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PubMed1991

[Clinical studies on ciprofloxacin in chronic respiratory tract infection].

Ciprofloxacin (CPFX), a new pyridone carboxylic acid, was administered orally to the patients with chronic respiratory tract infection and its clinical efficacy and safety were studied in a multicenter open trial. The results and summarized as follows. 1. The efficacy rate for the patients with acute exacerbation as 52.5% (21/40) in 2 week-treatment, and 75.0% (24/32) in 4 week-treatment. 2. The efficacy rate for the patients with chronic phase was 23.1% (6/26) in 2 week-treatment, and 26.9% (7/26) in 4 week-treatment, but acute exacerbation was not observed in any of the patients. 3. CPFX was administered to 6 patients over 60 days for the prophylaxis of acute exacerbation. Only 2 patients had acute exacerbation in 2 and 3 months after the start of the therapy, respectively. 4. Bacteriological eradication rate was high except P. aeruginosa, for which the eradication rate was about 20%. 5. Side effects were observed in 3 patients, and abnormal findings of laboratory tests were observed in 5 patients, though they were not severe. These results show that CPFX is a useful antimicrobial agent for the treatment of chronic respiratory tract infections.

Administration, Oral↗

PubMed2006

Utility of direct fluorescent antibody testing of nasopharyngeal washes in children with and without respiratory tract illness.

BACKGROUND: Direct fluorescent antibody (DFA) testing of nasopharyngeal wash specimens is a rapid and reliable means of diagnosing respiratory viral infection. The utility of DFA testing in the evaluation of febrile children without respiratory symptoms has not been critically evaluated. It is not known whether clinical or demographic factors apart from respiratory symptoms are associated with a positive DFA or whether a positive DFA is more likely to be associated with lower or upper respiratory tract symptoms (RTS). METHODS: This is a retrospective case-series of 756 consecutive nasopharyngeal specimens with respiratory DFA testing performed at the University of California San Francisco from November 1, 2002 through October 31, 2003. RESULTS: No RTS was a statistically significant predictor of negative DFA [odds ratio (OR), 0.03; 95% confidence interval (CI), 0.004-0.2; P = 0.001] compared with lower RTS. Male subjects were more likely than female subjects to have a positive DFA (OR 1.8; 95% CI 1.1-2.8; P = 0.02). Specimens collected from April to October were less likely to have a positive DFA (OR 0.4; 95% CI 0.2-0.7; P = 0.001). Specimens collected at the time of hospital admission and during a hospitalization were less likely to have a positive DFA (OR 0.5; 95% CI 0.3-0.9; P = 0.01 and OR, 0.07; 95% CI 0.02-0.2; P = 0.001, respectively) compared with specimens collected in the outpatient setting. CONCLUSION: The yield of testing children without respiratory tract illness is extremely low.

Acute Disease↗

PubMedDate not supplied

Comparison of two oral forms of erythromycin in the treatment of acute respiratory tract infections. A multicentre general practice study.

A total of 1244 patients with acute upper or lower respiratory tract infection were randomized to receive, twice daily for 7 days, either capsules of enteric-coated pellets of erythromycin base at a dose of 1 g/day or erythromycin ethylsuccinate tablets at a dose of 2 g/day in a single-blind, multicentre study. The efficacy of each formulation was similar, with about 90% of patients who had completed at least 5 days of treatment being reported as either cured or improved. Gastro-intestinal symptoms were the most commonly reported side-effects, being significantly more frequent in patients receiving erythromycin base. Gastro-intestinal intolerance was also the main reason for discontinuing either treatment, although it was a significantly more frequent reason in patients given erythromycin base. This study indicates that both formulations of erythromycin are highly effective for routine, empirical treatment of acute respiratory tract infections. Erythromycin base, however, appears to be less well tolerated than erythromycin ethylsuccinate.

Acute Disease↗

PubMed2002

Sarcoidosis of the upper respiratory tract. Selected cases emphasizing diagnostic and therapeutic difficulties.

BACKGROUND: Sarcoidosis of the upper respiratory tract (SURT) is a frequently overlooked and inadequately treated complication of sarcoidosis. AIM: The aim of this descriptive study is to present selected cases of sarcoidosis of the upper respiratory tract depicting diagnostic and therapeutic challenges. METHODS AND RESULTS: Five selected patients who either had an unusual initial presentation or an unusual clinical course were included if they also had long follow up. The diagnosis of SURT was based on the conventional criteria including histological evidence and appropriate microbiological studies. CONCLUSION: These case studies underline problems that may arise when SURT is not recognized early and appropriate and adequate treatment is delayed.

Adult↗

PubMed1988

Mycobacterium bovis in the anterior respiratory tracts in the heads of tuberculin-reacting cattle.

Twenty-five of 50 randomly selected tuberculin-reacting cattle were confirmed as tuberculous in the laboratory. All 25 cattle had macroscopic lesions in lymph nodes associated with the respiratory tracts but only one had lung lesions. M bovis was isolated from the anterior respiratory tracts in the heads of four of the 25 tuberculous animals and from a nostril lesion found in a fifth. For at least three of these five animals, the intervals between the final tuberculin test and their previously negative tests indicated that infection had established relatively rapidly. Four of them had been tuberculin tested solely because they were animals in contiguous 'at risk' herds. It would appear that although M bovis can be isolated from the anterior respiratory tracts in the heads of tuberculin-reacting cattle, it is unlikely that primary foci of infection exist in regions other than the lungs or associated tissues. The study demonstrates the potential for reactors with lesions to excrete M bovis and the continued importance of infected cattle in the epidemiology and eradication of the disease.

Animals↗

PubMed1991

Chronic upper respiratory tract disease of free-ranging desert tortoises (Xerobates agassizii).

Seventeen desert tortoises, Xerobates agassizii, with upper respiratory tract disease were examined; thirteen were euthanatized for necropsy. Four normal control desert tortoises from a clinically healthy population were similarly evaluated. Hemoglobin and phosphorus values were significantly (P less than or equal to 0.05) lower and serum sodium, urea, SGOT, and cholesterol values were significantly higher in ill tortoises compared to controls. No significant differences in concentrations of serum or liver vitamins A and E were found between the two groups. While no significant differences were found for concentrations of lead, copper, cadmium, and selenium, the livers of ill tortoises had higher concentrations of mercury and iron. Lesions were found consistently in the upper respiratory tract (URT) of ill tortoises. In all ill tortoises dense infiltrates of lymphocytes and histiocytes obscured the mucosal epithelium and underlying glands. The mucosal epithelium was variably dysplastic, hyperplastic, and occasionally ulcerated. Electron microscopic studies revealed small (350 to 900 nm), pleomorphic organisms resembling Mycoplasma sp., in close association with the surface epithelium of the URT of ill tortoises. Pasteurella testudinis was cultured from the nasal cavity of all ill tortoises and one of four control tortoises. A Mycoplasma sp. was cultured from the nasal passageways of four ill tortoises and was ultrastructurally similar to the pleomorphic organism present on the mucosa in tissue section.

Animals↗

PubMed1991

[Lower respiratory tract flora in intubated patients].

200 lower respiratory tract (LRT) aspirates were taken via endotracheal intubates in 49 respiratory failure patients for quantitative bacterial cultures. 373 strains of bacteria and fungi were isolated and 63.3% were gram negative bacilli (GNB). During intubation, the isolation rate of Pseudomonas species gradually increased. In recent years, Enterobacteriaceae species, S. pneumoniae and S. aureus as LRT flora are decreasing, but Pseudomonas species, is increasing. The bacteria in aspirates with concentration higher than 10(5)CFU/ml could be considered as etiologic bacteria. Accordingly we estimated that the GNB infection rate was 81.6% and fatality rate was 15.0% in these 49 cases. Bacteriologic survey of the patients' oropharynx, respiratory instrument and the medical workers' finger skin suggested that besides the descending of oropharynx flora, environmental bacteria may also form LRT flora via endotracheal intubates.

Adult↗

PubMed1996

Investigation of the effects and aftereffects of naturally occurring upper respiratory tract illnesses on mood and performance.

This study examined the effects and aftereffects of naturally occurring upper respiratory tract illnesses on mood and performance. Twenty-six subjects (12 males, 14 females, mean age 23 years 10 months, age range 18-39 years) were tested once a week for a period of a month. Fifteen subjects were suffering from a common cold on the first week and the other 11 subjects were matched healthy controls. Subjects attended for an initial 3-h testing period that consisted of a set of practice trials and two test sessions involving mood rating and performance of a battery of tests measuring psychomotor functions, attention, and memory. Sessions 3, 4, and 5 took place 1, 2, and 3 weeks later, respectively. In addition to measuring mood and mental performance, symptom severity was rated on a subjective checklist. The results showed that subjects with a cold reported an increase in negative mood and that this was only significant in the first week. Impairments of psychomotor function (simple reaction time and tracking) were also observed at this time. Performance of sustained and selective attention tasks was also impaired in subjects with colds but this effect was only significant in the second week. Other functions such as working and semantic memory were unimpaired in subjects with colds at any point in the experiment. Overall, the present results confirm many of the earlier results obtained in studies of experimentally induced upper respiratory tract illnesses. Indeed, these results are both of great practical importance and theoretical interest and further studies must now elucidate the mechanisms underlying these effects.

Adolescent↗

PubMed2004

Comparative in vitro activities of three new quinolones and azithromycin against aerobic pathogens causing respiratory tract and abdominal wound infections.

BACKGROUND: In our study the in vitro susceptibility of common pathogens that cause respiratory tract and abdominal wound infections was tested against two newer fluorquinolones (moxifloxacin and gatifloxacin) as well as levofloxacin and azithromycin. METHODS: 50 isolates each of methicillin-susceptible Staphylococcus aureus, Enterococcus faecalis, Enterococcus faecium, Streptococcus pneumoniae, Streptococcus pyogenes, Escherichia coli, Pseudomonas aeruginosa and Haemophilus influenzae isolated from the respiratory tract and from wounds were tested for their susceptibility to moxifloxacin, gatifloxacin, levofloxacin and azithromycin. RESULTS: Moxifloxacin proved to be the most active substance against the tested gram-positive pathogens. Gatifloxacin was the most active against P. aeruginosa. Moxifloxacin and gatifloxacin proved to be comparably active against the clinical isolates of E. coli and H. influenzae. CONCLUSIONS: Moxifloxacin and gatifloxacin display excellent activity against respiratory pathogens as well as nosocomial pathogens causing abdominal wound infections. When treating infections caused by P. aeruginosa the earlier fluorquinolones such as ciprofloxacin or ofloxacin are the substances of choice.

Abdominal Injuries↗

PubMed1991

Diagnosis of IgE-mediated allergy in the upper respiratory tract.

A statistical analysis was made of data concerning diagnosis of IgE-mediated allergy in the upper respiratory tract in 292 patients. A study was made of: skin test, total and specific IgE (RAST), X-sinus, red blood investigation, and cytology of nasal smear. It appears that screening for the presence of an IgE-mediated allergy in the upper respiratory tract can be performed efficiently with a limited number of skin tests (rye grass, timothy, birch, house dust mite and cat). In this study a greater number of skin tests (15 instead of 5) yielded little additional information (in 2% of the patients). A rather poor correlation between skin test and RAST was found.

Adolescent↗

PubMed2002

Long-term effects of chemical weapons on respiratory tract in Iraq-Iran war victims living in Babol (North of Iran).

In the Iraq-Iran war (1981-1989), extensive use of chemical weapons such as mustard gas caused high mortality, morbidity, injuries, and chronic side effects in vital organs, especially the respiratory tract. This study was performed to evaluate the long-term effects on respiratory tract of victims. Two hundred and twenty victims were referred from the Mostazafan and Janbazan Foundation of Babol from 1994 to 1998. Complete histories, physical examinations, chest X-rays, and PFTs were performed. Nearly all the victims complained of cough, dyspnea, and suffocation. Hemoptysis was found in 6 victims. In 4 patients, respiratory distress with use of accessory muscles was observed. Two-thirds of the subjects had wheezing and coarse rale. For the other third, physical examination revealed no abnormal finding. Radiographic findings were mostly normal. Spirometry revealed an obstructive pattern in all patients and PFT revealed mostly normal and restrictive patterns. The shortlist time from exposure to study was 7 years and the longest was 13 years. Most patients reported mustard gas exposure and a few of them did not know what type of gas exposure they had. The clinical evaluations, radiography, and PFTs revealed that the most prevalent effects of chemical weapons on respiratory tract were chronic obstructive lung disease, presenting as many types of obstructive involvement.

Adult↗

PubMed1999

[Antimicrobial activities of cefetamet against clinically isolated strains from community acquired respiratory tract infections. Part III].

Antimicrobial activities of cefetamet (CEMT) against clinically isolated strains from patients with community acquired respiratory tract infections were investigated in comparison with those of other oral beta-lactam antibiotics during the period from January to March, 1998. The results are summarized as follows; 1. CEMT showed strong antimicrobial activities against three major pathogens causing community acquired respiratory tract infections, Streptococcus pyogenes, Streptococcus pneumoniae and Haemophilus influenzae. However, antimicrobial activities of CEMT against penicillins (PCs)-intermediate S. pneumoniae (PISP) and PCs-resistant S. pneumoniae (PRSP) were slightly weaker than those of some of the reference antibiotics. 2. No chronological changes of CEMT-MIC level were observed in the antimicrobial activities against S. pyogenes, H. influenzae, Moraxella subgenus Branhamella catarrhalis or Klebsiella pneumoniae subsp. pneumoniae. In contrast to this, due to the increase of PISP and PRSP strains, resistance to CEMT appears increasing with time.

Anti-Bacterial Agents↗

PubMed1992

Upper respiratory tract deposition of inspired acetaldehyde.

Inhalation exposure of rodents to high concentrations of acetaldehyde produces lesions in the upper respiratory tract (URT, all regions of the respiratory tract anterior to and including the larynx). Information on the inhalation dosimetric relationships for this vapor are needed for a comprehensive understanding of its inhalation toxicity. Toward this end, uptake of acetaldehyde was measured in the surgically isolated URT of the urethane-anesthetized male F344 rat under unidirectional (50, 100, 200, or 300 ml/min) and cyclic (100 ml/min) flow conditions at inspired concentrations of 1, 10, 100, or 1000 ppm. Under all flow conditions URT deposition efficiency was strongly dependent on inspired concentration. URT deposition efficiency (under cyclic flow) averaged 76, 48, 41, and 26% at 1, 10, 100, and 1000 ppm, respectively. Nasal acetaldehyde dehydrogenase activity averaged 1.2 micrograms/min. Absolute acetaldehyde deposition rates (micrograms/min) at 100 and 1000 ppm exceeded this activity by 5- to 100-fold, suggesting a possible mechanism for the reduced deposition efficiency at high concentrations. URT deposition under unidirectional flow was strongly dependent on the inspiratory flow rate. The effect of flow rate on deposition was reasonably predicted by the mass-transfer model of Aharonson et al. (J. Appl. Physiol. 37, 654-657, 1974). The uptake coefficients determined from the unidirectional flow studies were used to predict uptake under cyclic flow by integration of the model. The predicted cyclic deposition efficiencies differed from the observed efficiencies by 2.3 +/- 4.3% (mean +/- SEM), suggesting this model might provide a reasonable first approximation for acetaldehyde uptake under cyclic breathing conditions.

Acetaldehyde↗

PubMed1981

Tumours in Iceland. 4. Tumours of the upper respiratory tract and ear. A histological classification and some etiological and epidemiological considerations.

All primary tumours from the upper respiratory tract and ear submitted for a histological diagnosis in Iceland during the 20 years, 1955-1974, were reviewed and typed according to the World Health Organization Classification published in 1978. The series included 83 benign and 114 malignant tumours from the upper respiratory tract. The nasal cavity was the commonest site for benign tumours in both sexes, most being squamous cell and transitional papillomas. The larynx was the commonest site for malignant tumours in males, all being squamous cell carcinomas, and the paranasal sinuses and the nasopharynx in females, squamous cell carcinoma forming the largest group in the sinuses and undifferentiated carcinoma in the nasopharynx. The distribution of tumours in the nasal cavity and sinuses differed much between the two sites and between the sexes, which emphasizes that these two sites should be separated and not combined as they have been until recently in epidemiological reports and cancer registries. A relatively high incidence of nasopharyngeal carcinoma in Iceland may be due to a high consumption of salted food. A rising incidence of laryngeal carcinoma is believed to be related to the use of tobacco and alcohol and is of special concern owing to its marked rise in young females.

Adolescent↗

PubMed1998

[Study of the viral etiology of lower respiratory tract infections in a neonatal unit].

OBJECTIVE: To study the possible viral etiology in 139 infants with lower respiratory tract infection who required hospitalization in the Infant Unit of our hospital, from October 1994 to June 1995. PATIENTS AND METHODS: 139 patients were admitted, aged from 13 days to 14 months, during this period. The etiological agent was detected by direct immunofluorescence from nasopharyngeal secretions. Monoclonal antibodies were used against Respiratory Syncitial Virus, Influenza A Virus, Influenza B Virus, Adenovirus and Parainfluenza 3 Virus. Antibody detection against these viruses by Complement Fixation Test was done on 29 of these patients, with paired sera (acute and convalescent phase). RESULTS: In 82 patients (59%) we found at least one viral agents from the nasopharyngeal specimens, but in 64 of these only one was detected, in the remaining 18, there were more than one. Significant levels of antibodies were detected in only six of the 29 patients tested. Serology was negative in the remaining 23 patients. CONCLUSIONS: Syncitial Respiratory Virus is the first virus responsible for the lower respiratory tract infection in this age group (49%). There was no correlation between serological diagnosis and antigen detection.

Antigens, Viral↗

PubMed1996

Hospital admissions for lower respiratory tract illness before the age of two years in western Australia.

In this study, hospital admissions for lower respiratory tract illness before two years of age have been documented for all children born in Western Australia in 1986. Admissions data were linked to birth and death records for individual children. Of the total cohort, 5% of non-Aboriginal and 17% of Aboriginal children were hospitalised only once for lower respiratory tract illness; 1% of non-Aboriginal and 11% of Aboriginal children had repeated admissions. Perinatal conditions comprised the greatest proportion of the admissions for non-Aboriginal children, and pneumonia for Aboriginal children. Non-Aboriginal children had decreasing admission rates from the neonatal period onwards, whereas those for Aboriginal children increased. For all children, those of low or high birthweight, male sex and those with young or unmarried mothers or residing in country regions were more likely to be admitted. This research has highlighted potential risk factors for serious respiratory illness in early childhood and has shown the feasibility of using linked data for the total population to formulate and test hypotheses relating to respiratory morbidity.

Adolescent↗

PubMed2002

Polymerase chain reaction-restriction fragment length polymorphism analysis of the SzP gene of Streptococcus zooepidemicus isolated from the respiratory tract of horses.

OBJECTIVE: To develop polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis for molecular typing of strains of Streptococcus zooepidemicus and to use the new typing method to analyze a collection of isolates from the respiratory tract of Thoroughbreds. SAMPLE POPULATION: 10 strains of S zooepidemicus, 65 isolates from the respiratory tract of 9 yearlings following long distance transportation, and 89 isolates from tracheal aspirates of 20 foals with pneumonia. PROCEDURE: Phenotypic variations in the SzP protein were detected by western immunoblot analysis. Using PCR-RFLP analysis, genotypes were obtained with primer sets from the SzP gene, followed by restriction endonuclease digestion of the amplicons. RESULTS: Unique genotypic patterns were obtained with a primer set designed from both ends of the structural gene and the restriction endonuclease DdeI. Forty-five isolates from the lymphoid tissue within the pharyngeal recess (ie, pharyngeal tonsil) of yearlings included 10 SzP genotypes and SzP phenotypes. Isolates from the trachea of each yearling were of a single genotype that was also present among isolates from the pharyngeal tonsil of the same horses. Isolates from tracheal aspirates of foals belonged to 14 genotypes. CONCLUSIONS AND CLINICAL RELEVANCE: Analysis of the SzP gene by use of PCR-RFLP was effective for molecular typing of strains of S zooepidemicus in the study of respiratory tract disease in horses. Results of PCR-RFLP analysis indicate that a single strain of S zooepidemicus can migrate from the pharyngeal tonsil to the trachea at a high rate in horses undergoing long distance transportation.

Adenoids↗

PubMed1979

Epidemiology of equine upper respiratory tract disease on standardbred racetracks.

The outbreaks of upper respiratory tract infections in horses at Standardbred racetracks were investigated over a three year period. The most serious epidemics of respiratory disease occurred in the winter and spring seasons. Both influenza viruses and equine herpesvirus 1 were shown to be present in the horse population. The herpesvirus was associated with respiratory disease particularly in the winter but the equine influenza viruses apparently were responsible for the major epidemics of respiratory disease at these tracks. Younger horses, two or three years of age, were particularly susceptible to upper respiratory disease and showed the greatest rate of seroconversion to influenza viruses. Major outbreaks of respiratory disease occurred when the proportion of young horses which had not previously been exposed to epidemics of respiratory disease reached 30 to 40% of the population at the track. Most horses over four years of age appeared to develop resistance to the infections.

Age Factors↗