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Results for “RESPIRATORY TRACT”

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PubMed1999

Bacterial flora of the lower respiratory tract in children with bronchial asthma.

The aims of this retrospective study were to (i) determine the risk of contamination of lower respiratory tract samples obtained during fiberoscopy in children; (ii) determine the incidence and profile of the bacterial flora of the lower respiratory tract in a selected group of asthmatic children at high risk for bacterial infection; and (iii) identify risk markers for such findings. In 29 asthmatic children, comparison of bacterial cultures of specimens obtained from the upper and, lower respiratory tracts showed that contamination was a possibility in only 3.4% (1/29) of cases. The results from bacterial samples obtained via flexible bronchoscopy in a further 273 consecutively investigated physician-diagnosed asthmatic children were analysed. Patients were selected for bronchoscopy if they had severe chronic asthma or in order to exclude other diseases able to provoke wheezing. Their mean (SD) and median ages were 32.2 (38.3) and 17.5 mo, respectively. The incidence of positive bacterial cultures was 12.1% (33/273 patients). Bacterial flora included H. influenzae (39.5%, 15/38), B. catarrhalis (23.7%, 9/38), Neisseria species (7.9%, 3/38), M. pneumoniae (7.9%, 3/38), P. non-aeruginosa (5.3%, 2/38) and P. aeruginosa (2.6%, 1/38). No clinical or radiological markers were significantly associated with lower respiratory tract bacterial infection. Large quantities of bacteria were present in the lower respiratory tracts of a substantial number of children (1/8) in this selected group of asthmatics. For the moment, however, the clinical implications of this finding remain unclear.

Asthma↗

PubMed1998

Acute respiratory-tract infections and risk of first-time acute myocardial infarction.

BACKGROUND: There is growing interest in the role of infections in the aetiology of acute myocardial infarction (AMI). We undertook a large, population-based study to explore the association between risk of AMI and recent acute respiratory-tract infection. METHODS: We used data from general practices in the UK (General Practice Research Database). Potential cases were people aged 75 years or younger, with no history of clinical risk factors, who had a first-time diagnosis of AMI between Jan 1, 1994, and Oct 31, 1996. Four controls were matched to each case on age, sex, and the practice attended. The date of the AMI in the case was defined as the index date. For both cases and controls the date of the last respiratory-tract infection before the index date was identified. We also did a case-crossover analysis of cases who had an acute respiratory-tract infection either before the index date or before an arbitrarily chosen date (1 year before AMI). FINDINGS: In the case-control analysis of 1922 cases and 7649 matched controls, significantly more cases than controls had an acute respiratory-tract infection in the 10 days before the index date (54 [2.8%] vs 72 [0.9%]). The odds ratios, adjusted for smoking and body-mass index, for first-time AMI in association with an acute respiratory-tract infection 1-5, 6-10, 11-15, or 16-30 days before the index date (compared with participants who had no such infection during the preceding year) were 3.6 (95% CI 2.2-5.7), 2.3 (1.3-4.2), 1.8 (1.0-3.3), and 1.0 (0.7-1.6); (test for trend p<0.01). The case-crossover analysis showed a relative risk of 2.7 (1.6-4.7) for AMI in relation to an acute respiratory-tract infection in the 10 days before the index date. INTERPRETATION: Our findings suggest that in people without a history of clinical risk factors for AMI, acute respiratory-tract infections are associated with an increased risk of AMI for a period of about 2 weeks. We cannot, however, completely exclude the possibility of misdiagnosis bias, if prodromal symptoms of AMI were mistaken for respiratory-tract infection.

Acute Disease↗

PubMed1997

[Usefulness of 7 day therapy with cefluprenam in the management of respiratory tract infections].

Efficacy and safety of a newer injectable cephalosporin, cefluprenam (CFLP) on cases with bacterial pneumonia and chronic respiratory tract infections were evaluated at a dose of 1g (potency), d.i.d for 7 days. 1. Of 130 cases in total, 116 cases were enrolled for the clinical efficacy evaluation. The efficacy rate (excellent and good responses) was 94.8% (110/116). The efficacy rate was 93.8% (60/64) for cases with bacterial pneumonia, and 96.2% (50/52) for cases with chronic respiratory tract infections. The recurrence was noted in 1.2% (1/82). The bacteriological response rate was 100.0% (32/32) for gram positive cocci, 93.8% (15/16) for gram negative rods and 97.9% (47/48) in total. 2. Adverse drug reactions were noted in 3.9% (5/129), consisting of 2 cases with skin rash, 1 case with drug fever, 1 case with skin rash and skin itching and 1 case with drug fever and headache. The abnormal laboratory changes were noted in 23.6% (30/127), mainly containing the elevation in GPT and GOT, and eosinophylia. The safety rate (no problem evaluation) was 74.8% (95/127). 3. The usefulness rate (very useful and useful evaluations) was 93.1% (108/116). As suggested by the evaluation on the secondary endpoint in the phase III comparative studies with both bacterial pneumonia and chronic respiratory tract infections, it was confirmed that the 7 day therapy of CFLP was promising for treatment of moderate bacterial pneumonia and chronic respiratory tract infections, because the high clinical efficacy was obtained and also the incidence of allergic reactions with CFLP was almost the same as that of ceftazidime (CAZ) evaluated highly safe. Based on these results, it was concluded that CFLP was useful in the management of moderate respiratory tract infections and also the recommended therapeutic period with CFLP was within 7 days.

Adult↗

PubMed1994

[Recurrent infections of the respiratory tract and staphylococcal pneumonia with septic shock and total respiratory failure in a patient with histiocytosis X].

Disseminated pulmonary infiltrates, cutaneous lesions and diabetes insipidus in a female patients with a history of recurrent pneumothorax and persistent respiratory tract infections suggested the diagnosis of histiocytosis X. The pathological examination of a biopsy lung tissue specimen confirmed that diagnosis. In the course of treatment many dangerous complications were observed. The intensive therapy including artificial ventilation (24 days) was fully effective and settle the beneficial clinical outcome.

Adult↗

PubMed1990

Upper respiratory tract infection in children, domestic temperatures, and humidity.

STUDY OBJECTIVE: The aim of the study was to seek for a possible association between the incidence of upper respiratory tract infections and air temperature and humidity in the home. DESIGN: Recordings of temperature and relative humidity were made in living rooms and children's bedrooms over a six month period and related to incidence of upper respiratory tract infection. SETTING: The study was carried out in one general practice of 10,000 patients. PATIENTS: 297 children aged 24-59 months were studied, selected in random order from the practice age-sex register. MEASUREMENTS AND MAIN RESULTS: Temperature and humidity recordings were made with thermohygrograph recorders over six days. Upper respiratory tract infections were recorded (a) retrospectively over the previous 12 months, and (b) during the study period. Past history of acute otitis media and recent family history of respiratory infection were also obtained. No significant association was found between the variables, although the bedrooms of children with reported upper respiratory tract infections were cooler overnight than those of non-infected children (mean difference 0.8 degrees C, 95% confidence limits 0.7 degrees C). No association was found between reported or recorded upper respiratory tract infections and age or type of home, family size, level of occupancy, social class, or smoking habits. Only 15 children (5%) were identified by their parents as having had asthma, but 58 (19.5%) had had a "wheezy chest". A greater proportion of children who wheezed slept in cooler bedrooms, had gas fires rather than central heating, and had more smokers in the house. CONCLUSIONS: No association between upper respiratory tract infection and domestic temperature or humidity levels could be shown in this study. Since dampness is repeatedly presented as a health risk, further study is required.

Child, Preschool↗

PubMed2005

[Effectiveness of Broncho-Vaxom in prevention of recurrent upper respiratory tract infection in children].

AIM OF THE STUDY: Evaluation of effectiveness of immunostimulating treatment with Broncho-Vaxom and his influence on concentration of proinflammatory cytokines in children with recurrent upper respiratory tract infection. MATERIAL AND METHODS: The study comprised 32 children (the average age 8 years and 4 months) with recurrent upper respiratory tract infection received immunostimulating treatment with Broncho-Vaxom. 20 children (the average age 7 years and 8 months) with recurrent upper respiratory tract infection which did not receive treatment with Broncho-Vaxom consisted the control group. In all children clinical state and concentration of cytokines TNF-alpha and, IL-1beta, IL-6, IL-8 in serum was examined. Period of observation in both groups carried out 24 months. Follow-up was executed after 6 months. RESULTS: In children treated with Broncho-Vaxom statistically significant (p<0.01) decrease in frequency of occurrence as well as shortening of duration of upper respiratory tract infection were observed. In children treated with Broncho-Vaxom statistically significant (p<0.01) decrease of serum concentration of TNF-alpha and in time of observation. The statistically significant changes were not observed in serum concentrations IL-1beta in time of observation. It was statistically significant (p<0.01) affirmed the rise of serum concentration of IL-6 in time of observation, the largest growth of concentration this cytokine stepped out in 1 year of treatment. The statistically significant (p<0.01) increase of concentration cytokine IL-8 in the first year of treatment as well as statistically significant (p<0.05) decrease of concentration this cytokine after end of treatment. CONCLUSION: The treatment with Broncho-Vaxom shows the high effectiveness in prevention of recurrent upper respiratory tract infection in children as well as the influences of profitable changes in profile of serum cytokines which can impact on limitation the inflammation process in the upper respiratory tract.

Adjuvants, Immunologic↗

PubMed1983

Cephalexin in lower respiratory tract infections.

Cephalexin has had 12 years of extensive clinical usage in the management of respiratory tract and other infections. It is reliably absorbed from the gastrointestinal tract and reaches therapeutic levels in serum and tissues. Toxicity and adverse side effects are minimal. The antimicrobial spectrum includes a majority of the pathogens usually associated with community-acquired lower respiratory tract infections with the significant exception of Haemophilus influenzae. Resistance of H. influenzae strains reduces the uses of cephalexin in the paediatric population and may limit its effectiveness in some patients with acute exacerbations of chronic bronchitis. In contrast, it is inordinately effective in managing most adult patients with lower respiratory tract infections, either as a primary agent, as a substitute for penicillins or other antimicrobial agents in patients unable to receive these, or for continuation of therapy in individuals who no longer require parenteral compounds. As with other cephalosporins, caution should be exercised to exclude meningitis when treating patients with respiratory tract infections since the majority of these compounds, including cephalexin, produce little or no cerebrospinal fluid levels.

Adult↗

PubMed1992

Etiology of acute severe lower respiratory tract infection in hospital-based patients.

Acute respiratory infections are common childhood illnesses. Most are mild and self-limiting. Five percent are lower respiratory tract diseases and are potentially serious. A prospective study was conducted to ascertain the etiology of community-acquired severe lower respiratory tract infections (LRTI) in hospital based patients. Mycoplasma was the most frequently identified agent (33%). This was followed by viruses (28%) and bacteria (15%). Twenty-four percent of children had no identified causative agent.

Acute Disease↗

PubMed2002

Antibiotic prescribing by primary care physicians for children with upper respiratory tract infections.

OBJECTIVES: To determine if the rate of appropriate antibiotic use in the treatment of children with bronchitis, viral upper respiratory tract infections, sinusitis, otitis media, and pharyngitis has changed in recent years and to identify factors that are associated with the use of inappropriate antibiotic therapy. DESIGN: The National Ambulatory Medical Care Survey was used to examine the antimicrobial prescribing habits of physicians who provide primary care for children. Data were analyzed from 1995-1998. SETTING: Office-based physician practices. PARTICIPANTS: Pediatricians, family physicians, and generalists completing survey forms for patients younger than 18 years. MAIN OUTCOME MEASURE: The appropriate use of antibiotics for upper respiratory tract infections. RESULTS: Multivariate analyses were used to examine factors associated with the use of inappropriate antibiotics to treat either upper respiratory tract infections or bronchitis. Patients seen in 1998 and diagnosed as having upper respiratory tract infections were 0.69 (95% confidence interval, 0.59-0.81) times less likely to be treated with antibiotics compared with patients seen in 1995. Multivariate analyses were also used to assess factors associated with the use of antibiotics with a suboptimal therapeutic profile for the treatment of either sinusitis or otitis media. Children diagnosed as having either sinusitis or otitis media were 0.3 (95% confidence interval [CI], 0.16-0.48) times less likely to receive antibiotics with a suboptimal therapeutic effect in 1998 compared with 1995. CONCLUSIONS: Physicians are slowly improving their antibiotic prescribing patterns but the use of inappropriate antibiotics is still common. Almost half of patients with upper respiratory tract infections receive antibiotics.

Adolescent↗

PubMed1997

Increased psychosocial stress and decreased mucosal immunity in children with recurrent upper respiratory tract infections.

The association between psychosocial stress and susceptibility to upper respiratory tract infection was investigated in 45 children with a history of recurrent colds and flu, and in 45 healthy children of similar age and distribution. In addition, mucosal immune protection against upper respiratory tract infections was assessed by measuring the concentration of secretory immunoglobulin A (sIgA) and its ratio to albumin in saliva. Several dimensions of psychosocial stress, including exposure to stressful experiences, stress-prone personality traits, and signs of emotional disturbance were elevated in children with a history of recurrent colds and flu. Furthermore, lower sIgA/albumin ratios in these children indicated a deficiency in local mucosal immunity. Thus, the findings are consistent with the view that psychosocial stress depletes local immune protection against viral invasion or bacterial colonization of the upper respiratory tract; this depletion may increase susceptibility to colds and flu. Alternatively, psychological disturbances could develop in response to frequent illness.

Affective Symptoms↗

PubMed1996

Haptoglobin response to clinical respiratory tract disease in feedlot cattle.

OBJECTIVE: To quantify haptoglobin response to respiratory tract disease in feedlot cattle, and to investigate its ability to predict disease outcome and response to antibiotic treatment. DESIGN: Randomized clinical trial. ANIMALS: 60 feedlot calves with clinical respiratory tract disease. PROCEDURE: Calves were randomly assigned to receive a standard antibiotic treatment regimen (TRT), or to observation pens without antibiotic treatment. Serum haptoglobin concentration was measured at initial and final examinations. Calves were examined for presence of gross pulmonary lesions at slaughter. RESULTS: Mean +/- SD serum haptoglobin concentration at initial examination was 67 +/- 108 mg/dl, with range of 0 to 508 mg/dl. Haptoglobin concentration at initial examination was similar for the TRT group and the group that did not receive antibiotic treatment, but at final examination, TRT-group calves had lower (P < 0.01) mean values. Calves receiving antibiotic treatment had haptoglobin concentration at or near zero at final examination. Calves not receiving antibiotic treatment had only slightly lower mean haptoglobin concentration at final examination, compared with initial examination. Within treatment groups, haptoglobin concentration was similar for cases with different outcomes. Calves with gross pulmonary lesions at slaughter had numerically higher, although statistically similar, haptoglobin concentrations at initial examination, compared with calves without lesions. CONCLUSIONS: Feedlot cattle with clinical respiratory tract disease have a large and variable haptoglobin response. Antibiotic treatment resulted in lower serum haptoglobin values, although low values were not required for full clinical recovery. CLINICAL RELEVANCE: Serum haptoglobin concentration may be an indicator of response to antibiotic therapy, although it appears to be unrelated to case severity or need for treatment.

Animals↗

PubMed2001

Development of an ex vivo model to study adherence of Mannheimia haemolytica serovar 1 to mucosal tissues of the respiratory tract of cattle.

OBJECTIVE: To develop and validate an ex vivo model for study of adherence of Mannheimia haemolytica (formerly Pasteurella haemolytica) to respiratory tract mucosa of cattle and to use this model to confirm adherence of M haemolytica serovar 1 (Mh1) to several relevant respiratory mucosal surfaces. SAMPLE POPULATION: Excised nasal, nasopharyngeal, turbinate, and tonsillar mucosal tissue from the bovine upper respiratory tract. PROCEDURE: Mh1 was radiolabeled by use of tritiated leucine. Various concentrations of labeled bacteria were incubated with bovine upper respiratory tract tissues for various times. Tissue was washed to remove nonadherent bacteria, and percentage of bacteria adhered (percentage of adherence) was estimated using radioactivity. Using an optimal inoculum concentration and incubation time, percentage of Mh1 adherence was compared on nasal, nasopharyngeal, turbinate, and tonsillar mucosal tissue, and adherence to nasopharyngeal tissue was confirmed by scanning and transmission electron microscopy. RESULTS: The optimal Mh1 inoculum concentration was 1 X 10(7) colony forming units/ml and incubation time was 3 hours. Percentage of adherence of Mh1 to nasopharyngeal tissue was greater than adherence to other tissue types. CONCLUSIONS AND CLINICAL RELEVANCE: The ex vivo model maintained the functional and structural integrity of bovine upper respiratory tract mucosa, as confirmed by light and electron microscopy. Electron microscopy revealed participation of epithelial cell cilia and surface mucus in adherence of Mh1 to nasopharyngeal tissue. Adherence of Mh1 was confirmed in repeated assays, indicating that this organism adheres to upper respiratory tract mucosa of cattle.

Animals↗

PubMed1997

Hospitalization of aboriginal and non-aboriginal patients for respiratory tract diseases in Western Australia, 1988-1993.

BACKGROUND: Aboriginal people have lower health standards than other Australians. Respiratory tract diseases are prominent causes of high morbidity and mortality rates in the Aboriginal population. However, very little is known about the patterns of respiratory illnesses which affect these people. METHOD: This paper compares Aboriginal and non-Aboriginal age-specific hospitalization patterns for respiratory tract diseases from 1988 to 1993 in Western Australia (WA). RESULTS: Aboriginal people were admitted for respiratory diseases 2-16 times more frequently than non-Aboriginals of the same age with considerable discrepancies in hospitalization rates particularly in infants, young children and older adults. High admission rates for acute respiratory tract infections, pneumonia and asthma occurred in Aboriginal infants. Pneumonia was a disproportionately frequent cause of admissions in Aboriginal infants, children and adults. Pneumonia is a more frequent cause of admission among non-metropolitan compared to metropolitan Aboriginals. Asthma was a frequent cause of admissions of Aboriginal children and hospitalization rates for this disease were higher in non-metropolitan than metropolitan areas. Chronic obstructive airway disease and respiratory tract carcinoma were important uses of hospitalization in older Aboriginals. CONCLUSIONS: Admission rates for respiratory conditions were consistently higher among the Aboriginal population and in non-metropolitan areas. The overwhelming importance of infections among Aboriginal admissions has significant implications for the prevention and management of respiratory diseases among Aboriginal people.

Adolescent↗

PubMed1989

Prognostic factors for lower respiratory tract infections after brain-tumor surgery.

Nosocomial infection of the lower respiratory tract is a frequent and serious complication after major operations. A 32% incidence of lower respiratory tract infections was found after brain-tumor surgery in 289 patients, with a 21% incidence of pneumonia. In 186 of these patients (Group A), five factors were identified which were associated with an increased risk of postoperative lower respiratory tract infection. These were: age, tumor type, cardiac insufficiency, preoperative disturbances of consciousness, and preoperative corticosteroid treatment. Based on these factors, a risk score was developed which correlated well with the incidence of infection in this group of patients. In a second group of patients (Group B), the derived risk score was applied and was found to possess a high degree of validity. As long as patients were intubated postoperatively, their freedom from infection decreased exponentially, with a half-life of 3.5 days.

Brain Neoplasms↗

PubMed1995

The relationship between intraoperative contamination of the lower respiratory tract and postoperative chest infection.

The relationship between intraoperative contamination of the lower respiratory tract and postoperative chest infection was studied in 193 patients undergoing biliary tract surgery. During surgery, sputum was obtained from the lower respiratory tract for bacteriological culture. The diagnosis of postoperative pulmonary complications was based on clinical criteria, supported by the pattern of sequential blood gas changes in the postoperative period. Chest infection was present in 30% of patients who harboured Haemophilus species in their sputum at the time of surgery compared with 10% of those with negative cultures. Contamination of the lower respiratory tract at operation by Haemophilus sp. is associated with development of postoperative chest infection.

Adult↗

PubMed1992

[Diseases of the upper respiratory tract in workers in "dusty" jobs].

Diseases of the upper respiratory tract are wide spread in the workers exposed to dust and closely correlate with the length of service. Pathologic process grows severe and disseminates the upper respiratory tract according to prolongation of the exposure to dust. The main pathologic mechanisms of process in the upper respiratory tract mucosa are: disorder of mucociliary clearance, disturbance of the regional immunity and the acid-base balance of tissues. Criteria of occupational connection of the nose, throat and larynx dystrophic diseases in workers exposed to dust are given.

Chronic Disease↗

PubMed2003

Presence of Campylobacter inthe respiratory tract of broiler carcasses before and after commercial scalding.

Campylobacter could be detected in the thoraco-abdominal cavity of broiler carcasses even if they were carefully eviscerated by hand with no evidence of intestinal rupture or leakage. If Campylobacter is present in the air sacs, which are unavoidably torn during evisceration, it could contaminate the thoraco-abdominal cavity of the eviscerated carcass. This study was done to determine if Campylobacter contamination is present in the respiratory tract of broilers prior to evisceration. Whole carcass rinses and respiratory tract washes were done on broiler carcasses collected at a commercial processing plant just before and just after scalding. Samples were cultured for presence and numbers of Campylobacter, Escherichia coli, coliforms, and total aerobic bacteria. Campylobacter isolates were subtyped by sequencing the short variable region of the flaA gene. The same subtypes of Campylobacter were detected in whole carcass rinse samples as in respiratory tract wash samples from individual broilers. Furthermore, the same numbers and subtypes of Campylobacter were recovered from respiratory tracts of carcasses collected before scalding and those collected after scalding. However, respiratory tracts of carcasses after scalding had higher numbers of E. coli, coliforms, and total aerobic bacteria than those tested before scalding. Although some bacterial counts were higher in the respiratory tracts of carcasses after scalding, Campylobacter counts were not. It appears that Campylobacter is present in the respiratory tracts of broilers as they enter processing, and contamination may be due to airborne bacteria during production or transport.

Animals↗

PubMed2003

[Patients compliance with antibiotherapy of respiratory tract infections].

Non-compliance frequently occurs during outpatient antibiotherapy of respiratory tract infections. The most frequent form of non-compliance in such circumstances is omittion of single doses. Patient non-compliance during antibiotherapy is of practical importance. It leads to therapy failure, need of additional health services, growth of direct and indirect therapy cost and development of resistant strains. This paper summarises the methods of evaluating compliance and the results of research on compliance during antibiotherapy of respiratory tract infections. The reasons of patient non-compliance as well as the factors influencing this phenomenon are reviewed. Practical methods of augmenting compliance are suggested with particular stress on the relationship between dosage frequency and compliance. It should be remembered that when the antibiotic is needed for respiratory tract infections treatment, once daily dosing ensures the best possible compliance.

Anti-Bacterial Agents↗