium and prevented its clearance from the body or translocation to other tissues and diminished dose to organ parenchyma. Alpha radiation activity from deposited plutonium in Human Case 0269 was observed primarily along the subpleural regions while no alpha activity was seen in the tracheobronchial lymph nodes of this individual. However, relatively high activity levels in the tracheobronchial lymph nodes of the beagles indicated the lymphatic system was effective in clearing deposited plutonium from the lung tissues. In both the human case and beagle dogs, the appearance of retained plutonium within the respiratory tract was inconsistent with current biokinetic models of clearance for soluble forms of plutonium. Bound plutonium can have a marked effect on the dose to the lungs and subsequent radiation exposure has the potential to increase cancer risk.

  14. Microdistribution and Long-Term Retention of 239Pu (NO3)4 in the Respiratory Tracts of an Acutely Exposed Plutonium Worker and Experimental Beagle Dogs

    Energy Technology Data Exchange (ETDEWEB)

    Nielsen, Christopher E.; Wilson, Dulaney A.; Brooks, Antone L.; McCord, Stacey; Dagle, Gerald E.; James, Anthony C.; Tolmachev, Sergei Y.; Thrall, Brian D.; Morgan, William F.

    2012-11-01

    The long-term retention of inhaled soluble forms of plutonium raises concerns as to the potential health effects in persons working in nuclear energy or the nuclear weapons program. The distributions of long-term retained inhaled plutonium-nitrate [239Pu (NO3)4] deposited in the lungs of an accidentally exposed nuclear worker (Human Case 0269) and in the lungs of experimentally exposed beagle dogs with varying initial lung depositions were determined via autoradiographs of selected histological lung, lymph node, trachea, and nasal turbinate tissue sections. These studies showed that both the human and dogs had a non-uniform distribution of plutonium throughout the lung tissue. Fibrotic scar tissue effectively encapsulated a portion of the plutonium and prevented its clearance from the body or translocation to other tissues and diminished dose to organ parenchyma. Alpha radiation activity from deposited plutonium in Human Case 0269 was observed primarily along the sub-pleural regions while no alpha activity was seen in the tracheobronchial lymph nodes of this individual. However, relatively high activity levels in the tracheobronchial lymph nodes of the beagles indicated the lymphatic system was effective in clearing deposited plutonium from the lung tissues. In both the human case and beagle dogs, the appearance of retained plutonium within the respiratory tract was inconsistent with current biokinetic models of clearance for soluble forms of plutonium. Bound plutonium can have a marked effect on the dose to the lungs and subsequent radiation exposure has the potential increase in cancer risk.

  15. Effect of InspirEase on the deposition of metered-dose aerosols in the human respiratory tract

    International Nuclear Information System (INIS)

    A radiotracer technique has been used to assess the effects of a 700-ml collapsible holding chamber (InspirEase, Key Pharmaceuticals Inc.) on the deposition of metered-dose aerosols in ten patients with obstructive airways disease (mean forced expiratory volume in one second [FEV1], 64.5 percent of predicted). Patterns of deposition obtained by patients' usual techniques with the metered-dose inhaler (MDI) were compared with those by correct MDI technique (actuation coordinated with slow deep inhalation and followed by ten seconds of breath-holding) and with those by InspirEase. Deposition of aerosol was assessed by placing Teflon particles labelled with 99mTc inside placebo canisters, and inhaling maneuvers were monitored by respiratory inductive plethysmography (Respitrace). Nine of the ten patients had imperfect technique with the MDI, the most prevalent errors being rapid inhalation and failure to hold their breath adequately. With patients' usual MDI techniques, 6.5 +/- 1.2 percent (mean +/- SE) of the dose reached the lungs. This was increased to 11.2 +/- 1.3 percent (p less than 0.02) with correct technique and increased further to 14.8 +/- 1.4 percent (p less than 0.05) with InspirEase. Oropharyngeal deposition exceeded 80 percent of the dose for the MDI alone but was only 9.5 +/- 0.9 percent with InspirEase (p less than 0.01); 59.2 +/- 2.1 percent of the dose was retained within InspirEase itself. It is concluded that InspirEase gives whole lung deposition of metered-dose aerosols greater than that from a correctly used MDI, while oropharyngeal deposition is reduced approximately nine times

  16. Case of invasive nontypable Haemophilus influenzae respiratory tract infection with a large quantity of neutrophil extracellular traps in sputum

    Directory of Open Access Journals (Sweden)

    Hamaguchi S

    2012-12-01

    Full Text Available Shigeto Hamaguchi,1,* Masafumi Seki,1,* Norihisa Yamamoto,1 Tomoya Hirose,2 Naoya Matsumoto,2 Taro Irisawa,2 Ryosuke Takegawa,2 Takeshi Shimazu,2 Kazunori Tomono11Division of Infection Control and Prevention, 2Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Osaka, Japan *These authors contributed equally to this workAbstract: Haemophilus influenzae type b was once the most common cause of invasive H. influenzae infection, but the incidence of this disease has decreased markedly with introduction of conjugate vaccines to prevent the disease. In contrast, the incidence of invasive infection caused by nontypable H. influenzae has increased in the US and in European countries. Neutrophil extracellular traps (NETs are fibrous structures released extracellularly from activated neutrophils during inflammation, including in pneumonia, and rapidly trap and kill pathogens as a first line of immunological defense. However, their function and pathological role have not been fully investigated. Here, we report a case of fatal nontypable H. influenzae infection with severe pneumonia and bacteremia in an adult found to have a vast amount of NETs in his sputum. The patient had a two-day history of common cold-like symptoms and was taken to the emergency room as a cardiopulmonary arrest. He recovered temporarily, but died soon afterwards, although appropriate antibiotic therapy and general management had been instituted. Massive lobular pneumonia and sepsis due to nontypable H. influenzae was found, in spite of H. influenzae type b vaccine being available. His sputum showed numerous bacteria phagocytosed by neutrophils, and immunohistological staining indicated a number of NETs containing DNA, histone H3, and neutrophil elastase. This case highlights an association between formation of NETs and severe respiratory and septic infection. An increase in severe nontypable H. influenzae disease can be expected as a

  17. Concurrent acute illness and comorbid conditions poorly predict antibiotic use in upper respiratory tract infections: a cross-sectional analysis

    Directory of Open Access Journals (Sweden)

    Perencevich Eli N

    2007-05-01

    Full Text Available Abstract Background Inappropriate antibiotic use promotes resistance. Antibiotics are generally not indicated for upper respiratory infections (URIs. Our objectives were to describe patterns of URI treatment and to identify patient and provider factors associated with antibiotic use for URIs. Methods This study was a cross-sectional analysis of medical and pharmacy claims data from the Pennsylvania Medicaid fee-for-service program database. We identified Pennsylvania Medicaid recipients with a URI office visit over a one-year period. Our outcome variable was antibiotic use within seven days after the URI visit. Study variables included URI type and presence of concurrent acute illnesses and chronic conditions. We considered the associations of each study variable with antibiotic use in a logistic regression model, stratifying by age group and adjusting for confounders. Results Among 69,936 recipients with URI, 35,786 (51.2% received an antibiotic. In all age groups, acute sinusitis, chronic sinusitis, otitis, URI type and season were associated with antibiotic use. Except for the oldest group, physician specialty and streptococcal pharyngitis were associated with antibiotic use. History of chronic conditions was not associated with antibiotic use in any age group. In all age groups, concurrent acute illnesses and history of chronic conditions had only had fair to poor ability to distinguish patients who received an antibiotic from patients who did not. Conclusion Antibiotic prevalence for URIs was high, indicating that potentially inappropriate antibiotic utilization is occurring. Our data suggest that demographic and clinical factors are associated with antibiotic use, but additional reasons remain unexplained. Insight regarding reasons for antibiotic prescribing is needed to develop interventions to address the growing problem of antibiotic resistance.

  18. Risk factor analysis of postoperative respiratory tract infections in patients undergoing lumbar vertebra surgery under general anesthesia%腰椎手术患者全麻术后呼吸道感染的相关因素分析

    Institute of Scientific and Technical Information of China (English)

    李宁; 张义龙; 赵国军; 宋有鑫; 任磊; 李建玲

    2016-01-01

    目的:探讨气管置管全身麻醉下行腰椎手术患者术后发生呼吸道感染的相关因素,为其临床预防治疗提供参考依据。方法收集2012年9月-2014年9月在医院住院拟行气管置管全身麻醉下腰椎后路切开减压内固定椎间融合术的患者303例作为研究对象,记录其基本信息及相关病史,分析术后呼吸道感染的相关因素,研究数据采用SPSS 17.0软件进行统计处理。结果300例患者中发生呼吸道感染34例,感染率为11.33%;多因素分析结果显示,年龄、吸烟史、既往有呼吸系统慢性感染、糖尿病、无口腔护理等因素与术后呼吸道感染有关,差异有统计学意义(P<0.05)。结论气管置管全身麻醉下行腰椎手术患者,如为高龄、吸烟者,既往有慢性呼吸道感染及糖尿病史,术后发生呼吸道感染危险因素明显增高;术前进行规范口腔护理可以降低术后发生呼吸道感染的风险。%OBJECTIVE To explore the related factors for respiratory tract infections in patients undergoing lumbar vertebra surgery under general anesthesia in order to guide the clinical prevention and treatment .METHODS The consecutive clinical data of 300 patients who needed lumbar vertebra surgery under general anesthesia from Sep . 2012 to Sep .2014 were collected and the general information and the relative medical history were recorded .The related factors for postoperative respiratory tract infection were analyzed .The data were statistically analyzed by software SPSS 17 .0 .RESULTS Of 300 patients with complete data ,respiratory tract infection occurred in 34 cases with the incidence rate of 11 .33% .The multivariate analysis indicated that age ,smoking history ,history of chro-nic respiratory tract infection or diabetes mellitus ,and oral care were correlated with postoperative respiratory tract infections ,with significant difference (P<0 .05) .CONCLUSION The risk factors of

  19. 呼吸道病毒特异性IgM检测对儿童呼吸道感染的指导意义%Guiding significance of respiratory virus specific IgM in children with respiratory tract infection

    Institute of Scientific and Technical Information of China (English)

    王加芬; 王凤秀; 郑媛媛; 马国英; 周红岩; 阚玉玲

    2015-01-01

    M in children with respiratory tract infection to guide the clinical.Methods: 1 609 cases of children with respiratory tract infection in department of Pediatrics in our hospital were collected in 2012 from 1 to 12 months.Serum was collected to detect the specific IgM of respiratory syncytial virus (RSV),adenovirus (ADV),influenza A virus (IVA),influenza B virus (IVB) and parainfluenza virus ( PIV) by method of indirect immunofluorescence.Results:263 positive cases were detected from 1 609 cases ( 16.35%) , and the positive rates of IVB was the highest (8.45%) with a total of 136 cases,followed by the rest of IVA 63 cases(3.92%),PIV 62 cases (3.85%),ADV 44 cases(2.73%) and RSV 42 cases(2.61%).The positive detection rate was different in children of different age groups,and the difference was statistical significant (χ2=134.822,P<0.01).Positive detection rate was gradually increased along with the age growth,and the detection rate of school-age children was the highest (34.55%);The comparison differences of IVB ,PIV,IVA positive detection rate between different age stages were significant (χ2=102.660 ,86.145 ,39.791 ,P<0.05 ).The detection rate of IVB and IVA was the highest in school-age children,20.00%and 8.64%respectively.The detection rate of PIV was the highest (12.07%) in preschool children.The positive rates of different respiratory virus specific IgM had their own characteristics in different months .IVB appeared two positive peaks in March and October with the rate of 20.15%and 11.11%respectively;IVA appeared two positive peaks in March and May with the rate of 10.27% and 11.81% respectively;PIV and RSV , the detection rate of which was the highest ( 7.98%and 6.46 respectively ) in March increased gently from January to June ,and then declined steadily.The detection rate of ADV was the highest (6.19%) during three months of March ,April and May.Conclusion:The positive rate of 5 kinds of respiratory virus specific IgM was 16.35%,especially the detection rate

  20. Possible Prevalence and Transmission of Acute Respiratory Tract Infections Caused by Streptococcus pneumoniae and Haemophilus influenzae among the Internally Displaced Persons in Tsunami Disaster Evacuation Camps of Sri Lanka

    OpenAIRE

    Watanabe, Hiroshi; Batuwanthudawe, Ranjith; Thevanesam, Vasanthi; Kaji, Chiharu; Qin, Liang; Nishikiori, Nobuyuki; Saito, Wakana; Saito, Mariko; Watanabe, Kiwao; Oishi, Kazunori; Abeysinghe, Nihal; Kunii, Osamu

    2007-01-01

    Objective The objective of this prospective study was to investigate the status of acute respiratory tract infections caused by Haemophilus influenzae and Streptococcus pneumoniae in tsunami disaster evacuation camps. Methods Nasopharyngeal swabs (NP) of 324 internally displaced persons (IDP) in 3 different tsunami disaster evacuation camps of Sri Lanka were collected between March 18th and 20th, 2005, and analyzed for MIC, β-lactamase production, serotypes, PCR and pulsed-field gel electroph...

  1. Comparison of Established Diagnostic Methodologies and a Novel Bacterial smpB Real-Time PCR Assay for Specific Detection of Haemophilus influenzae Isolates Associated with Respiratory Tract Infections

    OpenAIRE

    Reddington, Kate; Schwenk, Stefan; Tuite, Nina; Platt, Gareth; Davar, Danesh; Coughlan, Helena; Personne, Yoann; Gant, Vanya; Enne, Virve I.; Zumla, Alimuddin; Barry, Thomas

    2015-01-01

    Haemophilus influenzae is a significant causative agent of respiratory tract infections (RTI) worldwide. The development of a rapid H. influenzae diagnostic assay that would allow for the implementation of infection control measures and also improve antimicrobial stewardship for patients is required. A number of nucleic acid diagnostics approaches that detect H. influenzae in RTIs have been described in the literature; however, there are reported specificity and sensitivity limitations for th...

  2. Moxifloxacin hydrochloride treatment of respiratory tract infection of 44 cases%盐酸莫西沙星治疗下呼吸道感染44例临床分析

    Institute of Scientific and Technical Information of China (English)

    梁福贵

    2009-01-01

    目的 评价盐酸莫西沙星治疗下呼吸道感染的疗效.方法 88例下呼吸道感染患者随机分为两组,治疗组用盐酸莫西沙星注射液0.4g/次,qd;对照组用左氧氟沙星治疗.疗程均为7~10d.结果 莫西沙星组和左氧氟沙星组临床总有效率分别为93.2%和90.9%,细菌清除率为94.7%和89.5%,两组不良反应少见而轻微.结论 盐酸莫西沙星治疗下呼吸道感染疗效确切,可作为治疗下呼吸道感染的一线用药.%Objective To evaluate the moxifloxacin hydrochloride treatment of respiratory tract infection.Methods 88 cases of respiratory tract infections were, randomly divided into 2 groups, group therapy with moxifloxacin hydrochloride injection 0.4g / times, qd; with the control group. Courses are 7 ~ 10d. Results Moxifloxacin and levofloxacin clinical total effective rate of 93.2 percent and 90.9 percent; bacterial clearance rate 94.7% and 89.5%, two rare and minor side effects. Conclusion Moxifloxacin hydrochloride in the treatment of respiratory tract infection the exact effect can be used as the treatment of lower respiratory tract infection of the first-line drugs.

  3. RESPIRATORY SYSTEM

    Institute of Scientific and Technical Information of China (English)

    2004-01-01

    9. 1 Upper respiratory tract disease and bronchial asthma2004223 Inhibitive effect on airway mucus overproduction of DNA vaccine based on xenogeneic homologous calcium-activated chloride channel in asthmatic mice. SONG Liqiang (宋立强), et al. Dept Respir Med, Xijing Hosp , 4th Milit Med Univ, Xi’an 710032. Natl Med J China 2004;84(4):329-333.

  4. RESPIRATORY SYSTEM

    Institute of Scientific and Technical Information of China (English)

    2004-01-01

    6.1 Upper respiratory tract disease and bronchial asthma2004073 A study on the heterogenous apoptosis of lymphocytes, eosinophils, and neutrophils from peripheral blood of asthmatic patients. LIU Chuntao (刘春涛), et al. West China Hosp, Sichuan Univ, Chengdu 610041. Chin J Tuberc Respir Dis 2003; 26(10):610 - 614.

  5. Levofloxacin and penicillin combination therapy clinical evaluation of the lower respiratory tract infections%左氧氟沙星联合青霉素治疗下呼吸道感染的临床观察

    Institute of Scientific and Technical Information of China (English)

    陈艳成; 倪文梅; 马经平

    2011-01-01

    目的:探讨左氧氟沙星与青霉素联合治疗下呼吸道感染的疗效.方法:对82例下呼吸道感染病例均使用青霉素注射剂与左氧氟沙星注射剂联合治疗,观察症状体征改善及细菌阴转情况.结果:临床有效率为90.2%,细菌阴转率88.4%.结论:左氧氟沙星与青霉素联合治疗下呼吸道感染安全有效.%Objective:To investigate the levofloxacin and penicillin combined treatment of lower respiratory tract infection treatment. Methods: 82 cases of lower respiratory tract infections were penicillin injection and the injection of levofloxacin combination therapy, observed symptoms and signs improved and the bacterial conversion of. Results:Clinical response rate was 90. 2% , 88. I% negative rate of bacteria. Conclusion:Levofloxacin combined with penicillin safe and effective treatment of lower respiratory tract infections.

  6. The effects of the plastic operation on upper respiratory tract at one-stage for patients with OSAHS through the assessment of 3-D reconstruction of CT images%CT三维重建评估OSAHS患者上呼吸道一期成形术效果

    Institute of Scientific and Technical Information of China (English)

    王凯; 董明敏

    2012-01-01

    -proved the same results. Conclusion:Calculating the increment of the cross sections of the upper respiratory tract through tri-dimensional reconstruction can not only find the preoperative stenosis, but also assess the surgical effects objectively. Since the body of endoscope has a certain volume, surface anesthesia is needed to enter the na-sal cavity and nasopharyngeal which will impact the objectivity of the assessment of the upper respiratory tract ste-nosis.

  7. Symptoms of respiratory tract infection and associated care-seeking in subjects with and without obstructive lung disease; The Tromsø Study: Tromsø 6

    Directory of Open Access Journals (Sweden)

    Melbye Hasse

    2012-09-01

    Full Text Available Abstract Background Respiratory tract infections (RTIs may be more severe in those with asthma or COPD and these patients are more frequently in need of health care. The aim of the study was to describe the frequency of RTI symptoms in a general adult population and how care-seeking is associated with the presence of obstructive lung disease. Methods Cross-sectional data including spirometry and self-reported chronic diseases were collected among middle-aged and elderly subjects in the Tromsø population survey (Tromsø 6. Self- reported RTI symptoms, consultations and antibiotic use were the main outcome variables. Possible predictors of RTI symptoms were evaluated by multivariable logistic regression. Results Of the 6414 subjects included, 798 (12.4% reported RTI symptoms in the previous week. RTI symptoms were reported less frequently by subjects aged 75 years or above, than by those younger than 55 years (OR 0.5. Winter season (OR 1.28, current smoking (OR 1.60, low self-rated health (OR 1.26 and moderate to severe bronchial obstruction (OR 1.51, were also statistically significant independent predictors of RTI symptoms, but these variables did not predict RTI symptoms that had started within the previous seven days. Among subjects with RTI symptoms, 5.1% also reported a consultation with a doctor. In those with bronchial obstruction by spirometry, who did not report asthma or COPD, this frequency was 2.4%. Antibiotic treatment was reported by 7.4% of the participants, among whom one third had consulted a doctor. Antibiotics were taken more frequently when asthma or COPD was reported (13.7%, but not in subjects with bronchial obstruction who did not report these diseases (7.2%. Conclusions RTI symptoms seldom led to consultation with a doctor and not even in subjects with obstructive lung disease. This was in particular the case in subjects who did not know about their obstructive lung disease. Strategies for early diagnosis of COPD and

  8. 小儿上呼吸道感染致高热临床护理要点分析%Analysis of the main points of high fever caused by upper respiratory tract infection in children

    Institute of Scientific and Technical Information of China (English)

    鲍然然

    2015-01-01

    目的:分析小儿上呼吸道感染致高热的临床护理要点及护理效果.方法:选择我院收治的72例上呼吸道感染致高热患儿作为本次观察对象(2014年2月至2015年6月),随机将其分成两组,对照组36例采用基础护理,实验组36例在对照组基础上加用优质护理,观察两组上呼吸道感染致高热患儿高热缓解时间、一周内恢复率及住院时间.结果:对照组一周内恢复率(77.78%)明显低于实验组(94.44%),且两组上呼吸道感染致高热患儿高热缓解时间及住院时间存在显著差异(p<0.05).结论:针对上呼吸道感染致高热患儿采用优质护理的效果显著,能缩短患儿的恢复时间,促进患儿预后.%Objective Analysis of pediatric clinical nursing points of the upper respiratory tract infection caused by high fever and nursing effect. Methods Choose our hospital 72 cases of children with upper respiratory tract infection caused by high fever as the observation object (in February 2014 to June 2015), it is divided into two groups at random, the control group of 36 patients with primary care, experimental group based on 36 cases in the control group used high quality nursing care, observation of two groups of children with upper respiratory tract infection caused by high fever high fever relief time, recovery rate and the length of time in a week.Results Recovery rate (77.78%), significantly lower than the control group a week group (94.44%), and two groups of children with upper respiratory tract infection caused by high fever high fever relief time and hospital stay there were significant differences (p < 0.05).Conclusion In view of the upper respiratory tract infection of children with high fever caused by the high quality nursing effect is remarkable, can shorten the recovery time of children and promote the prognosis of children.

  9. Screening for Corynebacterium diphtheriae and Corynebacterium ulcerans in patients with upper respiratory tract infections 2007-2008: a multicentre European study.

    LENUS (Irish Health Repository)

    Wagner, K S

    2011-04-01

    Diphtheria is now rare in most European countries but, when cases do arise, the case fatality rate is high (5-10%). Because few countries continue to routinely screen for the causative organisms of diphtheria, the extent to which they are circulating amongst different European populations is largely unknown. During 2007-2008, ten European countries each screened between 968 and 8551 throat swabs from patients with upper respiratory tract infections. Six toxigenic strains of Corynebacterium diphtheriae were identified: two from symptomatic patients in Latvia (the country with the highest reported incidence of diphtheria in the European Union) and four from Lithuania (two cases, two carriers); the last reported case of diphtheria in Lithuania was in 2002. Carriage rates of non-toxigenic organisms ranged from 0 (Bulgaria, Finland, Greece, Ireland, Italy) to 4.0 per 1000 (95% CI 2.0-7.1) in Turkey. A total of 28 non-toxigenic strains were identified during the study (26 C. diphtheriae, one Corynebacterium ulcerans, one Corynebacterium pseudotuberculosis). The non-toxigenic C. ulcerans strain was isolated from the UK, the country with the highest reported incidence of cases due to C. ulcerans. Of the eleven ribotypes detected, Cluj was seen most frequently in the non-toxigenic isolates and, amongst toxigenic isolates, the major epidemic clone, Sankt-Petersburg, is still in circulation. Isolation of toxigenic C. diphtheriae and non-toxigenic C. diphtheriae and C. ulcerans in highly-vaccinated populations highlights the need to maintain microbiological surveillance, laboratory expertise and an awareness of these organisms amongst public health specialists, microbiologists and clinicians.

  10. Association between cord blood 25-hydroxyvitamin D concentrations and respiratory tract infections in the first 6 months of age in a Korean population: A birth cohort study (COCOA

    Directory of Open Access Journals (Sweden)

    Youn Ho Shin

    2013-10-01

    Full Text Available Purpose: Previous studies suggest that the concentration of 25-hydroxyvitamin D [25(OHD] in cord blood may show an inverse association with respiratory tract infections (RTI during childhood. The aim of the present study was to examine the influence of 25(OHD concentrations in cord blood on infant RTI in a Korean birth cohort. Methods: The levels of 25(OHD in cord blood obtained from 525 Korean newborns in the prospective COhort for Childhood Origin of Asthma and allergic diseases were examined. The primary outcome variable of interest was the prevalence of RTI at 6-month follow-up, as diagnosed by pediatricians and pediatric allergy and pulmonology specialists. RTI included acute nasopharyngitis, rhinosinusitis, otitis media, croup, tracheobronchitis, bronchiolitis, and pneumonia. Results: The median concentration of 25(OHD in cord blood was 32.0 nmol/L (interquartile range, 21.4 to 53.2. One hundred and eighty neonates (34.3% showed 25(OHD concentrations less than 25.0 nmol/L, 292 (55.6% showed 25(OHD concentrations of 25.0&#8211;74.9 nmol/L, and 53 (10.1% showed concentrations of ?#247;5.0 nmol/L. Adjusting for the season of birth, multivitamin intake during pregnancy, and exposure to passive smoking during pregnancy, 25(OHD concentrations showed an inverse association with the risk of acquiring acute nasopharyngitis by 6 months of age (P for trend= 0.0004. Conclusion: The results show that 89.9% of healthy newborns in Korea are born with vitamin D insufficiency or deficiency (55.6% and 34.3%, respectively. Cord blood vitamin D insufficiency or deficiency in healthy neonates is associated with an increased risk of acute nasopharyngitis by 6 months of age. More time spent outdoors and more intensified vitamin D supplementation for pregnant women may be needed to prevent the onset of acute nasopharyngitis in infants.

  11. Antibacterial resistance of community-acquired respiratory tract pathogens recovered from patients in Latin America: results from the PROTEKT surveillance study (1999-2000

    Directory of Open Access Journals (Sweden)

    Mendes C.

    2003-01-01

    Full Text Available PROTEKT (Prospective Resistant Organism Tracking and Epidemiology for the Ketolide Telithromycin is a global surveillance study established in 1999 to monitor antibacterial resistance of respiratory tract organisms. Thirteen centers from Argentina, Brazil and Mexico participat ed during 1999-2000; they collected 1,806 isolates (Streptococcus pneumoniae 518, Haemophilus influenzae 520, Moraxella catarrhalis 140, Staphylococcus aureus 351, S. pyogenes 277. Overall, 218 (42.1% of the S. pneumoniae isolates had reduced susceptibility to penicillin, 79 (15.3% were penicillin-resistant and 79 (15.3% were erythromycin-resistant. Mexico had the highest prevalence of penicillin (76.5% and erythromycin (31.2% resistance. Of 77 erythromycin-resistant S. pneumoniae tested for resistance genotype, 43 possessed mef(A, 33 possessed erm(B and 1 possessed both erm(B and mef(A mechanism. All S. pneumoniae isolates were fully susceptible to telithromycin, linezolid, teicoplanin and vancomycin. Among H. influenzae isolates, 88 (16.9% produced b-lactamase, ranging from 11% (Brazil to 24.5% (Mexico. Among M. catarrhalis isolates, 138 (98.6% produced b-lactamase. Twenty-four (8.7% of the S. pyogenes isolates were erythromycin-resistant; resistance being attributable to mefA (n=18, ermTR (n=5 and ermB (n=1. All H. influenzae, M. catarrhalis and S. pyogenes were fully susceptible to telithromycin. Methicillin resistance was found in 26.5% of the S. aureus isolates (Argentina 15%; Mexico 20%; Brazil 31.3%. Telithromycin was effective against 97.7% of methicillin-susceptible isolates. PROTEKT confirms that antibacterial resistance is an emerging problem in Latin America. The previously reported high levels of pneumococcal resistance to the b-lactam and macrolides were exceeded. New agents that do not induce resistance or that exert low selective pressure, e.g. telithromycin, are essential to safeguard future antibacterial efficacy.

  12. Significance of Aspergillus spp.isolation from lower respiratory tract samples for the diagnosis and prognosis of invasive pulmonary aspergillosis in chronic obstructive pulmonary disease

    Institute of Scientific and Technical Information of China (English)

    HE Hang-yong; CHANG Shuo; DING Lin; SUN Bing; LI Fang; ZHAN Qing-yuan

    2012-01-01

    Background Chronic obstructive pulmonary diseases (COPD) is an emerging population at risk for invasive infection of Aspergillus.Isolation of Aspergillus from lower respiratory tract (LRT) samples is important for the diagnosis of invasive pulmonary aspergillosis (IPA).The purpose of this study was to investigate the value of Aspergillus isolation from LRT samples for the diagnosis and prognosis of IPA in COPD population.Methods Clinical record with Aspergillus spp.isolation in COPD and immunocompromised patients was reviewed in a retrospective study.Patients were categorized and compared according to their severity of illness (admitted to general ward or ICU) and immunological function (COPD or immunocompromised).Results Multivariate statistical analysis showed that,combined with Aspergillus spp.isolation,APACHE Ⅱ scores >18,high cumulative doses of corticosteroids (>350 mg prednisone or equivalent dose) and more than four kinds of broad-spectrum antibiotics received in hospital may be predictors of IPA in COPD (OR=9.076,P=0.001; OR=4.073,P=-0.026; OR=4.448,P=0.021,respectively).The incidence of IPA,overall mortality,mortality of patients with IPA and mortality of patients with Aspergillus spp.colonization were higher in COPD patients in ICU than in general ward,but were similar between COPD and immunocompromised patients.Conclusions Aspergilltus spp.isolation from LRT in COPD may be of similar importance as in immunocompromised patients,and may indicate an increased diagnosis possibility of IPA and worse prognosis when these patients received corticosteroids,antibiotics,and need to admit to ICU.Aspergillus spp.isolation from LRT samples combined with certain risk factors may be useful in differentiating colonization from IPA and evaluating the prognosis of IPA in COPD patients.

  13. Colonization, safety, and tolerability study of the Streptococcus salivarius 24SMBc nasal spray for its application in upper respiratory tract infections.

    Science.gov (United States)

    Santagati, M; Scillato, M; Muscaridola, N; Metoldo, V; La Mantia, I; Stefani, S

    2015-10-01

    Streptococcus salivarius, a non-pathogenic species and the predominant colonizer of the oral microbiota, finds a wide application in the prevention of upper respiratory tract infections, also reducing the frequency of their main pathogens. In this pilot study, the primary objective was to evaluate the safety and tolerability of a nasal spray, S. salivarius 24SMBc, as a medical device in a clinical study involving 20 healthy adult subjects. The secondary aim was to determine the ability of colonization assessed by molecular fingerprinting. Twenty healthy adult subjects, aged between 30 and 54 years, without a medical history of recurrent otitis media, were enrolled. All patient characteristics fulfilled the inclusion criteria. All subjects were treated daily for 3 days with the nasal spray containing S. salivarius 24SMBc at a concentration of 5 × 10(9) colony-forming units (CFU)/ml. The persistence of S. salivarius in the nasopharynx was investigated by the antagonism test and random amplified polymorphic DNA polymerase chain reaction (RAPD-PCR). The tolerability and safety were clinically assessed by clinical examinations during treatment. Our results demonstrate the capability of S. salivarius 24SMBc to colonize the rhinopharynx tissues in 95% of subjects and persist in 55% of them after 6 days from the last dose of the formulation, maintaining a concentration of 10(5) CFU/ml. The treatment was well tolerated by all healthy patients and no adverse effects were found. The topical application of streptococcal probiotics is a relatively undeveloped field but is becoming an attractive approach for both prevention and therapy, especially for pediatric age patients. S. salivarius 24SMBc possess characteristics making this strain suitable for use in bacteriotherapy. PMID:26205666

  14. Antibiotic use for upper respiratory tract infections in children: A cross-sectional survey of knowledge, attitudes, and practices (KAP of parents in Greece

    Directory of Open Access Journals (Sweden)

    Theodoridou Maria N

    2011-07-01

    Full Text Available Abstract Background Upper respiratory tract infections (URTIs are common in children. The cause of URTIs is usually viral, but parents' attitudes often contribute to inappropriate prescription of antibiotics, promoting antibiotic resistance. The objective of this study was to document and analyse parental beliefs on antibiotic use for children with URTIs in Greece, a country with high levels of antibiotic use and antibiotic resistance. Methods A knowledge-attitude-practice questionnaire was developed and distributed to Greek parents caring for children who were 5-6 years old, between January and July of the same school year. The sample of the study contained parents from all geographic areas of Greece. Results The majority of Greek parents (80% believed that UTRIs are mostly self-limited, although 74% of them expected to receive antibiotics when such a diagnosis was given. Earache was the most common reason for which parents expected antibiotics (45%. Greek parents rarely gave antibiotics to their children without medical advice (10% and most (88% believed that unnecessary antibiotic use drives antibiotic resistance and they were happy to receive symptomatic therapy if instructed by their physician. Almost 70% of parents confused antibiotics with other medicines used for symptomatic therapy for a child with URTI. Conclusion Greek parents have a trusted relationship with their paediatrician and rarely give antibiotics without medical advice, indicating that parents contribute less than expected to antibiotic misuse. Parents also appreciate the benign course of most URTIs and the fact that unnecessary antibiotic use is harmful. More time needs to be invested in educating mostly physicians on the potential benefit from reducing antibiotic prescribing for children with URTI.

  15. Evaluation of a national programme to reduce inappropriate use of antibiotics for upper respiratory tract infections: effects on consumer awareness, beliefs, attitudes and behaviour in Australia.

    Science.gov (United States)

    Wutzke, Sonia E; Artist, Margaret A; Kehoe, Linda A; Fletcher, Miriam; Mackson, Judith M; Weekes, Lynn M

    2007-03-01

    The over-use of antibiotics, in particular, inappropriate use to treat upper respiratory tract infections (URTIs), is a global public health concern. In an attempt to reduce inappropriate use of antibiotics for URTIs, and, in particular, to modify patient misconceptions about the effectiveness of antibiotics for URTIs, Australia's National Prescribing Service Ltd (NPS) has undertaken a comprehensive, multistrategic programme for health professionals and the community. Targeted strategies for the community, via the NPS common colds community campaign, commenced in 2000 and have been repeated annually during the winter months. Community strategies were closely integrated, using the same tagline, key messages and visual images, and were delivered in numerous settings including general practice, community pharmacy, child-care centres and community groups. Strategies included written information via newsletters and brochures, mass media activity using billboards, television, radio and magazines and small grants to promote local community education. The evaluation used multiple methods and data sources to measure process, impact and outcomes. Consistent with intervention messages, the integrated nationwide prescriber and consumer programme is associated with modest but consistent positive changes in consumer awareness, beliefs, attitudes and behaviour to the appropriate use of antibiotics for URTIs. These positive changes among the community are corroborated by a national decline in total antibiotic prescriptions dispensed in the community (from 23.08 million prescriptions in 1998-99 to 21.44 million in 2001-02) and, specifically, by a decline among the nine antibiotics commonly used for URTI such that by 2003 nationally 216,000 fewer prescriptions for URTI are written each year by general practitioners.

  16. Salivary IgA response and upper respiratory tract infection symptoms during a 21-week competitive season in young soccer players.

    Science.gov (United States)

    Moreira, Alexandre; Mortatti, Arnaldo L; Arruda, Ademir F S; Freitas, Camila G; de Arruda, Miguel; Aoki, Marcelo S

    2014-02-01

    Sports training and competition are significant sources of stress, especially for young athletes. It is well known that physiological and psychological stressors induce neuroendocrine responses that could modulate immune system function. However, to date, little is known about the immune responses of young soccer players during a competitive season. Therefore, this study examined the effects of a 21-week competitive season divided into preseason, competitive season, and detraining on salivary immunoglobulin A (SIgA), upper respiratory tract infection (URTI) symptoms, and salivary cortisol in preadolescent male soccer players. Thirty-four young soccer players agreed to participate, and 26 (12.9 ± 0.2 years) completed the entire study. The investigation period was structured as follows: a 12-week preparatory training phase (preseason training), a 7-week competitive and a 2-week detraining phase. Resting saliva samples were taken to determine cortisol and SIgA responses. The players were required to complete a weekly log during the entire investigation reporting every sign or symptoms consistent with URTI. A significant increase in SIgA secretion rate and a decrease in URTI symptoms were observed after the 2-week detraining period (p cortisol during the study. These results indicate that training and competition demands affect the mucosal immune responses of young athletes. In addition, a short-prophylactic period (2-week detraining period) after a competitive period may attenuate mucosal immunosuppression related to URTI symptoms. Sport coaches should monitor markers of mucosal immune function to minimize illness that ultimately might lead to a decrease in performance.

  17. Antibiotic prescribing of village doctors for children under 15 years with upper respiratory tract infections in rural China: A qualitative study.

    Science.gov (United States)

    Zhang, Zhixia; Zhan, Xingxin; Zhou, Hongjun; Sun, Fang; Zhang, Heng; Zwarenstein, Merrick; Liu, Qian; Li, Yingxue; Yan, Weirong

    2016-06-01

    The aim of this study was to explore the knowledge, attitudes, and practices of village doctors regarding the prescribing of antibiotics for children under 15 years with upper respiratory tract infections (URTIs) in rural China. Twelve focus group discussions (FGDs) were conducted in Xianning, a prefecture-level city in rural China, during December 2014. We conducted 6 FGDs with 35 village doctors, 3 with 13 primary caregivers (11 parents), and 3 with 17 directors of township hospitals, county-level health bureaus, county-level Centers for Disease Control and Prevention, or county-level Chinese Food and Drug Administration offices. Audio records of the interviews were transcribed verbatim and analyzed using the thematic analysis approach. Participants believed that unnecessary antibiotic prescribing for children under 15 years with The occurrence of URTIs was a problem in village clinics in rural China. The discussions revealed that most of the village doctors had inadequate knowledge and misconceptions about antibiotic use, which was an important factor in the unnecessary prescribing. Village doctors and directors reported that the doctors' fear of complications, the primary caregivers' pressure for antibiotic treatment, and the financial considerations of patient retention were the main factors influencing the decision to prescribe antibiotics. Most of the primary caregivers insisted on antibiotics, even when the village doctors were reluctant to prescribe them, and they preferred to go to see those village doctors who prescribed antibiotics. The interviewees also gave their opinions on what would be the most effective measures for optimizing antibiotic prescriptions; these included educational/training campaigns, strict regulations on antibiotic prescription, and improved supervision. Findings emphasized the need to improve the dissemination of information and training/education, and implement legislation on the rational use of antibiotics. And it also provided

  18. Antimicrobial susceptibility of Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis isolated from community-acquired respiratory tract infections in China: Results from the CARTIPS Antimicrobial Surveillance Program.

    Science.gov (United States)

    Zhang, Yawei; Zhang, Feifei; Wang, Hui; Zhao, Chunjiang; Wang, Zhanwei; Cao, Bin; Du, Yan; Feng, Xianju; Hu, Yunjian; Hu, Bijie; Ji, Ping; Liu, Zhiyong; Liu, Yong; Liao, Wanzhen; Lu, Juan; Sun, Hongli; Wang, Zhongxin; Xu, Xiuli; Xu, Xuesong; Yang, Qing; Yu, Yunsong; Zhang, Rong; Zhuo, Chao

    2016-06-01

    This study investigated the antimicrobial susceptibilities of Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis isolates causing adult community-acquired respiratory tract infections (CARTIs) in China. A multicentre resistance surveillance study (CARTIPS) investigating 1046 clinical isolates from 19 hospitals in China was conducted from 2013 to 2014. Based on the minimum inhibitory concentration (MIC) breakpoints of oral penicillin, the percentages of penicillin-resistant, penicillin-intermediate and penicillin-susceptible S. pneumoniae were 44.1%, 13.7%, and 42.2%, respectively. The rates of penicillin-non-susceptible S. pneumoniae ranged from 27.9% to 72.2% in different cities, with the highest rate in Nanchang. Macrolides, including azithromycin, clarithromycin and erythromycin, showed the lowest activities against S. pneumoniae isolates, with resistance rates of 90.5%, 92.2% and 93.0%, respectively. However, 98% of these strains were susceptible to levofloxacin and moxifloxacin. For H. influenzae isolates, most of the antimicrobials agents exhibited good activities. However, ampicillin and trimethoprim/sulfamethoxazole showed relatively lower activity against H. influenzae, with resistance rates of 35.0% and 54.4%, respectively. β-lactamase production rates amongst H. influenzae and M. catarrhalis were 31.0% and 87.1%, respectively. In addition, a total of 15 β-lactamase-negative ampicillin-resistant (BLNAR) strains identified in this study were resistant to ampicillin, amoxicillin/clavulanic acid, cefaclor and cefuroxime. Most of the antimicrobial agents showed excellent activity against M. catarrhalis, with susceptibility rates of >90%. The results from the current study confirmed the regional variations in antimicrobial susceptibility of major CARTI pathogens and provided some choices for the treatment of these organisms. Continuous national surveillance of the epidemiology of CARTIs is strongly warranted in China.

  19. Family Practitioners’ Advice about Taking Time Off Work for Lower Respiratory Tract Infections: A Prospective Study in Twelve European Primary Care Networks

    Science.gov (United States)

    Godycki-Cwirko, Maciek; Nocun, Marek; Butler, Christopher C.; Little, Paul; Verheij, Theo; Hood, Kerenza; Fleten, Nils; Kowalczyk, Anna; Melbye, Hasse

    2016-01-01

    Background Acute cough and lower respiratory tract infections (LRTIs) are one of the most important causes of lost working hours. Aim to explore variation and predictors in family practitioners (FPs) advice to patients with LRTIs about taking time off work in different European countries. Methods Prospective observational study in primary care networks in 12 countries, with multilevel mixed-effects binomial logistic regression. Results 324 FPs recruited 1616 employed adults who presented to primary care with LRTIs. The proportion of patients advised to take time off work varied from 7.6% in the Netherlands to 89.2% in Slovakia, and of these, 88.2% overall were advised to stay off work for seven days or less. None of Finnish or Dutch patients were advised to take more than 7 days off, in contrast to 35.5% of Polish and 27.0% of Slovak patients. The strongest predictors of FPs’ advice about time off work were: patient symptoms interfering with normal activities (OR 4.43; P<0.001), fever (2.49; P<0.001), patients feeling generally unwell (2.21; P<0.001), antibiotic prescribing (1.51; P = 0.025) and auscultation abnormality (1.50; P = 0.029). Advice to take time off was not associated with patient reported recovery. Conclusions There is large variation in FPs’ advice given to patients with LRTIs in Europe about taking time off work, which is not explained by differences in patients’ reported illness duration, but might be explained by differences in regulations around certification and sick pay. Evidence based guidance for advising patients about taking time off work for this common condition is needed. PMID:27760225

  20. Diversity and Evolutionary Histories of Human Coronaviruses NL63 and 229E Associated with Acute Upper Respiratory Tract Symptoms in