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Results for “RESPIRATORY TRACT”

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PubMed1978

Carcinogenicity of nickel subsulfide for respiratory tract mucosa.

The carcinogenicity of nickel subsulfide, Ni3S2, for respiratory tract epithelium was studied in heterotopic tracheal transplants with doses of 1 and 3 mg Ni3S2 per trachea. Chemical determinations indicated that Ni3S2 persisted in the tracheas for seven to nine months. Ni3S2 showed marked toxicity for mucociliary epithelium, resulting in widespread atrophy and focal epithelial necrosis during the first two months of exposure. The submucosa showed mononuclear infiltration and signs of fibroblastic and capillary proliferation. Tumor studies indicated that Ni3S2 can induce carcinomas in tracheal epithelium. The carcinoma incidence was 10% at 1 mg and approximately 1.5% at 3 mg. The higher dose produced a 67% incidence of fibro- and myosarcomas. The data suggest that, compared to some carcinogenic polycyclic hydrocarbons, Ni3S2 may not be a strong carcinogen for the epithelium of conducting airways. The data are discussed in light of other experimental studies and of epidemiological findings on respiratory tract cancers in nickel workers.

Animals↗

PubMed1988

Prospective study of lower respiratory tract infections in an extended-care nursing home program: potential role of oral ciprofloxacin.

PURPOSE: Infections of the lower respiratory tract pose an important problem in nursing homes. Despite the magnitude of this problem, few, if any, antibiotic studies have been targeted specifically at nursing home-acquired bronchopulmonary infections. Following the establishment of a teaching Extended-Care Nursing Home Program, which facilitated the early diagnosis and therapy of bronchopulmonary infections, a comparative trial of oral ciprofloxacin and intramuscular cefamandole was initiated in elderly patients with lower respiratory tract infections. In addition to assessing the relative efficacy and safety of ciprofloxacin and cefamandole, our goals were to identify problems and pitfalls associated with conducting clinical research in this nursing home setting, evaluate selected clinical and laboratory features of lower respiratory tract infection in this patient population, and measure outcomes in all study groups. PATIENTS AND METHODS: During a 20-month period, 40 patients with pneumonia and 20 patients with acute bronchitis were enrolled in this randomized study. Sixty-three patients with pneumonia who were ineligible for the randomized study were also followed prospectively. The mean age of the 111 participants (123 cases) was 80.8 years; all patients had at least one chronic medical condition. RESULTS: Although Streptococcus pneumoniae was the single most common isolate, gram-negative bacteria were cultured from 81 percent of the cases that yielded pathogens from a satisfactory sputum specimen. The in-hospital mortality rate was strikingly low (6.5 percent), and a large majority of patients in all study groups were discharged safely back to their nursing homes well within the Diagnosis-Related Group length of stay. CONCLUSION: Ciprofloxacin appeared to be as safe and effective as cefamandole in this nursing home program; however, additional studies are needed to determine its role in the treatment of elderly patients with bronchopulmonary infections.

Administration, Oral↗

PubMed1995

Comparison of nasal prongs and nasopharyngeal catheter for the delivery of oxygen in children with hypoxemia because of a lower respiratory tract infection.

OBJECTIVE: To determine the best method of oxygen delivery for children in developing countries who have hypoxemia caused by acute lower respiratory tract infection. METHODS: One hundred eighteen children between 7 days and 5 years of age with a lower respiratory tract infection and arterial hemoglobin oxygen saturation (Sao2) less than 90% were randomly selected to receive oxygen by nasopharyngeal (NP) catheter (n = 56) or nasal prongs (n = 62). A crossover study to determine the flow rate necessary to achieve an Sao2 of 95% was performed in 60 children. RESULTS: One hundred twelve children could be oxygenated by the allocated method; in six oxygenation was poor with either method. The mean duration of therapy was 87.5 hours for the prongs and 94.9 hours for the NP catheter (not significant). The median oxygen consumption was 2142 L for prongs and 1692 L for the NP catheter (not significant). In the crossover study the prongs needed, on average, 26% higher oxygen flow rates than the NP catheter to obtain an Sao2 of 95% (p = 0.003). Complete nasal obstruction was observed in 24 of the children (44%) in the NP catheter group and in 8 (13%) in the prongs group (p < 0.001). Eighteen children died, 11 with NP catheter and 7 with prongs (not significant). CONCLUSIONS: Because nasal prongs are less prone to complications, and oxygenation in children is equally effective, they are a more appropriate method than the NP catheter for oxygen delivery to children in developing countries with acute lower respiratory tract infections.

Catheterization, Peripheral↗

PubMed2000

[The detection and analysis of human papillomavirus in infantile respiratory tract papillomas by PCR/RFLP study].

OBJECTIVE: To study the relationship between human papillomavirus (HPV) and pathological characteristics of the patients with infantile respiratory tract papillomas (IRP). METHOD: Thirteen cases of infantile respiratory tract papillomas tissue were analysed for Papillomavirus by the polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). RESULT: The amplified products of the HPV-L1 region by PCR by using the consensus primers showed that the presence of HPV was 100 percent. Eight cases(61.5 percent) were positive for HPV6 only. Four cases (30.8 percent) were positive for HPV11 only. One case (7.7 percent) showed the presence of HPV18. None were positive for HPV16, 31, 33, 52, 58. CONCLUSION: Infantile respiratory tract papillomas are associated with HPV6, 11, 18 infection, but the subtypes of HPV are not associated with clinical pathological characteristics.

Child, Preschool↗

PubMed2001

[Patient adherence in respiratory tract infections: ceftibuten versus other antibiotics (PARTICULAR study)].

The study was conducted to evaluate patient compliance to antibiotic therapy in respiratory tract infections. The main aim of the study was to establish whether dosing frequency (1 vs 2 or 3 times daily) and other factors influence compliance. Patients aged 18 and over attending selected primary health facilities in Lódź region were enrolled. Patients were randomly assigned to receive ceftibuten, 400 mg once daily or other antibiotic on physician's choice with 2 or 3 times daily dosing. On the 5th day during the home visit the questionnaire study was performed and the compliance was measured by a pill count. Four hundred and six patients (205 in ceftibuten and 201 in other antibiotics group, respectively) were fully evaluable. Overall compliance was 76.6% with 97.6% for ceftibuten, 66.0% for antibiotics with b.i.d. dosing and 23.5% for antibiotics with t.i.d. dosing. Using a logistic regression analysis with a stepwise variable selection, dosing frequency was found to be a major variable associated with patient compliance (p = 0.00000, odds ratio 0.09, 95% confidence interval 0.057-0.165). Non-compliance with antibiotics is a common phenomenon in respiratory tract infections therapy. Once-daily antibiotic dosing leads to the best possible compliance in such circumstances. Due to its once-daily dosing and rare side effects, ceftibuten ensures nearly perfect compliance in respiratory tract infections therapy.

Adolescent↗

PubMed1992

Diagnosis and interventions in lower respiratory tract infections.

In the elderly and in immunocompromised patients, respiratory tract infections are still a major cause of morbidity and mortality. The choice of a specific antibiotic treatment in pneumonia depends on the identification of the causative pathogen or on a judgment concerning the probable causative micro-organism. This judgment should be based on all the information obtained from clinical signs and symptoms, laboratory investigations of sputum and blood, and the pattern of infiltrations on chest X-ray. Different causative pathogens can be expected in bacterial and "atypical" community-acquired pneumonia than in hospital-acquired pneumonia. For the same reason, immunocompetent and immunocompromised patients have to be distinguished from each other. In chronic obstructive pulmonary disease, bronchial defenses will be impaired. Exacerbations can result from different causes, including infections of the bronchial mucosa. Most of these infections are of viral origin. Exacerbated pulmonary disease will result from bacterial bronchitis only in some patients. It is often difficult to assess the diagnosis "bacterial bronchitis." Evaluation of the effect of antibacterial treatment in exacerbated pulmonary disease is also difficult. Therapeutic interventions for these clinical conditions have to be directed primarily toward restoring or improving pulmonary host-defense factors. Fluoroquinolones, including lomefloxacin, have been shown to be effective in the treatment of lower respiratory tract infections caused by susceptible bacteria. Lomefloxacin presents a number of advantages: the drug has good bioavailability after oral and parenteral administration and penetrates well into bronchial secretions and lung tissue. In addition, lomefloxacin has no influence on the metabolic clearance of the methylxanthines theophylline and caffeine, which has been demonstrated for enoxacin, ciprofloxacin, and pefloxacin.

4-Quinolones↗

PubMed1998

[Foreign bodies in the respiratory tract of infants and young children taken from personal material].

The paper presents problems related to the aspiration of foreign bodies to the respiratory tract of children aged 0-2 years. The authors analyze the most common symptoms corresponding to particular stages of changes in the respiratory tract following foreign body aspiration along with their radiological pictures. Approximately 65% of aspiration cases in children occur in the period between 6 months and 3 years of life. The symptoms may suggest a misdiagnosis of chronic respiratory tract disease. Detailed analysis of the course of the disease in particular children may facilitate proper diagnostic and therapeutic management.

Bronchoscopy↗

PubMedDate not supplied

Clinical judgment predicts culture results in upper respiratory tract infections.

BACKGROUND: We wanted to describe the natural history, familial transmission, microbiology, and accuracy of clinical judgment of potential pathogens of respiratory tract infections in a community family practice. METHODS: The study was a prospective case series in which consecutive patients requesting treatment for respiratory tract infections were evaluated after nurse triage during 3 fall-spring months in a solo family practice in suburban Cleveland, Ohio. According to the physician's usual practice, patients were classified into high-, medium-, and low-risk groups for bacterial illness based on their clinical signs and symptoms. Cultures were performed and sensitivities were determined for pathogens from the infected throat, nasopharynx, conjunctiva, or other sites. Patient symptoms and well-being were scored at the initial visit and at 3, 7 and 14 days later. RESULTS: There were 111 illness episodes in 86 patients; 94% had cultures taken, of which 38% grew a potentially pathogenic bacteria, most commonly group A streptococci, Branhamella catarrhalis or Staphylococcus aureus. The physician's judgment of bacterial infection was associated (P < .001) with having a positive culture (sensitivity 53%, specificity 78%, positive and negative predictive values 60% and 73%, respectively). A positive culture was associated with 2 of 16 signs or symptoms: purulent discharge from any site or a red swollen eye. There was no association of treatment status with clinical outcomes during 2 weeks of follow-up observation. CONCLUSION: Infection with a potentially pathogenic bacteria is difficult to determine solely by clinical signs and symptoms, but clinical judgment is associated with positive culture results. The effect of selective treatment of upper respiratory tract infection based on clinical signs and symptoms and patient and family culture results remains to be determined, but using clinical judgment could result in more selective antibiotic use than found in current practice patterns.

Anti-Bacterial Agents↗

PubMedDate not supplied

Detection of proteolytic bacteria in the upper respiratory tract flora of poultry.

Proteolytic bacteria were readily demonstrated among the upper respiratory tract flora of poultry in two chicken flocks and two turkey flocks. Between 20% and 50% of birds in each flock had highly proteolytic bacteria in the upper respiratory tract flora, and the amount of the bacterial flora determined to be highly proteolytic in any given bird ranged from none to a majority. Highly proteolytic bacteria recovered included five species of staphylococci, as well as two gram-negative bacterial species, Flavobacterium sp. and Vibrio alginolyticus. All species of staphylococci isolated have previously been recovered from animal sources, whereas Flavobacterium sp. and V. alginolyticus are usually reported to be associated with soil and surface-water origins. The protocols used to screen for proteolytic bacteria among the flora and to assess protease activity required minimal supplies and equipment.

Animals↗

PubMed2002

Day care attendance, respiratory tract illnesses, wheezing, asthma, and total serum IgE level in early childhood.

BACKGROUND: It has been hypothesized that day care--related infections may explain the inverse relation between day care attendance in early life and asthma in childhood. OBJECTIVE: To examine the relation between day care attendance or respiratory tract illnesses in the first year of life and wheezing and asthma in the first 4 years of life among children with a parental history of atopy who were followed up from birth. RESULTS: Day care attendance in the first year of life was inversely associated with geometric mean total serum IgE level (12.9 [+/-1 SD = 3.3, 51.4] IU/mL for day care vs 18.5 [[+/-1 SD = 5.3, 64.7] IU/mL for no day care; P =.03) at 2 years of age but not significantly associated with wheezing at or after 2 years of age. Having at least 1 physician-diagnosed lower respiratory tract illness in the first year of life was significantly associated with recurrent wheezing (odds ratio [OR], 2.0; 95% confidence interval [CI], 1.0-4.1) and asthma (OR, 2.5; 95% CI, 1.1-5.5) at 4 years of age, but not with any wheezing (infrequent and frequent) at 3 years or older. Illnesses of the upper respiratory tract (> or = 1 physician-diagnosed upper respiratory tract illness or > or = 3 episodes of nasal catarrh) in the first year of life were associated with any wheezing (frequent and infrequent) between the ages of 1 and 4 years, but not with recurrent wheezing or asthma at 4 years of age. CONCLUSIONS: Our results suggest that among children with a parental history of atopy the protective effect of day care attendance in early life against the development of atopy has begun by 2 years of age, and that a protective effect of day care attendance in early life against wheezing may not be observed until after 4 years of age.

Asthma↗

PubMed1990

Identification of surface components of mammalian respiratory tract cilia.

Cilia isolation methods were modified to retain respiratory tract ciliary membranes and to identify accessible surface components. Prior to isolation of cilia, halves of cow tracheae were treated with the extended spacer arm analog of N-hydroxysuccinimido-biotin (NHS-LC-biotin) to label accessible membrane constituents. Mechanical disruption of the epithelium and substitution of CHAPS for Triton X-100 provided a good yield of cilia with membranes and with minimal contamination. Subsequent extraction of these cilia with Triton X-100 solubilized the membranes and released soluble matrix proteins. Proteins of membrane + matrix and axoneme fractions were analyzed after electrophoresis in sodium dodecyl sulfate polyacrylamide gels. The major biotin-labeled components in the membrane + matrix fraction were 105, 98, and 92 kd, were glycosylated, and remained with reconstituted, pelleted membrane vesicles along with the major non-biotinylated protein at 51 kd. Other membrane + matrix proteins at 126 and 76 kd bound streptavidin even from nonlabeled trachea, but remained soluble. Several biotin-labeled proteins distinct from those in the membrane fraction remained with Triton X-100-extracted axonemes. Streptavidin-colloidal-gold (SAG) particles appeared to bind randomly along the length of cilia. The peripheral join between A and B microtubules was a predominant nonspecific location of SAG on axonemes. Axonemes with biotin label also bound significant numbers of SAG to outer dynein arms, confirming the streptavidin reaction with separated proteins on transfers. These results suggest close association of the membrane with the axoneme in respiratory tract cilia and a membrane composition somewhat different from protozoan cilia.

Animals↗

PubMed1989

Peptide-containing nerve fibers in the respiratory tract of the ferret.

The ferret is widely used in functional and neuromorphological studies on the respiratory tract. We have examined the occurrence and distribution of peptide-containing and adrenergic nerve fibers (using dopamine-beta-hydroxylase as a marker). Adrenergic nerve fibers and fibers storing vasoactive intestinal peptide have a widespread distribution along the entire respiratory tract. Adrenergic nerve fibers were found in the lamina propria, as well as around blood vessels and glands and in smooth muscle. Nerve fibers storing vasoactive intestinal peptide occurred in the epithelium, the lamina propria, around blood vessels and glands, and among muscle bundles. Substance P-, neurokinin A- and calcitonin gene-related peptide-containing nerve fibers predominated beneath and within the epithelium along the entire respiratory tract. Neuropeptide Y-containing nerve fibers were prominent among smooth muscle bundles and around glands. The blood vessels in the wall of the airways were richly supplied with peptide-containing nerve fibers and adrenergic fibers. Ganglia located over the outer or dorsal surface of the tracheal wall harbored vasoactive intestinal peptide-containing nerve cell bodies. Substance P and neurokinin A invariably coexisted in the same nerve fibers. Further, coexistence of substance P/neurokinin A and calcitonin gene-related peptide was observed in the nerve fibers associated with the epithelium. Vasoactive intestinal peptide, neuropeptide Y and occasionally also substance P coexisted in the population of nerve fibers associated with blood vessels and smooth muscle. Many adrenergic nerve fibers contained neuropeptide Y.

Adrenergic Fibers↗

PubMed1983

[Branhamella catarrhalis in infectious pathology of the respiratory tract].

Branhamella catarrhalis has long been considered as a commensal of the upper respiratory tract. However, since 1972 several studies have shown that it can be responsible for respiratory tract infections. By isolating this micro-organism in sputum or nasal smear of 44 hospital patients we were able to confirm this finding, while delineating some of the clinical features of the infections observed. In all 44 patients these were mild infections, yet treatment appeared to be necessary in view of the risk of severe infection (B. catarrhalis septicaemia) in subjects with poor general condition. The germ is usually sensitive to antibiotics other than beta-lactam antibiotics (58% of the strains isolated were found to produce a beta-lactamase).

Adult↗

PubMed1987

Upper respiratory tract infection: predisposing factors and duration of symptoms in patients over 12 years of age.

Some patients suffer greatly from upper respiratory tract infections, while others suffer much less. Various factors, such as allergy and nasal injury, have been suggested in the literature to predispose patients to infection. Predisposing factors and patterns of disease were examined in a prospective, controlled study of 238 patients attending two general practices. A questionnaire, designed to study the development and duration of upper respiratory symptoms and the occurrence of factors which predispose patients to disease, was completed for index and control patients when they presented with symptoms. A follow-up card was completed by index patients one month later.Family history of catarrh was found to be a significant predisposing factor to upper respiratory tract infection. However, no significant differences between index and control patients were found for any of the other generally accepted factors. Heavy smoking and increased age were associated with prolonged symptoms lasting 60 days or more.It is concluded that traditional theories of the causes of upper respiratory tract infections may need to be revised.

Adult↗

PubMed2026

Streptococcus pneumoniae adaptation to nutrient deprivation and immune modulation drives upper respiratory tract colonization.

Streptococcus pneumoniae is a successful colonizer of the human upper respiratory tract; however, the mechanisms that enable its persistence in this nutrient-limited environment, with numerous immune mechanisms in place, remain enigmatic. Here, we examined how pneumococci adapt to upper respiratory tract conditions and how this affects host interactions. We measured intranasal metal ion and monosaccharide concentrations to create an in vivo-mimicking medium for studying pneumococcal adaptation. Growth in this medium was reduced compared to glucose-rich chemically defined media (CDM). Proteome analysis revealed a shift to galactose as the major carbohydrate source, and decreased levels of fatty acid biosynthesis proteins and pneumolysin, compared to other CDMs. Glycerophosphocholine accumulated extracellularly leading to decreased C-reactive protein and Immunoglobulin M binding to pneumococci. Pneumococci grown in in vivo-mimicking medium, compared to glucose-rich media, were more capable colonizers of primary epithelium and induced less epithelial cytokine release. Together, this shows how pneumococci adapt to the nutrient-limited respiratory environment, modulate epithelial cells, and evade humoral responses to facilitate persistent colonization.

Streptococcus pneumoniae↗

PubMed2004

Prevention of recurrent upper respiratory tract infections in a community of cloistered nuns using a new immunostimulating bacterial lysate. A randomized, double-blind clinical trial.

UNLABELLED: The aim of the present study was to evaluate the efficacy of the immunostimulating therapy with a new vaccine Ismigen in preventing recurrent infections of the upper respiratory tract in subjects belonging to a community of cloistered nuns. This product is a lysate obtained by mechanical lysis of bacteria (MLBL) usually responsible of respiratory tract infections. A randomized, double-blind, parallel groups, placebo controlled clinical trial was carried out in 47 nuns (age range 25-80 years) living in a cloistered religious community, suffering from recurrent infections of the upper respiratory tract. The 47 patients were allocated by randomization to two groups: Group A--The 24 patients (mean age SD: 48.12 +/- 14.25 years) of this group received one sublingual tablet of MLBL per day, for 10 consecutive days per month for 3 consecutive months (October, November and December 2001). Group B--The 23 patients (mean age +/- SD: 49.04 +/- 14.73 years) of this group received daily one sublingual tablet of taste masked placebo, for 10 consecutive days per month for 3 consecutive months (October, November and December 2001). At the end of the treatment period patients of both groups were followed up for further three months without any immunostimulating treatment. RESULTS: During and at the end of the treatment phase the number of respiratory infections (primary end-point) and their duration were statistically significantly lower in the MLBL group than in the placebo group. Moreover the administration of MLBL induced a marked reduction in the number of patients showing symptoms of infection in comparison to baseline and approximately 79 % of the patients showed an improvement of one or more of the evaluated symptoms. In the MLBL group a statistically significant increase of serum immunoglobulins (IgG +35%; IgM +86%; IgA +80 %) and salivary IgA (+110%) was found, in comparison to baseline; on the contrary no significant differences were observed in the placebo group. The beneficial effects of MLBL found in the treatment period were maintained also in the three-month follow-up. No adverse events associated with the treatment were found in both group. The results of this study demonstrate that MLBL is an efficacious and safe therapeutic option for the treatment and prevention of recurrent upper respiratory tract infections and that its use is recommended in subjects with a possible immune deficit.

Adjuvants, Immunologic↗

PubMed1989

[Oscillatory impedance measurement of the respiratory tract in children].

The author reports on his own experiences with monofrequent and polyfrequent oscillatory impedance measurements of the respiratory tract in childhood. The monofrequent oscillatory process was tested in a total of 10 trials in respect of its suitability to estimate the complex respiratory resistance in the region of lower and upper respiratory tract in a total of 1071 children most of whom were healthy, some children having a diseased respiratory tract, between 3 and 19 years of age. In 268 children the nasal respiratory resistance was measured, in 803 the bronchial respiratory resistance. The polyfrequent oscillation method was compared in 2 examinations with body plethysmography and spirometry in respect of its discriminatory powers between healthy subjects and children suffering from asthma, and in respect of its suitability to prove bronchial hypersensitivity on carbachol provocation, using 93 healthy and 81 asthmatic children. The results of the 12 examinarions are surveyed and discussed.

Adolescent↗

PubMed2006

Respiratory tract infections: at-risk patients, who are they? Implications for their management with levofloxacin.

Two of the most serious respiratory tract infections are community-acquired pneumonia (CAP) and acute exacerbations of chronic bronchitis (AECB). The most common pathogens found in patients with these infections are Haemophilus influenzae and Streptococcus pneumoniae. Pseudomonas aeruginosa is also relatively common, particularly in elderly patients with AECB. S. pneumoniae and P. aeruginosa are also of concern in relation to the development of resistance to antimicrobial drugs. The administration of antibiotics at doses that result in concentrations exceeding the mutant prevention concentration at the site of infection is one strategy to prevent the development of drug-resistant pathogens. AECB is associated with a high risk of in-hospital mortality, particularly in patients treated in the intensive care unit. CAP is also associated with significant risks and often requires treatment under hospital supervision. Several patient-related factors help identify those patients who are most at risk of mortality and morbidity. Treatment should be tailored towards the severity of the disease. The fluoroquinolones, such as levofloxacin, are an effective treatment option for AECB and CAP. Compared with many other antibiotics, resistance to levofloxacin remains low for most infecting pathogens. The oral bioavailability of levofloxacin is over 99%, enabling simple switching from intravenous to oral therapy during treatment. It is also preferentially distributed to compartments in the lung, thus achieving high concentrations at the site of respiratory tract infections. Combined with cover of the major infecting pathogens found in patients with AECB and CAP, and a cost-effective treatment compared with many alternative therapies, levofloxacin is an attractive option for the treatment of at-risk patients with these respiratory tract infections.

Anti-Bacterial Agents↗