[Serum copper, iron and zinc levels in cattle diseases. II. Changes in respiratory diseases in calves].
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The bovine respiratory disease complex continues to be an economically important syndrome in an era when immunologic control is likely to become increasingly important. Recent studies have yielded a better understanding of the interaction, at the molecular level, of various pathogens with the bovine immune system. Improved challenge models for important viral pathogens such as bovine viral diarrhea virus and bovine respiratory syncytial virus have provided evidence of the efficacy of immune responses stimulated by vaccination. This article highlights recent advances in understanding of the role of the immune response in the pathogenesis and prophylaxis of bovine respiratory disease complex.
Respiratory disease is common in pregnancy, and becoming more so: asthma, pneumonia and tuberculosis are all increasing in frequency. This review discusses these conditions and their relationship to pregnancy, as well as considering briefly some rarer diseases.
The occurrence of non-tuberculous non-tumorous respiratory diseases in children and in adults was investigated in a population of approximately 28 300 inhabitants from selected health communities of a Prague industrial district between October 1, 1976 and December 31, 1978. In the course of this period such a disease occurred once at least in 31% of the population. Of a total of 17 133 respiratory disease cases, acute upper respiratory infections occurred in 72.0%, acute bronchitis in 12.2%, influenza in 12.5%, pneumonia in 1.3%, chronic bronchitis in 0.3%, bronchial asthma in 0.6% and other respiratory diseases in 0.5%. Repeated respiratory diseases with four or more episodes of a disease in the course of one year occurred in 6.0% of preschool-age children (0-5 years of age), in 2.8% of school-age children (6-14 years of age), and in 0.2% subjects from the age of 15. Differences in the morbidity rate among the three age groups were statistically significant. In most cases repeated respiratory diseases began to occur after the entry of children to collective institutions. The most frequent respiratory diseases as a cause of incapacity for work were acute upper respiratory infections and influenza with a predominance of incidence in persons younger than 40 years of age. By contrast, in chronic bronchitis as a cause of incapacity for work there was a significant predominance of affected subjects from 40 years of age. The mean duration of incapacity for work due to chronic bronchitis was longer than that due to acute respiratory diseases. In respiratory diseases chronic bronchitis was found to be the most frequent primary cause of death, while pneumonia was quite often an immediate cause of death in the subjects weakened by other diseases.
Impairment of mucociliary clearance as a result of genetic defects of cilia in the respiratory tract has been recognized as a cause of chronic or recurrent respiratory diseases. Respiratory cilia have been examined by high resolution electron microscopy of nasal and bronchial biopsies from children and young adults from 6 months to 24 yr of age. In this series, 17 children with immotile cilia syndrome have been shown to have deficiencies of dynein arms in the cilia. Ultrastructural analysis reveals a variability of dynein defects from the lack of inner arms, the lack of outer arms, to the complete lack of both inner and outer dynein arms. The spectrum of defects that contribute to dynein-deficient cilia presumably reflects separate genetic determinants, affording further evidence that the immotile cilia syndrome is genetically heterogeneous. Despite ultrastructural differences in cilia, no significant differences are evident in the clinical course of the respiratory disease in affected subjects or in the incidence of situs inversus that affects 50% of subjects.
This article discusses the nomenclature of respiratory disease, acute respiratory distress syndromes, hypersensitivity diseases, chronic respiratory disease, and the differential diagnosis of respiratory disease.
INTRODUCTION: Infectious acute respiratory disease (ARD) is a significant cause of worldwide morbidity, disproportionately affecting individuals living in crowded conditions, such as found at military training centers, school dormitories, and correctional facilities. Vaccines have been used to protect against ARD; however, these are not always available or effective. METHODS: The medical literature (1963-2004) on preventive nonvaccine ARD interventions (NOVARDIs) for infectious diseases, which addressed personal measures, administrative controls, and engineering controls, was studied during 2000 to 2004. Population-based studies in community settings (non-health care) were reviewed in detail to evaluate the effectiveness of NOVARDIs. Budgetary and logistic factors as well as acceptance were considered in formulating recommendations for implementation of NOVARDIs in military training centers. RESULTS: Thirty-eight population-based studies contained in 35 publications were examined. Three studies contained information on multiple NOVARDIs. Nine studies supported the use of personal measures relating to hand hygiene. Ten studies supported administrative controls such as cohorting military training units to reduce contact between units (4 studies), providing adequate personal space to reduce crowding (5), and cloth barriers between beds (1); and 14 studies supported the use of engineering controls such as increased indoor air dilution and ventilation (2), dust suppression (4), and air sterilization (8). CONCLUSIONS: Promoting hand hygiene and reducing crowding through the provision of adequate living space and cohorting of training units may offer benefits in respiratory disease control. These interventions, along with UV lights and air dilution/ventilation, deserve further evaluation in controlled studies to assess their efficacy. NOVARDIs could benefit military and other populations living in close contact.
Upper respiratory disease has been a serious problem in Standardbred horses on racetracks in Ontario, with outbreaks occurring once or twice annually in late winter and early spring seasons. To determine the causes of these epidemics, a 3-year investigation was carried out in which nasal swabs and serum samples were obtained at intervals from apparently healthy horses and from horses suffering from upper respiratory disease. The nasal swabs were used to isolate bacteria and viruses. The serum samples were examined for the presence and level of antibodies to equine influenza viruses and equine herpesvirus 1. None of the bacteria isolated were associated with the outbreaks of disease. Equine herpesvirus 2 was isolated 72 times from both diseased and apparently healthy horses. Equine herpesvirus 1 was isolated 10 times from horses with respiratory disease, both during and between epidemics. Influenza equine/1 virus was isolated seven times and influenza equine/2 was isolated once during severe outbreaks of upper respiratory disease. Serological evidence confirmed that influenza viruses were the causes of the major epidemics, with the equine/1 strain being involved most often.
Multifactorial diseases such as respiratory disease call for a global analysis of such disorders. Recent advances in protein profiling techniques may allow for early diagnosis of respiratory disease, which is crucial for intervention and treatment. In order to reduce false-positive rates, clinical diagnosis requires a high degree of sensitivity and specificity to be an effective screening tool. Protein profiles identified by ProteinChip (Ciphergen Biosystems) technology coupled with mass spectrometry affords a global analysis of clinical samples and is beginning to reach acceptable levels of sensitivity and specificity. Combining the profile with another diagnostic tool enhances the effectiveness of protein profiles to classify disease. Although current efforts have centered on serum protein profiling, the local environment of the lung may be better reflected in proteins of bronchoalveolar lavage or sputum. Identification of biomarkers of disease by protein profiling analyses may lead to an understanding of the mechanisms of this disease and contribute to the discovery of new therapeutics for the prevention and treatment of disease. Advancing these analyses are techniques such as ProteinChip mass spectrometry, laser capture microdissection, tissue microarrays and fluorescently labeled antibody bead arrays, which enable the direct global analysis of complex mixtures. Effective high-throughput and ease of use of clinical testing will arrive with improvements in bioinformatics and decreases in instrumentation costs.
This review examines the relations between early childhood lower respiratory symptoms and adult respiratory disease. The problems associated with investigating potential associations between respiratory disease in children and adults are discussed. Some studies have limitations because they are retrospective and early childhood respiratory symptoms have not been accurately diagnosed. Therefore, in this review, particular attention is paid to longitudinal studies (some from birth) that have used strict diagnostic criteria for respiratory episodes. These studies provide unique insights into the risk factors for the development of childhood respiratory problems and for persistence of symptoms into adulthood. Although cross-sectional studies have indicated that early childhood respiratory disease is more frequent in adults with respiratory disease, evidence from longitudinal studies suggests that respiratory symptoms such as wheezing, are transient in the majority of infants and result from developmentally small airways. These longitudinal investigations have also indicated that persistence of symptoms into later childhood is associated with atopy. The important role of cigarette-smoke exposure as a risk factor for abnormal pulmonary development, persistence of respiratory disease and reduction in lung function is discussed. The discovery of genetic markers associated with respiratory syndromes such as asthma, should facilitate studies that investigate the childhood antecedents of adult respiratory disease. Future longitudinal studies using genetic markers, will allow relations between specific genotypes and phenotypic outcomes to be examined.
Swine influenza virus (SIV), porcine respiratory coronavirus (PRCV) and porcine reproductive and respiratory syndrome virus (PRRSV) are enzootic viruses causing pulmonary infections in pigs. The first part of this review concentrates on known clinical and pathogenetic features of these infections. SIV is a primary respiratory pathogen; PRCV and PRRSV, on the contrary, tend to cause subclinical infections if uncomplicated but they appear to be important contributors to multifactorial respiratory diseases. The exact mechanisms whereby these viruses cause symptoms and pathology, however, remain unresolved. Classical studies of pathogenesis have revealed different lung cell tropisms and replication kinetics for each of these viruses and they suggest the involvement of different lung inflammatory responses or mediators. The proinflammatory cytokines interferon-alpha (IFN-alpha), tumour necrosis factor-alpha (TNF-alpha) and interleukin-1 (IL-1) have been shown to play key roles in several respiratory disease conditions. The biological effects of these cytokines and their involvement in human viral respiratory disease are discussed in the second part of this review. The third part summarises studies that were recently undertaken in the authors' laboratory to investigate the relationship between respiratory disease in pigs and bioactive lung lavage levels of IFN-alpha, TNF-alpha and IL-1 during single and combined infections with the above viruses. In single SIV infections, typical signs of swine "flu" were tightly correlated with an excessive and coordinate production of the 3 cytokines examined. PRCV or PRRSV infections, in contrast, were subclinical and did not induce production of all 3 cytokines. Combined infections with these 2 subclinical respiratory viruses failed to potentiate disease or cytokine production. After combined inoculation with PRCV followed by bacterial lipopolysaccharide, both clinical respiratory disease and TNF-alpha/IL-1 production were markedly more severe than those associated with the respective single inoculations. Taken together, these data are the first to demonstrate that proinflammatory cytokines can be important mediators of viral respiratory diseases in pigs.
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Bovine Respiratory Disease (BRD) results from a complex, multifactorial interaction of stressors, animal susceptibility, and respiratory pathogens. The infectious agents associated with BRD are ubiquitous among cattle populations. Typically, one or a combination of stressors are necessary to initiate BRD. Prevention of BRD should, therefore, address management procedures to minimise stressors. Administration of vaccines against BRD agents may help reduce the incidence of BRD but is unlikely to eliminate the condition. The effectiveness of antimicrobials in the treatment of BRD depends primarily on early recognition and treatment. The use of antioxidant vitamins, minerals or other agents in the prevention and treatment of BRD warrants further research.
The prevalence of respiratory disease and the spread of risk factors were studied in adolescents living in Saratov. Respiratory diseases held the lead among other classes of diseases in young people; these diseases were more prevalent in adolescents than in children and adults. Examination of their outpatient cards revealed defects in the management of pulmonological patients. Screening could identify the most important risk factors of respiratory diseases (such as poor housing and living conditions, smoking, and recurrent acute respiratory viral infections (ARVI)) and make up three groups of patients: 1) those at risk for respiratory diseases and frequently ARVI; 2) those with acute respiratory diseases; and 3) those with chronic respiratory diseases.
Acute respiratory diseases, most of which are generally attributed to viruses, account for about 6% of all deaths and for about 60% of the deaths associated with all respiratory disease. The huge cost attributable to viral respiratory infections as a result of absenteeism and the disruption of business and the burden of medical care makes control of these diseases an important objective. The viruses that infect the respiratory tract fall taxonomically into five viral families. Although immunoprophylaxis would appear to be the logical approach, the development of suitable vaccines has been confronted with numerous obstacles, including antigenic drift and shift in the influenzaviruses, the large number of antigenically distinct immunotypes among rhinoviruses, the occurrence after immunization of rare cases of a severe form of the disease following subsequent natural infection with respiratory syncytial virus, and the risk of oncogenicity of adenoviruses for man. Considerable expenditure on the development of new antiviral drugs has so far resulted in only three compounds that are at present officially approved and licensed for use in the USA. Efforts to improve the tools available for control should continue and imaginative and inventive approaches are called for. However, creativity and ingenuity must operate within the constraints imposed by economic, political, ethical, and legal considerations.
Clinical, virologic and seroligic investigations on vaccinated and unvaccinated pigs fattened on two farms with a record of a stationary Aujeszky's disease infection were carried out. Aujeszky's virus was isolated from the lungs of all pigs and partially of other viscera of some of the animals. The serologic studies revealed the dynamics of the antibody titer reise which spoke of the development of an infectious process. The clinical signs observed along with the morphologic changes characteristic of pneumonia, coupled with the advancement of the Aujeszky's disease infection demonstrated that on stationary fattening pig farms Aujeszky's disease assumed the course of a respiratory affection. The discripancy between the results obtained with vaccinated and unvaccinated animals, which were negligible on one of the farms and considerable on the other, was due to variations in the intensity of the infection as well as to the level of passive immunity.
Clinical signs of acute respiratory disease of turkeys were transmitted to susceptible day-old poults by direct contact, litter contact, and drinking water. Attempts failed to transmit the disease by air (cage-to-cage) or by oral and nasal inoculation with feces, nasal exudates, or nasal turbinate extracts. The disease was not transmitted by inoculation with white blood cells. Chicks were not affected by the disease, but young quail developed signs of respiratory disease when exposed to contaminated drinking water. Thus, acute respiratory disease in turkeys appears to be of an infectious nature, and the infectious agent(s) probably exist in the heavily contaminated environment used to house young commercial turkey poults.
Outbreaks of respiratory disease constitute a major health problem in herds of finishing pigs and their aetiology often remains unclear. In this study, 16 outbreaks of respiratory disease with acute clinical signs in finishing pigs were investigated to determine which infectious agents were involved. From each herd four diseased and two clinically healthy pigs were examined pathologically and for the presence of viruses, bacteria and mycoplasmas. In addition, paired blood samples from 10 groupmates of the diseased pigs were tested for antibodies against commonly known causal agents of respiratory disease. A clear diagnosis was possible in 12 of the 16 outbreaks. Seven were due to an infection with influenza virus and five were due to an infection with Actinobacillus pleuropneumoniae. A combination of influenza virus and A pleuropneumoniae may have caused one other outbreak, but no clear cause could be established for the other three outbreaks.