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Sample records for poisoning respiratory tract

  1. Upper respiratory tract (image)

    Science.gov (United States)

    The major passages and structures of the upper respiratory tract include the nose or nostrils, nasal cavity, mouth, throat (pharynx), and voice box (larynx). The respiratory system is lined with a mucous membrane that ...

  2. Biological fractionation of lead isotopes in Sprague-Dawley rats lead poisoned via the respiratory tract.

    Science.gov (United States)

    Wu, Jing; Liu, Duojian; Xie, Qing; Wang, Jingyu

    2012-01-01

    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. 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). There are significant differences (pblood, 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 (204)Pb/(206)Pb matches the test substance well. As for feces, when (204)Pb/(206)Pb ratio is considered, there is no significant difference between feces-test substance pairs in medium and high dose group. 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 (204)Pb/(206)Pb ratio under high-dose exposure.

  3. Biological fractionation of lead isotopes in Sprague-Dawley rats lead poisoned via the respiratory tract.

    Directory of Open Access Journals (Sweden)

    Jing Wu

    Full Text Available 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.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.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.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.

  4. Biological Fractionation of Lead Isotopes in Sprague-Dawley Rats Lead Poisoned via the Respiratory Tract

    Science.gov (United States)

    Wu, Jing; Liu, Duojian; Xie, Qing; Wang, Jingyu

    2012-01-01

    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 (pisotope 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. PMID:23300678

  5. Respiratory Complications from Acute Corrosive Poisonings in Adults

    Science.gov (United States)

    Chibishev, Andon A.; Simonovska, Natasa; Bozinovska, Cvetanka; Pereska, Zanina; Smokovski, Ivica; Glasnovic, Marija

    2014-01-01

    Introduction: Acute corrosive poisonings are caused by ingestion of corrosive chemicals which are most commonly used as household agents. Intoxications with these kind of agents produce numerous and severe post-corrosive complications of the upper gastrointestinal tract. On the other hand, our experience showed that corrosive agents may also cause injuries of the respiratory system, which makes the treatment very hard and additionally complicates the severe clinical condition of the patient. Objective: The aim of the study is to show the incidence of respiratory complications in acute corrosive poisonings, the need of various clinical investigations and also the treatment and final outcome of these kind of poisoning. Methods: We retrospectively analyzed clinical records of 415 patients hospitalized and treated at the University clinic for toxicology and urgent internal medicine, in Skopje, Republic of Macedonia, in the period between 2007 and 2011. The protocol consisted of methods for analyzing the systemic complications, with an accent on the post-corrosive respiratory complications. Results: From the total number of patients even 98 (23.61%) exhibited systemic complications, from which 51 (52.04%) are respiratory complications. The majority of patients are female (n=40, 78.43%) and the most common complication is pneumonia (n=47). The youngest patient in this study was 14 and the oldest was 87 years old. Conclusion: Besides the gastrointestinal complications in the acute corrosive poisonings respiratory complications are also very often. They complicate the clinical state of patient and very often lead to fatal endings. PMID:24944527

  6. The microbiota of the respiratory tract : Gatekeeper to respiratory health

    NARCIS (Netherlands)

    Man, Wing Ho; De Steenhuijsen Piters, Wouter A.A.; Bogaert, Debby

    2017-01-01

    The respiratory tract is a complex organ system that is responsible for the exchange of oxygen and carbon dioxide. The human respiratory tract spans from the nostrils to the lung alveoli and is inhabited by niche-specific communities of bacteria. The microbiota of the respiratory tract probably acts

  7. [Diagnosis and treatment of respiratory tract burns].

    Science.gov (United States)

    Gerasimova, L I; Loginov, L P; Smol'skii, B G; Pelikh, S T; Skripal', A Iu

    1979-08-01

    The work gives an analysis of clinical signs in 111 patients with burns of the respiratory tract. Two complexes of curative measures are proposed according to anatomical changes found in fibrobronchoscopy. The fibrobronchoscopies are of special importance in the treatment of burns of the tracheobronchial tree.

  8. [Upper respiratory tract infections and sports].

    Science.gov (United States)

    Boffi El Amari, Emmanuelle

    2010-08-11

    Upper respiratory tract infections are frequent in athletes. Mainly of viral origin, they are treated symptomatically. Infectious mononucleosis is associated with an estimated 2% per hundred risk of splenic rupture, which occurs between day four and twenty one of the illness. Therefore return to play guidelines recommend avoiding, exercice during the first twenty one days. Physical exercise seems to influence the immune system, depending on the intensity and length of it. But the relationship between physical exercise and risk of infections remains controversial: some articles showing an increase in risk, whereas others suggesting a certain degree of protection, in athletes. The actual generally accepted working theory is the J-curve proposed by Nieman. This model remains to be formally proven.

  9. Cost Analysis of Medications Used in Upper Respiratory Tract ...

    African Journals Online (AJOL)

    Purpose: To conduct a cost analysis, a narrow cost-utility study, for upper respiratory tract infection medications in University Sans Malaysia's clinics. Methods: Retrospective analysis was done for all medical claims of upper respiratory tract infections in the period 2008 - 2009. The study was done in the clinics under ...

  10. Equal virulence of rhinovirus and respiratory syncytial virus in infants hospitalized for lower respiratory tract infection

    NARCIS (Netherlands)

    van Leeuwen, J.C.; Goossens, L.K.; Hendrix, R.; van der Palen, Jacobus Adrianus Maria; Lusthusz, A.; Thio, B.J.

    2012-01-01

    Respiratory syncytial virus (RSV) and rhinovirus (RV) are predominant viruses associated with lower respiratory tract infection in infants. We compared the symptoms of lower respiratory tract infection caused by RSV and RV in hospitalized infants. RV showed the same symptoms as RSV, so on clinical

  11. Adenovirus Respiratory Tract Infections in Peru

    Science.gov (United States)

    Ampuero, Julia S.; Ocaña, Víctor; Gómez, Jorge; Gamero, María E.; Garcia, Josefina; Halsey, Eric S.; Laguna-Torres, V. Alberto

    2012-01-01

    Background Currently, there is a paucity of data regarding human adenovirus (HAdv) circulation in Andean regions of South America. To address this shortcoming, we report the clinical, phylogenetic, and epidemiologic characteristics of HAdv respiratory tract infection from a large sentinel surveillance study conducted among adults and children in Peru. Methods/Principal Findings Oropharyngeal swabs were collected from participants visiting any of 38 participating health centers, and viral pathogens were identified by immunofluorescence assay in cell culture. In addition, molecular characterization was performed on 226 randomly selected HAdv samples. Between 2000 and 2010, a total of 26,375 participants with influenza-like illness (ILI) or severe acute respiratory infection (SARI) were enrolled in the study. HAdv infection was identified in 2.5% of cases and represented 6.2% of all viral pathogens. Co-infection with a heterologous virus was found in 15.5% of HAdv cases. HAdv infection was largely confined to children under the age of 15, representing 88.6% of HAdv cases identified. No clinical characteristics were found to significantly distinguish HAdv infection from other respiratory viruses. Geographically, HAdv infections were more common in sites from the arid coastal regions than in the jungle or highland regions. Co-circulation of subgroups B and C was observed each year between 2006 and 2010, but no clear seasonal patterns of transmission were detected. Conclusions/Significance HAdv accounted for a significant fraction of those presenting with ILI and SARI in Peru and tended to affect the younger population disproportionately. Longitudinal studies will help better characterize the clinical course of patients with HAdv in Peru, as well as determine the role of co-infections in the evolution of illness. PMID:23056519

  12. Adenovirus respiratory tract infections in Peru.

    Directory of Open Access Journals (Sweden)

    Julia S Ampuero

    Full Text Available BACKGROUND: Currently, there is a paucity of data regarding human adenovirus (HAdv circulation in Andean regions of South America. To address this shortcoming, we report the clinical, phylogenetic, and epidemiologic characteristics of HAdv respiratory tract infection from a large sentinel surveillance study conducted among adults and children in Peru. METHODS/PRINCIPAL FINDINGS: Oropharyngeal swabs were collected from participants visiting any of 38 participating health centers, and viral pathogens were identified by immunofluorescence assay in cell culture. In addition, molecular characterization was performed on 226 randomly selected HAdv samples. Between 2000 and 2010, a total of 26,375 participants with influenza-like illness (ILI or severe acute respiratory infection (SARI were enrolled in the study. HAdv infection was identified in 2.5% of cases and represented 6.2% of all viral pathogens. Co-infection with a heterologous virus was found in 15.5% of HAdv cases. HAdv infection was largely confined to children under the age of 15, representing 88.6% of HAdv cases identified. No clinical characteristics were found to significantly distinguish HAdv infection from other respiratory viruses. Geographically, HAdv infections were more common in sites from the arid coastal regions than in the jungle or highland regions. Co-circulation of subgroups B and C was observed each year between 2006 and 2010, but no clear seasonal patterns of transmission were detected. CONCLUSIONS/SIGNIFICANCE: HAdv accounted for a significant fraction of those presenting with ILI and SARI in Peru and tended to affect the younger population disproportionately. Longitudinal studies will help better characterize the clinical course of patients with HAdv in Peru, as well as determine the role of co-infections in the evolution of illness.

  13. Adenovirus respiratory tract infections in Peru.

    Science.gov (United States)

    Ampuero, Julia S; Ocaña, Víctor; Gómez, Jorge; Gamero, María E; Garcia, Josefina; Halsey, Eric S; Laguna-Torres, V Alberto

    2012-01-01

    Currently, there is a paucity of data regarding human adenovirus (HAdv) circulation in Andean regions of South America. To address this shortcoming, we report the clinical, phylogenetic, and epidemiologic characteristics of HAdv respiratory tract infection from a large sentinel surveillance study conducted among adults and children in Peru. Oropharyngeal swabs were collected from participants visiting any of 38 participating health centers, and viral pathogens were identified by immunofluorescence assay in cell culture. In addition, molecular characterization was performed on 226 randomly selected HAdv samples. Between 2000 and 2010, a total of 26,375 participants with influenza-like illness (ILI) or severe acute respiratory infection (SARI) were enrolled in the study. HAdv infection was identified in 2.5% of cases and represented 6.2% of all viral pathogens. Co-infection with a heterologous virus was found in 15.5% of HAdv cases. HAdv infection was largely confined to children under the age of 15, representing 88.6% of HAdv cases identified. No clinical characteristics were found to significantly distinguish HAdv infection from other respiratory viruses. Geographically, HAdv infections were more common in sites from the arid coastal regions than in the jungle or highland regions. Co-circulation of subgroups B and C was observed each year between 2006 and 2010, but no clear seasonal patterns of transmission were detected. HAdv accounted for a significant fraction of those presenting with ILI and SARI in Peru and tended to affect the younger population disproportionately. Longitudinal studies will help better characterize the clinical course of patients with HAdv in Peru, as well as determine the role of co-infections in the evolution of illness.

  14. Acute Respiratory Failure in Acute Poisoning by Neutrotropic Substances

    Directory of Open Access Journals (Sweden)

    A. N. Lodyagin

    2008-01-01

    Full Text Available Objective: to evaluate the efficiency of methods for diagnosing and treating critically ill patients with acute respiratory failure (ARF in acute poisoning by neurotropic substances. Subjects and methods. Two hundred and thirty-three patients with acute severe intoxication with neurotropic poisons were examined. All the patients were admitted for toxic-hypoxic coma and ARF; in this connection all the patients underwent artificial ventilation (AV. The patients were divided into 3 groups: 1 those in whom the traditional treatments (AV, detoxifying therapy, and infusional and cardiotropic support could restore the basic parameters of vital functions, as judged from the recovered oxygenation index; these patients had no metabolic shifts; 2 those who had signs of pulmonary hyperhydration, low cardiac output and moderate metabolic disorders, as suggested by elevated lactate levels; 3 seriously ill patients in whom the interval between the time of poisoning to care delivery was more than 20 hours; the patients of this group had the most significant metabolic disorders. Results. Correction of ARF in critically ill patients with acute poisoning should include, in addition to the rational parameters of AV and detoxifying therapy, agents for targeted therapy for sequels of hypoxia and energy deficiency states. For maximally rapid and effective oxygen transport recovery, the addition of perfluorane to the complex therapy cardinally improves the results of treatment and reduces mortality rates. Conclusion. The complexity of the pathogenesis of ARF and its sequels is a ground for diagnosing and correcting not only ventilation disturbances, but also pulmonary microcirculatory disorders and metabolic disturbances. Key words: acute intoxication with neu-rotropic poisons, acute respiratory failure, pulmonary hyperhydration, hypoxia, metabolic disturbances.

  15. 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.

  16. The respiratory tract microbial biogeography in alcohol use disorder.

    Science.gov (United States)

    Samuelson, Derrick R; Burnham, Ellen L; Maffei, Vincent J; Vandivier, R William; Blanchard, Eugene E; Shellito, Judd E; Luo, Meng; Taylor, Christopher M; Welsh, David A

    2018-01-01

    Individuals with alcohol use disorders (AUDs) are at an increased risk of pneumonia and acute respiratory distress syndrome. Data of the lung microbiome in the setting of AUDs are lacking. The objective of this study was to determine the microbial biogeography of the upper and lower respiratory tract in individuals with AUDs compared with non-AUD subjects. Gargle, protected bronchial brush, and bronchoalveolar lavage specimens were collected during research bronchoscopies. Bacterial 16S gene sequencing and phylogenetic analysis was performed, and the alterations to the respiratory tract microbiota and changes in microbial biogeography were determined. The microbial structure of the upper and lower respiratory tract was significantly altered in subjects with AUDs compared with controls. Subjects with AUD have greater microbial diversity [ P respiratory tract displayed greater similarity in subjects with AUDs. Alcohol use is associated with an altered composition of the respiratory tract microbiota. Subjects with AUDs demonstrate convergence of the microbial phylogeny and taxonomic communities between distinct biogeographical sites within the respiratory tract. These results support a mechanistic pathway potentially explaining the increased incidence of pneumonia and lung diseases in patients with AUDs.

  17. Pediatric recurrent respiratory tract infections: when and how to ...

    African Journals Online (AJOL)

    Pediatric recurrent respiratory tract infections: when and how to explore the immune system? (About 53 cases). Mohammed El-Azami-El-Idrissi, Mounia Lakhdar-Idrissi, Sanae Chaouki, Samir Atmani, Abdelhak Bouharrou, Moustapha Hida ...

  18. Hypersensitivity Reaction and Acute Respiratory Distress Syndrome in Pyrethroid Poisoning and Role of Steroid Therapy

    Directory of Open Access Journals (Sweden)

    Jisa George

    2015-06-01

    Full Text Available Background: Pyrethroids are generally of low toxicity to humans, but in suicidal poisonings which are usually associated with ingestion of high doses, they lead to severe systemic effects. Case Report: A 30-year old woman presented to emergency department with a history of intentional ingestion of about 15 mL of prallethrin around 3 days earlier. She complained of shortness of breath along with chest pain for the last 2 days. She reported no vomiting or stomach pain prior to presentation to hospital. On chest auscultation, breath sounds were mildly decreased in bilateral infrascapular areas with generalized crepitation. Arterial blood gas analysis revealed respiratory alkalosis. Chest X ray and computed tomography of thorax revealed widespread confluent areas of consolidation with interlobular septal thickening involving bilateral parahilar regions suggestive of acute respiratory distress syndrome (ARDS. The patient did not respond to broad spectrum antibiotic coverage, diuretics and oxygen inhalation. Intravenous methylprednisolone (2 mg/kg/day divided 6 hourly was started and slowly tapered off during the next days. The patient discharged after 3 weeks in good health. Discussion: As pyrethroids can affect sodium channels, the osmotic gradient of alveolar epithelium probably disrupts and therefore, alveolar infiltrations gradually spread over lungs. In addition, there is a possibility of hypersensitivity reactions to pyrethroids, which can cause progressive inflammation and involve respiratory tract in severe cases. Conclusion: Pyrethroid poisoning can lead to ARDS. Steroid therapy may help such patients tide over the pulmonary crisis.

  19. 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...

  20. Quantitation of respiratory viruses in relation to clinical course in children with acute respiratory tract infections

    NARCIS (Netherlands)

    Jansen, Rogier R.; Schinkel, Janke; dek, Irene; Koekkoek, Sylvie M.; Visser, Caroline E.; de Jong, Menno D.; Molenkamp, Richard; Pajkrt, Dasja

    2010-01-01

    Quantitation of respiratory viruses by PCR could potentially aid in clinical interpretation of PCR results. We conducted a study in children admitted with acute respiratory tract infections to study correlations between the clinical course of illness and semiquantitative detection of 14 respiratory

  1. Progressive delayed respiratory complications of sulfur mustard poisoning in 43 Iranian veterans, three decades after exposure.

    Science.gov (United States)

    Darchini-Maragheh, E; Balali-Mood, M; Malaknezhad, M; Mousavi, S R

    2018-02-01

    The most common delayed complication of sulfur mustard (SM) poisoning has been observed in the respiratory tracts. It was thus aimed to investigate the delayed respiratory complications in SM-exposed patients around 25 years before the study. Forty-three veterans with more than 25% disability of due to SM poisoning were investigated. Clinical examinations as well as pulmonary function test (PFT) were performed. High-resolution computed tomography (HRCT) of the lungs was done as clinically indicated. Triad of chronic cough, dyspnea, and expectoration were the most common symptoms that were recorded in 88.2%, 88.2%, and 64.7% of the patients, respectively. PFT abnormalities were detected in 44.18% of the patients. Restrictive pattern was the most common (41.86%), while pure obstructive pattern did not detect at all. Mixed pattern was significantly correlated with higher disability percentages among the veterans ( p < 0.001). Significant reverse correlation between the disability percentages and forced expiratory volume in 1 s/forced vital capacity ratio was obtained ( p = 0.010, r = -0.389). Air trapping was the most common abnormality in HRCTs (50%). Bronchiectasis (25%), pulmonary fibrosis (25%), and ground-glass attenuation (16.66%) were other common HRCT findings. Comparing with the previous studies on these patients, more restrictive and mixed pattern were observed. Moreover, bronchiolitis, bronchiectasis, and lung fibrosis were the main pathological findings in these patients.

  2. Consultation expectations among patients with respiratory tract infection symptoms

    DEFF Research Database (Denmark)

    Bruun Lauridsen, Gitte; Sejr Sørensen, Mette; Hansen, Malene Plejdrup

    2017-01-01

    ­pretation of patients’ expectations are associated with antibiotic overuse. The aim of this study was to explore Danish patients’ expectations when consulting a general prac­titioner with symptoms of acute respiratory tract infection, and to determine predictors for these expectations. Methods: A questionnaire survey......Introduction: Antibiotic resistance is a growing threat to public health, and antibiotic prescribing increases. About 90% of antibiotics are prescribed in general practice, mostly for acute respiratory tract infections. It is well known that patient expectations and general practitioners’ misinter...... was conducted in Danish primary care during 2014. Patients aged ≥ 18 years were asked about their expectations to the consultation when consulting with symptoms of acute respiratory tract infections. Associations between socio-demographic characteristics, self-reported antibiotic prescription and patients...

  3. Consultation expectations among patients with respiratory tract infection symptoms

    DEFF Research Database (Denmark)

    Lauridsen, Gitte Bruun; Sørensen, Mette Sejr; Hansen, Malene Plejdrup

    2017-01-01

    ' misinterpretation of patients' expectations are associated with antibiotic overuse. The aim of this study was to explore Danish patients' expectations when consulting a general practitioner with symptoms of acute respiratory tract infection, and to determine predictors for these expectations. METHODS......INTRODUCTION: Antibiotic resistance is a growing threat to public health, and antibiotic prescribing increases. About 90% of antibiotics are prescribed in general practice, mostly for acute respiratory tract infections. It is well known that patient expectations and general practitioners......: A questionnaire survey was conducted in Danish primary care during 2014. Patients aged ≥ 18 years were asked about their expectations to the consultation when consulting with symptoms of acute respiratory tract infections. Associations between socio-demographic characteristics, self-reported antibiotic...

  4. Respiratory tract retention of inhaled particles in experimental animals

    International Nuclear Information System (INIS)

    Cuddihy, R.G.

    1976-01-01

    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

  5. Diabetes and Risk of Community-Acquired Respiratory Tract Infections, Urinary Tract Infections, and Bacteremia

    DEFF Research Database (Denmark)

    Thomsen, Reimar W.; Mor, Anil

    2013-01-01

    This review provides an update on the risk of several important community-acquired infections seen in patients with diabetes: respiratory tract infections, urinary tract infections, and bacteremia. Respiratory tract infections: Recent epidemiological evidence shows a modest (1.25 to 1.75-fold) risk...... and tuberculosis. Limited data is available for diabetes and influenza, yet both influenza and pneumococcal vaccination is recommended in patients with diabetes. Urinary tract infections: The risk of asymptomatic bacteriuria and cystitis is 1.5 to 2 times increased in diabetes patients, while their risk...... factors for urinary tract infection are the same as in persons without diabetes. Bacteremia: The risk of bacteremia due to pneumococci is approximately 1.5 times increased in diabetes, similar to the increased risk for pneumonia. In comparison, diabetes is associated with 2.5 to 3 times increased risk...

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

    International Nuclear Information System (INIS)

    Kubota, Yoshihisa

    1991-01-01

    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 169 Yb-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 198 Au-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)

  7. Airflow limitation during respiratory syncytial virus lower respiratory tract infection predicts recurrent wheezing

    NARCIS (Netherlands)

    Bont, L.; van Aalderen, W. M.; Versteegh, J.; Brus, F.; Draaisma, J. T.; Pekelharing-Berghuis, M.; van Diemen-Steenvoorde, R. A.; Kimpen, J. L.

    2001-01-01

    Respiratory syncytial virus (RSV) lower respiratory tract infection (LRTI) is frequently followed by recurrent wheezing. Thus far no clinical risk factors have been identified to predict which infants will have wheezing episodes subsequent to RSV LRTI. To determine clinical predictors for airway

  8. 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

  9. Tetratrichomonads from the oral cavity and respiratory tract of humans

    Czech Academy of Sciences Publication Activity Database

    Kutišová, K.; Kulda, J.; Čepička, I.; Flegr, J.; Koudela, Břetislav; Teras, J.; Tachezy, J.

    2005-01-01

    Roč. 131, č. 1 (2005), s. 1-11 ISSN 0031-1820 Grant - others:Grantová agentura Karlovy univerzity v Praze(CZ) 264/1999 Institutional research plan: CEZ:AV0Z60220518 Keywords : Tetratrichomonas spp. * human respiratory tract * oral cavity Subject RIV: EE - Microbiology, Virology Impact factor: 1.703, year: 2005

  10. Cellular and mucosal immune responses in the respiratory tract of ...

    African Journals Online (AJOL)

    olayemitoyin

    Summary: This experiment was conducted to evaluate the cellular and mucosal responses in the respiratory tract of. Nigerian goats vaccinated intranasally with recombinant Mannheimia hemolytica bacterine. Twenty one goats were divided into five groups, five goats each in three vaccinated groups while three goats each ...

  11. Management of upper respiratory tract infections in children | Cotton ...

    African Journals Online (AJOL)

    Upper respiratory tract infection (URTI) occurs commonly in both children and adults and is a major cause of mild morbidity. It has a high cost to society, being responsible for absenteeism from school and work and unnecessary medical care, and is occasionally associated with serious sequelae. URTIs are usually caused ...

  12. Acute otitis media complicating upper respiratory tract infection ...

    African Journals Online (AJOL)

    Background: Upper respiratory tract infections (UTRIs), which may be complicated by acute otitis media (AOM), account for a large number of visits to the primary physician especially in the developed world. Materials and Methods: This study aims to determine the knowledge and treatment outcomes of UTRIs complicated ...

  13. Aetiology of Lower Respiratory Tract Infection in Benin City, Nigeria ...

    African Journals Online (AJOL)

    Patients with respiratory tract infections (RTI), Pneumonia inclusive account for a large proportion of a primary care physicians (PCP) work load and a frequent cause for prescription of antibacterial agents. The study was aimed at analyzing the various isolated organisms obtained from sputum and to test their susceptibility ...

  14. 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.

  15. Activity of Bryophyllum pinnatum S. Kurz extracts on respiratory tract ...

    African Journals Online (AJOL)

    These fractions were subjected to antibacterial testing against respiratory tract pathogenic bacteria. The n-hexane soluble fraction showed activity against the selected microorganism with highest on Staphylococcus aureus (12mm), Klebsiella pneumonia (11mm) and Salmonella typhi (08mm); ethyl acetate soluble fraction ...

  16. Bacterial aetiologic agents associated with upper respiratory tract ...

    African Journals Online (AJOL)

    Objectives: To identify the bacterial agents associated with upper respiratory tract infections in children less than five years old in Jos, Nigeria. Materials and Methods: Throat swabs were collected from a total of 200 children reporting at four (4) hospitals/clinics: Paediatric Units of OLA and Evangel hospitals and Primary ...

  17. Prescription status of Respiratory tract infection – a survey report ...

    African Journals Online (AJOL)

    Objective: The present study was carried out to investigate the Self-medication and non-doctor prescribing of drugs used for respiratory tract infection in developing countries. Problems and factors responsible for this practice in SouthIndia. Methods: The survey was based on the questionnaire method; it was carried out from ...

  18. Significance of Moraxella catarrhalis as a causative organism of lower respiratory tract infections

    Directory of Open Access Journals (Sweden)

    M.O. Ramadan

    2017-07-01

    Conclusion: This study shows that when microbiological and clinical criteria are met, M. catarrhalis when isolated should be considered as a pathogen causing lower respiratory tract infections. M. catarrhalis, lower respiratory tract infections.

  19. Risk factors for lower respiratory tract infections in children

    International Nuclear Information System (INIS)

    Silfeler, I.; Tanidir, I.C.

    2012-01-01

    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)

  20. 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...... 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...

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

    Science.gov (United States)

    Passos, Saulo Duarte; Gazeta, Rosa Estela; Felgueiras, Ana Paula; Beneli, Patrícia Costa; Coelho, Micheline de S Z S

    2014-01-01

    To review if pollution and climate changes can influence respiratory tract infections in children. 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.

  2. 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.

  3. Human respiratory syncytial virus load normalized by cell quantification as predictor of acute respiratory tract infection.

    Science.gov (United States)

    Gómez-Novo, Miriam; Boga, José A; Álvarez-Argüelles, Marta E; Rojo-Alba, Susana; Fernández, Ana; Menéndez, María J; de Oña, María; Melón, Santiago

    2018-01-05

    Human respiratory syncytial virus (HRSV) is a common cause of respiratory infections. The main objective is to analyze the prediction ability of viral load of HRSV normalized by cell number in respiratory symptoms. A prospective, descriptive, and analytical study was performed. From 7307 respiratory samples processed between December 2014 to April 2016, 1019 HRSV-positive samples, were included in this study. Low respiratory tract infection was present in 729 patients (71.54%). Normalized HRSV load was calculated by quantification of HRSV genome and human β-globin gene and expressed as log10 copies/1000 cells. HRSV mean loads were 4.09 ± 2.08 and 4.82 ± 2.09 log10 copies/1000 cells in the 549 pharyngeal and 470 nasopharyngeal samples, respectively (P respiratory tract infection and 4.22 ± 2.28 log10 copies/1000 cells with upper respiratory tract infection or febrile syndrome (P < 0.05). A possible cut off value to predict LRTI evolution was tentatively established. Normalization of viral load by cell number in the samples is essential to ensure an optimal virological molecular diagnosis avoiding that the quality of samples affects the results. A high viral load can be a useful marker to predict disease progression. © 2018 Wiley Periodicals, Inc.

  4. Respiratory viruses in children hospitalized for acute lower respiratory tract infection in Ghana.

    Science.gov (United States)

    Kwofie, Theophilus B; Anane, Yaw A; Nkrumah, Bernard; Annan, Augustina; Nguah, Samuel B; Owusu, Michael

    2012-04-10

    Acute respiratory tract infections are one of the major causes of morbidity and mortality among young children in developing countries. Information on the viral aetiology of acute respiratory infections in developing countries is very limited. The study was done to identify viruses associated with acute lower respiratory tract infection among children less than 5 years. Nasopharyngeal samples and blood cultures were collected from children less than 5 years who have been hospitalized for acute lower respiratory tract infection. Viruses and bacteria were identified using Reverse Transcriptase Real-Time Polymerase Chain Reaction and conventional biochemical techniques. Out of 128 patients recruited, 33(25.88%%, 95%CI: 18.5% to 34.2%) were positive for one or more viruses. Respiratory Syncytial Virus (RSV) was detected in 18(14.1%, 95%CI: 8.5% to 21.3%) patients followed by Adenoviruses (AdV) in 13(10.2%, 95%CI: 5.5% to 16.7%), Parainfluenza (PIV type: 1, 2, 3) in 4(3.1%, 95%CI: 0.9% to 7.8%) and influenza B viruses in 1(0.8%, 95%CI: 0.0 to 4.3). Concomitant viral and bacterial co-infection occurred in two patients. There were no detectable significant differences in the clinical signs, symptoms and severity for the various pathogens isolated. A total of 61.1% (22/36) of positive viruses were detected during the rainy season and Respiratory Syncytial Virus was the most predominant. The study has demonstrated an important burden of respiratory viruses as major causes of childhood acute respiratory infection in a tertiary health institution in Ghana. The data addresses a need for more studies on viral associated respiratory tract infection.

  5. Respiratory viruses in children hospitalized for acute lower respiratory tract infection in Ghana

    Directory of Open Access Journals (Sweden)

    Kwofie Theophilus B

    2012-04-01

    Full Text Available Abstract Background Acute respiratory tract infections are one of the major causes of morbidity and mortality among young children in developing countries. Information on the viral aetiology of acute respiratory infections in developing countries is very limited. The study was done to identify viruses associated with acute lower respiratory tract infection among children less than 5 years. Method Nasopharyngeal samples and blood cultures were collected from children less than 5 years who have been hospitalized for acute lower respiratory tract infection. Viruses and bacteria were identified using Reverse Transcriptase Real-Time Polymerase Chain Reaction and conventional biochemical techniques. Results Out of 128 patients recruited, 33(25.88%%, 95%CI: 18.5% to 34.2% were positive for one or more viruses. Respiratory Syncytial Virus (RSV was detected in 18(14.1%, 95%CI: 8.5% to 21.3% patients followed by Adenoviruses (AdV in 13(10.2%, 95%CI: 5.5% to 16.7%, Parainfluenza (PIV type: 1, 2, 3 in 4(3.1%, 95%CI: 0.9% to 7.8% and influenza B viruses in 1(0.8%, 95%CI: 0.0 to 4.3. Concomitant viral and bacterial co-infection occurred in two patients. There were no detectable significant differences in the clinical signs, symptoms and severity for the various pathogens isolated. A total of 61.1% (22/36 of positive viruses were detected during the rainy season and Respiratory Syncytial Virus was the most predominant. Conclusion The study has demonstrated an important burden of respiratory viruses as major causes of childhood acute respiratory infection in a tertiary health institution in Ghana. The data addresses a need for more studies on viral associated respiratory tract infection.

  6. Composition and immunological significance of the upper respiratory tract microbiota.

    Science.gov (United States)

    Schenck, Louis Patrick; Surette, Michael G; Bowdish, Dawn M E

    2016-11-01

    The intestinal microbiota is essential for nutrient acquisition, immune development, and exclusion of invading pathogens. The upper respiratory tract (URT) microbiota is less well studied and does not appear to abide by many of the paradigms of the gastrointestinal tract. Decades of carriage studies in children have demonstrated that microbe-microbe competition and collusion occurs in the URT. Whether colonization with common pathogens (e.g., Staphylococcus aureus and Streptococcus pneumoniae) alters immune development or susceptibility to respiratory conditions is just beginning to be understood. Herein, we discuss the biogeography of the URT microbiota, the succession and evolution of the microbiota through the life course, and discuss the evidence for microbe-microbe interactions in colonization and infection. © 2016 Federation of European Biochemical Societies.

  7. Metagenomic analysis of viral diversity in respiratory samples from patients with respiratory tract infections in Kuwait.

    Science.gov (United States)

    Madi, Nada; Al-Nakib, Widad; Mustafa, Abu Salim; Habibi, Nazima

    2018-03-01

    A metagenomic approach based on target independent next-generation sequencing has become a known method for the detection of both known and novel viruses in clinical samples. This study aimed to use the metagenomic sequencing approach to characterize the viral diversity in respiratory samples from patients with respiratory tract infections. We have investigated 86 respiratory samples received from various hospitals in Kuwait between 2015 and 2016 for the diagnosis of respiratory tract infections. A metagenomic approach using the next-generation sequencer to characterize viruses was used. According to the metagenomic analysis, an average of 145, 019 reads were identified, and 2% of these reads were of viral origin. Also, metagenomic analysis of the viral sequences revealed many known respiratory viruses, which were detected in 30.2% of the clinical samples. Also, sequences of non-respiratory viruses were detected in 14% of the clinical samples, while sequences of non-human viruses were detected in 55.8% of the clinical samples. The average genome coverage of the viruses was 12% with the highest genome coverage of 99.2% for respiratory syncytial virus, and the lowest was 1% for torque teno midi virus 2. Our results showed 47.7% agreement between multiplex Real-Time PCR and metagenomics sequencing in the detection of respiratory viruses in the clinical samples. Though there are some difficulties in using this method to clinical samples such as specimen quality, these observations are indicative of the promising utility of the metagenomic sequencing approach for the identification of respiratory viruses in patients with respiratory tract infections. © 2017 Wiley Periodicals, Inc.

  8. DNA repair capacity in the rat respiratory tract

    International Nuclear Information System (INIS)

    Bond, J.A.; Gubin, J.M.; Johnson, N.F.

    1988-01-01

    A product of alkylating agents and DNA, O 6 -methylguanine, can mispair with thymine, resulting in initiation of a carcinogenic tissue response. O 6 -alkylguanine-DNA alkyltransferase (AGT) is an acceptor protein responsible for repairing O 6 -methylguanine. The purpose of our experiments was to characterize AGT activity in vitro in tissue and cell extracts of the respiratory tract, a target tissue for inhaled alkylating agents. Removal of [ 3 H]Methyl from O 6 -methylguanine was measured by high-pressure liquid chromatography after incubation of tissue and cell extracts with the [ 3 H]DNA. With the exception of tracheal and bronchial extracts, all tissues and cells analyzed contained AGT activity, which increased in proportion to the amount of protein added to reaction flasks. AGT activity in tracheal and bronchial extracts was only detected at the highest protein concentration used (1.5 mg protein/mL) and ranged from 10-15 fmole/mg protein. AGT activity in the respiratory tract was highest in the lung and a region of the nasal tissue (i.e., ethmoturbinates) and ranged from 45-75 fmole/mg protein. These data suggest that methylated DNA in specific regions of the rat respiratory tract should be readily repaired, albeit to different extents. (author)

  9. The antioxidant system of the respiratory tract. The intracellular antioxidant protection in the respiratory tract (part 6

    Directory of Open Access Journals (Sweden)

    A.E. Abaturov

    2017-03-01

    Full Text Available The literature review presents the current data about peroxiredoxin system in the functioning of the intracellular antioxidant protection in the respiratory tract. We present a model of the molecular structure of certain peroxiredoxins. The peroxiredoxin-dependent oxidation reactions, antiapoptotic action and other physiological effects of peroxiredoxins system are considered in detail. Model of the molecular structure and biological function of the antioxidant factors with an indirect effect (APEX nuclease 1/Ref-1 are described.

  10. Respiratory Syncytial Virus Lower Respiratory Tract Infections in Premature Infants and Infants with Bronchopulmonary Dysplasia

    Directory of Open Access Journals (Sweden)

    D. Yu. Ovsyannikov

    2015-01-01

    Full Text Available The article is devoted to the study of features of lower respiratory tract infection associated with respiratory syncytial virus. 40 cases of RSV-bronchiolitis in preterm children under year with/without bronchopulmonary dysplasia were analyzed. It was established that disease in those groups of patients had severe course because of the respiratory failure, which dominates in clinical pictures as symptoms of bronchial obstruction and apnea. Treatment of severe RSV-infection often demand admission to intensive care unit, supplemental oxygen and/or mechanical ventilation.

  11. Early Fluid Overload Prolongs Mechanical Ventilation in Children With Viral-Lower Respiratory Tract Disease

    NARCIS (Netherlands)

    Ingelse, Sarah A.; Wiegers, Hanke M. G.; Calis, Job C.; van Woensel, Job B.; Bem, Reinout A.

    2017-01-01

    Viral-lower respiratory tract disease is common in young children worldwide and is associated with high morbidity. Acute respiratory failure due to viral-lower respiratory tract disease necessitates PICU admission for mechanical ventilation. In critically ill patients in PICU settings, early fluid

  12. Prevalence of mycoplasmas in the respiratory tracts of pneumonic calves.

    Science.gov (United States)

    ter Laak, E A; Noordergraaf, J H; Dieltjes, R P

    1992-10-01

    The prevalence of mycoplasmas in the respiratory tracts of 148 pneumonic calves originating from 25 herds in the Netherlands is reported. Four types of culture media were used to isolate mycoplasmas: solid modified Edward medium, 2 types of Friis media, and A7B differential agar medium. Mycoplasmas were isolated both from nasal swab specimens and lung lavage fluids collected from live calves and from nasal mucosa and lung tissue specimens collected post mortem. All of the mycoplasma strains isolated could be identified as either Ureaplasma diversum (isolated from 80% of 25 herds), Mycoplasma dispar (92%), M. bovirhinis (88%), M. bovis (20%), M. bovigenitalium (4%), M. arginini (16%), or M. canis (12%). Isolation rates of M. dispar and U. diversum were considerably higher from lung lavage fluids than from nasal swab specimens. M. bovis was detected only in fattening herds and not in dairy herds. The respiratory tracts of 75% of the calves examined contained at least 2 mycoplasma species. In total, 25 different combinations of mycoplasma species were detected in specimens collected from noses and lungs. The pathogenic species U. diversum and M. dispar had not been isolated before in the Netherlands.

  13. [Butamirate citrate in control of cough in respiratory tract inflammation].

    Science.gov (United States)

    Płusa, Tadeusz

    2017-08-21

    Cough is the reflex defense response of the respiratory tract to the present secretions in the throat, trachea and bronchi, and ongoing inflammation in the mucous membranes of the upper and lower respiratory tract. From a practical point of view, cough is dry (unproductive) and productive cough with expulsion of significant amounts of secretion. Drugs used to treat cough differ in both mechanism of action and pharmacokinetic activity. Butamirate citrate belongs to a new class of cough suppressants acting centrally through the receptors in the brainstem. In addition, it has a very beneficial effect, because it reduces the resistance in the airways by inhibiting bronchospasm and anti-inflammatory effect. It is rapidly absorbed after oral administration and its therapeutic plasma concentration is determined after 5-10 minutes of administration, irrespective of the dose. Possible side effects are rarely seen in 0.5-1% of patients, mainly in the form of skin rash, nausea, diarrhea, dizziness, which usually resolves during treatment. The cough effect of most cough suppressants is good, but their mechanisms are different and for that reason they should be individually selected. An important asset of this group of drugs is peripheral activity and effects on bronchodilator muscles, such as in the case of butamirate. Inclusion of this feature is particularly beneficial in chronic inflammatory bronchial diseases.

  14. New treatment options for lower respiratory tract infections.

    Science.gov (United States)

    Kocsis, Bela; Szabo, Dora

    2017-09-01

    Community-acquired pneumonia (CAP) and acute exacerbation of chronic obstructive pulmonary disease (AECOPD) are among the most frequent lower respiratory tract infections (LRTIs). They represent an increased morbidity and mortality rate in adults. Areas covered: This review describes recent advances regarding solithromycin, zabofloxacin and delafoxacin antibacterial agents that have been recently developed for treatment of CAP and in AECOPD. All of them have been introduced into phase III clinical trials. We will be summarising chemical structures, pharmacokinetics, antibacterial efficacy and toxicity of these agents. The manuscript has been prepared based on available scientific publications. Expert opinion: Novel agents of known antimicrobial classes have been developed that demonstrate treatment options in CAP and in AECOPD. Antimicrobials discussed in this review showed bactericide effect against major respiratory tract pathogens. Each has multiple targets in bacteria, thus enabling them for more potency, even against strains exhibiting resistance to commonly used antibiotics. Solithromycin, delafloxacin and zabofloxcian demonstrate broad-spectrum antibacterial activity together with other beneficial features like intracellular accumulation, anti-inflammatory effect and inhibition of biofilm production. These agents showed moderately severe or mild adverse events and demonstrated favourable tissue penetration. These features can make solithromycin, zabofloxacin and delafloxacin treatment options in LRTIs.

  15. Use of Echinacea in upper respiratory tract infection.

    Science.gov (United States)

    Islam, Jamal; Carter, Ramona

    2005-03-01

    The significant burden of upper respiratory tract infection in adults and children, coupled with a lack of specific treatment options, invites the use of alternative therapies. Echinacea is an herb widely used for the prevention or treatment of upper respiratory tract infection. This review article examines the mechanism of action, dose, and types of Echinacea used for these purposes. The principal mode of action of Echinacea is through immunostimulation. Most Echinacea studies were done in Germany, but their results are difficult to interpret because of variability of experimental parameters. Types of Echinacea commonly used are Echinacea purpurea, E pallida, and E angustifolia. Both the plant's upper parts and roots are used. For oral administration, tablets, extracts, fresh pressed juice, teas, and tinctures have been used. Though studies show a beneficial effect, clear conclusions and recommendations of Echinacea use cannot be made due to a lack of standard product, variability in dose, and variability in outcome measures. Therefore, well-designed studies with consistent standardized measures are required.

  16. Grepafloxacin Clinical Program for Lower Respiratory Tract Infections

    Directory of Open Access Journals (Sweden)

    Arne C Rodloff

    1998-01-01

    Full Text Available The present paper evaluates the clinical trial program in lower respiratory tract infections treated with a new fluoroquinolone antibiotic, grepafloxacin. Unlike older quinolones, grepafloxacin has excellent activity against Gram-positive organisms, which include Streptococcus pneumoniae and “atypical” pathogens Legionella species. Mycoplasma pneumoniae and Chlamydia pneumoniae. Grepafloxacin has a long half-life of 12 to 15 h, which allows once daily dosing. Six studies have been conducted regarding community-acquired lower respiratory tract infections (LRTls, four about community-acquired pneumonia (CAP and two about acute bacterial exacerbations of chronic bronchitis (ABECB . In these studies, grepafloxacin demonstrated clinical equivalence with standard therapies. but, in patients with documented infections. grepafloxacin was statistically superior to amoxycillin in both CAP and ABECB. The new fluoroquinolone has a good safety profile, comparable with that of ciprofloxacin. The most common adverse effects of grepafloxacin were nausea and a metallic taste; however, these effects resulted in only a few discontinuations of therapy. With the increasing prevalence of resistance in pathogens isolated from community-acquired LRTIs, grepafloxacin offers a good alternative for monotherapy in these patients.

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

    Science.gov (United States)

    2012-01-01

    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 in the cement industry. Mortality from urinary bladder cancer was used as an indirect indicator of the confounding effect of smoking. Results Mortality from all respiratory cancer was significantly increased in cement production workers (PMR = 1.91; 95% CI 1.54 to 2.33). The proportionate mortality from lung cancer was significantly elevated (PMR = 2.05; 95% CI 1.65 to 2.52). A statistically significant increase in proportionate mortality due to respiratory (PMR = 1.7; 95% CI 1.2 to 2.34). and lung cancer (PMR = 1.67;95% CI = 1.15-2.34) among maintenance workers has been observed. The PMR among the three groups of workers (production, maintenance, office) did differ significantly for lung cancer (p = 0.001), while the PMR for urinary bladder cancer found to be similar among the three groups of cement workers. Conclusion Cement production, and maintenance workers presented increased lung and respiratory cancer proportionate mortality, and this finding probably cannot be explained by the confounding effect of smoking alone. Further research including use of prospective cohort studies is needed in order to establish a causal association between occupational exposure to cement and risk of lung cancer. PMID:22738120

  18. Salbutamol premedication in children with a recent respiratory tract infection.

    Science.gov (United States)

    von Ungern-Sternberg, Britta S; Habre, Walid; Erb, Thomas O; Heaney, Mairead

    2009-11-01

    Premedication with beta-2 agonists (e.g. salbutamol) is effective in preventing increases in total respiratory resistance and in decreasing the incidence of perioperative bronchospasm in asthmatic children. Because children with recent respiratory tract infection (RTI) exhibit bronchial hyperreactivity similar to that observed in asthmatic children, the use of salbutamol in children with RTI has become popular among pediatric anesthetists for the prevention of perioperative respiratory adverse events (PRAE). In a prospective observational study, we therefore assessed the usefulness of salbutamol premedication on the occurrence of PRAE. Results from 600 children (0-16 years) undergoing general anesthesia were analyzed: 200 children with a recent RTI who received preoperative salbutamol 10-30 min prior to surgery, 200 children with a recent RTI without salbutamol premedication, and 200 children without a RTI during the last 4 weeks. All PRAE (laryngospasm, bronchospasm, oxygen desaturation [Children with a recent RTI who received salbutamol demonstrated a significantly reduced incidence of perioperative bronchospasm (5.5% vs 11%, P = 0.0270) and severe coughing (5.5% vs 11.5%, P = 0.0314) compared with children who had an RTI but did not receive salbutamol. However, healthy children presented with the lowest rate (bronchospasm 1.5%, severe coughing 4.5%) of respiratory complications compared with children with a recent RTI independent whether or not they received salbutamol preoperatively. The results from this audit suggest that children with a history of a recent RTI have significantly less PRAE following a premedication with salbutamol compared with no premedication. Therefore, premedication with salbutamol might be considered in children with recent RTI.

  19. 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.

  20. 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.

  1. Allergoses of upper respiratory tract of chemical genesis

    Energy Technology Data Exchange (ETDEWEB)

    Ostapkovich, V.E.; Pankova, V.B.

    The increasing use of chemistry in industry and agriculture and the introduction of new chemicals to technological processes, many of which have a sensitizing effect, have increased the number of people exposed to these agents. Such industrial chemicals as p-phenylenediamine, formaldehyde, as well as its derivatives, salts of heavy metals (chromium, nickel, cobalt), manganese, colophony, lubricants, synthetic vitamins, antibiotics, diisocyanates and others have the strongest allergizing properties. The main route of chemical penetration into the body in industry is by inhalation, which impairs the barrier properties of the mucosa of the upper respiratory tract. A working classification of the clinical, morphological, and functional distinctions of allergosis due to chemical inhalation distinguishes three clinical stages of chemical allergic disease. 12 references, 1 figure.

  2. Respiratory Tract Infection Caused by Fonsecaea monophora After Kidney Transplantation.

    Science.gov (United States)

    Cleinman, Isabella Barbosa; Gonçalves, Sarah Santos; Nucci, Marcio; Quintella, Danielle Carvalho; Halpern, Márcia; Akiti, Tiyomi; Barreiros, Glória; Colombo, Arnaldo Lopes; Santoro-Lopes, Guilherme

    2017-12-01

    Fonsecaea spp. are melanized fungi which cause most cases of chromoblastomycosis. The taxonomy of this genus has been revised, now encompassing four species, with different pathogenic potential: F. pedrosoi, F. nubica, F. pugnacius, and F. monophora. The latter two species present wider clinical spectrum and have been associated with cases of visceral infection, most often affecting the brain. To our knowledge, this is the first report of proven case of F. monophora respiratory tract infection. A Brazilian 57-year-old-female patient underwent kidney transplantation on January 12, 2013. On the fourth postoperative month, the patient presented with fever, productive cough, and pleuritic pain in the right hemithorax. A thoracic CT scan showed a subpleural 2.2-cm nodular lesion in the right lung lower lobe, with other smaller nodules (0.5-0.7 cm) scattered in both lungs. Bronchoscopy revealed a grayish plaque on the right bronchus which was biopsied. Microscopic examination demonstrated invasion of bronchial mucosa by pigmented hyphae. Culture from the bronchial biopsy and bronchoalveolar lavage samples yielded a melanized mold, which was eventually identified as F. monophora. She started treatment with voriconazole (400 mg q.12h on the first day, followed by 200 mg q.12h). After 4 weeks of therapy, voriconazole dose was escalated to 200 mg q.8h and associated with amphotericin B (deoxycolate 1 mg/kg/day) because of a suspected dissemination to the brain. The patient eventually died of sepsis 8 weeks after the start of antifungal therapy. In conclusion, F. monophora may cause respiratory tract infection in solid organ transplant recipients.

  3. Deposition of cigarette smoke particles in the rat respiratory tract

    International Nuclear Information System (INIS)

    Chen, B.T.; Weber, R.E.; Yeh, H.C.; Lundgren, D.L.; Snipes, M.B.; Mauderly, J.L.

    1988-01-01

    Male and female rats were exposed to mainstream cigarette smoke to determine the fractional deposition. Deposition studies were conducted by placing the rats in plethysmography tubes for respiratory minute volume measurements and exposing them to 14 C-dotriacontane-labeled cigarette smoke at mass concentrations of 202 or 624 mg/m 3 for 25 min. Immediately after the exposure, the rats were sacrificed and the 14 C contents in various tissues and organs were analyzed. Results showed that the GI tract contained 16-31% of the total activity, indicating significant clearance from the large airways and nose to the GI tract during the exposure and during the 10-15 min between cessation of the exposure and the removal of the organs. Total deposition of the inhaled activity was 20.1 ± 1.6% for both exposure concentrations. The intrapulmonary deposition fractions (lung lobes plus airways below the lobar bronchi) were 12.4 ± 0.9% and 15.9 ± 1.4% for high and low concentrations, respectively, suggesting a slight enhancement in upper airway deposition for animals exposed to the higher smoke concentration. (author)

  4. [Methaemoglobinaemia and respiratory tract irritation connected with poppers inhalation].

    Science.gov (United States)

    Łukasik-Głebocka, Magdalena; Matuszkiewicz, Eryk

    2010-01-01

    "Poppers" is the street name for volatile nitrites offered by online shops and sex-shops for their aphrodisiac and euphoric properties. Although nitrites have been abused since the late 1960s, recently they became popular in Poland. Recreational poppers using was associated with homosexual men at first. Currently they are commonly reported among heterosexual men and regular dicso participants. Advertisements of these substances tempt potential buyers with the promise of a legal narcotic high. Easy access and the sense of safety make these products the reason of acute toxicity. Volatile nitrites relaxes smooth muscle, the consequent intense peripheral vasodilatation produces flushing, a fall in blood pressure, and reflex increase in heart rate. These effects are accompanied by feeling of warmth, euphoria and intensifying of sexual pleasure. Serious poisoning results in severe methaemoglobinaemia, coma, respiratory and cardiovascular failure, and even death. Skin and mucous contact with poppers can produce a crusty lesion at the site. This article presents the case of 44-years old male hospitalized three times in Toxicology Department after history of poppers abusing. Methaemoglobinaemia (26.4%) and tracheobronchial irritation were the main symptoms observed. Patient was given specific therapy with methylene blue.

  5. An association between Helicobacter pylori and upper respiratory tract disease: Fact or fiction?

    Science.gov (United States)

    Kariya, Shin; Okano, Mitsuhiro; Nishizaki, Kazunori

    2014-01-01

    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. PMID:24587622

  6. Bacterial Topography of the Healthy Human Lower Respiratory Tract

    Directory of Open Access Journals (Sweden)

    Robert P. Dickson

    2017-02-01

    Full Text Available Although culture-independent techniques have refuted lung sterility in health, controversy about contamination during bronchoscope passage through the upper respiratory tract (URT has impeded research progress. We sought to establish whether bronchoscopic sampling accurately reflects the lung microbiome in health and to distinguish between two proposed routes of authentic microbial immigration, (i dispersion along contiguous respiratory mucosa and (ii subclinical microaspiration. During bronchoscopy of eight adult volunteers without lung disease, we performed seven protected specimen brushings (PSB and bilateral bronchoalveolar lavages (BALs per subject. We amplified, sequenced, and analyzed the bacterial 16S rRNA gene V4 regions by using the Illumina MiSeq platform. Rigorous attention was paid to eliminate potential sources of error or contamination, including a randomized processing order and the inclusion and analysis of exhaustive procedural and sequencing control specimens. Indices of mouth-lung immigration (mouth-lung community similarity, bacterial burden, and community richness were all significantly greater in airway and alveolar specimens than in bronchoscope contamination control specimens, indicating minimal evidence of pharyngeal contamination. Ecological indices of mouth-lung immigration peaked at or near the carina, as predicted for a primary immigration route of microaspiration. Bacterial burden, diversity, and mouth-lung similarity were greater in BAL than PSB samples, reflecting differences in the sampled surface areas. (This study has been registered at ClinicalTrials.gov under registration no. NCT02392182.

  7. The use of lasers for treatment of upper respiratory tract disorders.

    Science.gov (United States)

    Palmer, Scott E

    2003-04-01

    Lasers have become important tools for the equine surgeon in the treatment of upper respiratory tract disease in the horse. Multiple wavelengths and delivery systems are available. Indications for the use of lasers in the upper respiratory tract primarily include minimally invasive procedures not possible with conventional surgical instrumentation. New applications for the use of lasers to treat upper respiratory disease are likely to evolve with the development and introduction of new wavelengths and delivery systems.

  8. Hand hygiene to reduce community transmission of influenza and acute respiratory tract infection: a systematic review.

    OpenAIRE

    Warren-Gash, C; Fragaszy, E; Hayward, AC

    2012-01-01

    : Please cite this paper as: Warren-Gash et al. (2012) Hand hygiene to reduce community transmission of influenza and acute respiratory tract infection: a systematic review. Influenza and Other Respiratory Viruses DOI: 10.1111/irv.12015. Hand hygiene may be associated with modest protection against some acute respiratory tract infections, but its specific role in influenza transmission in different settings is unclear. We aimed to review evidence that improving hand hygiene reduces primary an...

  9. PCR Detection of Viral Nucleic Acid in Fatal Asthma: Is the Lower Respiratory Tract a Reservoir for Common Viruses?

    Directory of Open Access Journals (Sweden)

    Vasilija Macek

    1999-01-01

    Full Text Available BACKGROUND: There is indirect evidence implicating viral respiratory tract infections in the pathogenesis of fatal asthma. However, it is unknown whether viruses are present within the lower respiratory tract in fatal asthma.

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

    International Nuclear Information System (INIS)

    Thomas, R.G.; Healy, J.W.

    1985-01-01

    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

  11. 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, Ppneumonia patients and their healthy controls. Clustering resulted in 11 (sub)clusters including 95% (386/405) of samples. We observed three microbiota profiles strongly associated with pneumonia (Ppneumoniae (n=42). In contrast, three other microbiota clusters (in total n=183) were correlated with health (Ppneumonia 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.

  12. Bacterial interference in upper respiratory tract infections: a systematic review.

    Science.gov (United States)

    Benninger, Michael; Brook, Itzhak; Bernstein, Joel M; Casey, Janet R; Roos, Kristian; Marple, Bradley; Farrar, Judith R

    2011-01-01

    Published definitions of bacterial interference (BI) differ, some focusing on changes in the normal flora and others on changes in subsequent infection. A need for consensus was identified at a roundtable discussion of BI in upper respiratory tract infections (URTI). We conducted a systematic review of the available data to justify a consensus definition of BI specific to URTI as "a dynamic, antagonistic interaction between at least 2 organisms that affects the life cycle of each, changes the microenvironment, and alters the organisms' colonization, invasiveness, and ability to affect the health of the host." Continued communication among the faculty postroundtable was used to identify and refine the search criteria to (1) in vitro and in vivo studies assessing bacterial URTI, (2) BI evaluated by response to treatment of URTI with antimicrobial agents, and (3) bacterial function in relation to interactions between normal (nonpathogenic) and pathological flora. The criteria were applied to systematic searches of MEDLINE (1950 onward), EMBASE (1974 onward), and the Cochrane Library (2007). Twenty-nine studies met the inclusion criteria, most focused on children with recurrent infections. Qualitative analysis supports the consensus definition. Interfering organisms affected the life cycle of test pathogens and inhibited their colonization, invasiveness, and health outcomes. Data were insufficient for statistical analysis. Interactions between interfering organisms and potential pathogens isolated from the same host can alter response to infection and treatment. More studies are needed, particularly in adults, to understand the role of interfering organisms, the influence of antibiotics, and the potential for recolonization posttreatment.

  13. Digestive and respiratory tract motor responses associated with eructation.

    Science.gov (United States)

    Lang, Ivan M; Medda, Bidyut K; Shaker, Reza

    2013-06-01

    We studied the digestive and respiratory tract motor responses in 10 chronically instrumented dogs during eructation activated after feeding. Muscles were recorded from the cervical area, thorax, and abdomen. The striated muscles were recorded using EMG and the smooth muscles using strain gauges. We found eructation in three distinct functional phases that were composed of different sets of motor responses: gas escape, barrier elimination, and gas transport. The gas escape phase, activated by gastric distension, consists of relaxation of the lower esophageal sphincter and diaphragmatic hiatus and contraction of the longitudinal muscle of the thoracic esophagus and rectus abdominis. All these motor events promote gas escape from the stomach. The barrier elimination phase, probably activated by rapid gas distension of the thoracic esophagus, consists of relaxation of the pharyngeal constrictors and excitation of dorsal and ventral upper esophageal sphincter distracting muscles, as well as rapid contraction of the diaphragmatic dome fibers. These motor events allow esophagopharyngeal air movement by promoting retrograde airflow and opening of the upper esophageal sphincter. The transport phase, possibly activated secondary to diaphragmatic contraction, consists of a retrograde contraction of the striated muscle esophagus that transports the air from the thoracic esophagus to the pharynx. We hypothesize that the esophageal reverse peristalsis is mediated by elementary reflexes, rather than a coordinated peristaltic response like secondary peristalsis. The phases of eructation can be activated independently of one another or in a different manner to participate in physiological events other than eructation that cause gastroesophageal or esophagogastric reflux.

  14. Characterisation of antibiotic prescriptions for acute respiratory tract infections in Danish general practice

    DEFF Research Database (Denmark)

    Aabenhus, Rune; Hansen, Malene Plejdrup; Saust, Laura Trolle

    2017-01-01

    Inappropriate use of antibiotics is contributing to the increasing rates of antimicrobial resistance. Several Danish guidelines on antibiotic prescribing for acute respiratory tract infections in general practice have been issued to promote rational prescribing of antibiotics, however it is uncle......-line agents like macrolides and amoxicillin with or without clavulanic acid are overused. Strategies to improve the quality of antibiotic prescribing especially for pneumonia, acute otitis media and acute rhinosinusitis are warranted.......Inappropriate use of antibiotics is contributing to the increasing rates of antimicrobial resistance. Several Danish guidelines on antibiotic prescribing for acute respiratory tract infections in general practice have been issued to promote rational prescribing of antibiotics, however it is unclear...... if these recommendations are followed. We aimed to characterise the pattern of antibiotic prescriptions for patients diagnosed with acute respiratory tract infections, by means of electronic prescriptions, labeled with clinical indications, from Danish general practice. Acute respiratory tract infections accounted for 456...

  15. 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.

  16. 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.

    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

  17. Assessment of Mechanical Damage to Odontocete Respiratory Tract Tissues After Controlled Exposure to Blasting

    National Research Council Canada - National Science Library

    Reidenberg, Joy

    2004-01-01

    The odontocete respiratory tract is adapted to withstand the gradual pressure changes associated with diving, yet nothing is known about how it responds to the sudden pressure changes of a blast exposure...

  18. Periodontitis and nosocomial lower respiratory tract infection: preliminary findings.

    Science.gov (United States)

    Gomes-Filho, Isaac Suzart; Santos, Carla M L; Cruz, Simone S; Passos, Johelle de S; Cerqueira, Eneida de M M; Costa, Maria da Conceição N; Santana, Teresinha C; Seymour, Gregory J; Santos, Carlos Antonio de S T; Barreto, Maurício L

    2009-05-01

    To evaluate the possible association between periodontitis and nosocomial lower respiratory tract infection (LRTI). A case-control study was conducted at a General Hospital in Feira de Santana, Bahia, Brazil. The sample consisted of 103 individuals: 22 cases (presence of nosocomial LRTI) and 81 controls (absence of nosocomial LRTI). The diagnosis of periodontitis was based on probing depth, gingival recession, clinical attachment loss and bleeding on probing. The diagnosis of nosocomial LRTI was made in accordance with established medical criteria. Invasive ventilation was much more frequent in cases (95.5%) than in controls (7.4%). An orotracheal tube was used in 81.8% of cases and in 7.4% of controls; bronchoaspiration was suspected in 81.8% of cases and in 6.2% of controls. There was no statistically significant difference in any of the clinical periodontal parameters between cases and controls. The crude odds ratio (OR) value for individuals with periodontitis having LRTI was not statistically significant [OR(crude)=1.70; 95% confidence interval:(0.60-4.87)]. After including age, smoking and duration of hospitalization in the logistic regression, the adjusted OR for individuals with periodontitis having LRTI was statistically significant [OR(adjusted)=3.67 (1.01-13.53); p=0.049]. A marginal association between periodontitis and LRTI was found when smoking, age and length of hospitalization were included as covariates. Patients with LRTI had a high frequency of suspected bronchoaspiration and this could explain the possible association of periodontal disease and LRTI found in this and other studies. Additional studies are needed to further clarify the possible relationship between periodontal disease and LRTI.

  19. Respiratory Tract Infections and Voice Quality in 4-Year-old Children in the STEPS Study.

    Science.gov (United States)

    Kallvik, Emma; Toivonen, Laura; Peltola, Ville; Kaljonen, Anne; Simberg, Susanna

    2018-03-02

    Health-related factors are part of the multifactorial background of dysphonia in children. Respiratory tract infections affect the same systems and structures that are used for voice production. The purpose of this study was to investigate if the number of respiratory tract infections or the viral etiology were significant predictors for a more hoarse voice quality. The participants were 4-year-old children who participated in the multidisciplinary STEPS study (Steps to the Healthy Development and Well-being of Children) where they were followed up from pregnancy or birth to 4 years of age. Data were collected through questionnaires and a health diary filled in by the parents. Some of the children were followed up more intensively for respiratory tract infections during the first 2 years of life, and nasal swab samples were taken at the onset of respiratory symptoms. Our participants were 489 of these children who had participated in the follow-up for at least 1 year and for whom data on respiratory tract infections and data on voice quality were available. The number of hospitalizations due to respiratory tract infections was a significant predictor for a more hoarse voice quality. Neither the number of rhinovirus infections nor the number of respiratory syncytial virus infections was statistically significant predictors for a more hoarse voice quality. Based on our results, we would suggest including questions on the presence of respiratory tract infections that have led to hospitalization in the pediatric voice anamnesis. Whether the viral etiology of respiratory tract infections is of importance or not requires further research. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  20. Exploratory mixed methods study of respiratory physiotherapy for patients with lower respiratory tract infections.

    Science.gov (United States)

    Oliveira, A; Marques, A

    2016-03-01

    To assess the outcomes of respiratory physiotherapy for patients with lower respiratory tract infections (LRTI). Parallel group mixed-methods study. Patients were recruited from a general hospital. Respiratory physiotherapy took place in a community setting. Fifty-four patients aged ≥18 years and diagnosed with LRTI completed the study. Twenty-seven patients were allocated to the control group {CG: 10 male, mean age 53.3 [standard deviation (SD) 17.4] years} and 27 patients were allocated to the experimental group [EG: 10 male, mean age 58.6 (SD 17.2) years]. The CG received conventional medical treatment and the EG received conventional medical treatment plus respiratory physiotherapy for 3 weeks. Patients in both groups undertook the 6-minute walk test (6MWT), modified Borg scale (MBS), modified Medical Research Council questionnaire (mMRC), and Breathlessness, Cough and Sputum scale (BCSS) before and after the intervention. A telephone follow-up survey was performed 3 months after the first hospital visit. Interviews were conducted immediately after the intervention in the EG. In the EG, the distance walked in the 6MWT increased by more than the minimally important difference (P=0.001), and significantly more than the CG {EG: mean change 76m [standard deviation (SD) 63], 95% confidence interval (CI) 51 to 101; CG: mean change 27m (SD 56), 95% CI 5 to 49; mean difference between groups: 49m 95% CI 16 to 82; partial η(2)=0.15}. No differences in the MBS, mMRC and BCSS were found between the two groups. The EG reported high levels of satisfaction with the intervention (27/27; 100%) and with the physiotherapist (20/27; 74%). The intervention improved patients' symptoms (19/27; 70%) and their self-management skills to control/prevent future LRTI (19/27; 70%). Health service use was significantly less in the EG (P=0.04). Respiratory physiotherapy appears to be effective for the management of patients with LRTI. CLINICALTRIAL. NCT02053870. Copyright © 2015

  1. Association between HIV and proven viral lower respiratory tract ...

    African Journals Online (AJOL)

    p=0.595). Respiratory syncytial virus was the most prevalent virus identified overall, with adenovirus being most prevalent in the HIV-positive group. Conclusion. The results showed that patients with viral LRTIs who required respiratory support ...

  2. Dual infections of PRRSV / influenza or PRRSV / Actinobacillus pleuropneumoniae in the respiratory tract

    NARCIS (Netherlands)

    Pol, J.M.A.; Leengoed, van L.A.M.G.; Stockhofe, N.; Kok, G.; Wensvoort, G.

    1997-01-01

    To study the effect of a previous porcine respiratory and reproductive syndrome-infection (PRRS) of the respiratory tract on influenza virus and Actinobacillus pleuropneumoniae (App) infections, 3-week-old specific-pathogen-free (spf) piglets were intranasally infected with PRRS virus. One week

  3. Intensive care unit patients with lower respiratory tract nosocomial infections: the ENIRRIs project

    NARCIS (Netherlands)

    de Pascale, Gennaro; Ranzani, Otavio T.; Nseir, Saad; Chastre, Jean; Welte, Tobias; Antonelli, Massimo; Navalesi, Paolo; Garofalo, Eugenio; Bruni, Andrea; Coelho, Luis Miguel; Skoczynski, Szymon; Longhini, Federico; Taccone, Fabio Silvio; Grimaldi, David; Salzer, Helmut J. F.; Lange, Christoph; Froes, Filipe; Artigas, Antoni; Díaz, Emili; Vallés, Jordi; Rodríguez, Alejandro; Panigada, Mauro; Comellini, Vittoria; Fasano, Luca; Soave, Paolo M.; Spinazzola, Giorgia; Luyt, Charles-Edouard; Alvarez-Lerma, Francisco; Marin, Judith; Masclans, Joan Ramon; Chiumello, Davide; Pezzi, Angelo; Schultz, Marcus; Mohamed, Hafiz; van der Eerden, Menno; Hoek, Roger A. S.; Gommers, D. A. M. P. J.; Di Pasquale, Marta; Civljak, Rok; Kutleša, Marko; Bassetti, Matteo; Dimopoulos, George; Nava, Stefano; Rios, Fernando; Zampieri, Fernando G.; Povoa, Pedro; Bos, Lieuwe D.; Aliberti, Stefano; Torres, Antoni; Martín-Loeches, Ignacio

    2017-01-01

    The clinical course of intensive care unit (ICU) patients may be complicated by a large spectrum of lower respiratory tract infections (LRTI), defined by specific epidemiological, clinical and microbiological aspects. A European network for ICU-related respiratory infections (ENIRRIs), supported by

  4. Intensive care unit patients with lower respiratory tract nosocomial infections: The ENIRRIs project

    NARCIS (Netherlands)

    de Pascale, G. (Gennaro); Ranzani, O.T. (Otavio T.); Nseir, S. (Saad); Chastre, J. (Jean); Welte, T. (Tobias); Antonelli, M. (Massimo); P. Navalesi; Garofalo, E. (Eugenio); Bruni, A. (Andrea); Coelho, L.M. (Luis Miguel); S. Skoczyński (Szymon); Longhini, F. (Federico); F.S. Taccone (Fabio); Grimaldi, D. (David); Salzer, H.J.F. (Helmut J. F.); Lange, C. (Christoph); Froes, F. (Filipe); A. Artigas (Antonio); Díaz, E. (Emili); Vallés, J. (Jordi); A.H. Rodriguez; Panigada, M. (Mauro); Comellini, V. (Vittoria); Fasano, L. (Luca); Soave, P.M. (Paolo M.); Spinazzola, G. (Giorgia); Luyt, C.-E. (Charles-Edouard); Alvarez-Lerma, F. (Francisco); Marin, J. (Judith); Masclans, J.R. (Joan Ramon); Chiumello, D. (Davide); A. Pezzi (Angelo); M.J. Schultz (Marcus); Mohamed, H. (Hafiz); M. van der Eerden (Menno); Hoek, R.A.S. (Roger A. S.); D.A.M.P.J. Gommers (Diederik); di Pasquale, M. (Marta); Civljak, R. (Rok); Kutleša, M. (Marko); M. Bassetti (Matteo); Dimopoulos, G. (George); Nava, S. (Stefano); Rios, F. (Fernando); Zampieri, F.G. (Fernando G.); Povoa, P. (Pedro); Bos, L.D. (Lieuwe D.); S. Aliberti (Stefano); A. Torres; I. Martin-Loeches

    2017-01-01

    textabstractThe clinical course of intensive care unit (ICU) patients may be complicated by a large spectrum of lower respiratory tract infections (LRTI), defined by specific epidemiological, clinical and microbiological aspects. A European network for ICU-related respiratory infections (ENIRRIs),

  5. POTENTIALS OF SYMPTOMATIC TREATMENT OF ACUTE RESPIRATORY TRACT INFECTIONS IN CHILDREN

    Directory of Open Access Journals (Sweden)

    L. R. Selimzyanova

    2013-01-01

    Full Text Available Acute infection of upper respiratory tract is one of the most topical medical and social problems: it is respiratory diseases that cause the majority of children’s and adults’ non-attendance of school lessons and working days. Childhood respiratory infections are characterized by prolonged clinical course. The most common causes of upper respiratory tract infections are viruses, such as rhinovirus, respiratory syncytial virus, influenza and parainfluenza viruses, adeno-, corona- and metapneumoviruses as well as Coxsackie virus and ECHO virus. Antiviral agents are efficient only when administered during first 24–48 hours from the onset of disease, and a number of such drugs have only specific activity, therefore the limitation of possibilities of etiotropic therapy of acute respiratory infections can be established. This often leads to excessive inappropriate usage of antibacterial drugs. Such symptoms as nasal stuffiness and cough which accompany acute respiratory tract infections, can significantly affect patients’ and his family’s quality of life. Symptomatic therapy is traditionally used in order to relieve these symptoms. The article contains data on potentials of one of such symptomatic drugs in treatment of upper respiratory tract infections.

  6. Hand hygiene to reduce community transmission of influenza and acute respiratory tract infection: a systematic review

    Science.gov (United States)

    Warren‐Gash, Charlotte; Fragaszy, Ellen; Hayward, Andrew C.

    2012-01-01

    Please cite this paper as: Warren‐Gash et al. (2012) Hand hygiene to reduce community transmission of influenza and acute respiratory tract infection: a systematic review. Influenza and Other Respiratory Viruses DOI: 10.1111/irv.12015. Hand hygiene may be associated with modest protection against some acute respiratory tract infections, but its specific role in influenza transmission in different settings is unclear. We aimed to review evidence that improving hand hygiene reduces primary and secondary transmission of (i) influenza and (ii) acute respiratory tract infections in community settings. We searched Medline, Embase, Global Health and Cochrane databases up to 13 February 2012 for reports in any language of original research investigating the effect of hand hygiene on influenza or acute respiratory tract infection where aetiology was unspecified in community settings including institutions such as schools, and domestic residences. Data were presented and quality rated across outcomes according to the Grading of Recommendations Assessment, Development and Evaluation system. Sixteen articles met inclusion criteria. There was moderate to low‐quality evidence of a reduction in both influenza and respiratory tract infection with hand hygiene interventions in schools, greatest in a lower–middle‐income setting. There was high‐quality evidence of a small reduction in respiratory infection in childcare settings. There was high‐quality evidence for a large reduction in respiratory infection with a hand hygiene intervention in squatter settlements in a low‐income setting. There was moderate‐ to high‐quality evidence of no effect on secondary transmission of influenza in households that had already experienced an index case. While hand hygiene interventions have potential to reduce transmission of influenza and acute respiratory tract infections, their effectiveness varies depending on setting, context and compliance. PMID:23043518

  7. [Improvement of health care for patients with upper respiratory tract diseases associated with chlamydia infection].

    Science.gov (United States)

    Kapustina, T A; Markina, A N; Parilova, O V

    2012-01-01

    At present the issues in regard to Chlamydia infection are not only limited by urogenital system. By the way optimal organization and non-urogenital chlamydiosis treatment strategy (with respiratory tract involvement in particular) have not been worked out yet and require immediate solutions. Due to new knowledge on respiratory chlamidiosis the authors discuss scientific background for future development of complex measures and main directions of health care support strategy for patients with upper respiratory associated with Chlamydia infection.

  8. Cryptosporidial Infection of Lower Respiratory Tract in a Budgerigar (Melopsittacus undulates

    Directory of Open Access Journals (Sweden)

    Gharagozlou, M.J.,

    2014-05-01

    Full Text Available Cryptosporial and bacterial co-infection is reported in a budgerigar with clinical manifestations of septicemia and respiratory tract infection. Microscopically large number of round to oval 2-5μm cryptosporidial organisms were found to be lodged on the parabronchial epithelial cells of the respiratory tract. The bacterial colonies were seen around the parabronchial spaces of the lung tissue. It is suggested that the C. baileyi is the most likely cryptosporidium species which caused respiratory cryptosporidiosis in the budgerigar.

  9. Probiotics for preventing acute upper respiratory tract infections.

    Science.gov (United States)

    Hao, Qiukui; Dong, Bi Rong; Wu, Taixiang

    2015-02-03

    Probiotics may improve a person's health by regulating their immune function. Some trials have shown that probiotic strains can prevent respiratory infections. Even though the previous version of our review showed benefits of probiotics for acute upper respiratory tract infections (URTIs), several new studies have been published. To assess the effectiveness and safety of probiotics (any specified strain or dose), compared with placebo, in the prevention of acute URTIs in people of all ages, at risk of acute URTIs. We searched CENTRAL (2014, Issue 6), MEDLINE (1950 to July week 3, 2014), EMBASE (1974 to July 2014), Web of Science (1900 to July 2014), the Chinese Biomedical Literature Database, which includes the China Biological Medicine Database (from 1978 to July 2014), the Chinese Medicine Popular Science Literature Database (from 2000 to July 2014) and the Masters Degree Dissertation of Beijing Union Medical College Database (from 1981 to July 2014). We also searched the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov for completed and ongoing trials on 31 July 2014. Randomised controlled trials (RCTs) comparing probiotics with placebo to prevent acute URTIs. Two review authors independently assessed the eligibility and quality of trials, and extracted data using the standard methodological procedures expected by The Cochrane Collaboration. We included 13 RCTs, although we could only extract data to meta-analyse 12 trials, which involved 3720 participants including children, adults (aged around 40 years) and older people. We found that probiotics were better than placebo when measuring the number of participants experiencing episodes of acute URTI (at least one episode: odds ratio (OR) 0.53; 95% confidence interval (CI) 0.37 to 0.76, P value school absence (OR 0.10; 95% CI 0.02 to 0.47, very low quality evidence). Probiotics and placebo were similar when measuring the rate ratio of episodes of acute

  10. 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

    2016-06-01

    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. 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. 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. 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 effects of vitamin D on infections, pulmonary

  11. Distribution of respiratory viruses which cause lower respiratory tract infection in pediatric age group

    Directory of Open Access Journals (Sweden)

    Selim Dereci

    2015-07-01

    Full Text Available Objective: To determine the appropriate treatment regimen and the clinical course of the lower respiratory tract infections( RTI s and to detect the common viral causes of lower RTI s. Methods: The present study included a total of 255 pediatric patients aged less than 7 years old and admitted to the Department of Pediatrics of Rize Training and Research Hospital between January 2014 and January 2015 with clinical pre-diagnosis of lower RTI . Nasopharyngeal swab specimens collected from these patients were tested for viral pathogens by using multiplex RT- PCR kit the ResPlex II plus Panel PRE (Qiagen, Germany. Results: A total of 212 out of 255 (83.1% specimens revealed positive for one or more viral pathogens. The most common detected pathogens were respiratory syncytial virus ( RSV A/B in 110 samples (43.1%, rhinovirus in 51 samples (20.0%, adenovirus in 36 samples (14.1%, influenzae virus A in 32 samples (12.5%, and coronavirus in 24 samples (9.4%. In 76 samples (29.8%, more than one viral pathogen were detected. RSV was seen in more than 50% patients in the first 2 years. RSV was the most common pathogen in each year of the first 5 years but rhinovirus, influenza A and adenovirus were seen more than RSV after the fifth year. A total of 95.8% of the viral detections were seen between November and April without a significant peak amongst these months. The distribution of the pathogens by months of the year showed no significance. Conclusions: These findings can contribute to epidemiological data of Turkey. Detection of the viral pathogens causing lower RTIs can be critical in management of the disease, decrease inappropriate antibiotic treatment, and lower the morbidity and mortality rates in such diseases.

  12. Association between HIV and proven viral lower respiratory tract ...

    African Journals Online (AJOL)

    person by direct contact with contaminated secretions or aerosolised droplets. Viruses that have been identified as causing respiratory illness include respiratory ... samples and identification of the virus by immunofluorescence assays. (IFA).[5] However, cultures require a long incubation time and special incubation media ...

  13. Congenital respiratory tract disorders in 22q11.2 deletion syndrome.

    Science.gov (United States)

    Verheij, Emmy; Speleman, Lucienne; Mink van der Molen, Aebele B; Thomeer, Henricus G X M

    2018-01-01

    Respiratory tract disorders have been reported in patients with 22q11.2 deletion syndrome, however infrequently. This study describes the respiratory tract disorders encountered in a cohort of 278 patients with 22q11.2 deletion syndrome. We conducted a retrospective, cross-sectional, study at a single tertiary referral center. We identified the patients with 22q11.2 deletion syndrome and with an upper and/or lower respiratory tract disorder at our otorhinolaryngologic department. The different disorders were described. Out of 278 patients referred to the otorhinolaryngologic department, we identified 14 patients with a laryngeal and/or tracheal disorder. Nine patients had more than one congenital disorder in this anatomical area. Disorders included a choanal stenosis (n = 1), laryngeal web (n = 5), laryngeal cleft (n = 2), subglottic stenosis (n = 3), pharyngo-, laryngo-, tracheo- and/or bronchomalacia (n = 11) and tracheal stenosis (n = 1). Different types of respiratory tract disorders can be present in patients with 22q11.2 deletion syndrome. Clinicians should be aware of this clinical association for timely and accurate diagnosis and treatment. In addition, the diagnosis 22q11.2 deletion syndrome should be considered in patients presenting with a congenital respiratory tract disorder. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Coronavirus Infections in the Central Nervous System and Respiratory Tract Show Distinct Features in Hospitalized Children.

    Science.gov (United States)

    Li, Yuanyuan; Li, Haipeng; Fan, Ruyan; Wen, Bo; Zhang, Jian; Cao, Xiaoying; Wang, Chengwu; Song, Zhanyi; Li, Shuochi; Li, Xiaojie; Lv, Xinjun; Qu, Xiaowang; Huang, Renbin; Liu, Wenpei

    2016-01-01

    Coronavirus (CoV) infections induce respiratory tract illnesses and central nervous system (CNS) diseases. We aimed to explore the cytokine expression profiles in hospitalized children with CoV-CNS and CoV-respiratory tract infections. A total of 183 and 236 hospitalized children with acute encephalitis-like syndrome and respiratory tract infection, respectively, were screened for anti-CoV IgM antibodies. The expression profiles of multiple cytokines were determined in CoV-positive patients. Anti-CoV IgM antibodies were detected in 22/183 (12.02%) and 26/236 (11.02%) patients with acute encephalitis-like syndrome and respiratory tract infection, respectively. Cytokine analysis revealed that the level of serum granulocyte colony-stimulating factor (G-CSF) was significantly higher in both CoV-CNS and CoV-respiratory tract infection compared with healthy controls. Additionally, the serum level of granulocyte macrophage colony-stimulating factor (GM-CSF) was significantly higher in CoV-CNS infection than in CoV-respiratory tract infection. In patients with CoV-CNS infection, the levels of IL-6, IL-8, MCP-1, and GM-CSF were significantly higher in their cerebrospinal fluid samples than in matched serum samples. To the best of our knowledge, this is the first report showing a high incidence of CoV infection in hospitalized children, especially with CNS illness. The characteristic cytokine expression profiles in CoV infection indicate the importance of host immune response in disease progression. © 2017 S. Karger AG, Basel.

  15. Early Fluid Overload Prolongs Mechanical Ventilation in Children With Viral-Lower Respiratory Tract Disease.

    Science.gov (United States)

    Ingelse, Sarah A; Wiegers, Hanke M G; Calis, Job C; van Woensel, Job B; Bem, Reinout A

    2017-03-01

    Viral-lower respiratory tract disease is common in young children worldwide and is associated with high morbidity. Acute respiratory failure due to viral-lower respiratory tract disease necessitates PICU admission for mechanical ventilation. In critically ill patients in PICU settings, early fluid overload is common and associated with adverse outcomes such as prolonged mechanical ventilation and increased mortality. It is unclear, however, if this also applies to young children with viral-lower respiratory tract disease induced acute respiratory failure. In this study, we aimed to investigate the relation of early fluid overload with adverse outcomes in mechanically ventilated children with viral-lower respiratory tract disease in a retrospective dataset. Retrospective cohort study. Single, tertiary referral PICU. One hundred thirty-five children (mechanical ventilation admitted to the PICU of the Academic Medical Center, Amsterdam between 2008 and 2014. None. The cumulative fluid balance on day 3 of mechanical ventilation was compared against duration of mechanical ventilation (primary outcome) and daily mean oxygen saturation index (secondary outcome), using uni- and multivariable linear regression. In 132 children, the mean cumulative fluid balance on day 3 was + 97.9 (49.2) mL/kg. Higher cumulative fluid balance on day 3 was associated with a longer duration of mechanical ventilation in multivariable linear regression (β = 0.166; p = 0.048). No association was found between the fluid status and oxygen saturation index during the period of mechanical ventilation. Early fluid overload is an independent predictor of prolonged mechanical ventilation in young children with viral-lower respiratory tract disease. This study suggests that avoiding early fluid overload is a potential target to reduce duration of mechanical ventilation in these children. Prospective testing in a clinical trial is warranted to support this hypothesis.

  16. [Comparison of antimicrobial resistance pattern of selected respiratory tract pathogens isolated from different animal species].

    Science.gov (United States)

    Wettstein, K; Frey, J

    2004-09-01

    The antibiotic resistance pattern of respiratory tract pathogens isolated of different animal species suffering from respiratory tract diseases has been investigated by antibiograms performed by agar diffusion test. The results show that the resistance situation in Switzerland is favourable compared with studies from other countries. However, high resistance rates were found in certain species: 61% of Streptococcus spp. were resistant to erythromycin and 44% to tetracycline, 59% of Bordetella bronchiseptica were resistant to ampicillin and 50% of Mannheimia (Pasteurella) haemolytica were multiresistant to tetracycline, ampicillin and streptomycine. The gram negative isolates were widely resistant to streptomycine.

  17. [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.

  18. Antimicrobial use Guidelines for Treatment of Respiratory Tract Disease in Dogs and Cats

    DEFF Research Database (Denmark)

    Lappin, M. R.; Blondeau, J.; Boothe, D.

    2017-01-01

    Respiratory tract disease can be associated with primary or secondary bacterial infections in dogs and cats and is a common reason for use and potential misuse, improper use, and overuse of antimicrobials. There is a lack of comprehensive treatment guidelines such as those that are available...... veterinarians in making antimicrobial treatment choices for use in the management of bacterial respiratory diseases in dogs and cats....

  19. Respiratory tract dose calculation considering physiological parameters from samples of Brazilian population

    International Nuclear Information System (INIS)

    Reis, A.; Lopes, R.; Lourenco, M.; Cardoso, J.

    2006-01-01

    The Human Respiratory Tract Model proposed by the ICRP Publication 66 accounts for the morphology and physiology of the respiratory tract. The ICRP 66 presents deposition fraction in the respiratory tract regions considering reference values from Caucasian man. However, in order to obtain a more accurate assessment of intake and dose the ICRP recommends the use of specific information when they are available. The application of parameters from Brazilian population in the deposition and in the clearance model shows significant variations in the deposition fractions and in the fraction of inhaled activity transferred to blood. The main objective of this study is to evaluate the influence in dose calculation to each region of the respiratory tract when physiological parameters from Brazilian population are applied in the model. The purpose of the dosimetric model is to evaluate dose to each tissues of respiratory tract that are potentially risk from inhaled radioactive materials. The committed equivalent dose, H.T., is calculated by the product of the total number of transformations of the radionuclide in tissue source S over a period of fifty years after incorporation and of the energy absorbed per unit mass in the target tissue T, for each radiation emitted per transformation in tissue source S. The dosimetric model of Human Respirator y Tract was implemented in the software Excel for Windows (version 2000) and H.T. was determined in two stages. First it was calculated the number of total transformations, US, considering the fractional deposition of activity in each source tissue and then it was calculated the total energy absorbed per unit mass S.E.E., in the target tissue. It was assumed that the radionuclide emits an alpha particle with average energy of 5.15 MeV. The variation in the fractional deposition in the compartments of the respiratory tract in changing the physiological parameters from Caucasian to Brazilian adult man causes variation in the number of

  20. 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

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

    Directory of Open Access Journals (Sweden)

    Judith M A van den Brand

    Full Text Available 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

  2. Response of the ruminant respiratory tract to Mannheimia (Pasteurella) haemolytica.

    Science.gov (United States)

    Ackermann, M R; Brogden, K A

    2000-07-01

    Pneumonia is a leading cause of loss to the sheep and cattle industry throughout the world. Mannheimia (Pasteurella) haemolytica is one of the most important respiratory pathogens of domestic ruminants and causes serious outbreaks of acute pneumonia in neonatal, weaned and growing lambs, calves, and goats. M. haemolytica is also an important cause of pneumonia in adult animals. Transportation, viral infections with agents such as infectious bovine rhinotracheitis virus, parainfluenza-3 virus or bovine respiratory syncytial virus, overcrowding, housing of neonates and weaned animals together and other stressful conditions predispose animals to M. haemolytica infection [1, 2]. This review assimilates some of the findings key to cellular and molecular responses of the lung from a pathologist's perspective. It includes some of what is known and underscores areas that are not fully understood.

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

    DEFF Research Database (Denmark)

    Cordoba, Gloria; Caballero, Lidia; Sandholdt, Håkon

    2017-01-01

    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...... uncertainty and country variation requires greater support from the healthcare systems by providing GPs with evidence-based guidelines and tools to apply them....

  4. Predicting nosocomial lower respiratory tract infections by a risk index based system

    NARCIS (Netherlands)

    Chen, Yong; Shan, Xue; Zhao, Jingya; Han, Xuelin; Tian, Shuguang; Chen, Fangyan; Su, Xueting; Sun, Yansong; Huang, Liuyu; Grundmann, Hajo; Wang, Hongyuan; Han, Li

    2017-01-01

    Although belonging to one of the most common type of nosocomial infection, there was currently no simple prediction model for lower respiratory tract infections (LRTIs). This study aims to develop a risk index based system for predicting nosocomial LRTIs based on data from a large point-prevalence

  5. In Vitro Activities of Florfenicol against Bovine and Porcine Respiratory Tract Pathogens

    OpenAIRE

    Priebe, Saskia; Schwarz, Stefan

    2003-01-01

    Florfenicol in vitro activities for a total of 756 bacterial isolates from respiratory tract infections of cattle and swine were comparatively investigated by the agar diffusion method and the microdilution broth method. Florfenicol showed high in vitro activity against Pasteurella multocida, Mannheimia haemolytica, Actinobacillus pleuropneumoniae, and Streptococcus suis, with all of the isolates inhibited by ≤2 μg of florfenicol per ml.

  6. [Effect of industrial pollutants on mucous membrane of the upper respiratory tract].

    Science.gov (United States)

    Mickiewicz, L

    1978-01-01

    A survey of literature on upper respiratory tract diseases in workers exposed to irritating and toxic substances in industry has been presented. The effects of dusts of cotton, wood, rock-salt, hydrochloric and sulphuric acids, ammonia and fluorine compounds have been discussed.

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

    NARCIS (Netherlands)

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

    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

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

    NARCIS (Netherlands)

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

    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

  9. Effect of formaldehyde on the upper respiratory tract _ormal flora of ...

    African Journals Online (AJOL)

    Background: Formaldehyde is a chemical that is used to fix a tissue after death or removal from the body to prevent autolysis and putrefaction. Exposure to formaldehyde can occur as a result of occupation. Objective: To determine the effect of the formaldehyde on the throat and nasal flora of upper respiratory tract of rabbits ...

  10. The Mechanism of Activated Nitrogen-Containing Metabolites in the Respiratory Tract: Proinflammatory Effect (Part 3

    Directory of Open Access Journals (Sweden)

    O.Ye. Abaturov

    2016-03-01

    Full Text Available The literature review presents current data about modulating action of nitrogen monoxide on the inflammatory response and the apoptotic process depending on its concentration. There is demonstrated a dual action of nitric oxide in the respiratory tract — prevention of infection and strengthening the destruction of lung tissue.

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

    DEFF Research Database (Denmark)

    Kusiluka, L.J.M.; Ojeniyi, B.; Friis, N.F.

    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...

  12. Binding of Haemophilus influenzae to purified mucins from the human respiratory tract

    NARCIS (Netherlands)

    Davies, J.; Carlstedt, I.; Nilsson, A. K.; Håkansson, A.; Sabharwal, H.; van Alphen, L.; van Ham, M.; Svanborg, C.

    1995-01-01

    Mucins are high-molecular-weight glycoproteins and major constituents of the mucus layer which covers the airway surface. We have studied the interactions between bacteria, mucins, and epithelial cells from the human respiratory tract. Nontypeable strains of Haemophilus influenzae were found to bind

  13. Molecular epidemiology of pneumococcal carriage among children with upper respiratory tract infections in Hanoi, Vietnam

    NARCIS (Netherlands)

    D. Bogaert (Debby); N.T. Ha; M. Sluijter (Marcel); N. Lemmens; R. de Groot (Ronald); P.W.M. Hermans (Peter)

    2002-01-01

    textabstractTo investigate the molecular epidemiology of pneumococcal nasopharyngeal carriage in Hanoi, Vietnam, we studied 84 pneumococcal strains retrieved from children with upper respiratory tract infections. Serotypes 23F (32%), 19F (21%), 6B (13%), and 14 (10%) were found

  14. Mental health of Polish students and the occurrence of respiratory tract infections.

    Science.gov (United States)

    Baran, Sylwia; Teul-Swiniarska, Iwona; Dzieciolowska-Baran, Edyta; Lorkowski, Jacek; Gawlikowska-Sroka, Aleksandra

    2013-01-01

    The aim of the paper was to examine the association between the psychological status and the occurrence of respiratory tract infections which constitute the most common group of disorders in the student population. The study comprised 500 Polish students aged 19-21. Two psychological scales were utilized: the Goldberg GHQ-12 scale to examine the general psychological status and the CES-D scale to evaluate the symptoms of depression. In addition a pro-health questionnaire in the examined group of students was performed. We found an increased stress level in 51% of students and the symptoms of depression in 22%. An association between distress and the occurrence of respiratory tract infections was found, based on statistical analyses. The highest stress level and related high distress index were observed in the students suffering from lower respiratory tract infections (7.1 scale value). This group self-evaluated their health status as poor, based on the pro-health questionnaire. In the same group of students, lack of sleep (5.4), lack of regular eating habits (4.2) and lack of physical activity (3.9) were also observed. The study shows that the Polish student population is exposed to increased stress level, which, in turn, increases the occurrence of respiratory tract infections.

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

    Directory of Open Access Journals (Sweden)

    Emily S Charlson

    2010-12-01

    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.

  16. Significant impact of recurrent respiratory tract infections in children with Down syndrome.

    NARCIS (Netherlands)

    Verstegen, R.H.J.; Gameren-Oosterom, H.B. van; Fekkes, M.; Dusseldorp, E.; Vries, E. De; Wouwe, J.P. van

    2013-01-01

    OBJECTIVE: Parents and health professionals believe that recurrent respiratory tract infections (RRTI) have a large impact on children with Down syndrome (DS). We studied the relation between parent-reported RRTI and development, behaviour and health-related quality of life (HRQoL) in 8-year-old

  17. Cow's Milk and Immune Function in the Respiratory Tract: Potential Mechanisms.

    Science.gov (United States)

    Perdijk, Olaf; van Splunter, Marloes; Savelkoul, Huub F J; Brugman, Sylvia; van Neerven, R J Joost

    2018-01-01

    During the last decades, the world has witnessed a dramatic increase in allergy prevalence. Epidemiological evidence shows that growing up on a farm is a protective factor, which is partly explained by the consumption of raw cow's milk. Indeed, recent studies show inverse associations between raw cow's milk consumption in early life and asthma, hay fever, and rhinitis. A similar association of raw cow's milk consumption with respiratory tract infections is recently found. In line with these findings, controlled studies in infants with milk components such as lactoferrin, milk fat globule membrane, and colostrum IgG have shown to reduce respiratory infections. However, for ethical reasons, it is not possible to conduct controlled studies with raw cow's milk in infants, so formal proof is lacking to date. Because viral respiratory tract infections and aeroallergen exposure in children may be causally linked to the development of asthma, it is of interest to investigate whether cow's milk components can modulate human immune function in the respiratory tract and via which mechanisms. Inhaled allergens and viruses trigger local immune responses in the upper airways in both nasal and oral lymphoid tissue. The components present in raw cow's milk are able to promote a local microenvironment in which mucosal immune responses are modified and the epithelial barrier is enforced. In addition, such responses may also be triggered in the gut after exposure to allergens and viruses in the nasal cavity that become available in the GI tract after swallowing. However, these immune cells that come into contact with cow's milk components in the gut must recirculate into the blood and home to the (upper and lower) respiratory tract to regulate immune responses locally. Expression of the tissue homing-associated markers α4β7 and CCR9 or CCR10 on lymphocytes can be influenced by vitamin A and vitamin D3, respectively. Since both vitamins are present in milk, we speculate that raw

  18. Cow’s Milk and Immune Function in the Respiratory Tract: Potential Mechanisms

    Directory of Open Access Journals (Sweden)

    Olaf Perdijk

    2018-02-01

    Full Text Available During the last decades, the world has witnessed a dramatic increase in allergy prevalence. Epidemiological evidence shows that growing up on a farm is a protective factor, which is partly explained by the consumption of raw cow’s milk. Indeed, recent studies show inverse associations between raw cow’s milk consumption in early life and asthma, hay fever, and rhinitis. A similar association of raw cow’s milk consumption with respiratory tract infections is recently found. In line with these findings, controlled studies in infants with milk components such as lactoferrin, milk fat globule membrane, and colostrum IgG have shown to reduce respiratory infections. However, for ethical reasons, it is not possible to conduct controlled studies with raw cow’s milk in infants, so formal proof is lacking to date. Because viral respiratory tract infections and aeroallergen exposure in children may be causally linked to the development of asthma, it is of interest to investigate whether cow’s milk components can modulate human immune function in the respiratory tract and via which mechanisms. Inhaled allergens and viruses trigger local immune responses in the upper airways in both nasal and oral lymphoid tissue. The components present in raw cow’s milk are able to promote a local microenvironment in which mucosal immune responses are modified and the epithelial barrier is enforced. In addition, such responses may also be triggered in the gut after exposure to allergens and viruses in the nasal cavity that become available in the GI tract after swallowing. However, these immune cells that come into contact with cow’s milk components in the gut must recirculate into the blood and home to the (upper and lower respiratory tract to regulate immune responses locally. Expression of the tissue homing-associated markers α4β7 and CCR9 or CCR10 on lymphocytes can be influenced by vitamin A and vitamin D3, respectively. Since both vitamins are present

  19. Epidemiology of Respiratory Pathogens in Children with Lower Respiratory Tract Infections in Shanghai, China, from 2013 to 2015.

    Science.gov (United States)

    Liu, Pengcheng; Xu, Menghua; He, Leiyan; Su, Liyun; Wang, Aimin; Fu, Pan; Lu, Lijuan; Wang, Chuanqing; Xu, Jin

    2018-01-23

    This study aimed to explore the epidemiology of pathogens in children who were hospitalized with lower respiratory tract infections (LRTIs) at the Children's Hospital of Fudan University, Shanghai, China. Children aged less than 18 years who were hospitalized with LRTIs were enrolled from January 2013 to December 2015. Respiratory specimens were collected for the detection of common respiratory viruses, atypical bacteria, and other bacteria using current laboratory diagnostic tests. The epidemiological characteristics of the respiratory pathogens were analyzed. Of the 10,123 specimens obtained from the patients, 5,966 (58.7%) were positive for at least 1 pathogen. Mycoplasma pneumoniae (M.pneumoniae) was the most commonly detected pathogen (15.7%), followed by respiratory syncytial virus (RSV) (13.9%). Co-infections were found in 11.4% of patients. Of these co-infections, viral-bacterial co-infections were the most common. The detection rates for the respiratory pathogens varied considerably by age. RSV was the most common pathogen in children aged less than 24 months. Clear seasonal peaks were observed for RSV, M. pneumoniae, parainfluenza virus, human metapneumovirus, Moraxella catarrhalis, and Haemophilus influenza infections. Our findings demonstrate specific epidemiological patterns in children with LRTIs in Shanghai, China.

  20. The role of respiratory tract infections and the microbiome in the development of asthma

    DEFF Research Database (Denmark)

    van Meel, Evelien R; Jaddoe, Vincent W V; Bønnelykke, Klaus

    2017-01-01

    Asthma is a common disease in childhood, and might predispose for chronic obstructive respiratory morbidity in adolescence and adulthood. Various early-life risk factors might influence the risk of wheezing, asthma, and lower lung function in childhood. Cohort studies demonstrated that lower...... respiratory tract infections in the first years of life are associated with an increased risk of wheezing and asthma, while the association with lung function is less clear. Additionally, the gut and airway microbiome might influence the risk of wheezing and asthma. The interaction between respiratory tract...... infections and the microbiome complicates studies of their associations with wheezing, asthma, and lung function. Furthermore, the causality behind these observations is still unclear, and several other factors such as genetic susceptibility and the immune system might be of importance. This review...

  1. 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 Bielska

    2015-09-01

    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.

  2. Unravelling the transcriptome profile of the Swine respiratory tract mycoplasmas.

    Directory of Open Access Journals (Sweden)

    Franciele Maboni Siqueira

    Full Text Available The swine respiratory ciliary epithelium is mainly colonized by Mycoplasma hyopneumoniae, Mycoplasma flocculare and Mycoplasma hyorhinis. While colonization by M. flocculare is virtually asymptomatic, M. hyopneumoniae and M. hyorhinis infections may cause respiratory disease. Information regarding transcript structure and gene abundance provides valuable insight into gene function and regulation, which has not yet been analyzed on a genome-wide scale in these Mycoplasma species. In this study, we report the construction of transcriptome maps for M. hyopneumoniae, M. flocculare and M. hyorhinis, which represent data for conducting comparative studies on the transcriptional repertory. For each species, three cDNA libraries were generated, yielding averages of 415,265, 695,313 and 93,578 reads for M. hyopneumoniae, M. flocculare and M. hyorhinis, respectively, with an average read length of 274 bp. The reads mapping showed that 92%, 98% and 96% of the predicted genes were transcribed in the M. hyopneumoniae, M. flocculare and M. hyorhinis genomes, respectively. Moreover, we showed that the majority of the genes are co-expressed, confirming the previously predicted transcription units. Finally, our data defined the RNA populations in detail, with the map transcript boundaries and transcription unit structures on a genome-wide scale.

  3. Unravelling the Transcriptome Profile of the Swine Respiratory Tract Mycoplasmas

    Science.gov (United States)

    Siqueira, Franciele Maboni; Gerber, Alexandra Lehmkuhl; Guedes, Rafael Lucas Muniz; Almeida, Luiz Gonzaga; Schrank, Irene Silveira; Vasconcelos, Ana Tereza Ribeiro; Zaha, Arnaldo

    2014-01-01

    The swine respiratory ciliary epithelium is mainly colonized by Mycoplasma hyopneumoniae, Mycoplasma flocculare and Mycoplasma hyorhinis. While colonization by M. flocculare is virtually asymptomatic, M. hyopneumoniae and M. hyorhinis infections may cause respiratory disease. Information regarding transcript structure and gene abundance provides valuable insight into gene function and regulation, which has not yet been analyzed on a genome-wide scale in these Mycoplasma species. In this study, we report the construction of transcriptome maps for M. hyopneumoniae, M. flocculare and M. hyorhinis, which represent data for conducting comparative studies on the transcriptional repertory. For each species, three cDNA libraries were generated, yielding averages of 415,265, 695,313 and 93,578 reads for M. hyopneumoniae, M. flocculare and M. hyorhinis, respectively, with an average read length of 274 bp. The reads mapping showed that 92%, 98% and 96% of the predicted genes were transcribed in the M. hyopneumoniae, M. flocculare and M. hyorhinis genomes, respectively. Moreover, we showed that the majority of the genes are co-expressed, confirming the previously predicted transcription units. Finally, our data defined the RNA populations in detail, with the map transcript boundaries and transcription unit structures on a genome-wide scale. PMID:25333523

  4. Environmental radon and radon daughter dosimetry in the respiratory tract

    International Nuclear Information System (INIS)

    McPherson, R.B.

    1979-04-01

    This report describes work performed by Pacific Northwest Laboratory (PNL) for the Nuclear Regulatory Commission's program to determine safety and costs related to decommissioning nuclear fuel cycle facilities. Individual dose factors for the inhalation of radon and its daughter products are calculated for use in environmental dose assessments. The calculated committed dose equivalent factors for 222 Rn and its daughters are tabulated for lungs, bronchi tract and other organs. An activity median aerodynamic diameter of 0.1 μm was used. The dose to an individual is calculated by multiplying the estimated intake from inhalation for a particular radionuclide by the corresponding dose factor. A working level month-to-dose conversion factor is calculated to be 1 rad/WLM to the epithelial tissue of the T-B region, assuming 100% daughter equilibrium and 10% free 218 Po ions. This value is in reasonable agreement with recently reported values

  5. Environmental radon and radon daughter dosimetry in the respiratory tract

    Energy Technology Data Exchange (ETDEWEB)

    McPherson, R.B.

    1979-04-01

    This report describes work performed by Pacific Northwest Laboratory (PNL) for the Nuclear Regulatory Commission's program to determine safety and costs related to decommissioning nuclear fuel cycle facilities. Individual dose factors for the inhalation of radon and its daughter products are calculated for use in environmental dose assessments. The calculated committed dose equivalent factors for /sup 222/Rn and its daughters are tabulated for lungs, bronchi tract and other organs. An activity median aerodynamic diameter of 0.1 ..mu..m was used. The dose to an individual is calculated by multiplying the estimated intake from inhalation for a particular radionuclide by the corresponding dose factor. A working level month-to-dose conversion factor is calculated to be 1 rad/WLM to the epithelial tissue of the T-B region, assuming 100% daughter equilibrium and 10% free /sup 218/Po ions. This value is in reasonable agreement with recently reported values.

  6. 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.

  7. Man-made mineral fibers and the respiratory tract.

    Science.gov (United States)

    Costa, Roser; Orriols, Ramon

    2012-12-01

    Man-made mineral fibers are produced using inorganic materials and are widely used as thermal and acoustic insulation. These basically include continuous fiberglass filaments, glass wool (fiberglass insulation), stone wool, slag wool and refractory ceramic fibers. Likewise, in the last two decades nanoscale fibers have also been developed, among these being carbon nanotubes with their high electrical conductivity, mechanical resistance and thermal stability. Both man-made mineral fibers and carbon nanotubes have properties that make them inhalable and potentially harmful, which have led to studies to assess their pathogenicity. The aim of this review is to analyze the knowledge that currently exists about the ability of these fibers to produce respiratory diseases. Copyright © 2012 SEPAR. Published by Elsevier Espana. All rights reserved.

  8. Bovine pasteurellosis and other bacterial infections of the respiratory tract.

    Science.gov (United States)

    Griffin, Dee

    2010-03-01

    Despite technological, biologic, and pharmacologic advances the bacterial component of the bovine respiratory disease (BRD) complex continues to have a major adverse effect on the health and wellbeing of stocker and feeder cattle. Overlooked in this disappointing assessment is evaluation of the effects that working with younger, lighter-weight cattle have on managing the bacterial component of the BRD complex. Most problems associated with BRD come from cattle taken from and comingled with cattle operations that have inconsistent or nonexistent cattle health management. This article reviews the biologic, clinical, and management aspects of Pasteurella multocida, Mannheimia haemolytica, Histophilus somni, and Mycoplasma bovis, primarily as related to current production management considerations of stocker and feeder cattle. Copyright 2010 Elsevier Inc. All rights reserved.

  9. 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.

  10. Numerical simulation of inhaled aerosol particle deposition within 3D realistic human upper respiratory tract

    Science.gov (United States)

    Lin, J.; Fan, J. R.; Zheng, Y. Q.; Hu, G. L.; Pan, D.

    2010-03-01

    Computational fluid dynamics (CFD) simulations of airflow and particle deposition in the upper respiratory tract (URT) were conducted in this paper. Based on the CT (Computerized Tomography) scanned images of a 19-years-old healthy boy, a realistic geometric model of URT from oral cavity to the upper six-generation bronchial is rebuilt. To investigate airflow and particle deposition in the obtained realistic human upper respiratory tract, RNG k-ɛ turbulence model was used to describe the primary flow and particle deposition under three breathing intensity such as 15 L/min, 30 L/min and 60 L/min. The particle is tracked and analyzed in the Lagrangian frame. The velocity fields of airflow under different airflow rates were computed and discussed. In order to study the characteristics of particles movement and the effect of particles diameter on the deposition pattern, eleven kinds of sphere particles with different diameters are selected as research object. The diameters of selected particles as follows: 0.1 μm, 0.5 μm, 1 μm, 2.5 μm, 3 μm, 3.5 μm, 4 μm, 4.5 μm, 5 μm, 6.5 μm and 8 μm. The variation of inhalable particles deposition in realistic human upper respiratory tract with respiratory intensity and particle size was researched and compared. Furthermore, the more real inhalable particles with Rosin-Rammler mass distribution are used to study the effect of particles size. The deposition rate of particles with the different diameter scope in the different part of upper respiratory tract was summarized. The geometrical model based images technology promises to provide more real results of airflow field and particle deposition in the URT.

  11. 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. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Chloroquine-Azithromycin Combination Antimalarial Treatment Decreases Risk of Respiratory- and Gastrointestinal-Tract Infections in Malawian Children

    Science.gov (United States)

    Gilliams, Elizabeth A.; Jumare, Jibreel; Claassen, Cassidy W.; Thesing, Phillip C.; Nyirenda, Osward M.; Dzinjalamala, Fraction K.; Taylor, Terrie; Plowe, Christopher V.; Tracy, LaRee A.; Laufer, Miriam K.

    2014-01-01

    Background. Chloroquine-azithromycin is being evaluated as combination therapy for malaria. It may provide added benefit in treating or preventing bacterial infections that occur in children with malaria. Objective. We aim to evaluate the effect of treating clinical malaria with chloroquine-azithromycin on the incidence of respiratory-tract and gastrointestinal-tract infections compared to treatment with chloroquine monotherapy. Methods. We compared the incidence density and time to first events of respiratory-tract and gastrointestinal-tract infections among children assigned to receive chloroquine-azithromycin or chloroquine for all symptomatic malaria episodes over the course of 1 year in a randomized longitudinal trial in Blantyre, Malawi. Results. The incidence density ratios of total respiratory-tract infections and gastrointestinal-tract infections comparing chloroquine-azithromycin to chloroquine monotherapy were 0.67 (95% confidence interval [CI], .48, .94) and 0.74 (95% CI, .55, .99), respectively. The time to first lower-respiratory-tract and gastrointestinal-tract infections were significantly longer in the chloroquine-azithromycin arm compared to the chloroquine arm (P = .04 and P = .02, respectively). Conclusions. Children treated routinely with chloroquine-azithromycin had fewer respiratory and gastrointestinal-tract infections than those treated with chloroquine alone. This antimalarial combination has the potential to reduce the burden of bacterial infections among children in malaria-endemic countries. PMID:24652498

  13. Profiling acute respiratory tract infections in children from Assam, India

    Directory of Open Access Journals (Sweden)

    Farzana Islam

    2013-01-01

    Full Text Available Background: Acute respiratory infections (ARI are leading global cause of under-five mortality and morbidity. Objective: To elicit the prevalence and risk factors associated with ARI among under-five children. Materials and Methods: A community-based cross-sectional study was undertaken in 21 registered urban slums of Guwahati in Assam to determine the prevalence and risk factors associated with ARI among 370 under-five children from 184 households and 370 families. Results: The prevalence of ARI was found to be 26.22%; infants and female children were more affected. Majority of the ARI cases were from nuclear families (84.54%, living in kutcha houses (90.72% with inadequate ventilation (84.54%, overcrowded living condition (81.44%, with kitchen attached to the living room (65.98% and using biomass fuel for cooking (89.69%. ARI was significantly associated with ventilation, location of kitchen in household; presence of overcrowding, nutritional status, and primary immunization status also had impacts on ARI. Conclusion: The present study had identified a high prevalence of the disease among under-fives. It also pointed out various socio-demographic, nutritional, and environmental modifiable risk factors which can be tackled by effective education of the community.

  14. 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.

  15. [The detection of virus antigen in the lower respiratory tract of the patients with lung cancer].

    Science.gov (United States)

    Ou, M; Wang, H; Chen, H

    1999-12-01

    To find out about the viral infection situation of lower respiratory tract of the patients with lung cancer. The excretion from the surface of bronchiogenic carcinoma was brushed under fibrobronchoscopy. The respiratory virus antigen was detected and analysed by reagent kit produced by the 262nd Hospital of Beijing Military Region. The respiratory virus antigen was positive in eight cases of lung cancer group, the positive rate was 17.4%(8/46), it was significantly higher than that in non-lung cancer group (P < 0.05). Among them, there were one case of influenza virus A, two cases of influenza virus B, two cases of para-influenza 1,3, two cases of adenovirus and one case of respiratory syncytial virus. The carcinoma accompanied with viral infection were 4,3,1, cases in order of squamous carcinoma, small cell lung carcinoma and adenocarcinoma. The results showed that a relationship existed between lung cancer and viral infection of respiratory tract statistically. The viral infection increased in patients with lung cancer, this is worthy to pay attention to.

  16. Antibiotic treatment and the diagnosis of Streptococcus pneumoniae in lower respiratory tract infections in adults

    DEFF Research Database (Denmark)

    Korsgaard, Jens; Møller, Jens Kjølseth; Kilian, Mogens

    2005-01-01

    OBJECTIVE: To analyze the possible influence of antibiotic treatment on the results of different diagnostic tests for the diagnosis of lower respiratory tract infections with Streptococcus pneumoniae. MATERIAL AND METHODS: A prospective cohort of 159 unselected adult immunocompetent patients...... admitted to Silkeborg County Hospital in Denmark with community-acquired lower respiratory tract infections underwent microbiological investigations with fiber-optic bronchoscopy with bronchoalveolar lavage, blood and sputum culture and urine antigen test for type-specific polysaccharide capsular antigens...... was positive in both systems, making a total of 22 patients with documented pneumococcal infection. As a positive culture test was dependent on the absence of antibiotic treatment, whereas a positive urine antigen test depended on antibiotic treatment within 48 hours, the two tests were complementary...

  17. Infant Respiratory Tract Infections or Wheeze and Maternal Vitamin D in Pregnancy

    DEFF Research Database (Denmark)

    Christensen, Nikolas; Søndergaard, Jens; Fisker, Niels

    2017-01-01

    Respiratory tract infections (RTIs) are a common cause of morbidity and mortality in young children and can be associated with wheeze. Vitamin D can have a protective role against RTI. MATERIALS AND METHODS: A systematic search of Pubmed, Embase and the Cochrane library was performed. Titles and ....... Future intervention studies may need to exceed current recommendations of vitamin D supplementation during pregnancy to show benefit against childhood wheeze or infections.......Respiratory tract infections (RTIs) are a common cause of morbidity and mortality in young children and can be associated with wheeze. Vitamin D can have a protective role against RTI. MATERIALS AND METHODS: A systematic search of Pubmed, Embase and the Cochrane library was performed. Titles...... and abstracts were evaluated and selected articles were reviewed by two authors. We included randomized controlled trials (RCTs) investigating the effect of vitamin D supplementation during pregnancy on RTIs or wheeze in children of 5 years of age or younger. Observational studies on the association between...

  18. NASAL-Geom, a free upper respiratory tract 3D model reconstruction software

    Science.gov (United States)

    Cercos-Pita, J. L.; Cal, I. R.; Duque, D.; de Moreta, G. Sanjuán

    2018-02-01

    The tool NASAL-Geom, a free upper respiratory tract 3D model reconstruction software, is here described. As a free software, researchers and professionals are welcome to obtain, analyze, improve and redistribute it, potentially increasing the rate of development, and reducing at the same time ethical conflicts regarding medical applications which cannot be analyzed. Additionally, the tool has been optimized for the specific task of reading upper respiratory tract Computerized Tomography scans, and producing 3D geometries. The reconstruction process is divided into three stages: preprocessing (including Metal Artifact Reduction, noise removal, and feature enhancement), segmentation (where the nasal cavity is identified), and 3D geometry reconstruction. The tool has been automatized (i.e. no human intervention is required) a critical feature to avoid bias in the reconstructed geometries. The applied methodology is discussed, as well as the program robustness and precision.

  19. Vitamin D deficiency and recurrent lower respiratory tract infections: a case based discussion

    Directory of Open Access Journals (Sweden)

    Cenk Aypak

    2014-09-01

    Full Text Available Lower respiratory tract infections (LRTI are among the most prevalent infectious diseases.Vitamin D deficiency has been found to be a risk factor for LRTI. We here report a case with the diagnosis of recurrent LRTI treated safely by empirical antibiotherapy and vitamin D supplementation in order to underline the importance of assessment and treatment of vitamin D deficiency in pediatric patients with the diagnosis of LRTI.

  20. 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....

  1. A Biocompatible Synthetic Lung Fluid Based on Human Respiratory Tract Lining Fluid Composition

    OpenAIRE

    Kumar, Abhinav; Terakosolphan, Wachirun; Hassoun, Mireille; Vandera, Kalliopi-Kelli; Novicky, Astrid; Harvey, Richard; Royall, Paul G.; Bicer, Elif Melis; Eriksson, Jonny; Edwards, Katarina; Valkenborg, Dirk; Nelissen, Inge; Hassall, Dave; Mudway, Ian S.; Forbes, Ben

    2017-01-01

    Purpose: To characterise a biorelevant simulated lung fluid (SLF) based on the composition of human respiratory tract lining fluid. SLF was compared to other media which have been utilized as lung fluid simulants in terms of fluid structure, biocompatibility and performance in inhalation biopharmaceutical assays. Methods: The structure of SLF was investigated using cryo-transmission electron microscopy, photon correlation spectroscopy and Langmuir isotherms. Biocompatibility with A549 alveola...

  2. Haemophilus haemolyticus: A Human Respiratory Tract Commensal to Be Distinguished from Haemophilus influenzae

    DEFF Research Database (Denmark)

    Murphy, T.F.; Brauer, A.L.; Sethi, S.

    2007-01-01

    Background. Haemophilus influenzae is a common pathogen in adults with chronic obstructive pulmonary disease (COPD). In a prospective study, selected isolates of apparent H. influenzae had an altered phenotype. We tested the hypothesis that these variant strains were genetically different from ty...... distinguish H. haemolyticus from H. influenzae. H. haemolyticus is a respiratory tract commensal. The recognition that some strains of apparent H. influenzae are H. haemolyticus substantially strengthens the association of true H. influenzae with clinical infection....

  3. Particle deposition and clearance of atmospheric particles in the human respiratory tract during LACE 98

    Science.gov (United States)

    Bundke, U.; Hänel, G.

    2003-04-01

    During the LACE 98footnote{Lindenberg Aerosol Characterization Experiment, (Germany) 1998} experiment microphysical, chemical and optical properties of atmospheric particles were measured by several groups. (Bundke et al.). The particle deposition and clearance of the particles in the human respiratory tract was calculated using the ICRP (International Commission on Radiological Protection) deposition and clearance model (ICRP 1994). Particle growth as function of relative humidity outside the body was calculated from measurement data using the model introduced by Bundke et al.. Particle growth inside the body was added using a non-equilibrium particle growth model. As a result of the calculations, time series of the total dry particle mass and -size distribution were obtained for all compartments of the human respiratory tract defined by ICRP 1994. The combined ICRP deposition and clearance model was initialized for different probationers like man, woman, children of different ages and several circumstances like light work, sitting, sleeping etc. Keeping the conditions observed during LACE 98 constant a approximation of the aerosol burdens of the different compartments was calculated up to 4 years of exposure and compared to the results from Snipes et al. for the "Phoenix" and "Philadelphia" aerosol. References: footnotesize{ Bundke, U. et al.,it{Aerosol Optical Properties during the Lindenberg Aerosol Characterization Experiment (LACE 98)} ,10.1029/2000JD000188, JGR, 2002 ICRP,it{Human Respiratory Tract Model for Radiological Protection, Bd. ICRP Publication 66}, Annals of the ICRP, 24,1-3, Elsevier Science, Ocford, 1994 Snipes et al. ,it{The 1994 ICRP66 Human Respiratory Tract Model as a Tool for predicting Lung Burdens from Exposure to Environmental Aerosols}, Appl. Occup. Environ. Hyg., 12, 547-553,1997}

  4. Sublingual immunotherapy in children and its potential beneficial collateral effect on respiratory tract infections.

    Science.gov (United States)

    Occasi, Francesca; De Castro, Giovanna; Zicari, Anna Maria; Indinnimeo, Luciana; Tancredi, Giancarlo; Duse, Marzia

    2015-05-01

    Although directed to the control of allergic symptoms, a possible effect of sublingual immunotherapy (SLIT) on susceptibility to infections has been hypothesized. Two hundred sixty-five children aged between 3 and 4 years of age affected by allergic rhinitis completed a 6 year prospective case-control study. One hundred forty-three children after 2 years of SLIT reported a lower prevalence of respiratory tract infections when compared to children not undergoing SLIT.

  5. Intravenous Poison Hemlock Injection Resulting in Prolonged Respiratory Failure and Encephalopathy.

    Science.gov (United States)

    Brtalik, Douglas; Stopyra, Jason; Hannum, Jennifer

    2017-06-01

    Poison hemlock (Conium maculatum) is a common plant with a significant toxicity. Data on this toxicity is sparse as there have been few case reports and never a documented poisoning after intravenous injection. We present a case of intravenous poison hemlock injection encountered in the emergency department. We describe a 30-year-old male who presented to the emergency department after a brief cardiac arrest after injecting poison hemlock. The patient had return of spontaneous circulation in the emergency department but had prolonged muscular weakness and encephalopathy later requiring tracheostomy. Intravenous injection of poison hemlock alkaloids can result in significant toxicity, including cardiopulmonary arrest, prolonged weakness, and encephalopathy.

  6. 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

  7. Distribution of DNA adducts in the respiratory tract of rats exposed to diesel exhaust

    International Nuclear Information System (INIS)

    Bond, J.A.; Wolff, R.K.; Harkema, J.R.; Mauderly, J.L.; Henderson, R.F.; Griffith, W.C.; McClellan, R.O.

    1988-01-01

    Diesel exhaust, Inhaled chronically at high concentrations, induced tumors that were located exclusively In the peripheral lung of rats. The purpose of this study was to determine if differences in the level of DNA adducts among the regions of the respiratory tract paralleled the site of tumors. Groups of male F344/N rats were exposed 7 h/day, 5 day/wk for 12 wk to diesel engine exhaust at a soot concentration of 10 mg/m 3 or were sham-exposed to air. Respiratory tract tissues were dissected and DNA was isolated from the dissected samples and analyzed for the presence of adducts using the 32 P-postlabeling assay. The highest level of total DNA adducts occurred In peripheral lung tissue (∼ 18 adducts per 10 9 bases). About 1/4 to 1/5 the level of DNA adducts was detected in the nasal tissues as in peripheral lung. There were less than 3 adducts per 10 9 bases n each of the regions of the major conducting airways (.e., trachea, bronchi, axial airway). The data from this study indicate that higher levels of total DNA adducts were present In tissues where exhaust-induced tumors were located. These data suggest that DNA adduct levels in discrete locations of the respiratory tract may be good measures of the 'effective dose' of carcinogenic compounds. (author)

  8. USE OF A NEW FORM OF IBUPROFEN IN CHILDREN WITH FEVER AND ACUTE RESPIRATORY TRACT INFECTIONS

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    E. E. Lokshina

    2013-01-01

    Full Text Available Aim: to study clinical efficacy, tolerance and safety of a new pelleted ibuprofen form for children in treatment of fever in patients with acute respiratory tract infection. Patients and methods: children aged from 6 to 12 years old with clinical manifestation of respiratory tract infections and requiring antipyretic treatment were included into the study. Children (n = 50 were administered ibuprofen at a single dose of 5–10 mg/kg of body weight, not more than 3–4 times per day. The efficacy assessment included time needed for temperature decrease (assessment was performed in 15, 30 and 60 minutes and duration of the antipyretic effect (assessment in 6, 8 and 12 hours. Rapidity of analgesic effect in children with ear ache, headache and myalgias was performed in 15, 30, 60 minutes and 6, 8 and 12 hours after the drug intake. Results: antipyretic effect of pelleted ibuprofen for children begins in 15 minutes after its intake. Stable temperature decrease during the first 6 hours was observed in 58% of children (the mean temperature was 37,1 ± 0,3 and maintained up for 12 hours. Relief of pain intensity was established in 62,1% of patients during the first 3 hours, and in 37,9% the pain syndrome was arrested completely. Conclusions: the new pelleted form of ibuprofen for children was proved to have high clinical efficacy and safety in treatment of fever in children with acute respiratory tract infections.

  9. 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.

    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

  10. Isolation of dengue virus from the upper respiratory tract of four patients with dengue fever.

    Science.gov (United States)

    Cheng, Nai-Ming; Sy, Cheng Len; Chen, Bao-Chen; Huang, Tsi-Shu; Lee, Susan Shin-Jung; Chen, Yao-Shen

    2017-04-01

    Dengue fever is an important arboviral disease. The clinical manifestations vary from a mild non-specific febrile syndrome to severe life-threatening illness. The virus can usually be detected in the blood during the early stages of the disease. Dengue virus has also been found in isolated cases in the cerebrospinal fluid, urine, nasopharyngeal sections and saliva. In this report, we describe the isolation of dengue virus from the upper respiratory tract of four confirmed cases of dengue. We reviewed all laboratory reports of the isolation of dengue virus from respiratory specimens at the clinical microbiology laboratory of the Kaohsiung Veterans General Hospital during 2007 to 2015. We then examined the medical records of the cases from whom the virus was isolated to determine their demographic characteristics, family contacts, clinical signs and symptoms, course of illness and laboratory findings. Dengue virus was identified in four patients from a nasopharyngeal or throat culture. Two were classified as group A dengue (dengue without warning signs), one as group B (dengue with warning signs) and one as group C (severe dengue). All had respiratory symptoms. Half had family members with similar respiratory symptoms during the period of their illnesses. All of the patients recovered uneventfully. The isolation of dengue virus from respiratory specimens of patients with cough, rhinorrhea and nasal congestion, although rare, raises the possibility that the virus is capable of transmission by the aerosol route among close contacts. This concept is supported by studies that show that the virus can replicate in cultures of respiratory epithelium and can be transmitted through mucocutaneous exposure to blood from infected patients. However, current evidence is insufficient to prove the hypothesis of transmission through the respiratory route. Further studies will be needed to determine the frequency of respiratory colonization, viable virus titers in respiratory

  11. 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|info:eu-repo/dai/nl/304827762; 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

  12. Intensive care unit patients with lower respiratory tract nosocomial infections: the ENIRRIs project

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    Gennaro De Pascale

    2017-11-01

    Full Text Available The clinical course of intensive care unit (ICU patients may be complicated by a large spectrum of lower respiratory tract infections (LRTI, defined by specific epidemiological, clinical and microbiological aspects. A European network for ICU-related respiratory infections (ENIRRIs, supported by the European Respiratory Society, has been recently established, with the aim at studying all respiratory tract infective episodes except community-acquired ones. A multicentre, observational study is in progress, enrolling more than 1000 patients fulfilling the clinical, biochemical and radiological findings consistent with a LRTI. This article describes the methodology of this study. A specific interest is the clinical impact of non-ICU-acquired nosocomial pneumonia requiring ICU admission, non-ventilator-associated LRTIs occurring in the ICU, and ventilator-associated tracheobronchitis. The clinical meaning of microbiologically negative infectious episodes and specific details on antibiotic administration modalities, dosages and duration are also highlighted. Recently released guidelines address many unresolved questions which might be answered by such large-scale observational investigations. In light of the paucity of data regarding such topics, new interesting information is expected to be obtained from our network research activities, contributing to optimisation of care for critically ill patients in the ICU.

  13. Asthma exacerbations: Understanding role of viral respiratory tract infections and possible treatment strategies

    Directory of Open Access Journals (Sweden)

    Kavita Sekhri

    2015-01-01

    Full Text Available Asthma is common, affecting around 500 billion people worldwide. It is a complex disease influenced by both genetic and environmental factors. Upper respiratory tract infections with viruses commonly precipitate severe and sustained asthma exacerbations (AEs. Exacerbations are responsible for the enormous amount of emotional and economic stress apart from imposing risk of hospitalization and even death. Hence, agents targeting these infections can contribute toward decreasing asthma morbidity and associated financial burden. Over the past years novel, pharmacological therapies are evolved for the treatment of asthma, but their exact role in exacerbations is still unclear. This article reviews the role of respiratory viral infections in AEs and discusses role of new therapeutic approaches to overcome it. Medline, Medscape, EMBASE, Cochrane database, Scopus and clinicaltrials.gov were searched using terms such as "asthma," "AE" and "viral respiratory infections." Journal articles published from 2000 to 2013 describing AEs were screened.

  14. Factors influencing the development of otitis media among Sicilian children affected by upper respiratory tract infections.

    Science.gov (United States)

    Martines, Francesco; Salvago, Pietro; Ferrara, Sergio; Messina, Giuseppe; Mucia, Marianna; Plescia, Fulvio; Sireci, Federico

    2016-01-01

    Upper respiratory tract infection is a nonspecific term used to describe an acute infection involving the nose, paranasal sinuses, pharynx and larynx. Upper respiratory tract infections in children are often associated with Eustachian tube dysfunction and complicated by otitis media, an inflammatory process within the middle ear. Environmental, epidemiologic and familial risk factors for otitis media (such as sex, socioeconomic and educational factors, smoke exposure, allergy or duration of breastfeeding) have been previously reported, but actually no data about their diffusion among Sicilian children with upper respiratory tract infections are available. To investigate the main risk factors for otitis media and their prevalence in Sicilian children with and without upper respiratory tract infections. A case-control study of 204 children with upper respiratory tract infections who developed otitis media during a 3 weeks monitoring period and 204 age and sex-matched healthy controls. Seventeen epidemiologically relevant features were inventoried by means of standardized questionnaires and skin tests were performed. Univariate analysis and multivariate logistic regression analysis were used to examine the association between risk factors and occurrence of otitis media. Otitis media resulted strongly associated to large families, low parental educational attainment, schooling within the third years of life (pchildren were more susceptible to develop otitis media in the presence of asthma, cough, laryngopharyngeal reflux disease, snoring and apnea (potitis media in children exposed to smoke respectively of 166% and 277% (potitis media are common childhood diseases strongly associated with low parental educational attainment (p=0.0001), exposure to smoke (p=0.0001), indoor exposure to mold (p=0.0001), laryngopharyngeal reflux disease (p=0.0002) and the lack of breast-feeding (p=0.0014); an increased risk of otitis media recurrences was observed in the presence of

  15. Severity of Respiratory Syncytial Virus Lower Respiratory Tract Infection With Viral Coinfection in HIV-Uninfected Children.

    Science.gov (United States)

    Mazur, Natalie I; Bont, Louis; Cohen, Adam L; Cohen, Cheryl; von Gottberg, Anne; Groome, Michelle J; Hellferscee, Orienka; Klipstein-Grobusch, Kerstin; Mekgoe, Omphile; Naby, Fathima; Moyes, Jocelyn; Tempia, Stefano; Treurnicht, Florette K; Venter, Marietje; Walaza, Sibongile; Wolter, Nicole; Madhi, Shabir A

    2017-02-15

    Molecular diagnostics enable sensitive detection of respiratory viruses, but their clinical significance remains unclear in pediatric lower respiratory tract infection (LRTI). We aimed to determine whether viral coinfections increased life-threatening disease in a large cohort. Molecular testing was performed for respiratory viruses in nasopharyngeal aspirates collected from children aged HIV-uninfected children with respiratory syncytial virus (RSV)-associated LRTI, 1330 (57.3%) had RSV monoinfection, 38 (1.6%) had life-threatening disease, 575 (24.8%) had rhinovirus, 347 (14.9%) had adenovirus (ADV), and 30 (1.3%) had influenza virus. RSV and any other viral coinfection was not associated with severe disease (odds ratio [OR], 1.4; 95% confidence interval [CI], OR, 0.74; 95% CI, .39-1.4), ADV coinfection had increased odds of life-threatening disease (adjusted OR, 3.4; 95% CI, 1.6-7.2; P = .001), and influenza coinfection had increased odds of life-threatening disease and prolonged length of stay (adjusted OR, 2.1; 95% CI, 1.0-4.5; P = .05) compared with RSV monoinfection. RSV coinfection with any respiratory virus is not associated with more severe disease when compared to RSV alone in this study. However, increased life-threatening disease in RSV-ADV and RSV-influenza coinfection warrants further study. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  16. NORMAL NASOPHARYNGEAL MICROFLORA AS A RESERVOIR OF MULTIRESISTANT STRAINS OF UPPER RESPIRATORY TRACT INFECTIONS

    Directory of Open Access Journals (Sweden)

    Minukhin V.V.

    2015-05-01

    Full Text Available Nasopharinheal carriage of bacteria may play a central role in the development and spread of respiratory infections. In addition, so-called "healthy" carriage is often transformed under the influence of various factors into an active infection.It is necessary to take into account not only the range of possible pathogens, but also trends in the development of antibiotic resistance of leading etiologic agents while choosing tactics of antimicrobial therapy. The investigation was designed to study the role of normal microflora of the nasopharynx as a reservoir of resistant strains of respiratory infections. Materials and Methods. Fifty three healthy individuals and 168 patients with acute upper respiratory tract infections who had been treated in CEHC "Kharkiv Municipal Clinical Hospital № 30" were examined. Microbiological study included isolation and identification of pathogens in accordance with the Order of the Ministry of Health Care № 535 from 22.04.1985., determination of the sensitivity of microorganisms to antibiotics by diffusion method according to the Order of the Ministry of Health Care of Ukraine № 167 from 05.04.2007. Results and discussion. Bacteriological study of nasal swabs of healthy people showed that the composition of the microflora of the nasopharynx contained potentially pathogenic microorganisms. Among the isolated microorganisms essential place was occupied by S. epidermidis and S. aureus, both in monoculture and association. Epidermal staphylococcus was isolated in 36 % and Staphylococcus aureus in 27% of cases. Pneumococcus and hemolytic streptococcus of group A were isolated in 23 and 14% of cases, respectively. One hundred and eighty strains of opportunistic microorganisms were isolated in the study of nasopharyngeal microflora of patients with acute upper respiratory tract infection. The leading role belonged to S. pyogenes (40.5% and S.epidermidis (33,3%. S. aureus (12,8% and S.pneumoniae (10,6% were next

  17. Detection of respiratory viruses and Bordetella bronchiseptica in dogs with acute respiratory tract infections.

    Science.gov (United States)

    Schulz, B S; Kurz, S; Weber, K; Balzer, H-J; Hartmann, K

    2014-09-01

    Canine infectious respiratory disease (CIRD) is an acute, highly contagious disease complex caused by a variety of infectious agents. At present, the role of viral and bacterial components as primary or secondary pathogens in CIRD is not fully understood. The aim of this study was to investigate the prevalence of canine parainfluenza virus (CPIV), canine adenovirus type 2 (CAV-2), canine influenza virus (CIV), canine respiratory coronavirus (CRCoV), canine herpes virus-1 (CHV-1), canine distemper virus (CDV) and Bordetella bronchiseptica in dogs with CIRD and to compare the data with findings in healthy dogs. Sixty-one dogs with CIRD and 90 clinically healthy dogs from Southern Germany were prospectively enrolled in this study. Nasal and pharyngeal swabs were collected from all dogs and were analysed for CPIV, CAV-2, CIV, CRCoV, CHV-1, CDV, and B. bronchiseptica by real-time PCR. In dogs with acute respiratory signs, 37.7% tested positive for CPIV, 9.8% for CRCoV and 78.7% for B. bronchiseptica. Co-infections with more than one agent were detected in 47.9% of B. bronchiseptica-positive, 82.6% of CPIV-positive, and 100% of CRCoV-positive dogs. In clinically healthy dogs, 1.1% tested positive for CAV-2, 7.8% for CPIV and 45.6% for B. bronchiseptica. CPIV and B. bronchiseptica were detected significantly more often in dogs with CIRD than in clinically healthy dogs (P infectious agents in dogs with CIRD in Southern Germany. Mixed infections with several pathogens were common. In conclusion, clinically healthy dogs can carry respiratory pathogens and could act as sources of infection for susceptible dogs. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Respiratory Tract Infections in Diabetic and Non-Diabetic Individuals are Linked with Serum Surfactant Protein-D

    International Nuclear Information System (INIS)

    Jawed, S.; Parveen, N.

    2015-01-01

    Objective: To find out the rate of respiratory tract infections in diabetic and non-diabetic individuals and their relation with surfactant protein D. Methods: The cross-sectional study was conducted at Dow University of Health Sciences, Karachi, from September 2011 to April 2012, and comprised subjects of both genders between ages of 30 and 60 years. The subjects were divided into four groups: diabetic obese, non-diabetic obese, diabetic non-obese, and non-diabetic-non-obese. A structured questionnaire was used to collect information about respiratory tract infections. Serum surfactant protein D levels were analysed using human surfactant protein D enzyme-linked immunosorbent assay kit. Statistical analysis was performed using SPSS 16. Results: Of the 90 subjects, there were 20(22.2 percent) diabetic obese, 30(33.3 percent) non-diabetic obese, 10(11.1 percent) diabetic non-obese, and 30(33.3 percent) non-diabetic-non-obese. The overall mean age was 36.6±103 years. Among the diabetic obese, 15(75 percent) had respiratory tract infections which was higher than the other study groups, and patients having respiratory tract infections had lower surfactant protein D levels than those who did not have infections (p=0.01). Conclusion: Diabetic obese subjects had greater rate of recurrent respiratory tract infections and had lower concentration of serum surfactant protein D compared to subjects without respiratory tract infections. (author)

  19. Assessment of Mother's Practice toward Their ‎Children with Upper Respiratory Tract ‎Diseases

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    Abdulmahdi A. Hasan

    2017-12-01

    Full Text Available The findings of the study have proved that there is a high significant positive relationship between the mothers' practice and their demographic variables (age, educational level, occupation, residential area. In general, practice of mothers related to upper respiratory tract diseases was low however, the mothers applied preventive practices towards their children with upper respiratory tract diseases..A quasi-experimental study was conducted in one of pediatric teaching hospital in Babylon city from the end of December 2013 till the beginning of March 2014, in order to identify mothers' practice of their children with upper respiratory tract diseases. Aims of the study: To assess the practice of mothers toward upper respiratory disease under five years of age, it is aimed to find out demographic characteristics of mothers like age, level of education and occupation, and to find out demographic characteristic of child regarding age and the type of feeding. Methodology: Purposive sample of (50 mothers' who accompanied their children with upper respiratory disease have been selected. The reliability of the instrument was determined through test and the validity through a panel of experts.  The data were analyzed through the application of descriptive statistical analysis that include (frequency, the mean, the mean of scores, and percentage . Results: According to the interpretation and discussion of the study findings, the following conclusions were found (40% of mothers their age between (18-23 years.(40% of mothers are within the level of education from primary school.(84% of child age are less than one year. 40% of child are with mixture feeding, (85% of mothers use household herbs for their children with cough. (70% of mothers don't use of woolen clothing rather than clothing to keep from cold for their children with obstruction of nose and (88% of mothers do not measure the  body temperature for their children . Recommendations : Health

  20. A study of the barrier function of the upper respiratory tract covering epithelium in the event of combined respiratory tract injuries

    International Nuclear Information System (INIS)

    Ivanov, Z.; Kolev, K.; Dermendzhiev, Kh.; Nikolova, M.; Kantardzhiev, V.

    1976-01-01

    Functional and morphologic impairment of upper respiratory tract mucous membranes after chronic exposure to the three major occupational noxious agents in ore mining - radon-222, silica dust, and respirable dust - has been studied experimentally. Over a 6-month period, rats were given daily treatments, with the agents applied either individually or in combination. Radon-222 (at 1 x 10 -10 Ci/l, corresponding to the maximum permissible concentrotion in uranium mine atmospheres) and respirable dust (dispersed silicogen at 100 mg/m 3 ) were administered four hours daily in toxicological chambers. Monodisperse silica dust was given by tracheal tube, at 50 mg in 1 ml of saline per rat. At the end of the treatment period, the barrier function of the respiratory epithelium was tested, and found to have been affected, by measuring beta radioactivity in blood following introduction into -the animal's nasopharynx of a 32 P-labelled staphylococcus culture. The most severe degree if impairment was found to result from simultaneous exposure to radon and respirable dust. Any of ti'e agents given individually caused a similar degree of impairment. Intratracheal administration of silicic acid anhydride appeared to have no deleterious consequences. The evidence for functional impairment was supported by histologic findings, indicating Jevelopment of ulcerous bronchitis, metaplasia of cylindrical epithelium, etc., after both individual and combined radon exposure. (A.B.)

  1. Pediatric recurrent respiratory tract infections: when and how to explore the immune system? (About 53 cases).

    Science.gov (United States)

    El-Azami-El-Idrissi, Mohammed; Lakhdar-Idrissi, Mounia; Chaouki, Sanae; Atmani, Samir; Bouharrou, Abdelhak; Hida, Moustapha

    2016-01-01

    Recurrent respiratory tract infections are one of the most frequent reasons for pediatric visits and hospitalization. Causes of this pathology are multiple ranging from congenital to acquired and local to general. Immune deficiencies are considered as underlying conditions predisposing to this pathology. Our work is about to determine when and how to explore the immune system when facing recurrent respiratory infections. This was based on the records of 53 children hospitalized at the pediatrics unit of Hassan II University Hospital, Fez Morocco. Thirty boys and 23 girls with age ranging from 5 months to 12 years with an average age of 2 years were involved in this study. Bronchial foreign body was the main etiology in children of 3 to 6 year old. Gastro-esophageal reflux, which in some cases is a consequence of chronic cough, as well as asthma were most frequent in infants (17 and 15% respectively). Immune deficiency was described in 7.5% of patients and the only death we deplored in our series belongs to this group. Recurrent respiratory tract infections have multiple causes. In our series they are dominated by foreign body inhalation and gastroesophageal reflux, which in some cases is a consequence of a chronic cough. Immune deficiency is not frequent but could influence the prognosis. Therefore immune explorations should be well codified.

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

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    Zhancheng Gao

    2014-06-01

    Full Text Available The human pharyngeal microbiome, which resides at the juncture of digestive and respiratory 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 pharyngeal 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 treatment and vaccination. Hence continued research efforts on evaluating probiotic treatment and developing appropriate procedures are necessary to both prevent and treat respiratory infections.

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

    International Nuclear Information System (INIS)

    McCarthy, Grainne; Quinn, P.J.

    1986-01-01

    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

  4. Identification of a novel polyomavirus from patients with acute respiratory tract infections.

    Directory of Open Access Journals (Sweden)

    Anne M Gaynor

    2007-05-01

    Full Text Available We report the identification of a novel polyomavirus present in respiratory secretions from human patients with symptoms of acute respiratory tract infection. The virus was initially detected in a nasopharyngeal aspirate from a 3-year-old child from Australia diagnosed with pneumonia. A random library was generated from nucleic acids extracted from the nasopharyngeal aspirate and analyzed by high throughput DNA sequencing. Multiple DNA fragments were cloned that possessed limited homology to known polyomaviruses. We subsequently sequenced the entire virus genome of 5,229 bp, henceforth referred to as WU virus, and found it to have genomic features characteristic of the family Polyomaviridae. The genome was predicted to encode small T antigen, large T antigen, and three capsid proteins: VP1, VP2, and VP3. Phylogenetic analysis clearly revealed that the WU virus was divergent from all known polyomaviruses. Screening of 2,135 patients with acute respiratory tract infections in Brisbane, Queensland, Australia, and St. Louis, Missouri, United States, using WU virus-specific PCR primers resulted in the detection of 43 additional specimens that contained WU virus. The presence of multiple instances of the virus in two continents suggests that this virus is geographically widespread in the human population and raises the possibility that the WU virus may be a human pathogen.

  5. New Progress in the Cause Analysis and Nursing of Respiratory Tract Infection after Abdominal Surgery under General Anesthesia

    Directory of Open Access Journals (Sweden)

    Yang Congxian

    2016-09-01

    Full Text Available This article provides a review of the causes of respiratory tract infection after abdominal surgery. These causes include general anesthesia, intubation factors, factors inherent to the patient, surgical factors, the injudicious use of antimicrobial agents, and the environmental factors of the ward. The perioperative management of the respiratory tract should be strengthened. Health education, respiratory function training, oral nursing intervention, atomization inhalation, and personalized expectoration methods should receive more attention to decrease the complications and promote the early rehabilitation of patients after abdominal surgery.

  6. The peculiarities of food allergies in accordance with the level of injury of respiratory tract in children of Eastern Siberia.

    Science.gov (United States)

    Borisova, Irina V; Smirnova, Svetlana V

    2013-01-01

    To determine the course of food allergy in accordance with the level of respiratory tract injury in children of Eastern Siberia. We have examined 70 children aged 2-16 , who have food sensibilization. We divided them into 2 groups: group I (n = 32) with diseases of the upper and middle respiratory tract; and group II (n = 38) with diseases of the lower respiratory tract. Allergological medical history, clinical laboratory examination and immunological examination, including the determination of IgA, IgM, IgG and IgE in blood serum. In cases where causal allergens were found, elimination diets were recommended. Onset of upper respiratory tract injury in group I was more often registered in children aged 0-1; in group II, it was in the 3-7 age group. Isolated food sensibilization was more often marked in group I as compared to group II. Atopic mechanisms of respiratory tract injuries were more often registered in group II children. In the course of the elimination diet, we marked positive dynamics in 100% of group I and in 75% of group II. The most frequent allergens that cause respiratory forms of food allergy are hen eggs, cow milk, nutritive cereals, vegetables and fruit. Indices of a humoral link of immunity in the examined patients were more often registered as normal or their level is increased. Timely etiotropic therapy in the majority of cases allows for a stabilization of allergic inflammation.

  7. The effectiveness of systematic perioperative oral hygiene in reduction of postoperative respiratory tract infections after elective thoracic surgery in adults

    DEFF Research Database (Denmark)

    Pedersen, Preben Ulrich; Larsen, Palle; Håkonsen, Sasja Jul

    2016-01-01

    to increase patients' risk for nosocomial respiratory tract infection. OBJECTIVES: To identify, appraise and synthesize the best available evidence on the effectiveness of systematic perioperative oral hygiene in the reduction of postoperative respiratory airway infections in adult patients undergoing...... elective thoracic surgery. INCLUSION CRITERIA: Patients over the age of 18 years who had been admitted for elective thoracic surgery, regardless of gender, ethnicity, diagnosis severity, co-morbidity or previous treatment.Perioperative systematic oral hygiene (such as mechanical removal of dental biofilm......% confidence interval [CI] 0.55-0.78) for respiratory tract infections RR 0.48 (95%CI: 0.36-0.65) and for deep surgical site infections RR 0.48 (95%CI 0.27-0.84). CONCLUSIONS: Systematic perioperative oral hygiene reduces postoperative nosocomial, lower respiratory tract infections and surgical site infections...

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

    International Nuclear Information System (INIS)

    Boecker, B.B.

    1993-01-01

    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

  9. Protective Mechanisms of Respiratory Tract Streptococci against Streptococcus pyogenes Biofilm Formation and Epithelial Cell Infection

    Science.gov (United States)

    Fiedler, Tomas; Riani, Catur; Koczan, Dirk; Standar, Kerstin

    2013-01-01

    Streptococcus pyogenes (group A streptococci [GAS]) encounter many streptococcal species of the physiological microbial biome when entering the upper respiratory tract of humans, leading to the question how GAS interact with these bacteria in order to establish themselves at this anatomic site and initiate infection. Here we show that S. oralis and S. salivarius in direct contact assays inhibit growth of GAS in a strain-specific manner and that S. salivarius, most likely via bacteriocin secretion, also exerts this effect in transwell experiments. Utilizing scanning electron microscopy documentation, we identified the tested strains as potent biofilm producers except for GAS M49. In mixed-species biofilms, S. salivarius dominated the GAS strains, while S. oralis acted as initial colonizer, building the bottom layer in mixed biofilms and thereby allowing even GAS M49 to form substantial biofilms on top. With the exception of S. oralis, artificial saliva reduced single-species biofilms and allowed GAS to dominate in mixed biofilms, although the overall two-layer structure was unchanged. When covered by S. oralis and S. salivarius biofilms, epithelial cells were protected from GAS adherence, internalization, and cytotoxic effects. Apparently, these species can have probiotic effects. The use of Affymetrix array technology to assess HEp-2 cell transcription levels revealed modest changes after exposure to S. oralis and S. salivarius biofilms which could explain some of the protective effects against GAS attack. In summary, our study revealed a protection effect of respiratory tract bacteria against an important airway pathogen and allowed a first in vitro insight into local environmental processes after GAS enter the respiratory tract. PMID:23241973

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

    International Nuclear Information System (INIS)

    Taha, H.M.; Rasheedy, D.; Mahmoud, A.H.

    2013-01-01

    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.

  11. 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

  12. Simulation of The ICRP-30 Dosimetric Model for the Respiratory Tract

    International Nuclear Information System (INIS)

    Giaddui, T.; Atia, M. A.

    2004-01-01

    Matlab was used to write a simulation program (ACID1) to simulate the ICRP-30 dosimetric model for the respiratory tract. The program (a new version of the one presented at the sixth Arab conference held in Cairo 2002) calculates a series of dosimetric quantities for the reference man as a result of the inhalation of any radionuclide. The program also plots the variation of activity with time for all organs and provided with a graphical user interface to make it friendly user. The results obtained by this program was compared with similar results obtained by other source and found to be very close. (Authors)

  13. Quantitative culture of bronchoalveolar lavage fluid in community-acquired lower respiratory tract infections

    DEFF Research Database (Denmark)

    Rasmussen, TR; Korsgaard, Jens; Møller, Jens Kjølseth

    2001-01-01

    To evaluate the diagnostic value of quantitative bacterial culture of bronchoalveolar lavage (BAL) fluid obtained by fibreoptic bronchoscopy, 67 consecutive immunocompetent adult patients admitted to hospital with community-acquired lower respiratory tract infections from September 1997 to May 1998...... value for positive culture of 10(4) cfu ml(-1) the specificity of lavage culture of potential pathogenic bacteria in relation to actual lower airway infection was 100%. Therefore, quantitative bacterial culture of potential pathogenic bacteria in BAL fluid is very specific but only positive in about one...

  14. 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 a set of internationally developed quality indicators and to explore if there is an association between the GPs' assessment of the indicators and their practice characteristics as well as their antibiotic prescription pattern. Methods: A total of 102 Danish GPs were invited to assess the 41 quality...

  15. The potential of methylxanthine-based therapies in pediatric respiratory tract diseases.

    Science.gov (United States)

    Oñatibia-Astibia, Ainhoa; Martínez-Pinilla, Eva; Franco, Rafael

    2016-03-01

    Caffeine, theophylline and theobromine are the most known methylxanthines as they are present in coffee, tea and/or chocolate. In the last decades, a huge experimental effort has been devoted to get insight into the variety of actions that these compounds exert in humans. From such knowledge it is known that methylxanthines have a great potential in prevention, therapy and/or management of a variety of diseases. The benefits of methylxanthine-based therapies in the apnea of prematurity and their translational potential in pediatric affections of the respiratory tract are here presented. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Upper Respiratory Tract Symptoms, Renal Involvement and Vasculitis: A Case Report and Review of Wegener Granulomatosis

    Science.gov (United States)

    Said, Mohd Shahrir Mohamed

    2010-01-01

    Wegener’s Granulomatosis is a condition associated with systemic vasculitis which can present with upper respiratory tract symptoms initially. On September 2001, a 15-year-old girl presented with symptoms of nasal block for 3 weeks. She later developed joint pains and worsening renal status requiring dialysis. A renal biopsy was performed which showed pauci-immune cresentric glomerulonephritis. Her cANCA levels were positive. She was treated with oral cyclophosphamide and steroids and later responded. Keywords Wegener granulomatosis; Young girl; Cyclophophamide; cANCA PMID:21629538

  17. Anesthetic management of cesarean section with mitral stenosis and respiratory tract infection

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    Madagondapalli Srinivasan Nataraj

    2014-01-01

    Full Text Available Mitral stenosis in pregnancy is poorly tolerated because of the pregnancy induced physiological changes in the cardiovascular system. Our patient had presented with cardiac failure in 5 th month of gestation due to valve area of 0.8 cm 2 . She underwent commissurotomy and was asymptomatic with valve area of 1.6 cm 2 until term when she developed lower respiratory tract infection. Anesthetic management of emergency caesarean section in this patient is discussed where neuraxial block is not well-tolerated, and general anesthesia is associated with increased morbidity in the presence of reactive airways.

  18. Anatomy of the upper respiratory tract in domestic birds, with emphasis on vocalization.

    Science.gov (United States)

    Casteleyn, C; Cornillie, P; Van Cruchten, S; Van den Broeck, W; Van Ginneken, C; Simoens, P

    2018-04-01

    This work reviews the anatomy of the upper respiratory tract in domestic birds including the chicken and pigeon. Non-exhaustive additional information on other bird species, illustrating the extraordinary diversity in the biological class Aves, can be found in several footnotes. The described anatomical structures are functionally considered in view of avian sound production. In particular, the Syrinx is invaluable. Its most important structures are the Labia and the lateral and medial tympaniform membranes in non-songbirds and songbirds, respectively. These structures produce sound by vibrating during expiration and eventually inspiration. © 2018 Blackwell Verlag GmbH.

  19. The significance of Candida in the human respiratory tract: our evolving understanding.

    Science.gov (United States)

    Pendleton, Kathryn M; Huffnagle, Gary B; Dickson, Robert P

    2017-04-01

    Candida is an opportunistic pathogen and the most commonly isolated fungal genus in humans. Though Candida is often detected in respiratory specimens from humans with and without lung disease, its significance remains undetermined. While historically considered a commensal organism with low virulence potential, the status of Candida as an innocent bystander has recently been called into question by both clinical observations and animal experimentation. We here review what is currently known and yet to be determined about the clinical, microbiological and pathophysiological significance of the detection of Candida spp. in the human respiratory tract. Published by Oxford University Press on behalf of FEMS 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  20. 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.

  1. The bioactivity of plant extracts against representative bacterial pathogens of the lower respiratory tract.

    Science.gov (United States)

    Bocanegra-García, Virgilio; Del Rayo Camacho-Corona, María; Ramírez-Cabrera, Mónica; Rivera, Gildardo; Garza-González, Elvira

    2009-06-01

    Lower respiratory tract infections are a major cause of illness and death. Such infections are common in intensive care units (ICU) and their lethality persists despite advances in diagnosis, treatment and prevention. In Mexico, some plants are used in traditional medicine to treat respiratory diseases or ailments such as cough, bronchitis, tuberculosis and other infections. Medical knowledge derived from traditional societies has motivated searches for new bioactive molecules derived from plants that show potent activity against bacterial pathogens. Therefore, the aim of this study was to evaluate the effect of hexanic, chloroformic (CLO), methanolic (MET) and aqueous extracts from various plants used in Mexican traditional medicine on various microorganisms associated with respiratory disease. thirty-five extracts prepared from nine plants used in Mexican traditional medicine for the treatment of respiratory infections were evaluated against 15 control bacterial species and clinical isolates. Both chloroformic (CLO) and methanolic (MET) extracts of Larrea tridentata were active against Methicillin-resistant S. aureus, B. subtilis and L. monocytogenes. A MET extract of L. tridentata was also active against S. aureus, S. pneumoniae, S. maltophilia, E. faecalis and H. influenzae and the CLO extract was active against A. baumannii. An Aqueous extract of M. acumitata and a MET extract of N. officinale were active against S. pneumoniae. CLO and MET extracts of L. tridentata were active against clinical isolates of S. aureus, S. pneumoniae and E. faecalis. Overall, our results support the potential use of L. tridentata as a source of antibacterial compounds.

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

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    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

  3. Dose calculations for the respiratory tract from inhaled natural radioactive nuclides as a function of age

    International Nuclear Information System (INIS)

    Hofmann, W.; Steinhaeusler, F.; Pohl, E.

    1979-01-01

    The deposition and retention models and the anatomical and physiological data as proposed by the ICRP Task Groups on Lung Dynamics and Reference Man are valid only for adult dosimetry. However, the change of the growing organism causes an age-dependent variation of the radiation burden to the respiratory tract. Therefore, age-dependent functions of anatomical and physiological parameters were defined. For this purpose data were either interpolated from literature or calculated from theoretical modeling. With these functions and defined aerosol composition, age-dependent deposition probabilities in the single regions of the respiratory tract were determined. For the demonstration of lung dosimetry as a function of age the naturally occurring radon daughters were used as an example. By applying typical mean nuclide concentrations found in the atmosphere of an urban environment and defined age-dependent daily life patterns, the annual inhaled amount of radioactivity was computed. With the above data, dose calculations for the single ICRP lung model compartments were performed. This revealed that the inhaled dose in both the tracheobronchial and pulmonary regions showed a strong dependence on age; a pronounced maximum value was reached at the age of about 6 yr for radon and thoron decay products. (author)

  4. Comparative study of erythromycin, amoxicillin and ampicillin antimicrobial activity against human respiratory tract pathogens.

    Science.gov (United States)

    Liss, R H; Norman, J C; Goldmann, D A

    1979-01-01

    An in vitro test system was used to compare the antimicrobial activity of erythromycin, amoxicillin and ampicillin against respiratory tract pathogens isolated from man. The minimum inhibitory concentrations (MICs) of fresh clinical isolates of Streptoccus pyogenes, Streptocuccus pneumoniae, Staphylococcus aureus and Haemophilus influenzae to the macrolide and penicillins ranged between 0.01 and 0.9 microgram/ml. The microbes were exposed to each antibiotic for approximately 3 h at 1x,2x and 5x the relevant MIC. Irreversible surface defects and intracellular lesions were resolved by scanning and transmission electron microscopy in all antibiotic-treated bacterial species, irrespective of the antimicrobial used. In each case, inhibition of growth was recorded by turbometric assay; no significant difference was observed among the declining slopes of post-dosing growth curves for either erythromycin-, amoxicillin- or ampicillin-treated pathogens. The experimental observations show that the onset of antimicrobial activity and the bactericidal effectiveness of equipotent concentrations of erythromycin, amoxicillin and ampicillin were comparable in this study. The results complement previous clinical, bacteriologic and ultrastructure studies in vivo and demonstrate the contribution of the combined in vivo/in vitro study design for better understanding of antimicrobial activity in human respiratory tract infections.

  5. Streptococcus suis – The “Two Faces” of a Pathobiont in the Porcine Respiratory Tract

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    Désirée Vötsch

    2018-03-01

    Full Text Available Streptococcus (S. suis is a frequent early colonizer of the upper respiratory tract of pigs. In fact, it is difficult to find S. suis-free animals under natural conditions, showing the successful adaptation of this pathogen to its porcine reservoir host. On the other hand, S. suis can cause life-threatening diseases and represents the most important bacterial cause of meningitis in pigs worldwide. Notably, S. suis can also cause zoonotic infections, such as meningitis, septicemia, endocarditis, and other diseases in humans. In Asia, it is classified as an emerging zoonotic pathogen and currently considered as one of the most important causes of bacterial meningitis in adults. The “two faces” of S. suis, one of a colonizing microbe and the other of a highly invasive pathogen, have raised many questions concerning the interpretation of diagnostic detection and the definition of virulence. Thus, one major research challenge is the identification of virulence-markers which allow differentiation of commensal and virulent strains. This is complicated by the high phenotypic and genotypic diversity of S. suis, as reflected by the occurrence of (at least 33 capsular serotypes. In this review, we present current knowledge in the context of S. suis as a highly diverse pathobiont in the porcine respiratory tract that can exploit disrupted host homeostasis to flourish and promote inflammatory processes and invasive diseases in pigs and humans.

  6. [Molecular characterization of pathogenic bacteria of the respiratory tract in peruvian patients with cystic fibrosis].

    Science.gov (United States)

    Aquino, Ruth; Gonzáles, Emely; Samaniego, Sol; Rivera, Juan; Cedeño, Virna; Urbina, Yrene; Diringer, Benoit

    2017-01-01

    To molecularly characterize the pathogenic bacteria of the respiratory tract isolated from patients with cystic fibrosis (CF) in Peru. Bacterial communities cultured from sputum samples of pediatric and adult patients with CF admitted to the Edgardo Rebagliati Martins National Hospital and the National Institute of Child Health were characterized. Standard microbiological techniques were used for bacterial culture, and gene sequencing of 16S rRNA and matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) mass spectrometry and tandem MALDI-TOF mass spectrometry (MALDI TOF/TOF) were used for molecular characterization. Seventeen bacterial strains were characterized by 16S rRNA sequencing, and the identified pathogenic bacteria were Pseudomonas aeruginosa (31.5%), Staphylococcus aureus (12.6%), Pseudomonas spp. (11.8%), and Klebsiella oxytoca (3.1%). MALDI-TOF analysis generated a series of spectra representative of each isolated bacterial species, whereas MALDI TOF/TOF analysis identified the peptides and proteins of the most common strains and provided data on pathogenicity and sensitivity to antibiotics. The primary pathogenic microorganisms found in the respiratory tract of patients with CF in Peru were the same as those found in other countries. This study is the first to perform 16S rRNA sequencing as well as MALDI-TOF and MALDI-TOF/TOF analysis of the bacterial pathogens circulating in Peru. The inclusion of proteomic analysis further allowed for the identification of native microorganisms involved in CF.

  7. Surveillance of the activity of solithromycin (CEM-101) against bacteria from respiratory tract infections.

    Science.gov (United States)

    Hawser, Stephen; Morrissey, Ian; Lemos, Barbara; Keedy, Kara; Fernandes, Prabhavathi

    2017-07-01

    The activity of solithromycin, a fourth-generation macrolide and novel fluoroketolide, was evaluated by determining its minimum inhibitory concentration (MIC) (via Clinical and Laboratory Standards Institute broth microdilution) against 2797 contemporary clinical respiratory tract isolates collected from North America, Europe, Asia-Pacific and other regions of the world in 2012-13. Solithromycin was very active against Streptococcus pneumoniae and Streptococcus pyogenes, with MIC 90 of 0.25 and 0.12 µg/mL, respectively. Isolates with combined macrolide resistance genes ermB and mefE had a higher solithromycin MIC distribution, but the highest MIC recorded was 1 µg/mL for one S. pneumoniae isolate from Japan and one S. pyogenes isolate from China. Solithromycin was active against methicillin-susceptible Staphylococcus aureus (MIC 90 0.12 µg/mL) but not against methicillin-resistant S. aureus (MRSA) (MIC 90 >32 µg/mL). However, MRSA strains most commonly observed with community-associated infections (i.e. SCCmec IV) were more susceptible than other MRSA SCCmec types. Gram-negative pathogens that cause community-acquired respiratory tract infections (Haemophilus influenzae and Moraxella catarrhalis) were inhibited by solithromycin isolated from worldwide locations (MIC 90 2 and 0.25 µg/mL, respectively). These data support the continued development of solithromycin for the treatment of community-acquired pneumonia globally. Copyright © 2017 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

  8. Glycomic analysis of human respiratory tract tissues and correlation with influenza virus infection.

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    Trevenan Walther

    2013-03-01

    Full Text Available The first step in influenza infection of the human respiratory tract is binding of the virus to sialic (Sia acid terminated receptors. The binding of different strains of virus for the receptor is determined by the α linkage of the sialic acid to galactose and the adjacent glycan structure. In this study the N- and O-glycan composition of the human lung, bronchus and nasopharynx was characterized by mass spectrometry. Analysis showed that there was a wide spectrum of both Sia α2-3 and α2-6 glycans in the lung and bronchus. This glycan structural data was then utilized in combination with binding data from 4 of the published glycan arrays to assess whether these current glycan arrays were able to predict replication of human, avian and swine viruses in human ex vivo respiratory tract tissues. The most comprehensive array from the Consortium for Functional Glycomics contained the greatest diversity of sialylated glycans, but was not predictive of productive replication in the bronchus and lung. Our findings indicate that more comprehensive but focused arrays need to be developed to investigate influenza virus binding in an assessment of newly emerging influenza viruses.

  9. Perceptions of barriers to the management of respiratory tract infections in general practice settings in Australia.

    Science.gov (United States)

    Fletcher-Lartey, Stephanie; Khan, Rabia

    2017-10-01

    Inappropriate prescribing of antibiotics for the management of respiratory tract infections (RTIs) has contributed to increased prevalence of antibiotic resistance, and this remains a challenge. The aim of this study was to evaluate the effect of general practitioners' (GPs) participation in the Antibiotics: Clinical e-Audit, a quality-improvement activity, on GP self-reported knowledge and practice change, and explored barriers encountered in the management of respiratory tract infections (RTIs). Participants completed a survey at the end of the activity to assess the usefulness of the audit, any reported changes made and barriers encountered to their clinical practice. More than half of the 872 participants reported the audit assisted them in reviewing patients with RTIs. The majority of GP registrars (48.2%, N=66) indicated that the clinical e-Audit had changed their practice in terms of identifying patients for whom an antibiotic was recommended. GPs identified several barriers to achieving best practice in the management of RTIs, including patient or carer expectations for an antibiotic prescription and non-adherence to symptomatic management by patients. Empowering GPs to overcome these barriers should be the aim of future education and behaviour change programs.

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

    International Nuclear Information System (INIS)

    Abdullah, F.E.; Ahuja, K.R.; Kumar, H

    2013-01-01

    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)

  11. S. mansoni bolsters anti-viral immunity in the murine respiratory tract.

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    Sebastian Scheer

    Full Text Available The human intestinal parasite Schistosoma mansoni causes a chronic disease, schistosomiasis or bilharzia. According to the current literature, the parasite induces vigorous immune responses that are controlled by Th2 helper cells at the expense of Th1 helper cells. The latter cell type is, however, indispensable for anti-viral immune responses. Remarkably, there is no reliable literature among 230 million patients worldwide describing defective anti-viral immune responses in the upper respiratory tract, for instance against influenza A virus or against respiratory syncitial virus (RSV. We therefore re-examined the immune response to a human isolate of S. mansoni and challenged mice in the chronic phase of schistosomiasis with influenza A virus, or with pneumonia virus of mice (PVM, a mouse virus to model RSV infections. We found that mice with chronic schistosomiasis had significant, systemic immune responses induced by Th1, Th2, and Th17 helper cells. High serum levels of TNF-α, IFN-γ, IL-5, IL-13, IL-2, IL-17, and GM-CSF were found after mating and oviposition. The lungs of diseased mice showed low-grade inflammation, with goblet cell hyperplasia and excessive mucus secretion, which was alleviated by treatment with an anti-TNF-α agent (Etanercept. Mice with chronic schistosomiasis were to a relative, but significant extent protected from a secondary viral respiratory challenge. The protection correlated with the onset of oviposition and TNF-α-mediated goblet cell hyperplasia and mucus secretion, suggesting that these mechanisms are involved in enhanced immune protection to respiratory viruses during chronic murine schistosomiasis. Indeed, also in a model of allergic airway inflammation mice were protected from a viral respiratory challenge with PVM.

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

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    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

  13. Risk factors and features of recurrent bacterial complications of upper respiratory tract viral infections in children

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    Karpenko A.V.

    2017-10-01

    Full Text Available The aim of the study was to determine risk factors for recurrent bacterial complications of the upper respiratory tract viral infection (URTI in children, as well as the clinical and immunological features of the course of such complications. We enrolled 214 children aged 3-18 years with URTIs complicated with acute otitis media or acute bacterial rhinosinusitis. Frequency of bacterial complications of URI in 128 children was low (group I and in 86 children it met the criteria of recurrent course (group II. In addition to the standard examination, lysozyme levels in the oropharyngeal secretion were determined three times during the disease. It was found that children of group II were characterized by an early debut of respiratory morbidity (at the age of 6.00 (4.00, 12.00 months against 13.00 (4.50, 16.00 months in children of group I (p<0,0001, as well as a longer duration of catarrhal and intoxication syndromes in similar forms of the disease. The most significant risk factors for the formation of the recurring complication pattern were maternal smoking (OR=2.73, 95% CI [1.34, 5.48], along with gastroenterological pathology and frequent URTI in the mother and a shortened period of breastfeeding. In children with recurrent bacterial complications of URTI, there was an impaired local resistance of the upper respiratory tract mucous membranes (as a decrease in the concentrations of lysozyme in all periods of the disease, which persisted after recovery.

  14. Application of morphological and physiological parameters representative of a Brazilian population sample in the respiratory tract model

    International Nuclear Information System (INIS)

    Dos Reis, A. A.; Cardoso, J. C. S.; Lourenco, M. C.

    2007-01-01

    The human respiratory tract model (HRTM) adopted by ICRP in its 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. These characteristics are important to determine the fractional deposition. 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 wherever such information is available. The main purpose of this study is to verify the influence of using the morphology and physiology parameters representative of a sample of the Brazilian population on the deposition model of the ICRP Publication 66 model. (authors)

  15. How French general practitioners manage and prevent recurrent respiratory tract infections in children: the SOURIRRE survey

    Science.gov (United States)

    Chicoulaa, Bruno; Haas, Hervé; Viala, Jérôme; Salvetat, Maryline; Olives, Jean-Pierre

    2017-01-01

    Background Recurrent respiratory tract infections (RRTIs) are the most common reason for children’s visits to primary care physicians in France; however, little is known about general practitioners’ (GPs) opinions and expectations concerning the management and prevention of these common and recurrent pathologies. Purpose To describe French GPs’ daily practice in the management of respiratory infections and the prevention of their recurrence in children. Methods A sample group of French GPs answered a structured questionnaire on risk factors, RRTI management, antibiotic use and prevention measures. Results A total of 358 GPs participated in the survey. Rhinopharyngitis, the most frequent respiratory infection, was considered to be recurrent if six or more episodes occurred in a year. Four risk factors were acknowledged as substantial: living in communities, passive smoking, pollution and allergies. Around 63% of GPs said that RRTIs are too often treated with antibiotics. More than 85% thought that prevention of RRTIs is possible. Smoking cessation, vaccination, allergen avoidance and hygiene were identified as the main preventive measures. A large majority of GPs (84%) prescribed products for prevention and ~90% would prescribe a product stimulating immunity if the efficacy and tolerability of these agents was proven and confirmed in their daily practice. Conclusions French GPs are well aware of the health and socioeconomic burdens resulting from RRTIs, as well as the risk of antibiotic overuse. They have a prevention-oriented approach, implement preventive measures when possible and prescribe products for prevention. PMID:28293116

  16. Molecular Analysis of Human Metapneumovirus Detected in Patients with Lower Respiratory Tract Infection in Upper Egypt

    Science.gov (United States)

    Embarek Mohamed, Mona S.; Jacobsen, Sonja; Thabit, Amany G.; Badary, Mohamed S.; Brune, Wolfram; Schweiger, Brunhilde; Osmann, Ahmed H.

    2014-01-01

    Introduction. Since 2001, when Human metapneumovirus (HMPV) was isolated in the Netherlands, the virus has been detected in several continents. Although reports have confirmed the prevalence of HMPV worldwide, data from Egypt remain limited. HMPV plays an important role in respiratory tract infections in individuals of all ages particularly in children. This study was aimed at estimating the prevalence of HMPV in patients with community-acquired lower respiratory infection in Upper Egypt and characterizing the circulating Egyptian HMPV strains for the first time. Materials and Methods. From 2005 to 2008, respiratory samples from 520 patients were analyzed for the presence of HMPV by real-time RT-PCR. Molecular and phylogenetic analyses were performed on partial fusion gene sequences of HMPV-positive patients. Results. HMPV-positive patients were detected in 2007-2008. The overall infection rate was 4%, while 57% of the patients were children. Sequence analysis demonstrated circulation of subgroup B viruses with predominance of lineage B2. Nucleotide sequence identity within lineage B1 was 98.8%–99.7% and higher than that in lineage B2 (94.3%–100%). Three new amino acid substitutions (T223N, R229K, and D280N) of lineage B2 were observed. Conclusion. HMPV is a major viral pathogen in the Egyptian population especially in children. During 2007-2008, predominantly HMPV B2 circulated in Upper Egypt. PMID:24669221

  17. Protection against avian metapneumovirus subtype C in turkeys immunized via the respiratory tract with inactivated virus.

    Science.gov (United States)

    Cha, Ra Mi; Khatri, Mahesh; Sharma, Jagdev M

    2011-01-10

    Avian metapneumovirus subtype C (aMPV/C) causes a severe upper respiratory tract (URT) infection in turkeys. Turkeys were inoculated oculonasally with inactivated aMPV/C adjuvanted with synthetic double-stranded RNA polyriboinosinic polyribocytidylic acid (Poly IC). Immunized turkeys had elevated numbers of mucosal IgA+ cells in the URT and increased levels of virus-specific IgG and IgA in the lachrymal fluid and IgG in the serum. After 7 or 21 days post immunization, turkeys were challenged oculonasally with pathogenic aMPV/C. Immunized groups were protected against respiratory lesions induced by the challenge virus. Further, the viral copy number of the challenge virus in the URT were significantly lower in the immunized turkeys than in the unimmunized turkeys (P<0.05). These results showed that inactivated aMPV/C administered by the respiratory route induced protective immunity against pathogenic virus challenge. Copyright © 2010 Elsevier Ltd. All rights reserved.

  18. Epidemiological Features and Antibiotic Resistance Patterns of Haemophilus influenzae Originating from Respiratory Tract and Vaginal Specimens in Pediatric Patients.

    Science.gov (United States)

    Li, Jian-Ping; Hua, Chun-Zhen; Sun, Li-Ying; Wang, Hong-Jiao; Chen, Zhi-Min; Shang, Shi-Qiang

    2017-12-01

    Haemophilus influenzae (H. influenzae) is a common pathogen of respiratory tract infections in children, however, as a possible cause of vulvovaginitis in prepubertal girls, its epidemiological features, antibiotic-resistance patterns, and treatment are seldom noted. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: Specimens obtained from patients were inoculated on Haemophilus selective medium; and drug-sensitivities tests were determined using the disk diffusion method. A cefinase disk was used to detect β-lactamase. A total of 610 H. influenzae strains, 81.6% (498/610) from the respiratory tract and 18.0% (110/610) from the vagina, were identified in the Children's Hospital in 2015. The age of the children with respiratory tract strains were significantly younger than those with vaginal strains (P influenzae isolation rate in May was the highest. The β-lactamase positive rate was 51.5% (314/610), and 52.5% (320/610) were resistant to ampicillin. The susceptibilities rates to cefuroxime, ampicillin/sulbactam, cefotaxime, clarithromycin, and sulfamethoxazole-trimethoprim were 72.1% (440/610), 95.9%, 96.4% (588/610), 81.8% (499/610), and 36.4% (222/610), respectively. Higher resistance to ampicillin, cefuroxime, clarithromycin, and sulfamethoxazole-trimethoprim were found in respiratory tract strains, compared with vaginal strains (P influenzae in the respiratory tract were cured with oral or intravenous β-lactam antibiotics. Of all patients with vaginal strains, 50% (55/110) were cured with topical ofloxacin gel, and 44.5% (49/110) were cured with oral β-lactam antibiotics. The drug-resistance rates of H. influenzae isolated from vagina were lower than those from the respiratory tract. Topical ofloxacin gel or oral β-lactam antibiotics are effective treatments to eliminate the H. influenza causing infection in the vagina. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All

  19. Challenges to nurse prescribers of a no-antibiotic prescribing strategy for managing self-limiting respiratory tract infections.

    Science.gov (United States)

    Rowbotham, Samantha; Chisholm, Anna; Moschogianis, Susie; Chew-Graham, Carolyn; Cordingley, Lis; Wearden, Alison; Peters, Sarah

    2012-12-01

    To report a qualitative study of the experiences of nurse prescribers in managing patients with self-limiting respiratory tract infections. Patients frequently attend primary care with respiratory tract infections. Although a no-prescribing strategy is recommended for these consultations, general practitioners frequently prescribe antibiotics, citing non-clinical reasons such as patient pressure. Nurses increasingly manage people with respiratory tract infections, but research has not yet explored their experiences within such consultations. Semi-structured interviews and focus groups. Fifteen semi-structured interviews and three focus groups (n=5, n=4, and n=12) with a purposive sample of nurse prescribers (n=34) and other non-medical prescribers (n=2) were conducted between November 2009-November 2010. A qualitative approach was used to develop conceptual categories from the dataset, and emerging themes were explored in subsequent interviews/focus groups. Although participants reported experiencing numerous challenges within these consultations, they believed that they possessed some of the communication skills to deal effectively with patients without prescribing antibiotics. Participants reported that protocols supported their decision-making and welcomed the benefits of peer support in dealing with 'demanding' patients. However, the newness of nurses and other non-medical prescribers to the prescribing role meant that some were cautious in dealing with patients with respiratory tract infections. Training for nurses and other non-medical prescribers should focus on building their confidence and skills to manage people with respiratory tract infections without recourse to antibiotics. Further work should seek to explore which strategies are most effective in managing respiratory tract infections while maintaining patient satisfaction with care. © 2012 Blackwell Publishing Ltd.

  20. Application of morphological and physiological parameters representative of a sample Brazilian population in the human respiratory tract model

    International Nuclear Information System (INIS)

    Reis, A.A.; Cardoso, J.C.S.; Lourenco, M.C.

    2005-01-01

    Full text: The Human Respiratory Tract Model (HRTM) proposed in ICRP Publication 66 account 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. These changing characteristics can influence the rates and the sites of deposition. 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 HRTM model uses morphological and physiological parameters from the Caucasian man to establish deposition fractions in the respiratory tract regions. lt 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 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 in 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 respiratory values at different levels of activity for ages varying from

  1. New insights on the biology of swine respiratory tract mycoplasmas from a comparative genome analysis

    Science.gov (United States)

    2013-01-01

    Background Mycoplasma hyopneumoniae, Mycoplasma flocculare and Mycoplasma hyorhinis live in swine respiratory tracts. M. flocculare, a commensal bacterium, is genetically closely related to M. hyopneumoniae, the causative agent of enzootic porcine pneumonia. M. hyorhinis is also pathogenic, causing polyserositis and arthritis. In this work, we present the genome sequences of M. flocculare and M. hyopneumoniae strain 7422, and we compare these genomes with the genomes of other M. hyoponeumoniae strain and to the a M. hyorhinis genome. These analyses were performed to identify possible characteristics that may help to explain the different behaviors of these species in swine respiratory tracts. Results The overall genome organization of three species was analyzed, revealing that the ORF clusters (OCs) differ considerably and that inversions and rearrangements are common. Although M. flocculare and M. hyopneumoniae display a high degree of similarity with respect to the gene content, only some genomic regions display considerable synteny. Genes encoding proteins that may be involved in host-cell adhesion in M. hyopneumoniae and M. flocculare display differences in genomic structure and organization. Some genes encoding adhesins of the P97 family are absent in M. flocculare and some contain sequence differences or lack of domains that are considered to be important for adhesion to host cells. The phylogenetic relationship of the three species was confirmed by a phylogenomic approach. The set of genes involved in metabolism, especially in the uptake of precursors for nucleic acids synthesis and nucleotide metabolism, display some differences in copy number and the presence/absence in the three species. Conclusions The comparative analyses of three mycoplasma species that inhabit the swine respiratory tract facilitated the identification of some characteristics that may be related to their different behaviors. M. hyopneumoniae and M. flocculare display many differences

  2. Human metapneumovirus found in clinical materials of children with respiratory tract diseases

    Directory of Open Access Journals (Sweden)

    Katarina Logar

    2006-10-01

    Full Text Available Background: Human metapneumovirus (hMPV was first recognized in the Netherlands in 2001. Since then, it has been documented all over the world as a cause of human respiratory infections in all age groups. The objective of this study was to introduce and optimize an assay for detecting hMPV in clinical material of our patients. To date, there has not been a report that describes the detection of this virus in Slovenia.Methods: A total of 58 specimens, randomly collected during 2003/2004 from the patients ≤ 19 years old with respiratory disease and 20 specimens collected in 1997 were tested for hMPV. Extraction of RNA from frozen specimens and subsequent single-step reverse transcription-polymerase chain reaction (RT-PCR were performed. Human metapneumovirus amplicons were determined by electrophoresis in a 2 % (w/v agarose gel.Results: Human metapneumovirus was detected in 13/58 (22 % specimens; 10/40 (25 % specimens were from the upper and 3/18 (17 % from the lower respiratory tract. The mean age of infected patients was 3.2 ± 2.2 years. Out of 13 of the hMPV-positive specimens, 9 were positive also for another respiratory virus. Two of 20 (10 % archival specimens were hMPV-positive.Conclusions: This study is the first report about hMPV in Slovenia. Human metapneumovirus was detected as the second most frequent virus after RSV in children < 3 years of age. The virus was not found in the specimens from the children younger than 2 months. Based on the hMPV-positive results in archival clinical material, it is suggested that hMPV had circulated in Slovenia before the time it was discovered.

  3. The bioactivity of plant extracts against representative bacterial pathogens of the lower respiratory tract

    Directory of Open Access Journals (Sweden)

    Bocanegra-García Virgilio

    2009-06-01

    Full Text Available Abstract Background Lower respiratory tract infections are a major cause of illness and death. Such infections are common in intensive care units (ICU and their lethality persists despite advances in diagnosis, treatment and prevention. In Mexico, some plants are used in traditional medicine to treat respiratory diseases or ailments such as cough, bronchitis, tuberculosis and other infections. Medical knowledge derived from traditional societies has motivated searches for new bioactive molecules derived from plants that show potent activity against bacterial pathogens. Therefore, the aim of this study was to evaluate the effect of hexanic, chloroformic (CLO, methanolic (MET and aqueous extracts from various plants used in Mexican traditional medicine on various microorganisms associated with respiratory disease. Methods thirty-five extracts prepared from nine plants used in Mexican traditional medicine for the treatment of respiratory infections were evaluated against 15 control bacterial species and clinical isolates. Results Both chloroformic (CLO and methanolic (MET extracts of Larrea tridentata were active against Methicillin-resistant S. aureus, B. subtilis and L. monocytogenes. A MET extract of L. tridentata was also active against S. aureus, S. pneumoniae, S. maltophilia, E. faecalis and H. influenzae and the CLO extract was active against A. baumannii. An Aqueous extract of M. acumitata and a MET extract of N. officinale were active against S. pneumoniae. CLO and MET extracts of L. tridentata were active against clinical isolates of S. aureus, S. pneumoniae and E. faecalis. Conclusion Overall, our results support the potential use of L. tridentata as a source of antibacterial compounds.

  4. The preventive effect on respiratory tract infections of Oscillococcinum®. A cost-effectiveness analysis

    Directory of Open Access Journals (Sweden)

    Colombo GL

    2018-01-01

    Full Text Available Giorgio L Colombo,1,2 Sergio Di Matteo,2 Chiara Martinotti,2 Martina Oselin,2 Giacomo M Bruno,2 Gianfranco M Beghi3 1Department of Drug Sciences, University of Pavia, Pavia, Italy; 2S.A.V.E. Studi Analisi Valutazioni Economiche S.r.l., Health Economics & Outcomes Research, Milan, Italy; 3Unit of Pulmonary Rehabilitation, Hospital of Casorate Primo, Pavia, Italy Background: Anas barbariae hepatis et cordis extractum 200K (Oscillococcinum® is used to treat and prevent seasonal colds and airway inflammatory affections, improve symptom control, and reduce the frequency of respiratory tract infection (RTI episodes. The objective of this controlled observational study is to investigate, from the Italian National Health Service (NHS point of view, the role of Anas barbariae hepatis et cordis extractum 200K in preventing RTIs and estimate the annual average cost per patient due to visits and medicines in a real-world setting, investigating whether this method of treatment can bring savings for the NHS.Methods: Data from a single center from 2002 to 2011 were used. The analysis examined 455 patients who suffered from respiratory diseases. Of the total number of patients, 246 were treated with Anas barbariae hepatis et cordis extractum 200K while 209 were not treated (Control group. All the data concerning RTI episodes, pharmacological treatments, and pneumological visits were extracted from the database.Results: It was found that, regardless of the diagnosis, the frequency of RTI episodes was always lower in patients treated with Anas barbariae hepatis et cordis extractum 200K; the difference between the numbers of events occurring was statistically significant in every class of patients (p<0.001. The costs that the NHS had to incur were significantly lower in the classes of patients treated (p<0.001.Discussion: The results indicate that Anas barbariae hepatis et cordis extractum 200K has a preventive effect on the onset of RTI episodes. The analysis

  5. Functional and genetic predisposition to rhinovirus lower respiratory tract infections in prematurely born infants.

    Science.gov (United States)

    Drysdale, Simon B; Alcazar, Mireia; Wilson, Theresa; Smith, Melvyn; Zuckerman, Mark; Hodemaekers, Hennie M; Janssen, Riny; Bont, Louis; Johnston, Sebastian L; Greenough, Anne

    2016-12-01

    Term born infants are predisposed to human rhinovirus (HRV) lower respiratory tract infections (LRTI) by reduced neonatal lung function and genetic susceptibility. Our aim was to investigate whether prematurely born infants were similarly predisposed to HRV LRTIs or any other viral LRTIs. Infants born less than 36 weeks of gestational age were recruited. Prior to neonatal/maternity unit discharge, lung function (functional residual capacity by helium gas dilution and multiple breath washout, lung clearance index and compliance (C rs ), and resistance (R rs ) of the respiratory system) was assessed and DNA samples assessed for eight single nucleotide polymorphisms (SNPs) in seven genes: ADAM33, IL10, MMP16 NFκB1A,SFTPC, VDR, and NOS2A. Infants were prospectively followed until 1 year corrected age. Nasopharyngeal aspirates (NPAs) were sent whenever an infant developed a LRTI and tested for 13 viruses. One hundred and thirty-nine infants were included in the analysis. Infants who developed HRV LRTIs had reduced C rs (1.6 versus 1.2 mL/cmH 2 O/kg, p = 0.044) at 36 weeks postmenstrual age. A SNP in the gene coding for the vitamin D receptor was associated with the development of HRV LRTIs and any viral LRTIs (p = 0.02). Prematurely born infants may have both a functional and genetic predisposition to HRV LRTIs. What is Known: • Term born infants are predisposed to rhinovirus lower respiratory tract (HRV LRTIs) infection by reduced neonatal lung function. • Term born infants requiring hospitalisation due to HRV bronchiolitis were more likely to have single nucleotide polymorphism (SNP) in the IL-10 gene. What is New: • Prematurely born infants who developed a HRV LRTI had lower C rs before maternity unit discharge. • A SNP in the gene coding for the vitamin D receptor was associated with the development of HRV LRTIs and overall respiratory viral LRTIs in prematurely born infants.

  6. Experimental determination of the absorption rate of unattached radon progeny from respiratory tract to blood

    International Nuclear Information System (INIS)

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

    2002-01-01

    An exposure methodology was developed for the determination of the absorption rate of unattached radon progeny deposited in the human respiratory tract to blood. Twenty-one volunteers were exposed in a radon chamber during well-controlled aerosol and radon progeny conditions, with predominantly unattached radon daughters. Special efforts were made to restrict the dose to the volunteers to an absolute maximum of 0.08 mSv. Measurements of radon gas and radon progeny in blood samples of these volunteers indicated absorption half times of 20 min to 60 min. Former determinations, mainly performed with much larger aerosol particles of diameters between 100 nm and 1000 nm, implied absorption half times around 10 h. This indicates that the absorption of radon decay products from ciliated airways into blood is dependent upon particle size and particle composition. (author)

  7. Management of lower respiratory tract infection in outpatient settings: Focus on clarithromycin

    Directory of Open Access Journals (Sweden)

    Ashok Mahashur

    2018-01-01

    Full Text Available Lower respiratory tract infection (LRTI is a broad terminology which includes acute bronchitis, pneumonia, acute exacerbations of chronic obstructive pulmonary disease/chronic bronchitis (AECB, and acute exacerbation of bronchiectasis. Acute LRTIs (ALRTIs are one of the common clinical problems in community and hospital settings. Management of community-acquired pneumonia (CAP and AECB may pose challenges because of diagnostic difficulty in differentiating infections caused by typical and atypical microorganisms and rising rates of antimicrobial resistance. Beta-lactam antibiotics, macrolides, and fluoroquinolones are routinely prescribed medicines for the management of ALRTIs. Macrolides are time-tested and effective agents for the treatment of LRTIs. Clarithromycin, a macrolide, offers several benefits in the management of ALRTIs. In this article, we discuss the management approach of LRTIs with focus on clarithromycin in the management of mild-to-moderate LRTIs (CAP and AECB, i.e., in outpatient settings.

  8. 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

    of Infectious Diseases, Odense University Hospital, Denmark. METHOD: A total of 364 adults diagnosed with community-acquired LRTI by their GP were studied with chest radiography, vital signs, biochemical markers of inflammation (C-reactive protein [CRP] and leukocyte count), and microbiological examinations......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......; this emphasises the importance of coverage of S. pneumoniae when treatment is indicated. CRP should not be introduced for diagnosis of radiographic pneumonia in general practice before its use has been investigated in prospective, controlled intervention trials using CRP-guided treatment algorithms....

  9. 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....... In the group of GPs following the BI, first-line antibiotics accounted for 23.8% of antibiotics before the intervention and 29.4% after (increase 5.6%, 95% confidence interval (CI): 1.2-10%), while in the group of GPs following the II these figures were 26.2% and 48.6% (increase 22.4%, 95% CI: 18...

  10. 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...... practitioners, clinical microbiologists and clinical pharmacologists was invited. A list of 59 quality indicators focusing on the quality of the diagnostic process, the antibiotic treatment and the choice of antibiotics was generated. A thorough literature review was carried out to ensure that all potential...... indicators were considered. The experts were asked to rate the relevance of 59 quality indicators with regard to reducing antimicrobial resistance and improving patient health. Consensus for a quality indicator was reached if ≥ 75 % of experts scored the item ≥ 5 on a 7-point Likert scale, ranging from 1...

  11. External Validation of Prediction Models for Pneumonia in Primary Care Patients with Lower Respiratory Tract Infection

    DEFF Research Database (Denmark)

    Schierenberg, Alwin; Minnaard, Margaretha C; Hopstaken, Rogier M

    2016-01-01

    BACKGROUND: Pneumonia remains difficult to diagnose in primary care. Prediction models based on signs and symptoms (S&S) serve to minimize the diagnostic uncertainty. External validation of these models is essential before implementation into routine practice. In this study all published S&S models...... for prediction of pneumonia in primary care were externally validated in the individual patient data (IPD) of previously performed diagnostic studies. METHODS AND FINDINGS: S&S models for diagnosing pneumonia in adults presenting to primary care with lower respiratory tract infection and IPD for validation were...... identified through a systematical search. Six prediction models and IPD of eight diagnostic studies (N total = 5308, prevalence pneumonia 12%) were included. Models were assessed on discrimination and calibration. Discrimination was measured using the pooled Area Under the Curve (AUC) and delta AUC...

  12. 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.

  13. 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

  14. 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...... 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...... to microbiological sampling. Patients in the study group with known aetiology had higher values of inflammatory markers than patients with unknown aetiology. For Streptococcus pneumoniae infection culture and urine antigen detection were complimentary depending on recent antibiotic therapy since seven of eight...

  15. 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.

  16. Bacteria etiological agents causing respiratory tract infections in children and their resistance patterns to a panel of ten antibiotics

    Directory of Open Access Journals (Sweden)

    Nweze EI

    2012-02-01

    Full Text Available Objective: To study the bacteria etiological agents of respiratory tract infection among 280 school children in South East Nigeria, and to determine their antimicrobial resistance patterns to a panel of ten antibiotics. Methods: Throat swabs (280 were collected from students in four boarding schools located in Enugu and Onitsha metropolis. Standard microbiological procedures were used to screen these swabs to determine the prevalence of respiratory pathogens while the disc diffusion test was used to determine the antimicrobial resistance patterns of the recovered isolates. Results: Of the 280 samples screened, 57.1% were positive. Haemophilus influenzae was the most prevalent (16.1%, followed by Streptococcus pyogenes (13.9%, Klebsiella pneumoniae (12.5%, Streptococcus pneumoniae (6.8%, Staphylococcus aureus (5.4% and Corynebacterium diphtheriae (2.5%. More isolates were recovered in the two male schools investigated. However, there was no significant difference in the overall prevalence of isolates according to sex or school location of the subjects. Greater number of isolates (56% was recovered from those aged 11-14 years. This was statistically significant (P<0.05, compared to the other two age groups (15-18 years and 19-23 years. The pattern of resistance varied according to the bacteria species. There were multi-resistant isolates. Since these students stand the risk of contracting respiratory tract infection particularly from reservoirs among them, there is need to increase surveillance and develop better strategies to curb the increasing prevalence of respiratory tract infection in this and other similar regions of Africa. Conclusions: The spectrum of bacteria causing respiratory tract infection is still wide in Nigeria. Many isolates showed appreciable levels of antibiotic resistance apparently due to antibiotic abuse. Development of new strategies to curb this increasing prevalence of respiratory tract infection is warranted.

  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. -Structure of the respiratory system of the Ulodera Hynobius neblosus tokyoensis Tago, with special reference to the distribution of serotonin-immunoreactive cells in its respiratory tract epithelium.

    Science.gov (United States)

    Kikuchi, Y

    1995-12-01

    The respiratory tract epithelium in many vertebrate species has a neuroepithelial endocrine (NEE) system. This system is composed of solitary NEE cells or organoid cell groups called neuroepithelial bodies (NEBs). In response to chemical and physical stimuli, NEE cells may release bioactive substances. Serotonin, one of the biogenic amines, well-known as a constricter of smooth muscle, can be found in NEE cells, serotonin-immunoreactive cells can be used as a marker for these cells. Comparative histological studies of lower vertebrates can improve our understanding of mammalian respiratory systems. The Tokyo salamander (Hynobius neblosus tokyoensis Tago), classified as Ulodera, is particularly useful for comparative studies of respiration. In this study, the serial sections of respiratory tract of the Tokyo salamander were stained by a commonly used staining method and by an immunocytochemical method for serotonin, and the distribution of serotonin-immunoreactive cells in the respiratory tract was examined. The respiratory tract was found to be connected to the alimentary tract via an aditus laryngis, which opens on the medio-ventral side of the esophagus. The laryngotrachea was slit-like or elliptically shaped with a total length of about 3.5 mm, joining the aditus laryngis. The laryngotrachea was supported by a pair of lateral cartilages, and a fibromuscular layer was seen between the cartilages and the epithelium. In the cranial region, a laryngeal sphincter was seen around the laryngotrachea. The laryngotrachea branches into a pair of tube-like lungs, that are about 17-20 mm in length. Two apposed primary trabeclae run along the entire length of the lung wall, perpendicular to the axis, and containing the pulmonary arteries and veins. The lungs were divided into two portions: 1) an airway portion (trabeclae, septa) in which smooth muscles surrounding the large vessels were well developed, and 2) a respiratory portion which was give that name because it has well

  19. 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…

  20. 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,

  1. 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.

  2. Tailored interventions to improve antibiotic use for lower respiratory tract infections in hospitals: a cluster-randomized, controlled trial.

    NARCIS (Netherlands)

    Schouten, J.A.; Hulscher, M.E.J.L.; Trap-Liefers, J.; Akkermans, R.P.; Kullberg, B.J.; Grol, R.P.T.M.; Meer, J.W.M. van der

    2007-01-01

    BACKGROUND: Limited data exist on the most effective approach to increase the quality of antibiotic use for lower respiratory tract infections at hospitals. METHODS: One thousand nine hundred six patients with community-acquired pneumonia or an exacerbation of chronic obstructive pulmonary disease

  3. Heat and moisture exchange capacity of the upper respiratory tract and the effect of tracheotomy breathing on endotracheal climate

    NARCIS (Netherlands)

    Scheenstra, R.J.; Muller, S.H.; Vincent, A.; Hilgers, F.J.M.

    2011-01-01

    Background. The aim of this study was to assess the heat and moisture exchange (HME) capacity of the upper respiratory tract and the effect of tracheotomy breathing on endotracheal climate in patients with head and neck cancer. Methods. We plotted the subglottic temperature and humidity measurements

  4. HEAT AND MOISTURE EXCHANGE CAPACITY OF THE UPPER RESPIRATORY TRACT AND THE EFFECT OF TRACHEOTOMY BREATHING ON ENDOTRACHEAL CLIMATE

    NARCIS (Netherlands)

    Scheenstra, Renske J.; Muller, Sara H.; Vincent, Andrew; Hilgers, Frans J. M.

    2011-01-01

    Background. The aim of this study was to assess the heat and moisture exchange (HME) capacity of the upper respiratory tract and the effect of tracheotomy breathing on endotracheal climate in patients with head and neck cancer. Methods. We plotted the subglottic temperature and humidity measurements

  5. 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...

  6. Study of the pattern of lower respiratory tract infection within the first year in renal transplant patients

    Directory of Open Access Journals (Sweden)

    Nasr Affara

    2015-07-01

    Conclusion: Lower respiratory tract infection is a serious complication after renal transplantation. Bacterial and mixed bacterial infections are the most common etiologies, proper diagnosis using all tools of diagnosis especially bronchoscopy and quantitative culture can help in diagnosis and prevent the overuse of antibiotics.

  7. In utero exposure to 25-hydroxyvitamin D and risk of childhood asthma, wheeze, and respiratory tract infections

    DEFF Research Database (Denmark)

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

    2017-01-01

    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. A random-effects meta-analysis was conducted among 16...

  8. Decrease of Antibiotic Consumption in Children with Upper Respiratory Tract Infections after Implementation of an Intervention Program in Cyprus

    OpenAIRE

    Papaevangelou, V.; Rousounides, A.; Hadjipanagis, A.; Katsioulis, A.; Theodoridou, M.; Hadjichristodoulou, C.

    2012-01-01

    To assess the impact of intervention on antibiotic misuse in children, parents' and pediatricians' knowledge, attitudes, and practices (KAP) concerning antibiotic use were evaluated pre- and postintervention in Larnaca (Cyprus) and Limassol (Cyprus). Concurrently, pediatricians documented upper respiratory tract infection (URTI) visits and pharmacists provided antibiotic consumption data. Intervention was implemented for parents and pediatricians residing in Larnaca. The consumption/URTI inci...

  9. Reducing antibiotic prescriptions for respiratory tract infections in family practice: results of a multifaceted peer-group-based intervention.

    NARCIS (Netherlands)

    Vervloet, M.; Meulepas, M.A.; Cals, J.W.J.; Eimers, M.; Hoek, L.S. van der; Dijk, L. van

    2016-01-01

    Irrational antibiotic use for respiratory tract infections (RTI) is a major driver of bacterial resistance. The aim of this study was to evaluate the effect of a multifaceted peer-group based intervention aiming to reduce RTI-related antibiotic prescriptions in family practice. This was a cluster

  10. The study of aerobic bacterial flora of the upper respiratory tract of equines from Jammu and Kashmir region of India

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    Irfan Ahmad Mir

    2013-06-01

    Full Text Available Aim:To isolate aerobic bacterial micro flora residing in the upper respiratory tract of equines used by the pilgrims and tourists in Jammu & Kashmir. Materials and Methods:88 apparently healthy equines and 53 equines with respiratory tract diseases were used in this study. Swab samples were collected from the upper respiratory tract of equines. Isolation and identification of the bacteria was conducted under aerobic conditions. Each of the sample processed yielded at least one type of bacteria species. Results: A total of 321 bacterial isolates were recovered from both groups of equines. The majority of the isolates were Gram positive (84.11% and the rest were Gram negative (15.88%. Bacterial isolates identified in order of the magnitude were Streptococcus equi subsp. zooepidemicus (17.44%, Micrococcus spp. (9.96%, Corynebacterium (9.65%, Staphylococcus intermedius (9.65%, Staphylococcus aureus (8.72%, Bacillus spp. (7.16%, Streptococcus pneumonia (5.60%, Staphylococcus chromogens (5.60%, Streptococcus equismilis (5.29%, Pseudomonas aeruginosa (5.29%, Rhodococcus equi (3.73%, Escherichia coli (3.73%, Klebsiella pneumoniae (3.42%, Proteus vulgaris (3.42%, and Streptococcus equisubsp. equi(1.24%. Conclusion: The present study reveals the predominance of Gram positive bacteria in both healthy and diseased animals. Bacteria were recovered at a higher rate from diseased equines than from apparently healthy animals. Streptococcus equi subsp. zooepidemicuswas mainly found to be associated with respiratory tract infections.

  11. Antibiotic prescriptions for upper respiratory tract infections in France and The Netherlands: determinants at the patient and GP level.

    NARCIS (Netherlands)

    Mousquès, J.; Dijk, L. van; Renaud, T.

    2007-01-01

    Within Europe, France and the Netherlands are extremes when it comes to the prescription of antibiotics: France has the highest volume in the European Union, the Netherlands the lowest. Antibiotic prescribing for upper respiratory tract infections (URTI) is not recommended in both countries.

  12. Bacteria Isolated From Respiratory Tract Specimens of Renal Recipients With Acute Respiratory Distress Syndrome Due to Pneumonia: Epidemiology and Susceptibility of the Strains.

    Science.gov (United States)

    Mao, P; Wan, Q Q; Ye, Q F

    2015-12-01

    We estimated species distribution and frequency of antimicrobial resistance among bacterial pathogens isolated from respiratory tract specimens of renal recipients with acute respiratory distress syndrome (ARDS) due to pneumonia. We retrospectively collected patient demographics and clinical characteristics and microbiologic culture data with the use of standard microbiologic procedures and commercially available tests. From January 2001 to August 2014, 320 respiratory tract specimens were obtained from 94 renal recipients with ARDS. Bacterial cultures were positive in 134 specimens from 68 recipients (72.3%), yielding 139 bacterial strains. The most commonly isolated species were gram-negative bacteria (111 isolates) with dominance of Acinetobacter baumanii (29.7%) and Pseudomonas aeruginosa (18.0%). The gram-negative bacteria were relatively resistant to 1st- and 2nd-generation cephalosporin and monocyclic beta-lactam and relatively sensitive to levofloxacin and meropenem, with rates of resistance of 80.2%, 76.6%, 73.9%, 36.0%, and 44.1%, respectively. The gram-positive bacteria, excluding Streptococcus uberis, were sensitive to glycopeptides and oxazolidone. Gram-negative bacteria predominated as 79.9% of isolates from respiratory tract specimens of renal recipients with ARDS. The gram-negative bacteria were relatively sensitive to levofloxacin and meropenem and the gram-positive bacteria were sensitive to glycopeptides and oxazolidone. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. 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.

  14. Correlates of acute lower respiratory tract infections in children under 5 years of age in India.

    Science.gov (United States)

    Bhat, R Y; Manjunath, N

    2013-03-01

    In developing countries, acute lower respiratory tract infections (ALRTI) cause considerable morbidity, hospitalisation and mortality in children aged nutritional and environmental risk factors for ALRTI. The World Health Organization definition for ALRTI was used for cases. Healthy children attending child immunisation services were enrolled as controls. A total of 214 children, 107 cases and 107 controls, were enrolled. Among the cases, pneumonia, severe pneumonia and very severe disease constituted respectively 23.3%, 47.7% and 29%. Among cases and controls, the male-to-female ratio (1.3:1 vs. 0.9:1) and the proportion of infants (64.5% vs. 70.1%) were identical. Parents' literacy level was negatively associated with ALRTI. On multivariate logistic regression analysis, low socio-economic status (OR 4.89, 95%CI 1.93-12.36), upper respiratory infections in family members (OR 5.32, 95%CI 2.11-13.45), inappropriate weaning period (OR 3.01, 95%CI 1.12-8.07), malnutrition (OR 1.75, 95%CI 1.84-3.67), pallor (OR 7.18, 95%CI 2.08-24.82) and cooking fuel other than liquid petroleum gas (OR 3.58, 95%CI 1.23-10.45) were found to be significant risk factors (P education and public health measures.

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

    International Nuclear Information System (INIS)

    James, A.C.; Briant, J.K.; Stahlhofen, W.; Rudolf, G.; Gehr, P.

    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 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

  16. 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

    2014-04-01

    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.

  17. Pentraxin 3 as a clinical marker in children with lower respiratory tract infection.

    Science.gov (United States)

    Kim, Hwan Soo; Won, Sulmui; Lee, Eu Kyoung; Chun, Yoon Hong; Yoon, Jong-Seo; Kim, Hyun Hee; Kim, Jin Tack

    2016-01-01

    Pentraxin 3 (PTX-3) is an acute-phase protein that increases in the plasma during inflammation. We aimed to evaluate the usefulness of PTX-3 as a clinical marker in children with lower respiratory tract infection (LRTI) and examine the correlation of PTX-3 with other biomarkers such as C-reactive protein (CRP) and procalcitonin (PCT). We enrolled 117 consecutive patients admitted to Seoul St. Mary's Hospital with LRTI using the WHO criteria. We recorded data on fever duration and peak temperature before admission, duration of fever after admission, respiratory rate, heart rate, oxygen saturation upon admission, duration of oxygen supplementation, and duration of hospital stay. Upon admission, white blood cell (WBC) count, erythrocyte sedimentation rate, CRP level were measured. Multiplex respiratory virus polymerase chain reaction was performed using nasal swabs. PTX-3, PCT, and various cytokines were measured after the study had been completed. We found that there was no significant difference in the level of PTX-3 according to the type of viral infection. PTX-3 levels showed a significant correlation with PCT levels, but not with levels of CRP. The level of PTX-3 showed a significant correlation with peak temperature and duration of fever before admission as well as interleukin (IL)-6 levels. PCT levels showed a significant correlation with IL-6 and granulocyte-colony stimulating factor levels, peak temperature, and duration of fever before admission, and duration of hospital stay. CRP levels showed a significant correlation with duration of fever before admission, total WBC count, and neutrophil count. PCT levels significantly predicted a hospital stay of 7 days or more. PTX-3, PCT, and CRP levels showed no correlation with any other clinical features. PTX-3 reflected disease severity but failed to predict length of hospital stay. Further studies evaluating the use of PTX-3 as a biomarker in mild LRTI would be useful. © 2015 Wiley Periodicals, Inc.

  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. How French general practitioners manage and prevent recurrent respiratory tract infections in children: the SOURIRRE survey

    Directory of Open Access Journals (Sweden)

    Chicoulaa B

    2017-03-01

    Full Text Available Bruno Chicoulaa,1 Hervé Haas,2 Jérôme Viala,3 Maryline Salvetat,4 Jean-Pierre Olives,5 1Faculty of Medicine, Toulouse Rangueil, Toulouse, 2Paediatric Emergency and Infectious Disease Departments, Lenval University Hospital, Nice, 3Gastroenterology Department, Robert-Debré Hospital, Paris, 4Sports and General Medicine Practice, Labruguière, 5Gastroenterology and Nutrition Department, Children’s Hospital, University Hospital, Toulouse, France Background: Recurrent respiratory tract infections (RRTIs are the most common reason for children’s visits to primary care physicians in France; however, little is known about general practitioners’ (GPs opinions and expectations concerning the management and prevention of these common and recurrent pathologies. Purpose: To describe French GPs’ daily practice in the management of respiratory infections and the prevention of their recurrence in children. Methods: A sample group of French GPs answered a structured questionnaire on risk factors, RRTI management, antibiotic use and prevention measures. Results: A total of 358 GPs participated in the survey. Rhinopharyngitis, the most frequent respiratory infection, was considered to be recurrent if six or more episodes occurred in a year. Four risk factors were acknowledged as substantial: living in communities, passive smoking, pollution and allergies. Around 63% of GPs said that RRTIs are too often treated with antibiotics. More than 85% thought that prevention of RRTIs is possible. Smoking cessation, vaccination, allergen avoidance and hygiene were identified as the main preventive measures. A large majority of GPs (84% prescribed products for prevention and ~90% would prescribe a product stimulating immunity if the efficacy and tolerability of these agents was proven and confirmed in their daily practice. Conclusions: French GPs are well aware of the health and socioeconomic burdens resulting from RRTIs, as well as the risk of antibiotic overuse

  20. [Etiological analysis and establishment of a discriminant model for lower respiratory tract infections in hospitalized patients].

    Science.gov (United States)

    Chen, Y S; Lin, X H; Li, H R; Hua, Z D; Lin, M Q; Huang, W S; Yu, T; Lyu, H Y; Mao, W P; Liang, Y Q; Peng, X R; Chen, S J; Zheng, H; Lian, S Q; Hu, X L; Yao, X Q

    2017-12-12

    Objective: To analyze the pathogens of lower respiratory tract infection(LRTI) including bacterial, viral and mixed infection, and to establish a discriminant model based on clinical features in order to predict the pathogens. Methods: A total of 243 hospitalized patients with lower respiratory tract infections were enrolled in Fujian Provincial Hospital from April 2012 to September 2015. The clinical data and airway (sputum and/or bronchoalveolar lavage) samples were collected. Microbes were identified by traditional culture (for bacteria), loop-mediated isothermal amplification(LAMP) and gene sequencing (for bacteria and atypical pathogen), or Real-time quantitative polymerase chain reaction (Real-time PCR)for viruses. Finally, a discriminant model was established by using the discriminant analysis methods to help to predict bacterial, viral and mixed infections. Results: Pathogens were detected in 53.9% (131/243) of the 243 cases.Bacteria accounted for 23.5%(57/243, of which 17 cases with the virus, 1 case with Mycoplasma pneumoniae and virus), mainly Pseudomonas Aeruginosa and Klebsiella Pneumonia. Atypical pathogens for 4.9% (12/243, of which 3 cases with the virus, 1 case of bacteria and viruses), all were mycoplasma pneumonia. Viruses for 34.6% (84/243, of which 17 cases of bacteria, 3 cases with Mycoplasma pneumoniae, 1 case with Mycoplasma pneumoniae and bacteria) of the cases, mainly Influenza A virus and Human Cytomegalovirus, and other virus like adenovirus, human parainfluenza virus, respiratory syncytial virus, human metapneumovirus, human boca virus were also detected fewly. Seven parameters including mental status, using antibiotics prior to admission, complications, abnormal breath sounds, neutrophil alkaline phosphatase (NAP) score, pneumonia severity index (PSI) score and CRUB-65 score were enrolled after univariate analysis, and discriminant analysis was used to establish the discriminant model by applying the identified pathogens as the

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

    Directory of Open Access Journals (Sweden)

    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.

  2. ROLE OF ENTEROSORPTION IN COMPREHENSIVE THERAPY FOR ACUTE RESPIRATORY DISEASES COMBINED DAMAGE TO WITH GASTROINTESTINAL TRACT DISEASE

    Directory of Open Access Journals (Sweden)

    Yu.B. Belan

    2010-01-01

    Full Text Available The frequency of acute respiratory infections remains high in childhood. It is impossible to identify etiology most accurately in each particular case. However, according to multiple studies, viruses, their associations with each other and bacteria prevail as causative agents. In addition, it is quite often that a respiratory infection, especially in minor children, is combined with a condition of the gastrointestinal tract. Apart from symptomatic and antiviral therapies in these cases, as the authors of this article demonstrated, it is advisable to use enterosorbents. This tactics results in a decreased level of intoxication, lower intensity and duration of diarrheal syndrome, i.e. more speedy recovery.Key words: acute respiratory infections, condition of gastro tract, intoxication, diarrheal syndrome, treatment, enterosorbents, children. (Pediatric Pharmacology. – 2010; 7(3:88-90

  3. Clinical utility of bronchoalveolar lavage and respiratory tract biopsies in diagnosis and management of suspected invasive respiratory fungal infections in children.

    Science.gov (United States)

    Batra, Surabhi; Li, Betty; Underhill, Nicole; Maloney, Rebekah; Katz, Ben Z; Hijiya, Nobuko

    2015-09-01

    Bronchoscopy with bronchoalveolar lavage (BAL) and respiratory tract biopsies are important tools for diagnosing fungal infections in children with cancer and hematopoietic stem cell transplant (HSCT) recipients. Our objective was to evaluate the impact of BAL and respiratory tract biopsies on the management of suspected fungal infections in oncology and HSCT patients. We retrospectively reviewed the medical records of oncology and HSCT patients with possible, probable, or proven fungal infection of the respiratory tract and determined whether BAL or biopsy following computed tomography (CT) prompted a change in management. Among 101 patients (0.5-29 years of age), 24 underwent a BAL and 31 had biopsies (27 lung and 4 sinus). The remaining 46 patients had CT scans only. Of these, there were radiographic findings suggestive of a fungal infection in 38 patients (83%). Thirty of these 38 patients (79%) had a change in management. BAL provided a diagnosis in 6 of 24 patients (25%). There was a change in management in 2 of the 6 (33%). Respiratory tract biopsy provided a diagnosis in 12 of 31 patients (39%). Biopsy results led to a change in management in 4 of the 12 patients (33%). Significant postoperative morbidity attributed to biopsy occurred in 3 of 31 patients (10%); 2 patients had pneumothorax requiring chest tube and intubation and a patient had prolonged intubation. BAL and biopsy in children with an oncological diagnosis or those undergoing HSCT only infrequently lead to changes in management in the era of empiric therapy with broad-spectrum anti-fungal agents. © 2015 Wiley Periodicals, Inc.

  4. Oral Astragalus (Huang qi) for preventing frequent episodes of acute respiratory tract infection in children.

    Science.gov (United States)

    Su, Guobin; Chen, Xiankun; Liu, Zhuangzhu; Yang, Lihong; Zhang, La; Stålsby Lundborg, Cecilia; Wen, Zehuai; Guo, Xinfeng; Qin, Xindong; Liang, Jueyao; Liu, Xusheng

    2016-12-01

    Acute respiratory tract infections (ARTIs) are common in children and can involve both upper and lower airways. Many children experience frequent ARTI episodes or recurrent respiratory tract infections (RRTIs) in early life, which creates challenges for paediatricians, primary care physicians, parents and carers of children.In China, Astragalus (Huang qi), alone or in combination with other herbs, is used by Traditional Chinese Medicine (TCM) practitioners in the form of a water extract, to reduce the risk of ARTIs; it is believed to stimulate the immune system. Better understanding of the therapeutic mechanisms of Astragalus may provide insights into ARTI prevention, and consequently reduced antibiotic use. To assess the effectiveness and safety of oral Astragalus for preventing frequent episodes of acute respiratory tract infections (ARTIs) in children in community settings. We searched the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 12, 2015), MEDLINE (Ovid) (1946 to 31 December 2015), Embase (Elsevier) (1974 to 31 December 2015), AMED (Ovid) (1985 to 31 December 2015), Chinese National Knowledge Infrastructure (CNKI) (1979 to 31 December 2015) and Chinese Scientific Journals full text database (CQVIP) (1989 to 31 December 2015), China Biology Medicine disc (CBM 1976 to 31 December 2015) and Wanfang Data Knowledge Service Platform (WanFang) (1998 to 31 December 2015). We included randomised controlled trials (RCTs) comparing oral Astragalus as a sole Chinese herbal preparation with placebo to prevent frequent episodes of ARTIs in children. We used standard Cochrane methodological procedures for this review. We assessed search results to identify relevant studies. We planned to extract data using standardised forms. Disagreements were to be resolved through discussion. Risk of bias was to be assessed using the Cochrane 'Risk of bias' tool. We planned to use mean difference (MD) or standardised mean difference (SMD) for continuous data and risk

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

    Directory of Open Access Journals (Sweden)

    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.

  6. STUDY OF CORROSIVE POISONING AND ITS EFFECTS ON UPPER GASTROINTESTINAL TRACT AND SURGICAL MANAGEMENT- A SINGLE INSTITUTION EXPERIENCE

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    Ramesh Lingala

    2017-06-01

    Full Text Available BACKGROUND Corrosive injury to the upper gastrointestinal tract is an agonising experience for both the patient and surgeon. Caustic ingestion may cause wide spread injury to the lips, oral cavity, pharynx and the upper airway. The effect that these agents have on the oesophagus accounts for most of the serious injuries and on stomach, which may result in perforation and death in the acute phase. 1,2 If the patient survives the acute effects of caustic ingestion, the reparative response leads to the development of oesophageal and gastric strictures. There is also an increased incidence of oesophageal and gastric cancer in the longterm. 3,4,5 These patients present with the most distressing symptoms of dysphagia and are not able to swallow even liquids sometimes. For a surgeon, it is necessary to restore the GI continuity, so that the patients may be relieved of symptoms and can take food naturally for the rest of their lives. An insight is made into the various modalities of treatments available for corrosive effects of oesophagus and stomach. 6,7 Even though majority of oesophageal strictures can be managed by modern endoscopic interventional methods, surgery is mandatory in few cases. Surgery is the only modality of treatment for gastric complications. Corrosive injuries continue to result in high morbidity and mortality until more conclusive diagnostic and treatment recommendations can be made. Present study was done to know the effects of corrosive poisoning on upper gastrointestinal tract to evaluate the common surgical procedures in the management of corrosive poisoning and to know the mortality and morbidity after corrosive poisoning. MATERIALS AND METHODS It is a prospective observational study conducted at a tertiary care hospital in between December 2014 to December 2016. All the patients were evaluated by history, clinical examination and radiological examination. Treatment was given according to the severity of the injury. The modes

  7. Immunostimulation using bacterial antigens – mechanism ofaction and clinical practice inviral respiratory tract infections

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    Wojciech Feleszko

    2015-12-01

    Full Text Available Recurrent respiratory tract infections constitute a significant problem in the practice of a general practitioner and paediatrician. Antibiotic resistance of bacterial strains, which has been growing for years, prompts the search for alternative ways of combating pathogens. One of them is the usage of preparations based on cell lysis of various bacterial strains. Bacterial lysates have been available in Europe for many years. In preclinical trials, they are characterised by the capability of reducing infections caused by bacteria and viruses that are not the components of the preparations. A range of clinical trials have demonstrated their usefulness in reducing the frequency of seasonal respiratory tract infections and antibiotic use. Moreover, patients with chronic obstructive pulmonary disease gain an additional advantage in the form of the reduction of the risk of hospitalization due to disease exacerbations and a positive influence on the survival curve. The action of bacterial lysates is based on oral immunostimulation of gut-associated lymphoid tissue, which results in increased antibody production. Moreover, they activate a range of mucosal mechanisms of non-specific immunity, mainly by enhancing the activity of TLR-dependent mechanisms. The efficacy of this group of drugs has been confirmed in a range of clinical trials, systematic reviews and meta-analyses. Recent studies also indicate their immunoregulatory potential, suggesting that they might be used in the future in preventing allergies, asthma and autoimmune diseases. To conclude, physicians (paediatricians, laryngologists, pulmonologists should consider reducing the use of antibiotics in their daily practice. Instead, they should offer preparations that promote the immune system, thus controlling infections in a better way.

  8. The role of respiratory tract infections and the microbiome in the development of asthma: A narrative review.

    Science.gov (United States)

    van Meel, Evelien R; Jaddoe, Vincent W V; Bønnelykke, Klaus; de Jongste, Johan C; Duijts, Liesbeth

    2017-10-01

    Asthma is a common disease in childhood, and might predispose for chronic obstructive respiratory morbidity in adolescence and adulthood. Various early-life risk factors might influence the risk of wheezing, asthma, and lower lung function in childhood. Cohort studies demonstrated that lower respiratory tract infections in the first years of life are associated with an increased risk of wheezing and asthma, while the association with lung function is less clear. Additionally, the gut and airway microbiome might influence the risk of wheezing and asthma. The interaction between respiratory tract infections and the microbiome complicates studies of their associations with wheezing, asthma, and lung function. Furthermore, the causality behind these observations is still unclear, and several other factors such as genetic susceptibility and the immune system might be of importance. This review is focused on the association of early-life respiratory tract infections and the microbiome with wheezing, asthma, and lung function, it is possible influencing factors and perspectives for future studies. © 2017 Wiley Periodicals, Inc.

  9. Significance of human beta-defensins in the epithelial lining fluid of patients with chronic lower respiratory tract infections.

    Science.gov (United States)

    Yanagi, S; Ashitani, J; Imai, K; Kyoraku, Y; Sano, A; Matsumoto, N; Nakazato, M

    2007-01-01

    Human beta-defensins (hBDs) are the most abundant antimicrobial peptides in epithelial cells, and function in the host immune system. Respiratory epithelial cells express hBDs to inhibit bacterial proliferation during respiratory tract infections. The aim of this study was to investigate the release of hBDs into the respiratory tract and their benefit as a host defence system in chronic Pseudomonas aeruginosa infections. The levels of four hBD peptides (hBD-1-hBD-4) were measured in the bronchial epithelial lining fluid (ELF) of nine patients with chronic lower respiratory tract infection caused by P. aeruginosa. Eight patients with idiopathic pulmonary fibrosis and eight volunteers free of pulmonary disease were recruited as controls. ELF was obtained by bronchoscopic microsampling and hBD levels were measured by radioimmunoassays. The antimicrobial effects of hBDs were studied individually and in combination using an in-vitro colony count assay for P. aeruginosa. Concentrations of hBD-1 and hBD-3 tended to be higher in patients with chronic lower respiratory tract infection than in the controls. hBD-2 and hBD-4 were detected in ELF from five and four of nine patients, respectively, but the hBD levels in controls were all below the limits of detection. All patients with infection caused by mucoid P. aeruginosa had detectable hBD-2 and hBD-4 levels in ELF. In-vitro colony count assays showed a potential synergism between hBD-2 and hBD-4 in inhibiting bacterial proliferation. The findings indicate that hBDs, especially hBD-2 and hBD-4, are pathophysiologically important in infections caused by mucoid strains of P. aeruginosa.

  10. An optimized in vitro model of the respiratory tract wall to study particle cell interactions.

    Science.gov (United States)

    Blank, Fabian; Rothen-Rutishauser, Barbara M; Schurch, Samuel; Gehr, Peter

    2006-01-01

    As a part of the respiratory tissue barrier, lung epithelial cells play an important role against the penetration of the body by inhaled particulate foreign materials. In most cell culture models, which are designed to study particle-cell interactions, the cells are immersed in medium. This does not reflect the physiological condition of lung epithelial cells which are exposed to air, separated from it only by a very thin liquid lining layer with a surfactant film at the air-liquid interface. In this study, A549 epithelial cells were grown on microporous membranes in a two chamber system. After the formation of a confluent monolayer the cells were exposed to air. The morphology of the cells and the expression of tight junction proteins were studied with confocal laser scanning and transmission electron microscopy. Air-exposed cells maintained monolayer structure for 2 days, expressed tight junctions and developed transepithelial electrical resistance. Surfactant was produced and released at the apical side of the air-exposed epithelial cells. In order to study particle-cell interactions fluorescent 1 microm polystyrene particles were sprayed over the epithelial surface. After 4 h, 8.8% of particles were found inside the epithelium. This fraction increased to 38% after 24 h. During all observations, particles were always found in the cells but never between them. In this study, we present an in vitro model of the respiratory tract wall consisting of air-exposed lung epithelial cells covered by a liquid lining layer with a surfactant film to study particle-cell interactions.

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

    Energy Technology Data Exchange (ETDEWEB)

    Hernandez, Oscar [Texas A & M Univ., College Station, TX (United States)

    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.

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

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    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.

  13. 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

  14. Pressing Issues of Rational Antibiotic Therapy for Inflammatory Diseases of the Lower Respiratory Tract in Pediatric Practice

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    Ye.N. Okhotnikova

    2015-03-01

    Full Text Available Over the past 30 years, high incidence of acute lower respiratory tract infections of bacterial origin, primarily pneumonia and bronchitis, treatment of which under the spread of antibiotic resistance is often a difficult task, cause alarm. Bronchitis — one of the most common respiratory diseases in childhood after acute respiratory viral infections. Application of antibiotics for acute bronchitis in children is not recommended, but they are prescribed for severe intoxication and prolonged hyperthermia (over 3 days, especially in infants, children with poor premorbid background and high risk of pneumonia. Antibiotic therapy is considered as the only science-based treatment of pneumonia. Taking into account the broad spectrum of modern antibiotics, monotherapy is most suitable. If it is necessary to extend their effect, combination of amoxicillin/clavulanate with macrolides, to which all the major respiratory pathogens are sensitive, is preferred.

  15. Colonization capability of lactobacilli and pathogens in the respiratory tract of mice: microbiological, cytological, structural, and ultrastructural studies.

    Science.gov (United States)

    Cangemi de Gutierrez, Rosa; Santos, Viviana M; Nader-Macías, María Elena

    2004-01-01

    Respiratory tract infections are among the bacterial infections that affect humans with higher frequency. Those produced by Streptococcus pneumoniae are reported to have the highest incidence in the world, affecting both children and old people. As a 2001 report from the World Health Organization expressed it, the basic fight of children under 5 yr old is to survive. Five different conditions (acute respiratory infections, diarrhea, measles, palludism, and undernutrition) directly produce more than 50% of the deaths in this age group. Respiratory tract infections in the developing countries in the Americas are among the first three causes of death in children under 1 yr and between the first and second cause in children between 1 and 4 yr old. Pneumonia is responsible for 85 and 90% of deaths in children under 5 yr old (approx 150,000 annually), 95% of them occurring in the developing countries in the Americas. There is an increased worldwide tendency to use preventive measures and to consume products that help to maintain the health status of the individual. Thus the use of probiotics has increased systematically during the last decade, and the scientific literature trying to demonstrate the positive effect of such preparations has also increased. The term probiotic has been applied to products that (1) contain live microorganisms, freeze-dried or included in fermented products or (2) improve the health status of humans and animals, exerting effects in the mouth or gastrointestinal tract (included in foods or capsules), in the respiratory tract (as aerosols), or in the urogenital tract (by local application)Having in mind the high incidence of respiratory tract infections, and looking for preventive measures as well as the possible applications of probiotics, the aim of this chapter was to use mice as experimental models to determine whether members of the genus Lactobacillus were able to colonize and give protection from infections after inoculation by the

  16. Respiratory actions of tachykinins in the nucleus of the solitary tract: effect of neonatal capsaicin pretreatment

    Science.gov (United States)

    Mazzone, Stuart B; Geraghty, Dominic P

    2000-01-01

    The respiratory response to microinjection of capsaicin and tachykinin receptor agonists into the commissural nucleus of the solitary tract (cNTS) was investigated in adult, urethane-anaesthetized rats which had been pretreated with capsaicin (50 mg kg−1 s.c.) or vehicle (10% Tween 80, 10% ethanol in saline) as day 2 neonates. Microinjection of capsaicin (1 nmol) into the cNTS of vehicle-pretreated rats, significantly reduced respiratory frequency (59 breaths min−1, preinjection control, 106 breaths min−1) without affecting tidal volume (VT). In capsaicin-pretreated rats, the capsaicin-induced bradypnoea was markedly attenuated (minimum frequency, 88 breaths min−1; control, 106 breaths min−1). In vehicle-pretreated rats, microinjection of substance P (SP, 33 pmol), neurokinin A (NKA, 33 pmol) and NKB (330 pmol), and the selective NK1 tachykinin receptor agonists, [Sar9,Met(O2)11]-SP (33 pmol) and septide (10 pmol), increased VT (maxima, 3.60–3.93 ml kg−1) compared with preinjection control (2.82 ml kg−1), without affecting frequency. The selective NK3 agonist senktide (10 pmol) also increased VT (3.93 ml kg−1) which was accompanied by a bradypnoea (−25 breaths min−1). The selective NK2 agonist, [Nle10]-NKA(4-10) (330 pmol) increased VT slightly but significantly decreased frequency (−12 breaths min−1). In capsaicin-pretreated rats, VT responses to SP and [Sar9,Met(O2)11]-SP were increased whereas the response to septide was abolished. Both the VT and bradypnoeic responses to senktide and [Nle10]-NKA(4-10) were significantly enhanced. These results show that neonatal capsaicin administration markedly reduces the respiratory response to microinjection of capsaicin into the cNTS. The destruction of capsaicin-sensitive afferents appears to sensitize the NTS to SP, NKB, [Sar9,Met(O2)11]-SP, senktide and [Nle10]-NKA(4-10). Moreover, the loss of septide responsiveness in capsaicin-pretreated rats

  17. Antibiotic Utilization and Opportunities for Stewardship Among Hospitalized Patients With Influenza Respiratory Tract Infection.

    Science.gov (United States)

    Ghazi, Islam M; Nicolau, David P; Nailor, Michael D; Aslanzadeh, Jaber; Ross, Jack W; Kuti, Joseph L

    2016-05-01

    Hospitalized influenza patients are often treated with antibiotics empirically while awaiting final diagnosis. The goal of this study was to describe the inappropriate continuation of antibiotics for influenza respiratory tract infections (RTIs). We retrospectively studied adults admitted to our institution over 2 respiratory flu seasons with positive influenza RTIs. Inappropriate antibiotic duration (IAD) was defined as antibiotic use for >24 hours after a positive influenza test in patients presenting with <72 hours of RTI symptoms and with no other indications of bacterial infection. During the study period, 322 patients included in this study were admitted for influenza RTI. Respiratory cultures were ordered for 50 of these patients (15.5%) and 71 patients (22%) had a positive chest x-ray, but antibiotics were prescribed to 211 patients (65.5%) on admission. Antibiotics were inappropriately continued in 73 patients (34.5%). Patients receiving IAD had a longer length of stay (LOS) (median, 6 days; range, 4-9 days) compared with those whose antibiotics were discontinued appropriately (median, 5 days; range, 3-8 days) and those who were not treated with antibiotics (median, 4 days; range, 3-6 days; P<.001). However, mortality was similar among these 3 groups: 3 patients (4.1%) from the IAD cohort died; 6 patients (4.3%) from the group with an appropriate antibiotic duration died; and 2 patients [1.8%] from the group given no antibiotics died (P=.510). The 30-day readmission rates were similar as well: 9 patients (12.3%) from the IAD group were readmitted within 30 days; 21 patients (15.2%) from the group with appropriate antibiotic duration were readmitted; and 11 patients (9.9%) from the group given no antibiotics were readmitted (P=.455). Total hospital costs were greater in patients treated with IAD ($10,645; range, $6,485-$18,035) compared with the group treated with appropriate antibiotic duration ($7,479; range, $4,866-$12,922) and the group given no

  18. Seroprevalence of anti-Chlamydia trachomatis IgM in neonatal respiratory tract infections in Hungary.

    Science.gov (United States)

    Balla, Eszter; Donders, Gilbert G G; Petrovay, Fruzsina; Urbán, Edit

    2017-08-04

    To determine the seroprevalence of specific IgM indicative of respiratory tract infection (RTI) due to Chlamydia trachomatis (CT) among symptomatic infants. A descriptive study was conducted on young infants up to 5 months old at the Bacterial Sexually Transmitted Infections Reference Laboratory, National Centre for Epidemiology, Budapest, covering the period 2008-2016. Serum samples from infants suffering from RTIs were screened with a micro-immunofluorescence test (Focus, Cypress, USA) for the presence of anti-Chlamydia trachomatis-specific IgM. A parallel Bordetella pertussis screening was performed by an indirect immunofluorescence test (Euroimmun, Lübeck, Germany) that detected specific IgM. The CT-specific serum IgM was highly reactive in 50 (19.1 %) of the 262 neonates with RTIs, while all proved negative for Bordetella pertussis-specific IgM. Vertically transmitted C. trachomatis must be regarded as a common pathogen among symptomatic neonates with RTIs in Hungary. Routine screening and treatment of pregnant women could be one option to help prevent these conditions. Focused laboratory testing based on raised clinical awareness should enable early diagnosis and appropriate therapy for symptomatic infants.

  19. Respiratory tract tumors in Syrian hamsters following inhalation of Pu--ZrO2 particles

    International Nuclear Information System (INIS)

    Thomas, R.G.; Smith, D.M.

    1979-01-01

    Inhalation of radionuclide-bearing particles remains one of the most intensely pursued problems concerning the nuclear industry. This route of entry is generally accepted as the most probable, in case of human exposure, with ingestion being the other prominent source of concern. Many laboratory investigations, such as those reported here, continue to evaluate the possible consequences that may present health problems to the public domain. Syrian hamsters of both sexes received either inhaled (INH) PuO 2 /ZrO 2 particles, intravenous (IV) PuO 2 /ZrO 2 microspheres, a combination of INH PuO 2 /ZrO 2 particles and injected PuO 2 /ZrO 2 microspheres, or no radionuclides (controls). The INH particles and IV microspheres were tagged with γ-emitting 57 Co to facilitate whole body counting and establishment of retention curves. Total lung burdens ranged from 8 nCi to 143 nCi. Significant numbers of primary lung tumors (5 to 50% per group) were induced in those animals that received INH exposures. Additional α radiation administered via Pu-laden IV microspheres had little or no effect on tumor production or nonneoplastic, degenerative changes in the respiratory tract

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

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    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.

  1. Antibiotic resistance of bacteria responsible of acute respiratory tract infections in children

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    Makhtar Camara

    2017-03-01

    Full Text Available Background and aims. Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis are the most common causative agents of acute respiratory tract infections (RTIs. The objective of this study was to assess their susceptibility to several antibiotics.Materials and methods. A total of 58 strains (16 S. pneumoniae, 19 H. influenzae and 23 M. catarrhalis were isolated from samples collected in two paediatric centres, and their susceptibility to commonly used antibiotics tested by E-test. Results. Among H. influenzae isolates, 10.5% were resistant to ampicillin (all β-lactamase-positive, and 88.9% were susceptible to cefaclor. High β-lactam resistance rates (penicillin: 31.3% and cephalosporins: 18.7 to 31.3% had been observed among S. pneumonia strains. Only 50% of isolates were susceptible to azithromycine. 91.3% of M. catarrhalis isolates β-lactamases producers were resistant to ampicillin while susceptible to the most tested antibiotics. Conclusions. Except M. catarrhalis β-lactamases producing strains, frequency of antibiotic resistance was mainly observed among S. pneumoniae, and to a lesser extent among H. influenzae clinical isolates, suggesting the need for continuous surveillance of antimicrobial resistance patterns in the management of RTIs.

  2. Infrared Hollow Optical Fiber Probe for Localized Carbon Dioxide Measurement in Respiratory Tracts.

    Science.gov (United States)

    Katagiri, Takashi; Shibayama, Kyosuke; Iida, Takeru; Matsuura, Yuji

    2018-03-27

    A real-time gas monitoring system based on optical absorption spectroscopy is proposed for localized carbon dioxide (CO₂) measurement in respiratory tracts. In this system, a small gas cell is attached to the end of a hollow optical fiber that delivers mid-infrared light with small transmission loss. The diameters of the fiber and the gas cell are smaller than 1.2 mm so that the probe can be inserted into a working channel of common bronchoscopes. The dimensions of the gas cell are designed based on absorption spectra of CO₂ standard gases in the 4.2 μm wavelength region, which are measured using a Fourier-transform infrared spectrometer. A miniature gas cell that is comprised of a stainless-steel tube with slots for gas inlet and a micro-mirror is fabricated. A compact probing system with a quantum cascade laser (QCL) light source is built using a gas cell with a hollow optical fiber for monitoring CO₂ concentration. Experimental results using human breaths show the feasibility of the system for in-situ measurement of localized CO₂ concentration in human airways.

  3. Smoke-free legislation reduces hospital admissions for childhood lower respiratory tract infection.

    Science.gov (United States)

    Lee, So Lun; Wong, Wilfred Hing Sang; Lau, Yu Lung

    2016-12-01

    Previous studies showed reduction of hospital admissions for asthma after implementation of comprehensive smoke-free legislation. We aimed to evaluate the impact of comprehensive smoke-free legislation implemented in Hong Kong in 2007 on hospital admissions for childhood lower respiratory tract infection (LRTI). We obtained data on 75 870 hospital admissions for LRTI among children ≤18 years of age between January 2004 and December 2012 from all Hospital Authority hospitals. Using a negative binomial regression model, we assessed the impact of smoke-free legislation on admission counts. After legislation implementation, there was an immediate effect with a change in the admission count of -33.5% (95% CI -36.4% to -30.5%), and a change in time trend to -13.9% per year (95% CI -16.0% to -11.7%). Overall, the legislation was associated with a net 47.4% reduction in admission counts in the first year. We estimated that the legislation was associated with a reduction of 13 635 admissions in the first 6 years after implementation. The immediate reduction and change in time trend was more apparent among school-age than preschool children. Implementation of comprehensive smoke-free legislation was associated with a significant reduction in hospital admissions for childhood LRTI. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  4. Respiratory tract lining fluid antioxidants: the first line of defence against gaseous pollutants.

    Science.gov (United States)

    Kelly, F J; Cotgrove, M; Mudway, I S

    1996-01-01

    All tissues are vulnerable to oxidant damage, but by virtue of its location, anatomy and function, the epithelial surface of the lung is one of the most vulnerable targets in the body. Recent studies have shown that epithelial lining fluid (ELF), a thin layer of fluid which covers the epithelial surface of the respiratory tract, contains an interesting complement of antioxidants, some of which, like glutathione, are present in concentrations much higher than those found in plasma. It is likely that ELF forms the first line of defence against inhaled toxins such as ozone and nitrogen dioxide. By employing an ex vivo exposure system we have demonstrated that when lung lining fluid is in contact with environmentally relevant concentrations of ozone or nitrogen dioxide, there is differential consumption of the water-soluble antioxidants in the order, uric acid > ascorbic acid > glutathione. Given that the majority of ozone and nitrogen dioxide reacts within the ELF compartment, the antioxidant composition of this fluid is critically important in determining an individual's sensitivity to gaseous pollutants.

  5. A Biocompatible Synthetic Lung Fluid Based on Human Respiratory Tract Lining Fluid Composition.

    Science.gov (United States)

    Kumar, Abhinav; Terakosolphan, Wachirun; Hassoun, Mireille; Vandera, Kalliopi-Kelli; Novicky, Astrid; Harvey, Richard; Royall, Paul G; Bicer, Elif Melis; Eriksson, Jonny; Edwards, Katarina; Valkenborg, Dirk; Nelissen, Inge; Hassall, Dave; Mudway, Ian S; Forbes, Ben

    2017-12-01

    To characterise a biorelevant simulated lung fluid (SLF) based on the composition of human respiratory tract lining fluid. SLF was compared to other media which have been utilized as lung fluid simulants in terms of fluid structure, biocompatibility and performance in inhalation biopharmaceutical assays. The structure of SLF was investigated using cryo-transmission electron microscopy, photon correlation spectroscopy and Langmuir isotherms. Biocompatibility with A549 alveolar epithelial cells was determined by MTT assay, morphometric observations and transcriptomic analysis. Biopharmaceutical applicability was evaluated by measuring the solubility and dissolution of beclomethasone dipropionate (BDP) and fluticasone propionate (FP), in SLF. SLF exhibited a colloidal structure, possessing vesicles similar in nature to those found in lung fluid extracts. No adverse effect on A549 cells was apparent after exposure to the SLF for 24 h, although some metabolic changes were identified consistent with the change of culture medium to a more lung-like composition. The solubility and dissolution of BDP and FP in SLF were enhanced compared to Gamble's solution. The SLF reported herein constitutes a biorelevant synthetic simulant which is suitable to study biopharmaceutical properties of inhalation medicines such as those being proposed for an inhaled biopharmaceutics classification system.

  6. Antioxidant macromolecules in the epithelial lining fluid of the normal human lower respiratory tract.

    Science.gov (United States)

    Cantin, A M; Fells, G A; Hubbard, R C; Crystal, R G

    1990-09-01

    We hypothesized that the alveolar structures may contain extracellular macromolecules with antioxidant properties to defend against oxidants. To evaluate this 51Cr-labeled human lung fibroblasts (HFL-1) and cat lung epithelial cells (AKD) were exposed to a H2O2-generating system and alveolar epithelial lining fluid (ELF) from healthy nonsmokers was tested for its ability to protect the lung cells from H2O2-mediated injury. The ELF provided marked antioxidant protection, with most from a H2O-soluble fraction in the 100-300-kD range. Plasma proteins with anti-H2O2 properties were in insufficient concentrations to provide the antioxidant protection observed. However, catalase, a normal intracellular antioxidant, was present in sufficient concentration to account for most of the observed anti-H2O2 properties of ELF. Depletion of ELF with an anticatalase antibody abolished the anti-H2O2 macromolecular defenses of ELF. Since catalase is not normally released by cells, a likely explanation for its presence in high concentrations in normal ELF is that it is released by lung inflammatory and parenchymal cells onto the epithelial surface of the lower respiratory tract during their normal turnover and collects there due to the slow turnover of ELF. It is likely that catalase in the ELF of normal individuals plays a role in protecting lung parenchymal cells against oxidants present in the extracellular milieu.

  7. Obesity and risk of respiratory tract infections: results of an infection-diary based cohort study.

    Science.gov (United States)

    Maccioni, Livia; Weber, Susanne; Elgizouli, Magdeldin; Stoehlker, Anne-Sophie; Geist, Ilona; Peter, Hans-Hartmut; Vach, Werner; Nieters, Alexandra

    2018-02-20

    Respiratory tract infections (RTIs) are a major morbidity factor contributing largely to health care costs and individual quality of life. The aim of the study was to test whether obesity (BMI ≥ 30 kg/m 2 ) is one of the risk factors underlying frequent RTIs in the German adult population. We recruited 1455 individuals between 18 to 70 years from a cross-sectional survey on airway infections in Germany and invited them to self-report in diaries incident RTIs experienced during three consecutive winter/spring seasons. RTIs reported in these 18 months and summary measures adding-up individual RTIs were the outcomes of interest. Compared to individuals with normal weight, obese individuals reported a consistently higher frequency of upper and lower RTIs and predominantly fell in the upper 10% group of a diary sumscore adding-up 10 different RTI symptoms over time. Obesity was associated both with lower RTIs ( adjusted OR = 2.02, 95%CI = 1.36-3.00) and upper RTIs ( adjusted OR = 1.55, 95%CI = 1.22-1.96). Adjusting for demographic and lifestyle variables did only marginally affect ORs. Stratified analyses suggested a stronger association for women and effect modifications by sports activity and dietary habits. We confirm the association of obesity with infection burden and present evidence for putative interaction with sports activity and dietary patterns.

  8. The Use of Bipolar Electrocautery Tonsillectomy in Patients with Pediatric Respiratory Tract Obstruction

    Directory of Open Access Journals (Sweden)

    Sinan Kocatürk

    2012-01-01

    Full Text Available Aim: This study offers a comparative analysis of the intraoperative and postoperative clinical results of bipolar electrocautery tonsillectomy and conventional tonsillectomy techniques in children with respiratory tract obstruction because of tonsillar hypertrophy. Material and Method: Results in 31 children who underwent bipolar electrocautery tonsillectomy were compared with those in 45 children who had conventional cold dissection tonsillectomy. Postoperative pain scores were measured in the early postoperative period by the %u201CModified Hannalah Scale%u201D and in the late postoperative period by the %u201CVisual Analog Score.%u201D Intraoperative blood loss, operation time, duration of oral intake, intake of painkillers, recovery time, and postoperative pain scores of the two groups are also compared.Result: Children who underwent bipolar electrocautery tonsillectomy group had significantly less scores in pain throughout their recovery period, intraoperative blood loss, operation time, duration of oral intake, intake of painkiller, recovery time, and postoperative pain than those who had conventional tonsillectomy. Discussion: Bipolar electrocautery tonsillectomy is as effective and safe as conventional tonsillectomy to relieve obstructive sleep apnea in pediatric patients. Bipolar electrocautery tonsillectomy reduces postoperative pain, improves the quality of life and shortens the recovery time. Therefore, this procedure is more tolerable in children than conventional tonsillectomy.

  9. Connections between voice ergonomic risk factors and voice symptoms, voice handicap, and respiratory tract diseases.

    Science.gov (United States)

    Rantala, Leena M; Hakala, Suvi J; Holmqvist, Sofia; Sala, Eeva

    2012-11-01

    The aim of the study was to investigate the connections between voice ergonomic risk factors found in classrooms and voice-related problems in teachers. Voice ergonomic assessment was performed in 39 classrooms in 14 elementary schools by means of a Voice Ergonomic Assessment in Work Environment--Handbook and Checklist. The voice ergonomic risk factors assessed included working culture, noise, indoor air quality, working posture, stress, and access to a sound amplifier. Teachers from the above-mentioned classrooms reported their voice symptoms, respiratory tract diseases, and completed a Voice Handicap Index (VHI). The more voice ergonomic risk factors found in the classroom the higher were the teachers' total scores on voice symptoms and VHI. Stress was the factor that correlated most strongly with voice symptoms. Poor indoor air quality increased the occurrence of laryngitis. Voice ergonomics were poor in the classrooms studied and voice ergonomic risk factors affected the voice. It is important to convey information on voice ergonomics to education administrators and those responsible for school planning and taking care of school buildings. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  10. Delayed antibiotic prescription for upper respiratory tract infections in children under primary care: Physicians' views.

    Science.gov (United States)

    Raft, Camilla Flintholm; Bjerrum, Lars; Arpi, Magnus; Jarløv, Jens Otto; Jensen, Jette Nygaard

    2017-12-01

    Overprescribing antibiotics for common or inaccurately diagnosed childhood infections is a frequent problem in primary healthcare in most countries. Delayed antibiotic prescriptions have been shown to reduce the use of antibiotics in primary healthcare. The aim was to examine primary care physicians' views on delayed antibiotic prescriptions to preschool children with symptoms of upper respiratory tract infections (URTIs). A questionnaire was sent to 1180 physicians working in general practice in the Capital Region of Denmark, between January and March 2015. The questions focused on physicians' attitude and use of delayed antibiotic prescriptions to children with URTIs. The response rate was 49% (n = 574). Seven per cent of the physicians often used delayed prescriptions to children with symptoms of URTI, but 46% believed that delayed prescription could reduce antibiotic use. The physicians' views on delayed antibiotic prescription were significantly associated with their number of years working in general practice. Parents' willingness to wait-and-see, need for reassurance, and knowledge about antibiotics influenced the physicians' views. Also, clinical symptoms and signs, parents' willingness to shoulder the responsibility, the capability of observation without antibiotic treatment, and structural factors like out-of-hour services were relevant factors in the decision. Most physicians, especially those with fewer years of practice, had a positive attitude towards delayed antibiotic prescription. Several factors influence the views of the physicians-from perceptions of parents to larger structural elements and years of experience.

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

    Science.gov (United States)

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

    2015-08-01

    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 characteristics and disease severity was not available. The aim of this study is to quantify and qualify inappropriate antibiotic prescribing for RTIs. This is an observational study of the (antibiotic) management of patients with RTIs, using a detailed registration of RTI consultations by general practitioners (GPs). Consultations of which all necessary information was available were benchmarked to the prescribing guidelines for acute otitis media (AOM), acute sore throat, rhinosinusitis or acute cough. Levels of overprescribing for these indications and factors associated with overprescribing were determined. The overall antibiotic prescribing rate was 38%. Of these prescriptions, 46% were not indicated by the guidelines. Relative overprescribing was highest for throat (including tonsillitis) and lowest for ear consultations (including AOM). Absolute overprescribing was highest for lower RTIs (including bronchitis). Overprescribing was highest for patients between 18 and 65 years of age, when GPs felt patients' pressure for an antibiotic treatment, for patients presenting with fever and with complaints longer than 1 week. Underprescribing was observed in overprescribing can help in the development of targeted strategies to improve GPs' prescribing routines for RTIs. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. [Lower respiratory tract infections related to Stenotrophomonas maltophilia and Acinetobacter baumannii].

    Science.gov (United States)

    Baranzelli, A; Wallyn, F; Nseir, S

    2013-10-01

    Stenotrophomonas maltophilia and Acinetobacter baumannii are both non-fermenting ubiquitous Gram-negative bacilli. The incidence of lower respiratory tract infections related to these microorganisms is increasing, especially in intensive care units. Their capacity to acquire resistance against several antimicrobials is challenging for clinicians and microbiologists. Despite their low virulence, these pathogens are responsible for colonization and infection in patients with comorbidities, immunosuppression, and critically ill patients. S. maltophilia and A. baumannii are mainly identified in nosocomial infections: ventilator-associated pneumonia, bacteremia and surgical wound infection. Infections related to these microorganism are associated with high mortality and morbidity. Trimethoprime-sulfamethoxazole and carbapenem are the first line treatment for infections related to S. maltophilia and A. baumannii respectively. However, the increasing rate of resistance against these agents results in difficulties in treating patients with infections related to these pathogens. New antimicrobial agents and further randomized studies are needed to improve the treatment of these infections. Prevention of spared of these multidrug-resistant bacteria is mandatory, including hand-hygiene, environment cleaning, and limited usage of large spectrum antibiotics. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  13. STUDY ON CAMPHOR-FREE NATURAL TOPICAL MEDICINE FOR UPPER RESPIRATORY TRACT INFECTIONS IN CHILDREN

    Directory of Open Access Journals (Sweden)

    Zubair Ali

    2016-12-01

    Full Text Available Upper respiratory tract infections (URTI are the most common acute illnesses that are often of viral origin. Cough and chest congestion are the common symptoms of this disease. Children are prescribed with drugs that are considered to relive the symptoms of this disease. The topical medications contain vegetable camphor for more than a century that relieve chest congestion and cough caused by URTI. The use of camphor in such products remains questionable especially in children who are more sensitive to its side effects. Herbion “Chest Rub” for children is a camphor-free formulation that contains eucalyptus oil mixture, menthol,turpentine and clove oils and is used to relieve symptoms of URTI.The objective of the present investigationwas to determine the effectiveness of the chest rub inchildren suffering with congestion and cough caused by URTI. The study compared the results of the chest rub applied to a group of infected children with a placebo group. Patients were selected randomly on the basis of the criteria set for the study. The results indicated that the chest rub was quite effective in majority of the cases in relieving the symptoms of URTI as compared to the placebo group.

  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. Geographic variations in antibiotic prescription for pediatric acute upper respiratory tract infections in South Korea.

    Science.gov (United States)

    Jung, Youn; Cho, Hyemin; Ji, Eunhee; Park, Eun-Ji; Jang, Sunmee

    2018-01-10

    This study aimed to investigate the factors affecting the geographic differences in antibiotic prescription rates in pediatric upper respiratory tract infections (URI) patients in South Korea. We performed a nationwide cross-sectional study using 228 administrative districts of Korea, which are the unit of analysis. Prescription rate of antibiotics, the outcome variable, was measured as the proportion of antibiotic prescription days out of total visit days for the treatment of acute URIs using National Health Insurance Service (NHIS) claims data for 2012. Multivariate regression analysis was performed to identify factors affecting geographic variation in antibiotic prescription rates. The socioeconomic status of the district, as measured by the amount of local property tax payable and the proportion of individuals with higher level of education, were negatively correlated with prescription rate. The degree of competition in the hospital market within a district was positively associated with it. Patients living in areas with better access to family medicine physicians and those living in rural areas were less likely to use antibiotics to treat URIs. Our findings indicate the importance of considering demand factors as well as supply factors when developing intervention strategies for antibiotic overuse.
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  16. Radon-enriched hot spring water therapy for upper and lower respiratory tract inflammation.

    Science.gov (United States)

    Passali, Desiderio; Gabelli, Giacomo; Passali, Giulio Cesare; Mösges, Ralph; Bellussi, Luisa Maria

    2017-08-31

    Background Radon-222-enriched hot spring therapy, which is characterized by a safe level of radioactivity, is used for the treatment of rheumatic disorders, and its efficacy has already been studied in several clinical trials. Radon-water inhalation therapy for the treatment of upper and lower airway inflammatory diseases is used in many hot springs centers. However, its application has not been reviewed to date. Methods We systematically searched the PubMed and Scopus databases for clinical trials published in the last 20 years in which objective parameters of upper and lower airway function had been tested before and after radon-enriched inhalation treatment. Results Four prospective studies were found: 1 asthma trial, 1 placebo-controlled chronic rhinosinusitis trial, 1 upper respiratory tract inflammation with nasal obstruction trial, and 1 case-control allergic rhinitis trial. Patients were treated with nasal inhalations of radon-enriched water for 12 to 28 days and were assessed at baseline and after therapy. After 2 weeks of treatment, nasal resistance decreased, flow increased, mucociliary clearance was enhanced, ciliated-to-muciparous cell ratio increased, and %FEV1 increased in asthmatic patients. Conclusion Radon-enriched inhalation therapy improves objective indicators of nasal function in allergic rhinitis and chronic rhinosinusitis, and causes relief of pulmonary obstruction in asthma.

  17. 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

    OBJECTIVE: Patient-reported outcomes are seldom validated measures in clinical trials of acute respiratory tract infections (ARTIs) in primary care. We developed and validated a patient-reported outcome sum-scaling measure to assess the severity and functional impacts of ARTIs. METHODS: Qualitati......, sum-scaling questionnaire with high face and content validity and adequate psychometric properties for assessing severity and functional impacts from ARTIs in adults is available to clinical trials and audits in primary care.......OBJECTIVE: Patient-reported outcomes are seldom validated measures in clinical trials of acute respiratory tract infections (ARTIs) in primary care. We developed and validated a patient-reported outcome sum-scaling measure to assess the severity and functional impacts of ARTIs. METHODS: Qualitative...... 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...

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

    International Nuclear Information System (INIS)

    Vezzu, G.; Butterweck-Dempewolf, G.; Schuler, C.

    1998-01-01

    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.)

  19. Oralfacialdigital-like syndrome with respiratory tract symptoms from birth and ultrastructural centriole/basal body disarray.

    Science.gov (United States)

    Stenram, Unne; Cramnert, Catarina; Axfors-Olsson, Helene

    2007-07-01

    A girl with polydactyly has had respiratory tract problems, including atelectasis, since birth. She has a high arched palate, a tongue hamartoma and dysmorphic face. Electron microscopy of nasal and bronchial brush biopsies repeatedly revealed centriole/basal body disarray and extreme sparseness of cilia. At the age of 2 years and 11 months, she displayed retardation of both motor and mental skills. The manifestations tally with a ciliopathy, partly with the Bardet--Biedl syndrome (BBS) but especially with the oralfacialdigital syndrome (OFDS); however, with the addition of persistent respiratory tract problems. As these two syndromes are considered to be due to mutations affecting the centriole/basal body apparatus, the ultrastructural demonstration of disarray of these structures, never before demonstrated in such a patient, is of fundamental interest.

  20. THE ROLE OF SALIVARY IMMUNOGLOBULIN A IN THE PREVENTION OF THE UPPER RESPIRATORY TRACT INFECTIONS IN ATHLETES – AN OVERVIEW

    Directory of Open Access Journals (Sweden)

    Joanna Orysiak

    2012-11-01

    Full Text Available Athletes subjected to high work loads may experience temporary suppression of the functions in the immune system which increases the susceptibility to infections of such subjects. Namely, upper respiratory tract infections (URTI are the most common disorders among individuals subjected to high work loads and that issue is of utmost importance for sport immunologists. So far, no simple explanation has been offered as to the specific roles of detailed elements of the immune system in URTI incidence. One of the most likely markers is supposed to be the secretory immunoglobulin A (sIgA, associated with mucosal membranes of upper respiratory  tracts, although the results are far from being unequivocal yet. The most important results published in that area were discussed in this paper.

  1. Impact of amoxicillin therapy on resistance selection in patients with community-acquired lower respiratory tract infections

    DEFF Research Database (Denmark)

    Malhotra-Kumar, Surbhi; Van Heirstraeten, Liesbet; Coenen, Samuel

    2016-01-01

    OBJECTIVES: To determine the effect of amoxicillin treatment on resistance selection in patients with community-acquired lower respiratory tract infections in a randomized, placebo-controlled trial. METHODS: Patients were prescribed amoxicillin 1 g, three times daily (n = 52) or placebo (n = 50...... that recommend amoxicillin when an antibiotic is indicated for community-acquired lower respiratory tract infections.......) for 7 days. Oropharyngeal swabs obtained before, within 48 h post-treatment and at 28-35 days were assessed for proportions of amoxicillin-resistant (ARS; amoxicillin MIC ≥2 mg/L) and -non-susceptible (ANS; MIC ≥0.5 mg/L) streptococci. Alterations in amoxicillin MICs and in penicillin...

  2. Hospital Outcomes of Adult Respiratory Tract Infections with Extended-Spectrum B-Lactamase (ESBL) Producing Klebsiella Pneumoniae

    OpenAIRE

    Loh, Li-Cher; Nor Izran Hanim bt Abdul Samad,; Rosdara Masayuni bt Mohd Sani,; Raman, Sree; Thayaparan, Tarmizi; Kumar, Shalini

    2007-01-01

    Klebsiella pneumoniae ranks high as a cause of adult pneumonia requiring hospitalization in Malaysia. To study whether extended-spectrum b-lactamase (ESBL) producing K. pneumoniae was linked to hospital outcomes, we retrospectively studied 441 cases of adult respiratory tract infections with microbial proven K. pneumoniae from an urban-based university teaching hospital between 2003 and 2004. 47 (10.6%) cases had ESBL. Requirement for ventilation and median length of hospital stay, were great...

  3. Maternal vitamin D status in pregnancy and risk of lower respiratory tract infections, wheezing, and asthma in offspring.

    Science.gov (United States)

    Morales, Eva; Romieu, Isabelle; Guerra, Stefano; Ballester, Ferrán; Rebagliato, Marisa; Vioque, Jesús; Tardón, Adonina; Rodriguez Delhi, Cristina; Arranz, Leonor; Torrent, Maties; Espada, Mercedes; Basterrechea, Mikel; Sunyer, Jordi

    2012-01-01

    Adequate vitamin D status in mothers during pregnancy may influence the health status of the child later in life. We assessed whether maternal circulating 25-hydroxyvitamin D (25[OH]D) concentrations in pregnancy are associated with risk of lower respiratory tract infections, wheezing, and asthma in the offspring. Data were obtained from 1724 children of the INfancia y Medio Ambiente (INMA) Project, a population-based birth cohort study. Maternal circulating 25(OH)D concentrations were measured in pregnancy (mean gestational age = 12.6 [SD = 2.5] weeks). When the child was age 1 year, parents were asked if their child had a physician-confirmed history of lower respiratory tract infections or a history of wheezing. The questions about wheezing were repeated annually thereafter. Asthma was defined as parental report of doctor diagnosis of asthma or receiving treatment at the age of 4-6 years or wheezing since the age of 4 years. The median maternal circulating 25(OH)D concentration in pregnancy was 29.5 ng/mL (interquartile range, 22.5-37.1 ng/mL). After multivariable adjustment, there was a trend for an independent association between higher levels of maternal circulating 25(OH)D levels in pregnancy and decreased odds of lower respiratory tract infections in offspring (for cohort- and season-specific quartile Q4 vs. Q1, odds ratio = 0.67 [95% confidence interval = 0.50-0.90]; test for trend, P = 0.016). We found no association between 25(OH)D levels in pregnancy and risk of wheezing at age 1 year or 4 years, or asthma at age 4-6 years. Higher maternal circulating 25(OH)D concentrations in pregnancy were independently associated with lower risk of lower respiratory tract infections in offspring in the first year of life but not with wheezing or asthma in childhood.

  4. Value of washed sputum gram stain smear and culture for management of lower respiratory tract infections in children.

    Science.gov (United States)

    Cao, Luong Dong; Ishiwada, Naruhiko; Takeda, Nobue; Nigo, Yukiko; Aizawa, Jirou; Kuroki, Haruo; Kohno, Yoichi

    2004-02-01

    To date, the technique of washed sputum examinations has not been widely used in the clinical management of lower respiratory tract infections in children. A total of 224 sputum samples from 125 pediatric patients with lower respiratory tract infections were collected for washed sputum Gram stain smears and cultures. The results with these methods were compared to find correlation rates. The value of washed sputum cultures was assessed by examining the clinical responses of the patients who received antibiotic therapies instituted on the basis of the sputum culture results. Isolation rates of Haemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis, and Staphylococcus aureus were 22.4%, 9.4%, 4.9%, and 0.4%, respectively. For the prediction of H. influenzae, S. pneumoniae, and M. catarrhalis, the sensitivities of the washed sputum Gram stain smears compared with the culture method were 86.0%, 81.0%, and 90.9%, respectively. The specificities of the washed sputum Gram stain smear technique were 94.8%, 97.5%, and 98.1%, respectively. Overall, the sensitivity and specificity of the washed sputum Gram stain smear method were 85.5% and 87.2%, respectively. S. aureus was isolated from only one specimen; and washed sputum Gram stain smear estimation was correlated with the culture result. On the basis of the washed sputum culture results, appropriate antibiotic therapies were instituted for 93.3% of the patients with acute lower respiratory tract infections. This study suggests that the techniques of washed sputum Gram stain smear and culture are valuable and should be encouraged in clinical practice for the management of lower respiratory tract infections in children.

  5. Augmentation of glutathione in the fluid lining the epithelium of the lower respiratory tract by directly administering glutathione aerosol.

    OpenAIRE

    Buhl, R; Vogelmeier, C; Critenden, M; Hubbard, R C; Hoyt, R F; Wilson, E M; Cantin, A M; Crystal, R G

    1990-01-01

    Glutathione (GSH), a cysteine-containing tripeptide, functions as an antioxidant, provides cells with cysteine, and is required for optimal function of the immune system. Because the epithelial-lining fluid (ELF) of the lower respiratory tract normally contains high GSH levels and lung ELF GSH deficiency states can exist, we evaluated the feasibility of augmenting lung ELF GSH levels by (i) administering GSH to sheep i.v. and by direct aerosolization and then (ii) measuring the GSH levels in ...

  6. 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.

  7. Evaluation the Antibacterial Effects of Two Commercial Products of Eucalyptus globulus Against Common Microbial Causes of Respiratory Tract Infections

    Directory of Open Access Journals (Sweden)

    Mohammadreza Nahaei, Mahsa Kalejahi 1, Parisa Rahbarfam 1, Solmaz Maleki Dizaj 2, Farzaneh Lotfipour *

    2016-12-01

    Full Text Available Background: Recently, antimicrobial activity of medicinal plants have attained once more importance due to drug resistance of microbial isolates to common antibiotics as well as fewer side effects and low cost of herbal products comparing to chemical drugs. Eucalyptus globules (E. globulus has been widely applied as a natural remedy in respiratory tract infections. The present study focused on the evaluation of antibacterial effect of two commercial products of E. globulus against common microbial causes of respiratory tract infections. To this end, two commercial products of E. globules including inhaler and oral soft capsule with standard expiration date, (in three different batch numbers were purchased from the pharmacy stores of Tabriz city. Methods: The antibacterial efficiency of these products were investigated using Minimum Inhibitory Concentration (MIC, Minimum Bactericidal Concentration (MBC and disk diffusion methods against Staphylococcus aureus, Streptococcus pyogenes and Pseudomona aeruginosa. Results: Based on the obtained results, these commercial products of E. globules showed significant inhibitory effects against Gram-positive bacteria. The findings also indicated that the Eucalyptus inhaler products had more inhibitory effects than Eucalyptus oral soft capsule, however batch to batch variations were of concern. Conclusion: This research presents optimistic result on using the Eucalyptus as an alternative antibacterial agent against respiratory tract pathogenic microorganisms.

  8. Long-Term Effects of Breastfeeding on Children's Hospitalization for Respiratory Tract Infections and Diarrhea in Early Childhood in Japan.

    Science.gov (United States)

    Yamakawa, Michiyo; Yorifuji, Takashi; Kato, Tsuguhiko; Inoue, Sachiko; Tokinobu, Akiko; Tsuda, Toshihide; Doi, Hiroyuki

    2015-09-01

    Whether or not the protective effects of breastfeeding last during or after a shift to a weaning diet is not clear. In the present study, we examined the effects of breastfeeding on hospitalization for respiratory tract infections and diarrhea in early childhood in Japan. Data were extracted from a nationwide longitudinal survey of Japanese children. We restricted the study participants to singleton children who were born after 37 gestational weeks and whose information on feeding practice during infancy were included (n = 43,367). We used logistic regression models to evaluate the associations of breastfeeding with hospitalization for the two diseases among young children (i.e., between ages 6 and 18 months, between ages 18 and 30 months, and between ages 30 and 42 months, respectively), adjusting for children's factors (sex, birth weight, childcare attendance and presence of siblings) and maternal factors (educational attainment and smoking status). Breastfeeding compared with infant formula was not associated with reduced risk of hospitalization for diarrhea during the periods we examined. Although breastfeeding was not associated with reduced risk of hospitalization for respiratory tract infections between ages 6 and 18 months, breastfeeding showed protective effects after that period: the adjusted odds ratios (95% confidence intervals) of exclusive breastfeeding were 0.82 (0.66-1.01) between ages 18 and 30 months and 0.76 (0.58-0.99) between ages 30 and 42 months. Breastfeeding may have long-term protective effects on hospitalization for respiratory tract infections after infancy, but not for diarrhea.

  9. 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.

  10. Prenatal exposure to bisphenol A and phthalates and childhood respiratory tract infections and allergy.

    Science.gov (United States)

    Gascon, Mireia; Casas, Maribel; Morales, Eva; Valvi, Damaskini; Ballesteros-Gómez, Ana; Luque, Noelia; Rubio, Soledad; Monfort, Núria; Ventura, Rosa; Martínez, David; Sunyer, Jordi; Vrijheid, Martine

    2015-02-01

    There is growing concern that prenatal exposure to bisphenol A (BPA) and phthalates, which are widely used in consumer products, might affect susceptibility to infections and the development of allergy and asthma in children, but there are currently very few prospective studies. We sought to evaluate whether prenatal exposure to BPA and phthalates increases the risk of respiratory and allergic outcomes in children at various ages from birth to 7 years. We measured BPA and metabolites of high-molecular-weight phthalates, 4 di-(2-ethylhexyl) phthalate (DEHP) metabolites (Σ4DEHP) and mono-benzyl phthalate (MBzP), and 3 low-molecular-weight phthalate (LMWP) metabolites (Σ3LMWP) in urine samples collected during the first and third trimesters in pregnant women participating in the Infancia y Medio Ambiente-Sabadell birth cohort study. The occurrence of chest infections, bronchitis, wheeze, and eczema in children was assessed at ages 6 and 14 months and 4 and 7 years through questionnaires given to the mothers. Atopy (specific IgE measurement) and asthma (questionnaire) were assessed at ages 4 and 7 years, respectively. The relative risks (RRs) of wheeze (RR, 1.20; 95% CI, 1.03-1.40; P = .02), chest infections (RR, 1.15; 95% CI, 1.00-1.32; P = .05), and bronchitis (RR, 1.18; 95% CI, 1.01-1.37; P = .04) at any age increased for each doubling in concentration of maternal urinary BPA. Σ4DEHP metabolites were associated with the same outcomes (wheeze: RR, 1.25; 95% CI, 1.04-1.50, P = .02; chest infections: RR, 1.15; 95% CI, 0.97-1.35; P = .11; bronchitis: RR, 1.20; 95% CI, 1.01-1.43; P = .04). MBzP was associated with higher risk of wheeze (RR, 1.15; 95% CI, 1.00-1.33; P = .05). The risk of asthma at age 7 years was also increased with increasing prenatal BPA, Σ4DEHP, and MBzP exposure. There were no other exposure-outcome associations. Prenatal exposure to BPA and high-molecular-weight phthalates might increase the risk of asthma symptoms and respiratory tract

  11. [The epidemiological study of adenovirus in children with respiratory tract infections in Nanjing area from 2010 to 2011].

    Science.gov (United States)

    Gao, Xiao-Qian; Jin, Yu; Xie, Zhi-Ping; Gao, Han-Chun; Xie, Le-Yun; Zhang, Jian; Duan, Zhao-Jun

    2012-09-01

    To investigate the epidemiological features and types of human adenoviruses (ADV) in children with acute respiratory tract infection in Nanjing area, China. Nasopharyngeal aspirates and nasopharyngeal swabs were collected from 644 outpatients or hospitalized pediatric patients with ARTI at the Children Hospital of Nanjing, Jiangsu Province, China, between August 2010 and July 2011. Adenoviruses were identified and typed from the collected clinical specimens by nested-PCR based on the partial region of the hexon gene. Other 12 respiratory viruses including human bocavirus (HBoV), respiratory syncytial virus (RSV), human rhinovirus (HRV), parainfluenza viruses 1-4 (PIV1-4), influenza virus A/B (IFVA/B), human metapneumovirus (HMPV), human coronavirus NL63 and HKU1 (HCoV-HKU1 and HCoV-NL63) were also identified by PCR method. All PCR positive products were sequenced and phylogenetic analysis was conducted. It was showed that adenoviruses were detected in 171 patients out of 644 (26. 55%) children, 120 (70.18%, 120/171) for ADV3, 16 (9.36%,16/171) for ADV7, 12 (7.02%, 12/171) for ADV1, 10 (5.85%, 10/171) for ADV2, 6 (3.51%, 6/171) for ADV5, 3 (1.75%, 3/171) for ADV6, 3 (1.75%, 3/171) for ADV57, and 1 (0.58%,1/171) for ADV41. ADV infection could occur in any season. There was a higher possibility of ADV infection from April to July in 2011. Most cases (96.49%) were younger than 7 years old. A total of 99 of the 171 ADV-positive children (57.89%) were co-infected with other respiratory viruses. Respiratory syncytial virus (RSV) and human rhinovirus (HRV) were the most common additional respiratory viruses, Lower respiratory tract infections were the most frequent diagnoses made in the hospital, in which there were 52 pneumonia (30.4%) cases. ADV is one of the most important pathogens of acute respiratory tract infection in children in Nanjing area, and adenovirus type 3 was the most prevalent serotype. It is important to develop long-term surveillance.

  12. Probiotics and respiratory and gastrointestinal tract infections in Finnish military conscripts - a randomised placebo-controlled double-blinded study.

    Science.gov (United States)

    Kalima, K; Lehtoranta, L; He, L; Pitkäniemi, J; Lundell, R; Julkunen, I; Roivainen, M; Närkiö, M; Mäkelä, M J; Siitonen, S; Korpela, R; Pitkäranta, A

    2016-09-01

    Military conscripts are susceptible to respiratory and gastrointestinal tract infections. In previous studies probiotics have shown potency to reduce upper respiratory and gastrointestinal infections. The aim was to study whether probiotic intervention has an impact on seasonal occurrence of upper respiratory and gastrointestinal infections in two different conscript groups. In a randomised, double-blinded, placebo controlled study (https://clinicaltrials.gov NCT01651195), a total of 983 healthy adults were enrolled from two intakes of conscripts. Conscripts were randomised to receive either a probiotic combination of Lactobacillus rhamnosus GG (LGG) and Bifidobacterium animalis ssp. lactis BB12 (BB12) or a control chewing tablet twice daily for 150 days (recruits) or for 90 days (reserve officer candidates). Clinical examinations were carried out and daily symptom diaries were collected. Outcome measures were the number of days with respiratory and gastrointestinal symptoms and symptom incidence, number and duration of infection episodes, number of antibiotic treatments received and number of days out of service because of the infection. Statistically no significant differences were found between the intervention groups either in the risk of symptom incidence or duration. However, probiotic intervention was associated with reduction of specific respiratory infection symptoms in military recruits, but not in reserve officer candidates. Probiotics did not significantly reduce overall respiratory and gastrointestinal infection morbidity.

  13. Lung Function in Wheezing Infants after Acute Lower Respiratory Tract Infection and Its Association with Respiratory Outcome

    Directory of Open Access Journals (Sweden)

    Yuan-Yuan Qi

    2017-01-01

    Conclusions: Impaired lung function was present in wheezing infants with ALRTI and the deficits persisted. In addition, the lower level of TPTEF/TE and VPTEF/VE was a risk factor for poor respiratory outcome.

  14. 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.

  15. Influence of Clinical Communication on Parents' Antibiotic Expectations for Children With Respiratory Tract Infections.

    Science.gov (United States)

    Cabral, Christie; Ingram, Jenny; Lucas, Patricia J; Redmond, Niamh M; Kai, Joe; Hay, Alastair D; Horwood, Jeremy

    2016-03-01

    The purpose of this study was to understand clinicians' and parents' perceptions of communication within consultations for respiratory tract infections (RTI) in children and what influence clinician communication had on parents' understanding of antibiotic treatment. We video recorded 60 primary care consultations for children aged 3 months to 12 years who presented with RTI and cough in 6 primary care practices in England. We then used purposive sampling to select 27 parents and 13 clinicians for semistructured video-elicitation interviews. The videos were used as prompts to investigate participants' understanding and views of communication within the consultations. We analyzed the interview data thematically. While clinicians commonly told parents that antibiotics are not effective against viruses, this did not have much impact on parents' beliefs about the need to consult or on their expectations concerning antibiotics. Parents believed that antibiotics were needed to treat more severe illnesses, a belief that was supported by the way clinicians accompanied viral diagnoses with problem-minimizing language and antibiotic prescriptions with more problem-oriented language. Antibiotic prescriptions tended to confirm parents' beliefs about what indicated illness severity, which often took into account the wider impact on a child's life. While parents understood antimicrobial resistance poorly, most held beliefs that supported reduced antibiotic prescribing. A minority attributed it to resource rationing, however. Clinician communication and prescribing behavior confirm parents' beliefs that antibiotics are needed to treat more severe illnesses. Interventions to reduce antibiotic expectations need to address communication within the consultation, prescribing behavior, and lay beliefs. © 2016 Annals of Family Medicine, Inc.

  16. From Visiting a Physician to Expecting Antibiotics: Korean Perspectives and Practices toward Respiratory Tract Infections.

    Science.gov (United States)

    Freidoony, Leila; Kim, Chun Bae; Haghani, Hamid; Park, Myung Bae; Chang, Sei Jin; Kim, Sang Ha; Koh, Sang Baek

    2017-02-01

    Antibiotic resistance is steadily rising worldwide. Respiratory tract infections (RTIs) are common indications, mostly imprudent, for antibiotic prescriptions in outpatient setting. In Korea, antibiotic prescription rate for RTIs is still high. As physician visit and antibiotic prescribing are influenced by patient's perceptions and beliefs, we aimed to explore the general public's perspectives and practices toward RTIs and to develop the 'RTI clinical iceberg.' A cross-sectional survey was conducted in Wonju Severance Christian Hospital (WSCH) among 550 adults attending outpatient departments during January 2016. Differences in distributions between groups were examined using two-tailed Pearson χ² test. Using the Andersen's behavioral model as a conceptual framework, we constructed logistic regression models to assess factors associated with physician visit. Of 547 participants with complete questionnaires, 62.9% reported having experienced an RTI in the previous six months; 59.3% visited a physician for the illness, most commonly because the symptoms were severe or prolonged, and approximately 16% of them expected an antibiotic prescription from the visit. Perceptions of symptoms severity, the need factor, most strongly influenced physician visit. Predisposing and enabling factors such as inappropriate expectations for antibiotic for a sore throat or having national health insurance also influenced physician visit. Almost all participants who reported asking for an antibiotic were prescribed one, with a 37.1% non-adherence rate. Conclusively, public education on self-care for RTI symptoms that addresses their main concerns may reduce physician visits. Improving physician-patient relationship and informing patients about the lack of antibiotic benefit for most RTIs may also reduce antibiotic prescriptions.

  17. Aspergillus infection of the respiratory tract after lung transplantation: chest radiographic and CT findings

    International Nuclear Information System (INIS)

    Diederich, S.; Scadeng, M.; Flower, C.D.R.; Dennis, C.; Stewart, S.

    1998-01-01

    The objective of our study was to assess radiographic and CT findings in lung transplant patients with evidence of Aspergillus colonization or infection of the airways and correlate the findings with clinical, laboratory, bronchoalveolar lavage, biopsy and autopsy findings. The records of 189 patients who had undergone lung transplantation were retrospectively reviewed for evidence of Aspergillus colonization or infection of the airways. Aspergillus was demonstrated by culture or microscopy of sputum or bronchoalveolar lavage fluid or histologically from lung biopsies or postmortem studies in 44 patients (23 %). Notes and radiographs were available for analysis in 30 patients. In 12 of the 30 patients (40 %) chest radiographs remained normal. In 11 of 18 patients with abnormal radiographs pulmonary abnormalities were attributed to invasive pulmonary aspergillosis (IPA) in the absence of other causes for pulmonary abnormalities (8 patients) or because of histological demonstration of IPA (3 patients). In these 11 patients initial radiographic abnormalities were focal areas of patchy consolidation (8 patients), ill-defined pulmonary nodules (2 patients) or a combination of both (1 patient). In some of the lesions cavitation was demonstrated subsequently. At CT a ''halo'' of decreased density was demonstrated in some of the nodules and lesion morphology and location were shown more precisely. Demonstration of Aspergillus from the respiratory tract after lung transplantation does not necessarily reflect IPA but may represent colonization of the airways or semi-invasive aspergillosis. The findings in patients with IPA did not differ from those described in the literature in other immunocompromised patients, suggesting that surgical disruption of lymphatic drainage and nervous supply or effects of preservation and transport of the transplant lung do not affect the radiographic appearances. (orig.)

  18. Impact of immunosuppression on incidence, aetiology and outcome of ventilator-associated lower respiratory tract infections.

    Science.gov (United States)

    Moreau, Anne-Sophie; Martin-Loeches, Ignacio; Povoa, Pedro; Salluh, Jorge; Rodriguez, Alejandro; Thille, Arnaud W; Diaz Santos, Emilio; Vedes, Elisa; Lobo, Suzana Margareth; Mégarbane, Bruno; Molero Silvero, Esperanza; Coelho, Luis; Argaud, Laurent; Sanchez Iniesta, Rafael; Labreuche, Julien; Rouzé, Anahita; Nseir, Saad

    2018-03-01

    The aim of this planned analysis of the prospective multinational TAVeM database was to determine the incidence, aetiology and impact on outcome of ventilator-associated lower respiratory tract infections (VA-LRTI) in immunocompromised patients.All patients receiving mechanical ventilation for >48 h were included. Immunocompromised patients (n=663) were compared with non-immunocompromised patients (n=2297).The incidence of VA-LRTI was significantly lower among immunocompromised than among non-immunocompromised patients (16.6% versus 24.2%; sub-hazard ratio 0.65, 95% CI 0.53-0.80; p<0.0001). Similar results were found regarding ventilator-associated tracheobronchitis (7.3% versus 11.6%; sub-hazard ratio 0.61, 95% CI 0.45-0.84; p=0.002) and ventilator-associated pneumonia (9.3% versus 12.7%; sub-hazard ratio 0.72, 95% CI 0.54-0.95; p=0.019). Among patients with VA-LRTI, the rates of multidrug-resistant bacteria (72% versus 59%; p=0.011) and intensive care unit mortality were significantly higher among immunocompromised than among non-immunocompromised patients (54% versus 30%; OR 2.68, 95% CI 1.78-4.02; p<0.0001). In patients with ventilator-associated pneumonia, mortality rates were higher among immunocompromised than among non-immunocompromised patients (64% versus 34%; p<0.001).Incidence of VA-LRTI was significantly lower among immunocompromised patients, but it was associated with a significantly higher mortality rate. Multidrug-resistant pathogens were more frequently found in immunocompromised patients with VA-LRTI. Copyright ©ERS 2018.

  19. Unnecessary Antibiotics for Acute Respiratory Tract Infections: Association With Care Setting and Patient Demographics.

    Science.gov (United States)

    Barlam, Tamar F; Soria-Saucedo, Rene; Cabral, Howard J; Kazis, Lewis E

    2016-01-01

    Background.  Up to 40% of antibiotics are prescribed unnecessarily for acute respiratory tract infections (ARTIs). We sought to define factors associated with antibiotic overprescribing of ARTIs to inform efforts to improve practice. Methods.  We conducted a retrospective analysis of ARTI visits between 2006 and 2010 from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey. Those surveys provide a representative sample of US visits to community-based physicians and to hospital-based emergency departments (EDs) and outpatient practices. Patient factors (age, sex, race, underlying lung disease, tobacco use, insurance), physician specialty, practice demographics (percentage poverty, median household income, percentage with a Bachelor's Degree, urban-rural status, geographic region), and care setting (ED, hospital, or community-based practice) were evaluated as predictors of antibiotic overprescribing for ARTIs. Results.  Hospital and community-practice visits had more antibiotic overprescribing than ED visits (odds ratio [OR] = 1.64 and 95% confidence interval [CI], 1.27-2.12 and OR = 1.59 and 95% CI, 1.26-2.01, respectively). Care setting had significant interactions with geographic region and urban and rural location. The quartile with the lowest percentage of college-educated residents had significantly greater overprescribing (adjusted OR = 1.41; 95% CI, 1.07-1.86) than the highest quartile. Current tobacco users were overprescribed more often than nonsmokers (OR = 1.71; 95% CI, 1.38-2.12). Patient age, insurance, and provider specialty were other significant predictors. Conclusions.  Tobacco use and a lower grouped rate of college education were associated with overprescribing and may reflect poor health literacy. A focus on educating the patient may be an effective approach to stewardship.

  20. Determinants of antibiotic overprescribing in respiratory tract infections in general practice.

    Science.gov (United States)

    Akkerman, Annemiek E; Kuyvenhoven, Marijke M; van der Wouden, Johannes C; Verheij, Theo J M

    2005-11-01

    To assess determinants of antibiotic overprescribing in patients with sinusitis, tonsillitis and bronchitis in Dutch general practice. A total of 146 general practitioners (GPs) from The Netherlands included all patients with sinusitis, tonsillitis and bronchitis during a 4 week period in the winter of 2002/2003, and recorded patient characteristics, clinical presentation and management. Overprescribing of antibiotics was assessed using the recommendations of the Dutch national guidelines as a benchmark. In almost 50% of all 1469 respiratory tract infection (RTI) consultations (694/1469), the antibiotic prescribing decisions were in accordance with the recommendations of the Dutch national guidelines. Overprescribing was highest in tonsillitis and bronchitis [71% (168/238) and 63% (415/656), respectively], while in sinusitis this was only 22% (128/575). Underprescribing was seen in 1% (3/238), 3% (17/656) and 8% (44/575), respectively. Patients who received an antibiotic prescription that was not in accordance with the guidelines had more inflammation signs such as fever (ORs 2.08, 2.18 and 3.04, for sinusitis, tonsillitis and bronchitis, respectively), were more severely ill according to their GP (ORs 2.37, 1.87 and 1.42, respectively), and their GP assumed more often that they expected an antibiotic (ORs 1.95, 1.70 and 2.11, respectively), compared with those who did not receive an antibiotic prescription. GPs overestimate symptoms and probably patients' expectations when indicating antibiotic therapy in RTI cases in daily practice. Correct interpretation of combinations of symptoms for antibiotic treatment should be emphasized, combined with adopting more patient-centred consulting skills to rationalize the prescribing of antibiotics.

  1. 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.

  2. Effects of upper respiratory tract illnesses, ibuprofen and caffeine on reaction time and alertness.

    Science.gov (United States)

    Smith, Andrew P; Nutt, David J

    2014-05-01

    Compared with healthy individuals, those with upper respiratory tract illnesses (URTIs) report reduced alertness and have slower reaction times. It is important to evaluate medication that can remove this behavioural malaise. The aim of this study was to compare the effects of a combination of ibuprofen plus caffeine with ibuprofen and caffeine alone, and placebo on malaise associated with URTIs, as measured by psychomotor performance and mood testing. Volunteers were randomly assigned to one of four medication conditions as follows: 200 mg ibuprofen and 100 mg caffeine; 200 mg ibuprofen; 100 mg caffeine; placebo. A single oral dose was given and testing followed for 3 h. Efficacy variables were based on the volunteers' performance, measured by psychomotor performance and mood. The pre-drug results confirmed that those with an URTI had a more negative mood and impaired performance. Results from the simple reaction time task, at both 55- and 110-min post-dosing, showed that a single-dose of caffeinated products (I200/C100 and CAF100) led to significantly faster reaction times than IBU200 and placebo. These effects were generally confirmed with the other performance tasks. Subjective measures showed that the combination of ibuprofen and caffeine was superior to the other conditions. There were no serious adverse events reported, and study medication was well tolerated. The results from the post-drug assessments suggest that a combination of ibuprofen and caffeine was the optimum treatment for malaise associated with URTIs in that it had significant effects on objective performance and subjective measures.

  3. 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.

  4. Relationship of secondhand smoke and infant lower respiratory tract infection severity by familial atopy status.

    Science.gov (United States)

    Lemke, Meghan; Hartert, Tina V; Gebretsadik, Tebeb; Carroll, Kecia N

    2013-06-01

    Individuals with atopy have more severe complications of infectious diseases. We hypothesized that the importance of secondhand smoke (SHS) on lower respiratory tract infection (LRTI) severity would be greater in infants with a familial atopic predisposition. To determine whether infants with a familial atopic predisposition are more susceptible to adverse effects of SHS, resulting in more severe LRTI. We conducted cross-sectional analyses of mother-infant dyads enrolled during 2004 to 2008 during an infant LRTI. Predictor variables were SHS and 2 measures of a familial atopic predisposition (maternal atopic disease with allergen sensitization or familial atopy). LRTI severity was determined by bronchiolitis severity score (BSS) and hospital length of stay (LOS). We conducted multivariable regression analysis to test for a differential relationship between SHS and LRTI severity by measures of familial atopic predisposition. In 451 dyads, 57% of infants had SHS exposure, 36% had a mother with atopic disease, and 68% had familial atopy. We did not detect differences in BSS or LOS by SHS exposure stratified by history of maternal atopic disease. In bivariate analysis, there was a significant difference in LOS by SHS in those with familial atopy (P = .006) but not in those without (P = .66). In multivariable analysis, among infants with familial atopy, there was a 23% increased LOS in infants with SHS exposure (P = .03), whereas no statistical significance was detected in those without familial atopy (P = .07). In infants with familial atopy, SHS was associated with longer hospital LOS for LRTI but not BSS. Because the effect was seen only among hospitalized infants, confirmation is required. Copyright © 2013 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  5. Streptococcus himalayensis sp. nov., isolated from the respiratory tract of Marmota himalayana.

    Science.gov (United States)

    Niu, Lina; Lu, Shan; Lai, Xin-He; Hu, Shoukui; Chen, Cuixia; Zhang, Gui; Yang, Jing; Jin, Dong; Wang, Yi; Lan, Ruiting; Lu, Gang; Xie, Yingping; Ye, Changyun; Xu, Jianguo

    2017-02-01

    Five strains of Gram-positive-staining, catalase-negative, coccus-shaped, chain-forming organisms isolated separately from the respiratory tracts of five Marmota himalayana animals in the Qinghai-Tibet Plateau of China were subjected to phenotypic and molecular taxonomic analyses. Comparative analysis of the 16S rRNA gene indicated that these singular organisms represent a new member of the genus Streptococcus, being phylogenetically closest to Streptococcus marmotae DSM 101995T (98.4 % similarity). The groEL, sodA and rpoB sequence analysis showed interspecies similarity values between HTS2T and Streptococcus. marmotae DSM 101995T, its closest phylogenetic relative based on 16S rRNA gene sequences, of 98.2, 78.8 and 93.7 %, respectively. A whole-genome phylogenetic tree built from 82 core genes of genomes from 16 species of the genus Streptococcus validated that HTS2T forms a distinct subline and exhibits specific phylogenetic affinity with S. marmotae. In silico DNA-DNA hybridization of HTS2T showed an estimated DNA reassociation value of 40.5 % with Streptococcus. marmotae DSM 101995T. On the basis of their phenotypic characteristics and phylogenetic findings, it is proposed that the five isolates be classified as representatives of a novel species of the genus Streptococcus, Streptococcus himalayensis sp. nov. The type strain is HTS2T (=DSM 101997T=CGMCC 1.15533T). The genome of Streptococcus himalayensis sp. nov. strain HTS2T contains 2195 genes with a size of 2 275 471 bp and a mean DNA G+C content of 41.3 mol%.

  6. Auto Poisoning of the Respiratory Chain by a Quorum Sensing Regulated Molecule Favors Biofilm Formation and Antibiotic Tolerance

    Science.gov (United States)

    Hazan, Ronen; Que, Yok Ai; Maura, Damien; Strobel, Benjamin; Majcherczyk, Paul Anthony; Hopper, Laura Rose; Wilbur, David J.; Hreha, Teri N.; Barquera, Blanca; Rahme, Laurence G.

    2015-01-01

    Summary Bacterial programmed cell death and quorum sensing are direct examples of prokaryote group behaviors, wherein cells coordinate their actions to function cooperatively like one organism for the benefit of the whole culture. We demonstrate here that 2-n-heptyl-4-hydroxyquinoline-N-oxide (HQNO), a Pseudomonas aeruginosa quorum sensing -regulated low-molecular-weight excreted molecule, and triggers autolysis by self-perturbing the electron transfer reactions of the cytochrome bc1 complex. HQNO induces specific self-poisoning by disrupting the flow of electrons through the respiratory chain at the cytochrome bc1 complex, causing a leak of reducing equivalents to O2 whereby electrons that would normally be passed to cytochrome c are donated directly to O2. The subsequent mass production of reactive oxygen species (ROS) reduces membrane potential and disrupts membrane integrity, causing bacterial cell autolysis and DNA release. DNA subsequently promotes biofilm formation and increases antibiotic tolerance to beta-lactams, suggesting that HQNO-dependent cell autolysis is advantageous to the bacterial populations. These data both identify a new programmed cell death system, and a novel role for HQNO as a critical-inducer of biofilm formation and antibiotic tolerance. This newly identified pathway suggests intriguing mechanistic similarities with the initial mitochondrial-mediated steps of eukaryotic apoptosis. PMID:26776731

  7. 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.

  8. Development of upper respiratory tract microbiota in infancy is affected by mode of delivery

    NARCIS (Netherlands)

    Bosch, A.A.T.M.; Levin, E.; van Houten, M.A.; Hasrat, R.; Kalkman, G.; Biesbroek, G.; de Steenhuijsen Piters, W.A.A.; de Groot, P.-K.C.M.; Pernet, P.; Keijser, B.J.F.; Sanders, E.A.M.; Bogaert, D.

    2016-01-01

    Birth by Caesarian section is associated with short- and long-term respiratory morbidity. We hypothesized that mode of delivery affects the development of the respiratory microbiota, thereby altering its capacity to provide colonization resistance and consecutive pathobiont overgrowth and

  9. Isolation of mycoplasma species from the lower respiratory tract of healthy cattle and cattle with respiratory disease in Belgium.

    Science.gov (United States)

    Thomas, A; Ball, H; Dizier, I; Trolin, A; Bell, C; Mainil, J; Linden, A

    2002-10-19

    Between 1997 and 2000, a total of 150 healthy cattle and 238 animals with respiratory disease were examined for six Mycoplasma species. Attempts were made to detect Mycoplasma canis, Mycoplasma dispar and Ureaplasma diversum in calves with recurrent disease, and all three of these species were identified in calves with recurrent disease and in healthy lungs. In healthy calves, 84 per cent of bronchoalveolar lavage fluids were mycoplasma free; when cultures were positive, Mycoplasma bovirhinis was the only species isolated. Mycoplasmas were isolated from 78 per cent of animals suffering recurrent respiratory disease and from 65 per cent of acute respiratory cases. Mycoplasma bovis was isolated from bronchoalveolar lavages from 35 per cent of calves suffering recurrent respiratory disease, and from 50 per cent of acute cases, and from 20 per cent of pneumonic cases examined postmortem. M bovis was associated with other Mycoplasma species in 44 per cent of cases. M dispar was also isolated from 45.5 per cent of calves suffering recurrent respiratory disease, often in association with M bovis. M canis was identified for the first time in diseased Belgian cattle. Other mycoplasmas, including Mycoplasma arginini, Mycoplasma alkalescens and U diversum, were isolated less frequently. Associations between mycoplasmas and other pathogens were often observed. Among lungs infected with Pasteurella and/or Mannheimia species, more than 50 per cent were mixed infections with M bovis.

  10. Infected or not: Are PCR-positive oropharyngeal swabs indicative of low pathogenic influenza A virus infection in the respiratory tract of Mallard Anas platyrhynchos?

    NARCIS (Netherlands)

    M. Wille (Michelle); P. van Run (Peter); J. Waldenström (Jonas); T. Kuiken (Thijs)

    2014-01-01

    textabstractDetection of influenza virus in oropharyngeal swabs collected during wild bird surveillance is assumed to represent respiratory infection, although intestine is the main site of infection. We tested this assumption by histological examination of the respiratory tract of wild Mallards

  11. The Clinical and Economic Impact of Probiotics Consumption on Respiratory Tract Infections: Projections for Canada

    Science.gov (United States)

    Gerlier, Laetitia; Roy, Denis; Reid, Gregor

    2016-01-01

    Introduction There is accumulating evidence supporting the use of probiotics, which are defined as “live micro-organisms which, when administered in adequate amounts, confer a health benefit on the host”, as a preventive measure against respiratory tract infections (RTI). Two recent meta-analyses showed probiotic consumption (daily intake of 107 to 1010 CFU in any form for up to 3 months) significantly reduced RTI duration, frequency, antibiotic use and work absenteeism. Objectives The aim of this study was to assess the impact of probiotic use in terms of number of RTI episodes and days averted, and the number of antibiotic prescriptions and missed workdays averted, in the general population of Canada. In addition, the corresponding economic impact from both a healthcare payer and a productivity perspective was estimated. Methods A microsimulation model was developed to reproduce the Canadian population (sample rate of 1/1000 = 35 540 individuals) employing age and gender. RTI incidence was taken from FluWatch consultation rates for influenza-like illness (2013–14) and StatCan all-cause consultations statistics. The model was calibrated on a 2.1% RTI annual incidence in the general population (5.2 million RTI days) and included known risk factors (smoking status, shared living conditions and vaccination status). RTI-related antibiotic prescriptions and work absenteeism were obtained from the literature. Results The results indicate that probiotic use saved 573 000–2.3 million RTI-days, according to the YHEC–Cochrane scenarios respectively. These reductions were associated with an avoidance of 52 000–84 000 antibiotic courses and 330 000–500 000 sick-leave days. A projection of corresponding costs reductions amounted to Can$1.3–8.9 million from the healthcare payer perspective and Can$61.2–99.7 million when adding productivity losses. Conclusion The analysis shows that the potential of probiotics to reduce RTI-related events may have a substantial

  12. The cost of lower respiratory tract infections hospital admissions in the Canadian Arctic

    Directory of Open Access Journals (Sweden)

    Anna Banerji

    2013-08-01

    Full Text Available Background . Inuit infants who reside in the Nunavut (NU regions of Arctic Canada have extremely high rates of lower respiratory tract infections (LRTIs associated with significant health expenditures, but the costs in other regions of Arctic Canada have not been documented. Objective . This prospective surveillance compares, across most of Arctic Canada, the rates and costs associated with LRTI admissions in infants less than 1 year of age, and the days of hospitalization and costs adjusted per live birth. Design . This was a hospital-based surveillance of LRTI admissions of infants less than 1 year of age, residing in Northwest Territories (NT, the 3 regions of Nunavut (NU; [Kitikmeot (KT, Kivalliq (KQ and Qikiqtani (QI] and Nunavik (NK from 1 January 2009 to 30 June 2010. Costs were obtained from the territorial or regional governments and hospitals, and included transportation, hospital stay, physician fees and accommodation costs. The rates of LRTI hospitalizations, days of hospitalization and associated costs were calculated per live birth in each of the 5 regions. Results . There were 513 LRTI admissions during the study period. For NT, KT, KQ, QI and NK, the rates of LRTI hospitalization per 100 live births were 38, 389, 230, 202 and 445, respectively. The total days of LRTI admission per live birth were 0.25, 3.3, 2.6, 1.7 and 3 for the above regions. The average cost per live birth for LRTI admission for these regions was $1,412, $22,375, $14,608, $8,254 and $10,333. The total cost for LRTI was $1,498,232 in NT, $15,662,968 in NU and $3,874,881 in NK. Medical transportation contributed to a significant proportion of the costs. Conclusion . LRTI admission rates in NU and Nunavik are much higher than that in NT and remain among the highest rates globally. The costs of these admissions are exceptionally high due to the combination of very high rates of admission, very expensive medical evacuations and prolonged hospitalizations

  13. Consumer knowledge and perceptions about antibiotics and upper respiratory tract infections in a community pharmacy.

    Science.gov (United States)

    Fredericks, Ian; Hollingworth, Samantha; Pudmenzky, Alex; Rossato, Laurence; Syed, Shahzad; Kairuz, Therése

    2015-12-01

    Overuse of antibiotics is a global concern and the World Health Organisation (WHO) has warned of relapsing to an era with no effective antibiotics. In Australia, various national consumer campaigns had been running since 2000, and the concern was prioritised in 2011, when the need for a national approach to address antibiotic resistance was identified. The aim of this study was to explore consumer attitudes and knowledge about (upper respiratory tract) infections, colds and flu, and antibiotics, and to identify factors contributing to antibiotic misuse which could be addressed by tailored patient counselling. A community pharmacy in an area of Brisbane, Australia. A self-administered anonymous questionnaire was distributed among pharmacy consumers. Perceptions of, and knowledge about antibiotics were measured using a 5-point Likert-type scale of agreement/disagreement. The proportion of self-diagnosers and non self-diagnosers who agreed/disagreed with the attitude statement, "I know that I need antibiotics before I visit my doctor"; and the proportion of mistaken and non-mistaken who agreed/disagreed with the statement, "I will get better faster if I take antibiotics when I have a cold or flu". Over a third of the 252 participants believed that they would recover faster by taking antibiotics when suffering from a cold or flu, and nearly one-fifth felt that antibiotics would cure viral infections. More females (62.2 vs. 43.9 %) self-diagnosed (p = 0.002) although more males (42.1 vs. 30.8 %) were mistaken about the efficacy of antibiotics for treating colds and flus. Mistaken respondents were more likely than non-mistaken respondents to self-diagnose (p = 0.01). This study confirms a lack of knowledge among consumers about the efficacy of antibiotics in treating viral infections despite education campaigns. The findings strongly suggest there is a need for pharmacists and other health care professionals to elicit consumer beliefs and understanding about antibiotics

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

    Science.gov (United States)

    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 198Au are produced with a spinning top generator in the aerodynamic size range between 1 to 10 micrometers. 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(TI)-detectors. The geometrical arrangement, the collimation and the shielding of the four detectors have been optimized by computer calculations in such a way that the response of the counter is independent of the distribution of activity within the chest. Another 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 (intrathoracic airways) is found to be much slower for the material deposited in the alveolar region (non-ciliated air spaces) than for the amount deposited in the tracheobronchial tree (ciliated airways). This allows the intrathoracic deposition to be divided into tracheobronchial and alveolar deposition by means of the different slopes of the normalized chest retention function. Different normalized chest retention

  15. Pharmacokinetics of telithromycin: application to dosing in the treatment of community-acquired respiratory tract infections.

    Science.gov (United States)

    Ciervo, Carman A; Shi, Jun

    2005-10-01

    telithromycin and oral anticoagulants simultaneously. Overall, the pharmacokinetic/pharmaco dynamic properties of telithromycin indicate that this ketolide antibacterial is a valuable and convenient treatment option for community-acquired respiratory tract infections.

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

    Directory of Open Access Journals (Sweden)

    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

  17. Reduction of antibiotic prescriptions for acute respiratory tract infections in primary care: a systematic review.

    Science.gov (United States)

    Köchling, Anna; Löffler, Christin; Reinsch, Stefan; Hornung, Anne; Böhmer, Femke; Altiner, Attila; Chenot, Jean-François

    2018-03-20

    Although most respiratory tract infections (RTIs) are due to viral infections, they cause the majority of antibiotic (Abx) prescriptions in primary care. This systematic review summarises the evidence on the effectiveness of interventions in primary care aiming to reduce Abx prescriptions in patients ≥ 13 years for acute RTI. We searched the databases "MEDLINE/PubMed" and "Cochrane Library" for the period from January 1, 2005, to August 31, 2016, for randomised controlled trials (RCTs) in primary care aiming at the reduction of Abx prescriptions for patients suffering from RTI. Out of 690 search results, 67 publications were retrieved and 17 RCTs were included. We assumed an absolute change of 10% as minimal important change. Twelve out of 17 included RCTs showed statistically significant lower Abx prescription rates in the intervention groups, but only six of them reported a clinically relevant reduction according to our definition. Communication skills training (CST) and point-of-care testing (POCT) were the most effective interventions. Pre-intervention Abx prescription rates varied between 13.5% and 80% and observed reductions ranged from 1.5 to 23.3%. Studies with post-intervention rates lower than 20% had no significant effects. Post-intervention observation periods ranged from 2 weeks up to 3.5 years. The design of the trials was heterogeneous precluding calculation of pooled effect size. The reporting of many RCTs was poor. CST and POCT alone or as adjunct can reduce antibiotic prescriptions for RTI. Eleven out of 17 trials were not successfully reducing Abx prescription rates according to our definition of minimal important change. However, five of them reported a statistically significant reduction. Trials with initially lower prescription rates were less likely to be successful. Future trials should investigate sustainability of intervention effects for a longer time period. The generalisability of findings was limited due to heterogeneous designs

  18. Fungi-Induced Upper and Lower Respiratory Tract Allergic Diseases: One Entity

    Directory of Open Access Journals (Sweden)

    Aleksandra Barac

    2018-04-01

    Full Text Available Introduction:Aspergillus can cause different allergic diseases including allergic bronchopulmonary aspergillosis (ABPA and allergic fungal rhinosinusitis (AFRS. ABPA is allergic pulmonary disease against Aspergillus antigens. AFRS is a type of chronic rhinosinusitis (CRS presented as hypersensitivity reactions to the fungal presence in sinuses. The aim of the present study was to clarify if ABPA and AFRS could be considered as a common disease entity.Methodology: The prospective cohort study included 75 patients with ABPA. Patients were divided into two groups and compared with each other: (i patients with CT confirmation of rhinosinusitis and presence of fungi in sinuses (ABPA+AFRS group and (ii patients without CT or without mycological evidence of AFRS (ABPA group.Results: Findings of this study were: (i AFRS was confirmed in 80% of patients with ABPA; (ii all ABPA+AFRS patients had allergic mucin while fungal hyphae were present in 60% sinonasal aspirate; (iii ABPA+AFRS patients had more often complicated CRS with (nasal polyps NP (p < 0.001 and more severe forms of CRS; (iv culture of sinonasal aspirate revealed fungal presence in 97% patients with ABPA+AFRS; (v patients with ABPA+AFRS had more common positive skin prick test (SPT for A. fumigatus (p = 0.037, while patients without AFRS had more common positive SPT for Alternaria alternata and Penicillium notatum (p = 0.04 and p = 0.03, respectively; (vi 67% of ABPA patients had Aspergillus induced AFRS; (vii larger number of fungi was isolated from the air-samples obtained from homes of patients with ABPA+AFRS than from the homes of patients without AFRS, while the most predominant species were A. fumigatus and A. niger isolated from almost 50% of the air-samples.Conclusion: The pathogenesis of ABPA and AFRS is similar, and AFRS can be considered as the upper airway counterpart of ABPA. Fungi-induced upper and lower respiratory tract allergic diseases present common entity. Next studies

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

    Directory of Open Access Journals (Sweden)

    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

  20. The Clinical and Economic Impact of Probiotics Consumption on Respiratory Tract Infections: Projections for Canada.

    Directory of Open Access Journals (Sweden)

    Irene Lenoir-Wijnkoop

    Full Text Available There is accumulating evidence supporting the use of probiotics, which are defined as "live micro-organisms which, when administered in adequate amounts, confer a health benefit on the host", as a preventive measure against respiratory tract infections (RTI. Two recent meta-analyses showed probiotic consumption (daily intake of 107 to 1010 CFU in any form for up to 3 months significantly reduced RTI duration, frequency, antibiotic use and work absenteeism.The aim of this study was to assess the impact of probiotic use in terms of number of RTI episodes and days averted, and the number of antibiotic prescriptions and missed workdays averted, in the general population of Canada. In addition, the corresponding economic impact from both a healthcare payer and a productivity perspective was estimated.A microsimulation model was developed to reproduce the Canadian population (sample rate of 1/1000 = 35 540 individuals employing age and gender. RTI incidence was taken from FluWatch consultation rates for influenza-like illness (2013-14 and StatCan all-cause consultations statistics. The model was calibrated on a 2.1% RTI annual incidence in the general population (5.2 million RTI days and included known risk factors (smoking status, shared living conditions and vaccination status. RTI-related antibiotic prescriptions and work absenteeism were obtained from the literature.The results indicate that probiotic use saved 573 000-2.3 million RTI-days, according to the YHEC-Cochrane scenarios respectively. These reductions were associated with an avoidance of 52 000-84 000 antibiotic courses and 330 000-500 000 sick-leave days. A projection of corresponding costs reductions amounted to Can$1.3-8.9 million from the healthcare payer perspective and Can$61.2-99.7 million when adding productivity losses.The analysis shows that the potential of probiotics to reduce RTI-related events may have a substantial clinical and economic impact in Canada.

  1. The sensitivity and the specifity of rapid antigen test in streptococcal upper respiratory tract infections.

    Science.gov (United States)

    Gurol, Yesim; Akan, Hulya; Izbirak, Guldal; Tekkanat, Zuhal Tazegun; Gunduz, Tehlile Silem; Hayran, Osman; Yilmaz, Gulden

    2010-06-01

    It is aimed to detect the sensitivity and specificity of rapid antigen detection of group A beta hemolytic streptococci from throat specimen compared with throat culture. The other goal of the study is to help in giving clinical decisions in upper respiratory tract infections according to the age group, by detection of sensitivity and positive predictive values of the rapid tests and throat cultures. Rapid antigen detection and throat culture results for group A beta hemolytic streptococci from outpatients attending to our university hospital between the first of November 2005 and 31st of December 2008 were evaluated retrospectively. Throat samples were obtained by swabs from the throat and transported in the Stuart medium and Quickvue Strep A [Quidel, San Diego, USA] cassette test was applied and for culture, specimen was inoculated on 5% blood sheep agar and identified according to bacitracin and trimethoprim-sulphametaxazole susceptibility from beta hemolytic colonies. During the dates between the first of November 2005 and 31st of December 2008, from 453 patients both rapid antigen detection and throat culture were evaluated. Rapid antigen detection sensitivity and specificity were found to be 64.6% and 96.79%, respectively. The positive predictive value was 80.95% whereas negative predictive value was 92.82%. Kappa index was 0.91. When the results were evaluated according to the age groups, the sensitivity and the positive predictive value of rapid antigen detection in children were 70%, 90.3% and in adults 59.4%, 70.4%. When bacterial infection is concerned to prevent unnecessary antibiotic use, rapid streptococcal antigen test (RSAT) is a reliable method to begin immediate treatment. To get the maximum sensitivity of RSAT, the specimen collection technique used and education of the health care workers is important. While giving clinical decision, it must be taken into consideration that the sensitivity and the positive predictive value of the RSAT is quite

  2. Assessing bacterial populations in the lung by replicate analysis of samples from the upper and lower respiratory tracts.

    Directory of Open Access Journals (Sweden)

    Emily S Charlson

    Full Text Available Microbes of the human respiratory tract are important in health and disease, but accurate sampling of the lung presents challenges. Lung microbes are commonly sampled by bronchoscopy, but to acquire samples the bronchoscope must pass through the upper respiratory tract, which is rich in microbes. Here we present methods to identify authentic lung microbiota in bronchoalveolar lavage (BAL fluid that contains substantial oropharyngeal admixture. We studied clinical BAL samples from six selected subjects with potential heavy lung colonization. A single sample of BAL fluid was obtained from each subject along with contemporaneous oral wash (OW to sample the oropharynx, and then DNA was extracted from three separate aliquots of each. Bacterial 16S rDNA sequences were amplified and products analyzed by 454 pyrosequencing. By comparing replicates, we were able to specify the depth of sequencing needed to reach a 95% chance of identifying a bacterial lineage of a given proportion--for example, at a depth of 5,000 tags, OTUs of proportion 0.3% or greater would be called with 95% confidence. We next constructed a single-sided outlier test that allowed lung-enriched organisms to be quantified against a background of oropharyngeal admixture, and assessed improvements available with replicate sequence analysis. This allowed identification of lineages enriched in lung in some BAL specimens. Finally, using samples from healthy volunteers collected at multiple sites in the upper respiratory tract, we show that OW provides a reasonable but not perfect surrogate for bacteria carried into to the lung by a bronchoscope. These methods allow identification of microbes that can replicate in the lung despite the background due to oropharyngeal microbes derived from aspiration and bronchoscopic carry-over.

  3. Immunocytochemical survey of the neuroepithelial endocrine system in the respiratory tract of the Tokyo salamander, Hynobius nebulosus tokyoensis TAgo.

    Science.gov (United States)

    Gomi, T; Kikuchi, Y; Adriaensen, D; Timmermans, J P; De Groodt-Lasseel, M H; Kimura, A; Naruse, H; Ishikawa, Y; Kishi, K; Scheuermann, D W

    1994-12-01

    The epithelial lining of the respiratory tract of urodeles has been shown to harbor an innervated system of neuroepithelial endocrine (NEE) cells. Even between phylogenetically closely related species, large differences have been reported in the appearance and chemical coding of the NEE system. Although urodeles are well suited for the purpose, none of the prior studies have provided an immunocytochemical survey of the NEE system in all parts of the respiratory tract. In the present study, many bioactive substances and a general marker were immunocytochemically demonstrated in serial sections of the entire respiratory tract of the Tokyo salamander, Hynobius nebulosus tokyoensis, a species in which neuroepithelial bodies (NEBs) were previously characterized at the electron microscopic level. In the current study, serotonin-immunoreactive solitary NEE cells were observed in variable numbers in the larynx, in all parts of the trachea, and in areas of the lungs covered with ciliomucous epithelium. Serotonin-containing NEBs, however, were detected in small cranial areas of the lung only. Solitary NEE cells were seen in the trachea and lungs of H. nebulosus tokyoensis by immunocytochemical staining for somatostatin, calcitonin, calcitonin gene-related peptide, and bombesin, but the number, localization, and appearance of the labeled NEE cells differed considerably. Only calcitonin-like immunoreactivity was also noted in some NEB-like cell clusters in the cranial parts of the lungs. Unlike many other vertebrates, neuron specific enolase was found to be a poor marker for the NEE system in the salamander species used in this investigation. It may be concluded that the NEE system of H. nebulosus tokyoensis contains at least five different bioactive substances.(ABSTRACT TRUNCATED AT 250 WORDS)

  4. Augmentation of glutathione in the fluid lining the epithelium of the lower respiratory tract by directly administering glutathione aerosol.

    Science.gov (United States)

    Buhl, R; Vogelmeier, C; Critenden, M; Hubbard, R C; Hoyt, R F; Wilson, E M; Cantin, A M; Crystal, R G

    1990-06-01

    Glutathione (GSH), a cysteine-containing tripeptide, functions as an antioxidant, provides cells with cysteine, and is required for optimal function of the immune system. Because the epithelial-lining fluid (ELF) of the lower respiratory tract normally contains high GSH levels and lung ELF GSH deficiency states can exist, we evaluated the feasibility of augmenting lung ELF GSH levels by (i) administering GSH to sheep i.v. and by direct aerosolization and then (ii) measuring the GSH levels in lung ELF, lung lymph, venous plasma, and urine. When GSH (600 mg) was administered i.v. (n = 11), GSH levels in venous plasma, lung lymph, and ELF rose, but only transiently, suggesting the i.v. route would not deliver adequate GSH to the alveolar epithelial surface. For directly administering GSH to the lung by the aerosol route, in vitro studies were first conducted to show that greater than 50% of a GSH solution could be converted to droplets less than 3 microns in aerodynamic diameter without oxidizing the GSH. To target functional GSH to the lower respiratory tract, an aerosolized solution of GSH (600 mg) was administered to sheep (n = 12). Significantly, the GSH level in ELF increased 7-fold at 30 min (preaerosol, 45.7 +/- 10 microM; 30-min postaerosol, 337 +/- 64 microM; P less than 0.001). The ELF GSH levels remained above baseline at 1 hr (P less than 0.01), returning toward baseline over a 2-hr period. In contrast, GSH levels in lung lymph, venous plasma, and urine were not significantly increased during the period--i.e., aerosol therapy selectively augmented the GSH levels only at the lung epithelial surface. Thus, functional GSH can be delivered by aerosol to directly augment the ELF GSH levels of the lower respiratory tract. Such an approach may prove useful in treating a variety of lung disorders.

  5. Analysis of risk factors for acute respiratory tract infections (ARI) of Toddlers in Ingin Jaya community health centre of Aceh Besar district

    Science.gov (United States)

    Safitri, Faradilla; Hayati, Risna; Marniati

    2017-09-01

    Acute Respiratory Infections (ARI) is a disease in developing countries 25% that caused the death of children under five. In Aceh province disease is always on the list of 10 biggest disease each year which amounted to 47.258 cases. In Ingin Jaya Community Health Centre cases of acute respiratory tract infections in infants in 2014 were 112 cases, while in 2015 an increase of as many as 123 cases. Objective: To analyze the risk factors of acute respiratory diseases in health centers of Toddlers Ingin Jaya, Aceh Besar district. Analytical research the design of case control, case-control comparison of 1: 1 ie the sample of 60 cases and 60 control, retrieval of data taken from the register space IMCI Health Center. The study was conducted in 2016. Results: Factor toddler age (OR=11.811), gender (OR=3.512), birth weight (OR=8.805), immunization status (OR=4.846), exclusive breastfeeding (OR=2.529). Conclusions and Recommendations: Toddlers aged>2 years has the opportunity 11.811 times of acute respiratory tract infections. Male Toddler has a chance 3.512 times of acute respiratory tract infections. Toddlers are born with a normal weight does not have a chance of 8.805 times of acute respiratory tract infections. Toddlers who do not get complete immunization has the opportunity 4.846 times of acute respiratory tract infections. Toddlers who did not receive exclusive breastfeeding has 2,529 times greater chance of respiratory tract infections. Health workers and the Aceh Provincial Health Office can provide information through health education each month for each work area of health centers, or create a billboard on the causes of the ispa in infants.

  6. 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...

  7. The Mechanism of Action of the Activated Nitrogen-Containing Metabolites in the Respiratory Tract. Proinflammatory Effect (Part 2

    Directory of Open Access Journals (Sweden)

    O.Ye. Abaturov

    2016-02-01

    Full Text Available The review of literature presents modern data about antibacterial and antiviral effect of nitrogen monoxide. Bactericidal action of nitric monoxide in the phagosome, involvement of nitrogen monoxide in the development of influenza infection are considered in detail. The value of activity of inducible isoform of nitrogen oxide synthetase in infectious di­seases caused by various pathogens is presented. The participation of alveolar macrophages in the formation of peroxynitrite, the effect of nitric monoxide on the drainage function of the respiratory tract, bronchodilatory and bronchoprotective action of nitrogen monoxide are shown.

  8. SIgA response and incidence of upper respiratory tract infections during intensified training in youth basketball players.

    Science.gov (United States)

    Moraes, H; Aoki, M S; Freitas, C G; Arruda, Afs; Drago, G; Moreira, A

    2017-03-01

    The aim of the present study was to examine the effect of an intensified training phase followed by a tapering phase on the salivary immunoglobulin A concentration and on the upper respiratory tract infection (URTI) symptoms in young male basketball players. The session rating of perceived exertion method was used to quantify the internal training load, and the Wisconsin Upper Respiratory Symptom Survey-21 questionnaire was used to assess URTI symptoms. The Yo-Yo IR1 test and saliva collection were carried out at the beginning of the study (T1), after the intensified phase (T2), and after tapering (T3). A higher internal training load was observed for the intensified phase compared with the tapering phase (t=19.10; ptraining load followed by a tapering period negatively affects the mucosal immune function with no significant change in severity of URTI in young basketball players.

  9. Plasma cytokines eotaxin, MIP-1α, MCP-4, and vascular endothelial growth factor in acute lower respiratory tract infection

    DEFF Research Database (Denmark)

    Relster, Mette Marie; Holm, Anette; Pedersen, Court

    2017-01-01

    ), monocyte chemoattractant protein 4 (MCP-4), and vascular endothelial growth factor (VEGF) in 40 patients hospitalized with acute lower respiratory tract infections (LRTI). The cytokines contribute to the pathogenesis of several inflammatory respiratory diseases, indicating a potential as markers for LRTI....... Patients were stratified according to etiology and severity of LRTI, based on baseline C-reactive protein and CURB-65 scores. Using a multiplex immunoassay of plasma, levels of eotaxin and MCP-4 were shown to increase from baseline until day 6 after admission to hospital. The four cytokines were unable...... the full potential of eotaxin, MCP-4, MIP-1α, and VEGF as biomarkers for LRTI because of their low predictive power and a high interindividual variation of cytokine levels....

  10. 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......, 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......-of-care test for procalcitonin with acceptable precision, severely hampering its application in primary care. This article reviews the physiology of procalcitonin, describes the assays available for its measurement, evaluates the present evidence from primary care on its use to identify correctly patients who...

  11. Risk Factors for Acute Respiratory Tract Infections in Under-five ...

    African Journals Online (AJOL)

    hanumantp

    Subjects and Methods: A cross‑sectional study of 436 under‑five ... diagnosed of any form of acute respiratory infections were consecutively enrolled for the study. Children who were above 5 years, but had ARIs were excluded. Children who ... respiratory distress, and pulse oximetry reading of less than. 90% that required ...

  12. Population structure and characterization of viridans group streptococci (VGS) isolated from the upper respiratory tract of patients in the community.

    Science.gov (United States)

    Nakajima, Takuya; Nakanishi, Shigeyuki; Mason, Charlene; Montgomery, Janice; Leggett, Paul; Matsuda, Motoo; Coulter, Wilson A; Millar, B Cherie; Goldsmith, Colin E; Moore, John E

    2013-09-01

    A study was undertaken to examine the population structure of viridans group streptococci (VGS) isolated the upper respiratory tract of adult and paediatric patients within the community. VGS are common commensal bacterial inhabitants of the upper respiratory tract and valuable sentinel reporters of underlying antibiotic resistance (AR). Laboratory examination of the colonising VGS species may provide a valuable ecological description of the species isolated from the upper respiratory tract and their antibiotic susceptibility, including an estimation of the AR reservoir in this population. Freshly obtained nasal and oropharyngeal swabs from 84 patients were examined by selective conventional culture on Mitis-Salivarius agar and yielded 363 isolates of VGS. Sequence analyses of the rpnB and 16-23S rRNA ITS genes identified these isolates to belong to 10 species of VGS and included S. anginosus, S. australis, S. constellatus, S. infantis, S. mitis, S. oralis, S. parasanguinis, S. salivarius, S. sanguinis and S. vestibularis. The most frequent VGS organisms isolated was S. salivarius (282/363; 78.0%), followed by S. sanguinis (23/363; 6.3%), S. parasanguinis (21/363; 5.8%), S. mitis (18/363; 5.0%), S. anginosus (5/363; 1.4%), S. vestibularis (5/363; 1.4%), S. australis (3/363; 0.8%), S. oralis (3/363; 0.8%), S. infantis (1/363; 0.3%) and S. constellatus (1/363; 0.3%). All patients examined carried at least one VGS organism, where there were 17 combination patterns of carriage of the 10 species of VGS species isolated, where 54.2%, 37.3%, 7.2% and 1.2% of patients harboured one, two, three and four different VGS species, respectively. Antibiotic susceptibility was determined by standard disk diffusion assay testing against four classes of antibiotics, including the b-lactams [cefotaxime, cefuroxime], the tetracyclines [doxycycline], the fluoroquinolones [levofloxacin] and the macrolides [erythromycin]. Overall, there was no resistance to levofloxacin and cefuroxime

  13. Frequency and time to onset of community-acquired respiratory tract infections in patients receiving esomeprazole: a retrospective analysis of patient-level data in placebo-controlled studies.

    Science.gov (United States)

    Estborn, L; Joelson, S

    2015-09-01

    Debate continues on whether a causal association exists between the use of proton pump inhibitors (PPIs) and the risk of respiratory tract infections, in particular pneumonia. To investigate the occurrence of community-acquired respiratory tract infections, including pneumonia, in patients receiving esomeprazole. A retrospective investigation of pooled data on adverse events related to respiratory tract infections, originally reported in 24 randomised, double-blind clinical studies, was conducted. The frequencies of respiratory tract infections and their relative risks were calculated retrospectively for the total patient population (9602 patients receiving esomeprazole and 5500 receiving placebo) and for sub-populations defined according to sex, age, esomeprazole dose, indication and geographical region. The cumulative frequency of first occurrence of events was calculated over 180 days. Frequencies of respiratory tract infections were similar in patients receiving esomeprazole and in those receiving placebo (any respiratory tract infection or signs/symptoms potentially indicating an respiratory tract infection, 0.278 and 0.296 patients per patient-year; lower respiratory tract infections, 0.048 and 0.058 per patient-year; pneumonia, 0.006 and 0.009 per patient-year, respectively). The relative risk for any respiratory tract infection in patients receiving esomeprazole compared with placebo was 0.94 (95% CI, 0.86-1.04). For lower respiratory tract infections, the relative risk was 0.82 (95% CI, 0.65-1.03) and for pneumonia, 0.66 (95% CI, 0.36-1.22). Sub-analyses by demographics, dose and indication yielded similar results to the overall analysis. The occurrence of respiratory tract infections was evenly distributed over time and similar in the esomeprazole and placebo groups. There is no causal association between treatment with esomeprazole and the occurrence of community-acquired respiratory tract infections, including pneumonia. © 2015 John Wiley & Sons Ltd.

  14. Heat and moisture exchange capacity of the upper respiratory tract and the effect of tracheotomy breathing on endotracheal climate.

    Science.gov (United States)

    Scheenstra, Renske J; Muller, Sara H; Vincent, Andrew; Hilgers, Frans J M

    2011-01-01

    The aim of this study was to assess the heat and moisture exchange (HME) capacity of the upper respiratory tract and the effect of tracheotomy breathing on endotracheal climate in patients with head and neck cancer. We plotted the subglottic temperature and humidity measurements in 10 patients with head and neck cancer with a temporary precautionary tracheotomy during successive 10-minute periods of nose, mouth, and tracheotomy breathing in a randomized sequence. End-inspiratory temperatures of nose, mouth, and tracheotomy breathing were 31.1, 31.3, and 28.3°C, respectively. End-inspiratory humidity measurements of nose, mouth, and tracheotomy breathing were 29.3, 28.6, and 21.1 mgH₂O/L, respectively. There was a trend toward lower end-inspiratory humidity in patients with radiotherapy or with large surgery-induced oropharyngeal mucosal defects, whereas temperatures were similar. This study gives objective information about the HME capacity of the upper respiratory tract in patients with head and neck cancer with precautionary tracheotomy, and thus provides target values for HMEs for laryngectomized and tracheotomized patients. © 2010 Wiley Periodicals, Inc. Head Neck, 2011.

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

    Directory of Open Access Journals (Sweden)

    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.

  16. Relative magnitudes of the effects of electrostatic image and thermo-phoretic forces on particles in the respiratory tract

    International Nuclear Information System (INIS)

    Jeffers, D. E.

    2005-01-01

    The National Radiological Protection Board's Advisory Group on Non-ionising Radiation has recommended research into the deposition, in the lung, of charged particles in the size range 0.005-1 μm. In vivo measurements of the temperature distribution in the respiratory tract have been used to estimate the temperature gradients in the generations up to the segmental bronchus. These gradients define the thermo-phoretic velocities, which oppose deposition during inhalation and assist it during exhalation. The thermo-phoretic forces are effective over a longer range than those due to the electrostatic image of a single charge; and, at distances greater than a few microns from the airway wall, the thermo-phoretic velocities of 0.02 and 0.1 μn particles are greater than those due to electrostatic drift. It is concluded that models describing the effects of electric charge on the deposition of particles with diameters of order 0.1 μm need to take account of the thermal conditions in the respiratory tract. (authors)

  17. In vitro activity of josamycin against Streptococcus pyogenes isolated from patients with upper respiratory tract infections in France.

    Science.gov (United States)

    Auzou, M; Caillon, J; Poyart, C; Weber, P; Ploy, M-C; Leclercq, R; Cattoir, V

    2015-07-01

    The primary objective of our study was to obtain susceptibility data for josamycin against Streptococcus pyogenes isolated from patients presenting with upper respiratory tract infections in France. The secondary objective was to characterize the molecular mechanism of resistance in macrolide-resistant isolates. MICs of erythromycin, clarithromycin, azithromycin, josamycin, and clindamycin were determined by the broth microdilution method. Resistance genes erm(B), erm(TR), and mef(A) were screened by PCR. The MIC50 and MIC90 of josamycin against 193 isolates of S. pyogenes were 0.12 and 0.25mg/L, respectively, with a resistance rate estimated at 4.7%. Resistance was due to the erm(B) gene whereas strains harboring erm(TR) or mef(A) remained susceptible. Josamycin was active against >95% of S. pyogenes isolated from patients with upper respiratory tract infections, and can be used as an alternative for the treatment of pharyngitis. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Matt S Conover

    2011-02-01

    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.

  19. Diagnostic Imaging of the Lower Respiratory Tract in Neonatal Foals: Radiography and Computed Tomography.

    Science.gov (United States)

    Lascola, Kara M; Joslyn, Stephen

    2015-12-01

    Diagnostic imaging plays an essential role in the diagnosis and monitoring of lower respiratory disease in neonatal foals. Radiography is most widely available to equine practitioners and is the primary modality that has been used for the characterization of respiratory disease in foals. Computed tomography imaging, although still limited in availability to the general practitioner, offers advantages over radiography and has been used diagnostically in neonatal foals with respiratory disease. Recognition of appropriate imaging protocols and patient-associated artifacts is critical for accurate image interpretation regardless of the modality used. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Diagnostic Value of Nasopharyngeal Aspirates in Children with Lower Respiratory Tract Infections

    Directory of Open Access Journals (Sweden)

    Ai-Zhen Lu

    2017-01-01

    Conclusions: NPAs are less invasive diagnostic respiratory specimens, a negative NPA result is helpful in “rule out” lower airway infection; however, a positive result does not reliably “rule in” the presence of pathogens.

  1. Respiratory-Gated Proton Beam Therapy for Hepatocellular Carcinoma Adjacent to the Gastrointestinal Tract without Fiducial Markers

    Directory of Open Access Journals (Sweden)

    Miu Mizuhata

    2018-02-01

    Full Text Available The efficacy of proton beam therapy (PBT for hepatocellular carcinoma (HCC has been reported, but insertion of fiducial markers in the liver is usually required. We evaluated the efficacy and toxicity of respiratory-gated PBT without fiducial markers for HCC located within 2 cm of the gastrointestinal tract. From March 2011 to December 2015 at our institution, 40 patients were evaluated (median age, 72 years; range, 38–87 years. All patients underwent PBT at a dose of 60 to 80 cobalt gray equivalents (CGE in 20 to 38 fractions. The median follow-up period was 19.9 months (range, 1.2–72.3 months. The median tumor size was 36.5 mm (range, 11–124 mm. Kaplan–Meier estimates of the 2-year overall survival, progression-free survival, and local tumor control rates were 76%, 60%, and 94%, respectively. One patient (2.5% developed a grade 3 gastric ulcer and one (2.5% developed grade 3 ascites retention; none of the remaining patients developed grade >3 toxicities (National Cancer Institute Common Terminology Criteria for Adverse Events ver. 4.0.. This study indicates that PBT without fiducial markers achieves good local control without severe treatment-related toxicity of the gastrointestinal tract for HCC located within 2 cm of the gastrointestinal tract.

  2. Respiratory Tract Problems among Wood Furniture Manufacturing Factory Workers in the Northeast of Thailand.

    Science.gov (United States)

    Soongkhang, I; Laohasiriwong, W

    2015-01-01

    Wood furniture manufacturing factory workers are at high risk of exposure to wood dust in wood working processes. Wood dust exposure could cause respiratory symptoms, such as reduce lung function, chronic bronchitis, and asthma. The Northeast region of Thailand has many wood furniture manufacturing factories. However, limited studies were carried out to explore the effect of wood dust exposure on workers. This study aimed to assess the respiratory symptoms and determine factors associated with these symptoms among wood furniture manufacturing factory workers. This cross-sectional analytical research used a multistage random sampling to select 511 workers from three provinces in the Northeast of Thailand. The data was collected using a structured questionnaire interview. The content validity of questionnaire was tested by 3 experts and had a Cronbach's alpha coefficient of 0.82. Data were analyzed using descriptive statistics and multiple logistic regressions. The result indicated that 29.94% of these workers had respiratory symptoms, including coughing(18.79%), nasal secretion (15.66%), and stuffy nose (15.07%). Factors that were significantly associated with respiratory symptoms (p-value furniture manufacturing factory workers had respiratory symptoms with related to both personal preventive behaviors and their working environments. Therefore, the raising awareness for using personal protective equipment during work will help them to prevent from various respiratory track problems.

  3. Geographic Variability in Diagnosis and Antibiotic Prescribing for Acute Respiratory Tract Infections.

    Science.gov (United States)

    Hersh, Adam L; Shapiro, Daniel J; Pavia, Andrew T; Fleming-Dutra, Katherine E; Hicks, Lauri A

    2018-03-01

    Antibiotic prescribing rates vary substantially across regions in the USA. Whether these differences are driven primarily by a greater tendency to treat certain infections (i.e., overtreatment) in certain regions or differences in the tendency to diagnose certain infections (i.e., overdiagnosis) is poorly understood. We examined data from 2012 to 2013 using the National Ambulatory Medical Care Survey, which is a nationally representative sample of visits to office-based physicians. For each of nine geographic regions, we examined the relationship between the visit rate/1000 population for respiratory diagnoses for which antibiotics were prescribed to the visit rate/1000 population for selected respiratory diagnoses where antibiotic therapy may be warranted. The visit rate for all respiratory conditions resulting in an antibiotic prescription was lowest (109/1000 population) in the Pacific Region and highest (176/1000, 95% CI 138-213) in the East South Central Region. The diagnosis rate for selected respiratory conditions where antibiotic therapy may be warranted was also lowest (119/1000, 95% CI 91-147) in the Pacific Region and highest (189/1000, 95% CI 153-225) in the East South Central Region. Antibiotic prescribing rates for respiratory conditions vary by region and are strongly associated with the rate with which selected respiratory conditions are diagnosed.

  4. Development of Upper Respiratory Tract Microbiota in Infancy is Affected by Mode of Delivery

    Directory of Open Access Journals (Sweden)

    Astrid A.T.M. Bosch

    2016-07-01

    Full Text Available Birth by Caesarian section is associated with short- and long-term respiratory morbidity. We hypothesized that mode of delivery affects the development of the respiratory microbiota, thereby altering its capacity to provide colonization resistance and consecutive pathobiont overgrowth and infections. Therefore, we longitudinally studied the impact of mode of delivery on the nasopharyngeal microbiota development from birth until six months of age in a healthy, unselected birth cohort of 102 children (n = 761 samples. Here, we show that the respiratory microbiota develops within one day from a variable mixed bacterial community towards a Streptococcus viridans-predominated profile, regardless of mode of delivery. Within the first week, rapid niche differentiation had occurred; initially with in most infants Staphylococcus aureus predominance, followed by differentiation towards Corynebacterium pseudodiphteriticum/propinquum, Dolosigranulum pigrum, Moraxella catarrhalis/nonliquefaciens, Streptococcus pneumoniae, and/or Haemophilus influenzae dominated communities. Infants born by Caesarian section showed a delay in overall development of respiratory microbiota profiles with specifically reduced colonization with health-associated commensals like Corynebacterium and Dolosigranulum, thereby possibly influencing respiratory health later in life.

  5. 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)

    Krautwald-Junghanns, M.E.; Valerius, K.P.; Duncker, H.R.; Sohn, H.G.

    1998-01-01

    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

  6. Water extract of Pueraria lobata Ohwi has anti-viral activity against human respiratory syncytial virus in human respiratory tract cell lines

    Directory of Open Access Journals (Sweden)

    Tzeng-Jih Lin

    2013-12-01

    Full Text Available Human respiratory syncytial virus (HRSV infects all age groups and causes bronchiolitis, pneumonia, and acute respiratory distress syndrome with a significant mortality rate. To date, only ribavirin has been used to manage HRSV infection. However, ribavirin is expensive with an only modest effect. Furthermore, ribavirin has several side effects, which means it has limited clinical benefit. Pueraria lobata Ohwi (P. lobata is a common ingredient of Ge-Gen-Tang (Kakkon-to and Sheng-Ma-Ge-Gen-Tang (Shoma-kakkon-to, which are prescriptions of Chinese traditional medicine proven to have antiviral activity against HRSV. Therefore, it was hypothesized that P. lobata might be effective against HRSV. To find a cost-effective therapeutic modality, both human upper (HEp-2 and lower (A549 respiratory tract cell lines were used to test the hypothesis that P. lobata could inhibit HRSV-induced plaque formation. Results showed that the water extract of P. lobata was effective (p < 0.0001 against HRSV-induced plaque formation. P. lobata was more effective when given prior to viral inoculation (p < 0.0001 by inhibiting viral attachment (p < 0.0001 and penetration (p < 0.0001. However, supplementation with P. lobata could not stimulate interferon secretion after HRSV infection. In conclusion, P. lobata has antiviral activity against HRSV-induced plaque formation in airway mucosa mainly by inhibiting viral attachment and internalization. Further identification of effective constituents could contribute to the prevention of HRSV infection.

  7. 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.

  8. Prevalence of respiratory tract infections, allergies and assessment of humoral immunity within the Malopolska region's cohort of 11- year old children born with extremely low birth weight in comparison with to their term born peers.

    Science.gov (United States)

    Zasada, Magdalena; Klimek, Małgorzata; Durlak, Wojciech; Kotula, Monika; Tomasik, Tomasz; Kwinta, Przemko

    2016-01-01

    Children born with extremely low birth weight (ELBW) have more respiratory tract complications during childhood. Little is known about respiratory and allergy problems in ELBW children at the threshold of adolescence. A follow-up study was conducted at the age of 11 among ELBW children (n=65) and age-matched controls (n=36). The primary outcomes in the study were the occurrence of respiratory and allergy problems and the rate of hospitalization due to respiratory complications at the age of 11 years, assessed with a questionnaire. Secondary outcome variables were serum levels of immunoglobulin classes. ELBW children had more respiratory tract infections (31 vs.11%, p = 0.03), but less allergies (3 vs. 22%, p allergies at the age of 11 years compared with children born at term. Lower respiratory tract problems decrease in ELBW children with age. Respiratory tract infections are not connected with deficiency in humoral immunity.

  9. 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...

  10. Exposure to Cigarette Smoke Reduces Vitamin D3 in the Blood Stream and Respiratory Tract

    Science.gov (United States)

    ... Published Online: April 2, 2014 Cigarette smoking and exposure to secondhand smoke have long been known to exacerbate respiratory diseases ... the inflammatory effects of cigarette smoke. In conclusion, exposure to ... exposed to secondhand smoke, or who have chronic sinusitis with nasal ...

  11. 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

    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...

  12. Study of retention and absorption of radioactive dust in the respiratory tract

    International Nuclear Information System (INIS)

    Petruczenko, A.; Gnatowski, B.; Meyer-Brodniewicz, J.; Chas, J.

    1986-01-01

    The study of deposition and clearance by the lungs of silicon dust labelled with 24 Na is described. The animals were contaminated by the ''nose only'' method using PIANO-4 unit. The silicon dust is mainly deposited in the nasal cavities and passes through the throat to the gastrointestinal tract. The biological dust elimination time was 30 ± 4.4 h, which means that the silicon dust can be classified to the group of minimal retention. 18 refs., 4 figs. (author)

  13. Respiratory

    Science.gov (United States)

    The words "respiratory" and "respiration" refer to the lungs and breathing. ... Boron WF. Organization of the respiratory system. In: Boron WF, Boulpaep EL, eds. Medical Physiology . 3rd ed. Philadelphia, PA: Elsevier; 2017:chap 26.

  14. Role of lymphotoxin and homeostatic chemokines in the development and function of local lymphoid tissues in the respiratory tract.

    Science.gov (United States)

    Rangel-Moreno, Javier; Carragher, Damian; Randall, Troy D

    2007-01-01

    Secondary lymphoid organs are strategically placed to recruit locally activated antigen presenting cells (APCs) as well as naïve, recirculating T and B cells. The structure of secondary lymphoid organs - separated B and T zones, populations of specialized stromal cells, high endothelial venules and lymphatic vessles - has also evolved to maximize encounters between APCs and lymphocytes and to facilitate the expansion and differentiation of antigen-stimulated T and B cells. Many of the general mechanisms that govern the development and organization of secondary lymphoid organs have been identified over the last decade. However, the specific cellular and molecular interactions involved in the development and organization of each secondary lymphoid organ are slightly different and probably reflect the cell types available at that time and location. Here we review the mechanisms involved in the development, organization and function of local lymphoid tissues in the respiratory tract, including Nasal Associated Lymphoid Tissue (NALT) and inducible Bronchus Associated Lymphoid Tissue (iBALT).

  15. Acupuncture therapy for fever induced by viral upper respiratory tract infection (URTI) in military medical service: a case series.

    Science.gov (United States)

    Kwon, SeungWon; Shin, KyoungHo; Jung, WooSang; Moon, SangKwan; Cho, KiHo

    2014-12-01

    We report the cases of eight military patients with fever (≥38°C) induced by viral upper respiratory tract infection (URTI) who requested treatment with acupuncture in the military medical service room. All patients were treated immediately after diagnosis with classical acupuncture (GV14, GB20, TE8 points) and a new type of acupuncture, equilibrium acupuncture (Feibing and Ganmao points). After one treatment session (20 min), reduction of body temperature was confirmed in all patients. Accompanying symptoms such as headache, myalgia and nasal obstruction also showed a tendency to decrease. Within 3 days of treatment, six of the eight patients had recovered from the URTI. No adverse effects of acupuncture treatment were reported. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  16. 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.

  17. 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)

    Reis, Arlene Alves dos

    2005-01-01

    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)

  18. STUDY OF CORROSIVE POISONING AND ITS EFFECTS ON UPPER GASTROINTESTINAL TRACT AND SURGICAL MANAGEMENT- A SINGLE INSTITUTION EXPERIENCE

    OpenAIRE

    Ramesh Lingala; Ramesh Kota

    2017-01-01

    BACKGROUND Corrosive injury to the upper gastrointestinal tract is an agonising experience for both the patient and surgeon. Caustic ingestion may cause wide spread injury to the lips, oral cavity, pharynx and the upper airway. The effect that these agents have on the oesophagus accounts for most of the serious injuries and on stomach, which may result in perforation and death in the acute phase. 1,2 If the patient survives the acute effects of caustic ingestion, the repa...

  19. Modeling of indoor 222Rn distribution in ventilated room and resulting radiation doses measured in the respiratory tract

    Directory of Open Access Journals (Sweden)

    R. Rabi

    2017-07-01

    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 therefore important to understanding the distribution of radon and their progeny in indoor environment helps in calculating the inhalation doses due to them. This paper focuses on effects of exhalation from different sources (wall, floor and ceiling and the ventilation profile on distribution of the concentrations of radon and their progeny indoor. The radon exhalation rate from walls, floor and ceiling, and ventilation rate were measured as a part of this study and are used as input in Finite Volume Method (FVM simulation. The findings show that the radon concentration which is distributed in a non-homogeneous way in the room is due to the difference in the radon concentration of different sources (wall, floor and ceiling. Moreover, the radon concentration is much larger near walls, and decreases in the middle of the room because of the effect of air velocity. It has also been found that the distributions of unattached and attached fraction of 218Po, 214Pb and 214Po radionuclides are similar to that of 222Rn. In addition, equilibrium fraction F and the unattached fraction ( fj  of 218Po, 214Pb and 214Po radionuclides for different values of the attachment rate were evaluated. The committed equivalent doses due to 218Po and 214Po radon short-lived progeny were evaluated in different tissues of the respiratory tract of workers from the inhalation of indoor air.

  20. 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.

  1. 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.

  2. The impact of pediatric obesity on hospitalized children with lower respiratory tract infections in the United States.

    Science.gov (United States)

    Okubo, Yusuke; Nochioka, Kotaro; Testa, Marcia A

    2018-04-01

    Obesity is the most common public health problem and is a clinically complicating risk factor among hospitalized children. The impact of pediatric obesity on the severity and morbidity of lower respiratory tract infections remains unclear. We conducted a retrospective cohort study of bronchitis and pneumonia among children aged 2-20 years using hospital discharge records. The data were obtained from the Kid's Inpatient Database in 2003, 2006, 2009, and 2012, and were weighted to estimate the number of hospitalizations in the United States. We used the International Classification of Diseases, Ninth Revision, Clinical Modification code (278.0×) to classify whether the patient was obese or not. We investigated the associations between pediatric obesity and use of mechanical ventilation using multivariable logistic regression model. In addition, we ascertained the relationships between pediatric obesity, comorbid blood stream infections, mean healthcare cost, and length of hospital stay. We estimated a total of 133 602 hospitalizations with pneumonia and bronchitis among children aged between 2 and 20 years. Obesity was significantly associated with use of mechanical ventilation (adjusted OR 2.90, 95% CI 2.15-3.90), comorbid bacteremia or septicemia (adjusted OR 1.58, 95% CI 1.03-2.44), elevated healthcare costs (adjusted difference $383, 95%CI $276-$476), and prolonged length of hospital stay (difference 0.32 days, 95%CI 0.23-0.40 days), after adjusting for patient and hospital characteristics using multivariable logistic regression models. Pediatric obesity is an independent risk factor for severity and morbidity among pediatric patients with lower respiratory tract infections. These findings suggest the importance of obesity prevention for pediatric populations. © 2017 John Wiley & Sons Ltd.

  3. 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.

  4. [Paralytic shellfish poisoning (author's transl)].

    Science.gov (United States)

    Imbert, J C; Essaïd el Feydi, A; Kadiri, A

    Different diseases as viral or bacterian gastro-enteritis, Tiphoid, viral hepatitis can come from shellfishes. Less known is the shellfish poisoning although recent outbreaks took place in Spain, France, England, Morocco. Toxic poisoning is caused by a poison produced by dinoflagelates of plankton which get developped in shells and make them dangerous, even cooked, to be eaten. A respiratory failure can result from this neurotropic poison.

  5. [Distribution and drug-resistance of bacteria in the lower respiratory tract in patients with tuberculosis and severe pneumonia receiving invasive mechanical ventilation].

    Science.gov (United States)

    Lao, Suihua; Wang, Juan; Yu, Chaoxian; Li, Dexian

    2014-07-01

    To investigate the distribution and drug-resistance of bacteria in the lower respiratory tract in patients with tuberculosis and severe pneumonia receiving invasive mechanical ventilation. The clinical data, lower respiratory tract infection pathogens and bacterial drug sensitivity were analyzed in 208 patients receiving invasive mechanical ventilation for tuberculosis and severe pneumonia. A total of 355 pathogenic microbial strains were obtained from the patients, among which 281 (79.2%) strains were Gram-negative bacteria, 62 (17.5%) were fungi, and 12 (3.4%) were Gram-positive bacteria. Mixed infections were found in 68 cases (19.2%). The sensitivity rates of meropenem, imipenem and amikacin were over 60% for Gram-negative bacteria, and those of teicoplanin, vancomycin, and fusidic acid were 100% for Gram-positive bacteria. The main pathogenic bacteria are Gram-negative bacteria, fungi and Gram-positive bacteria in the lower respiratory tract of patients with tuberculosis and severe pneumonia receiving mechanical ventilation. Meropenem, imipenem and amikacin are effective antibiotics for lower respiratory tract infections, and multi-drug resistance is frequent in these patients, which urges appropriate use of the antibiotics.

  6. In vitro antibiotic susceptibility of Dutch Mycoplasma synoviae field isolates originating from joint lesions and the respiratory tract of commercial poultry

    NARCIS (Netherlands)

    Landman, W.J.M.; Mevius, D.J.; Veldman, K.T.; Feberwee, A.

    2008-01-01

    The in vitro susceptibility of 17 Dutch Mycoplasma synoviae isolates from commercial poultry to enrofloxacin, difloxacin, doxycycline, tylosin and tilmicosin was examined. Three isolates originated from joint lesions and 14 were from the respiratory tract. The type strain M. synoviae WVU 1853 was

  7. Cost effectiveness of amoxicillin for lower respiratory tract infections in primary care : An economic evaluation accounting for the cost of antimicrobial resistance

    NARCIS (Netherlands)

    Oppong, Raymond; Smith, Richard D.; Little, Paul; Verheij, Theo; Butler, Christopher C.; Goossens, Herman; Coenen, Samuel; Moore, Michael; Coast, Joanna

    2016-01-01

    Background Lower respiratory tract infections (LRTIs) are a major disease burden and are often treated with antibiotics. Typically, studies evaluating the use of antibiotics focus on immediate costs of care, and do not account for the wider implications of antimicrobial resistance. Aim This study

  8. The role of procalcitonin as a guide for the diagnosis, prognosis, and decision of antibiotic therapy for lower respiratory tract infections

    Directory of Open Access Journals (Sweden)

    Amal Abd El-Azeem

    2013-10-01

    Conclusion: Serum PCT level could be used as a novel marker of lower respiratory tract bacterial infections for diagnosis, prognosis and follow up of therapy. This reduces side-effects of an unnecessary antibiotic use, lowers costs, and in the long-term, leads to diminishing drug resistance.

  9. Efficacy, safety and tolerability of 3 day azithromycin versus 10 day co-amoxiclav in the treatment of children with acute lower respiratory tract infections

    NARCIS (Netherlands)

    A. Ferwerda (Annemarie); H.A. Moll (Henriëtte); W.C.J. Hop (Wim); J.M. Kouwenberg (Jan); C.V. Tjon Pian Gi

    2001-01-01

    textabstractTo compare the efficacy, safety and tolerability of a 3 day course of azithromycin with a 10 day course of co-amoxiclav in the treatment of children with acute lower respiratory tract infection (LRTI), 118 patients with community-acquired LRTI were

  10. Impact of amoxicillin therapy on resistance selection in patients with community-acquired lower respiratory tract infections : A randomized, placebo-controlled study

    NARCIS (Netherlands)

    Malhotra-Kumar, Surbhi; Van Heirstraeten, Liesbet; Coenen, Samuel; Lammens, Christine; Adriaenssens, Niels; Kowalczyk, Anna; Godycki-Cwirko, Maciek; Bielicka, Zuzana; Hupkova, Helena; Lannering, Christina; Mölstad, Sigvard; Fernandez-Vandellos, Patricia; Torres, Antoni; Parizel, Maxim; Ieven, Margareta; Butler, Chris C.; Verheij, Theo; Little, Paul; Goossens, Hermanon; Frimodt-Møller, Niels; Bruno, Pascale; Hering, Iris; Lemiengre, Marieke; Loens, Katherine; Malmvall, Bo Eric; Muras, Magdalena; Romano, Nuria Sanchez; Prat, Matteu Serra; Svab, Igor; Swain, Jackie; Tarsia, Paolo; Leus, Frank; Veen, Robert; Worby, Tricia

    2016-01-01

    Objectives: To determine the effect of amoxicillin treatment on resistance selection in patients with community-acquired lower respiratory tract infections in a randomized, placebo-controlled trial. Methods: Patients were prescribed amoxicillin 1 g, three times daily (n = 52) or placebo (n = 50) for

  11. Can the Pelargonium sidoides root extract EPs® 7630 prevent asthma attacks during viral infections of the upper respiratory tract in children?

    Science.gov (United States)

    Tahan, Fulya; Yaman, Melih

    2013-01-15

    Asthma is a chronic disease characterized by airway inflammation. Viral infection initiates an immune inflammatory response that may produce asthma attacks. There is no effective preventing therapy for asthma attack during upper respiratory tract viral infections. To investigate the efficacy of 5 days of Pelargonium sidoides therapy for preventing asthma attack during upper respiratory tract viral infections. Sixty one asthmatic children with upper respiratory tract viral infection were enrolled in the study. The patients were randomized to receive Pelargonium sidoides daily for 5 days (n=30) or not (n=31). Before and after treatment, they all were examined and symptom scores were determined. Following five days treatment, children were evaluated whether or not they had an asthma attack. Treatment with Pelargonium sidoides was not associated with a statistically significant differences in fever and muscle aches (p>0.05, Chi-square test). There were significant differences in cough frequency and nasal congestion between the groups (pasthma attack between the groups (pasthma attack. Our study shows that Pelargonium sidoides may prevent asthma attacks during upper respiratory tract viral infections. Copyright © 2012 Elsevier GmbH. All rights reserved.

  12. Effects of influenza plus pneumococcal conjugate vaccination versus influenza vaccination alone in preventing respiratory tract infections in children : a randomized, double-blind, placebo-controlled trial

    NARCIS (Netherlands)

    Jansen, Angelique G S C; Sanders, Elisabeth A M; Hoes, Arno W; van Loon, Anton M; Hak, Eelko

    2008-01-01

    OBJECTIVE: To evaluate the effects of influenza vaccination with or without heptavalent pneumococcal conjugate vaccination on respiratory tract infections (RTIs) in children. STUDY DESIGN: This was a randomized, double-blind, placebo-controlled trial comprising 579 children age 18 to 72 months with

  13. 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...

  14. Use of Selective Fungal Culture Media Increases Rates of Detection of Fungi in the Respiratory Tract of Cystic Fibrosis Patients.

    Science.gov (United States)

    Hong, Gina; Miller, Heather B; Allgood, Sarah; Lee, Richard; Lechtzin, Noah; Zhang, Sean X

    2017-04-01

    The prevalence of fungi in the respiratory tracts of cystic fibrosis (CF) patients has risen. However, fungal surveillance is not routinely performed in most clinical centers in the United States, which may lead to an underestimation of the true prevalence of the problem. We conducted a prospective study comparing the rates of detection for clinically important fungi (CIF), defined as Aspergillus , Scedosporium , and Trichosporon species and Exophiala dermatitidis , in CF sputa using standard bacterial and selective fungal culture media, including Sabouraud dextrose agar with gentamicin (SDA), inhibitory mold agar (IMA), and brain heart infusion (BHI) agar with chloramphenicol and gentamicin. We described the prevalence of these fungi in an adult CF population. A total of 487 CF respiratory samples were collected from 211 unique participants. CIF were detected in 184 (37.8%) samples. Only 26.1% of CIF-positive samples were detected in bacterial culture medium, whereas greater rates of detection for fungi were found in IMA (65.8%; P culture media and longer incubation periods yielded higher rates of detection for CIF in CF sputum samples compared with that detected in bacterial culture medium, resulting in an underdetection of fungi by bacterial culture alone. The prevalence of fungi in CF may be better estimated by using selective fungal culture media, and this may translate to important clinical decisions. Copyright © 2017 American Society for Microbiology.

  15. A novel host-protein assay outperforms routine parameters for distinguishing between bacterial and viral lower respiratory tract infections.

    Science.gov (United States)

    Stein, Michal; Lipman-Arens, Shelly; Oved, Kfir; Cohen, Asi; Bamberger, Ellen; Navon, Roy; Boico, Olga; Friedman, Tom; Etshtein, Liat; Paz, Meital; Gottlieb, Tanya M; Kriger, Or; Fonar, Yura; Pri-Or, Ester; Yacobov, Renata; Dotan, Yaniv; Hochberg, Amit; Grupper, Moti; Chistyakov, Irina; Potasman, Israel; Srugo, Isaac; Eden, Eran; Klein, Adi

    2018-03-01

    Bacterial and viral lower respiratory tract infections (LRTIs) are often clinically indistinguishable, leading to antibiotic overuse. We compared the diagnostic accuracy of a new assay that combines 3 host-biomarkers (TRAIL, IP-10, CRP) with parameters in routine use to distinguish bacterial from viral LRTIs. Study cohort included 184 potentially eligible pediatric and adult patients. Reference standard diagnosis was based on adjudication by an expert panel following comprehensive clinical and laboratory investigation (including respiratory PCRs). Experts were blinded to assay results and assay performers were blinded to reference standard outcomes. Evaluated cohort included 88 bacterial and 36 viral patients (23 did not fulfill inclusion criteria; 37 had indeterminate reference standard outcome). Assay distinguished bacterial from viral LRTI patients with sensitivity of 0.93±0.06 and specificity of 0.91±0.09, outperforming routine parameters, including WBC, CRP and chest x-ray signs. These findings support the assay's potential to help clinicians avoid missing bacterial LRTIs or overusing antibiotics. Published by Elsevier Inc.

  16. 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.

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

    Science.gov (United States)

    Casas, Lidia; Zock, Jan Paul; Carsin, Anne Elie; Fernandez-Somoano, Ana; Esplugues, Ana; Santa-Marina, Loreto; Tardón, Adonina; Ballester, Ferran; Basterrechea, Mikel; Sunyer, Jordi

    2013-10-01

    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 multivariable regression analyses and estimates were combined using random-effects meta-analyses. The period prevalence of LRTI was higher when sprays (combined odds ratio (OR) = 1.29; 95 % confidence interval (CI) 1.04-1.59) or air fresheners (OR = 1.29; CI 1.03-1.63) were used during pregnancy. The odds of wheezing increased with spray (OR = 1.37; CI 1.10-1.69) and solvent (OR = 1.30; CI 1.03-1.62) use. The associations between spray and air freshener use during pregnancy and both outcomes remained apparent when these products were not used after pregnancy. Nevertheless, the estimates were higher when post-natal exposure was included. The use of cleaning sprays, air fresheners and solvents during pregnancy may increase the risk of wheezing and infections in the offspring.

  18. Comparative study of respiratory tract immune toxicity induced by three sterilisation nanoparticles: silver, zinc oxide and titanium dioxide.

    Science.gov (United States)

    Liu, Huanliang; Yang, Danfeng; Yang, Honglian; Zhang, Huashan; Zhang, Wei; Fang, Yanjun; Lin, Zhiqing; Tian, Lei; Lin, Bencheng; Yan, Jun; Xi, Zhuge

    2013-03-15

    Silver, zinc oxide, and titanium dioxide nanoparticles are used as sterilisation materials to enhance the performance of disinfectants. We investigated the respiratory tract immune toxicity ("immunotoxicity") of these nanoparticles in vivo and in vitro, and we explored the relationships between particle size, particle shape, chemical composition, chemical stability and the toxicological effects of these typical nanoparticles in rats. In vivo, the rats were exposed to nanoparticles by intratracheal instillation. Exposure to nanoparticles caused an increase in oxidative injury to the lungs and disorders in regulating the cytokine network, which were detected in the bronchoalveolar lavage fluid, suggesting that oxidative stress might be important for inducing the respiratory immunotoxicity of nanoparticles. In vitro, the phagocytic function of alveolar macrophages (AMs) was dose-dependently reduced by nanoparticles, and ZnO nanoparticles induced greater cytotoxicity than the silver and titanium-dioxide nanoparticles, which were coincident with the results of multiple measurements, such as a cell viability assay by WST-8 and LDH measurements. Comparative analyses demonstrated that particle composition and chemical stability most likely had a primary role in the biological effects of different nanoparticles. Copyright © 2013 Elsevier B.V. All rights reserved.

  19. IMMUNOMODULATORY AND THERAPEUTIC ACTIVITY OF BIFIDO- AND LACTOBACTERIA IN CHILDREN WITH ALLERGIC DISEASES AND FREQUENT RESPIRATORY TRACT INFECTIONS

    Directory of Open Access Journals (Sweden)

    N. V. Khoroshilova

    2013-01-01

    Full Text Available Recently probiotics have attracted more and more attention of clinicians and researchers. According to the results of numerous studies, these agents are effective in treatment of acute and chronic diseases of the gastro-intestinal system, and possibility of usage of such drugs in patients with allergic disorders and frequent respiratory tract infections is under active investigation. This review contains data on bifido- and lactobacteria usage in patients with the above-mentioned conditions. It was shown, that lactobacteria have little effect in prophylaxis and treatment of allergic diseases in infants younger 1 year of life, while their efficacy was observed in older patients. According to the results of clinical trials, probiotics with bifido- and lactobacteria decrease the frequency and severity of respiratory infections. Frequently and protractedly ill children are characterized by persistent combined viral-bacterial and viral-bacterial-fungal associations resistant to therapy. In the experimental studies it was established, that species and cultures of lacto- and bifidobacteria including into the composition of a new combined probiotic drug have antagonistic action to conditionally pathogenic causative agents, restore integrity of the intestinal epithelium and increase cytokine production by the immunocompetent cells. Moreover, there are data on antiviral action of lactobacteria. All these makes the above-mentioned combined probiotic a promising drug for complex therapy of frequently and protractedly ill patients with mixed infections.

  20. Influence of systemic fluoroquinolone administration on the presence of Pasteurella multocida in the upper respiratory tract of clinically healthy calves

    Directory of Open Access Journals (Sweden)

    Kehrenberg Corinna

    2008-09-01

    Full Text Available Abstract The influence of enrofloxacin administration (5 mg/kg for five consecutive days on the occurrence of Pasteurella multocida in the upper respiratory tract of two healthy calves was monitored over a 10-day period. From nasal swabs of two additional healthy control calves, which received a placebo saline administration, P. multocida was isolated throughout the study period. In the enrofloxacin treated calves, P. multocida was not demonstrated in the nasopharynx from 48 h after the first injection until two days after the last administration, when P. multocida reappeared and proved to be clonal in nature to the original isolates. During the experiment, no change in minimal inhibitory concentration for enrofloxacin of the P. multocida isolates was detected (MIC ≤ 0.015 μg/mL. Enrofloxacin concentrations were determined in the plasma by a high-performance liquid chromatography method with fluorescence detection. The PK/PD indices AUC/MIC and Cmax/MIC ratio were calculated and found to be 1157.7 and 129.8, respectively. Remarkably, the respiratory pathogen Arcanobacterium pyogenes became the predominant recovered organism in the nasopharynx of one animal following enrofloxacin therapy throughout the remaining of the experiment.

  1. Respiratory actions of tachykinins in the nucleus of the solitary tract: characterization of receptors using selective agonists and antagonists

    Science.gov (United States)

    Mazzone, Stuart B; Geraghty, Dominic P

    2000-01-01

    The respiratory response to microinjection of tachykinins and analogues into the commissural nucleus of the solitary tract (cNTS) of urethane-anaesthetized rats was investigated in the presence and absence of selective tachykinin NK1, NK2 and NK3 antagonists (RP 67580, SR 48968 and SR 142801, respectively). All tachykinins, except for the selective NK2 agonist, [Nle10]-NKA(4-10), increased tidal volume (VT). The rank potency order of naturally-occurring tachykinins was neurokinin A (NKA)⩾substance P (SP)>>NKB, whereas the rank order for selective analogues was senktide⩾septide>> [Sar9,Met(O2)11]-SP>>[Nle10]-NKA(4-10). Septide (NK1-selective) and senktide (NK3-selective) were 22 fold more potent (pD2∼12) at stimulating VT than SP (pD2∼10.5). Tachykinin agonists produced varying degrees of respiratory slowing, independent of changes in VT. At doses producing maximum stimulation of VT, agonists induced either a mild (tachykinin receptors (NK1, NK2 and NK3) are present in the cNTS and are involved in the central control of respiration. PMID:10725260

  2. COMPARATIVE COMPUTATIONAL MODELING OF AIRFLOWS AND VAPOR DOSIMETY IN THE RESPIRATORY TRACTS OF RAT, MONKEY, AND HUMAN

    Energy Technology Data Exchange (ETDEWEB)

    Corley, Richard A.; Kabilan, Senthil; Kuprat, Andrew P.; Carson, James P.; Minard, Kevin R.; Jacob, Rick E.; Timchalk, Charles; Glenny, Robb W.; Pipavath, Sudhaker; Cox, Timothy C.; Wallis, Chris; Larson, Richard; Fanucchi, M.; Postlewait, Ed; Einstein, Daniel R.

    2012-07-01

    Coupling computational fluid dynamics (CFD) with physiologically based pharmacokinetic (PBPK) models is useful for predicting site-specific dosimetry of airborne materials in the respiratory tract and elucidating the importance of species differences in anatomy, physiology, and breathing patterns. Historically, these models were limited to discrete regions of the respiratory system. CFD/PBPK models have now been developed for the rat, monkey, and human that encompass airways from the nose or mouth to the lung. A PBPK model previously developed to describe acrolein uptake in nasal tissues was adapted to the extended airway models as an example application. Model parameters for each anatomic region were obtained from the literature, measured directly, or estimated from published data. Airflow and site-specific acrolein uptake patterns were determined under steadystate inhalation conditions to provide direct comparisons with prior data and nasalonly simulations. Results confirmed that regional uptake was dependent upon airflow rates and acrolein concentrations with nasal extraction efficiencies predicted to be greatest in the rat, followed by the monkey, then the human. For human oral-breathing simulations, acrolein uptake rates in oropharyngeal and laryngeal tissues were comparable to nasal tissues following nasal breathing under the same exposure conditions. For both breathing modes, higher uptake rates were predicted for lower tracheo-bronchial tissues of humans than either the rat or monkey. These extended airway models provide a unique foundation for comparing dosimetry across a significantly more extensive range of conducting airways in the rat, monkey, and human than prior CFD models.

  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. Rationale and design of the prevention of respiratory infections and management in children (PRIMAKid) study : a randomized controlled trial on the effectiveness and costs of combined influenza and pneumococcal vaccination in pre-school children with recurrent respiratory tract infections

    NARCIS (Netherlands)

    Schönbeck, Y; Sanders, E A M; Hoes, A W; Schilder, A G M; Verheij, Th J M; Hak, E

    2005-01-01

    Health and economic burden of recurrent respiratory tract infections (RTIs) in early childhood is considerable. A systematic review of licensed influenza and pneumococcal vaccines showed substantial efficacy in children, but the health-economic impact of such vaccines among pre-school children with

  5. Access to Point-of-Care Tests Reduces the Prescription of Antibiotics Among Antibiotic-Requesting Subjects With Respiratory Tract Infections

    DEFF Research Database (Denmark)

    Llor, C.; 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...... explicitly requested an antibiotic prescription. METHODS: Spanish GPs registered all cases of respiratory tract infections over a 3-week period before and after an intervention undertaken in 2008 and 2009. Patients with acute sinusitis, pneumonia, and exacerbations of COPD were excluded. Two types...... tract infections were included, of whom 344 (1.4%) requested antibiotic prescribing. Antibiotics were more frequently prescribed to subjects requesting them compared with those who did not (49.1% vs 18.5%, P

  6. Non-typeable Haemophilus influenzae biofilm production and severity in lower respiratory tract infections in a tertiary hospital in Mexico.

    Science.gov (United States)

    Martínez-Reséndez, Michel Fernando; González-Chávez, Juan Manuel; Garza-González, Elvira; Castro-Fuentes, Lorena Nefertiti; Gutiérrez-Ferman, Jessica Lizzeth; Echániz-Aviles, Gabriela; Camacho-Ortíz, Adrián; Carnalla-Barajas, María Noemí; Soto-Noguerón, Araceli; Maldonado-Garza, Héctor Jesús; Hernández-Balboa, Cristina Liliana; Llaca-Díaz, Jorge M; Flores-Treviño, Samantha

    2016-12-01

    Non-typeable Haemophilus influenzae (NTHi) is a common opportunistic bacterial pathogen that primarily infects the respiratory mucosa. This study was conducted to assess clinical and microbiological data related to disease severity in patients with lower respiratory tract infections caused by NTHi in a tertiary care hospital in Mexico. NTHi isolates were subjected to serotyping, antimicrobial susceptibility evaluationand analyses of β-lactamase production, genetic relatednessand biofilm formation. Clinical and demographic data were retrieved from patients' records. The mean age of the patients was 40.3 years; the majority (n=44, 72.1 %) were male. The main comorbidities were arterial hypertension (n=22, 36.1 %) and diabetes mellitus (n=17, 27.9 %). NTHi isolates (n=98) were recovered from tracheal aspirate (n=57, 58.2 %), sputum (n=26, 26.5 %)and bronchial aspirate (n=15, 15.3 %) specimens. Low resistance to cefotaxime (n=0, 0.0 %), rifampin (n=1, 1.1 %) and chloramphenicol (n=3, 3.2 %) and greater resistance to ampicillin (n=30, 32.3 %) and trimethoprim-sulfamethoxazole (n=49, 52.7 %) were detected. β-Lactamase production was found in 17 (17.3 %) isolates. Isolates displayed high genetic diversity, and only 10 (10.2 %) were found to be biofilm producers. The antimicrobial susceptibility patterns of biofilm-producing and non-producing isolates did not differ. Biofilm production was associated with prolonged hospital stay (P=0.05). Lower respiratory NTHi isolates from Mexico showed low antimicrobial resistance and weak biofilm production. Younger age was correlated with lower Acute Physiology and Chronic Health Evaluation II score (moderate, P=0.07; severe, P=0.03).

  7. Investigation of Clinical Relevance of Bacterial Colonization in Patients With Suspected Viral Respiratory Tract Infection By Using Multiplex PCR Method

    Directory of Open Access Journals (Sweden)

    Vedat Turhan

    2013-02-01

    Full Text Available Numerous viral and bacterial pathogens have been reported causing acute respiratory tract infection (ARTI. Nasopharyngeal swab (NPS specimens from 351 patients (278 children, 73 adults with suspected upper and lower ARTI were submitted during the study period from Jan. 2005 to Dec. 2006. Organism-specific nucleic acids were detected using TemPlex technology (ResPlex I and II, Genaco Biomedical Products, Huntsville, AL. Amplified products were identified using a suspension array for multiplex detection performed on a Luminex 100 instrument (Luminex, Austin, TX. A total of 221 viral and bacterial respiratory agents were detected in 148 patients (135 [48.5%] of the 278 children and 13 [17.8%] of the 73 adults with suspected ARTI. A single respiratory pathogen was detected in 89 patients [25.35%], whereas mixed infection with two or three pathogens was found in 59 [16.8%] of 351 suspected patients. S. pneumonia was the most frequently isolated strain (54 [15.3%] of 351 patients, followed by H. influenzae (37 [10.5%], rhinoviruses (35 [9.9%], influenza A virus (23 [6.5%], enteroviruses (19 [5.4%], hMPV (14 [3.9%], PIV-1 (12 [3.4%], PIV-3 (11 [3.1%], RSV (10 [2.8%], and influenza B virus (6 [1.7%]. Mixed infections were more frequent in children (56 [20.1%] of 278 than adult patients (3 [4.1%] of 73 patients. The detection rate of the bacteria peaked in the spring season (37 [40.6%] of 91 bacteria, followed by winter (24 infections, autumn (18 infections and summer (12 infections. The prevalence of co-infection is ~40%, finding a much higher incidence of co-infection with more than one agent than that reported previously. [Dis Mol Med 2013; 1(1.000: 2-7

  8. How to avoid the inappropriate use of antibiotics in upper respiratory tract infections? A position statement from an expert panel.

    Science.gov (United States)

    Piltcher, Otávio Bejzman; Kosugi, Eduardo Macoto; Sakano, Eulalia; Mion, Olavo; Testa, José Ricardo Gurgel; Romano, Fabrizio Ricci; Santos, Marco Cesar Jorge; Di Francesco, Renata Cantisani; Mitre, Edson Ibrahim; Bezerra, Thiago Freire Pinto; Roithmann, Renato; Padua, Francini Greco; Valera, Fabiana Cardoso Pereira; Lubianca Neto, José Faibes; Sá, Leonardo Conrado Barbosa; Pignatari, Shirley Shizue Nagata; Avelino, Melissa Ameloti Gomes; Caixeta, Juliana Alves de Souza; Anselmo-Lima, Wilma Terezinha; Tamashiro, Edwin

    2018-02-25

    Bacterial resistance burden has increased in the past years, mainly due to inappropriate antibiotic use. Recently it has become an urgent public health concern due to its impact on the prolongation of hospitalization, an increase of total cost of treatment and mortality associated with infectious disease. Almost half of the antimicrobial prescriptions in outpatient care visits are prescribed for acute upper respiratory infections, especially rhinosinusitis, otitis media, and pharyngotonsillitis. In this context, otorhinolaryngologists play an important role in orienting patients and non-specialists in the utilization of antibiotics rationally and properly in these infections. To review the most recent recommendations and guidelines for the use of antibiotics in acute otitis media, acute rhinosinusitis, and pharyngotonsillitis, adapted to our national reality. A literature review on PubMed database including the medical management in acute otitis media, acute rhinosinusitis, and pharyngotonsillitis, followed by a discussion with a panel of specialists. Antibiotics must be judiciously prescribed in uncomplicated acute upper respiratory tract infections. The severity of clinical presentation and the potential risks for evolution to suppurative and non-suppurative complications must be taken into 'consideration'. Periodic revisions on guidelines and recommendations for treatment of the main acute infections are necessary to orient rationale and appropriate use of antibiotics. 'Continuous medical education and changes in physicians' and patients' behavior are required to modify the paradigm that all upper respiratory infection needs antibiotic therapy, minimizing the consequences of its inadequate and inappropriate use. Copyright © 2018 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  9. Models to predict both sensible and latent heat transfer in the respiratory tract of Morada Nova sheep under semiarid tropical environment

    Science.gov (United States)

    Fonseca, Vinícius Carvalho; Saraiva, Edilson Paes; Maia, Alex Sandro Campos; Nascimento, Carolina Cardoso Nagib; da Silva, Josinaldo Araújo; Pereira, Walter Esfraim; Filho, Edgard Cavalcanti Pimenta; Almeida, Maria Elivânia Vieira

    2017-05-01

    The aim of this study was to build a prediction model both sensible and latent heat transfer by respiratory tract for Morada Nova sheep under field conditions in a semiarid tropical environment, using easily measured physiological and environmental parameters. Twelve dry Morada Nova ewes with an average of 3 ± 1.2 years old and average body weight of 32.76 ± 3.72 kg were used in a Latin square design 12 × 12 (12 days of records and 12 schedules). Tidal volume, respiratory rate, expired air temperature, and partial vapor pressure of the expired air were obtained from the respiratory facial mask and using a physiological measurement system. Ewes were evaluated from 0700 to 1900 h in each day under shade. A simple nonlinear model to estimate tidal volume as a function of respiratory rate was developed. Equation to estimate the expired air temperature was built, and the ambient air temperature was the best predictor together with relative humidity and ambient vapor pressure. In naturalized Morada Nova sheep, respiratory convection seems to be a mechanism of heat transfer of minor importance even under mild air temperature. Evaporation from the respiratory system increased together with ambient air temperature. At ambient air temperature, up to 35 °C respiratory evaporation accounted 90 % of the total heat lost by respiratory system, on average. Models presented here allow to estimate the heat flow from the respiratory tract for Morada Nova sheep bred in tropical region, using easily measured physiological and environmental traits as respiratory rate, ambient air temperature, and relative humidity.

  10. 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...

  11. 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.

  12. 3-chlorotyrosine and 3,5-dichlorotyrosine as biomarkers of respiratory tract exposure to chlorine gas.

    Science.gov (United States)

    Sochaski, Mark A; Jarabek, Annie M; Murphy, John; Andersen, Melvin E

    2008-01-01

    Modification of tyrosine by reactive chlorine can produce both 3-chlorotyrosine (CY) and 3,5-dichlorotyrosine (dCY). Both of these amino acids have proven to be promising biomarkers for assessing the extent of myeloperoxidase-catalyzed chlorine stress in a number of adverse physiological conditions. To date, there has been no application of these biomarkers for determining the extent of exposure to environmentally present gaseous chlorinating chemicals. In this manuscript, we present a method using selective ion monitoring gas chromatography for the simultaneous analysis of both CY and dCY in nasal tissue excised from Fisher 344 rats exposed to varying concentrations of chlorine gas. Using this method, we were able to demonstrate the following: 1. a dose-dependent increase in the conversion of tyrosine to CY and dCY in the respiratory epithelium tissue; 2. preferential formation of CY and dCY in the respiratory and transitional epithelium versus the olfactory epithelium of the nasal cavity of the rat; and 3. similar rates of formation for CY and dCY when exposed to chlorine gas based on a strong [CY] versus [dCY] correlation (slope = 1.001, r(2) = 0.912).

  13. Lead poisoning

    Science.gov (United States)

    ... help if this information is not immediately available. Poison Control If someone has severe symptoms from possible ... be caused by lead poisoning, call your local poison control center. Your local poison center can be ...

  14. To assess the relations between breast feeding and illness in children under two years of age with particular reference to respiratory tract infections

    International Nuclear Information System (INIS)

    Javed, N.; Zaidi, N.; Khan, M.A.

    2008-01-01

    The study was carried out to examine the relation between the breast feeding and morbidity as a result of respiratory illness and infection in the children less than two years of age. This is a prospective analysis of 131 children attending the outdoor paediatric department of Federal Government Services Hospital, Islamabad during the month of February 2006. A close ended pretested questionnaire was filled after taking informed consent from patient's parents. Out of total 131 enrolled cases (76 male and 55 female) 62 (47%) were breast fed; 56 (43%) bottle fed; while 13 (10%) had mix feeding. Among 38 children, having past history of respiratory tract infections episodes in last one month, only 04 (10%) were breast fed and remaining 34 (90%) were either bottle fed or had partial breast feeding. Out of 62 breast fed children, only 04 (6%) had recurrent episodes of respiratory tract infections, on the other hand out of 56 bottle fed 32 (57%) had previous history of respiratory illness. In our study there is a significant correlation between breast feeding and reduction in number of Respiratory tact infections episodes. Predominant breast feeding for at leas six months and partial breast feeding for up to one year may reduce the prevalence and subsequent morbidity of respiratory illness and infection in infancy. (author)

  15. Brazilian medicinal plants to treat upper respiratory tract and bronchial illness: systematic review and meta-analyses-study protocol.

    Science.gov (United States)

    Lopes, Luciane C; Silva, Maria Carolina O; Motta, Cristiane Bergamashi; Macho Quirós, Antonio; Biavatti, Maique Weber; de Oliveira, Jardel Corrêa; Guyatt, Gordon

    2014-07-23

    Respiratory illness, often associated with cough and sputum, is frequent. In Brazil, herbal medicines are often recommended as a first-line treatment for respiratory illness. There exists uncertainty regarding the effectiveness of these treatments. No systematic review has evaluated Brazilian medicinal plants (BMP) to treat upper respiratory tract and bronchial illness (URTI). We will conduct a systematic review and, if appropriate, a series of meta-analyses evaluating the safety and effectiveness of BMP for URTI. Eligible randomised controlled trials and observational studies will enrol adult or paediatric patients presenting with URTI treated by BMP approved by the Brazilian Health Surveillance Agency compared with placebo, no treatment or an alternative therapy. Our search will include the Cochrane Central Register of Controlled Trials (CENTRAL), which contains the Cochrane Acute Respiratory Illness Group's Specialized Register; MEDLINE; EMBASE; CINAHL (Cumulative Index to Nursing and Allied Health Literature); Web of Science; AMED; LILACS; CAB abstracts; clinical trial.gov; the WHO Trial Register and the Brazilian thesis database (CAPES) without any language restrictions. Outcomes of interest are time to resolution of clinical symptoms and/or signs (cough, sputum production or activity limitations), severity of symptoms prior to resolution and major/minor adverse events. Teams of reviewers will, independently and in duplicate, screen titles and abstracts and the complete full text to determine eligibility. For eligible studies, reviewers will perform data abstraction and assess risk of bias of eligible trials. When appropriate, we will conduct meta-analyses. We will also assess the quality of body of evidence (confidence in estimates of effect) for each of the outcomes using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. The systematic review will be published in a peer-reviewed journal. Brief reports of review findings

  16. 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

  17. 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......, respectively, for a 59-day period (from 37 kg to 90 kg bodyweight) followed by necropsy. In an aerosol chamber all pigs were exposed to an aerosol of toxigenic I! multocida type A (mean bacterial concentration in the aerosol-exposure chamber: 10(5) colony forming units/m(3); exposure period: 25 min) at day 10......, 21, 35 and 49 after the onset of ammonia exposure. During the experiment none of the pigs showed clinical signs of pneumonia nor did they develop visible distortion of the snout. None of the pigs had gross lesions in the lungs at necropsy and toxigenic Il multocida was not detected by culture from...

  18. 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

    2014-05-01

    Burns are associated with hyperglycemia leading to increased incidence of infections with pneumonia being one of the most prominent and adverse complications. 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. 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. 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. 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. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  19. Characterization of the Localized Immune Response in the Respiratory Tract of Ferrets following Infection with Influenza A and B Viruses.

    Science.gov (United States)

    Carolan, Louise A; Rockman, Steve; Borg, Kathryn; Guarnaccia, Teagan; Reading, Patrick; Mosse, Jennifer; Kelso, Anne; Barr, Ian; Laurie, Karen L

    2015-12-30

    The burden of infection with seasonal influenza viruses is significant. Each year is typically characterized by the dominance of one (sub)type or lineage of influenza A or B virus, respectively. The incidence of disease varies annually, and while this may be attributed to a particular virus strain or subtype, the impacts of prior immunity, population differences, and variations in clinical assessment are also important. To improve our understanding of the impacts of seasonal influenza viruses, we directly compared clinical symptoms, virus shedding, and expression of cytokines, chemokines, and immune mediators in the upper respiratory tract (URT) of ferrets infected with contemporary A(H1N1)pdm09, A(H3N2), or influenza B virus. Gene expression in the lower respiratory tract (LRT) was also assessed. Clinical symptoms were minimal. Overall cytokine/chemokine profiles in the URT were consistent in pattern and magnitude between animals infected with influenza A and B viruses, and peak expression levels of interleukin-1α (IL-1α), IL-1β, IL-6, IL-12p40, alpha interferon (IFN-α), IFN-β, and tumor necrosis factor alpha (TNF-α) mRNAs correlated with peak levels of viral shedding. MCP1 and IFN-γ were expressed after the virus peak. Granzymes A and B and IL-10 reached peak expression as the virus was cleared and seroconversion was detected. Cytokine/chemokine gene expression in the LRT following A(H1N1)pdm09 virus infection reflected the observations seen for the URT but was delayed 2 or 3 days, as was virus replication. These data indicate that disease severities and localized immune responses following infection with seasonal influenza A and B viruses are similar, suggesting that other factors are likely to modulate the incidence and impact of seasonal influenza. Both influenza A and B viruses cocirculate in the human population, and annual influenza seasons are typically dominated by an influenza A virus subtype or an influenza B virus lineage. Surveillance data

  20. Effect of High-Dose vs Standard-Dose Wintertime Vitamin D Supplementation on Viral Upper Respiratory Tract Infections in Young Healthy Children.

    Science.gov (United States)

    Aglipay, Mary; Birken, Catherine S; Parkin, Patricia C; Loeb, Mark B; Thorpe, Kevin; Chen, Yang; Laupacis, Andreas; Mamdani, Muhammad; Macarthur, Colin; Hoch, Jeffrey S; Mazzulli, Tony; Maguire, Jonathon L

    2017-07-18

    Epidemiological studies support a link between low 25-hydroxyvitamin D levels and a higher risk of viral upper respiratory tract infections. However, whether winter supplementation of vitamin D reduces the risk among children is unknown. To determine whether high-dose vs standard-dose vitamin D supplementation reduces the incidence of wintertime upper respiratory tract infections in young children. A randomized clinical trial was conducted during the winter months between September 13, 2011, and June 30, 2015, among children aged 1 through 5 years enrolled in TARGet Kids!, a multisite primary care practice-based research network in Toronto, Ontario, Canada. Three hundred forty-nine participants were randomized to receive 2000 IU/d of vitamin D oral supplementation (high-dose group) vs 354 participants who were randomized to receive 400 IU/d (standard-dose group) for a minimum of 4 months between September and May. The primary outcome was the number of laboratory-confirmed viral upper respiratory tract infections based on parent-collected nasal swabs over the winter months. Secondary outcomes included the number of influenza infections, noninfluenza infections, parent-reported upper respiratory tract illnesses, time to first upper respiratory tract infection, and serum 25-hydroxyvitamin D levels at study termination. Among 703 participants who were randomized (mean age, 2.7 years, 57.7% boys), 699 (99.4%) completed the trial. The mean number of laboratory-confirmed upper respiratory tract infections per child was 1.05 (95% CI, 0.91-1.19) for the high-dose group and 1.03 (95% CI, 0.90-1.16) for the standard-dose group, for a between-group difference of 0.02 (95% CI, -0.17 to 0.21) per child. There was no statistically significant difference in number of laboratory-confirmed infections between groups (incidence rate ratio [RR], 0.97; 95% CI, 0.80-1.16). There was also no significant difference in the median time to the first laboratory-confirmed infection: 3.95 months

  1. Reduction in antibiotic prescribing for respiratory tract infections in Swedish primary care- a retrospective study of electronic patient records.

    Science.gov (United States)

    Tyrstrup, Mia; Beckman, Anders; Mölstad, Sigvard; Engström, Sven; Lannering, Christina; Melander, Eva; Hedin, Katarina

    2016-11-25

    Swedish studies on antibiotic use in primary care have been based on one-week registrations of infections. In order to study adherence to guidelines, analyses based on large databases that provide information on diagnosis linked prescriptions, are needed. This study describes trends in management of infections in Swedish primary care particularly with regards to antibiotic prescribing and adherence to national guidelines. A descriptive study of Sweden's largest database regarding diagnosis linked antibiotic prescription data, the Primary care Record of Infections in Sweden (PRIS), for the years 2008, 2010 and 2013. Although the consultation rate for all infections remained around 30% each year, antibiotic prescribing rates decreased significantly over the years from 53.7% in 2008, to 45.5% in 2010, to 38.6% in 2013 (p = .032). The antibiotic prescribing rate for respiratory tract infections (RTIs) decreased from 40.5% in 2008 to 24.9% in 2013 while those for urinary tract infections and skin and soft tissue infections were unchanged. For most RTI diagnoses there was a decrease in prescription rate from 2008 to 2013, particularly for the age group 0-6 years. Phenoxymethylpenicillin (PcV) was the antibiotic most often prescribed, followed by tetracycline. Tonsillitis and acute otitis media were the two RTI diagnoses with the highest number of prescriptions per 1000 patient years (PY). For these diagnoses an increase in adherence to national guidelines was seen, with regards to treatment frequency, choice of antibiotics and use of rapid antigen detection test. The frequency in antibiotic prescribing varied greatly between different Primary Healthcare Centres (PHCCs). Falling numbers of consultations and decreased antibiotic prescription rates for RTIs have reduced the antibiotic use in Swedish primary care substantially. Overprescribing of antibiotics could still be suspected due to large variability in prescribing frequency, especially for acute bronchitis and

  2. Exploring association between gastrointestinal heat retention syndrome and recurrent respiratory tract infections in children: a prospective cohort study.

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    Dong, Fei; Yu, He; Ma, Jiaju; Wu, Liqun; Liu, Tiegang; Lv, Guokai; Zhen, Jianhua; Li, Xiaofei; Lewith, George; Gu, Xiaohong

    2016-02-27

    Recurrent respiratory tract infections (RRTIs) have a negative impact on both children's health and family wellbeing. Deficiency of ZhengQi used to be an instinct factor driving RRTI in Traditional Chinese Medicine (TCM). Our clinical observations suggest that children with gastrointestinal heat retention syndrome (GHRS) may have a greater risk of catching respiratory tract infections (RTIs). GHRS is a new predisposing factor for RRTI and it is dietary related. This study is aimed to explore association between GHRS and RRTI. A prospective cohort study has been conducted in Beijing, China; children aged 1-18 were enrolled. TCM symptoms, demographic and physiological characteristics were recorded by using semi-structured questionnaire. GHRS was considered as a predisposing factor. Children were followed up for next 12 months. We contacted with their parents using a face-to-face questionnaire survey, via email or phone every 3 months. Episodes of RTIs were recorded in detail. Three hundred thirty four children were enrolled and 307 (91.92%) followed up for 12 months. The incidence of RTI was 4.32 episodes per child-year (95 % CI 4.03-4.61). 69 (43.13%) children in the group with GHRS suffered from RRTI; there were 48 (32.65%) children in group without GHRS. The risk ratio (RR) value of RRTI occurrence was 1.32 (95 % CI 0.91-1.91, P = 0.139), and the attributable risk percent (AR%) was 24.28%. Dry stool and irritability were positively correlated with RTI episodes, age and BMI were negatively correlated with RTI episodes in a linear regression model. Dry stool (OR = 1.510) was positively correlated with RRTI occurrence, age (OR = 0.889) and BMI (OR = 0.858) were negatively correlated with RRTI occurrence in our logistic regression model. GHRS is associated with RRTI in this cohort. Dry stool was positively associated with RRTI, and BMI was negatively associated with RRTI. Studies with larger sample size and longer follow up are needed to further

  3. Mouse Saliva Inhibits Transit of Influenza Virus to the Lower Respiratory Tract by Efficiently Blocking Influenza Virus Neuraminidase Activity.

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    Gilbertson, Brad; Ng, Wy Ching; Crawford, Simon; McKimm-Breschkin, Jenny L; Brown, Lorena E

    2017-07-15

    We previously identified a novel inhibitor of influenza virus in mouse saliva that halts the progression of susceptible viruses from the upper to the lower respiratory tract of mice in vivo and neutralizes viral infectivity in MDCK cells. Here, we investigated the viral target of the salivary inhibitor by using reverse genetics to create hybrid viruses with some surface proteins derived from an inhibitor-sensitive strain and others from an inhibitor-resistant strain. These viruses demonstrated that the origin of the viral neuraminidase (NA), but not the hemagglutinin or matrix protein, was the determinant of susceptibility to the inhibitor. Comparison of the NA sequences of a panel of H3N2 viruses with differing sensitivities to the salivary inhibitor revealed that surface residues 368 to 370 (N2 numbering) outside the active site played a key role in resistance. Resistant viruses contained an EDS motif at this location, and mutation to either EES or KDS, found in highly susceptible strains, significantly increased in vitro susceptibility to the inhibitor and reduced the ability of the virus to progress to the lungs when the viral inoculum was initially confined to the upper respiratory tract. In the presence of saliva, viral strains with a susceptible NA could not be efficiently released from the surfaces of infected MDCK cells and had reduced enzymatic activity based on their ability to cleave substrate in vitro This work indicates that the mouse has evolved an innate inhibitor similar in function, though not in mechanism, to what humans have created synthetically as an antiviral drug for influenza virus. IMPORTANCE Despite widespread use of experimental pulmonary infection of the laboratory mouse to study influenza virus infection and pathogenesis, to our knowledge, mice do not naturally succumb to influenza. Here, we show that mice produce their own natural form of neuraminidase inhibitor in saliva that stops the virus from reaching the lungs, providing a

  4. Unexpectedly Higher Morbidity and Mortality of Hospitalized Elderly Patients Associated with Rhinovirus Compared with Influenza Virus Respiratory Tract Infection

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    Ivan F. N. Hung

    2017-01-01

    Full Text Available Rhinovirus is a common cause of upper and lower respiratory tract infections in adults, especially among the elderly and immunocompromised. Nevertheless, its clinical characteristics and mortality risks have not been well described. A retrospective analysis on a prospective cohort was conducted in a single teaching hospital center over a one-year period. We compared adult patients hospitalized for pneumonia caused by rhinovirus infection with those hospitalized for influenza infection during the same period. All recruited patients were followed up for at least 3 months up to 15 months. Independent risk factors associated with mortality for rhinovirus infection were identified. Between 1 March 2014 and 28 February 2015, a total of 1946 patients were consecutively included for analysis. Of these, 728 patients were hospitalized for rhinovirus infection and 1218 patients were hospitalized for influenza infection. Significantly more rhinovirus patients were elderly home residents and had chronic lung diseases (p < 0.001, whereas more influenza patients had previous stroke (p = 0.02; otherwise, there were no differences in the Charlson comorbidity indexes between the two groups. More patients in the rhinovirus group developed pneumonia complications (p = 0.03, required oxygen therapy, and had a longer hospitalization period (p < 0.001, whereas more patients in the influenza virus group presented with fever (p < 0.001 and upper respiratory tract symptoms of cough and sore throat (p < 0.001, and developed cardiovascular complications (p < 0.001. The 30-day (p < 0.05, 90-day (p < 0.01, and 1-year (p < 0.01 mortality rate was significantly higher in the rhinovirus group than the influenza virus group. Intensive care unit admission (odds ratio (OR: 9.56; 95% confidence interval (C.I. 2.17–42.18, elderly home residents (OR: 2.60; 95% C.I. 1.56–4.33, requirement of oxygen therapy during hospitalization (OR: 2.62; 95% C.I. 1.62–4.24, and hemoglobin

  5. Yeast-derived β-1,3/1,6 glucan, upper respiratory tract infection and innate immunity in older adults.

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    Fuller, Richard; Moore, Michael V; Lewith, George; Stuart, Beth L; Ormiston, Rory V; Fisk, Helena L; Noakes, Paul S; Calder, Philip C

    The aims of this study were to test whether yeast-derived β-1,3/1,6 glucan can prevent the occurrence or reduce the severity of upper respiratory tract infection (URTI) and modulate innate immune responses during winter months in community-dwelling older adults. This was a double-blind placebo-controlled trial of community-dwelling adults ages 50 to 70 y randomized to once-daily β-1,3/1,6 glucan (Wellmune 250 mg/d; n = 50) or identical placebo capsule (n = 50) over 90 d during winter. URTI episodes were medically confirmed. Symptom severity was recorded via self-reported daily Wisconsin Upper Respiratory Tract Infection Score 21. Blood and saliva samples were collected at days 0, 45, and 90 for measurements of innate immune parameters. Forty-nine participants completed the trial in each group. Supplementation was well tolerated. Forty-five URTIs were confirmed: 28 in the placebo group and 17 in the Wellmune group (odds ratio, 0.55; 95% confidence interval, 0.24-1.26; P = 0.149). There was a strong trend for Wellmune to decrease the number of symptom days (P = 0.067). Symptom severity did not differ significantly between groups. Compared with the placebo group, lipopolysaccharide-stimulated blood from participants in the Wellmune group showed an increase in interferon-γ concentration from baseline at day 45 (P = 0.016) and smaller decreases in monokine induced by interferon-γ concentration from baseline at days 45 and 90 (P = 0.032 and 0.046, respectively). No difference was seen in serum or nonstimulated blood cytokines and chemokines or in salivary immunoglobulin A. Daily oral β-1,3/1,6 glucan may protect against URTIs and reduce the duration of URTI symptoms in older individuals once infected. This may be linked to effects on innate immune function. Larger studies are needed to confirm the benefits of β-1,3/1,6 glucan on URTIs in this older population. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Statistical analysis aiming at predicting respiratory tract disease hospital admissions from environmental variables in the city of São Paulo.

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    de Sousa Zanotti Stagliorio Coêlho, Micheline; Luiz Teixeira Gonçalves, Fabio; do Rosário Dias de Oliveira Latorre, Maria

    2010-01-01

    This study is aimed at creating a stochastic model, named Brazilian Climate and Health Model (BCHM), through Poisson regression, in order to predict the occurrence of hospital respiratory admissions (for children under thirteen years of age) as a function of air pollutants, meteorological variables, and thermal comfort indices (effective temperatures, ET). The data used in this study were obtained from the city of São Paulo, Brazil, between 1997 and 2000. The respiratory tract diseases were divided into three categories: URI (Upper Respiratory tract diseases), LRI (Lower Respiratory tract diseases), and IP (Influenza and Pneumonia). The overall results of URI, LRI, and IP show clear correlation with SO₂ and CO, PM₁₀ and O₃, and PM₁₀, respectively, and the ETw4 (Effective Temperature) for all the three disease groups. It is extremely important to warn the government of the most populated city in Brazil about the outcome of this study, providing it with valuable information in order to help it better manage its resources on behalf of the whole population of the city of Sao Paulo, especially those with low incomes.

  7. Prevention of Pneumococcal Infection in Children with Chronic Diseases of the Nasopharynx Reduces the Incidence of Other Respiratory Tract Infections: Results of a Comparative Prospective Study

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    V. P. Vavilova

    2015-01-01

    Full Text Available Background: A promising approach to solving the problem of widespread infections of the respiratory tract in children is the use ofspecific prophylaxis against the pneumococcus.Objective: Our aim was to examine the clinical efficacy of PCV13 of children with chronic foci of infection in the nasopharynx and the changes of local factors of protection of the upper respiratory tract.Methods: We have evaluated the incidence of respiratory tract and ENT infections in children with chronic diseases of the nasopharynx. Research period: January 2011 — January 2015. Upper airway function examination included cytologic analysis — counting the main cell populations ratio in the common cytoplasm, lysozym activity and secretory immunoglobulin of class A (sIgA in nasal secretions.Results: The study involved 876 children 2–5 years old. Main group (PCV13 amounted to 448 patients, and the control group (unvaccinated 428. Annual dynamic observation showed a significant reduction of acute morbidity by 2 times (p < 0.001, pneumonia by 2.4 times (p = 0.042, acute bronchitis by 2.5 times (p = 0.008, concomitant ENT pathology (acute otitis media and acute exacerbations of chronic sinusitis by 2.2 times (p = 0.001 and 2.3 times (p = 0.004, respectively. There was a positive effect of vaccination on the level of local factors of protection of the upper respiratory tract (lysozyme, sIgA, the somatic cell count in nasal secretions.Conclusion: PCV13 vaccination reduces the risk of developing acute respiratory infections and ENT infections in children with chronic diseases of the nasopharynx. This is against the background of recovery in the levels of factors of local immunity.

  8. Prevalence of antimicrobial resistance among respiratory tract isolates in Latin America: results from SENTRY antimicrobial surveillance program (1997-98).

    Science.gov (United States)

    Sader, H S; Gales, A C; Granacher, T D; Pfaller, M A; Jones, R N

    2000-10-01

    One thousand seventy-three bacterial isolates were collected from patients with community acquired respiratory tract infections (CARTI) in 11 Latin American centers (7 countries) during 1997 and 1998. They were tested against numerous antimicrobial agents by the reference broth microdilution method as part of the ongoing multinational SENTRY Antimicrobial Surveillance Program. Among Streptococcus pneumoniae (553 isolates), approximately 61% were susceptible to penicillin. There was a great variation of the penicillin susceptibility rates among participating countries. The highest susceptibility rates were found in Argentina (76.7%) and Brazil (71.9%), while the lowest rate of penicillin susceptibility was detected in Mexico (33.3%). High level resistance to penicillin and resistance to cefotaxime were observed in nearly 10% of the isolates. The newer quinolones, levofloxacin (MIC(90) 2 microg/mL) and gatifloxacin (MIC90 0.5 microg/mL), were active against 100% of the isolates tested. Among the other non-beta-lactams drugs tested, the rank order of susceptibility against the pneumococci was: chloramphenicol (93.9%)>clindamycin (93.2%)> azithromycin (89.1%) > clarithromycin (88.7%)>tetracycline (78.5%)> trimethoprim/sulfamethoxazole (55.7%). The percentage of Haemophilus influenzae (361 isolates) isolates resistant to amoxicillin was 12. 7% (beta-lactamase positive). Among Moraxella catarrhalis (159 isolates) isolates, only 8.2% were susceptible. Clavulanic acid restored the activity of amoxicillin against both species. Trimethoprim/sulfamethoxazole was active against only 59.5% of H. influenzae, while susceptibility to this compound among M. catarrhalis was 96.1%. All other compounds tested were active against>95% of H. influenzae and M. catarrhalis isolates. These species were susceptible to levofloxacin (MIC90 resistance rates are particularly high among pneumococci in some countries. The newer fluoroquinolones show an excellent potency and spectrum against

  9. Chemosensory TRP channels in the respiratory tract: role in toxic lung injury and potential as "sweet spots" for targeted therapies.

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    Büch, Thomas; Schäfer, Eva; Steinritz, Dirk; Dietrich, Alexander; Gudermann, Thomas

    2013-01-01

    Acute toxic lung injury by reactive inhalational compounds is an important and still unresolved medical problem. Hazardous gases or vapors, e. g. chlorine, phosgene, sulfur mustard or methyl isocyanate, are released during occupational accidents or combustion processes and also represent a potential threat in terroristic scenarios. According to their broad-range chemical reactivity, the mechanism of lung injury evoked by these agents has long been described as rather unspecific. Consequently, therapeutic options are still restricted to symptomatic treatment. However, in recent years, ion channels of the transient receptor potential (TRP) family have been identified to act as specific sensor molecules expressed in the respiratory tract and to engage defined signaling pathways upon inhalational exposure to toxic challenges. These pulmonary receptor molecules have been primarily characterized in sensory neurons of the lung. However, chemosensory molecules are also expressed in non-neuronal cells, e.g. in the lung epithelium as well as in the pulmonary vasculature. Thus, activation of respiratory chemosensors by toxic inhalants promotes a complex signaling network directly or indirectly regulating pulmonary blood flow, the integrity of the epithelial lining, and the mucociliary clearance of the bronchial system. This review gives a synopsis on reactive lung-toxic agents and their specific target molecules in the lung and summarizes the current knowledge about the pathophysiological role of chemosensory signaling in neuronal and non-neuronal cells in toxic lung injury. Finally, we describe possible future strategies for a causal, specifically tailored treatment option based on the mechanistic understanding of molecular events ensuing inhalation of lung-toxic agents.

  10. SIgA response and incidence of upper respiratory tract infections during intensified training in youth basketball players

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    H Moraes

    2016-12-01

    Full Text Available The aim of the present study was to examine the effect of an intensified training phase followed by a tapering phase on the salivary immunoglobulin A concentration and on the upper respiratory tract infection (URTI symptoms in young male basketball players. The session rating of perceived exertion method was used to quantify the internal training load, and the Wisconsin Upper Respiratory Symptom Survey-21 questionnaire was used to assess URTI symptoms. The Yo-Yo IR1 test and saliva collection were carried out at the beginning of the study (T1, after the intensified phase (T2, and after tapering (T3. A higher internal training load was observed for the intensified phase compared with the tapering phase (t=19.10; p<0.001, and a significant decrease in salivary immunoglobulin A concentration was detected (F=7.48; p=0.004 at T3 compared to T1 (p=0.02 and T2 (p=0.05. However, there was no significant difference between phases for severity of URTI (χ2= 2.83; p=0.242. The Yo-Yo IR1 test performance increased from T2 and T3 compared to T1 (F=58.24; p<0.001. There was no significant effect of aerobic fitness level on salivary immunoglobulin A response (F=1.095; p=0.344. In summary, the present findings suggest that an intensified training load followed by a tapering period negatively affects the mucosal immune function with no significant change in severity of URTI in young basketball players.

  11. Association between air pollution and general outpatient clinic consultations for upper respiratory tract infections in Hong Kong.

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    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.

  12. Appropriateness of antibiotic prescribing for upper respiratory tract infections in general practice: Comparison between Denmark and Iceland.

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    Rún Sigurðardóttir, Nanna; Nielsen, Anni Brit Sternhagen; Munck, Anders; Bjerrum, Lars

    2015-01-01

    To compare the appropriateness of antibiotic prescribing for upper respiratory tract infections (URTIs) in two countries with different prevalence of antimicrobial resistance: Denmark and Iceland. A cross-sectional study. General practitioners (GPs) in Denmark (n = 78) and Iceland (n = 21) registered all patients with URTI according to the Audit Project Odense (APO) method during a three-week period in the winter months of 2008 and 2009. Appropriateness of antibiotic prescribing in patients with URTI in Denmark and Iceland. A total of 1428 patients were registered (Denmark: n = 1208; Iceland: n = 220). A majority of patients in both countries were prescribed antibiotics, and only a minority of the prescriptions could be classified as appropriate prescribing. In general, Icelandic GPs more often prescribed antibiotics (Iceland = 75.8% vs. Denmark = 59.3%), but Danish GPs had a higher percentage of inappropriate antibiotic prescribing for sinusitis, and Icelandic GPs for pharyngotonsillitis. No differences were found for acute otitis media (AOM). The different antibiotic prescribing patterns between Denmark and Iceland could not fully be explained by different symptoms and signs among patients. Icelandic GPs have a higher antibiotic prescribing rate compared with Danish GPs, but the percentage of inappropriate antibiotic prescribing is highest in Denmark for sinusitis, and in Iceland for pharyngotonsillitis. Key points Within the Nordic countries there are marked differences in antimicrobial resistance and antibiotic use. Iceland differs from Denmark by a higher antibiotic prescribing rate and a higher prevalence of antimicrobial resistance. The majority of antibiotics are prescribed in primary care and most often for upper respiratory infections (URTIs). Only a minor amount of antibiotic prescriptions for URTIs can be classified as appropriate; inappropriate antibiotic prescribing is higher in Denmark than in Iceland for sinusitis and the opposite for

  13. Association between air pollution and general outpatient clinic consultations for upper respiratory tract infections in Hong Kong.

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    Tam, Wilson W S; Wong, Tze Wai; Ng, Lorna; Wong, Samuel Y S; Kung, Kenny K L; Wong, Andromeda H S

    2014-01-01

    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. 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. 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. 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.

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

    Science.gov (United States)

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

    2014-10-27

    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 and middle-aged adults. Data are reported for 568 UK general practices contributing to the Clinical Practice Research Datalink. Participants were adults aged 18-59 years. Consultations were identified for acute upper RTIs including colds, cough, otitis-media, rhino-sinusitis and sore throat. For each consultation, we identified whether an antibiotic was prescribed. The proportion of RTI consultations with antibiotics prescribed was estimated. There were 568 general practices analysed. The median general practice prescribed antibiotics at 54% of RTI consultations. At the highest prescribing 10% of practices, antibiotics were prescribed at 69% of RTI consultations. At the lowest prescribing 10% of practices, antibiotics were prescribed at 39% RTI consultations. The median practice prescribed antibiotics at 38% of consultations for 'colds and upper RTIs', 48% for 'cough and bronchitis', 60% for 'sore throat', 60% for 'otitis-media' and 91% for 'rhino-sinusitis'. The highest prescribing 10% of practices issued antibiotic prescriptions at 72% of consultations for 'colds', 67% for 'cough', 78% for 'sore throat', 90% for 'otitis-media' and 100% for 'rhino-sinusitis'. Most UK general practices prescribe antibiotics to young and middle-aged adults with respiratory infections at rates that are considerably in excess of what is clinically justified. This will fuel antibiotic resistance. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  15. Adenovirus serotype 7 associated with a severe lower respiratory tract disease outbreak in infants in Shaanxi Province, China

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    Xu Wenbo

    2011-01-01

    Full Text Available Abstract Background Pneumonia caused by adenovirus infection is usually severe especially with adenovirus serotype 7 commonly associated with lower respiratory tract disease outbreaks. We reported an outbreak of 70 cases of severe pneumonia with one death of infants in Shaanxi Province, China. Sampling showed adenovirus 7 (Ad7 as the primary pathogen with some co-infections. Results Two strains of adenovirus and two strains of enterovirus were isolated, the 21 pharynx swabs showed 14 positive amplifications for adenovirus; three co-infections with respiratory syncytial virus, two positive for rhinovirus, one positive for parainfluenza 3, and four negative. Adenovirus typing showed nine of the nine adenovirus positive samples were HAdV-7, three were HAdV-3 and two were too weak to perform sequencing. The entire hexon gene of adenovirus was sequenced and analyzed for the two adenovirus serotype 7 isolates, showing the nucleic acid homology was 99.8% between the two strains and 99.5% compared to the reference strain HAdV-7 (GenBank accession number AY769946. For the 21 acute phase serum samples from the 21 patients, six samples had positives results for ELISA detection of HAdV IgA, and the neutralization titers of the convalescent-phase samples were four times higher than those of the acute-phase samples in nine pairs. Conclusions We concluded adenovirus was the viral pathogen, primarily HAdV-7, with some co-infections responsible for the outbreak. This is the first report of an infant pneumonia outbreak caused by adenovirus serotype 7 in Shaanxi Province, China.

  16. The cost-effectiveness of OM-85 in managing respiratory tract infections in China.

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    Xuan, Jianwei; Wang, Lijie; Yin, Hongjun; Xuan, Dennis; Zhou, Yan; Hu, Shanlian

    2015-03-01

    To demonstrate the health economic impact of OM-85, a bacterial lysates based immunostimulant, for its approved indications in China. A cost-effectiveness decision tree model was constructed comparing OM-85 with the best supportive care/placebo therapy for managing the acute exacerbation of chronic bronchitis and rhinosinusitis in the Chinese population. Clinical efficacy and adverse events (AE) data were included in the model based on a thorough literature review. All localized direct treatment costs, including drug cost, AE costs, and medical treatment costs for underlining diseases were included from a Chinese third party payer perspective. A Key Opinion Leaders (KOL) survey was conducted with 20 senior physicians specialized in respiratory, ENT, allergy, and immunology fields from tertiary hospitals in Beijing, Shanghai, Guangzhou, Hangzhou, Shenyang, and Wuhan to validate the local treatment costs. Incremental cost-effectiveness ratio (ICER) was calculated based on the above efficacy and cost information. OM-85 is a cost-effective therapy when compared with placebo (standard care). OM-85 can treat/prevent one additional full episode exacerbation of chronic bronchitis and one additional full episode exacerbation of rhinosinusitis with only additional costs of RMB 653 and RMB 1182.84, respectively. In comparison, each acute exacerbation of chronic bronchitis will cost RMB 4510.10, and each acute exacerbation of rhinosinuisitis will cost RMB 1807.21 in a Chinese clinical management setting. One-way sensitivity analyses were performed and the ICER result was demonstrated to be consistent. OM 85 reduces acute exacerbations among patients with chronic bronchitis and chronic rhinosinusitis when compared with Placebo (standard care). From a Chinese payer perspective, OM 85 is a cost-effective therapy in the clinical management of both chronic bronchitis and rhinosinusitis in the adult population.

  17. Hospital Outcomes of Adult Respiratory Tract Infections with Extended-Spectrum B-Lactamase (ESBL) Producing Klebsiella Pneumoniae

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    Loh, Li-Cher; Nor Izran Hanim bt Abdul Samad; Rosdara Masayuni bt Mohd Sani; Raman, Sree; Thayaparan, Tarmizi; Kumar, Shalini

    2007-01-01

    Klebsiella pneumoniae ranks high as a cause of adult pneumonia requiring hospitalization in Malaysia. To study whether extended-spectrum b-lactamase (ESBL) producing K. pneumoniae was linked to hospital outcomes, we retrospectively studied 441 cases of adult respiratory tract infections with microbial proven K. pneumoniae from an urban-based university teaching hospital between 2003 and 2004. 47 (10.6%) cases had ESBL. Requirement for ventilation and median length of hospital stay, were greater in ‘ESBL’ than in ‘non-ESBL’ group [34% vs. 7.4%, p<0.001; 14 days vs. 5 days, p<0.001 respectively] but not crude hospital mortality rate [21.3% vs. 12.4%, p=0.092]. There was a four-fold increased risk of requiring ventilation [4.61 (2.72–7.85)] when ESBL was present. Our findings support the association of ESBL producing K. pneumoniae with adversed hospital outcomes and reiterate the need for vigilance on the part of treating clinicians. PMID:22993489

  18. 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.

  19. Density, Serotype Diversity, and Fitness of Streptococcus pneumoniae in Upper Respiratory Tract Cocolonization With Nontypeable Haemophilus influenzae.

    Science.gov (United States)

    Lewnard, Joseph A; Huppert, Amit; Givon-Lavi, Noga; Pettigrew, Melinda M; Regev-Yochay, Gili; Dagan, Ron; Weinberger, Daniel M

    2016-11-01

     Coinfections by Streptococcus pneumoniae and nontypeable Haemophilus influenzae (NTHi) are frequently implicated in complex otitis media. Whereas upper respiratory tract carriage precedes disease for both pathogens, interactions between species in cocolonized hosts are poorly understood. We compared colonization densities and the diversity and fitness of pneumococcal serotypes in single-species and mixed-species colonization.  We analyzed nasopharyngeal pneumococcal carriage and nasopharyngeal and oropharyngeal NTHi carriage in 13 541 samples collected over 6909 study visits from 769 children 2-30 months old in a 7-valent pneumococcal conjugate vaccine dosing trial. We measured density associations between the species and compared pneumococcal serotype diversity during and in the absence of NTHi colonization. We used logistic regression to quantify associations between NTHi colonization and previously published pneumococcal serotype factors related to fitness.  Densities of the 2 species were positively associated when they co-occur in the nasopharynx. NTHi colonization was associated with reduced pneumococcal serotype diversity among children 2-18 months old and was more prevalent among children carrying pneumococcal serotypes with greater capsular thickness, neutrophil resistance, and metabolic efficiency.  Pneumococcal-NTHi cocolonization is associated with an elevated density of both species and with reduced diversity and increased fitness of pneumococcal serotypes. NTHi colonization may create a selective environment favoring pneumococci with immune-evasive phenotypes. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  20. Utility of bronchoalveolar lavage in diagnosing respiratory tract infections in patients with hematological malignancies: are invasive diagnostics still needed?

    Science.gov (United States)

    Svensson, Tobias; Lundström, Kristina Lamberg; Höglund, Martin; Cherif, Honar

    2017-03-01

    Patients treated for hematological malignancies have an increased risk of serious infections. Diagnosis and prompt initiation of therapy are essential. Bronchoalveolar lavage (BAL) is a well-established investigation for identifying the cause of pulmonary infiltrates in immunocompromised patients. The aim of the study was to determine the diagnostic yield of BAL in patients treated for hematological malignancies and how often it contributed to a modification of the anti-infectious therapy. We reviewed records from 151 consecutive BAL procedures in 133 adult patients with hematological malignancies, treated at a tertiary hematology unit from 2004 to 2013. Extensive microbiological work-ups on BAL samples had been performed according to a standardized protocol. A microbiological finding causing the infectious episode could be identified in 59 (39%) cases. In 44 (29%) of the cases, results from BAL had an impact on clinical management either by contributing to a specific diagnosis (25%) or by leading to cessation of ongoing microbiological therapy. The most common diagnoses were invasive pulmonary aspergillosis (IPA) and Pneumocystis jirovecii pneumonia (PJP). Diagnoses of IPA and PJP were based on results from BAL in 65% and 93% of cases, respectively. Several microbiological tests on BAL samples rendered no positive results. Complications were few and mainly mild. BAL is still important for either verifying or excluding some of the most important respiratory tract pathogens in patients with hematological malignancies, particularly IPA and PJP. Standardized procedures for BAL sampling should be continually revised to exclude unnecessary microbiological tests.

  1. 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.

  2. 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 (presistance.

  3. The consumption of propolis and royal jelly in preventing upper respiratory tract infections and as dietary supplementation in children

    Directory of Open Access Journals (Sweden)

    Sevda Yuksel

    2016-09-01

    Full Text Available Propolis and royal jelly (RJ, two important honeybee products, have been used commonly all over the World as traditional and ethnopharmacological nutrients since ancient times. Both of them have a lot of active ingredients, which are known to be effective for several medical conditions. In this article, medical databases were searched for the usage of RJ and propolis in upper respiratory tract infections (URTI and as a dietary supplementation, together and separately. 10-hydroxy-2-decenoic acid (10-HDA is the most prominent active compound showing antimicrobial effect within RJ. Caffeic acid phenethyl ester (CAPE is the most famous one that shows antimicrobial and anti-inflammatory effect within propolis. When compared with propolis, RJ was found to have richer content for all three main nutrients; proteins, carbohydrates, and lipids. More clinical, experimental, and basic studies are needed to find out the best-standardized mixture to cope with URTI in which RJ and propolis will be main ingredients in addition to the other secondary compounds that have health-beneficial effects. [J Complement Med Res 2016; 5(3.000: 308-311

  4. Calcification of the lower respiratory tract in relation to flight development in Jamaican fruit bats (Phyllostomidae, Artibeus jamaicensis).

    Science.gov (United States)

    Carter, Richard T

    2017-04-01

    The production of echolocation calls in bats along with forces produced by contraction of thoracic musculature used in flight presumably puts relatively high mechanical loads on the lower respiratory tract (LRT). Thus, there are likely adaptations to prevent collapse or distortion of the bronchial tree and trachea during flight in echolocating bats. By clearing and staining (Alcian blue and Alizarin red) LRTs removed from nonvolant neonates, semivolant juveniles, volant subadults, and adult Jamaican fruit bats (Artibeus jamaicensis), I found that calcification of the tracheal, primary bronchial, and secondary bronchial (lobar) cartilage rings occurs over the span of about 3 days and coincides with later developmental stages of flight and the increased production of echolocation calls. Tracheal rings that are immediately adjacent to the larynx calcified first, followed by more caudal tracheal rings and then the rings of the primary and secondary bronchi. I suggest that calcification of LRT cartilage rings in echolocating bats provides increased rigidity to counter the thoracic compressions incurred during flight. Calcification of the LRT rings is an adaptation to support the emission of laryngeally produced echolocation calls during flight in bats. © 2016 Anatomical Society.

  5. Inter-observer variation in the interpretation of chest radiographs for pneumonia in community-acquired lower respiratory tract infections

    International Nuclear Information System (INIS)

    Hopstaken, R.M.; Witbraad, T.; Engelshoven, J.M.A. van; Dinant, G.J.

    2004-01-01

    AIM: To assess inter-observer variation in the interpretation of chest radiographs of individuals with pneumonia versus those without pneumonia. MATERIALS AND METHODS: Chest radiographs of out-patients with a lower respiratory tract infection (LRTI) were assessed for the presence of infiltrates by radiologists from three local hospitals and were reassessed by one university hospital radiologist. Various measures of inter-observer agreement were calculated. RESULTS: The observed proportional agreement was 218 in 243 patients (89.7%). Kappa was 0.53 (moderate agreement) with a 95% confidence interval of 0.37 to 0.69. The observed positive agreement (59%) was much lower than for negative agreement (94%). Kappa was considerably lower, if chronic obstructive pulmonary disease was present (κ=0.20) or Streptococcus pneumoniae (κ=-0.29) was the infective agent. CONCLUSION: The overall inter-observer agreement adjusted for chance was moderate. Inter-observer agreement in cases with pneumonia was much worse than the agreement in negative (i.e. non-pneumonia) cases. A general practitioner's selection of patients with a higher chance of having pneumonia for chest radiography would thus not improve the observer agreement

  6. Indoor air quality and risk of severe lower respiratory tract infection in Inuit infants in Baffin Region, Nunavut

    Energy Technology Data Exchange (ETDEWEB)

    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.

  7. General practitioners' knowledge, attitude and prescribing of antibiotics for upper respiratory tract infections in Selangor, Malaysia: findings and implications.

    Science.gov (United States)

    Hassali, Mohamed Azmi; Kamil, Tengku Karmila Tengku; Md Yusof, Faridah Aryani; Alrasheedy, Alian A; Yusoff, Zuraidah Mohd; Saleem, Fahad; Al-Tamimi, Saleh Karamah; Wong, Zhi Yen; Aljadhey, Hisham; Godman, Brian

    2015-04-01

    Antibiotics are widely prescribed especially for upper respiratory tract infections (URTIs). Their irrational use can increase costs and resistance. Assess knowledge, attitude and prescribing of antibiotics for URTIs in Selangor, Malaysia, using a cross-sectional survey among general practitioners (GPs) working in private clinics in 2011. One hundred and thirty-nine physicians completed the questionnaire (response rate = 34.8%). 49.6% (n = 69) agreed antibiotics are helpful in treating URTIs, with most GPs agreeing antibiotics may reduce URTI duration and complications. The majority of GPs reported they felt patients expected antibiotics, with 36.7% (n = 51) agreeing patients would change doctors if they did not prescribe antibiotics and 21.6% (n = 30) agreeing when requested they prescribe antibiotics even if they believe them to be unnecessary. When assessed against six criteria, most GPs had a moderate level of knowledge of prescribing for URTIs. However, antibiotic prescriptions could be appreciably reduced. Further programs are needed to educate GPs and patients about antibiotics building on current initiatives.

  8. Oral cholera vaccination promotes homing of IgA+ memory B cells to the large intestine and the respiratory tract.

    Science.gov (United States)

    van Splunter, M; van Hoffen, E; Floris-Vollenbroek, E G; Timmerman, H; de Bos, E Lucas-van; Meijer, B; Ulfman, L H; Witteman, B; Wells, J M; Brugman, S; Savelkoul, H F J; van Neerven, R J J

    2018-02-21

    Oral cholera vaccination is used to induce immune responses in the intestines to protect against cholera infection. However, oral vaccination may also affect immune responses in other mucosal tissues. To study this, tissue-specific homing potential and kinetics of B-cell responses were characterized after oral cholera vaccination. Healthy adult volunteers received two doses of Dukoral® and blood, saliva, nasal wash, and fecal samples were collected over time to detect vaccine-specific antibodies. Additionally, homing potential of lymphocytes to small intestine, colon, airways, skin, and periphery was measured by expression of Integrin β1 and β7, CCR9, CCR10, CCR7, and CLA. After vaccination, antibody responses to cholera toxin B (CTB) and Dukoral® were detected in serum and nasal wash. CTB-specific memory B cells in peripheral blood and tissue homing profiles of memory B cells peaked at day 18. IgA + memory B cells expressed markers that enable homing to the airways and colon, while IgA - memory B cells primarily expressed small-intestine-homing markers. These data show that oral cholera vaccination has a differential effect on immune responses in various mucosal sites, including the respiratory tract.

  9. Coal Mine Air Pollution and Number of Children Hospitalizations because of Respiratory Tract Infection: A Time Series Analysis

    Directory of Open Access Journals (Sweden)

    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.

  10. Is Higher Viral Load in the Upper Respiratory Tract Associated With Severe Pneumonia? Findings From the PERCH Study

    Science.gov (United States)

    Fu, Wei; Park, Daniel E.; Shi, Qiyuan; Higdon, Melissa M.; Baggett, Henry C.; Brooks, W. Abdullah; Deloria Knoll, Maria; Hammitt, Laura L.; Howie, Stephen R. C.; Kotloff, Karen L.; Levine, Orin S.; Madhi, Shabir A.; Scott, J. Anthony G.; Thea, Donald M.; Adrian, Peter V.; Antonio, Martin; Awori, Juliet O.; Baillie, Vicky L.; DeLuca, Andrea N.; Driscoll, Amanda J.; Ebruke, Bernard E.; Goswami, Doli; Karron, Ruth A.; Li, Mengying; Morpeth, Susan C.; Mwaba, John; Mwansa, James; Prosperi, Christine; Sawatwong, Pongpun; Sow, Samba O.; Tapia, Milagritos D.; Whistler, Toni; Zaman, Khalequ; Zeger, Scott L.; O’ Brien, Katherine L.; Murdoch, David R.; O’Brien, Katherine L.; Levine, Orin S.; Knoll, Maria Deloria; Feikin, Daniel R.; DeLuca, Andrea N.; Driscoll, Amanda J.; Fancourt, Nicholas; Fu, Wei; Hammitt, Laura L.; Higdon, Melissa M.; Kagucia, E. Wangeci; Karron, Ruth A.; Li, Mengying; Park, Daniel E.; Prosperi, Christine; Wu, Zhenke; Zeger, Scott L.; Watson, Nora L.; Crawley, Jane; Murdoch, David R.; Brooks, W. Abdullah; Endtz, Hubert P.; Zaman, Khalequ; Goswami, Doli; Hossain, Lokman; Jahan, Yasmin; Ashraf, Hasan; Howie, Stephen R. C.; Ebruke, Bernard E.; Antonio, Martin; McLellan, Jessica; Machuka, Eunice; Shamsul, Arifin; Zaman, Syed M.A.; Mackenzie, Grant; Scott, J. Anthony G.; Awori, Juliet O.; Morpeth, Susan C.; Kamau, Alice; Kazungu, Sidi; Ominde, Micah Silaba; Kotloff, Karen L.; Tapia, Milagritos D.; Sow, Samba O.; Sylla, Mamadou; Tamboura, Boubou; Onwuchekwa, Uma; Kourouma, Nana; Toure, Aliou; Madhi, Shabir A.; Moore, David P.; Adrian, Peter V.; Baillie, Vicky L.; Kuwanda, Locadiah; Mudau, Azwifarwi; Groome, Michelle J.; Mahomed, Nasreen; Baggett, Henry C.; Thamthitiwat, Somsak; Maloney, Susan A.; Bunthi, Charatdao; Rhodes, Julia; Sawatwong, Pongpun; Akarasewi, Pasakorn; Thea, Donald M.; Mwananyanda, Lawrence; Chipeta, James; Seidenberg, Phil; Mwansa, James; wa Somwe, Somwe; Kwenda, Geoffrey; Anderson, Trevor P.; Mitchell, Joanne

    2017-01-01

    Abstract Background. The etiologic inference of identifying a pathogen in the upper respiratory tract (URT) of children with pneumonia is unclear. To determine if viral load could provide evidence of causality of pneumonia, we compared viral load in the URT of children with World Health Organization–defined severe and very severe pneumonia and age-matched community controls. Methods. In the 9 developing country sites, nasopharyngeal/oropharyngeal swabs from children with and without pneumonia were tested using quantitative real-time polymerase chain reaction for 17 viruses. The association of viral load with case status was evaluated using logistic regression. Receiver operating characteristic (ROC) curves were constructed to determine optimal discriminatory viral load cutoffs. Viral load density distributions were plotted. Results. The mean viral load was higher in cases than controls for 7 viruses. However, there was substantial overlap in viral load distribution of cases and controls for all viruses. ROC curves to determine the optimal viral load cutoff produced an area under the curve of <0.80 for all viruses, suggesting poor to fair discrimination between cases and controls. Fatal and very severe pneumonia cases did not have higher viral load than less severe cases for most viruses. Conclusions. Although we found higher viral loads among pneumonia cases than controls for some viruses, the utility in using viral load of URT specimens to define viral pneumonia was equivocal. Our analysis was limited by lack of a gold standard for viral pneumonia. PMID:28575373

  11. Acute fibrinous and organizing pneumonia masquerading as a lower respiratory tract infection: a case report and review of the literature.

    Science.gov (United States)

    Akhtar, Aftab; Ul Abideen, Zain

    2015-02-10

    Acute Fibrinous and Organizing Pneumonia is a rare entity characterized by the histological pattern suggestive of diffuse alveolar damage, eosinophilic pneumonia and organizing pneumonia; the presence of intra alveolar "fibrin balls" distinguishes it from these conditions. Herein, we describe the association of acute fibrinous and organizing pneumonia with a respiratory tract infection. We believe that such an association has been extremely rarely described. We report the case of a 68 year old female patient of Afghan descent who presented with shortness of breath, cough and high grade fever not responding satisfactorily to standard antibiotic therapy. Imaging revealed bilateral basilar infiltrates and ground glass opacification of the right lower lung zone. Though the inflammatory markers decreased with antibiotic therapy, there was minimal improvement in the patient's symptoms and radiological appearance of the lungs. Bronchoscopy was refused by the patient's family and a Computed Tomography guided biopsy of the lung revealed a histological diagnosis of acute fibrinous and organizing pneumonia. Patient was initiated on high dose intravenous corticosteroid therapy followed by a maintenance dose of prednisolone at 40 mg/day. She recovered dramatically. However, due to poor compliance with treatment, she relapsed and was re-treated with the same regimen. Currently she is completely symptom free and is on a tapering corticosteroid dose. We conclude that AFOP may be a rare but under diagnosed entity and recommend that it should be considered in the differentials of a suspected pulmonary infection unresponsive to optimum antibiotic therapy.

  12. Identifying volatile metabolite signatures for the diagnosis of bacterial respiratory tract infection using electronic nose technology: A pilot study.

    Directory of Open Access Journals (Sweden)

    Joseph M Lewis

    Full Text Available New point of care diagnostics are urgently needed to reduce the over-prescription of antimicrobials for bacterial respiratory tract infection (RTI. We performed a pilot cross sectional study to assess the feasibility of gas-capillary column ion mobility spectrometer (GC-IMS, for the analysis of volatile organic compounds (VOC in exhaled breath to diagnose bacterial RTI in hospital inpatients.71 patients were prospectively recruited from the Acute Medical Unit of the Royal Liverpool University Hospital between March and May 2016 and classified as confirmed or probable bacterial or viral RTI on the basis of microbiologic, biochemical and radiologic testing. Breath samples were collected at the patient's bedside directly into the electronic nose device, which recorded a VOC spectrum for each sample. Sparse principal component analysis and sparse logistic regression were used to develop a diagnostic model to classify VOC spectra as being caused by bacterial or non-bacterial RTI.Summary area under the receiver operator characteristic curve was 0.73 (95% CI 0.61-0.86, summary sensitivity and specificity were 62% (95% CI 41-80% and 80% (95% CI 64-91% respectively (p = 0.00147.GC-IMS analysis of exhaled VOC for the diagnosis of bacterial RTI shows promise in this pilot study and further trials are warranted to assess this technique.

  13. Is acute idiopathic pericarditis associated with recent upper respiratory tract infection or gastroenteritis? A case–control study

    Science.gov (United States)

    Rey, Florian; Delhumeau-Cartier, Cecile; Meyer, Philippe; Genne, Daniel

    2015-01-01

    Objectives The aim of this study was to assess the association of a clinical diagnosis of acute idiopathic pericarditis (AIP), and a reported upper respiratory tract infection (URTI) or gastroenteritis (GE) in the preceding month. Design Patients who were hospitalised with a first diagnosis of AIP were retrospectively compared with a control group of patients admitted with deep vein thrombosis (DVT), matched by gender and age. Setting Primary and secondary care level; one hospital serving a population of about 170 000. Participants A total of 51 patients with AIP were included, of whom 46 could be matched with 46 patients with control DVT. Only patients with a complete review of systems on the admission note were included in the study. Main outcome measure Conditional logistic regression was used to assess the association of a clinical diagnosis of AIP and an infectious episode (URTI or GE) in the month preceding AIP diagnosis. Results Patients with AIP had more often experienced a recent episode of URTI or GE than patients with DVT (39.1% vs 10.9%, p=0.002). The multivariate conditional regression showed that AIP was independently associated with URTI or GE in the last month preceding diagnosis (OR=37.18, 95% CI=1.91 to 724.98, p=0.017). Conclusions This is, to the best of our knowledge, the first study demonstrating an association between a recent episode of URTI or GE and a clinical diagnosis of AIP. PMID:26603247

  14. 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 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.

  15. Expression of SCGB1C1 gene as a potential marker of susceptibility to upper respiratory tract infections in elite athletes ? a pilot study

    OpenAIRE

    Orysiak, J; Malczewska-Lenczowska, J; Bik-Multanowski, M

    2016-01-01

    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 infecti...

  16. Converting habits of antibiotic prescribing for respiratory tract infections in German primary care--the cluster-randomized controlled CHANGE-2 trial.

    Science.gov (United States)

    Altiner, Attila; Berner, Reinhard; Diener, Annette; Feldmeier, Gregor; Köchling, Anna; Löffler, Christin; Schröder, Helmut; Siegel, Achim; Wollny, Anja; Kern, Winfried V

    2012-12-20

    With an average prescription rate of 50%, in German primary care antibiotics are still too frequently prescribed for respiratory tract infections. The over-prescription of antibiotics is often explained by perceived patient pressure and fears of a complicated disease progression. The CHANGE-2 trial will test the effectiveness of two interventions to reduce the rate of inappropriate antibiotic prescriptions for adults and children suffering from respiratory tract infections in German primary care. The study is a three-arm cluster-randomized controlled trial that measures antibiotic prescription rates over three successive winter periods and reverts to administrative data of the German statutory health insurance company AOK. More than 30,000 patients in two regions of Germany, who visit their general practitioner or pediatrician for respiratory tract infections will be included. Interventions are: A) communication training for general practitioners and pediatricians and B) intervention A plus point-of-care testing. Both interventions are tested against usual care. Outcome measure is the physicians' antibiotic prescription rate for respiratory tract infections derived from data of the health insurance company AOK. Secondary outcomes include reconsultation rate, complications, and hospital admissions. Major aim of the study is to improve the process of decision-making and to ensure that patients who are likely to benefit from antibiotics are treated accordingly. Our approach is simple to implement and might be used rapidly among general practitioners and pediatricians. We expect the results of this trial to have major impact on antibiotic prescription strategies and practices in Germany, both among general practitioners and pediatricians. The study is registered at the Current Controlled Trials Ltd (ISRCTN01559032).

  17. GC-MS analysis of leaf extracts of Terminalia macroptera and Dioclea reflexa, two medicinal plants used for the treatment of respiratory tract disorders

    OpenAIRE

    Theresa Ibibia Edewor; Nimotalai Olabisi Kazeem; Stephen Oluwagbemiga Owa

    2016-01-01

    Objective: To analyze the phytochemicals that are present in two medicinal plants which are used for the treatment of respiratory tract infections by gas chromatography-mass spectrometer. Methods: The plant leaves were extracted with n-hexane and methanol separately. Both extracts were analyzed for present phytochemicals using the method described by Harborne, 1985 while only methanol extracts were subjected to gas chromatography-mass spectrometer analysis. Results: Phytoche...

  18. Comparative in vitro activities of ceftaroline and ceftriaxone against bacterial pathogens associated with respiratory tract infections: results from the AWARE surveillance study.

    Science.gov (United States)

    Biedenbach, D J; Iaconis, J P; Sahm, D F

    2016-12-01

    Ceftaroline fosamil is indicated for the treatment of community-acquired bacterial pneumonia and ceftriaxone has an indication for lower respiratory tract infections. This study was conducted to compare the relative in vitro activities of these two agents against bacterial species associated with community-associated respiratory tract infections. In all, 13 005 isolates of Staphylococcus aureus, Streptococcus pneumoniae, Moraxella catarrhalis and Haemophilus influenzae were collected in 2012-14 from 39 countries in the Asia-Pacific region, Europe, Latin America and Africa-Middle East from respiratory tract specimens. The identification was confirmed centrally by MALDI-TOF and broth microdilution susceptibility testing and interpretation was done according to CLSI guidelines. Ceftaroline was 16-fold more potent against MSSA (MIC 90 0.25 versus 4 mg/L) than ceftriaxone and ≥16-fold more potent against MRSA (MIC 90 2 versus >32 mg/L). Ceftaroline was 16-fold more potent against S. pneumoniae (MIC 90 0.12-0.25 mg/L) compared with ceftriaxone (MIC 90 1-2 mg/L), with higher MIC values observed among penicillin-non-susceptible isolates for both agents. Similar activity (MIC 90 ≤0.03 mg/L) was observed for ceftaroline and ceftriaxone against H. influenzae, with higher MIC values observed in the Asia-Pacific region for both agents compared with other regions. Ceftaroline was 4- to 8-fold more active against M. catarrhalis (MIC 90 0.12-0.25 mg/L) compared with ceftriaxone (MIC 90 1 mg/L). These global MIC data demonstrated that ceftaroline exhibited superior in vitro activity compared with ceftriaxone against bacterial species that commonly cause community-associated respiratory tract infections. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  19. Pyopneumothorax following kerosene poisoning.

    Science.gov (United States)

    Chaudhary, Shyam Chand; Sawlani, Kamal Kumar; Yathish, B E; Singh, Ambukeshwar; Kumar, Suresh; Parihar, Anit

    2014-01-01

    Kerosene poisoning is a common poisoning in India especially in childhood, and clinical spectrum can range from meager chemical pneumonitis to grave complications such as hypoxia, pneumothorax, pneumomediastinum, and emphysema. Pyopneumothorax that may require aggressive management in the form of thoracotomy has not been reported in literature. We hereby report a 22-year young female who had developed series of respiratory complications including pyopneumothorax following ingestion of kerosene with suicidal intent and was treated successfully.

  20. Cartap Hydrochloride Poisoning.

    Science.gov (United States)

    Kalyaniwala, Kimmin; Abhilash, Kpp; Victor, Peter John

    2016-08-01

    Cartap hydrochloride is a moderately hazardous nereistoxin insecticide that is increasingly used for deliberate self-harm in India. It can cause neuromuscular weakness resulting in respiratory failure. We report a patient with 4% Cartap hydrochloride poisoning who required mechanical ventilation for 36-hours. He recovered without any neurological deficits. We also review literature on Cartap hydrochloride poisoning. © Journal of the Association of Physicians of India 2011.

  1. Screening of the antibacterial effects of a variety of essential oils on respiratory tract pathogens, using a modified dilution assay method.

    Science.gov (United States)

    Inouye, S; Yamaguchi, H; Takizawa, T

    2001-12-01

    The purpose of this study was to examine the antibacterial effects of a wide variety of essential oils on major respiratory tract pathogens. The antibacterial activity of 14 essential oils and their major components was evaluated by agar-plate dilution assay under sealed conditions, with agar used as a stabilizer for homogeneous dispersion. Of the selected strains of four major bacteria causing respiratory tract infection, Haemophilus influenzae was most susceptible to the essential oils, followed by Streptococcus pneumoniae and Streptococcus pyogenes. Staphylococcus aureus was less susceptible. No cross-resistance was observed between penicillin-sensitive and penicillin-resistant S. pneumoniae. Escherichia coli, used as a control bacterium, showed the lowest susceptibility. Essential oils containing aldehyde or phenol as a major component showed the highest antibacterial activity, followed by the essential oils containing terpene alcohols. Other essential oils, containing terpene ketone, or ether, had much weaker activity, and an oil containing terpene hydrocarbon was inactive. Based on these findings, thyme (wild, red, and geraniol types), cinnamon bark, lemongrass, perilla, and peppermint oils were selected for further evaluation of their effects on respiratory tract infection.

  2. Needle-free delivery of measles virus vaccine to the lower respiratory tract of non-human primates elicits optimal immunity and protection.

    Science.gov (United States)

    de Swart, Rik L; de Vries, Rory D; Rennick, Linda J; van Amerongen, Geert; McQuaid, Stephen; Verburgh, R Joyce; Yüksel, Selma; de Jong, Alwin; Lemon, Ken; Nguyen, D Tien; Ludlow, Martin; Osterhaus, Albert D M E; Duprex, W Paul

    2017-01-01

    Needle-free measles virus vaccination by aerosol inhalation has many potential benefits. The current standard route of vaccination is subcutaneous injection, whereas measles virus is an airborne pathogen. However, the target cells that support replication of live-attenuated measles virus vaccines in the respiratory tract are largely unknown. The aims of this study were to assess the in vivo tropism of live-attenuated measles virus and determine whether respiratory measles virus vaccination should target the upper or lower respiratory tract. Four groups of twelve cynomolgus macaques were immunized with 10 4 TCID 50 of recombinant measles virus vaccine strain Edmonston-Zagreb expressing enhanced green fluorescent protein. The vaccine virus was grown in MRC-5 cells and formulated with identical stabilizers and excipients as used in the commercial MV EZ vaccine produced by the Serum Institute of India. Animals were immunized by hypodermic injection, intra-tracheal inoculation, intra-nasal instillation, or aerosol inhalation. In each group six animals were euthanized at early time points post-vaccination, whereas the other six were followed for 14 months to assess immunogenicity and protection from challenge infection with wild-type measles virus. At early time-points, enhanced green fluorescent protein-positive measles virus-infected cells were detected locally in the muscle, nasal tissues, lungs, and draining lymph nodes. Systemic vaccine virus replication and viremia were virtually absent. Infected macrophages, dendritic cells and tissue-resident lymphocytes predominated. Exclusive delivery of vaccine virus to the lower respiratory tract resulted in highest immunogenicity and protection. This study sheds light on the tropism of a live-attenuated measles virus vaccine and identifies the alveolar spaces as the optimal site for respiratory delivery of measles virus vaccine.

  3. Reduction in antibiotic prescribing for respiratory tract infections in Swedish primary care- a retrospective study of electronic patient records

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    Mia Tyrstrup

    2016-11-01

    Full Text Available Abstract Background Swedish studies on antibiotic use in primary care have been based on one-week registrations of infections. In order to study adherence to guidelines, analyses based on large databases that provide information on diagnosis linked prescriptions, are needed. This study describes trends in management of infections in Swedish primary care particularly with regards to antibiotic prescribing and adherence to national guidelines. Methods A descriptive study of Sweden’s largest database regarding diagnosis linked antibiotic prescription data, the Primary care Record of Infections in Sweden (PRIS, for the years 2008, 2010 and 2013. Results Although the consultation rate for all infections remained around 30% each year, antibiotic prescribing rates decreased significantly over the years from 53.7% in 2008, to 45.5% in 2010, to 38.6% in 2013 (p = .032. The antibiotic prescribing rate for respiratory tract infections (RTIs decreased from 40.5% in 2008 to 24.9% in 2013 while those for urinary tract infections and skin and soft tissue infections were unchanged. For most RTI diagnoses there was a decrease in prescription rate from 2008 to 2013, particularly for the age group 0–6 years. Phenoxymethylpenicillin (PcV was the antibiotic most often prescribed, followed by tetracycline. Tonsillitis and acute otitis media were the two RTI diagnoses with the highest number of prescriptions per 1000 patient years (PY. For these diagnoses an increase in adherence to national guidelines was seen, with regards to treatment frequency, choice of antibiotics and use of rapid antigen detection test. The frequency in antibiotic prescribing varied greatly between different Primary Healthcare Centres (PHCCs. Conclusion Falling numbers of consultations and decreased antibiotic prescription rates for RTIs have reduced the antibiotic use in Swedish primary care substantially. Overprescribing of antibiotics could still be suspected due to large variability

  4. 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)

    Melandri, C.; Battisti, P.; Tarroni, G.

    1991-02-01

    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 f and slow-clearing thoracic T 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 calculating radiation doses to tissues of the respiratory system following inhalation of α, β and γ emitting particulate and gaseous radionuclides. (author)

  5. A novel pancoronavirus RT-PCR assay: frequent detection of human coronavirus NL63 in children hospitalized with respiratory tract infections in Belgium

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    Berkhout Ben

    2005-02-01

    Full Text Available Abstract Background Four human coronaviruses are currently known to infect the respiratory tract: human coronaviruses OC43 (HCoV-OC43 and 229E (HCoV-229E, SARS associated coronavirus (SARS-CoV and the recently identified human coronavirus NL63 (HCoV-NL63. In this study we explored the incidence of HCoV-NL63 infection in children diagnosed with respiratory tract infections in Belgium. Methods Samples from children hospitalized with respiratory diseases during the winter seasons of 2003 and 2004 were evaluated for the presence of HCoV-NL63 using a optimized pancoronavirus RT-PCR assay. Results Seven HCoV-NL63 positive samples were identified, six were collected during January/February 2003 and one at the end of February 2004. Conclusions Our results support the notation that HCoV-NL63 can cause serious respiratory symptoms in children. Sequence analysis of the S gene showed that our isolates could be classified into two subtypes corresponding to the two prototype HCoV-NL63 sequences isolated in The Netherlands in 1988 and 2003, indicating that these two subtypes may currently be cocirculating.

  6. Cost-effectiveness of procalcitonin-guided antibiotic therapy for outpatient management of acute respiratory tract infections in adults.

    Science.gov (United States)

    Michaelidis, Constantinos I; Zimmerman, Richard K; Nowalk, Mary Patricia; Fine, Michael J; Smith, Kenneth J

    2014-04-01

    Two clinical trials suggest that procalcitonin-guided antibiotic therapy can safely reduce antibiotic prescribing in outpatient management of acute respiratory tract infections (ARTIs) in adults. Yet, it remains unclear whether procalcitonin testing is cost-effective in this setting. To evaluate the cost-effectiveness of procalcitonin-guided antibiotic therapy in outpatient management of ARTIs in adults. Cost-effectiveness model based on results from two published European clinical trials, with all parameters varied widely in sensitivity analyses. Two hypothetical cohorts were modeled in separate trial-based analyses: adults with ARTIs judged by their physicians to require antibiotics and all adults with ARTIs. Procalcitonin-guided antibiotic therapy protocols versus usual care. Costs and cost per antibiotic prescription safely avoided. We estimated the health care system willingness-to-pay threshold as $43 (range $0–$333) per antibiotic safely avoided, reflecting the estimated cost of antibiotic resistance per outpatient antibiotic prescribed. In the cohort including all adult ARTIs judged to require antibiotics by their physicians, procalcitonin cost $31 per antibiotic prescription safely avoided and the likelihood of procalcitonin use being favored compared to usual care was 58.4 % in a probabilistic sensitivity analysis. In the analysis that included all adult ARTIs, procalcitonin cost $149 per antibiotic prescription safely avoided and the likelihood of procalcitonin use being favored was 2.8 %. Procalcitonin-guided antibiotic therapy for outpatient management of ARTIs in adults would be cost-effective when the costs of antibiotic resistance are considered and procalcitonin testing is limited to adults with ARTIs judged by their physicians to require antibiotics.

  7. Antibiotic prescribing practice for acute, uncomplicated respiratory tract infections in primary care settings in New Delhi, India.

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    Kotwani, Anita; Holloway, Kathleen

    2014-07-01

    To obtain information on prescribing rates and choice of antibiotics for acute, uncomplicated respiratory tract infections (RTIs) in the community. Antibiotic use in acute, uncomplicated RTIs consisting of common cold/sore throat/cough for not more than five days was surveyed in the community (December 2007-November 2008) using patient exit interviews at public and private facilities from four localities in New Delhi. Data were collected from 10 public sector facilities and 20 private clinics over one year. The percentage of acute, uncomplicated RTIs patients receiving antibiotics in general and using the Anatomical Therapeutic Chemical classification and the Defined Daily Dose (ATS/DDD) were analysed. At public and private facilities, 45% (746/1646) and 57% (259/457) of acute, uncomplicated RTI patients were prescribed at least one antibiotic, respectively. The main antibiotic class calculated as percentage of total antibiotics DDDs/1000 prescribed to acute, uncomplicated RTI patients at private clinics was cephalosporins, J01DA (39%), followed by fluoroquinolones, J01MA (24%), penicillins, J01C (19%) and macrolides, J01FA (15%). Newer members from each class were prescribed; older antibiotics such as co-trimoxazole or tetracyclines were rarely prescribed. At public facilities, the main class of antibiotic prescribed was penicillins (31%), followed by macrolides (25%), fluoroquinolones (20%) and cephalosporins (10%). Study clearly shows overuse and inappropriate choice of antibiotics for the treatment of acute, uncomplicated RTIs which are mainly due to virus and do not require antibiotic treatment. Results of the study warrant interventional strategies to promote rational use of antibiotics to decrease the overgrowing threat of antibiotic resistance. © 2014 John Wiley & Sons Ltd.

  8. Reducing early career general practitioners' antibiotic prescribing for respiratory tract infections: a pragmatic prospective non-randomised controlled trial.

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    Magin, Parker; Tapley, Amanda; Morgan, Simon; Davis, Joshua S; McElduff, Patrick; Yardley, Lucy; Henderson, Kim; Dallas, Anthea; McArthur, Lawrie; Mulquiney, Katie; Davey, Andrew; Little, Paul; Spike, Neil; van Driel, Mieke L

    2018-01-16

    Inappropriate antibiotic prescription and consequent antibacterial resistance is a major threat to healthcare. To evaluate the efficacy of a multifaceted intervention in reducing early career general practitioners' (GPs') antibiotic prescribing for upper respiratory tract infections (URTIs) and acute bronchitis/bronchiolitis. A pragmatic non-randomized trial employing a non-equivalent control group design nested within an existing cohort study of GP registrars' (trainees') clinical practice. The intervention included access to online modules (covering the rationale of current clinical guidelines recommending non-prescription of antibiotics for URTI and bronchitis/bronchiolitis, and communication skills in management of acute bronchitis) followed by a face-to-face educational session. The intervention was delivered to registrars (and their supervisors) in two of Australia's seventeen regional GP training providers (RTPs). Three other RTPs were the control group. Outcomes were proportion of registrars' URTI consultations and bronchitis/bronchiolitis consultations prescribed antibiotics. Intention-to-treat analyses employed logistic regression within a Generalised Estimating Equation framework, adjusted for relevant independent variables. The predictors of interest were time; treatment group; and an interaction term for time-by-treatment group. The P value associated with an interaction term determined statistically significant differences in antibiotic prescribing. Analyses include data of 217 intervention RTPs' and 311 control RTPs' registrars. There was no significant reduction in antibiotic prescribing for URTIs. For bronchitis/bronchiolitis, a significant reduction (interaction P value = 0.024) remained true for analysis adjusted for independent variables (P value = 0.040). The adjusted absolute reduction in prescribing was 15.8% (95% CI: 4.2%-27.5%). A multifaceted intervention reduced antibiotic prescribing for bronchitis/bronchiolitis but not URTIs. © The

  9. Antibiotic overuse for acute respiratory tract infections in Sri Lanka: a qualitative study of outpatients and their physicians.

    Science.gov (United States)

    Tillekeratne, L Gayani; Bodinayake, Champica K; Dabrera, Thushani; Nagahawatte, Ajith; Arachchi, Wasantha Kodikara; Sooriyaarachchi, Anoji; Stewart, Kearsley; Watt, Melissa; Østbye, Truls; Woods, Christopher W

    2017-03-16

    Acute respiratory tract infections (ARTIs) are a common reason for antibiotic overuse worldwide. We previously showed that over 80% of outpatients presenting to a tertiary care hospital in Sri Lanka with influenza-like illness received antibiotic prescriptions, although almost half were later confirmed to have influenza. The purpose of this qualitative study was to assess Sri Lankan patients' and physicians' attitudes towards ARTI diagnosis and treatment. Semi-structured interviews were conducted with 50 outpatients with ARTIs and five physicians in the Outpatient Department (OPD) at a large, public tertiary care hospital in southern Sri Lanka. Interviews were audio-recorded, transcribed, and analyzed for themes related to ARTI diagnosis and treatment. Patients frequently sought ARTI care in the public sector due to the receipt of free care and the perception that government hospitals carried a sense of responsibility for patients' health. Patients reported multiple medical visits for their illnesses of short duration and many indicated that they were seeking care in the OPD while at the hospital for another reason. While patients generally expected to receive medication prescriptions at their visit, most patients were not specifically seeking an antibiotic prescription. However, more than 70% of patients received antibiotic prescriptions at their OPD visit. Physicians incorrectly perceived that patients desired antibiotics or "capsules," a common formulation of antibiotics dispensed in this outpatient setting, and cited patient demand as an important cause of antibiotic overuse. Physicians also indicated that high patient volume and fear of bacterial superinfection drove antibiotic overuse. Patients in this study were seeking medication prescriptions for their ARTIs, but physicians incorrectly perceived that antibiotic prescriptions were desired. High patient volume and fear of bacterial superinfection were also important factors in antibiotic overuse. Training of

  10. Amoxicillin for acute lower respiratory tract infection in primary care: subgroup analysis of potential high-risk groups.

    Science.gov (United States)

    Moore, Michael; Stuart, Beth; Coenen, Samuel; Butler, Chris C; Goossens, Herman; Verheij, Theo J M; Little, Paul

    2014-02-01

    Antibiotics are of limited overall clinical benefit for uncomplicated lower respiratory tract infection (LRTI) but there is uncertainty about their effectiveness for patients with features associated with higher levels of antibiotic prescribing. To estimate the benefits and harms of antibiotics for acute LRTI among those producing coloured sputum, smokers, those with fever or prior comorbidities, and longer duration of prior illness. Secondary analysis of a randomised controlled trial of antibiotic placebo for acute LRTI in primary care. Two thousand and sixty-one adults with acute LRTI, where pneumonia was not suspected clinically, were given amoxicillin or matching placebo. The duration of symptoms, rated moderately bad or worse (primary outcome), symptom severity on days 2-4 (0-6 scale), and the development of new or worsening symptoms were analysed in pre-specified subgroups of interest. Evidence of differential treatment effectiveness was assessed in prespecified subgroups by interaction terms. No subgroups were identified that were significantly more likely to benefit from antibiotics in terms of symptom duration or the development of new or worsening symptoms. Those with a history of significant comorbidities experienced a significantly greater reduction in symptom severity between days 2 and 4 (interaction term -0.28, P = 0.003; estimated effect of antibiotics among those with a past history -0.28 [95% confidence interval = -0.44 to -0.11], P = 0.001), equivalent to three people in 10 rating symptoms as a slight rather than a moderately bad problem. For subgroups not specified in advance antibiotics provided a modest reduction in symptom severity for non-smokers and for those with short prior illness duration (resistance.

  11. 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. Copyright © 2014 John Wiley & Sons, Ltd.

  12. Interleukin-6 G-174C gene polymorphism and susceptibility to upper respiratory tract infection among endurance athletes

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    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.

  13. Public beliefs on antibiotics and symptoms of respiratory tract infections among rural and urban population in Poland: a questionnaire study.

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    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.

  14. Mucosal immunity and upper respiratory tract infections during a 24-week competitive season in young ice hockey players.

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    Orysiak, Joanna; Witek, Konrad; Zembron-Lacny, Agnieszka; Morawin, Barbara; Malczewska-Lenczowska, Jadwiga; Sitkowski, Dariusz

    2017-07-01

    The aim of this study was to examine upper respiratory tract infections (URTI) and their associations with resting saliva and blood immune and endocrine parameters in ice hockey players. Twenty-seven participants (age 16.5 ± 0.5 years) completed the 24-week study period. The counts/concentrations of immune and endocrine markers were compared between healthy-prone athletes (≤2 episodes of URTI during the study period) and illness-prone athletes (≥3 episodes of URTI) and between the URTI state (when athletes had infections) and the healthy state (the time without URTI). There were no differences in concentration/counts of saliva and blood immune and endocrine parameters between the illness-prone and illness-free athletes. Athletes had significantly lower sIgA, sIgA1 and sIgA2 concentrations (sIgA: 119.88 ± 66.88, 144.10 ± 75.0 µg/ml; sIgA1: 90.2 ± 40.64, 108.44 ± 29.8 U; sIgA2: 67.58 ± 30.1, 80.3 ± 25.61 U, respectively) and significantly higher WBC, neutrophil, monocyte and eosinophil count values and IL-1ra concentration at the time when they had symptoms of URTI than in the period without symptoms of infections. There were no differences in salivary cortisol concentration between the period of URTI symptoms and the period without URTI symptoms. In conclusion, we observed lower concentrations of salivary immunoglobulins and higher levels of blood immune parameters during URTI in athletes, which may confirm the suppression of mucosal immunity and initiation responses to pathogenic infections by innate immunity.

  15. Streptococcus halotolerans sp. nov. isolated from the respiratory tract of Marmota himalayana in Qinghai-Tibet Plateau of China.

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    Niu, Lina; Lu, Shan; Hu, Shoukui; Jin, Dong; Lai, Xinhe; Yang, Jing; Chen, Cuixia; Wang, Yiting; Bai, Xiangning; Lan, Ruiting; Lv, Gang; Xie, Yingping; Ye, Changyun; Xu, Jianguo

    2016-10-01

    Two Gramstaining-positive, catalase-negative, α-hemolytic, coccus-shaped organisms were isolated separately from the respiratory tracts of two Marmota himalayana animals from the Qinghai-Tibet Plateau, PR China. Morphological, biological, biochemical, and molecular genetic studies were performed on these two isolates (HTS9T and HTS12). Their biochemical characteristics, such as acid production from different sugars and enzymatic activities, indicated that they represented a member of the genus Streptococcus. They are most closely related to Streptococcus thoraltensis CIP 105518T based on sequence analysis of their 16S rRNA, groEL, sodA and rpoB genes, with similarities of 97.6, 89.9, 92.6 and 91.1 % the four genes respectively. The whole genome phylogenetic tree reconstructed using 372 core genes from 65 genomes of members of the genus Streptococcus validates that HTS9T forms a distinct subline and exhibits specific phylogenetic affinity with S. thoraltensis. In silico DNA-DNA hybridization of HTS9T showed a DNA reassociation value of 32.1 %, closest to that of S. thoraltensis CIP 105518T. Based on their phenotypic characteristics and in particular the phylogenetic findings (DNA-DNA hybridization, three phylogenetic trees built from the partial 16S rRNA/housekeeping genes, and from 372 core genes of 65 genomes of members of the genus Streptococcus), we propose with confidence that strains HTS9T and HTS12 should be classified as representing a novel species of the genus Streptococcus, Streptococcus halotolerans sp. nov. The type strain is HTS9T (=DSM 101996T=CGMCC1.15532T). Genome analysis of Streptococcus halotolerans sp. nov. shows that its genome is 1 823 556 bp long with a DNA G+C content of 39.9 mol% and contains 2068 genes.

  16. Molecular identification of adenovirus causing respiratory tract infection in pediatric patients at the University of Malaya Medical Center

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    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.

  17. Philodendron poisoning

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    ... if known Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

  18. Copper poisoning

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    ... swallowed or inhaled The amount swallowed or inhaled Poison Control Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

  19. Yew poisoning

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    ... if known Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

  20. Ammonia poisoning

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    ... if known) Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

  1. Malathion poisoning

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    ... if known) Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

  2. Poison Ivy

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    ... Staying Safe Videos for Educators Search English Español Poison Ivy KidsHealth / For Kids / Poison Ivy What's in ... the leaves of the plants. Look Out for Poison Plants These plants can be anywhere — from the ...

  3. Diazinon poisoning

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    ... if known) Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

  4. Foxglove poisoning

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    ... if known Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

  5. Frequency of respiratory virus infections and next-generation analysis of influenza A/H1N1pdm09 dynamics in the lower respiratory tract of patients admitted to the ICU.

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    Antonio Piralla

    Full Text Available Recent molecular diagnostic methods have significantly improved the diagnosis of viral pneumonia in intensive care units (ICUs. It has been observed that 222G/N changes in the HA gene of H1N1pdm09 are associated with increased lower respiratory tract (LRT replication and worse clinical outcome. In the present study, the frequency of respiratory viruses was assessed in respiratory samples from 88 patients admitted to 16 ICUs during the 2014-2015 winter-spring season in Lombardy. Sixty-nine out of 88 (78.4% patients were positive for a respiratory viral infection at admission. Of these, 57/69 (82.6% were positive for influenza A (41 A/H1N1pdm09 and 15 A/H3N2, 8/69 (11.6% for HRV, 2/69 (2.9% for RSV and 2/69 (2.9% for influenza B. Phylogenetic analysis of influenza A/H1N1pdm09 strains from 28/41 ICU-patients and 21 patients with mild respiratory syndrome not requiring hospitalization, showed the clear predominance of subgroup 6B strains. The median influenza A load in LRT samples of ICU patients was higher than that observed in the upper respiratory tract (URT (p<0.05. Overall, a greater number of H1N1pdm09 virus variants were observed using next generation sequencing on partial HA sequences (codons 180-286 in clinical samples from the LRT as compared to URT. In addition, 222G/N/A mutations were observed in 30% of LRT samples from ICU patients. Finally, intra-host evolution analysis showed the presence of different dynamics of viral population in LRT of patients hospitalized in ICU with a severe influenza infection.

  6. Attitudes and behaviours of adolescents towards antibiotics and self-care for respiratory tract infections: a qualitative study.

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    Hawking, Meredith Kd; Lecky, Donna M; Touboul Lundgren, Pia; Aldigs, Eman; Abdulmajed, Hind; Ioannidou, Eleni; Paraskeva-Hadjichambi, Demetra; Khouri, Pauline; Gal, Micaela; Hadjichambis, Andreas Ch; Mappouras, Demetrios; McNulty, Cliodna Am

    2017-06-06

    To understand attitudes and behaviours of adolescents towards antibiotics, antimicrobial resistance and respiratory tract infections. Qualitative approach informed by the Theory of Planned Behaviour. Semi-structured interviews and focus groups were undertaken. We aimed to inform the development of an intervention in an international setting to improve antibiotic use among adolescents; therefore on completion of thematic analysis, findings were triangulated with qualitative data from similar studies in France, Saudi Arabia and Cyprus to elucidate differences in the behaviour change model and adaptation to diverse contexts. 7 educational establishments from the south of England. 53 adolescents (16-18 years) participated in seven focus groups and 21 participated in interviews. Most participants had taken antibiotics and likened them to other common medications such as painkillers; they reported that their peers treat antibiotics like a 'cure-all' and that they themselves were not interested in antibiotics as a discussion topic. They demonstrated low knowledge of the difference between viral and bacterial infections.Participants self-cared for colds and flu but believed antibiotics are required to treat other RTIs such as tonsillitis, which they perceived as more 'serious'. Past history of taking antibiotics for RTIs instilled the belief that antibiotics were required for future RTIs. Those who characterised themselves as 'non-science students' were less informed about antibiotics and AMR. Most participants felt that AMR was irrelevant to them and their peers. Some 'non-science' students thought resistance was a property of the body, rather than bacteria. Addressing adolescents' misperceptions about antibiotics and the treatment of RTIs using a behaviour change intervention should help improve antibiotic awareness and may break the cycle of patient demand for antibiotics to treat RTIs amongst this group. Schools should consider educating all students in further

  7. Influence of patient symptoms and physical findings on general practitioners' treatment of respiratory tract infections: a direct observation study

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    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

  8. Progress in Pediatrics in 2012: choices in allergy, endocrinology, gastroenterology, hematology, infectious diseases, neurology, nutrition and respiratory tract illnesses.

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    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

  9. Spectrum and potency of ceftaroline tested against leading pathogens causing community-acquired respiratory tract infections in Europe (2010).

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    Farrell, David J; Flamm, Robert K; Jones, Ronald N; Sader, Helio S

    2013-01-01

    Ceftaroline, the active metabolite of the prodrug ceftaroline fosamil, is a novel cephalosporin exhibiting in vitro bactericidal activity against Gram-positive organisms, including Streptococcus pneumoniae and methicillin-susceptible and -resistant Staphylococcus aureus, as well as common Gram-negative organisms. The objective of this study was to determine the spectrum and potency of ceftaroline against recent leading pathogens causing community-acquired respiratory tract infections (CARTI) isolated in Europe. A total of 1563 isolates from the 2010 Assessing Worldwide Antimicrobial Resistance Evaluation (AWARE) Program were identified as CARTI pathogens by the infection type and/or specimen type recorded by the participating laboratory. Isolates were collected from patients in 52 medical centers located in 19 European countries (including Israel and Turkey). Susceptibility testing for ceftaroline and commonly used antimicrobials was performed by Clinical and Laboratory Standards Institute (CLSI) broth microdilution methodology. Susceptibility interpretations for comparators were as published in CLSI and the European Committee on Antimicrobial Susceptibility Testing guidelines, and for ceftaroline US-FDA breakpoints were also applied. Ceftaroline was very active overall against 799 S. pneumoniae (MIC(50/90,) ≤ 0.008/0.12 μg/mL) and inhibited 100.0% of all isolates at a MIC ≤ 0.5 μg/mL. Ceftaroline was very potent against penicillin-resistant (CLSI oral penicillin V breakpoints) and -intermediate S. pneumoniae (MIC(50/90), 0.12/0.25 and 0.03/0.12 μg/mL, respectively), but potency was lower than observed against penicillin-susceptible isolates (MIC(50/90), ≤ 0.008/≤ 0.008 μg/mL). Ceftaroline was also very active (MIC(50/90), ≤ 0.008/0.015 μg/mL) against 515 Haemophilus influenzae, including β-lactamase-producing strains (MIC(50/90), 0.015/0.06 μg/mL). Ceftaroline also demonstrated good activity against 205 Moraxella catarrhalis isolates (MIC(50

  10. Short courses of daily prednisolone during upper respiratory tract infections reduce relapse frequency in childhood nephrotic syndrome.

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    Abeyagunawardena, Asiri S; Thalgahagoda, R S; Dissanayake, Pathum V; Abeyagunawardena, Shamali; Illangasekera, Y A; Karunadasa, Umeshi I; Trompeter, Richard S

    2017-08-01

    Relapses of childhood nephrotic syndrome (NS) are frequently precipitated by viral upper respiratory tract infections (URTIs). A review of the literature reveals that in patients with steroid-dependent NS on alternate day corticosteroids, a short course of daily corticosteroid therapy during the course of an URTI may reduce relapse frequency. To assess the effect of a short course of low-dose corticosteroid therapy during the course of an URTI on relapse frequency in patients with steroid-sensitive NS who have not been taking any treatment for a minimum period of 3 months. A double-blind placebo-controlled crossover trial was conducted on 48 patients with idiopathic NS who had not been receiving corticosteroid therapy for a minimum of 3 months. Patients were randomized into two groups. Group A received 5 days of daily prednisolone at 0.5 mg/kg at the onset of an URTI while group B received 5 days of placebo. Both groups were followed up for 1 year and the URTI-induced relapse frequency was noted. A crossover was performed during the next year, with group A receiving placebo and group B receiving prednisolone. Thirty-three patients completed the study. In the treatment group, 115 episodes of URTI led to 11 relapses while in the control group 101 episodes of URTI led to 25 relapses. There was no significant difference between the mean number of URTIs between the treatment and control groups. The treatment group had significantly less relapses compared to the control group (p = 0.014). Within the treatment group, 65.6% did not relapse, while the remainder had a single relapse. In contrast, only 40.6% of the control group remained in remission while 40.6% suffered a single relapse and 18.8% had two or more relapses. Prescribing a short course of daily corticosteroids during an URTI significantly reduces the frequency of URTI-induced relapse in patients with steroid-responsive NS who are off corticosteroid therapy.

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

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    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

  12. 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.

  13. Molecular identification of adenovirus causing respiratory tract infection in pediatric patients at the University of Malaya Medical Center.

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    Abd-Jamil, Juraina; Teoh, Boon-Teong; Hassan, Eddy H; Roslan, Nuruliza; Abubakar, Sazaly

    2010-07-02

    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. 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. At least 2,583 pediatric patients with RTI sought consultation and treatment at the UMMC from 1999 to 2005. Among these patients, 48 (type 1 (HAdV-1) and HAdV type 2 (HAdV-2), and among the HAdV-B species, HAdV type 3 (HAdV-3) was the most common serotype identified. HAdV-C species also was isolated from throat and rectal swabs of children with hand, foot, and mouth disease (HFMD). Two isolates were identified as corresponding to HAdV-F species from a child with HFMD and a patient with intestinal obstruction. 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 approximately 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.

  14. Association of Broad- vs Narrow-Spectrum Antibiotics With Treatment Failure, Adverse Events, and Quality of Life in Children With Acute Respiratory Tract Infections.

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    Gerber, Jeffrey S; Ross, Rachael K; Bryan, Matthew; Localio, A Russell; Szymczak, Julia E; Wasserman, Richard; Barkman, Darlene; Odeniyi, Folasade; Conaboy, Kathryn; Bell, Louis; Zaoutis, Theoklis E; Fiks, Alexander G

    2017-12-19

    Acute respiratory tract infections account for the majority of antibiotic exposure in children, and broad-spectrum antibiotic prescribing for acute respiratory tract infections is increasing. It is not clear whether broad-spectrum treatment is associated with improved outcomes compared with narrow-spectrum treatment. To compare the effectiveness of broad-spectrum and narrow-spectrum antibiotic treatment for acute respiratory tract infections in children. A retrospective cohort study assessing clinical outcomes and a prospective cohort study assessing patient-centered outcomes of children between the ages of 6 months and 12 years diagnosed with an acute respiratory tract infection and prescribed an oral antibiotic between January 2015 and April 2016 in a network of 31 pediatric primary care practices in Pennsylvania and New Jersey. Stratified and propensity score-matched analyses to account for confounding by clinician and by patient-level characteristics, respectively, were implemented for both cohorts. Broad-spectrum antibiotics vs narrow-spectrum antibiotics. In the retrospective cohort, the primary outcomes were treatment failure and adverse events 14 days after diagnosis. In the prospective cohort, the primary outcomes were quality of life, other patient-centered outcomes, and patient-reported adverse events. Of 30 159 children in the retrospective cohort (19 179 with acute otitis media; 6746, group A streptococcal pharyngitis; and 4234, acute sinusitis), 4307 (14%) were prescribed broad-spectrum antibiotics including amoxicillin-clavulanate, cephalosporins, and macrolides. Broad-spectrum treatment was not associated with a lower rate of treatment failure (3.4% for broad-spectrum antibiotics vs 3.1% for narrow-spectrum antibiotics; risk difference for full matched analysis, 0.3% [95% CI, -0.4% to 0.9%]). Of 2472 children enrolled in the prospective cohort (1100 with acute otitis media; 705, group A streptococcal pharyngitis; and 667, acute sinusitis), 868

  15. Amitraz poisoning: case report

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    Jaime Alexander Molina-Bolaños

    2017-10-01

    Full Text Available Amitraz is an insecticide compound used worldwide for controlling pests, especially in agricultural and livestock areas. However, amitraz poisoning in Colombia is rare. This article reports the case of an 18-year-old female patient who was admitted in the emergency service 3 hours after the intake of an unknown amount of Triatox® (amitraz. The patient presented with a depressed level of consciousness, respiratory distress, hypotension, bradycardia, myosis and metabolic acidosis compensated with respiratory alkalosis. Initial treatment was provided using life support measures in the emergency ward, and subsequent transfer and support in the intensive care unit. She was discharged 24 hours after admission. This case considers the clinical similarity between amitraz poisoning and poisoning caused by other more frequent toxic compounds such as carbamates, organophosphates and opioids, which require different management.

  16. Characterization and sensitivity to antibiotics of bacteria isolated from the lower respiratory tract of ventilated patients hospitalized in intensive care units

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    Manuel Medell

    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

  17. GC-MS analysis of leaf extracts of Terminalia macroptera and Dioclea reflexa, two medicinal plants used for the treatment of respiratory tract disorders

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    Theresa Ibibia Edewor

    2016-07-01

    Full Text Available Objective: To analyze the phytochemicals that are present in two medicinal plants which are used for the treatment of respiratory tract infections by gas chromatography-mass spectrometer. Methods: The plant leaves were extracted with n-hexane and methanol separately. Both extracts were analyzed for present phytochemicals using the method described by Harborne, 1985 while only methanol extracts were subjected to gas chromatography-mass spectrometer analysis. Results: Phytochemical screening of the methanolic extracts of Terminalia macroptera (T. macroptera revealed the presence of glycosides, tannins, flavonoids, saponins and steroids while that of Dioclea reflexa (D. reflexa showed the presence of flavonoids, saponins and steroids. The n-hexane extracts were devoid of the screened phytochemicals. Twelve and twenty-five compounds were identified in the leaves of T. macroptera and D. reflexa respectively. These compounds were fatty acids, fatty acid esters, other esters, heterocyclics and phenolics. The most abundant compound in T. macroptera was benzenetriol (53.30% while the predominant compounds in D. reflexa were dodecanoic acid, methyl ester (15.31%, 5, 5, 8a-trimethyl-3, 5, 6, 7, 8, 8a-hexahydro-2H-chromene (9.73%, 10-octadecenoic acid, methyl ester and 2-hexadecanoic acid, methyl ester (8.95%. Benzofuran, 2, 3-dihydro, 3, 7, 11, 15- tetramethyl-2-hexadecen-1-ol and hexadecanoic acid, methyl ester were common in both plant extracts. The antimicrobial properties of the leaves of these plants could be responsible for their use in the treatment of respiratory tract infections. Conclusions: Some of the identified phytochemicals in the plant leaves are responsible for its use in the treatment of respiratory tract infections.

  18. Medicine use practices in management of symptoms of acute upper