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Biomedical subjects

Birgit Winther

Publications and source records attributed to Birgit Winther.

11 recordsLinked to original sources
PubMed2006

A high prevalence of new onset otitis media during parent diagnosed common colds.

INTRODUCTION: Past studies suggest that the majority of new otitis media (OM) diagnoses is a complication of a colds/flu. A prospective format was used to determine the coincidence of otitis media and parent diagnosed cold/flu episodes in young children followed over a typical cold/flu season. METHODS: Eighteen families with children aged 1-8 years were followed from October 1 to April 30 using parent-completed daily diaries focused on cold/flu signs and weekly examinations using pneumatic otoscopy for diagnosis of the presence/absence of otitis media. RESULTS: Overall, 108 cold episodes were documented in 36 enrolled children with 20 colds (19%) occurring during a pre-existing OM episode and 40 colds (37%) complicated by a new OM episode. Conversely, there were 82 new OM episodes, 40 (49%) were associated with a cold in the individual child and 18 (22%) with a concurrent cold in a family member. The median duration of the OM episodes was approximately 2 weeks but this was longer for OM episodes where earache was reported. CONCLUSION: The results confirm past observation relating new OM episodes to a concurrent cold/flu but show these episodes to usually be of short duration. Two sources of potential bias were identified for point prevalence study formats: the presence of a pre-existing OM for a new onset cold/flu and the possibility of subclinical colds in patients with new OM episodes. These biases reinforce the need for longitudinal study formats to address this important relationship.

Child↗
PubMed2006

Picornavirus infections in children diagnosed by RT-PCR during longitudinal surveillance with weekly sampling: Association with symptomatic illness and effect of season.

RT-PCR is more sensitive for rhinovirus detection than cell culture, but healthy controls are frequently rhinovirus (or picornavirus) positive in cross-sectional studies. Fifteen healthy children were followed over at least three seasons of the year with weekly sampling of nasal/nasopharyngeal secretion for RT-PCR testing for picornavirus and daily recording of respiratory symptoms. One sample positive for picornavirus was diagnosed as an infection; consecutive positive weekly samples constituted a single infection. Picornavirus illness was diagnosed if RNA was detected 7 days prior through 21 days after onset. One hundred fifty-five (21%) of 740 weekly samples were picornavirus positive and associated with illness; 37(5%) positives were not associated with illness (P = 0.001). The 192 positive samples occurred in 121 infections, 74 with a single positive and 47 with "runs" of positives in two or more consecutive samples. Forty five (96%) of the 47 runs comprised 2 or 3 consecutive positives. Ninety six (52%) of 185 reported illnesses during 235 child-months were picornavirus positive (0.4/child-month); 25 infections were asymptomatic (0.11/child-month). The infection rate was highest in fall (0.66/child-month); the winter rate (0.44/child-month) was similar to that in spring (0.5) and summer (0.43). Picornavirus infections in healthy children were common (0.51/child-month), episodic, and usually associated with brief illness; one fifth of infections were asymptomatic. The infection rate was highest in fall; infections in winter occurred at the same rate as in spring and summer.

Carrier State↗
PubMed2006

Rhinosinusitis: developing guidance for clinical trials.

The Rhinosinusitis Initiative was developed by 5 national societies. The current guidance document is an expansion of the 2004 publication "Rhinosinusitis: Establishing definitions for clinical research and patient care" and provides templates for clinical trials in antimicrobial, anti-inflammatory, and symptom-relieving therapies for the following: (1) acute presumed bacterial rhinosinusitis, (2) chronic rhinosinusitis (CRS) without nasal polyps, (3) CRS with nasal polyps, and (4) classic allergic fungal rhinosinusitis. In addition to the templates for clinical trials and proposed study designs, the Rhinosinusitis Initiative has developed 6 appendices, which address (1) health outcomes, (2) nasal endoscopy and staging of CRS, (3) radiologic imaging, (4) microbiology, (5) laboratory measures, and (6) biostatistical methods.

Chronic Disease↗
PubMed2006

Rhinosinusitis: Developing guidance for clinical trials.

The Rhinosinusitis Initiative was developed by 5 national societies. The current guidance document is an expansion of the 2004 publication, "Rhinosinusitis: Establishing definitions for clinical research and patient care" and provides templates for clinical trials in antimicrobial, anti-inflammatory, and symptom-relieving therapies for the following: (1) acute presumed bacterial rhinosinusitis, (2) chronic rhinosinusitis (CRS) without nasal polyps, (3) CRS with nasal polyps, and (4) classic allergic fungal rhinosinusitis. In addition to the templates for clinical trials and proposed study designs, the Rhinosinusitis Initiative has developed 6 appendices, which address (1) health outcomes, (2) nasal endoscopy and staging of CRS, (3) radiologic imaging, (4) microbiology, (5) laboratory measures, and (6) biostatistical methods.

Chronic Disease↗
PubMed2005

Weekly point prevalence of Streptococcus pneumoniae, Hemophilus influenzae and Moraxella catarrhalis in the upper airways of normal young children: effect of respiratory illness and season.

The aim was to determine the effect of respiratory illness and season on carriage rates in the upper airways of Streptococcus pneumoniae, Hemophilus influenzae and Moraxella catarrhalis in normal children. Sixteen healthy children, 1-10 years old, amenable to weekly sampling were followed longitudinally for at least three seasons of the year. Respiratory symptoms were recorded daily; weekly nasal aspirate/wash samples were cultured on selective agars. Urea concentration in samples was used to define dilution of secretion. 68% of 950 samples were culture positive; 44% of positives had two or all three species. Each species was detected in about one third of samples. Bacteria were detected in 76% of samples during illness vs. 65% during wellness (p=0.004). Seasonal carriage rates varied from 56% in summer and fall to 85% in winter. There was a strong inverse correlation between dilution of secretion and bacterial detection rate in illness and wellness aspirate samples during the four seasons (r=-0.82, p=0.01). Detection of bacteria varied with the amount of secretion in the sample. This variation accounts for the apparent differences in bacterial carriage during illness vs. wellness and during different seasons.

Carrier State↗
PubMed2002

Combined antiviral-antimediator treatment for the common cold.

A randomized, controlled, double-masked clinical trial was conducted with a combination antiviral-antimediator treatment for experimental rhinovirus colds. In all, 150 healthy men and women (aged 18-51 years) were randomly assigned to 1 of 3 groups: intranasal interferon (IFN)-alpha2b (6 x 10(6) U every 12 h x 3) plus oral chlorpheniramine (12 mg extended release) and ibuprofen (400 mg) every 12 h for 4.5 days (n=59 subjects); intranasal placebo plus oral chlorpheniramine and ibuprofen (n=61 subjects); or intranasal and oral placebos (n=30 subjects). Treatment was started 24 h after intranasal viral challenge. During the 4.5 days of treatment with IFN-alpha2b, chlorpheniramine, and ibuprofen, the daily mean total symptom score was reduced by 33%-73%, compared with placebo. Treatment reduced the severity of rhinorrhea, sneezing, nasal obstruction, sore throat, cough, and headache and reduced nasal mucus production, nasal tissue use, and virus concentrations in nasal secretions. IFN-alpha2b added to the effectiveness of chlorpheniramine and ibuprofen and was well tolerated.

Adolescent↗
PubMed2002

Cross-linked fibrin in the nasal fluid of patients with the common cold.

To determine whether adherent material found on the walls of the paranasal sinuses during common colds might be fibrin clot, we examined the nasal fluid (a surrogate for sinus secretion) of 11 young adults with experimentally induced rhinovirus colds and that of 4 control subjects for the presence of fibrin. The mean concentration (+/- the standard error) of insoluble fibrin (measured as D-dimer) in subjects with rhinovirus colds increased from a baseline level of 0.8+/-0.4 microgram/mL to a peak of 2.4+/-0.7 microgram/mL (P=.0008) on day 4 after inoculation of the virus, but the fibrin concentration remained at baseline levels in the 4 uninfected control subjects.

Adult↗
PubMed2002

Expression of ICAM-1 in nasal epithelium and levels of soluble ICAM-1 in nasal lavage fluid during human experimental rhinovirus infection.

Most rhinovirus serotypes use intercellular adhesion molecule-1 (ICAM-1) as the receptor to enter cells, but ICAM-1 expression has not been detected on normal nasal epithelial cells. During experimental rhinovirus infection, expression of ICAM-1 on nasal epithelial cells was examined with immunohistochemical staining of nasal scrape biopsy specimens, and levels of soluble ICAM-1 in nasal lavage fluid were measured by sandwich enzyme-linked immunosorbent assay technique. Expression of ICAM-1 on nasal epithelial cells increased following inoculation in 20 of 23 infected subjects. The median number of ICAM-1-positive cells per 6.25-mm(2) area of stained biopsy specimen was 0 in control samples (day 20 or 33 after inoculation), and in those without infection, 6 on day 1 (P< or =.05), 14.5 on day 3 (P< or =.01), 1.5 on day 5, and 0 on day 9. In a different group of volunteers, soluble ICAM-1 in nasal lavage fluid was higher on days 1 and 3 compared with preinoculation levels (P< or =.001), but only 11 of 23 infected subjects had a 2-fold or greater increase. Up-regulation of ICAM-1 receptor expression on nasal epithelial cells occurred within 24 hours after inoculation in experimental rhinovirus infections (prior to onset of symptoms) and declined promptly by day 5.

Adult↗
PubMed2002

Viral respiratory infection in schoolchildren: effects on middle ear pressure.

OBJECTIVE: To evaluate the effect of uncomplicated viral respiratory infections (colds) on middle ear pressure in healthy school-aged children. METHODS: Children (ages 2-12) with normal tympanograms before onset of illness had bilateral tympanometry daily except weekends for 2 weeks after the onset of a cold. Nasopharyngeal secretion obtained at onset of illness was cultured for bacterial pathogens of otitis media using selective agars and tested for rhinovirus, coronavirus, respiratory syncytial virus, influenza A and B, and parainfluenza 1-3 by reverse transcriptase polymerase chain reaction technology. Tympanometry was designated as abnormal with peak pressure of < or =-100 daPa or > or =50 daPa and/or a compliance peak of < 0.2 cm(3). RESULTS: Eighty-six colds were studied, 82 in schoolchildren (5-12 years old) and 4 in 2- to 3-year-olds. Abnormal negative middle ear pressure occurred at least once during the 2 weeks after onset in 57 (66%) of the 86 colds. Tympanometry was abnormal in the first week after onset in 50 (88%) of the 57 colds and was abnormal on a single day in 17 (30%) of the 57. The middle ear pressure abnormalities were intermittent and shifted from one ear to the other ear from day to day. Reverse transcriptase polymerase chain reaction was positive for a respiratory virus in 56 (65%) of the 86 illnesses. Rhinovirus was found in 48% and respiratory syncytial virus in 14%. Pathogenic bacteria (Streptococcus pneumoniae, Haemophilus influenzae, or Moraxella catarrhalis) were detected in nasopharyngeal secretion in 29 (34%) of the 86 colds; the bacteria were in high titer (> or =10(3) cfu/mL) in 26 of the 29 positive specimens. None developed illness that required a visit to a physician. Age, detection of a respiratory virus, and presence of bacterial pathogen in the nasopharyngeal secretion had a negligible effect on the occurrence of abnormal tympanometry. Occurrence of negative middle ear pressure in winter-spring colds was significantly greater than in fall colds for unexplained reasons. CONCLUSIONS: Transient negative middle ear pressure occurred in two thirds of uncomplicated colds in healthy children. This negative pressure, which may facilitate secondary viral or bacterial otitis media, seems to result from viral infection of the nasopharynx and distal tube causing bilateral eustachian tube dysfunction. Tympanometry provides an objective measure of the potential beneficial effects of investigational treatments on the risk of eustachian tube dysfunction/otitis media.

Acoustic Impedance Tests↗
PubMedDate not supplied

Nasopharyngeal reservoir of bacterial otitis media and sinusitis pathogens in adults during wellness and viral respiratory illness.

BACKGROUND: The carriage rate of pathogenic bacteria in the nasopharynx (NP) was determined using three separate techniques for obtaining samples. METHODS: The NP of 99 healthy adults was sampled with (1) nasal swab, (2) oral swab, and (3) nasal aspiration; 49 adults with common cold were sampled with an oral swab and nasal aspiration. Three selective agars were used to detect Streptococcus pneumoniae, Hemophilus influenzae, and Moraxella catarrhalis. RESULTS: Seventy-three percent of healthy adults and 74% of cold sufferers had at least one pathogen detected in the NP. Detection rates were 65% (oral NP swab), 38% (catheter aspiration), and 28% (nasal swab; p < 0.001). Carriage rates for S. pneumoniae, M. catarrhalis, and H. influenzae were 45, 33, and 30%, respectively. Both a nasal and an oral sample were required for optimal detection. CONCLUSION: Bacterial pathogens were present in the NP of three-quarters of adults during wellness and during colds.

Adult↗