Respiratory disease among military personnel in Saudi Arabia during Operation Desert Shield.

PubMed Central

Richards, A L; Hyams, K C; Watts, D M; Rozmajzl, P J; Woody, J N; Merrell, B R

1993-01-01

OBJECTIVES. The purpose of this study was to determine whether respiratory disease due to crowded living conditions and high levels of suspended and blowing sand had a major adverse impact on US military personnel during Operation Desert Shield. METHODS. A questionnaire survey was administered to 2598 combat troops stationed in Northeast Saudi Arabia for a mean of 102 days. Samples of surface sand from seven different locations were analyzed by scanning electron microscopy and x-ray diffraction. RESULTS. Among surveyed troops, 34.4% reported a sore throat, 43.1% complained of a cough, 15.4% complained of chronic rhinorrhea, and 1.8% were unable to perform their routine duties because of upper respiratory symptoms. Evaluation of sleeping accommodations indicated that complaints of a sore throat and cough were most closely associated with sleeping in air-conditioned buildings; in contrast, complaints of rhinorrhea were associated with exposure to the outdoor environment while living in tents. Sand samples consisted mostly of quartz, with just 0.21% by weight of respirable size (< 10 microns in diameter). CONCLUSIONS. These findings indicate that upper respiratory complaints were frequent among Operation Desert Shield troops and were related both to the troops' housing and to their exposure to the outside environment. PMID:8363011

Air pollution and emergency department visits for respiratory diseases: A multi-city case crossover study.

PubMed

Szyszkowicz, Mieczysław; Kousha, Termeh; Castner, Jessica; Dales, Robert

2018-05-01

Increasing evidence suggests that ambient air pollution is a major risk factor for both acute and chronic respiratory disease exacerbations and emergencies. The objective of this study was to determine the association between ambient air pollutants and emergency department (ED) visits for respiratory conditions in nine districts across the province of Ontario in Canada. Health, air pollutant (PM 2.5 , NO 2 , O 3 , and SO 2 ), and meteorological data were retrieved from April 2004 to December 2011. Respiratory diseases were categorized as: chronic obstructive pulmonary disease (COPD, including bronchiectasis) and acute upper respiratory diseases. A case-crossover design was used to test the associations between ED visits and ambient air pollutants, stratified by sex and season. For COPD among males, positive results were observed for NO 2 with lags of 3-6 days, for PM 2.5 with lags 1-8, and for SO 2 with lags of 4-8 days. For COPD among females, positive results were observed for O 3 with lags 2-4 days, and for SO 2 among lags of 3-6 days. For upper respiratory disease emergencies among males, positive results were observed for NO 2 (lags 5-8 days), for O 3 , (lags 0-6 days), PM 2.5 (all lags), and SO 2 (lag 8), and among females, positive results were observed for NO 2 for lag 8 days, for O 3 , PM 2.5 among all lags. Our study provides evidence of the associations between short-term exposure to air pollution and increased risk of ED visits for upper and lower respiratory diseases in an environment where air pollutant concentrations are relatively low. Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.

Air pollution and hospital visits for acute upper and lower respiratory infections among children in Ningbo, China: A time-series analysis.

PubMed

Zheng, Pei-Wen; Wang, Jian-Bing; Zhang, Zhen-Yu; Shen, Peng; Chai, Peng-Fei; Li, Die; Jin, Ming-Juan; Tang, Meng-Ling; Lu, Huai-Chu; Lin, Hong-Bo; Chen, Kun

2017-08-01

Acute upper and lower respiratory infections are main causes of mortality and morbidity in children. Air pollution has been recognized as an important contributor to development and exacerbation of respiratory infections. However, few studies are available in China. In this study, we investigated the short-term effect of air pollution on hospital visits for acute upper and lower respiratory infections among children under 15 years in Ningbo, China. Poisson generalized models were used to estimate the associations between air pollution and hospital visits for acute upper and lower respiratory infections adjusted for temporal, seasonal, and meteorological effects. We found that four pollutants (PM 2.5 , PM 10 , NO 2 , and SO 2 ) were significantly associated with hospital visits for acute upper and lower respiratory infections. The effect estimates for acute upper respiratory infections tended to be higher (PM 2.5 ER = 3.46, 95% CI 2.18, 4.76; PM 10 ER = 2.81, 95% CI 1.93, 3.69; NO 2 ER = 11.27, 95% CI 8.70, 13.89; SO 2 ER = 15.17, 95% CI 11.29, 19.19). Significant associations for gaseous pollutants (NO 2 and SO 2 ) were observed after adjustment for particular matter. Stronger associations were observed among older children and in the cold period. Our study suggested that short-term exposure to outdoor air pollution was associated with hospital visits for acute upper and lower respiratory infections in Ningbo.

Upper respiratory tract (image)

MedlinePlus

The major passages and structures of the upper respiratory tract include the nose or nostrils, nasal cavity, mouth, throat (pharynx), and voice box (larynx). The respiratory system is lined with a mucous membrane that ...

Respiratory inflammation and infections in high-performance athletes.

PubMed

Gleeson, Maree; Pyne, David B

2016-02-01

Upper respiratory illness is the most common reason for non-injury-related presentation to a sports medicine clinic, accounting for 35-65% of illness presentations. Recurrent or persistent respiratory illness can have a negative impact on health and performance of athletes undertaking high levels of strenuous exercise. The cause of upper respiratory symptoms (URS) in athletes can be uncertain but the majority of cases are related to common respiratory viruses, viral reactivation, allergic responses to aeroallergens and exercise-related trauma to the integrity of respiratory epithelial membranes. Bacterial respiratory infections are uncommon in athletes. Undiagnosed or inappropriately treated asthma and/or allergy are common findings in clinical assessments of elite athletes experiencing recurrent URS. High-performance athletes with recurrent episodes of URS should undergo a thorough clinical assessment to exclude underlying treatable conditions of respiratory inflammation. Identifying athletes at risk of recurrent URS is important in order to prescribe preventative clinical, training and lifestyle strategies. Monitoring secretion rates and falling concentrations of salivary IgA can identify athletes at risk of URS. Therapeutic interventions are limited by the uncertainty of the underlying cause of inflammation. Topical anti-inflammatory sprays can be beneficial for some athletes. Dietary supplementation with bovine colostrum, probiotics and selected antioxidants can reduce the incidence or severity of URS in some athletes. Preliminary studies on athletes prone to URS indicate a genetic predisposition to a pro-inflammatory response and a dysregulated anti-inflammatory cytokine response to intense exercise as a possible mechanism of respiratory inflammation. This review focuses on respiratory infections and inflammation in elite/professional athletes.

Postoperative respiratory muscle dysfunction: pathophysiology and preventive strategies.

PubMed

Sasaki, Nobuo; Meyer, Matthew J; Eikermann, Matthias

2013-04-01

Postoperative pulmonary complications are responsible for significant increases in hospital cost as well as patient morbidity and mortality; respiratory muscle dysfunction represents a contributing factor. Upper airway dilator muscles functionally resist the upper airway collapsing forces created by the respiratory pump muscles. Standard perioperative medications (anesthetics, sedatives, opioids, and neuromuscular blocking agents), interventions (patient positioning, mechanical ventilation, and surgical trauma), and diseases (lung hyperinflation, obesity, and obstructive sleep apnea) have differential effects on the respiratory muscle subgroups. These effects on the upper airway dilators and respiratory pump muscles impair their coordination and function and can result in respiratory failure. Perioperative management strategies can help decrease the incidence of postoperative respiratory muscle dysfunction. Such strategies include minimally invasive procedures rather than open surgery, early and optimal mobilizing of respiratory muscles while on mechanical ventilation, judicious use of respiratory depressant anesthetics and neuromuscular blocking agents, and noninvasive ventilation when possible.

Conjunctival Lymphangioma: A Case Report and Brief Review of the Literature

PubMed Central

Seca, Mariana; Borges, Pedro; Reimão, Pedro; Gomes, Miguel; Meireles, Angelina

2012-01-01

Background. Lymphangioma is a rare venolymphatic lesion, characterized by dilation of lymphatic vessels. It may occur as an isolated lesion or, more often, represent the surface component of a deep orbital lymphangioma. Case. We report a case of a conjunctival lymphangioma on a 58-year-old male that had simultaneously an upper respiratory tract infection. Excision and biopsy confirmed the nature of the lesion, and there has been no relapse to date. Conclusion. Conjunctival lymphangioma is a rare condition in which the diagnose, must be kept in mind in patients with a red eye resistance to topical therapy and in association with an upper respiratory tract infection. Finally, it is also necessary to be aware of possible recurrence of the lesion. PMID:22666617

Delayed prescribing for upper respiratory tract infections: a qualitative study of GPs' views and experiences

PubMed Central

Høye, Sigurd; Frich, Jan; Lindbœk, Morten

2010-01-01

Background Delayed prescribing has been promoted as a strategy that meets patients' expectations and helps to avoid unnecessary use of antibiotics in upper respiratory tract infections. Aim To explore GPs' views on and experiences with delayed prescribing in patients with acute upper respiratory tract infections. Design of study Qualitative study involving focus groups. Setting Norwegian general practice. Method Qualitative analysis of data collected from five focus groups comprising 33 GPs who took part in a quality-improvement programme of antibiotic prescribing. Results The views of GPs differed on the usefulness of delayed prescribing. GPs who endorsed the strategy emphasised shared decision making and the creation of opportunities for educating patients, whereas GPs who were negative applied the strategy mainly when being pressed to prescribe. Mild and mainly harmless conditions of a possible bacterial origin, such as acute sinusitis and acute otitis, were considered most suitable for delayed prescribing. A key argument for issuing a wait-and-see prescription was that it helped patients avoid seeking after-hours care. For issuing a wait-and-see prescription, the GPs required that the patient was ‘knowledgeable’, able to understand the indications for antibiotics, and motivated for shared decision making. GPs emphasised that patients should be informed thoroughly when receiving a wait-and-see prescription. Conclusion Not all GPs endorse delayed prescribing; however, it appears to be a feasible approach for managing patients with early symptoms of mild upper respiratory tract infections of a possible bacterial origin. Informing the patients properly while issuing wait-and-see prescriptions is essential. PMID:21144201

Role of guaifenesin in the management of chronic bronchitis and upper respiratory tract infections.

PubMed

Albrecht, Helmut H; Dicpinigaitis, Peter V; Guenin, Eric P

2017-01-01

Guaifenesin, a mucoactive drug, acts by loosening mucus in the airways and making coughs more productive. It is used for relief of wet cough and chest congestion due to the common cold, and remains the only legally marketed expectorant in the US (per OTC Monograph). An ingredient in numerous over-the-counter (OTC) cough/cold medications, guaifenesin has a secondary indication for use in stable chronic bronchitis (professional indication). Clinical pharmacology and patient studies support the clinical utility of guaifenesin in respiratory conditions where mucus hypersecretion is prevalent: acute upper respiratory tract infections (URTIs), stable chronic bronchitis, and possibly rhinosinusitis. Guaifenesin has a well-established and favorable safety and tolerability profile in adult and pediatric populations. Its dosing range (200-400 mg 4-hourly, up to 6× daily) allows flexible dose titration to allow an increase of plasma concentrations. Multiple daily doses are needed to maintain 24-h therapeutic effect with immediate-release formulations. Extended-release guaifenesin tablet formulations are available, providing convenience with 12-hourly dosing and portability compared to liquids. Guaifenesin is considered as a safe and effective expectorant for the treatment of mucus-related symptoms in acute URTIs and stable chronic bronchitis. Its clinical efficacy has been demonstrated most widely in chronic respiratory conditions, where excess mucus production and cough are more stable symptoms. Progress is being made to establish clinical models and measures that are more appropriate for studying symptomatic relief with guaifenesin in acute respiratory infections. This will help generate the up-to-date and high-quality data needed to optimize guaifenesin's effectiveness in established uses, and in new respiratory indications associated with mucus hypersecretion.

Down Syndrome: A Current Perspective. Bulletin 1762.

ERIC Educational Resources Information Center

Louisiana State Dept. of Education, Baton Rouge.

This informational document is intended to help answer questions commonly asked by families, professionals, and the general public concerning Down Syndrome. Medical problems associated with Down Syndrome include heart conditions, upper respiratory disorders, ear infections and hearing loss, vision/eye problems, cervical problems, and…

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

PubMed Central

Ross, A; Collins, M; Sanders, C

1990-01-01

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. PMID:2370503

Seasonal and pandemic human influenza viruses attach better to human upper respiratory tract epithelium than avian influenza viruses.

PubMed

van Riel, Debby; den Bakker, Michael A; Leijten, Lonneke M E; Chutinimitkul, Salin; Munster, Vincent J; de Wit, Emmie; Rimmelzwaan, Guus F; Fouchier, Ron A M; Osterhaus, Albert D M E; Kuiken, Thijs

2010-04-01

Influenza viruses vary markedly in their efficiency of human-to-human transmission. This variation has been speculated to be determined in part by the tropism of influenza virus for the human upper respiratory tract. To study this tropism, we determined the pattern of virus attachment by virus histochemistry of three human and three avian influenza viruses in human nasal septum, conchae, nasopharynx, paranasal sinuses, and larynx. We found that the human influenza viruses-two seasonal influenza viruses and pandemic H1N1 virus-attached abundantly to ciliated epithelial cells and goblet cells throughout the upper respiratory tract. In contrast, the avian influenza viruses, including the highly pathogenic H5N1 virus, attached only rarely to epithelial cells or goblet cells. Both human and avian viruses attached occasionally to cells of the submucosal glands. The pattern of virus attachment was similar among the different sites of the human upper respiratory tract for each virus tested. We conclude that influenza viruses that are transmitted efficiently among humans attach abundantly to human upper respiratory tract, whereas inefficiently transmitted influenza viruses attach rarely. These results suggest that the ability of an influenza virus to attach to human upper respiratory tract is a critical factor for efficient transmission in the human population.

Role of upper airway in ventilatory control in awake and sleeping dogs.

PubMed

Stradling, J R; England, S J; Harding, R; Kozar, L F; Andrey, S; Phillipson, E A

1987-03-01

We examined the role of the upper airway in the regulation of the pattern of breathing in six adult dogs during wakefulness and sleep. The dogs breathed through a fenestrated endotracheal tube inserted through a tracheostomy. The tube was modified to allow airflow to be directed either through the nose or through the tracheostomy. When airflow was diverted from nose to tracheostomy there was an abrupt increase in the rate of expiratory airflow, resulting in prolongation of the end-expiratory pause but no change in overall expiratory duration or respiratory frequency. Furthermore, electromyogram recordings from implanted diaphragmatic and laryngeal muscle electrodes did not show any changes that could be interpreted as an attempt to delay expiratory airflow or increase end-expiratory lung volume. The effects of switching from nose to tracheostomy breathing could be reversed by adding a resistance to the endotracheal tube so as to approximate upper airway resistance. The findings indicate that under normal conditions in the adult dog upper airway receptors play little role in regulation of respiratory pattern and that the upper airway exerts little influence on the maintenance of end-expiratory lung volume.

[Correction of immune and mediator characteristics by low-frequency magnetotherapy in children who frequently fall ill].

PubMed

Useĭnova, N N

2010-01-01

The objective of this work was to compare characteristics of clinical condition and immune status of children with repeated respiratory diseases of different clinical and nosological forms after standard treatment and magnetotherapy. It was shown that magnetotherapy produces well-apparent immunocorrective effects in children with the affected upper and lower respiratory tracts including patients with bronchial obstruction syndrome. Positive changes of both cellular and humoral immunity characteristics were documented coupled to the improvement of serum cortisol levels. Results of the study give reason to recommend inclusion of magneotherapy in the combined treatment of children with repeated respiratory diseases.

Replication and Shedding of MERS-CoV in Upper Respiratory Tract of Inoculated Dromedary Camels

PubMed Central

Adney, Danielle R.; van Doremalen, Neeltje; Brown, Vienna R.; Bushmaker, Trenton; Scott, Dana; de Wit, Emmie; Munster, Vincent J.

2014-01-01

In 2012, a novel coronavirus associated with severe respiratory disease in humans emerged in the Middle East. Epidemiologic investigations identified dromedary camels as the likely source of zoonotic transmission of Middle East respiratory syndrome coronavirus (MERS-CoV). Here we provide experimental support for camels as a reservoir for MERS-CoV. We inoculated 3 adult camels with a human isolate of MERS-CoV and a transient, primarily upper respiratory tract infection developed in each of the 3 animals. Clinical signs of the MERS-CoV infection were benign, but each of the camels shed large quantities of virus from the upper respiratory tract. We detected infectious virus in nasal secretions through 7 days postinoculation, and viral RNA up to 35 days postinoculation. The pattern of shedding and propensity for the upper respiratory tract infection in dromedary camels may help explain the lack of systemic illness among naturally infected camels and the means of efficient camel-to-camel and camel-to-human transmission. PMID:25418529

Resource Utilization in Ambulatory Primary Care at Darnall Army Community Hospital, Fort Hood, Texas

DTIC Science & Technology

1991-07-23

population: gastroenteritis (GI), otitis media (OM), and upper respiratory infection (URI). These resources will be thc- dependent variables of the study...1991. The children ranged in age from 3 to 5 years old and were diagnosed with otitis media , upper respiratory tract infection, and gastroenteritis. A...x-rays wer-e rarely ordered to confirm the diagnoses of otitis media , gastroeinteritis. and upper respiratory tract infection. Only eight, laboratory

Psychosocial Risk Factors for Upper Respiratory Infection: Demographic and Health History Predictors of URI (Upper Respiratory Illness) During Basic Training

DTIC Science & Technology

1988-07-05

jaundice), (v) dysentery, (w) infectious mononucleosis , (x) warts, (y) whooping cough, and (z) bronchitis. Other Diseases: Thirteen items with a "true...substantial, and knowledge about susceptibility to URIs may provide information regarding general susceptibility to infectious disease. A risk profile for...upper respiratory infections, therefore, may help develop methods for predicting and controlling the influence of infectious diseases in general, and

Exercising upper respiratory videoendoscopic evaluation of 100 nonracing performance horses with abnormal respiratory noise and/or poor performance.

PubMed

Davidson, E J; Martin, B B; Boston, R C; Parente, E J

2011-01-01

Although well documented in racehorses, there is paucity in the literature regarding the prevalence of dynamic upper airway abnormalities in nonracing performance horses. To describe upper airway function of nonracing performance horses with abnormal respiratory noise and/or poor performance via exercising upper airway videoendoscopy. Medical records of nonracing performance horses admitted for exercising evaluation with a chief complaint of abnormal respiratory noise and/or poor performance were reviewed. All horses had video recordings of resting and exercising upper airway endoscopy. Relationships between horse demographics, resting endoscopic findings, treadmill intensity and implementation of head and neck flexion during exercise with exercising endoscopic findings were examined. Dynamic upper airway obstructions were observed in 72% of examinations. Head and neck flexion was necessary to obtain a diagnosis in 21 horses. Pharyngeal wall collapse was the most prevalent upper airway abnormality, observed in 31% of the examinations. Complex abnormalities were noted in 27% of the examinations. Resting laryngeal dysfunction was significantly associated with dynamic arytenoid collapse and the odds of detecting intermittent dorsal displacement of the soft palate (DDSP) during exercise in horses with resting DDSP was only 7.7%. Exercising endoscopic observations were different from the resting observations in 54% of examinations. Dynamic upper airway obstructions were common in nonracing performance horses with respiratory noise and/or poor performance. Resting endoscopy was only helpful in determining exercising abnormalities with recurrent laryngeal neuropathy. This study emphasises the importance of exercising endoscopic evaluation in nonracing performance horses with abnormal respiratory noise and/or poor performance for accurate assessment of dynamic upper airway function. © 2010 EVJ Ltd.

Reduction in emergency department visits for children's asthma, ear infections, and respiratory infections after the introduction of state smoke-free legislation.

PubMed

Hawkins, Summer Sherburne; Hristakeva, Sylvia; Gottlieb, Mark; Baum, Christopher F

2016-08-01

Despite the benefits of smoke-free legislation on adult health, little is known about its impact on children's health. We examined the effects of tobacco control policies on the rate of emergency department (ED) visits for childhood asthma (N=128,807), ear infections (N=288,697), and respiratory infections (N=410,686) using outpatient ED visit data in Massachusetts (2001-2010), New Hampshire (2001-2009), and Vermont (2002-2010). We used negative binomial regression models to analyze the effect of state and local smoke-free legislation on ED visits for each health condition, controlling for cigarette taxes and health care reform legislation. We found no changes in the overall rate of ED visits for asthma, ear infections, and upper respiratory infections after the implementation of state or local smoke-free legislation or cigarette tax increases. However, an interaction with children's age revealed that among 10-17-year-olds state smoke-free legislation was associated with a 12% reduction in ED visits for asthma (adjusted incidence rate ratios (aIRR) 0.88; 95% CI 0.83, 0.95), an 8% reduction for ear infections (0.92; 0.88, 0.97), and a 9% reduction for upper respiratory infections (0.91; 0.87, 0.95). We found an overall 8% reduction in ED visits for lower respiratory infections after the implementation of state smoke-free legislation (0.92; 0.87, 0.96). The implementation of health care reform in Massachusetts was also associated with a 6-9% reduction in all children's ED visits for ear and upper respiratory infections. Our results suggest that state smoke-free legislation and health care reform may be effective interventions to improve children's health by reducing ED visits for asthma, ear infections, and respiratory infections. Copyright © 2016 Elsevier Inc. All rights reserved.

Respiratory tract immune response to microbial pathogens.

PubMed

Wilkie, B N

1982-11-15

Effective resistance to respiratory tract infection depends principally on specific immunity on mucosal surfaces of the upper or lower respiratory tract. Respiratory tract immune response comprises antibody and cell-mediated systems and may be induced most readily by surface presentation of replicating agents but can result from parenteral or local presentation of highly immunogenic antigens. Upper and lower respiratory tract systems differ in immunologic competence, with the lungs having a greater inventory of protective mechanisms than the trachea or nose. Several effective vaccines have been developed for prevention or modification of respiratory tract diseases.

Disease patterns of outpatient visits by Japanese expatriate children in Thailand.

PubMed

Sakai, Rie; Wongkhomthong, Som-arch; Marui, Eiji

2009-03-01

To clarify the health-related conditions of Japanese expatriate children in Thailand. Records of Japanese children who consulted outpatient clinics at Bangkok Hospital in 2005 and 2006 (n = 2141) were analysed, and then compared with data from the patient survey conducted by the Ministry of Health, Labour and Welfare of Japan in 2005 (n = 575 400). 'diseases of the respiratory system', categorized as chapter X under ICD-10 was the most frequent category in both Thailand and Japan. Although 'certain infectious and parasitic diseases' (chapter I) was the second most frequent category in Thailand, it was infrequent in Japan. In the subcategories of 'diseases of the respiratory system', 'acute upper respiratory infections' was frequent and asthma was infrequent in Thailand. Conversely, 'acute upper respiratory infections' showed a low percentage and asthma was the most frequently observed disease in Japan. This study examined Japanese children having the same genetic background but divided into two groups according to different living environments. Results demonstrate that children living in Japan contract asthma more frequently than infectious diseases, whereas those living in Thailand show the opposite trend, which supports the hygiene hypothesis that infections may protect against the development of allergic diseases, such as asthma.

21 CFR 520.246 - Butorphanol tartrate tablets.

Code of Federal Regulations, 2014 CFR

2014-04-01

....246 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS ORAL DOSAGE FORM NEW ANIMAL DRUGS § 520.246 Butorphanol... associated with inflammatory conditions of the upper respiratory tract. (3) Limitations. For oral use in dogs...

21 CFR 520.246 - Butorphanol tartrate tablets.

Code of Federal Regulations, 2011 CFR

2011-04-01

....246 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS ORAL DOSAGE FORM NEW ANIMAL DRUGS § 520.246 Butorphanol... associated with inflammatory conditions of the upper respiratory tract. (3) Limitations. For oral use in dogs...

21 CFR 520.246 - Butorphanol tartrate tablets.

Code of Federal Regulations, 2013 CFR

2013-04-01

....246 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS ORAL DOSAGE FORM NEW ANIMAL DRUGS § 520.246 Butorphanol... associated with inflammatory conditions of the upper respiratory tract. (3) Limitations. For oral use in dogs...

[Relationship between sulfur dioxide pollution and upper respiratory outpatients in Jiangbei, Ningbo].

PubMed

Wu, Yifeng; Zhao, Fengmin; Qian, Xujun; Xu, Guozhang; He, Tianfeng; Shen, Yueping; Cai, Yibiao

2015-07-01

To describe the daily average concentration of sulfur dioxide (SO2) in Ningbo, and to analysis the health impacts it caused in upper respiratory disease. With outpatients log and air pollutants monitoring data matched in 2011-2013, the distributed lag non-linear models were used to analysis the relative risk of the number of upper respiratory patients associated with SO2, and also excessive risk, and the inferred number of patients due to SO2 pollution. The daily average concentration of SO2 didn't exceed the limit value of second class area. The coefficient of upper respiratory outpatient number and daily average concentration of SO2 matched was 0.44,with the excessive risk was 10% to 18%, the lag of most SO2 concentrations was 4 to 6 days. It could be estimated that about 30% of total upper respiratory outpatients were caused by SO2 pollution. Although the daily average concentration of SO2 didn't exceed the standard in 3 years, the health impacts still be caused with lag effect.

Role of the superior pharyngeal constrictor muscle in forced breathing in dogs.

PubMed

Yaman, Z; Kogo, M; Senoo, H; Iida, S; Ishii, S; Matsuya, T

2000-03-01

Respiratory-related electromyographic (EMG) activity of the superior pharyngeal constrictor (SPC) muscle was analyzed during the early stage of forced breathing. Four adult dogs anesthetized with sodium pentobarbital were used. In the first part of the study, oral and nasal breathing tubes were placed into the respective cavities, and a tracheotomy tube was placed in the second part of the study. Two conditions, the presence (oral-nasal tube breathing) and absence (tracheotomy breathing) of airflow in the upper airway, were achieved in each dog. Following quiet breathing, animals were connected to a closed breathing system, first by an oral-nasal tube and then by a tracheotomy tube. We proposed to induce a forced breathing condition mechanically by using this system for 1 minute. We increased resistance to airflow during forced breathing by means of connecting tubes and a bag. Our aim was not to produce chemical drive but to produce a forced respiration by increasing the resistance to airflow. Tidal volume, breathing frequency, minute volume, chest wall movement, and EMG activity of the SPC muscle were measured and analyzed. During quiet breathing through an oral-nasal or tracheotomy tube, low-amplitude EMG activity of the SPC muscle corresponding to the expiratory cycle of the respiration was observed. In both study conditions, phasic expiratory EMG activity increased immediately after the advent of the breathing from the closed system. Tidal volumes and frequencies also increased rapidly during forced breathing. An increase in the resistance to airflow increased the activity of the SPC muscle. This augmented respiratory activity probably assists the patency of the upper airway. The augmented respiratory activity was independent of the local reflex pathways. Respiratory-related activity of the SPC muscle may help dilate and stiffen the pharyngeal airway, promoting airway patency.

Respiratory sequelae of whooping cough. Swansea Research Unit of the Royal College of General Practitioners.

PubMed Central

1985-01-01

Eight hundred and thirteen children who had had whooping cough when under 5 years of age in the 1977-9 epidemic were compared with a control group roughly four and a half years later, each child being matched by age and sex and from the same class in school. The index group showed long term respiratory sequelae of whooping cough--namely, deterioration in lung function, increase in respiratory symptoms, and increased admission to hospital for both upper and lower respiratory conditions. Asthma was significantly more common in the index group, suggesting that asthma was being regarded as a contraindication to pertussis vaccination. Only 3.5% of the asthmatic children in the index group had been vaccinated as against 29.1% of the controls. PMID:3924316

Effect of brachycephaly and body condition score on respiratory thermoregulation of healthy dogs.

PubMed

Davis, Michael S; Cummings, Sabrina L; Payton, Mark E

2017-11-15

OBJECTIVE To evaluate the effect of brachycephaly and body condition score on respiratory thermoregulation of healthy dogs. DESIGN Prospective study. ANIMALS 52 brachycephalic and 53 nonbrachycephalic dogs. PROCEDURES All dogs were exposed to a cool treatment (temperature, 21.8 ± 1.7°C [71.2 ± 3.1°F]; relative humidity, 62.2 ± 9.7%; and ambient enthalpy, 47.7 ± 6.6 kcal/kg) and then a hot treatment (temperature, 32.9 ± 1.7°C [91.2 ± 3.1°F]; relative humidity, 51.9 ± 9.8%; and ambient enthalpy, 74.8 ± 8.7 kcal/kg; heat stress) at least 1 hour later. For each treatment, dogs were allowed to acclimatize to the environment for 15 minutes and then were placed in a sealed whole-body plethysmograph for continuous measurement of the respiratory pattern for 10 minutes. Treatment was discontinued if a dog developed signs of respiratory distress. Respiratory variables and body temperature were compared between the 2 breed types (brachycephalic and nonbrachycephalic) and between treatments. RESULTS Body condition score was positively associated with body temperature independent of environmental conditions or breed type and negatively associated with tidal volume. Brachycephalic dogs had a greater increase in respiratory rate in response to heat stress than did nonbrachycephalic dogs. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that brachycephalic dogs had decreased capacity for thermoregulation, compared with nonbrachycephalic dogs, but body condition score was a greater determinant of body temperature than breed type. Nevertheless, both upper airway conformation and body condition score should be considered when evaluating whether an individual dog is capable of tolerating heat stress.

The prevalence of upper respiratory symptoms in a cohort of adults presenting with symptoms of gastro-oesophageal reflux disease.

PubMed

Amarasiri, D L; Pathmeswaran, A; Dassanayake, A S; de Silva, A P; Adikari, M D; Sanjeewa, P A; Jayaratne, A; de Silva, H J

2016-06-01

Gastro-oesophageal reflux disease (GORD) is the pathological reflux of gastric contents into the oesophagus. The oesophagus and the upper respiratory tract have a common origin from the foregut. There is increasing evidence for multiple associations of GORD with the upper respiratory tract. To study the presence of and association of upper respiratory symptoms (URS) with GORD. Seventy adults scoring ≥12.5 on a previously validated GORD symptom score (GORD patients) and 70 healthy controls who had infrequent GORD symptoms or no upper gastro-intestinal complaints completed a pre-tested URS questionnaire on the frequency of 14 URS in 5 categories (laryngeal, nasal, pharyngeal, sinusal and aural). All GORD patients underwent upper gastro-intestinal endoscopy. The calculated URS score was correlated against the GORD symptom score and endoscopy findings. URS scores and individual symptom scores were higher in GORD patients compared to controls (mean ± SE, 4.7 ± 4.0; 1.9 ± 2.3). Individuals with higher GORD symptom scores reported more frequent URS. Pharyngeal symptoms had the highest correlation with the GORD symptom score (r=0.507, p<0.001). The presence of oeso-phagitis did not seem to influence the frequency of reporting URS. Upper respiratory symptoms are common in individuals with GORD symptoms though there appears to be no association with oesophageal mucosal damage.

Influenza Virus Respiratory Infection and Transmission Following Ocular Inoculation in Ferrets

PubMed Central

Belser, Jessica A.; Gustin, Kortney M.; Maines, Taronna R.; Pantin-Jackwood, Mary J.; Katz, Jacqueline M.; Tumpey, Terrence M.

2012-01-01

While influenza viruses are a common respiratory pathogen, sporadic reports of conjunctivitis following human infection demonstrates the ability of this virus to cause disease outside of the respiratory tract. The ocular surface represents both a potential site of virus replication and a portal of entry for establishment of a respiratory infection. However, the properties which govern ocular tropism of influenza viruses, the mechanisms of virus spread from ocular to respiratory tissue, and the potential differences in respiratory disease initiated from different exposure routes are poorly understood. Here, we established a ferret model of ocular inoculation to explore the development of virus pathogenicity and transmissibility following influenza virus exposure by the ocular route. We found that multiple subtypes of human and avian influenza viruses mounted a productive virus infection in the upper respiratory tract of ferrets following ocular inoculation, and were additionally detected in ocular tissue during the acute phase of infection. H5N1 viruses maintained their ability for systemic spread and lethal infection following inoculation by the ocular route. Replication-independent deposition of virus inoculum from ocular to respiratory tissue was limited to the nares and upper trachea, unlike traditional intranasal inoculation which results in virus deposition in both upper and lower respiratory tract tissues. Despite high titers of replicating transmissible seasonal viruses in the upper respiratory tract of ferrets inoculated by the ocular route, virus transmissibility to naïve contacts by respiratory droplets was reduced following ocular inoculation. These data improve our understanding of the mechanisms of virus spread following ocular exposure and highlight differences in the establishment of respiratory disease and virus transmissibility following use of different inoculation volumes and routes. PMID:22396651

21 CFR 522.820 - Erythromycin.

Code of Federal Regulations, 2011 CFR

2011-04-01

...) Indications for use. For the treatment of bacterial pneumonia, upper respiratory infections (tonsillitis... for use. For the treatment of bacterial pneumonia, upper respiratory infections (rhinitis, bronchitis... disease (shipping fever complex and bacterial pneumonia) associated with Pasteurella multocida susceptible...

21 CFR 522.820 - Erythromycin.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) Indications for use. For the treatment of bacterial pneumonia, upper respiratory infections (tonsillitis... for use. For the treatment of bacterial pneumonia, upper respiratory infections (rhinitis, bronchitis... disease (shipping fever complex and bacterial pneumonia) associated with Pasteurella multocida susceptible...

21 CFR 522.820 - Erythromycin.

Code of Federal Regulations, 2012 CFR

2012-04-01

...) Indications for use. For the treatment of bacterial pneumonia, upper respiratory infections (tonsillitis... for use. For the treatment of bacterial pneumonia, upper respiratory infections (rhinitis, bronchitis... disease (shipping fever complex and bacterial pneumonia) associated with Pasteurella multocida susceptible...

21 CFR 522.820 - Erythromycin.

Code of Federal Regulations, 2014 CFR

2014-04-01

...) Indications for use. For the treatment of bacterial pneumonia, upper respiratory infections (tonsillitis... for use. For the treatment of bacterial pneumonia, upper respiratory infections (rhinitis, bronchitis... disease (shipping fever complex and bacterial pneumonia) associated with Pasteurella multocida susceptible...

21 CFR 522.820 - Erythromycin.

Code of Federal Regulations, 2013 CFR

2013-04-01

...) Indications for use. For the treatment of bacterial pneumonia, upper respiratory infections (tonsillitis... for use. For the treatment of bacterial pneumonia, upper respiratory infections (rhinitis, bronchitis... disease (shipping fever complex and bacterial pneumonia) associated with Pasteurella multocida susceptible...

Importance of viruses in acute otitis media.

PubMed

Nokso-Koivisto, Johanna; Marom, Tal; Chonmaitree, Tasnee

2015-02-01

Acute otitis media occurs as a complication of viral upper respiratory tract infection. Bacterial otopathogens and respiratory viruses interact and play important roles in acute otitis media development. A better understanding of viral and bacterial interactions may lead to innovative ways to lessen the burden of this common childhood disease. There has been increasing evidence that acute otitis media occurs during upper respiratory infection, even in the absence of nasopharyngeal bacterial colonization. Among the types of viruses associated with acute otitis media, respiratory syncytial virus continues to be the most commonly detected. It is still unclear whether viral load plays an important role in acute otitis media development, but symptomatic upper respiratory tract infection (as opposed to asymptomatic viral infection) is crucial. Widespread use of bacterial and viral vaccines in young children, including pneumococcal conjugate and influenza vaccines, has led to the reduction in otitis media-related healthcare use between 2001 and 2011. There has been no new vaccine against respiratory viruses other than influenza. Progress has been made toward the reduction of the burden of acute otitis media in the last decade. Success in reducing acute otitis media incidence will rely mainly on prevention of nasopharyngeal otopathogen colonization, as well as reduction in the incidence of viral upper respiratory tract infection.

Equine respiratory pharmacology.

PubMed

Foreman, J H

1999-12-01

Differentiation of diseases of the equine respiratory tract is based on history, clinical signs, auscultation, endoscopy, imaging, and sampling of airway exudate. Upper respiratory therapies include surgical correction of airway obstructions; flushing of localized abscesses (strangles), guttural pouch disease, or sinusitis; and oral or parenteral antibiotic and anti-inflammatory therapy if deemed necessary. Pneumonia usually is treated with antimicrobials, anti-inflammatories, and bronchodilators. Pleural drainage is indicated if significant pleural effusion is present. The most commonly used therapies for early inflammatory and chronic allergic obstructive conditions include bronchodilators and anti-inflammatories. Acute respiratory distress, particularly acute pulmonary edema, is treated with diuretics (usually furosemide), intranasal oxygen, bronchodilators, corticosteroids, and alleviation of the underlying cause. Furosemide also had been used in North America as a race-day preventative for exercise-induced pulmonary hemorrhage (EIPH), but recent data have shown that furosemide may be a performance-enhancing agent itself.

Discharge properties of upper airway motor units during wakefulness and sleep.

PubMed

Trinder, John; Jordan, Amy S; Nicholas, Christian L

2014-01-01

Upper airway muscle motoneurons, as assessed at the level of the motor unit, have a range of different discharge patterns, varying as to whether their activity is modulated in phase with the respiratory cycle, are predominantly inspiratory or expiratory, or are phasic as opposed to tonic. Two fundamental questions raised by this observation are: how are synaptic inputs from premotor neurons distributed over motoneurons to achieve these different discharge patterns; and how do different discharge patterns contribute to muscle function? We and others have studied the behavior of genioglossus (GG) and tensor palatini (TP) single motor units at transitions from wakefulness to sleep (sleep onset), from sleep to wakefulness (arousal from sleep), and during hypercapnia. Results indicate that decreases or increases in GG and TP muscle activity occur as a consequence of derecruitment or recruitment, respectively, of phasic and tonic inspiratory-modulated motoneurons, with only minor changes in rate coding. Further, sleep-wake state and chemical inputs to this "inspiratory system" appear to be mediated through the respiratory pattern generator. In contrast, phasic and tonic expiratory units and units with a purely tonic pattern, the "tonic system," are largely unaffected by sleep-wake state, and are only weakly influenced by chemical stimuli and the respiratory cycle. We speculate that the "inspiratory system" produces gross changes in upper airway muscle activity in response to changes in respiratory drive, while the "tonic system" fine tunes airway configuration with activity in this system being determined by local mechanical conditions. © 2014 Elsevier B.V. All rights reserved.

Respiratory diseases and their effects on respiratory function and exercise capacity.

PubMed

Van Erck-Westergren, E; Franklin, S H; Bayly, W M

2013-05-01

Given that aerobic metabolism is the predominant energy pathway for most sports, the respiratory system can be a rate-limiting factor in the exercise capacity of fit and healthy horses. Consequently, respiratory diseases, even in mild forms, are potentially deleterious to any athletic performance. The functional impairment associated with a respiratory condition depends on the degree of severity of the disease and the equestrian discipline involved. Respiratory abnormalities generally result in an increase in respiratory impedance and work of breathing and a reduced level of ventilation that can be detected objectively by deterioration in breathing mechanics and arterial blood gas tensions and/or lactataemia. The overall prevalence of airway diseases is comparatively high in equine athletes and may affect the upper airways, lower airways or both. Diseases of the airways have been associated with a wide variety of anatomical and/or inflammatory conditions. In some instances, the diagnosis is challenging because conditions can be subclinical in horses at rest and become clinically relevant only during exercise. In such cases, an exercise test may be warranted in the evaluation of the patient. The design of the exercise test is critical to inducing the clinical signs of the problem and establishing an accurate diagnosis. Additional diagnostic techniques, such as airway sampling, can be valuable in the diagnosis of subclinical lower airway problems that have the capacity to impair performance. As all these techniques become more widely used in practice, they should inevitably enhance veterinarians' diagnostic capabilities and improve their assessment of treatment effectiveness and the long-term management of equine athletes. © 2013 EVJ Ltd.

The Role of the Immune Response in the Pathogenesis of Bronchiectasis.

PubMed

King, Paul T

2018-01-01

Bronchiectasis is a prevalent respiratory condition characterised by permanent and abnormal dilation of the lung airways (bronchi). There are a large variety of causative factors that have been identified for bronchiectasis; all of these compromise the function of the immune response to fight infection. A triggering factor may lead to the establishment of chronic infection in the lower respiratory tract. The bacteria responsible for the lower respiratory tract infection are usually found as commensals in the upper respiratory tract microbiome. The consequent inflammatory response to infection is largely responsible for the pathology of this condition. Both innate and adaptive immune responses are activated. The literature has highlighted the central role of neutrophils in the pathogenesis of bronchiectasis. Proteases produced in the lung by the inflammatory response damage the airways and lead to the pathological dilation that is the pathognomonic feature of bronchiectasis. The small airways demonstrate infiltration with lymphoid follicles that may contribute to localised small airway obstruction. Despite aggressive treatment, most patients will have persistent disease. Manipulating the immune response in bronchiectasis may potentially have therapeutic potential.

Bone pain, growth failure, and skin rash after an upper respiratory illness in a boy with autism: possible association with altered retinoid metabolism.

PubMed

Mawson, Anthony R

2009-01-01

Symptoms of bone pain and skin rashes are not uncommon following a variety of infectious illnesses, but the underlying mechanisms are not well understood. The case of a 9-year-old boy with autism was recently described, who was hospitalized because of pain in the right hip, refusal to walk, fatigue, irritability, skin rash, and subsequent gingival swelling after an unspecified upper respiratory illness. The boy was diagnosed with scurvy. However, the gingival symptoms occurred after treatment with indomethacin, which lowers vitamin C levels; severe bone pain and fatigue are also well-documented symptoms of hypervitaminosis A. This review of a case report of a boy with autism provides an opportunity to present a new hypothesis of the mechanism of these postinfection symptoms in the context of an increasingly common condition of childhood.

Procalcitonin Testing to Guide Antibiotic Therapy in Acute Upper and Lower Respiratory Tract Infections.

PubMed

Schuetz, Philipp; Wirz, Yannick; Mueller, Beat

2018-03-06

Is the use of procalcitonin for guiding antibiotic decisions in patients with acute upper and lower respiratory tract infections associated with improved clinical outcomes compared with usual care? Among patients with varying types and severity of acute respiratory infection, using procalcitonin to guide decisions about antibiotics is associated with lower rates of antibiotic exposure, antibiotic-related adverse effects, and mortality.

Pulmonary Stress Induced by Hyperthermia: Role of Airway Sensory Nerves

DTIC Science & Technology

2011-10-01

patients with mild asthma, allergic rhinitis and upper respiratory infection, which makes these patients more susceptible to the bronchoconstriction...and other respiratory dysfunctions induced by thermal stress. There are two specific aims for the first year of this translational project: 1) To...dyspnea, airway constriction, cough, etc) in healthy volunteers, and in patients with mild asthma, allergic rhinitis and post upper respiratory

Repeating cardiopulmonary health effects in rural North Carolina population during a second large peat wildfire.

PubMed

Tinling, Melissa A; West, J Jason; Cascio, Wayne E; Kilaru, Vasu; Rappold, Ana G

2016-01-27

Cardiovascular health effects of fine particulate matter (PM2.5) exposure from wildfire smoke are neither definitive nor consistent with PM2.5 from other air pollution sources. Non-comparability among wildfire health studies limits research conclusions. We examined cardiovascular and respiratory health outcomes related to peat wildfire smoke exposure in a population where strong associations were previously reported for the 2008 Evans Road peat wildfire. We conducted a population-based epidemiologic investigation of associations between daily county-level modeled wildfire PM2.5 and cardiopulmonary emergency department (ED) visits during the 2011 Pains Bay wildfire in eastern North Carolina. We estimated changes in the relative risk cumulative over 0-2 lagged days of wildfire PM2.5 exposure using a quasi-Poisson regression model adjusted for weather, weekends, and poverty. Relative risk associated with a 10 μg/m(3) increase in 24-h PM2.5 was significantly elevated in adults for respiratory/other chest symptoms 1.06 (1.00-1.13), upper respiratory infections 1.13 (1.05-1.22), hypertension 1.05 (1.00-1.09) and 'all-cause' cardiac outcomes 1.06 (1.00-1.13) and in youth for respiratory/other chest symptoms 1.18 (1.06-1.33), upper respiratory infections 1.14 (1.04-1.24) and 'all-cause' respiratory conditions 1.09 (1.01-1.17). Our results replicate evidence for increased risk of cardiovascular outcomes from wildfire PM2.5 and suggest that cardiovascular health should be considered when evaluating the public health burden of wildfire smoke.

IFN-λ prevents influenza virus spread from the upper airways to the lungs and limits virus transmission

PubMed Central

Ye, Liang; Schwaderlapp, Marilena; Gad, Hans Henrik; Hartmann, Rune; Garcin, Dominique; Mahlakõiv, Tanel

2018-01-01

Host factors restricting the transmission of respiratory viruses are poorly characterized. We analyzed the contribution of type I and type III interferon (IFN) using a mouse model in which the virus is selectively administered to the upper airways, mimicking a natural respiratory virus infection. Mice lacking functional IFN-λ receptors (Ifnlr1−/−) no longer restricted virus dissemination from the upper airways to the lungs. Ifnlr1−/− mice shed significantly more infectious virus particles via the nostrils and transmitted the virus much more efficiently to naïve contacts compared with wild-type mice or mice lacking functional type I IFN receptors. Prophylactic treatment with IFN-α or IFN-λ inhibited initial virus replication in all parts of the respiratory tract, but only IFN-λ conferred long-lasting antiviral protection in the upper airways and blocked virus transmission. Thus, IFN-λ has a decisive and non-redundant function in the upper airways that greatly limits transmission of respiratory viruses to naïve contacts. PMID:29651984

Guillain-Barré syndrome in pregnancy: A case report

PubMed Central

Hukuimwe, Misai; Matsa, Tawanda T; Gidiri, Muchabayiwa F

2017-01-01

Guillain-Barré syndrome is a rare condition in pregnancy which is characterised by symmetrical progressive ascending polyneuropathy. A case of a 16-year-old nulliparous woman who presented with rapidly progressive limb paralysis following an upper respiratory tract infection a week prior to presentation is discussed. She was intubated as she had developed respiratory failure and managed in the intensive care unit by a multidisciplinary team. Plasma exchange and intravenous immunoglobulin were not readily available so she was managed conservatively. The management of Guillain-Barré syndrome, maternal and foetal outcomes have been discussed. PMID:28438080

Guillain-Barré syndrome in pregnancy: A case report.

PubMed

Hukuimwe, Misai; Matsa, Tawanda T; Gidiri, Muchabayiwa F

2017-04-01

Guillain-Barré syndrome is a rare condition in pregnancy which is characterised by symmetrical progressive ascending polyneuropathy. A case of a 16-year-old nulliparous woman who presented with rapidly progressive limb paralysis following an upper respiratory tract infection a week prior to presentation is discussed. She was intubated as she had developed respiratory failure and managed in the intensive care unit by a multidisciplinary team. Plasma exchange and intravenous immunoglobulin were not readily available so she was managed conservatively. The management of Guillain-Barré syndrome, maternal and foetal outcomes have been discussed.

Health conditions in rural areas with high livestock density: Analysis of seven consecutive years.

PubMed

van Dijk, Christel E; Zock, Jan-Paul; Baliatsas, Christos; Smit, Lidwien A M; Borlée, Floor; Spreeuwenberg, Peter; Heederik, Dick; Yzermans, C Joris

2017-03-01

Previous studies investigating health conditions of individuals living near livestock farms generally assessed short time windows. We aimed to take time-specific differences into account and to compare the prevalence of various health conditions over seven consecutive years. The sample consisted of 156,690 individuals registered in 33 general practices in a (rural) area with a high livestock density and 101,015 patients from 23 practices in other (control) areas in the Netherlands. Prevalence of health conditions were assessed using 2007-2013 electronic health record (EHR) data. Two methods were employed to assess exposure: 1) Comparisons between the study and control areas in relation to health problems, 2) Use of individual estimates of livestock exposure (in the study area) based on Geographic Information System (GIS) data. A higher prevalence of chronic bronchitis/bronchiectasis, lower respiratory tract infections and vertiginous syndrome and lower prevalence of respiratory symptoms and emphysema/COPD was found in the study area compared with the control area. A shorter distance to the nearest farm was associated with a lower prevalence of upper respiratory tract infections, respiratory symptoms, asthma, COPD/emphysema, allergic rhinitis, depression, eczema, vertiginous syndrome, dizziness and gastrointestinal infections. Especially exposure to cattle was associated with less health conditions. Living within 500m of mink farms was associated with increased chronic enteritis/ulcerative colitis. Livestock-related exposures did not seem to be an environmental risk factor for the occurrence of health conditions. Nevertheless, lower respiratory tract infections, chronic bronchitis and vertiginous syndrome were more common in the area with a high livestock density. The association between exposure to minks and chronic enteritis/ulcerative colitis remains to be elucidated. Copyright © 2016 Elsevier Ltd. All rights reserved.

Effect of High-Dose vs Standard-Dose Wintertime Vitamin D Supplementation on Viral Upper Respiratory Tract Infections in Young Healthy Children

PubMed Central

Aglipay, Mary; Birken, Catherine S.; Parkin, Patricia C.; Loeb, Mark B.; Thorpe, Kevin; Chen, Yang; Laupacis, Andreas; Mamdani, Muhammad; Macarthur, Colin; Hoch, Jeffrey S.; Mazzulli, Tony

2017-01-01

Importance Epidemiological studies support a link between low 25-hydroxyvitamin D levels and a higher risk of viral upper respiratory tract infections. However, whether winter supplementation of vitamin D reduces the risk among children is unknown. Objective To determine whether high-dose vs standard-dose vitamin D supplementation reduces the incidence of wintertime upper respiratory tract infections in young children. Design, Setting, and Participants A randomized clinical trial was conducted during the winter months between September 13, 2011, and June 30, 2015, among children aged 1 through 5 years enrolled in TARGet Kids!, a multisite primary care practice–based research network in Toronto, Ontario, Canada. Interventions Three hundred forty-nine participants were randomized to receive 2000 IU/d of vitamin D oral supplementation (high-dose group) vs 354 participants who were randomized to receive 400 IU/d (standard-dose group) for a minimum of 4 months between September and May. Main Outcome Measures The primary outcome was the number of laboratory-confirmed viral upper respiratory tract infections based on parent-collected nasal swabs over the winter months. Secondary outcomes included the number of influenza infections, noninfluenza infections, parent-reported upper respiratory tract illnesses, time to first upper respiratory tract infection, and serum 25-hydroxyvitamin D levels at study termination. Results Among 703 participants who were randomized (mean age, 2.7 years, 57.7% boys), 699 (99.4%) completed the trial. The mean number of laboratory-confirmed upper respiratory tract infections per child was 1.05 (95% CI, 0.91-1.19) for the high-dose group and 1.03 (95% CI, 0.90-1.16) for the standard-dose group, for a between-group difference of 0.02 (95% CI, −0.17 to 0.21) per child. There was no statistically significant difference in number of laboratory-confirmed infections between groups (incidence rate ratio [RR], 0.97; 95% CI, 0.80-1.16). There was also no significant difference in the median time to the first laboratory-confirmed infection: 3.95 months (95% CI, 3.02-5.95 months) for the high-dose group vs 3.29 months (95% CI, 2.66-4.14 months) for the standard-dose group, or number of parent-reported upper respiratory tract illnesses between groups (625 for high-dose vs 600 for standard-dose groups, incidence RR, 1.01; 95% CI, 0.88-1.16). At study termination, serum 25-hydroxyvitamin D levels were 48.7 ng/mL (95% CI, 46.9-50.5 ng/mL) in the high-dose group and 36.8 ng/mL (95% CI, 35.4-38.2 ng/mL) in the standard-dose group. Conclusions and Relevance Among healthy children aged 1 to 5 years, daily administration of 2000 IU compared with 400 IU of vitamin D supplementation did not reduce overall wintertime upper respiratory tract infections. These findings do not support the routine use of high-dose vitamin D supplementation in children for the prevention of viral upper respiratory tract infections. Trial Registration clinicaltrials.gov Identifier: NCT01419262 PMID:28719693

Effect of High-Dose vs Standard-Dose Wintertime Vitamin D Supplementation on Viral Upper Respiratory Tract Infections in Young Healthy Children.

PubMed

Aglipay, Mary; Birken, Catherine S; Parkin, Patricia C; Loeb, Mark B; Thorpe, Kevin; Chen, Yang; Laupacis, Andreas; Mamdani, Muhammad; Macarthur, Colin; Hoch, Jeffrey S; Mazzulli, Tony; Maguire, Jonathon L

2017-07-18

Epidemiological studies support a link between low 25-hydroxyvitamin D levels and a higher risk of viral upper respiratory tract infections. However, whether winter supplementation of vitamin D reduces the risk among children is unknown. To determine whether high-dose vs standard-dose vitamin D supplementation reduces the incidence of wintertime upper respiratory tract infections in young children. A randomized clinical trial was conducted during the winter months between September 13, 2011, and June 30, 2015, among children aged 1 through 5 years enrolled in TARGet Kids!, a multisite primary care practice-based research network in Toronto, Ontario, Canada. Three hundred forty-nine participants were randomized to receive 2000 IU/d of vitamin D oral supplementation (high-dose group) vs 354 participants who were randomized to receive 400 IU/d (standard-dose group) for a minimum of 4 months between September and May. The primary outcome was the number of laboratory-confirmed viral upper respiratory tract infections based on parent-collected nasal swabs over the winter months. Secondary outcomes included the number of influenza infections, noninfluenza infections, parent-reported upper respiratory tract illnesses, time to first upper respiratory tract infection, and serum 25-hydroxyvitamin D levels at study termination. Among 703 participants who were randomized (mean age, 2.7 years, 57.7% boys), 699 (99.4%) completed the trial. The mean number of laboratory-confirmed upper respiratory tract infections per child was 1.05 (95% CI, 0.91-1.19) for the high-dose group and 1.03 (95% CI, 0.90-1.16) for the standard-dose group, for a between-group difference of 0.02 (95% CI, -0.17 to 0.21) per child. There was no statistically significant difference in number of laboratory-confirmed infections between groups (incidence rate ratio [RR], 0.97; 95% CI, 0.80-1.16). There was also no significant difference in the median time to the first laboratory-confirmed infection: 3.95 months (95% CI, 3.02-5.95 months) for the high-dose group vs 3.29 months (95% CI, 2.66-4.14 months) for the standard-dose group, or number of parent-reported upper respiratory tract illnesses between groups (625 for high-dose vs 600 for standard-dose groups, incidence RR, 1.01; 95% CI, 0.88-1.16). At study termination, serum 25-hydroxyvitamin D levels were 48.7 ng/mL (95% CI, 46.9-50.5 ng/mL) in the high-dose group and 36.8 ng/mL (95% CI, 35.4-38.2 ng/mL) in the standard-dose group. Among healthy children aged 1 to 5 years, daily administration of 2000 IU compared with 400 IU of vitamin D supplementation did not reduce overall wintertime upper respiratory tract infections. These findings do not support the routine use of high-dose vitamin D supplementation in children for the prevention of viral upper respiratory tract infections. clinicaltrials.gov Identifier: NCT01419262.

A novel modelling approach to energy transport in a respiratory system.

PubMed

Nithiarasu, Perumal; Sazonov, Igor

2017-10-01

In this paper, energy transport in a respiratory tract is modelled using the finite element method for the first time. The upper and lower respiratory tracts are approximated as a 1-dimensional domain with varying cross-sectional and surface areas, and the radial heat conduction in the tissue is approximated using the 1-dimensional cylindrical coordinate system. The governing equations are solved using 1-dimensional linear finite elements with convective and evaporative boundary conditions on the wall. The results obtained for the exhalation temperature of the respiratory system have been compared with the available animal experiments. The study of a full breathing cycle indicates that evaporation is the main mode of heat transfer, and convection plays almost negligible role in the energy transport. This is in-line with the results obtained from animal experiments. Copyright © 2016 John Wiley & Sons, Ltd.

FLOW SIMULATION IN THE HUMAN UPPER RESPIRATORY TRACT

EPA Science Inventory

ABSTRACT

Computer simulations of airflow patterns within the human upper respiratory tract (URT) are presented. The URT model includes airways of the head (nasal and oral), throat (pharyngeal and laryngeal), and lungs (trachea and main bronchi). The head and throat mor...

TRANSPORT AND DEPOSITION OF NANO-SIZE PARTICLES IN THE UPPER HUMAN RESPIRATORY AIRWAYS

EPA Science Inventory

TRANSPORT AND DEPOSITION OF NANO-SIZE PARTICLES IN THE UPPER HUMAN RESPIRATORY AIRWAYS. Zhe Zhang*, Huawei Shi, Clement Kleinstreuer, Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695-7910; Chong S. Kim, National Health and En...

Evaluating humidity recovery efficiency of currently available heat and moisture exchangers: a respiratory system model study.

PubMed

Lucato, Jeanette Janaina Jaber; Adams, Alexander Bernard; Souza, Rogério; Torquato, Jamili Anbar; Carvalho, Carlos Roberto Ribeiro; Marini, John J

2009-01-01

To evaluate and compare the efficiency of humidification in available heat and moisture exchanger models under conditions of varying tidal volume, respiratory rate, and flow rate. Inspired gases are routinely preconditioned by heat and moisture exchangers to provide a heat and water content similar to that provided normally by the nose and upper airways. The absolute humidity of air retrieved from and returned to the ventilated patient is an important measurable outcome of the heat and moisture exchangers' humidifying performance. Eight different heat and moisture exchangers were studied using a respiratory system analog. The system included a heated chamber (acrylic glass, maintained at 37 degrees C), a preserved swine lung, a hygrometer, circuitry and a ventilator. Humidity and temperature levels were measured using eight distinct interposed heat and moisture exchangers given different tidal volumes, respiratory frequencies and flow-rate conditions. Recovery of absolute humidity (%RAH) was calculated for each setting. Increasing tidal volumes led to a reduction in %RAH for all heat and moisture exchangers while no significant effect was demonstrated in the context of varying respiratory rate or inspiratory flow. Our data indicate that heat and moisture exchangers are more efficient when used with low tidal volume ventilation. The roles of flow and respiratory rate were of lesser importance, suggesting that their adjustment has a less significant effect on the performance of heat and moisture exchangers.

The effect of stable bedding materials on dust levels, microbial air contamination and equine respiratory health.

PubMed

Kwiatkowska-Stenzel, Agnieszka; Witkowska, Dorota; Sowińska, Janina; Stopyra, Artur

2017-12-01

The choice of bedding material affects the quality of air in a stable and, consequently, the respiratory health of horses and humans. The risk of respiratory problems can be mitigated by improving the quality of air in the stable. The choice of bedding material is particularly important in cold climate conditions where horses are kept indoors throughout the year. This study examined the impact of three bedding materials: straw (S), peat with shavings (PS), and crushed wood pellets (CWP). The investigated factors were air contamination, including dust contamination and microbial (bacterial and fungal) contamination, and the condition of the equine respiratory tract. The condition of the respiratory tract was evaluated based on the results of arterial blood biochemistry tests and endoscopic evaluations of the upper respiratory tract. Mechanical dust contamination was lowest for PS (1.09mg/m 3 ) and highest for CWP (4.07mg/m 3 ). Bacterial contamination (in CFU - colony forming units) was highest for PS (5.14log 10 CFU/m 3 ) and lowest for CWP (4.81log 10 CFU/m 3 ). Fungal air contamination was lowest for CWP (4.54log 10 CFU/m 3 ) and highest for S (4.82log 10 CFU/m 3 ) and PS (4.88log 10 CFU/m 3 ). An analysis of physiological indicators revealed that all horses were clinically healthy regardless of the type of applied bedding. The type of bedding material did not exert a clear influence on arterial blood biochemistry or the results of endoscopic evaluations of the respiratory tract; however, the use of alternative for straw bedding materials improved endoscopy results. Copyright © 2017 Elsevier Ltd. All rights reserved.

Respiratory Problems Associated with Surfing in Coastal Waters.

PubMed

O'Halloran, Chris; Silver, Mary W; Lahiff, Maureen; Colford, John

2017-03-01

A pilot project was conducted to examine the health status and possible adverse health effects associated with seawater exposure (microbial water-quality indicators and phytoplankton abundance and their toxins) of surfers in Monterey Bay, Central California coastal waters. Forty-eight surfers enrolled in the study and completed an initial health background survey and weekly health surveys online using Survey Monkey. Descriptive statistics and generalized estimating equation, a regression technique, were used to identify longitudinal and correlated results. The surfers were predominately Caucasian, male, and physically active. They surfed approximately 4 h a week. Their average age was 34 years. The data indicated that the surfers were generally "healthy," with a low prevalence of diabetes, high cholesterol, and hypertension. Their most common health problems were allergies and asthma. During the study, 10% of the surfers reported gastrointestinal symptoms and 29% reported upper respiratory symptoms. This study suggests surfers were significantly more likely to report upper respiratory symptoms when they had a history of allergies, housemates with upper respiratory symptoms, and/or a history of previous adverse health symptoms while surfing during a "red tide" (an event often associated with the presence of phytoplankton toxins). Additionally, female surfers reported upper respiratory symptoms more than males.

[Arousal of respiratory origin and upper airway resistance syndrome: pathophysiological and diagnostic aspects].

PubMed

Puertas, F J; Ondzé, B; Carlander, B; Billiard, M

The description of Upper Airway Resistance Syndrome (UARS) let us to recognize the importance of the pair 'respiratory effort-arousal' on sleep-disordered breathing pathophysiology. First part of this paper reviews knowledge about respiratory arousal pathophysiology. Arousal response is normally needed to end obstructive respiratory episodes, but it is also the cause of sleep fragmentation. Among respiratory stimuli able to provoke arousal (respiratory effort, hypoxemia and hypercapnia), respiratory effort is the most constant. Neurophysiological mechanisms involved in arousal, sleep and vegetative consequences, and the possible role of non visible arousals, are also discussed. In UARS, because of the absence of apnea/hypopnea and significative O2 desaturations, arousals are induced by the increased respiratory effort. Diagnosis needs the simultaneous recording of polysomnography and esophageal pressure. Some symptoms and signs of UARS are similar to those of Obstructive Sleep Apnea Syndrome. However, UARS shows any differences: a lower Body Mass Index, less constant snoring, males and females are similarly affected or higher frequency of craniofacial abnormalities. Diagnostic difficulties may be due to confusion between hypopneas and episodes of increased resistance of upper airway, or to the lack of definitive diagnostic criteria. Finally, differential diagnosis needs a broad knowledge of disorders of excessive daytime sleepiness.

3-D PARTICLE TRANSPORT WITHIN THE HUMAN UPPER RESPIRATORY TRACT

EPA Science Inventory

In this study trajectories of inhaled particulate matter (PM) were simulated within a three-dimensional (3-D) computer model of the human upper respiratory tract (URT). The airways were described by computer-reconstructed images of a silicone rubber cast of the human head, throat...

Myeloablation-associated deletion of ORF4 in a human coronavirus 229E infection.

PubMed

Greninger, Alexander L; Pepper, Gregory; Shean, Ryan C; Cent, Anne; Palileo, Isabel; Kuypers, Jane M; Schiffer, Joshua T; Jerome, Keith R

2017-01-01

We describe metagenomic next-generation sequencing (mNGS) of a human coronavirus 229E from a patient with AML and persistent upper respiratory symptoms, who underwent hematopoietic cell transplantation (HCT). mNGS revealed a 548-nucleotide deletion, which comprised the near entirety of the ORF4 gene, and no minor allele variants were detected to suggest a mixed infection. As part of her pre-HCT conditioning regimen, the patient received myeloablative treatment with cyclophosphamide and 12 Gy total body irradiation. Iterative sequencing and RT-PCR confirmation of four respiratory samples over the 4-week peritransplant period revealed that the pre-conditioning strain contained an intact ORF4 gene, while the deletion strain appeared just after conditioning and persisted over a 2.5-week period. This sequence represents one of the largest genomic deletions detected in a human RNA virus and describes large-scale viral mutation associated with myeloablation for HCT.

Modeling Associations between Principals' Reported Indoor Environmental Quality and Students' Self-Reported Respiratory Health Outcomes Using GLMM and ZIP Models.

PubMed

Toyinbo, Oluyemi; Matilainen, Markus; Turunen, Mari; Putus, Tuula; Shaughnessy, Richard; Haverinen-Shaughnessy, Ulla

2016-03-30

The aim of this paper was to examine associations between school building characteristics, indoor environmental quality (IEQ), and health responses using questionnaire data from both school principals and students. From 334 randomly sampled schools, 4248 sixth grade students from 297 schools participated in a questionnaire. From these schools, 134 principals returned questionnaires concerning 51 IEQ related questions of their school. Generalized linear mixed models (GLMM) were used to study the associations between IEQ indicators and existence of self-reported upper respiratory symptoms, while hierarchical Zero Inflated Poisson (ZIP)-models were used to model the number of symptoms. Significant associations were established between existence of upper respiratory symptoms and unsatisfactory classroom temperature during the heating season (ORs 1.45 for too hot and cold, and 1.27 for too cold as compared to satisfactory temperature) and dampness or moisture damage during the year 2006-2007 (OR: 1.80 as compared to no moisture damage), respectively. The number of upper respiratory symptoms was significantly associated with inadequate ventilation and dampness or moisture damage. A higher number of missed school days due to respiratory infections were reported in schools with inadequate ventilation (RR: 1.16). The school level IEQ indicator variables described in this paper could explain a relatively large part of the school level variation observed in the self-reported upper respiratory symptoms and missed school days due to respiratory infections among students.

Modeling Associations between Principals’ Reported Indoor Environmental Quality and Students’ Self-Reported Respiratory Health Outcomes Using GLMM and ZIP Models

PubMed Central

Toyinbo, Oluyemi; Matilainen, Markus; Turunen, Mari; Putus, Tuula; Shaughnessy, Richard; Haverinen-Shaughnessy, Ulla

2016-01-01

Background: The aim of this paper was to examine associations between school building characteristics, indoor environmental quality (IEQ), and health responses using questionnaire data from both school principals and students. Methods: From 334 randomly sampled schools, 4248 sixth grade students from 297 schools participated in a questionnaire. From these schools, 134 principals returned questionnaires concerning 51 IEQ related questions of their school. Generalized linear mixed models (GLMM) were used to study the associations between IEQ indicators and existence of self-reported upper respiratory symptoms, while hierarchical Zero Inflated Poisson (ZIP)—models were used to model the number of symptoms. Results: Significant associations were established between existence of upper respiratory symptoms and unsatisfactory classroom temperature during the heating season (ORs 1.45 for too hot and cold, and 1.27 for too cold as compared to satisfactory temperature) and dampness or moisture damage during the year 2006–2007 (OR: 1.80 as compared to no moisture damage), respectively. The number of upper respiratory symptoms was significantly associated with inadequate ventilation and dampness or moisture damage. A higher number of missed school days due to respiratory infections were reported in schools with inadequate ventilation (RR: 1.16). Conclusions: The school level IEQ indicator variables described in this paper could explain a relatively large part of the school level variation observed in the self-reported upper respiratory symptoms and missed school days due to respiratory infections among students. PMID:27043595

Nasopharyngeal polymicrobial colonization during health, viral upper respiratory infection and upper respiratory bacterial infection.

PubMed

Xu, Qingfu; Wischmeyer, Jareth; Gonzalez, Eduardo; Pichichero, Michael E

2017-07-01

We sought to understand how polymicrobial colonization varies during health, viral upper respiratory infection (URI) and acute upper respiratory bacterial infection to understand differences in infection-prone vs. non-prone patients. Nasopharyngeal (NP) samples were collected from 74 acute otitis media (AOM) infection-prone and 754 non-prone children during 2094 healthy visits, 673 viral URI visits and 631 AOM visits. Three otopathogens Streptococcus pneumoniae (Spn), Nontypeable Haemophilus influenzae (NTHi), and Moraxella catarrhalis (Mcat) were identified by culture. NP colonization rates of multiple otopathogens during health were significantly lower than during viral URI, and during URI they were lower than at onset of upper respiratory bacterial infection in both AOM infection-prone and non-prone children. AOM infection-prone children had higher polymicrobial colonization rates than non-prone children during health, viral URI and AOM. Polymicrobial colonization rates of AOM infection-prone children during health were equivalent to that of non-prone children during viral URI, and during viral URI were equivalent to that of non-prone during AOM infection. Spn colonization was positively associated with NTHi and Mcat colonization during health, but negatively during AOM infection. The infection-prone patients more frequently have multiple potential bacterial pathogens in the NP than the non-prone patients. Polymicrobial interaction in the NP differs during health and at onset of infection. Copyright © 2017 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Variation of p53 mutational spectra between carcinoma of the upper and lower respiratory tract.

PubMed

Law, J C; Whiteside, T L; Gollin, S M; Weissfeld, J; El-Ashmawy, L; Srivastava, S; Landreneau, R J; Johnson, J T; Ferrell, R E

1995-07-01

Mutations of the p53 tumor suppressor gene are the most common genetic alterations associated with human cancer. Tumor-associated p53 mutations often show characteristic tissue-specific profiles which may infer environmentally induced mutational mechanisms. The p53 mutational frequency and spectrum were determined for 95 carcinomas of the upper and lower respiratory tract (32 lung and 63 upper respiratory tract). Mutations were identified at a frequency of 30% in upper respiratory tract (URT) tumors and 31% in lung tumors. All 29 identified mutations were single-base substitutions. Comparison of the frequency of specific base substitutions between lung and URT showed a striking difference. Transitions occurred at a frequency of 68% in URT, but only 30% in lung. Mutations involving G:C-->A:T transitions, which are commonly reported in gastric and esophageal tumors, were the most frequently identified alteration in URT (11/19). Mutations involving G:C-->T:A transversions, which were relatively common in lung tumors (3/10) and are representative of tobacco smoke-induced mutations were rare in URT tumors (1/19). Interestingly, G:C-->A:T mutations at CpG sites, which are characteristic of endogenous processes, were observed frequently in URT tumors (9/19) but only rarely in lung tumors (1/10), suggesting that both endogenous and exogenous factors are responsible for the observed differences in mutational spectra between the upper and lower respiratory systems.

Localizing Effects of Leptin on Upper Airway and Respiratory Control during Sleep.

PubMed

Yao, Qiaoling; Pho, Huy; Kirkness, Jason; Ladenheim, Ellen E; Bi, Sheng; Moran, Timothy H; Fuller, David D; Schwartz, Alan R; Polotsky, Vsevolod Y

2016-05-01

Obesity hypoventilation and obstructive sleep apnea are common complications of obesity linked to defects in respiratory pump and upper airway neural control. Leptin-deficient ob/ob mice have impaired ventilatory control and inspiratory flow limitation during sleep, which are both reversed with leptin. We aimed to localize central nervous system (CNS) site(s) of leptin action on respiratory and upper airway neuroventilatory control. We localized the effect of leptin to medulla versus hypothalamus by administering intracerbroventricular leptin (10 μg/2 μL) versus vehicle to the lateral (n = 14) versus fourth ventricle (n = 11) of ob/ob mice followed by polysomnographic recording. Analyses were stratified for effects on respiratory (nonflow-limited breaths) and upper airway (inspiratory flow limitation) functions. CNS loci were identified by (1) leptin-induced signal transducer and activator of transcription 3 (STAT3) phosphorylation and (2) projections of respiratory and upper airway motoneurons with a retrograde transsynaptic tracer (pseudorabies virus). Both routes of leptin administration increased minute ventilation during nonflow-limited breathing in sleep. Phrenic motoneurons were synaptically coupled to the nucleus of the solitary tract, which also showed STAT3 phosphorylation, but not to the hypothalamus. Inspiratory flow limitation and obstructive hypopneas were attenuated by leptin administration to the lateral but not to the fourth cerebral ventricle. Upper airway motoneurons were synaptically coupled with the dorsomedial hypothalamus, which exhibited STAT3 phosphorylation. Leptin relieves upper airway obstruction in sleep apnea by activating the forebrain, possibly in the dorsomedial hypothalamus. In contrast, leptin upregulates ventilatory control through hindbrain sites of action, possibly in the nucleus of the solitary tract. © 2016 Associated Professional Sleep Societies, LLC.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rohles, F.H. Jr.

Studies by the Institute for Environmental Research, Kansas State University, show that in terms of comfort, health, and performance, humidity control is an important element of environmental control and should not be eliminated for the sake of energy conservation. A constant level of comfort can be maintained if the humidity is increased and the temperature is decreased and vice versa; school absenteeism due to upper respiratory infection is related to classroom humidifcation; and psychomotor performance is better under warm, dry conditions than under warm, moist conditions. Humidification may be valuable in thermostat-setback programs by making cooler conditions comfortable.

[Infant morbidity caused by respiratory diseases and its relation with the air pollution in Juarez City, Chihuahua, Mexico].

PubMed

Hernández-Cadena, Leticia; Barraza-Villarreal, Albino; Ramírez-Aguilar, Matiana; Moreno-Macías, Hortencia; Miller, Paul; Carbajal-Arroyo, Luz Aurora; Romieu, Isabelle

2007-01-01

To assess the impact of atmospheric pollutants on the respiratory health of children of different age groups in Juarez City, Chihuahua, Mexico. Data on emergency room visits between 1997 and 2001 for respiratory diseases in children less than 17 years old were obtained from hospitals in the Juarez City belonging to the Mexican Social Security Institute (IMSS). Diseases were classified into three groups according to ICD 9th and 10th codes: a) upper respiratory diseases, b) lower respiratory diseases, and c) asthma attacks. This information was stratified by age group (< = 5 years and > 5 years). Daily air pollution data (ozone and PM10) and weather conditions were obtained from the Monitoring Network System in Juarez City. Statistical analysis was carried out using a Generalized Additive Model assuming a Poisson distribution. Ozone concentrations, but not PM 10, were statistically associated with emergency room visits for respiratory diseases, mainly among children 5 years old or younger. In this group, an increase of 20 ppb 1-hr maximum for ozone was associated with an increase of 8.3% in the number of emergency room visits for upper respiratory diseases, with a 3-day exposure lag; and an increase of 12.7% in the number of emergency room visits for lower respiratory diseases when considering a 4-day exposure lag in a maximum 8-hr mobile average. The largest effect for the complete sample and for the group 6 to 16 years of age was observed for 3-day lag (5.1% for an increase of 20 ppb 1-hr maximum for ozone). For the 6 to 16 year old group we did not find a significant effect. The wide range of risk is quite important and might represent a substantial cost for the health system as well as for the society. Our results emphasize the need to implement preventive and control measures for air pollution and avoid the worsening of the present situation.

Knowledge of Upper Respiratory Tract Infection In Elementary School Children.

ERIC Educational Resources Information Center

McCann-Sanford, Thurma; And Others

1982-01-01

This study assessed elementary school students' knowledge of upper respiratory tract infection and correlated it with parental socioeconomic status, ethnic background, and school absences. Schools chosen for the study represented different socioeconomic and ethnic populations. Students had a general knowledge of the etiology, symptoms, treatment,…

Evaluation of the likelihood of reflux developing in patients with recurrent upper respiratory infections, recurrent sinusitis or recurrent otitis seen in ear-nose-throat outpatient clinics.

PubMed

Önal, Zerrin; Çullu-Çokuğraş, Fügen; Işıldak, Hüseyin; Kaytaz, Asım; Kutlu, Tufan; Erkan, Tülay; Doğusoy, Gülen

2015-01-01

Gastroesophageal reflux is considered a risk factor for recurrent or persistent upper and lower respiratory tract conditions including asthma, chronic cough, sinusitis, laryngitis, serous otitis and paroxysmal laryngospasm. Fifty-one subjects with recurrent (more than three) episodes of upper respiratory tract infection (URTI), serous otitis or sinusitis who had been admitted to an earnose- throat (ENT) outpatient clinic during the previous year were enrolled in the present study to evaluate the presence of laryngeal and/or esophageal reflux. The participants, who were randomly selected, were questioned about symptoms of reflux, including vomiting, abdominal pain, failure to thrive, halitosis, bitter taste in the mouth, chronic cough, heartburn, constipation and hoarseness. All subjects had an endoscopic examination, an otoscopic examination, a tympanogram and upper GI system endoscopy. Esophagitis was diagnosed endoscopically and histologically. The likelihood of occurrence of esophagitis was found to be higher only among subjects with postglottic edema/erythema as determined by pathological laryngeal examination. The reflux complaints reported did not predict the development of esophagitis, but the odds of esophagitis occurring were ninefold greater among subjects with recurrent otitis. Of the subjects, 45.1% were Helicobacter pylori-positive. However, no association was found between esophagitis and Helicobacter pylori positivity. The likelihood of the occurrence of esophagitis was found to be increased in the presence of recurrent otitis media and/or postglottic edema, irrespective of the presence of reflux symptoms. We concluded that, in contrast to the situation where adults are concerned, the boundaries for discriminating laryngopharyngeal reflux from gastroesophageal reflux are somewhat blurred in pediatric patients.

The adenoid as a key factor in upper airway infections.

PubMed

van Cauwenberge, P B; Bellussi, L; Maw, A R; Paradise, J L; Solow, B

1995-06-01

The adenoids (and the nasopharynx) play a key role in the normal functioning and in various pathologies of the upper respiratory tract. In this paper the role of adenoidal pathology and the beneficial effect of adenoidectomy in some upper respiratory tract and facial anomalies and diseases are discussed; otitis media with effusion, recurrent acute otitis media, sinusitis, snoring and sleep apnea and abnormal patterns in the midface growth and development.

Impact of Cabin Ozone Concentrations on Passenger Reported Symptoms in Commercial Aircraft

PubMed Central

Bekö, Gabriel; Allen, Joseph G.; Weschler, Charles J.; Vallarino, Jose; Spengler, John D.

2015-01-01

Due to elevated ozone concentrations at high altitudes, the adverse effect of ozone on air quality, human perception and health may be more pronounced in aircraft cabins. The association between ozone and passenger-reported symptoms has not been investigated under real conditions since smoking was banned on aircraft and ozone converters became more common. Indoor environmental parameters were measured at cruising altitude on 83 US domestic and international flights. Passengers completed a questionnaire about symptoms and satisfaction with the indoor air quality. Average ozone concentrations were relatively low (median: 9.5 ppb). On thirteen flights (16%) ozone levels exceeded 60 ppb, while the highest peak level reached 256 ppb for a single flight. The most commonly reported symptoms were dry mouth or lips (26%), dry eyes (22.1%) and nasal stuffiness (18.9%). 46% of passengers reported at least one symptom related to the eyes or mouth. A third of the passengers reported at least one upper respiratory symptom. Using multivariate logistic (individual symptoms) and linear (aggregated continuous symptom variables) regression, ozone was consistently associated with symptoms related to the eyes and certain upper respiratory endpoints. A concentration-response relationship was observed for nasal stuffiness and eye and upper respiratory symptom indicators. Average ozone levels, as opposed to peak concentrations, exhibited slightly weaker associations. Medium and long duration flights were significantly associated with more symptoms compared to short flights. The relationship between ultrafine particles and ozone on flights without meal service was indicative of ozone-initiated chemistry. PMID:26011001

Should homeopathy be considered as part of a treatment strategy for otitis media with effusion in children?

PubMed

Fixsen, Alison

2013-04-01

Otitis media with effusion (OME) or 'glue ear' is the most common cause of pediatric hearing loss, and a drain on global healthcare resources. It is associated with frequent episodes of acute otitis media (AOM) and upper respiratory tract infections (URTIs) and linked with environmental and social factors, including diet, smoking households, overcrowding and day care use. Current conventional treatment for OME is unsatisfactory, the area constitutes an 'effectiveness gap'. Homeopathy is a relatively common and popular choice of complementary and alternative medicine (CAM) treatment for childhood conditions, including otitis media. Antibiotic resistance is now a major global problem, homeopathy may have a role to play in combating its further development. Systematic review of the literature for clinical studies of homeopathy for AOM and upper respiratory tract disorders. Discussion in the context of current treatment options and public health issues including antibiotic resistance. Several randomized trials and outcome studies of homeopathy for AOM and upper respiratory tract disorders have been published. The results are encouraging, but the volume of research is small and insufficient to draw definitive conclusions. A strategy based on multi-centre or multiple, linked clinical trials of homeopathy for OME, using a pragmatic framework and evaluating long-term effects in different settings, in conjunction with other healthcare and social services should be considered. Reduction of antibiotic use is an important outcome. Copyright © 2013 The Faculty of Homeopathy. Published by Elsevier Ltd. All rights reserved.

Improved detection of Pneumocystis jirovecii in upper and lower respiratory tract specimens from children with suspected pneumocystis pneumonia using real-time PCR: a prospective study

PubMed Central

2011-01-01

Background Pneumocystis pneumonia (PCP) is a major cause of hospitalization and mortality in HIV-infected African children. Microbiologic diagnosis relies predominantly on silver or immunofluorescent staining of a lower respiratory tract (LRT) specimens which are difficult to obtain in children. Diagnosis on upper respiratory tract (URT) specimens using PCR has been reported useful in adults, but data in children are limited. The main objectives of the study was (1) to compare the diagnostic yield of PCR with immunofluorescence (IF) and (2) to investigate the usefulness of upper compared to lower respiratory tract samples for diagnosing PCP in children. Methods Children hospitalised at an academic hospital with suspected PCP were prospectively enrolled. An upper respiratory sample (nasopharyngeal aspirate, NPA) and a lower respiratory sample (induced sputum, IS or bronchoalveolar lavage, BAL) were submitted for real-time PCR and direct IF for the detection of Pneumocystis jirovecii. A control group of children with viral lower respiratory tract infections were investigated with PCR for PCP. Results 202 children (median age 3.3 [inter-quartile range, IQR 2.2 - 4.6] months) were enrolled. The overall detection rate by PCR was higher than by IF [180/349 (52%) vs. 26/349 (7%) respectively; p < 0.0001]. PCR detected more infections compared to IF in lower respiratory tract samples [93/166 (56%) vs. 22/166 (13%); p < 0.0001] and in NPAs [87/183 (48%) vs. 4/183 (2%); p < 0.0001]. Detection rates by PCR on upper (87/183; 48%) compared with lower respiratory tract samples (93/166; 56%) were similar (OR, 0.71; 95% CI, 0.46 - 1.11). Only 2/30 (6.6%) controls were PCR positive. Conclusion Real-time PCR is more sensitive than IF for the detection of P. jirovecii in children with PCP. NPA samples may be used for diagnostic purposes when PCR is utilised. Wider implementation of PCR on NPA samples is warranted for diagnosing PCP in children. PMID:22123076

Childhood respiratory illness presentation and service utilisation in primary care: a six-year cohort study in Wellington, New Zealand, using natural language processing (NLP) software.

PubMed

Dowell, Anthony; Darlow, Ben; Macrae, Jayden; Stubbe, Maria; Turner, Nikki; McBain, Lynn

2017-08-01

To identify childhood respiratory tract-related illness presentation rates and service utilisation in primary care by interrogating free text and coded data from electronic medical records. Retrospective cohort study. Data interrogation used a natural language processing software inference algorithm. 36 primary care practices in New Zealand. Data analysed from January 2008 to December 2013. The records from 77 582 children enrolled were reviewed over a 6-year period to estimate the presentation of childhood respiratory illness and service utilisation. This cohort represents 268 919 person-years of data and over 650 000 unique consultations. Childhood respiratory illness presentation rate to primary care practice, with description of seasonal and yearly variation. Respiratory conditions constituted 46% of all child-general practitioner consultations with a stable year-on-year pattern of seasonal peaks. Upper respiratory tract infection was the most common respiratory category accounting for 21.0% of all childhood consultations, followed by otitis media (12.2%), wheeze-related illness (9.7%), throat infection (7.4%) and lower respiratory tract infection (4.4%). Almost 70% of children presented to their general practitioner with at least one respiratory condition in their first year of life; this reduced to approximately 25% for children aged 10-17. This is the first study to assess the primary care incidence and service utilisation of childhood respiratory illness in a large primary care cohort by interrogating electronic medical record free text. The study identified the very high primary care workload related to childhood respiratory illness, especially during the first 2 years of life. These data can enable more effective planning of health service delivery. The findings and methodology have relevance to many countries, and the use of primary care 'big data' in this way can be applied to other health conditions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

[Examination of upper abdominal region in high spatial resolution diffusion-weighted imaging using 3-Tesla MRI].

PubMed

Terada, Masaki; Matsushita, Hiroki; Oosugi, Masanori; Inoue, Kazuyasu; Yaegashi, Taku; Anma, Takeshi

2009-03-20

The advantage of the higher signal-to-noise ratio (SNR) of 3-Tesla magnetic resonance imaging (3-Tesla) has the possibility of contributing to the improvement of high spatial resolution without causing image deterioration. In this study, we compared SNR and the apparent diffusion coefficient (ADC) value with 3-Tesla as the condition in the diffusion-weighted image (DWI) parameter of the 1.5-Tesla magnetic resonance imaging (1.5-Tesla) and we examined the high spatial resolution images in the imaging method [respiratory-triggering (RT) method and breath free (BF) method] and artifact (motion and zebra) in the upper abdominal region of DWI at 3-Tesla. We have optimized scan parameters based on phantom and in vivo study. As a result, 3-Tesla was able to obtain about 1.5 times SNR in comparison with the 1.5-Tesla, ADC value had few differences. Moreover, the RT method was effective in correcting the influence of respiratory movement in comparison with the BF method, and image improvement by the effective acquisition of SNR and reduction of the artifact were provided. Thus, DWI of upper abdominal region was a useful sequence for the high spatial resolution in 3-Tesla.

[Evaluation and prognosis of occupational risk in workers of nonferrous metallurgy enterprises].

PubMed

Shliapnikov, D M; Kostarev, V G

2014-01-01

The article deals with results of a priori and a posteriori evaluation of occupational risk for workers' health. Categories of a priori occupational risk for workers are estimated as high to very high (intolerable) risk. Findings are that work conditions in nonferrous metallurgy workshop result in upper respiratory tract diseases (medium degree of occupational conditionality). Increased prevalence of such diseases among the workers is connected with length of service. The authors revealed priority factors for occupationally conditioned diseases. A promising approach in occupational medicine is creation of methods to evaluate and forecast occupational risk, that enable to specify goal parameters for prophylactic measures. For example, modelling the risk of occupationally conditioned diseases via changes in exposure to occupational factor and length of service proved that decrease of chemical concentrations in air of workplace to maximally allowable ones lowers risk of respiratory diseases from 14 to 6 cases per year, for length of service of 5 years and population risk.

Psychosocial Risk Factors for Upper Respiratory Infections: Assessment of Upper Respiratory Illness during Basic Training

DTIC Science & Technology

1988-05-23

association was low enough to ensure that the URI composite was not merely an index of somatic stress reactions or hypochondriasis . The eight-item...report somatic symptoms in response to stress. Adjusted URI Severity also is consistent with the clinical practice of ruling out other possible types

Respiratory and sleep disorders in mucopolysaccharidosis.

PubMed

Berger, Kenneth I; Fagondes, Simone C; Giugliani, Roberto; Hardy, Karen A; Lee, Kuo Sheng; McArdle, Ciarán; Scarpa, Maurizio; Tobin, Martin J; Ward, Susan A; Rapoport, David M

2013-03-01

MPS encompasses a group of rare lysosomal storage disorders that are associated with the accumulation of glycosaminoglycans (GAG) in organs and tissues. This accumulation can lead to the progressive development of a variety of clinical manifestations. Ear, nose, throat (ENT) and respiratory problems are very common in patients with MPS and are often among the first symptoms to appear. Typical features of MPS include upper and lower airway obstruction and restrictive pulmonary disease, which can lead to chronic rhinosinusitis or chronic ear infections, recurrent upper and lower respiratory tract infections, obstructive sleep apnoea, impaired exercise tolerance, and respiratory failure. This review provides a detailed overview of the ENT and respiratory manifestations that can occur in patients with MPS and discusses the issues related to their evaluation and management.

[Antibiotic prescribing in acute respiratory tract infections in general practice].

PubMed

Malo, S; Bjerrum, L; Feja, C; Lallana, M J; Poncel, A; Rabanaque, M J

2015-06-01

Antimicrobial resistance is a worldwide threat to public health. Acute respiratory tract infections are the main reason for antibiotic prescribing in the Spanish paediatric population. The aim of the study was to describe the frequency of antibiotic prescription and their pattern of use in acute respiratory tract infections diagnosed in children in Primary Care in Aragón (Spain). A study was conducted over a 1-year period on children between 0 and 14 years-old, recording all episodes of acute otitis, acute pharyngotonsillitis, non-specific upper respiratory infection, and acute bronchitis. The proportion of episodes within each diagnosis receiving an antibiotic prescription was calculated, and the prescribing pattern was determined. Half (50%) of the children in Aragón were diagnosed with a respiratory tract infection during the study period. Non-specific upper respiratory infection was the most frequent diagnosis. An antibiotic was prescribed in 75% of pharyngotonsillitis episodes, 72% of otitis, 27% of bronchitis, and 16% of non-specific upper respiratory infections. Broad spectrum antibiotics, mainly amoxicillin and amoxicillin-clavulanic, were predominantly prescribed. Antibiotic prescribing in respiratory tract infections in children was generally high, and the choice of antibiotics was probably inappropriate in a high percentage of cases. Therefore an improvement in antibiotic prescribing in children appears to be needed. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

Evaluating Humidity Recovery Efficiency of Currently Available Heat and Moisture Exchangers: A Respiratory System Model Study

PubMed Central

Lucato, Jeanette Janaina Jaber; Adams, Alexander Bernard; Souza, Rogério; Torquato, Jamili Anbar; Carvalho, Carlos Roberto Ribeiro; Marini, John J

2009-01-01

OBJECTIVES: To evaluate and compare the efficiency of humidification in available heat and moisture exchanger models under conditions of varying tidal volume, respiratory rate, and flow rate. INTRODUCTION: Inspired gases are routinely preconditioned by heat and moisture exchangers to provide a heat and water content similar to that provided normally by the nose and upper airways. The absolute humidity of air retrieved from and returned to the ventilated patient is an important measurable outcome of the heat and moisture exchangers’ humidifying performance. METHODS: Eight different heat and moisture exchangers were studied using a respiratory system analog. The system included a heated chamber (acrylic glass, maintained at 37°C), a preserved swine lung, a hygrometer, circuitry and a ventilator. Humidity and temperature levels were measured using eight distinct interposed heat and moisture exchangers given different tidal volumes, respiratory frequencies and flow-rate conditions. Recovery of absolute humidity (%RAH) was calculated for each setting. RESULTS: Increasing tidal volumes led to a reduction in %RAH for all heat and moisture exchangers while no significant effect was demonstrated in the context of varying respiratory rate or inspiratory flow. CONCLUSIONS: Our data indicate that heat and moisture exchangers are more efficient when used with low tidal volume ventilation. The roles of flow and respiratory rate were of lesser importance, suggesting that their adjustment has a less significant effect on the performance of heat and moisture exchangers. PMID:19578664

Upper and lower respiratory tract microbiota in horses: bacterial communities associated with health and mild asthma (inflammatory airway disease) and effects of dexamethasone.

PubMed

Bond, Stephanie L; Timsit, Edouard; Workentine, Matthew; Alexander, Trevor; Léguillette, Renaud

2017-08-23

The microbial composition of the equine respiratory tract, and differences due to mild equine asthma (also called Inflammatory Airway Disease (IAD)) have not been reported. The primary treatment for control of IAD in horses are corticosteroids. The objectives were to characterize the upper and lower respiratory tract microbiota associated with respiratory health and IAD, and to investigate the effects of dexamethasone on these bacterial communities using high throughput sequencing. The respiratory microbiota of horses was dominated by four major phyla, Proteobacteria (43.85%), Actinobacteria (21.63%), Firmicutes (16.82%), and Bacteroidetes (13.24%). Fifty genera had a relative abundance > 0.1%, with Sphingomonas and Pantoea being the most abundant. The upper and lower respiratory tract microbiota differed in healthy horses, with a decrease in richness in the lower airways, and 2 OTUs that differed in abundance. There was a separation between bacterial communities in the lower respiratory tract of healthy and IAD horses; 6 OTUs in the tracheal community had different abundance with disease status, with Streptococcus being increased in IAD horses. Treatment with dexamethasone had an effect on the lower respiratory tract microbiota of both heathy and IAD horses, with 8 OTUs increasing in abundance (including Streptococcus) and 1 OTU decreasing. The lower respiratory tract microbiota differed between healthy and IAD horses. Further research on the role of Streptococcus in IAD is warranted. Dexamethasone treatment affected the lower respiratory tract microbiota, which suggests that control of bacterial overgrowth in IAD horses treated with dexamethasone could be part of the treatment strategy.

Poverty related risk for potentially preventable hospitalisations among children in Taiwan.

PubMed

Chen, Likwang; Lu, Hsin-Ming; Shih, Shu-Fang; Kuo, Ken N; Chen, Chi-Liang; Huang, Lynn Chu

2010-07-07

This study investigated the incidence of potentially preventable hospitalisations in the first two years of life among children in the National Health Insurance (NHI) system of Taiwan. It also examined income disparities in potentially preventable hospitalisations across four economic categories: below a government-established poverty line and low-, middle-, and upper-income. Five major diseases causing potentially preventable hospitalisations were investigated: gastroenteritis and dehydration, asthma and chronic bronchitis, acute upper respiratory infections, lower respiratory infections, and acute injuries and poisonings. NHI data on enrolee registrations and use of ambulatory and hospital care by all children born between July 1, 2003 and June 30, 2004 (n = 218,158) was used for the study. The negative binomial regression method was used to identify factors associated with total inpatient care and the severity level for various types of potentially preventable hospitalisations during the first two years of life. This study found high inpatient expenses for lower respiratory infections for children in all income categories. Furthermore, results from the multivariate analysis indicate that children in the lowest economic category used inpatient care to a much greater extent than better-off children for problems considered potentially avoidable through primary prevention or through timely outpatient care. This was especially true for acute injuries and poisonings and for lower respiratory infections. On average, and controlling for other variables, a child in poverty spent 6.1 times more days in inpatient care for acute injuries and poisonings (p < 0.01) and 2.7 times more days for lower respiratory infections (p < 0.01) before age two, compared with a similarly-aged high-income child. The results also suggest a connection between economic status and the severity of a condition causing a potentially avoidable hospital admission. On average, length of stay for each admission for gastroenteritis and dehydration for children in poverty was 1.3 times that for high-income children (p < 0.01). Both the ratios for lower respiratory infections and for acute upper respiratory infections were 1.2 (p < 0.01 for both). There were high hospital admission rates and lengths of stays for lower respiratory infections among young children in all income categories. Hospital care use of young children in the poorest category was significantly higher for acute injuries and poisonings as well as for lower respiratory infections, compared with those of better-off children. The findings suggest the need for increased attention to these two disease types. It particularly calls for more research on the causes of high hospital care use for lower respiratory infections and on the reasons for large economic disparities in hospital care use for acute injuries and poisonings.

Acute hemorrhagic edema of infancy: a report of two cases.

PubMed

Dongre, Atul; Adhe, Vijay; Kothari, Dimple; Kardekar, Suchitra; Khopkar, Uday

2012-01-01

Acute hemorrhagic edema of infancy is one of the clinical forms of leukocytoclastic vasculitis seen in children. The condition runs a benign course. We report two male children who presented with upper respiratory tract infection followed by limb swelling and purpuric and ecchymotic lesions on the skin. Skin biopsy revealed leukocytoclastic vasculitis in both patients. In both cases, the lesions resolved completely without any sequelae.

Dynamic respiratory endoscopy of Standardbred racehorses during qualifying races.

PubMed

Priest, D T; Cheetham, J; Regner, A L; Mitchell, L; Soderholm, L V; Tamzali, Y; Ducharme, N G

2012-09-01

Examination of the equine upper airway during racing has not previously been documented. To describe the feasibility and appearance of the upper airways by overground respiratory endoscopic examination during racing conditions. Overground videoendoscopic examinations were performed on 46 Standardbred racehorses during qualifying races. Examined horses' speeds were recorded throughout the race with a portable GPS device. The procedure did not interfere with performance as there were no significant differences in race times between races in which horses were examined with the endoscope in place and prior unexamined races. Airway obstructions during or after the race were documented in 21 horses. Most previously reported causes of upper airway obstruction were observed; surprisingly bilateral ventro-medial arytenoid displacement (VMAD; n = 5) was seen during exercise as frequently as dorsal displacement of the soft palate (DDSP). Although DDSP (n = 10) was the most common diagnosis made, many displacements (n = 5) occurred after the race. Horses that demonstrated DDSP after the race had slower speeds than unaffected horses during the race. Racing endoscopy permits the diagnosis of upper airway obstructions without affecting performance. The occurrence of DDSP immediately after exercise may be clinically relevant. During racing VMAD may be an important anomaly. Racing endoscopy could be used to correlate the sensitivity of diagnostic endoscopy during race-training or treadmill examination. The pathogenesis and significance of VMAD deserves further investigation. © 2012 EVJ Ltd.

Cage size, movement in and out of housing during daily care, and other environmental and population health risk factors for feline upper respiratory disease in nine North American animal shelters.

PubMed

Wagner, Denae C; Kass, Philip H; Hurley, Kate F

2018-01-01

Upper respiratory infection (URI) is not an inevitable consequence of sheltering homeless cats. This study documents variation in risk of URI between nine North American shelters; determines whether this reflects variation in pathogen frequency on intake or differences in transmission and expression of disease; and identifies modifiable environmental and group health factors linked to risk for URI. This study demonstrated that although periodic introduction of pathogens into shelter populations may be inevitable, disease resulting from those pathogens is not. Housing and care of cats, particularly during their first week of stay in an animal shelter environment, significantly affects the rate of upper respiratory infection.

Responses to negative pressure surrounding the neck in anesthetized animals.

PubMed

Wolin, A D; Strohl, K P; Acree, B N; Fouke, J M

1990-01-01

Continuous positive pressure applied at the nose has been shown to cause a decrease in upper airway resistance. The present study was designed to determine whether a similar positive transmural pressure gradient, generated by applying a negative pressure at the body surface around the neck, altered upper airway patency. Studies were performed in nine spontaneously breathing anesthetized supine dogs. Airflow was measured with a pneumotachograph mounted on an airtight muzzle placed over the nose and mouth of each animal. Upper airway pressure was measured as the differential pressure between the extrathoracic trachea and the inside of the muzzle. Upper airway resistance was monitored as an index of airway patency. Negative pressure (-2 to -20 cmH2O) was applied around the neck by using a cuirass extending from the jaw to the thorax. In each animal, increasingly negative pressures were transmitted to the airway wall in a progressive, although not linear, fashion. Decreasing the pressure produced a progressive fall in upper airway resistance, without causing a significant change in respiratory drive or respiratory timing. At -5 cmH2O pressure, there occurred a significant fall in upper airway resistance, comparable with the response of a single, intravenous injection of sodium cyanide (0.5-3.0 mg), a respiratory stimulant that produces substantial increases in respiratory drive. We conclude that upper airway resistance is influenced by the transmural pressure across the airway wall and that such a gradient can be accomplished by making the extraluminal pressure more negative.(ABSTRACT TRUNCATED AT 250 WORDS)

Ultrasound investigation of fetal human upper respiratory anatomy.

PubMed

Wolfson, V P; Laitman, J T

1990-07-01

Although the human upper respiratory-upper digestive tract is an area of vital importance, relatively little is known about either the structural or functional changes that occur in the region during the fetal period. While investigations in our laboratory have begun to chart these changes through the use of postmortem materials, in vivo studies have been rarely attempted. This study combines ultrasonography with new applications of video editing to examine aspects of prenatal upper respiratory development. Structures of the fetal upper respiratory-digestive tract and their movements were studied through the use of ultrasonography and detailed frame-by-frame analysis. Twenty-five living fetuses, aged 18-36 weeks gestation, were studied in utero during routine diagnostic ultrasound examination. These real-time linear array sonograms were videotaped during each study. Videotapes were next analyzed for anatomical structures and movement patterns, played back through the ultrasound machine in normal speed, and then examined with a frame-by-frame video editor (FFVE) to identify structures and movements. Still images were photographed directly from the video monitor using a 35 mm camera. Results show that upper respiratory and digestive structures, as well as their movements, could be seen clearly during normal speed and repeat frame-by-frame analysis. Major structures that could be identified in the majority of subjects included trachea in 20 of 25 fetuses (80%); larynx, 76%; pharynx, 76%. Smaller structures were more variable, but were nevertheless observed on both sagittal and coronal section: piriform sinuses, 76%; thyroid cartilage, 36%; cricoid cartilage, 32%; and epiglottis, 16%. Movements of structures could also be seen and were those typically observed in connection with swallowing: fluttering tongue movements, changes in pharyngeal shape, and passage of a bolus via the piriform sinuses to esophagus. Fetal swallows had minimal laryngeal motion. This study represents the first time that the appearance of upper airway and digestive tract structures have been quantified in conjunction with their movements in the living fetus.

Misdiagnosing of malaria as RTI decreased after introduction of RDTs in rural areas of Kenya.

PubMed

Mamova, Alexandra; Mikolasova, Gertruda; Krčméry, Vladimír; Mulera, Michaela

2017-11-01

Clinical presentation of malaria is highly variable and can be mistaken for number of other diseases, including respiratory tract diseases, which are associated with significant morbidity and mortality. However, presumptive management of fever as malaria can result in significant overdiagnosis, even in high-risk areas. Quality microscopy services for the diagnosis of malaria are not widely available in rural areas of Sub-Saharan Africa as well as in substandard conditions of low-income settings and the accuracy of microscopy is usually poor. The aim of the study was to determine how introduction of RDTs influenced diagnostics of malaria in high risk area of Eldoret, Kenya. Documentation of every patient was screened for data of current disease and diagnostic tools used. In patients with suspected malaria, either microscopy, or RDT or both were done to confirm the diagnosis. Initially, incidence of malaria was very high, about 50-70% of all visits in OPD due to any infectious condition. In 2010, when rapid diagnostic tests became available in Eldoret, decrease in incidence of malaria from 49% (2010) to 29% (2011) and further to 5.3% (2016) was noted. At the same time, increased incidence of upper and especially lower respiratory tract infections was noted. Results suggest that upper and lower respiratory tract infections were formerly diagnosed and treated as malaria. Other contributing factors, such as improvement of infrastructure and malaria preventive and treatment programs also play a role in decreasing malaria incidence in rural areas of Kenya, however, RDTs play a key role in proper diagnostics of malaria.

Detergent protease exposure and respiratory disease: case-referent analysis of a retrospective cohort.

PubMed

Brant, A; Upchurch, S; van Tongeren, M; Zekveld, C; Helm, J; Barnes, F; Newman Taylor, A J; Cullinan, P

2009-11-01

To examine the relationship between protease exposure and respiratory disease in a cohort of detergent enzyme manufacturers. Case-referent analysis of a cohort of employees working in a European detergent factory between 1989 and 2002. Cases with new lower or upper respiratory disease were ascertained by examination of occupational health records and matched to referents on date of first employment. Personal exposures to airborne detergent protease were estimated, using a job exposure matrix, from >12,000 measurements taken in the factory during the period of study. We found clear, monotonic relationships between estimated protease exposure and both lower and upper respiratory disease. After control for age, sex and smoking, the odds ratio of lower respiratory disease was significantly elevated (1.98, 95% CI 1.04 to 3.79) in those employees working in jobs in the highest quartile of protease exposure (geometric mean 7.9 ng x m(-3)). For employees with upper respiratory disease, the risk was significantly elevated at a lower level of estimated protease exposure (geometric mean 2.3 ng x m(-3)). These findings provide strong evidence of an association between detergent enzyme exposure and the development of respiratory disease in an occupational setting. Using the routinely collected information on specific sensitisation and the close attention to workplace exposures that are characteristic of this industry, it should be possible to derive meaningful occupational exposure standards for most detergent enzymes.

Relations among questionnaire and laboratory measures of rhinovirus infection.

PubMed

Barrett, B; Brown, R; Voland, R; Maberry, R; Turner, R

2006-08-01

Due to high incidence and quality-of-life impact, upper respiratory infection substantially impacts on population health. To test or compare treatment effectiveness, a well-designed and validated illness-specific quality-of-life instrument is needed. Data reported in the current study were obtained from a trial testing echinacea for induced rhinovirus infection. Laboratory-assessed biomarkers included interleukin (IL)-8, nasal neutrophil count (polymorphonuclear neutrophils (PMN)), mucus weight, viral titre and seroconversion. The questionnaires used included the general health short form (SF)-8 (24-h recall version), the eight-item Jackson cold scale, and the 44-item Wisconsin Upper Respiratory Symptom Survey (WURSS). In total, 399 participants were inoculated with rhinovirus and monitored over 2,088 person-days. Statistically significant associations were found among nearly all variables. Between-questionnaire correlations were: WURSS-Jackson = 0.81; WURSS-SF-8 = 0.62; and Jackson-SF-8 = 0.60. Correlations with laboratory values were as follows: WURSS-mucus weight = 0.53; Jackson-mucus weight = 0.55; WURSS-viral titre = 0.37; Jackson-viral titre = 0.46; WURSS-IL-8 = 0.31; Jackson-IL-8 = 0.36; WURSS-PMN = 0.31; and Jackson-PMN = 0.28. Neither WURSS nor Jackson yielded satisfactory cut-off scores for diagnosis of infection. Symptomatic and biological outcomes of upper respiratory infection are highly variable, with only modest associations. While Wisconsin Upper Respiratory Symptom Survey and Jackson questionnaires both correlate with biomarkers, neither is a good predictor of induced infection. The inclusion of functional and quality-of-life items in the Wisconsin Upper Respiratory Symptom Survey does not significantly decrease the strength of association with laboratory-assessed biomarkers.

State-dependent and reflex drives to the upper airway: basic physiology with clinical implications

PubMed Central

Hughes, Stuart W.; Malhotra, Atul

2013-01-01

The root cause of the most common and serious of the sleep disorders is impairment of breathing, and a number of factors predispose a particular individual to hypoventilation during sleep. In turn, obstructive hypopneas and apneas are the most common of the sleep-related respiratory problems and are caused by dysfunction of the upper airway as a conduit for airflow. The overarching principle that underpins the full spectrum of clinical sleep-related breathing disorders is that the sleeping brain modifies respiratory muscle activity and control mechanisms and diminishes the ability to respond to respiratory distress. Depression of upper airway muscle activity and reflex responses, and suppression of arousal (i.e., “waking-up”) responses to respiratory disturbance, can also occur with commonly used sedating agents (e.g., hypnotics and anesthetics). Growing evidence indicates that the sometimes critical problems of sleep and sedation-induced depression of breathing and arousal responses may be working through common brain pathways acting on common cellular mechanisms. To identify these state-dependent pathways and reflex mechanisms, as they affect the upper airway, is the focus of this paper. Major emphasis is on the synthesis of established and recent findings. In particular, we specifically focus on 1) the recently defined mechanism of genioglossus muscle inhibition in rapid-eye-movement sleep; 2) convergence of diverse neurotransmitters and signaling pathways onto one root mechanism that may explain pharyngeal motor suppression in sleep and drug-induced brain sedation; 3) the lateral reticular formation as a key hub of respiratory and reflex drives to the upper airway. PMID:23970535

Hand Hygiene Program Decreases School Absenteeism Due to Upper Respiratory Infections

ERIC Educational Resources Information Center

Azor-Martinez, Ernestina; Cobos-Carrascosa, Elena; Seijas-Vazquez, Maria Luisa; Fernández-Sánchez, Carmen; Strizzi, Jenna M.; Torres-Alegre, Pilar; Santisteban-Martínez, Joaquin; Gimenez-Sanchez, Francisco

2016-01-01

Background: We assessed the effectiveness of a handwashing program using hand sanitizer to prevent school absenteeism due to upper respiratory infections (URIs). Methods: This was a randomized, controlled, and open study on a sample of 1341 children 4-12 years old, attending 5 state schools in Almería (Spain), with an 8-month follow-up. The…

Bighorn sheep (Ovis canadensis) sinus tumors are associated with coinfections by potentially pathogenic bacteria in the upper respiratory tract.

PubMed

Fox, Karen A; Rouse, Natalie M; Huyvaert, Kathryn P; Griffin, Karen A; Killion, Halcyon J; Jennings-Gaines, Jessica; Edwards, William H; Quackenbush, Sandra L; Miller, Michael W

2015-01-01

Bighorn sheep (Ovis canadensis) sinus tumors are hyperplastic to neoplastic, predominantly stromal masses of the paranasal sinuses that expand the sinus lining and obstruct the sinus cavities. Obstruction of the sinus cavities and disruption of normal sinus lining anatomy may interfere with clearance of bacterial pathogens from the upper respiratory tract. To examine this possibility, we explored whether the presence of sinus tumor features (tumor score) affected the likelihood of detecting potentially pathogenic bacteria from upper respiratory sinus lining tissues in bighorn sheep. We developed or used existing PCR assays for the detection of leukotoxigenic Pasteurellaceae and Mycoplasma ovipneumoniae in sinus lining tissues collected from 97 bighorn sheep in Colorado, US from 2009 to 2012. With the use of logistic regression analyses we found that tumor score was a good predictor of the probability of detecting potentially pathogenic bacteria in sinus lining tissues; we were more likely to detect potentially pathogenic bacteria from samples with high tumor scores. These findings add to our understanding of possible mechanisms for the maintenance and shedding of bacterial agents from the upper respiratory tracts of bighorn sheep.

Decreased measles antibody response after measles-mumps-rubella vaccine in infants with colds.

PubMed

Krober, M S; Stracener, C E; Bass, J W

1991-04-24

We examined the possibility that the common cold or afebrile upper respiratory tract infection might interfere with successful immunization in children who receive standard measles-mumps-rubella vaccine. Infants 15 to 18 months of age presenting at our well-child clinics for routine examination and immunizations were divided into two groups. Those infants with a history and physical findings of upper respiratory tract infection were compared with healthy control group infants who did not have upper respiratory tract infections, and who did not have a history of upper respiratory tract infection symptoms within the previous month. Both groups were studied for their serologic response to measles-mumps-rubella vaccination. Prevaccination serum samples were obtained prior to vaccine administration and postvaccination serum samples were obtained 6 to 8 weeks later. Measles antibody was measured in these serum samples by an indirect fluorescein-tagged antibody test. Ten (21%) of 47 infants with colds failed to develop measles antibody, while only one (2%) of 51 well infants failed to develop antibody. We conclude that infants with colds have a significant seroconversion failure rate associated with measles vaccine administration and that this may be the cause of some primary measles vaccine failures.

Nasopharyngeal culture

MedlinePlus

Culture - nasopharyngeal; Swab for respiratory viruses; Swab for staph carriage ... test identifies viruses and bacteria that cause upper respiratory tract symptoms. These include: Bordetella pertussis Neisseria meningitidis ...

Pressure-volume behavior of the upper airway.

PubMed

Fouke, J M; Teeter, J P; Strohl, K P

1986-09-01

The study was performed to investigate the relationship between force generation and upper airway expansion during respiratory efforts by upper airway muscles. In 11 anesthetized dogs we isolated the upper airway (nasal, oral, pharyngeal, and laryngeal regions) by transecting the cervical trachea and sealing the nasal and oral openings. During spontaneous respiratory efforts the pressure within the sealed upper airway, used as an index of dilating force, decreased during inspiration. On alternate breaths the upper airway was opened to a pneumotachograph, and an increase in volume occurred, also during inspiration. Progressive hyperoxic hypercapnia produced by rebreathing increased the magnitude of change in pressure and volume. At any level of drive, peak pressure or volume occurred at the same point during inspiration. At any level of drive, volume and pressure changes increased with end-expiratory occlusion of the trachea. The force-volume relationship determined from measurements during rebreathing was compared with pressure-volume curves performed by passive inflation of the airway while the animal was apneic. The relationship during apnea was 1.06 +/- 0.55 (SD) ml/cmH2O, while the force-volume relationship from rebreathing trials was -1.09 +/- 0.45 ml/cmH2O. We conclude that there is a correspondence between force production and volume expansion in the upper airway during active respiratory efforts.

Chronic Pseudomonas aeruginosa infection and respiratory muscle impairment in cystic fibrosis.

PubMed

Dassios, Theodore G; Katelari, Anna; Doudounakis, Stavros; Dimitriou, Gabriel

2014-03-01

Chronic infection with Pseudomonas aeruginosa in patients with cystic fibrosis (CF) is associated with increased morbidity. Chronic infection can cause limb and respiratory muscle compromise. Respiratory muscle function can be assessed via maximal inspiratory pressure (PImax), maximal expiratory pressure (PEmax), and the pressure-time index of the respiratory muscles (PTImus). We studied the effect of chronic P. aeruginosa infection on respiratory muscle function in patients with CF. This cross-sectional study assessed PImax, PEmax, PTImus, FEV1, FVC, maximum expiratory flow during the middle half of the FVC maneuver, body mass index, and upper arm muscle area in 122 subjects with CF, in 4 subgroups matched for age and sex at different stages of P. aeruginosa infection, according to the Leeds criteria. We compared respiratory muscle function in the subgroups according to P. aeruginosa infection state. Median PImax was significantly lower in CF subjects with chronic P. aeruginosa infection (PImax = 62 cm H2O), compared to subjects who were never infected (PImax = 86 cm H2O, P = .02), free of infection (PImax = 74 cm H2O, P = .01), or intermittently infected (PImax = 72 cm H2O, P = .02). Median PTImus was significantly increased in CF subjects with chronic P. aeruginosa infection (PTImus = .142), compared to subjects who were free of infection (PTImus = .102, P = .006). Median upper-arm muscle area was significantly lower in CF subjects with chronic P. aeruginosa infection (upper-arm muscle area = 2,219 mm(2)), compared to subjects who were never infected (2,754 mm(2), P = .03), free of infection (2,678 mm(2), P = .01), or intermittently infected (2,603 mm(2), P = .04). Multivariate logistic regression revealed P. aeruginosa state of infection as a significant determinant of PTImus (P = .03) independently of sex, upper-arm muscle area, and FEV1. CF subjects with chronic P. aeruginosa infection exhibited impaired respiratory muscle function and decreased inspiratory muscle strength, and chronic P. aeruginosa infection independently impacts respiratory muscle function in subjects with CF.

[Regeneration of the ciliary beat of human ciliated cells].

PubMed

Wolf, G; Koidl, B; Pelzmann, B

1991-10-01

The influence of an isotonic, alkaline saline solution (diluted "Emser Sole" or brine from the spa of Bad Ems) on the ciliary beat of isolated cultured human ciliated cells of the upper respiratory tract was investigated. The ciliary beat was observed via an inverted phase contrast microscope (Zeiss Axiomat IDPC) and measured microphotometrically under physiological conditions and after the damaging influence of 1% propanal solution. Under physiological conditions the saline solution had a positive, although statistically not significant influence on the frequency of the ciliary beat. After damage of the cultivated cells by 1% propanal solution, the saline solution had a significant better influence on the regeneration of the cultured cells than a physiological sodium chloride solution. It is concluded that diluted brine from Bad Ems has a positive effect on the ciliary beat of the respiratory epithelium and accelerates its regeneration after damage by viral and bacterial infections, surgery or inhaled noxae.

Factors influencing the development of otitis media among Sicilian children affected by upper respiratory tract infections.

PubMed

Martines, Francesco; Salvago, Pietro; Ferrara, Sergio; Messina, Giuseppe; Mucia, Marianna; Plescia, Fulvio; Sireci, Federico

2016-01-01

Upper respiratory tract infection is a nonspecific term used to describe an acute infection involving the nose, paranasal sinuses, pharynx and larynx. Upper respiratory tract infections in children are often associated with Eustachian tube dysfunction and complicated by otitis media, an inflammatory process within the middle ear. Environmental, epidemiologic and familial risk factors for otitis media (such as sex, socioeconomic and educational factors, smoke exposure, allergy or duration of breastfeeding) have been previously reported, but actually no data about their diffusion among Sicilian children with upper respiratory tract infections are available. To investigate the main risk factors for otitis media and their prevalence in Sicilian children with and without upper respiratory tract infections. A case-control study of 204 children with upper respiratory tract infections who developed otitis media during a 3 weeks monitoring period and 204 age and sex-matched healthy controls. Seventeen epidemiologically relevant features were inventoried by means of standardized questionnaires and skin tests were performed. Univariate analysis and multivariate logistic regression analysis were used to examine the association between risk factors and occurrence of otitis media. Otitis media resulted strongly associated to large families, low parental educational attainment, schooling within the third years of life (p<0.05); children were more susceptible to develop otitis media in the presence of asthma, cough, laryngopharyngeal reflux disease, snoring and apnea (p<0.05). Allergy and urban localization increased the risk of otitis media in children exposed to smoke respectively of 166% and 277% (p<0.05); the joint effect of asthma and presence of pets in allergic population increased the risk of recurrence of 11%, while allergy, cough and runny nose together increased this risk of 74%. Upper respiratory tract infections and otitis media are common childhood diseases strongly associated with low parental educational attainment (p=0.0001), exposure to smoke (p=0.0001), indoor exposure to mold (p=0.0001), laryngopharyngeal reflux disease (p=0.0002) and the lack of breast-feeding (p=0.0014); an increased risk of otitis media recurrences was observed in the presence of allergy, persistent cough and runny nose (p=0.0001). The modification of the identified risk factors for otitis media should be recommended to realize a correct primary care intervention. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Health Status of Women in the Armed Forces

DTIC Science & Technology

1991-12-01

1984, howeper, women’s rates for acute upper respiratory infection, diarrheal disease, ribella, and infectious mononucleosis had declined to such an...were observed for induced abortions and acute upper respiratory infection for the 1973-77 cohort; alcohol abuse and complications of pregnancy for the...1978-82 cohort; and complications of pregnancy and transient situational disturbances for the 1983-87 cohort. The most vulnerable time for the

Is recurrent respiratory infection associated with allergic respiratory disease?

PubMed

de Oliveira, Tiago Bittencourt; Klering, Everton Andrei; da Veiga, Ana Beatriz Gorini

2018-03-13

Respiratory infections cause high morbidity and mortality worldwide. This study aims to estimate the relationship between allergic respiratory diseases with the occurrence of recurrent respiratory infection (RRI) in children and adolescents. The International Study of Asthma and Allergies in Childhood questionnaire and a questionnaire that provides data on the history of respiratory infections and the use of antibiotics were used to obtain data from patients. The relationship between the presence of asthma or allergic rhinitis and the occurrence of respiratory infections in childhood was analyzed. We interviewed the caregivers of 531 children aged 0 to 15 years. The average age of participants was 7.43 years, with females accounting for 52.2%. This study found significant relationship between: presence of asthma or allergic rhinitis with RRI, with prevalence ratio (PR) of 2.47 (1.51-4.02) and 1.61 (1.34-1.93), respectively; respiratory allergies with use of antibiotics for respiratory problems, with PR of 5.32 (2.17-13.0) for asthma and of 1.64 (1.29-2.09) for allergic rhinitis; asthma and allergic rhinitis with diseases of the lower respiratory airways, with PR of 7.82 (4.63-13.21) and 1.65 (1.38-1.96), respectively. In contrast, no relationship between upper respiratory airway diseases and asthma and allergic rhinitis was observed, with PR of 0.71 (0.35-1.48) and 1.30 (0.87-1.95), respectively. RRI is associated with previous atopic diseases, and these conditions should be considered when treating children.

Effects of Long-Haul Transmeridian Travel on Subjective Jet-Lag and Self-Reported Sleep and Upper Respiratory Symptoms in Professional Rugby League Players.

PubMed

Fowler, Peter M; Duffield, Rob; Lu, Donna; Hickmans, Jeremy A; Scott, Tannath J

2016-10-01

To examine the effects of 24-h travel west across 11 time zones on subjective jet-lag and wellness responses together with self-reported sleep and upper respiratory symptoms in 18 professional rugby league players. Measures were obtained 1 or 2 d before (pretravel) and 2, 6, and 8 d after travel (post-2, post-6, and post-8) from Australia to the United Kingdom (UK) for the 2015 World Club Series. Compared with pretravel, subjective jet-lag remained significantly elevated on post-8 (3.1 ± 2.3, P < .05, d > 0.90), although it was greatest on post-2 (4.1 ± 1.4). Self-reported sleep-onset times were significantly earlier on post-2 than at all other time points (P < .05, d > 0.90), and large effect sizes suggested that wake times were earlier on post-2 than on post-6 and post-8 (d > 0.90). Although significantly more upper respiratory symptoms were reported on post-6 than at pretravel (P < .05, d ˃ 0.90), no incidence of injury and negligible changes in wellness and muscle strength and range of motion (P > .05, d < 0.90) were evident after travel. Results suggest that westward long-haul travel between Australia and the UK exacerbates subjective jet-lag and sleep responses, along with upper respiratory symptoms, in professional rugby league players. Of note, the increase in self-reported upper respiratory symptoms is a reminder that the demands of long-haul travel may be an additional concern in jet-lag for traveling athletes. However, due to the lack of sport-specific performance measures, it is still unclear whether international travel interferes with training to the extent that subsequent competition performance is impaired.

INFLUENZA VIRUS HOST RESISTANCE MODELS IN MICE AND RATS: UTILIZATION FOR UMMUNE FUNCTION ASSESSMENT AND IMMUNOTOXICOLOGY

EPA Science Inventory

Each year influenza viruses are responsible for epidemic respiratory diseases with excess morbidity and mortality. he severity of influenza disease ranges from mid upper respiratory tract infections to severe lower respiratory tract infections involving pneumonia, bronchiolitis a...

Medical Surveillance Monthly Report (MSMR). Volume 9, Number 6, September/October 2003

DTIC Science & Technology

2003-10-01

October 2003Vol. 9 No. 6 Contents Incidence, severity, and trends of pneumonia/influenza and acute respiratory failure/pulmonary insufficiency, US...high risk of acute respiratory illnesses.1-3 In the US military, acute respiratory illnesses continue to be leading causes of hospitalizations and...ambulatory visits of servicemembers.4,5 The most frequent acute respiratory illnesses of US servicemembers are upper respiratory infections (URIs) that

Use of plant extracts as an efficient alternative therapy of respiratory tract infections.

PubMed

Šmejkal, Karel; Rjašková, Veronika

Medicinal plants are advantageously used in the treatment of respiratory tract diseases. Upper respiratory tract catarrh is one of the diseases associated with seasonal weakening of immunity, and therefore, plant drugs with a non-specific immunomodulation effect are often used. Such plants include, but are not limited to, Echinacea (Echinacea purpurea) and American ginseng (Panax quinquefolius). In combination with medicinal plants having antibacterial and antiseptic effects, such as thyme (Thymus vulgaris) and pelargonium (Pelargonium sidoides), they can constitute efficient help in the treatment of respiratory tract diseases, shorten the duration of the disease and reduce the need of antibiotic therapy. The text presented summarizes the basic information about these plants, their ingredients, mechanisms of action and clinical tests confirming their effect and monitoring eventual adverse effects.Key words: Echinacea purpurea Panax quinquefolius Pelargonium sidoides Thymus vulgaris upper respiratory tract catarrh immunity.

[Detection of human papillomavirus in the upper respiratory tract in children without recurrent respiratory papillomatosis].

PubMed

Sun, Yue-feng; Wu, Yi-dong; Wu, Lei; Jiang, Juan-juan; Gao, Rong; Xu, Bin; Chen, Xiao-wei; Zhao, Zheng-yan

2012-12-01

The purpose of this prospective study was to investigate the presence of human papillomavirus (HPV) in tonsillectomy and adenoidectomy specimens from pediatric patients without juvenile-onset recurrent respiratory papillomatosis (JORRP), so as to understand the effect of HPV infection in the upper respiratory tract in children. Two hundred and forty-one pediatric patients without known JORRP or other HPV-related diseases undergoing tonsillectomy and/or adenoidectomy for hypertrophy or chronic tonsillitis were enrolled in this prospective study. One hundred and seventy-seven fresh samples of tonsillar tissues and 195 samples of adenoid tissues were collected and then examined for the presence of HPV DNA with the polymerase chain reaction (PCR) technique and typing. Laryngeal papilloma specimens from 17 patients obtained during routine debulking procedures were also analyzed and served as positive controls. All 17 papilloma specimens were positive for HPV DNA and the type was 6 or 11. This result confirmed that the methods used were valid for detecting HPV infection. HPV DNA was detected in 2 of the 177 tonsillar specimens and zero of the 195 adenoid specimens. The two positive samples were confirmed with typing. One was positive for HPV6 and the other for HPV11. Review of the medical records of these two cases confirmed that there were no history of HPV-related diseases. Histologic analysis of their specimens showed lymphoid hyperplasia, no specific changes suggesting HPV infection and no signs of malignancy. The HPV infection rate in upper respiratory tract was 0.8% (2/241). There is HPV infection in upper respiratory tract in Chinese children without JORRP, but maybe is not sufficient for the formation of JORRP.

Self-Reported Mental Health Predicts Acute Respiratory Infection.

PubMed

Maxwell, Lizzie; Barrett, Bruce; Chase, Joseph; Brown, Roger; Ewers, Tola

2015-06-01

Poor mental health conditions, including stress and depression, have been recognized as a risk factor for the development of acute respiratory infection. Very few studies have considered the role of general mental health in acute respiratory infection occurrence. The aim of this analysis is to determine if overall mental health, as assessed by the mental component of the Short Form 12 Health Survey, predicts incidence, duration, or severity of acute respiratory infection. Data utilized for this analysis came from the National Institute of Health-funded Meditation or Exercise for Preventing Acute Respiratory Infection (MEPARI) and MEPARI-2 randomized controlled trials examining the effects of meditation or exercise on acute respiratory infection among adults aged > 30 years in Madison, Wisconsin. A Kendall tau rank correlation compared the Short Form 12 mental component, completed by participants at baseline, with acute respiratory infection incidence, duration, and area-under-the-curve (global) severity, as assessed by the Wisconsin Upper Respiratory Symptom Survey. Participants were recruited from Madison, Wis, using advertisements in local media. Short Form 12 mental health scores significantly predicted incidence (P = 0.037) of acute respiratory infection, but not duration (P = 0.077) or severity (P = 0.073). The Positive and Negative Affect Schedule (PANAS) negative emotion measure significantly predicted global severity (P = 0.036), but not incidence (P = 0.081) or duration (P = 0.125). Mindful Attention Awareness Scale scores significantly predicted incidence of acute respiratory infection (P = 0.040), but not duration (P = 0.053) or severity (P = 0.70). The PHQ-9, PSS-10, and PANAS positive measures did not show significant predictive associations with any of the acute respiratory infection outcomes. Self-reported overall mental health, as measured by the mental component of Short Form 12, predicts acute respiratory infection incidence.

Composition and Predicted Metabolic Capacity of Upper and Lower Airway Microbiota of Healthy Dogs in Relation to the Fecal Microbiota.

PubMed

Ericsson, Aaron C; Personett, Alexa R; Grobman, Megan E; Rindt, Hansjorg; Reinero, Carol R

2016-01-01

The upper and lower airways of healthy humans are reported to harbor stable and consistent bacterial populations, and the composition of these communities is altered in individuals affected with several respiratory diseases. Data regarding the presence of airway microbiota in other animals are scant and a better understanding of the composition and metabolic function of such bacterial populations is essential for the development of novel therapeutic and diagnostic modalities for use in both veterinary and human medicine. Based on targeted next-generation sequencing of feces and samples collected at multiple levels of the airways from 16 healthy female dogs, we demonstrate that canine airways harbor a topographically continuous microbiota with increasing relative abundance of proteobacterial species from the upper to lower airways. The lung-associated microbiota, as assessed via bronchoalveolar lavage fluid (BALF), was the most consistent between dogs and was dominated by three distinct taxa, two of which were resolved to the species level and one to the level of family. The gene content of the nasal, oropharyngeal, and lung-associated microbiota, predicted using the Phylogenetic Investigations into Communities by Reconstruction of Unobserved States (PICRUSt) software, provided information regarding the glyoxylate and citrate cycle metabolic pathways utilized by these bacterial populations to colonize such nutrient-poor, low-throughput environments. These data generated in healthy subjects provide context for future analysis of diseased canine airways. Moreover, as dogs have similar respiratory anatomy, physiology, and immune systems as humans, are exposed to many of the same environmental stimuli, and spontaneously develop similar respiratory diseases, these data support the use of dogs as a model species for prospective studies of the airway microbiota, with findings translatable to the human condition.

The impact of sport related stressors on immunity and illness risk in team-sport athletes.

PubMed

Keaney, Lauren C; Kilding, Andrew E; Merien, Fabrice; Dulson, Deborah K

2018-06-19

Elite team-sport athletes are frequently exposed to stressors that have the potential to depress immunity and increase infection risk. Therefore, the purpose of this review is to describe how team-sport stressors impact upon immune responses, along with exploring whether alterations in these markers have the potential to predict upper respiratory tract illness symptoms. Narrative review. Salivary secretory immunoglobulin A (SIgA) and T-cell markers have been shown to predict infection risk in individual endurance athletes. Papers discussing the impact of team-sport stressors on SIgA and T-cells were discussed in the review, studies discussing other aspects of immunity were excluded. Journal articles were sourced from PubMed, Web of science and Scopus. Key search terms included team-sport athletes, stressors, immunity, T-cells, cytokines, SIgA and upper respiratory illness. Most team-sport stressors appear to increase risk for illness. An association between reduced SIgA and increased illness incidence has been demonstrated. Intensive training and competition periods have been shown to reduce SIgA, however, it is less clear how additional stressors including extreme environmental conditions, travel, psychological stress, sleep disturbance and poor nutrition affect immune responses. Monitoring SIgA may provide an assessment of a team-sport athletes risk status for developing upper respiratory tract symptoms, however there is currently not enough evidence to suggest SIgA alone can predict illness. Team-sport stressors challenge immunity and it is possible that the combination of stressors could have a compounding effect on immunodepression and infection risk. Given that illness can disrupt training and performance, further research is required to better elucidate how stressors individually and collectively influence immunity and illness. Copyright © 2018 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Automated graphic assessment of respiratory activity is superior to pulse oximetry and visual assessment for the detection of early respiratory depression during therapeutic upper endoscopy.

PubMed

Vargo, John J; Zuccaro, Gregory; Dumot, John A; Conwell, Darwin L; Morrow, J Brad; Shay, Steven S

2002-06-01

Recommendations from the American Society of Anesthesiologists suggest that monitoring for apnea using the detection of exhaled carbon dioxide (capnography) is a useful adjunct in the assessment of ventilatory status of patients undergoing sedation and analgesia. There are no data on the utility of capnography in GI endoscopy, nor is the frequency of abnormal ventilatory activity during endoscopy known. The aims of this study were to determine the following: (1) the frequency of abnormal ventilatory activity during therapeutic upper endoscopy, (2) the sensitivity of observation and pulse oximetry in the detection of apnea or disordered respiration, and (3) whether capnography provides an improvement over accepted monitoring techniques. Forty-nine patients undergoing therapeutic upper endoscopy were monitored with standard methods including pulse oximetry, automated blood pressure measurement, and visual assessment. In addition, graphic assessment of respiratory activity with sidestream capnography was performed in all patients. Endoscopy personnel were blinded to capnography data. Episodes of apnea or disordered respiration detected by capnography were documented and compared with the occurrence of hypoxemia, hypercapnea, hypotension, and the recognition of abnormal respiratory activity by endoscopy personnel. Comparison of simultaneous respiratory rate measurements obtained by capnography and by auscultation with a pretracheal stethoscope verified that capnography was an excellent indicator of respiratory rate when compared with the reference standard (auscultation) (r = 0.967, p < 0.001). Fifty-four episodes of apnea or disordered respiration occurred in 28 patients (mean duration 70.8 seconds). Only 50% of apnea or disordered respiration episodes were eventually detected by pulse oximetry. None were detected by visual assessment (p < 0.0010). Apnea/disordered respiration occurs commonly during therapeutic upper endoscopy and frequently precedes the development of hypoxemia. Potentially important abnormalities in respiratory activity are undetected with pulse oximetry and visual assessment.

A Brief Review of Non-invasive Monitoring of Respiratory Condition for Extubated Patients with or at Risk for Obstructive Sleep Apnea after Surgery

PubMed Central

Zhang, Xuezheng; Kassem, Mahmoud Attia Mohamed; Zhou, Ying; Shabsigh, Muhammad; Wang, Quanguang; Xu, Xuzhong

2017-01-01

Obstructive sleep apnea (OSA) is one of the important risk factors contributing to postoperative airway complications. OSA alters the respiratory physiology and increases the sensitivity of muscle tone of the upper airway after surgery to residual anesthetic medication. In addition, the prevalence of OSA was reported to be much higher among surgical patients than the general population. Therefore, appropriate monitoring to detect early respiratory impairment in postoperative extubated patients with possible OSA is challenging. Based on the comprehensive clinical observation, several equipment have been used for monitoring the respiratory conditions of OSA patients after surgery, including the continuous pulse oximetry, capnography, photoplethysmography (PPG), and respiratory volume monitor (RVM). To date, there has been no consensus on the most suitable device as a recommended standard of care. In this review, we describe the advantages and disadvantages of some possible monitoring strategies under certain clinical conditions. According to the literature, the continuous pulse oximetry, with its high sensitivity, is still the most widely used device. It is also cost-effective and convenient to use but has low specificity and does not reflect ventilation. Capnography is the most widely used device for detection of hypoventilation, but it may not provide reliable data for extubated patients. Even normal capnography cannot exclude the existence of hypoxia. PPG shows the state of both ventilation and oxygenation, but its sensitivity needs further improvement. RVM provides real-time detection of hypoventilation, quantitative precise demonstration of respiratory rate, tidal volume, and MV for extubated patients, but no reflection of oxygenation. Altogether, the sole use of any of these devices is not ideal for monitoring of extubated patients with or at risk for OSA after surgery. However, we expect that the combined use of continuous pulse oximetry and RVM may be promising for these patients due to their complementary function, which need further study. PMID:28337439

Safe prescribing practices in pregnancy and lactation.

PubMed

Hansen, Wendy F; Peacock, Anne E; Yankowitz, Jerome

2002-01-01

Midwives and other health care providers face a dilemma when a pregnant woman develops a condition that usually is treated with a pharmacologic agent. Understanding of basic teratology associated with drugs as well as the FDA categorization of agents can assist professionals in recognizing which pharmaceuticals should be used or avoided. In addition to reviewing teratology, this article addresses the use of common drugs for the treatment of upper respiratory conditions, minor pain, gastrointestinal problems, psychiatric illnesses, and neurologic disorders. In each category, current evidence is presented pertaining to which agents should be recommended for pregnant women.

THE ETIOLOGY OF ACUTE UPPER RESPIRATORY INFECTION (COMMON COLD)

PubMed Central

Long, Perrin H.; Doull, James A.; Bourn, Janet M.; McComb, Emily

1931-01-01

Experimental upper respiratory infections similar to "common colds" were transmitted singly and in series through two and four passages in nine out of fifteen persons, by intransal inoculations with bacteria-free filtrates of nasopharyngeal washings obtained from individuals ill with natural "colds." These observations conform with those reported by previous workers and lend further support to the view that the incitant of the "common cold" is a filtrable virus. PMID:19869857

U.S. Military Civic Action in Honduras, 1982-1985: Tactical Success, Strategic Uncertainty. CLIC Papers

DTIC Science & Technology

1988-09-01

four doctors treated about 600 patients, mostly for upper respiratory infections, malnutrition, skin infections and anemia . One villager, Jose Nolasco...gastro-intestinal problems, upper respiratory and skin infection, anemia , and malnutrition. Captain Gilbert Handal, a US Army doctor and a native of Chile...created by government opponents, but have been exploited by them. As former President of Peru , Fernando Belaunde-Terry argued "The enemies of democracy

Evaluation of the Specificity and Sensitivity of a Potential Rapid Influenza Screening System

DTIC Science & Technology

2013-01-01

Linder JA, Singer DE , Stafford RS. Association between antibiotic prescribing and visit duration in adults with upper respiratory tract infections. Clin...collected from emergency department patients presenting with influenza-like symptoms at a large military academic hospital and on de -identified nasal swabs...in the United States (Franck and Smith, 2010; Linder et al., 2003). For instance, in a national ambulatory network study of 52,135 upper respiratory

Effect of Zinc Supplements on Preventing Upper Respiratory Infections in Air Force Academy Cadets in Basic Training

DTIC Science & Technology

2009-01-01

and Nutrition Board (2001). Dietary Reference Intakes: A Report of the Panel on Micronutrients , Subcommittees on Upper Reference Levels of Nutrients...Respiratory Infections in Air Force Academy Cadets in Basic Training Summary Background: As a dietary essential, zinc plays a number of important roles...Introduction Zinc is considered one of the essential micronutrients used by the human body. Although zinc fulfills a number of metabolic and

NASAL-Geom, a free upper respiratory tract 3D model reconstruction software

NASA Astrophysics Data System (ADS)

Cercos-Pita, J. L.; Cal, I. R.; Duque, D.; de Moreta, G. Sanjuán

2018-02-01

The tool NASAL-Geom, a free upper respiratory tract 3D model reconstruction software, is here described. As a free software, researchers and professionals are welcome to obtain, analyze, improve and redistribute it, potentially increasing the rate of development, and reducing at the same time ethical conflicts regarding medical applications which cannot be analyzed. Additionally, the tool has been optimized for the specific task of reading upper respiratory tract Computerized Tomography scans, and producing 3D geometries. The reconstruction process is divided into three stages: preprocessing (including Metal Artifact Reduction, noise removal, and feature enhancement), segmentation (where the nasal cavity is identified), and 3D geometry reconstruction. The tool has been automatized (i.e. no human intervention is required) a critical feature to avoid bias in the reconstructed geometries. The applied methodology is discussed, as well as the program robustness and precision.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Poenkae, A.

The weekly changes in ambient sulfur dioxide, nitrogen dioxide, and temperature were compared with the figures for respiratory infection in children and adults and for absenteeism from day-care centers (DCC), schools, and workplaces during a 1-year period in Helsinki. The annual average level of sulfur dioxide was 21 micrograms/m3 and of nitrogen dioxide 47 micrograms/m3; the average temperature was +3.1 degrees C. The levels of these pollutants and the temperature were significantly correlated with the number of upper respiratory infections reported from health centers. Low temperature also correlated with increased frequency of acute tonsillitis, of lower respiratory tract infection amongmore » DCC children, and of absenteeism from day-care centers, schools and workplaces. Furthermore, a significant association was found between levels of sulfur dioxide and absenteeism. After statistical standardization for temperature, no other correlations were observed apart from that between high levels of sulfur dioxide and numbers of upper respiratory tract infections diagnosed at health centers (P = 0.04). When the concentrations of sulfur dioxide were above the mean, the frequency of the upper respiratory tract infections was 15% higher than that during the periods of low concentration. The relative importance of the effects of low-level air pollution and low temperature on health is difficult to assess.« less

Equine Welfare during Exercise: An Evaluation of Breathing, Breathlessness and Bridles

PubMed Central

Mellor, David J.; Beausoleil, Ngaio J.

2017-01-01

Simple Summary Horses have superior athletic capabilities due largely to their exceptional cardiorespiratory responses during exercise. This has particular relevance to horses’ potential to experience breathlessness, especially when their athletic performance is reduced by impaired respiratory function. Breathlessness, incorporating three types of unpleasant experiences, has been noted as of significant animal welfare concern in other mammals. However, the potential for breathlessness to occur in horses as usually ridden wearing bitted bridles has not yet been evaluated in detail. Accordingly, key physiological responses to exercise and the consequences of impaired respiratory function are outlined. Then the physiological control of breathing and the generation of the aversive experiences of breathlessness are explained. Finally, the potential for horses with unimpaired and impaired respiratory function to experience the different types of breathlessness is evaluated. This information provides a basis for considering the circumstances in which breathlessness may have significant negative welfare impacts on horses as currently ridden wearing bitted bridles. Potential beneficial impacts on respiratory function of using bitless bridles are then discussed with emphasis on the underlying mechanisms and their relevance to breathlessness. It is noted that direct comparisons of cardiorespiratory responses to exercise in horses wearing bitless and bitted bridles are not available and it is recommended that such studies be undertaken. Abstract Horses engaged in strenuous exercise display physiological responses that approach the upper functional limits of key organ systems, in particular their cardiorespiratory systems. Maximum athletic performance is therefore vulnerable to factors that diminish these functional capacities, and such impairment might also lead to horses experiencing unpleasant respiratory sensations, i.e., breathlessness. The aim of this review is to use existing literature on equine cardiorespiratory physiology and athletic performance to evaluate the potential for various types of breathlessness to occur in exercising horses. In addition, we investigate the influence of management factors such as rein and bit use and of respiratory pathology on the likelihood and intensity of equine breathlessness occurring during exercise. In ridden horses, rein use that reduces the jowl angle, sometimes markedly, and conditions that partially obstruct the nasopharynx and/or larynx, impair airflow in the upper respiratory tract and lead to increased flow resistance. The associated upper airway pressure changes, transmitted to the lower airways, may have pathophysiological sequelae in the alveolae, which, in their turn, may increase airflow resistance in the lower airways and impede respiratory gas exchange. Other sequelae include decreases in respiratory minute volume and worsening of the hypoxaemia, hypercapnia and acidaemia commonly observed in healthy horses during strenuous exercise. These and other factors are implicated in the potential for ridden horses to experience three forms of breathlessness—”unpleasant respiratory effort”, “air hunger” and “chest tightness”—which arise when there is a mismatch between a heightened ventilatory drive and the adequacy of the respiratory response. It is not known to what extent, if at all, such mismatches would occur in strenuously exercising horses unhampered by low jowl angles or by pathophysiological changes at any level of the respiratory tract. However, different combinations of the three types of breathlessness seem much more likely to occur when pathophysiological conditions significantly reduce maximal athletic performance. Finally, most horses exhibit clear behavioural evidence of aversion to a bit in their mouths, varying from the bit being a mild irritant to very painful. This in itself is a significant animal welfare issue that should be addressed. A further major point is the potential for bits to disrupt the maintenance of negative pressure in the oropharynx, which apparently acts to prevent the soft palate from rising and obstructing the nasopharynx. The untoward respiratory outcomes and poor athletic performance due to this and other obstructions are well established, and suggest the potential for affected animals to experience significant intensities of breathlessness. Bitless bridle use may reduce or eliminate such effects. However, direct comparisons of the cardiorespiratory dynamics and the extent of any respiratory pathophysiology in horses wearing bitted and bitless bridles have not been conducted. Such studies would be helpful in confirming, or otherwise, the claimed potential benefits of bitless bridle use. PMID:28587125

Laryngeal Trauma Following an Inhalation Injury: A Review and Case Report.

PubMed

Hogg, Gemma; Goswamy, Jay; Khwaja, Sadie; Khwaja, Nadeem

2017-05-01

The primary concern when managing a patient with inhalation injury is security of the airway. Airflow may be impeded by both edema of the upper airway and reduction of oxygen delivery to the lower respiratory tract. Although there has been much discussion regarding management of the latter, the focus of this article is the management of the former. This review aimed to determine the optimum management in burn victims with upper airway inhalation injury as an attempt to prevent laryngeal trauma leading to long-term voice disorders and upper airway dyspnea. We describe the case of a 57-year-old woman with significant inhalation injury and discuss the natural progression of her injuries and the laryngeal controversies surrounding her care. We conclude with advice on the optimal management of this condition based on our experience, combined with current best evidence. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

Particulate air pollution and respiratory disease in Anchorage, Alaska.

PubMed Central

Gordian, M E; Ozkaynak, H; Xue, J; Morris, S S; Spengler, J D

1996-01-01

This paper examines the associations between average daily particulate matter less than 10 microns in diameter (PM10) and temperature with daily outpatient visits for respiratory disease including asthma, bronchitis, and upper respiratory illness in Anchorage, Alaska, where there are few industrial sources of air pollution. In Anchorage, PM10 is composed primarily of earth crustal material and volcanic ash. Carbon monoxide is measured only during the winter months. The number of outpatients visits for respiratory diagnoses during the period 1 May 1992 to 1 March 1994 were derived from medical insurance claims for state and municipal employees and their dependents covered by Aetna insurance. The data were filtered to reduce seasonal trends and serial autocorrelation and adjusted for day of the week. The results show that an increase of 10 micrograms/m3 in PM10 resulted in a 3-6% increase in visits for asthma and a 1-3% increase in visits for upper respiratory diseases. Winter CO concentrations were significantly associated with bronchitis and upper respiratory illness, but not with asthma. Winter CO was highly correlated with automobile exhaust emissions. These findings are consistent with the results of previous studies of particulate pollution in other urban areas and provide evidence that the coarse fraction of PM10 may affect the health of working people. Images Figure 1. A Figure 1. B Figure 2. A Figure 2. B Figure 3. A Figure 3. B Figure 4. A Figure 4. B PMID:8919767

Fluctuations and Noise in Stochastic Spread of Respiratory Infection Epidemics in Social Networks

NASA Astrophysics Data System (ADS)

Yulmetyev, Renat; Emelyanova, Natalya; Demin, Sergey; Gafarov, Fail; Hänggi, Peter; Yulmetyeva, Dinara

2003-05-01

For the analysis of epidemic and disease dynamics complexity, it is necessary to understand the basic principles and notions of its spreading in long-time memory media. Here we considering the problem from a theoretical and practical viewpoint, presenting the quantitative evidence confirming the existence of stochastic long-range memory and robust chaos in a real time series of respiratory infections of human upper respiratory track. In this work we present a new statistical method of analyzing the spread of grippe and acute respiratory track infections epidemic process of human upper respiratory track by means of the theory of discrete non-Markov stochastic processes. We use the results of our recent theory (Phys. Rev. E 65, 046107 (2002)) for the study of statistical effects of memory in real data series, describing the epidemic dynamics of human acute respiratory track infections and grippe. The obtained results testify to an opportunity of the strict quantitative description of the regular and stochastic components in epidemic dynamics of social networks with a view to time discreteness and effects of statistical memory.

Psychosocial Risk Factors for Upper Respiratory Infections: Effects of Upper Respiratory Illness on Academic Performance in U.S. Navy Basic Training

DTIC Science & Technology

1989-03-15

training which take the form of somatisized distress or situational hypochondriasis . If so, URI-performance associations would be spurious. This...indications of hypochondriasis or symptom reporting as a form of psychological distress. General Synptom Reporting was used in the present study to test...the distress hypothesis was not supported. General Symptom Reporting did affect URI, but somatically -expressed distress could not be a cause of

Monitoring of immunological parameters in adolescent basketball athletes during and after a sports season.

PubMed

Brunelli, Diego Trevisan; Rodrigues, Ariel; Lopes, Wendell Arthur; Gáspari, Arthur Fernandes; Bonganha, Valéria; Montagner, Paulo César; Borin, João Paulo; Cavaglieri, Cláudia Regina

2014-01-01

The objective of the present study was to monitor the immunological and hormonal responses and the occurrence of upper respiratory symptoms in adolescent basketball athletes during the different stages of a sports season. Anthropometric measures, biochemical analyses (interleukin-6, interleukin-10, tumour necrosis factor-alpha, C-reactive protein, testosterone and cortisol), neuromuscular evaluations (standing vertical jumping ability, agility and estimated VO2max) and leukocyte counts were performed at four moments: 72 h before the season (-72 h); before the season (Pre-season); after six weeks, at the end of the preparatory period (Preparatory); and after 20 weeks, at the end of the competitive period (Competitive). Also, the occurrence of upper respiratory symptoms was collected weekly during all stages of the season. There were significant increases in monocytes, cortisol, tumour necrosis factor-alpha and C-reactive protein at the Competitive moment as compared to the Pre-season. In addition, interleukin-10 decreased at the Competitive moment as compared to the Pre-season. Occurrence of upper respiratory symptoms demonstrated increases (38%) during the competitive period as compared to the preparatory. These results suggest that periods of training and competition could increase the occurrence of upper respiratory symptoms in adolescent athletes and this may be due to the unwanted effects of an inflammatory process in response to the excessive stress of training and competition.

Respiratory system involvement in Costello syndrome.

PubMed

Gomez-Ospina, Natalia; Kuo, Christin; Ananth, Amitha Lakshmi; Myers, Angela; Brennan, Marie-Luise; Stevenson, David A; Bernstein, Jonathan A; Hudgins, Louanne

2016-07-01

Costello syndrome (CS) is a multisystem disorder caused by heterozygous germline mutations in the HRAS proto-oncogene. Respiratory system complications have been reported in individuals with CS, but a comprehensive description of the full spectrum and incidence of respiratory symptoms in these patients is not available. Here, we report the clinical course of four CS patients with respiratory complications as a major cause of morbidity. Review of the literature identified 56 CS patients with descriptions of their neonatal course and 17 patients in childhood/adulthood. We found that in the neonatal period, respiratory complications are seen in approximately 78% of patients with transient respiratory distress reported in 45% of neonates. Other more specific respiratory diagnoses were reported in 62% of patients, the majority of which comprised disorders of the upper and lower respiratory tract. Symptoms of upper airway obstruction were reported in CS neonates but were more commonly diagnosed in childhood/adulthood (71%). Analysis of HRAS mutations and their respiratory phenotype revealed that the common p.Gly12Ser mutation is more often associated with transient respiratory distress and other respiratory diagnoses. Respiratory failure and dependence on mechanical ventilation occurs almost exclusively with rare mutations. In cases of prenatally diagnosed CS, the high incidence of respiratory complications in the neonatal period should prompt anticipatory guidance and development of a postnatal management plan. This may be important in cases involving rarer mutations. Furthermore, the high frequency of airway obstruction in CS patients suggests that otorhinolaryngological evaluation and sleep studies should be considered. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Abdominal expiratory activity in the rat brainstem–spinal cord in situ: patterns, origins and implications for respiratory rhythm generation

PubMed Central

Abdala, A P L; Rybak, I A; Smith, J C; Paton, J F R

2009-01-01

We studied respiratory neural activity generated during expiration. Motoneuronal activity was recorded simultaneously from abdominal (AbN), phrenic (PN), hypoglossal (HN) and central vagus nerves from neonatal and juvenile rats in situ. During eupnoeic activity, low-amplitude post-inspiratory (post-I) discharge was only present in AbN motor outflow. Expression of AbN late-expiratory (late-E) activity, preceding PN bursts, occurred during hypercapnia. Biphasic expiratory (biphasic-E) activity with pre-inspiratory (pre-I) and post-I discharges occurred only during eucapnic anoxia or hypercapnic anoxia. Late-E activity generated during hypercapnia (7–10% CO2) was abolished with pontine transections or chemical suppression of retrotrapezoid nucleus/ventrolateral parafacial (RTN/vlPF). AbN late-E activity during hypercapnia is coupled with augmented pre-I discharge in HN, truncated PN burst, and was quiescent during inspiration. Our data suggest that the pons provides a necessary excitatory drive to an additional neural oscillatory mechanism that is only activated under conditions of high respiratory drive to generate late-E activity destined for AbN motoneurones. This mechanism may arise from neurons located in the RTN/vlPF or the latter may relay late-E activity generated elsewhere. We hypothesize that this oscillatory mechanism is not a necessary component of the respiratory central pattern generator but constitutes a defensive mechanism activated under critical metabolic conditions to provide forced expiration and reduced upper airway resistance simultaneously. Possible interactions of this oscillator with components of the brainstem respiratory network are discussed. PMID:19491247

The role of respiratory viruses in the etiology of bacterial pneumonia

PubMed Central

Lee, Kyu Han; Gordon, Aubree; Foxman, Betsy

2016-01-01

Pneumonia is the leading cause of death among children less than 5 years old worldwide. A wide range of viral, bacterial and fungal agents can cause pneumonia: although viruses are the most common etiologic agent, the severity of clinical symptoms associated with bacterial pneumonia and increasing antibiotic resistance makes bacterial pneumonia a major public health concern. Bacterial pneumonia can follow upper respiratory viral infection and complicate lower respiratory viral infection. Secondary bacterial pneumonia is a major cause of influenza-related deaths. In this review, we evaluate the following hypotheses: (i) respiratory viruses influence the etiology of pneumonia by altering bacterial community structure in the upper respiratory tract (URT) and (ii) respiratory viruses promote or inhibit colonization of the lower respiratory tract (LRT) by certain bacterial species residing in the URT. We conducted a systematic review of the literature to examine temporal associations between respiratory viruses and bacteria and a targeted review to identify potential mechanisms of interactions. We conclude that viruses both alter the bacterial community in the URT and promote bacterial colonization of the LRT. However, it is uncertain whether changes in the URT bacterial community play a substantial role in pneumonia etiology. The exception is Streptococcus pneumoniae where a strong link between viral co-infection, increased carriage and pneumococcal pneumonia has been established. PMID:26884414

Effects of viral respiratory disease education and surveillance on antibiotic prescribing.

PubMed

Temte, J L; Shult, P A; Kirk, C J; Amspaugh, J

1999-02-01

We describe a partnership between family practice residency clinics and a state public health virology laboratory that has produced comprehensive viral respiratory disease education and surveillance. Family practice residents have been provided with education on respiratory viruses and the results of ongoing viral surveillance. The preliminary effects of this program on antibiotic prescribing by senior residents are evaluated in this paper. We used a questionnaire to assess the acceptance by family practice residents of the educational component and the utility of ongoing viral surveillance. We used chart review to evaluate rates of antibiotic prescribing and the number of patients diagnosed per year with acute upper respiratory infection and acute bronchitis by senior residents in 1992 (preexposure) and 1996 (postexposure). By the third year of training, most residents (79%) reported receiving adequate training regarding common viral respiratory diseases. Moreover, residents reported that they were less likely to prescribe antibiotics to patients presenting with respiratory infections when provided with specific information on circulating viral pathogens. Antibiotic prescribing in the postexposure group was 68% lower for upper respiratory infection (URI) and 45% lower for a composite of URI and bronchitis. Education and monitoring of circulating respiratory viruses can result in familiarity with common disorders in primary care and reduce unnecessary antibiotic use.

Long-term effects of mustard gas on respiratory system of Iranian veterans after Iraq-Iran war: a review.

PubMed

Razavi, Seyed-Mansour; Ghanei, Mostafa; Salamati, Payman; Safiabadi, Mehdi

2013-01-01

To review long-term respiratory effects of mustard gas on Iranian veterans having undergone Iraq-Iran war. Electronic databases of Scopus, Medline, ISI, IranMedex, and Irandoc sites were searched. We accepted articles published in scientific journals as a quality criterion.The main pathogenic factors are free radical mediators. Prevalence of pulmonary involvement is approximately 42.5%. The most common complaints are cough and dyspnea. Major respiratory complications are chronic obstructive pulmonary disease, bronchiectasis, and asthma. Spirometry results can reveal restrictive and obstructive pulmonary disease. Plain chest X-ray does not help in about 50% of lung diseases. High-resolution CT of the lung is the best modality for diagnostic assessment of parenchymal lung and bronchi. There is no definite curative treatment for mustard lung. The effective treatment regimens consist of oxygen administration, use of vaporized moist air, respiratory physiotherapy, administration of mucolytic agents, bronchodilators, corticosteroids, and long-acting beta-2 agonists, antioxidants, surfactant, magnesium ions, therapeutic bronchoscopy, laser therapy, placement of respiratory stents, early tracheostomy in laryngospasm, and ultimately lung transplantation. High-resolution CT of the lung is the most accurate modality for the evaluation of the lung parenchyma and bronchi. The treatment efficacy of patients exposed to mustard gas depends on patient conditions (acute or chronic, upper or lower respiratory tract involvement). There are various treatment protocols, but unfortunately none of them is definitely curable.

Clinical characteristics of black asthmatic children.

PubMed

Luyt, D K; Davis, G; Dance, M; Simmank, K; Patel, D

1995-10-01

A prospective study of 455 black asthmatic children (277 boys) attending the Baragwanath Hospital asthma clinic was undertaken. A history was obtained by means of a standardised questionnaire and skin tests were performed. Cough was the commonest presenting symptom and upper respiratory tract infections, exercise and cold weather the commonest symptom precipitants. The relative incidences of the other precipitants reflected the environment of the study population. Associated atopic conditions were present in 75.5% of patients and a family background in 22.2%. Other respiratory diagnoses were commonly made, particularly tuberculosis, which was diagnosed in 7.4%. Fewer than one-third had no positive skin reaction. The commonest allergens were grasses, pollen and house-dust mites. The high proportion of house-dust mite sensitivity (44.2%) contradicts beliefs that they are rare at higher altitudes.

Agricultural lung diseases.

PubMed Central

Kirkhorn, S R; Garry, V F

2000-01-01

Agriculture is considered one of the most hazardous occupations. Organic dusts and toxic gases constitute some of the most common and potentially disabling occupational and environmental hazards. The changing patterns of agriculture have paradoxically contributed to both improved working conditions and increased exposure to respiratory hazards. Animal confinement operations with increasing animal density, particularly swine confinement, have contributed significantly to increased intensity and duration of exposure to indoor air toxins. Ongoing research has implicated bacterial endotoxins, fungal spores, and the inherent toxicity of grain dusts as causes of upper and lower airway inflammation and as immunologic agents in both grain and animal production. Animal confinement gases, particularly ammonia and hydrogen sulfide, have been implicated as additional sources of respiratory irritants. It has become evident that a significant percentage of agricultural workers have clinical symptoms associated with long-term exposure to organic dusts and animal confinement gases. Respiratory diseases and syndromes, including hypersensitivity pneumonitis, organic dust toxic syndrome, chronic bronchitis, mucous membrane inflammation syndrome, and asthmalike syndrome, result from ongoing acute and chronic exposures. In this review we focus upon the emerging respiratory health issues in a changing agricultural economic and technologic environment. Environmental and occupational hazards and exposures will be emphasized rather than clinical diagnosis and treatment. Methods of prevention, from both engineering controls and personal respiratory perspectives, are also addressed. PMID:10931789

Intensified Training Period Increases Salivary IgA Responses But Does Not Affect the Severity of Upper Respiratory Tract Infection Symptoms in Prepuberal Rhythmic Gymnasts.

PubMed

Antualpa, Kizzy; Aoki, Marcelo Saldanha; Moreira, Alexandre

2018-05-01

This study examined the effect of a 4-week intensified training (IT) period, followed by a 2-week tapering period (TP), on salivary immunoglobulin A (SIgA), salivary cortisol, and the severity of upper respiratory tract infection symptoms in 23 rhythmic gymnasts [12.1 (2.6) y; 143.9 (13.7) cm; 37.2 (9.4) kg]. Saliva sampling was conducted at pre- and post-IT, and post-TP (analyzed using enzyme-linked immunosorbent assay). The Wisconsin Upper Respiratory Symptom Survey (WURSS-21) questionnaire was completed daily to analyze the severity of upper respiratory tract infection symptoms. The session rating of the perceived exertion was used to determine the internal training load and the acute:chronic workload ratio. A higher SIgA concentration [SIgA abs (μg/mL); F = 7.6; P = .001] for post-IT [234 (104)] versus pre-IT [173 (91)], and post-TP [182 (70)], and a higher SIgA secretion rate [SIgA rate (μg/min); F = 3.4; P = .04] for post-IT [69 (28)] versus pre-IT [55 (27)], and post-TP [58 (22)] were observed. No significant change was observed for cortisol (F = 0.81; P = .45) or for the severity of upper respiratory tract infection symptoms (χ 2  = 2.81; P = .24). Internal training load was higher during IT (vs TP; effect size = 2.37). The acute:chronic workload for the IT weeks varied from 1.2 (0.3) to 1.4 (0.3). These results suggest that a 4-week IT may temporarily augment the oral mucosal immunity, and an acute:chronic workload of 1.2-1.4 seems to be a safe approach to periodized training loads in youth rhythmic gymnasts.

Assessing Airflow Sensitivity to Healthy and Diseased Lung Conditions in a Computational Fluid Dynamics Model Validated In Vitro.

PubMed

Sul, Bora; Oppito, Zachary; Jayasekera, Shehan; Vanger, Brian; Zeller, Amy; Morris, Michael; Ruppert, Kai; Altes, Talissa; Rakesh, Vineet; Day, Steven; Robinson, Risa; Reifman, Jaques; Wallqvist, Anders

2018-05-01

Computational models are useful for understanding respiratory physiology. Crucial to such models are the boundary conditions specifying the flow conditions at truncated airway branches (terminal flow rates). However, most studies make assumptions about these values, which are difficult to obtain in vivo. We developed a computational fluid dynamics (CFD) model of airflows for steady expiration to investigate how terminal flows affect airflow patterns in respiratory airways. First, we measured in vitro airflow patterns in a physical airway model, using particle image velocimetry (PIV). The measured and computed airflow patterns agreed well, validating our CFD model. Next, we used the lobar flow fractions from a healthy or chronic obstructive pulmonary disease (COPD) subject as constraints to derive different terminal flow rates (i.e., three healthy and one COPD) and computed the corresponding airflow patterns in the same geometry. To assess airflow sensitivity to the boundary conditions, we used the correlation coefficient of the shape similarity (R) and the root-mean-square of the velocity magnitude difference (Drms) between two velocity contours. Airflow patterns in the central airways were similar across healthy conditions (minimum R, 0.80) despite variations in terminal flow rates but markedly different for COPD (minimum R, 0.26; maximum Drms, ten times that of healthy cases). In contrast, those in the upper airway were similar for all cases. Our findings quantify how variability in terminal and lobar flows contributes to airflow patterns in respiratory airways. They highlight the importance of using lobar flow fractions to examine physiologically relevant airflow characteristics.

The Impact of Ambient Air Pollution on Daily Hospital Visits for Various Respiratory Diseases and the Relevant Medical Expenditures in Shanghai, China.

PubMed

Zhang, Hao; Niu, Yue; Yao, Yili; Chen, Renjie; Zhou, Xianghong; Kan, Haidong

2018-02-28

The evidence concerning the acute effects of ambient air pollution on various respiratory diseases was limited in China, and the attributable medical expenditures were largely unknown. From 2013 to 2015, we collected data on the daily visits to the emergency- and outpatient-department for five main respiratory diseases and their medical expenditures in Shanghai, China. We used the overdispersed generalized additive model together with distributed lag models to fit the associations of criteria air pollutants with hospital visits, and used the linear models to fit the associations with medical expenditures. Generally, we observed significant increments in emergency visits (8.81-17.26%) and corresponding expenditures (0.33-25.81%) for pediatric respiratory diseases, upper respiratory infection (URI), and chronic obstructive pulmonary disease (COPD) for an interquartile range increase of air pollutant concentrations over four lag days. As a comparison, there were significant but smaller increments in outpatient visits (1.36-4.52%) and expenditures (1.38-3.18%) for pediatric respiratory diseases and upper respiratory infection (URI). No meaningful changes were observed for asthma and lower respiratory infection. Our study suggested that short-term exposure to outdoor air pollution may induce the occurrences or exacerbation of pediatric respiratory diseases, URI, and COPD, leading to considerable medical expenditures upon the patients.

Obstructive sleep apnea in Down syndrome: Benefits of surgery and noninvasive respiratory support.

PubMed

Dudoignon, Benjamin; Amaddeo, Alessandro; Frapin, Annick; Thierry, Briac; de Sanctis, Livio; Arroyo, Jorge Olmo; Khirani, Sonia; Fauroux, Brigitte

2017-08-01

Children with Down syndrome are at increased risk of obstructive sleep apnea (OSA). The aim of the study was to describe the management of OSA in a large cohort of children with Down syndrome. A retrospective analysis of sleep studies and consequent management was performed for all consecutive Down syndrome patients evaluated between September 2013 and April 2016. The data of 57 patients were analyzed: 51/53 had an interpretable overnight polygraphy and 4 the recording of nocturnal gas exchange. Mean age at baseline sleep study was 6.2 ± 5.9 years. Eighteen patients (32%) had prior upper airway surgery. Mean apnea-hypopnea index (AHI) was 14 ± 16 events/hr with 41 of the 51 (80%) patients having OSA with an AHI >1 event/hr and 20 patients (39%) having an AHI ≥10 events/hr. Consequently, eight patients (14%) had upper airway surgery. OSA improved in all patients except two who needed noninvasive respiratory support. Nineteen (33%) patients required noninvasive respiratory support. Mean age at noninvasive respiratory support initiation was 7 ± 7 years. On 11 patients with objective adherence data available, mean compliance at 2 ± 1 years of treatment was excellent with an average use per night of 8 hr46 ± 3 hr59 and 9 patients using the noninvasive respiratory support >4 hr/night. Noninvasive respiratory support was associated with an improvement of nocturnal gas exchange. The prevalence of OSA is high in Down syndrome. Upper airway surgery is not always able to correct OSA. Noninvasive respiratory support represents then an effective treatment for OSA and good compliance may be achieved in a majority of patients. © 2017 Wiley Periodicals, Inc.

Immunomodulation of allergic autocytotoxicity in bronchial asthma by a bacterial lysate--Broncho-Vaxom.

PubMed

Podleski, W K

1985-01-01

The direct and antibody-dependent allergic autocytotoxicity (ACT) response, mediated by food antigens and its immunoregulation with bacterial lysate of the eight most common pathogens of the upper respiratory tract--Broncho-Vaxom (BX), was investigated in fifteen bronchial asthma patients and eight normal control individuals. Under the described experimental conditions, the BX inhibits ACT response in vitro. In analyzing the mechanism of this effect, the enhancement of T suppressor cells by BX was under consideration.

Psychosocial Risk Factors for Upper Respiratory Infection: Depression as a Mediator of Associations between Neuroticism and Upper Respiratory Illness

DTIC Science & Technology

1989-03-31

Roessler, R., & Crosley, A.P. (1959). Ego strength and length of recovery from infectious mononucleosis . Journal of Nervous and Mental Disease, 128...operational settings. The development of methods of reducing the effects of infectious disease will progress more rapidly if high risk individuals can be...Na.y recruits (n . 130 and n - 253) who volun- teered to participate in a study of risk factors for infectious disease completed personality measures at

Upper respiratory tract infections in athletes.

PubMed

Page, Clifton L; Diehl, Jason J

2007-07-01

Upper respiratory tract infections (URTIs) represent the most common acute illnesses in the general population and account for the leading acute diagnoses in the outpatient setting. Given the athlete's expectation to return to activity as soon as possible, the sports medicine physician should be able to accurately diagnose and aggressively treat these illnesses. This article discusses the common pathogens, diagnosis, treatment options, and return-to-play decisions for URTIs, with a focus on the common cold, sinusitis, pharyngitis, and infectious mononucleosis in the athlete.

Genomic signatures of Mannheimia haemolytica that associate with the lungs of cattle with respiratory disease, an integrative conjugative element, and antibiotic resistance genes

USDA-ARS?s Scientific Manuscript database

Background: Mannheimia haemolytica typically resides in cattle as a commensal member of the upper respiratory tract microbiome. However, some strains can invade their lungs and cause respiratory disease and death, including those with multi-drug resistance. A nucleotide polymorphism typing system ...

The prevalence of respiratory symptoms among mushroom workers in Ireland.

PubMed

Hayes, J P; Rooney, J

2014-10-01

Respiratory conditions such as asthma, bronchitis, hypersensitivity pneumonitis and upper airways symptoms have been ascribed to fungal exposures. Mushroom workers may be at risk of these as a consequence. To assess the prevalence of respiratory symptoms in mushroom workers. A cross-sectional study assessed 4 weeks of respiratory symptoms among mushroom workers divided into four categories of exposure, using a self-administered respiratory questionnaire and spirometry. The population of 191 subjects was predominantly (66%) from Eastern Europe; 61% were women and 39% were under 30. It included 73 growers, 38 composters, 26 administrators and 52 packers. Among all workers, there was a high prevalence (67%) of one or more respiratory symptoms which did not appear to vary by age, gender, pack-years of smoking or duration of employment. There was a significant improvement in respiratory symptoms in workers during absence from the workplace (P < 0.001). Spirometry readings across all groups were within normal values. Symptom profiles suggest that as many as 22 workers had symptoms of airways disease; 18 (82%) of these were mushroom growers. Growers were significantly more likely to have symptoms consistent with airways disease than all other workers, odds ratio 9.2 (95% CI 3.0-28.4). There was a high prevalence of respiratory symptoms among mushroom workers. Mushroom growers may be at high risk of airways disease, possibly from fungal antigens or related exposures. © The Author 2014. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Effect of Lactobacillus paracasei subsp. paracasei, L. casei 431 on immune response to influenza vaccination and upper respiratory tract infections in healthy adult volunteers: a randomized, double-blind, placebo-controlled, parallel-group study.

PubMed

Jespersen, Lillian; Tarnow, Inge; Eskesen, Dorte; Morberg, Cathrine Melsaether; Michelsen, Birgit; Bügel, Susanne; Dragsted, Lars Ove; Rijkers, Ger T; Calder, Philip C

2015-06-01

Probiotics can modulate the immune system in healthy individuals and may help reduce symptoms related to respiratory infections. The objective of the study was to investigate the effect of the probiotic strain Lactobacillus paracasei subsp. paracasei, L. casei 431 (Chr. Hansen A/S) (hereafter, L. casei 431) on immune response to influenza vaccination and respiratory symptoms in healthy adults. A randomized double-blind, placebo-controlled trial was conducted in 1104 healthy subjects aged 18-60 y at 2 centers in Germany and Denmark. Subjects were randomly assigned to receive an acidified milk drink containing ≥10(9) colony-forming units of L. casei 431 (n = 553) or placebo (n = 551) for 42 d. After 21 d, subjects received the seasonal influenza vaccination. The primary outcome was seroprotection rate (anti-influenza antibody titers by hemagglutination inhibition) 21 d after vaccination. Other outcomes were seroconversion rate and mean titers, influenza A-specific antibodies and incidence, and duration and severity of upper respiratory symptoms. Antibiotic use and use of health care resources were recorded. There was no effect of L. casei 431 on immune responses to influenza vaccination. Generalized linear mixed modeling showed a shorter duration of upper respiratory symptoms in the probiotic group than in the placebo group (mean ± SD: 6.4 ± 6.1 vs. 7.3 ± 9.7 d, P = 0.0059) in the last 3 wk of the intervention period. No statistically significant differences were found for incidence or severity. Daily consumption of L. casei 431 resulted in no observable effect on the components of the immune response to influenza vaccination but reduced the duration of upper respiratory symptoms. The trial was registered at www.isrctn.com as ISRCTN08280229. © 2015 American Society for Nutrition.

Safe sleeping positions: practice and policy for babies with cleft palate.

PubMed

Davies, Karen; Bruce, Iain A; Bannister, Patricia; Callery, Peter

2017-05-01

Guidance recommends 'back to sleep' positioning for infants from birth in order to reduce the risk of sudden infant death. Exceptions have been made for babies with severe respiratory difficulties where lateral positioning may be recommended, although uncertainty exists for other conditions affecting the upper airway structures, such as cleft palate. This paper presents research of (i) current advice on sleep positioning provided to parents of infants with cleft palate in the UK; and (ii) decision making by clinical nurse specialists when advising parents of infants with cleft palate. A qualitative descriptive study used data from a national survey with clinical nurse specialists from 12 regional cleft centres in the UK to investigate current practice. Data were collected using semi-structured telephone interviews and analysed using content analysis. Over half the regional centres used lateral sleep positioning based on clinical judgement of the infants' respiratory effort and upper airway obstruction. Assessment relied upon clinical judgement augmented by a range of clinical indicators, such as measures of oxygen saturation, heart rate and respiration. Specialist practitioners face a clinical dilemma between adhering to standard 'back to sleep' guidance and responding to clinical assessment of respiratory effort for infants with cleft palate. In the absence of clear evidence, specialist centres rely on clinical judgement regarding respiratory problems to identify what they believe is the most appropriate sleeping position for infants with cleft palate. Further research is needed to determine the best sleep position for an infant with cleft palate. What is Known • Supine sleep positioning reduces the risk of sudden infant death in new born infants. • There is uncertainty about the benefits or risks of lateral sleep positioning for infants with upper airway restrictions arising from cleft palate. What is New • Variability exists in the information/advice provided to parents of infants with cleft palate regarding sleep positioning. • Over half the national specialist centres for cleft palate in the UK advise positioning infants with CP in the lateral position as a routine measure to reduce difficulties with respiration.

Development and Function of the Mucosal Immune System in the Upper Respiratory Tract of Neonatal Calves.

PubMed

Osman, Rahwa; Malmuthuge, Nilusha; Gonzalez-Cano, Patricia; Griebel, Philip

2018-02-15

Respiratory infections remain the second most common cause of clinical disease and mortality in newborn calves, which has led to increased interest in using vaccines early in life to mitigate this risk. Intranasal vaccination of neonatal calves can be an effective strategy to circumvent vaccine interference by maternal antibody, but this raises questions regarding onset of immune competence in the upper respiratory tract (URT) following birth. Little is known, however, about the development and function of mucosa-associated lymphoid tissue (MALT) in the URT of newborn calves and what factors, including the commensal microbiome, contribute to this early development. We review the structure, development, and function of MALT in the bovine URT during the first six weeks of life and identify knowledge gaps regarding this early developmental time. This information is critical when designing vaccination programs for young calves, especially when targeting respiratory pathogens that may reside within the commensal microbiome.

Immediate impact of rapid maxillary expansion on upper airway dimensions and on the quality of life of mouth breathers.

PubMed

Izuka, Edna Namiko; Feres, Murilo Fernando Neuppmann; Pignatari, Shirley Shizue Nagata

2015-01-01

To assess short-term tomographic changes in the upper airway dimensions and quality of life of mouth breathers after rapid maxillary expansion (RME). A total of 25 mouth breathers with maxillary atresia and a mean age of 10.5 years old were assessed by means of cone-beam computed tomography (CBCT) and a standardized quality of life questionnaire answered by patients' parents/legal guardians before and immediately after rapid maxillary expansion. Rapid maxillary expansion resulted in similar and significant expansion in the width of anterior (2.8 mm, p < 0.001) and posterior nasal floor (2.8 mm, p < 0.001). Although nasopharynx and nasal cavities airway volumes significantly increased (+1646.1 mm3, p < 0.001), oropharynx volume increase was not statistically significant (+1450.6 mm3, p = 0.066). The results of the quality of life questionnaire indicated that soon after rapid maxillary expansion, patients' respiratory symptoms significantly decreased in relation to their initial respiratory conditions. It is suggested that RME produces significant dimensional increase in the nasal cavity and nasopharynx. Additionally, it also positively impacts the quality of life of mouth-breathing patients with maxillary atresia.

Incidence of Lower Respiratory Tract Infections and Atopic Conditions in Boys and Young Male Adults: Royal College of General Practitioners Research and Surveillance Centre Annual Report 2015-2016

PubMed Central

Correa, Ana; Pebody, Richard; Yonova, Ivelina; Smith, Gillian; Byford, Rachel; Pathirannehelage, Sameera Rankiri; McGee, Christopher; Elliot, Alex J; Hriskova, Mariya; Ferreira, Filipa IM; Rafi, Imran; Jones, Simon

2018-01-01

Background The Royal College of General Practitioners Research and Surveillance Centre comprises more than 150 general practices, with a combined population of more than 1.5 million, contributing to UK and European public health surveillance and research. Objective The aim of this paper was to report gender differences in the presentation of infectious and respiratory conditions in children and young adults. Methods Disease incidence data were used to test the hypothesis that boys up to puberty present more with lower respiratory tract infection (LRTI) and asthma. Incidence rates were reported for infectious conditions in children and young adults by gender. We controlled for ethnicity, deprivation, and consultation rates. We report odds ratios (OR) with 95% CI, P values, and probability of presenting. Results Boys presented more with LRTI, largely due to acute bronchitis. The OR of males consulting was greater across the youngest 3 age bands (OR 1.59, 95% CI 1.35-1.87; OR 1.13, 95% CI 1.05-1.21; OR 1.20, 95% CI 1.09-1.32). Allergic rhinitis and asthma had a higher OR of presenting in boys aged 5 to 14 years (OR 1.52, 95% CI 1.37-1.68; OR 1.31, 95% CI 1.17-1.48). Upper respiratory tract infection (URTI) and urinary tract infection (UTI) had lower odds of presenting in boys, especially those older than 15 years. The probability of presenting showed different patterns for LRTI, URTI, and atopic conditions. Conclusions Boys younger than 15 years have greater odds of presenting with LRTI and atopic conditions, whereas girls may present more with URTI and UTI. These differences may provide insights into disease mechanisms and for health service planning. PMID:29712621

[Status of acute upper respiratory infection, influenza-like illness, and influenza vaccination coverage among community residents in Jinan].

PubMed

Liu, Ying; Song, Shaoxia; Wang, Wei; Geng, Xingyi; Liu, Wen; Han, Debiao; Liu, Ti; Wu, Julong; Li, Zhong; Wang, Xianjun; Bi, Zhenqiang

2015-12-01

To analyze the status of acute upper respiratory infection and influenza-like illness (ILI) among community residents in Jinan in 2015, and to make a understand of the patient's medical treatment behavior and influenza vaccination coverage status in 2014. Balloting method and convenient sampling method were used to launch a household survey. The residents who had been in Jinan for more than 3 months were selected, to investigate the residents' attack ratio of acute upper respiratory and influenza-like from Jan. 8 to Feb. 7, 2015. Totally, 1 300 persons from 410 families were involved in this survey which recovered 1 241 valid questionnaires with the efficiency of 95.5%. Based on the national age-urban demographic statistics in 2010, the attack rates of acute respiratory infections, influenza-like illness were estimated by the direct standardization method, and the influenza vaccination rates were also calculated in this study. χ(2)-test method was used to compare the different status of incidence and vaccination among residents with different features. The attack rate of acute upper respiratory infection and influenza-like illness in Jinan from January 8, 2015 to February 7, 2015 were 30.2% (375 cases), and 6.1% (76 cases), respectively, with a standardized rate of 29.1% and 5.4%. 5.3% (66 cases) of the residents have vaccinated with the influenza vaccine inoculation, with an adjusted rate of 3.8%. The attack rate difference of acute upper respiratory tract infections was statistically significant between each age group (χ(2)=17.121, P= 0.002). The 0-4 age group had a highest attack rate (45.4%) of acute respiratory infection, while the 15-24 age group got the lowest (26.5%). 38.9% (146 cases) of patients went for a treatment in hospital. Among them, 37.7% (55 cases) of them selected the county level hospitals for treatment, 37.7% (55 cases) selected the community level hospitals, and 24.6% (36 cases) selected the individual clinic. Significant differences of influenza-like illness attack rate between each age group were also found in this study (χ(2)=76.79, P<0.001). 0-4 age group had the highest attack rate (22.7%). 81.6% (62 cases) of the ILI sought treatment in the hospital, of which 53.2% (33 cases) selected county level hospital or above, and 33.9% (21 cases) selected community hospital, and 12.9% (8 cases) selected the individual clinic. The attack rate of acute upper respiratory infections among the residents of Jinan was high, whereas that of influenza-like illness was relatively low. 0-4 age group had a higher risk of ILI than other age groups. Most of the cases were likely to take the treatment in large hospitals. In general, the coverage rate of influenza vaccination was relatively low.

Comparative assessment of respiratory and other occupational health effects among elementary workers.

PubMed

Hamid, Almas; Saleem, Wajeeha; Yaqub, Ghazala; Ghauri, Moin Ud Din

2017-12-14

This study was conducted to assess hazards faced by elementary workers. A questionnaire survey and a respiratory function test (spirometry) were carried out on 150 respondents. Major hazards identified related to sharp objects, heavy weight lifting, thermally harsh conditions, working at height, whole body vibration, chemicals, pathogens, increased noise levels and confined space entry. Workers suffered from upper and lower respiratory disorder symptoms, digestive problems, optical and musculoskeletal issues, etc. Spirometric measurement showed obstructive lung disorders to be highest among construction workers (CW) (48%) followed by sanitation workers (SW) (32%) and solid waste pickers (SWP) (28%). Restrictive lung pattern was dominant among SW (56%) followed by SWP (46%) and CW (42%). The observed FEV 1 /FVC in diseased SWP, SW and CW ranged from 51 to 96%, from 52 to 98% and from 31 to 99% respectively while observed mean FEV 1 was 2.15, 1.79 and 1.70 L, respectively. The study findings show that occupational exposure can significantly influence respiratory system impairment and contribute to other ailments among elementary workers. The study recommends use of appropriate protective equipment and regular medical examination for early recognition of any health risk so that timely interventions for effective management may be undertaken.

The movement and deposition of PM2.5 in the upper respiratory tract for the patients with heart failure: an elementary CFD study.

PubMed

Zhang, Tiantian; Gao, Bin; Zhou, Zhixiang; Chang, Yu

2016-12-28

PM2.5 is an important factor to affect the patients with respiratory and cardiovascular diseases. Clinical studies have found that the morbidity and mortality of patients with heart failure (HF) have a close relationship with the movement and deposition state of PM2.5. One reason is that the breathing pattern of patients with HF has obvious difference with healthy people, however the effect caused by these differences on the distribution regularity of PM2.5 in the respiratory tract is still unclear. Hence, a computational fluid dynamics simulation was conducted to clarify the aerodynamic effect of breathing pattern of patients with HF on respiratory system. Ideal upper respiratory tract geometric model was established based on standardized aerosol research laboratory of Alberta and Weibel A dimension. The discrete phase method is used to calculate the movement of the airflow and particles. The flow rate were chosen as the inlet boundary conditions, and the outlets are set at a constant pressure. The rate of particle deposition, distribution location, wall pressure, flow velocity and wall shear stress are obtained, and compared to the normal control. The results demonstrated that the rate of escaped particles in every bronchial outlet of the patients with HF was more than the normal controls, meanwhile the trapped was less (1024 < 1160). There was higher by 12.9% possibility that the PM2.5 entered the lungs than the normal control. The aerodynamic performances of HF patients are different from normal control. Compared to the normal control, under similar environment, there is higher possibility of PM2.5 moving into lungs, and these particles could affect the function of the respiratory system, resulting in the deterioration of the state of cardiovascular system. In short, it's necessary to pay more attention to the living environment of HF patients, to reduce the content of PM2.5 particles in the air, and reduce the damage of PM2.5 particles caused by breathing patterns.

The Effectiveness and Safety of a Homeopathic Medicinal Product in Pediatric Upper Respiratory Tract Infections With Fever

PubMed Central

van Haselen, Robert; Thinesse-Mallwitz, Manuela; Maidannyk, Vitaliy; Buskin, Stephen L.; Weber, Stephan; Keller, Thomas; Burkart, Julia; Klement, Petra

2016-01-01

We investigated the clinical effectiveness of a homeopathic add-on therapy in a pediatric subpopulation with upper respiratory tract infections (URTI) in a randomized, controlled, multinational clinical trial. Patients received either on-demand symptomatic standard treatment (ST-group) or the same ST plus a homeopathic medication (Influcid; IFC-group) for 7 days. Outcome assessment was based on symptom and fever resolution and the Wisconsin Upper Respiratory Symptom Survey–21 (WURSS-21). A total of 261 pediatric (<12 years) patients (130 IFC-group; 131 ST-group) were recruited in Germany and the Ukraine. The IFC-group used less symptomatic medication, symptoms resolved significantly earlier (P = .0001), had higher proportions of fever-free children from day 3 onwards, and the WURSS-assessed global disease severity was significantly less (P < .0001) during the entire URTI episode. One adverse event (vomiting) was possibly related to IFC. IFC as add-on treatment in pediatric URTI reduced global disease severity, shortened symptom resolution, and was safe in use. PMID:27493984

In vitro activity of josamycin against Streptococcus pyogenes isolated from patients with upper respiratory tract infections in France.

PubMed

Auzou, M; Caillon, J; Poyart, C; Weber, P; Ploy, M-C; Leclercq, R; Cattoir, V

2015-07-01

The primary objective of our study was to obtain susceptibility data for josamycin against Streptococcus pyogenes isolated from patients presenting with upper respiratory tract infections in France. The secondary objective was to characterize the molecular mechanism of resistance in macrolide-resistant isolates. MICs of erythromycin, clarithromycin, azithromycin, josamycin, and clindamycin were determined by the broth microdilution method. Resistance genes erm(B), erm(TR), and mef(A) were screened by PCR. The MIC50 and MIC90 of josamycin against 193 isolates of S. pyogenes were 0.12 and 0.25mg/L, respectively, with a resistance rate estimated at 4.7%. Resistance was due to the erm(B) gene whereas strains harboring erm(TR) or mef(A) remained susceptible. Josamycin was active against >95% of S. pyogenes isolated from patients with upper respiratory tract infections, and can be used as an alternative for the treatment of pharyngitis. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Sleep apnoea during upper respiratory infection and metabolic alkalosis in infancy.

PubMed Central

Abreu e Silva, F A; MacFadyen, U M; Williams, A; Simpson, H

1986-01-01

Three to four hour polygraphic sleep studies were carried out in 10 infants, five with upper respiratory infection and five with metabolic alkalosis secondary to vomiting during and after recovery from illness. During upper respiratory infection, the main abnormality detected was brief (greater than 3 less than 6 seconds) or prolonged (greater than 6 seconds) attacks of obstructive apnoea. Other indices of apnoea were similar to recovery data. Gross body movements were also increased. In infants with metabolic alkalosis indices of central apnoea were significantly increased when compared with recovery or case control data. Prolonged (greater than 15 seconds) attacks of central apnoea and obstructive apnoea (greater than 6 seconds) were only observed during illness. Gross body movements and periodic breathing were also increased. These findings suggest that the functional consequences of apparently 'mild' illnesses in young infants may be greater than is generally suspected and perhaps relevant to mechanism(s) of death in sudden infant death syndrome. PMID:3789786

Video-based respiration monitoring with automatic region of interest detection.

PubMed

Janssen, Rik; Wang, Wenjin; Moço, Andreia; de Haan, Gerard

2016-01-01

Vital signs monitoring is ubiquitous in clinical environments and emerging in home-based healthcare applications. Still, since current monitoring methods require uncomfortable sensors, respiration rate remains the least measured vital sign. In this paper, we propose a video-based respiration monitoring method that automatically detects a respiratory region of interest (RoI) and signal using a camera. Based on the observation that respiration induced chest/abdomen motion is an independent motion system in a video, our basic idea is to exploit the intrinsic properties of respiration to find the respiratory RoI and extract the respiratory signal via motion factorization. We created a benchmark dataset containing 148 video sequences obtained on adults under challenging conditions and also neonates in the neonatal intensive care unit (NICU). The measurements obtained by the proposed video respiration monitoring (VRM) method are not significantly different from the reference methods (guided breathing or contact-based ECG; p-value  =  0.6), and explain more than 99% of the variance of the reference values with low limits of agreement (-2.67 to 2.81 bpm). VRM seems to provide a valid solution to ECG in confined motion scenarios, though precision may be reduced for neonates. More studies are needed to validate VRM under challenging recording conditions, including upper-body motion types.

Cow’s Milk and Immune Function in the Respiratory Tract: Potential Mechanisms

PubMed Central

Perdijk, Olaf; van Splunter, Marloes; Savelkoul, Huub F. J.; Brugman, Sylvia; van Neerven, R. J. Joost

2018-01-01

During the last decades, the world has witnessed a dramatic increase in allergy prevalence. Epidemiological evidence shows that growing up on a farm is a protective factor, which is partly explained by the consumption of raw cow’s milk. Indeed, recent studies show inverse associations between raw cow’s milk consumption in early life and asthma, hay fever, and rhinitis. A similar association of raw cow’s milk consumption with respiratory tract infections is recently found. In line with these findings, controlled studies in infants with milk components such as lactoferrin, milk fat globule membrane, and colostrum IgG have shown to reduce respiratory infections. However, for ethical reasons, it is not possible to conduct controlled studies with raw cow’s milk in infants, so formal proof is lacking to date. Because viral respiratory tract infections and aeroallergen exposure in children may be causally linked to the development of asthma, it is of interest to investigate whether cow’s milk components can modulate human immune function in the respiratory tract and via which mechanisms. Inhaled allergens and viruses trigger local immune responses in the upper airways in both nasal and oral lymphoid tissue. The components present in raw cow’s milk are able to promote a local microenvironment in which mucosal immune responses are modified and the epithelial barrier is enforced. In addition, such responses may also be triggered in the gut after exposure to allergens and viruses in the nasal cavity that become available in the GI tract after swallowing. However, these immune cells that come into contact with cow’s milk components in the gut must recirculate into the blood and home to the (upper and lower) respiratory tract to regulate immune responses locally. Expression of the tissue homing-associated markers α4β7 and CCR9 or CCR10 on lymphocytes can be influenced by vitamin A and vitamin D3, respectively. Since both vitamins are present in milk, we speculate that raw milk may influence homing of lymphocytes to the upper respiratory tract. This review focuses on potential mechanisms via which cow’s milk or its components can influence immune function in the intestine and the upper respiratory tract. Unraveling these complex mechanisms may contribute to the development of novel dietary approaches in allergy and asthma prevention. PMID:29483908

Cow's Milk and Immune Function in the Respiratory Tract: Potential Mechanisms.

PubMed

Perdijk, Olaf; van Splunter, Marloes; Savelkoul, Huub F J; Brugman, Sylvia; van Neerven, R J Joost

2018-01-01

During the last decades, the world has witnessed a dramatic increase in allergy prevalence. Epidemiological evidence shows that growing up on a farm is a protective factor, which is partly explained by the consumption of raw cow's milk. Indeed, recent studies show inverse associations between raw cow's milk consumption in early life and asthma, hay fever, and rhinitis. A similar association of raw cow's milk consumption with respiratory tract infections is recently found. In line with these findings, controlled studies in infants with milk components such as lactoferrin, milk fat globule membrane, and colostrum IgG have shown to reduce respiratory infections. However, for ethical reasons, it is not possible to conduct controlled studies with raw cow's milk in infants, so formal proof is lacking to date. Because viral respiratory tract infections and aeroallergen exposure in children may be causally linked to the development of asthma, it is of interest to investigate whether cow's milk components can modulate human immune function in the respiratory tract and via which mechanisms. Inhaled allergens and viruses trigger local immune responses in the upper airways in both nasal and oral lymphoid tissue. The components present in raw cow's milk are able to promote a local microenvironment in which mucosal immune responses are modified and the epithelial barrier is enforced. In addition, such responses may also be triggered in the gut after exposure to allergens and viruses in the nasal cavity that become available in the GI tract after swallowing. However, these immune cells that come into contact with cow's milk components in the gut must recirculate into the blood and home to the (upper and lower) respiratory tract to regulate immune responses locally. Expression of the tissue homing-associated markers α4β7 and CCR9 or CCR10 on lymphocytes can be influenced by vitamin A and vitamin D3, respectively. Since both vitamins are present in milk, we speculate that raw milk may influence homing of lymphocytes to the upper respiratory tract. This review focuses on potential mechanisms via which cow's milk or its components can influence immune function in the intestine and the upper respiratory tract. Unraveling these complex mechanisms may contribute to the development of novel dietary approaches in allergy and asthma prevention.

A HYBRID CFD-PBPK MODEL OF INHALED CHLORINE GAS UPTAKE AND TISSUE DOSIMETRY IN THE ISOLATED UPPER RESPIRATORY TRACT (URT) OF F344 RATS

EPA Science Inventory

Chlorine (Cl₂), an important commercial gas, is highly reactive in water, causing irritant effects in the respiratory tract on inhalation. Nasal extraction of Cl₂ is high and resultant lesions in the respiratory tract show a proximal to distal distribution ...

Respiratory pathophysiology: sleep-related breathing disorders

PubMed Central

Schäfer, Thorsten

2006-01-01

A widespread network of respiratory-related neurons within the brainstem controls the regular respiratory cycle, which is dependent upon unspecific and specific drives like hypoxia or hypercapnia. This respiratory network and its respiratory drives are subjects to typical changes during the transition from wakefulness to sleep and within the various sleep states, which favor a destabilization of breathing during sleep. There is also a respiratory-related innervation of the dilating and stiffening pharyngeal muscles as well as a local reflex control of the basic tone of upper airway muscles, both of which are influenced by the different states of wakefulness and sleep. These sleep-related changes cause an increase in upper airway resistance during sleep. In healthy subjects, however, these features during sleep are almost completely compensated and the gas exchange is hardly hindered. However, in the case of illness, severe disordered breathing, disturbed gas exchange and interrupted sleep may occur. The central hypoventilation syndrome, central apnea-hypopnea syndromes, as well as the obstructive sleep apnea syndrome belong to these diseases. Because of the intense research, we have a detailed picture of the pathophysiological mechanisms of the origin and the maintenance of sleep-related breathing disorders. PMID:22073070

[The respiratory system--its self-cleaning system. General mechanisms of clearance].

PubMed

Mustajbegović, J; Zuskin, E

1998-01-01

The behaviour of particles and deposition in different parts of respiratory system are described. Listed are factors which contribute to the deposition of particles in the lungs and upper areas of the respiratory system. The general mechanisms of lung clearance and their action such as cough, mucociliary transport, alveolar clearance and immunological system are reported. Particularly is stressed the necessity of coordination of all defense mechanisms in order to maintain normal respiratory function.

[Study of etiologic factors of infectious diseases of respiratory tract in school-age children during period of remission of a respiratory disease].

PubMed

Maĭorov, R V; Chereshneva, M V; Chereshnev, V A

2013-01-01

Detect features of microflora of upper respiratory tract on the example of flora of palatine tonsils and level of antibodies against intracellular parasites as markers of etiologic factors of respiratory infections in school-age children in remission period. 466 children from frequently and episodically ill groups were examined. Bacteriologic study of smears from the surface of palatine tonsils was carried out in all the children. By using EIA with the corresponding commercial test systems IgG level against Herpes simplex virus, Cytomegalovirus, Chlamydophila pneumoniae, Mycoplasma pneumoniae, Human respiratory syncytial virus was determined in blood sera according to instruction manual. During remission period of infectious process in the structure of microflora of upper respiratory tract in frequently ill children characteristic differences from their episodically ill peers were detected. In children with frequent respiratory infections a higher occurrence of antibodies against intracellular causative agents of these diseases was also detected. In the group of frequently ill, a direct correlation between frequency of infectious diseases of respiratory tract and occurrence of carriage of pathogenic and opportunistic microorgan isms as well as increase of antibodies against Herpesviridae, Cytomegalovirus, C. pneumoniae and M. pneumoniae was detected. Higher occurrence ofintra- and extra-cellular infectious agents as well as their associations may be considered as one of the reasons of insufficient effectiveness of prophylaxis measures in frequently ill children.

What Does Tympanostomy Tube Placement in Children Teach Us About the Association Between Atopic Conditions and Otitis Media?

PubMed Central

Juhn, Young J.; Wi, Chung-Il

2014-01-01

Otitis media is the most common infection second only to viral upper respiratory infection in the outpatient setting. Tympanostomy tube insertion (TTI) is the most common ambulatory surgical procedure in the United States. While many risk factors for otitis media have been identified, atopic conditions have been under-recognized as risk factors for recurrent and persistent otitis media. Given that asthma and other atopic conditions are the most common chronic conditions during childhood, it is worth examining the association between atopic conditions and risk of otitis media, which can provide insight into how atopic conditions influence the risk of microbial infections. This paper focuses its discussion on otitis media, however it is important that the association between atopic conditions and risk of otitis media be interpreted in the context of the association of atopic conditions with increased risks of various microbial infections. PMID:24816652

Towards numerical simulations of fluid-structure interactions for investigation of obstructive sleep apnea

NASA Astrophysics Data System (ADS)

Huang, Chien-Jung; White, Susan M.; Huang, Shao-Ching; Mallya, Sanjay; Eldredge, Jeff D.

2014-11-01

Obstructive sleep apnea(OSA) is a medical condition characterized by repetitive partial or complete occlusion of the airway during sleep. The soft tissues in the airway of OSA patients are prone to collapse under the low pressure loads incurred during breathing. The numerical simulation with patient-specific upper airway model can provide assistance for diagnosis and treatment assessment. The eventual goal of this research is the development of numerical tool for air-tissue interactions in the upper airway of patients with OSA. This tool is expected to capture collapse of the airway in respiratory flow conditions, as well as the effects of various treatment protocols. Here, we present our ongoing progress toward this goal. A sharp-interface embedded boundary method is used on Cartesian grids for resolving the air-tissue interface in the complex patient-specific airway geometries. For the structure simulation, a cut-cell FEM is used. Non-linear Green strains are used for properly resolving the large tissue displacements in the soft palate structures. The fluid and structure solvers are strongly coupled. Preliminary results will be shown, including flow simulation inside the 3D rigid upper airway of patients with OSA, and several validation problem for the fluid-structure coupling.

Risk Factors in Heating, Ventilating, and Air-Conditioning Systemsfor Occupant Symptoms in U.S. Office Buildings: the EPA BASE Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mendell, M.J.; Lei-Gomez, Q.; Mirer, A.

2006-10-01

Nonspecific building-related symptoms among occupants of modern office buildings worldwide are common and may be associated with important reductions in work performance, but their etiology remains uncertain. Characteristics of heating, ventilating, and air-conditioning (HVAC) systems in office buildings that increase risk of indoor contaminants or reduce effectiveness of ventilation may cause adverse exposures and subsequent increase in these symptoms among occupants. We analyzed data collected by the U.S. EPA from a representative sample of 100 large U.S. office buildings--the Building Assessment and Survey Evaluation (BASE) study--using multivariate logistic regression models with generalized estimating equations adjusted for potential personal and buildingmore » confounders. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) for associations between seven building-related symptom outcomes and selected HVAC system characteristics. Among factors of HVAC design or configuration: Outdoor air intakes less than 60 m above the ground were associated with approximately doubled odds of most symptoms assessed. Sealed (non-operable) windows were associated with increases in skin and eye symptoms (ORs= 1.9, 1.3, respectively). Outdoor air intake without an intake fan was associated with an increase in eye symptoms (OR=1.7). Local cooling coils were associated with increased headache (OR=1.5). Among factors of HVAC condition, maintenance, or operation: the presence of humidification systems in good condition was associated with an increase in headache (OR=1.4), whereas the presence of humidification systems in poor condition was associated with increases in fatigue/difficulty concentrating, as well as upper respiratory symptoms (ORs=1.8, 1.5). No regularly scheduled inspections for HVAC components was associated with increased eye symptoms, cough and upper respiratory symptoms (ORs=2.2, 1.6, 1.5). Less frequent cleaning of cooling coils or drip pans was associated with increased headache (OR=1.6). Fair or poor condition of duct liner was associated with increased upper respiratory symptoms (OR=1.4). Most of the many potential risk factors assessed here had not been investigated previously, and associations found with single symptoms may have been by chance, including several associations that were the reverse of expected. Risk factors newly identified in these analyses that deserve attention include outdoor air intakes less than 60 m above the ground, lack of operable windows, poorly maintained humidification systems, and lack of scheduled inspection for HVAC systems. Infrequent cleaning of cooling coils and drain pans were associated with increases in several symptoms in these as well as prior analyses of BASE data. Replication of these findings is needed, using more objective measurements of both exposure and health response. Confirmation of the specific HVAC factors responsible for increased symptoms in buildings, and development of prevention strategies could have major public health and economic benefits worldwide.« less

Influence of the respiratory cycle structure on the flow field in human nasal cavity at a fixed level of breath depth

NASA Astrophysics Data System (ADS)

Bosykh, L. Yu.; Ganimedov, V. L.; Muchnaya, M. I.; Sadovskii, A. S.

2016-10-01

The evolution of air flow field in the human nasal cavity has studied during the respiratory cycle. Real tomographic scans of the adult without abnormalities in the upper airway have been used to construct the geometric model. Quiet breathing mode is selected: the duration of the respiratory cycle is 4.3 sec and the depth of breathing is 600 ml, which provides pulmonary ventilation at 8.4 liters of air per minute. The system of Navier - Stokes equations was used to describe the flow. Laminar flow regime was postulated. The Lagrange approach was used for calculation of submicron particles motion. The numerical solution was built on the basis of gas-dynamic solver FLUENT of software package ANSYS 12. Calculations were made for two cases in which the same value of the integral characteristic (the depth of breathing) was reached, but which had different kind of boundary conditions on the exit. In the first case, the velocity was assumed symmetrical with respect to inhalation - exhalation and was approximated by sinusoid. In the second case, the velocity as a function of time is determined by processing of the real person spirogram. For the both variants the flow fields were obtained and compared. Analysis of the results showed that in non-stationary case the use of symmetric boundary condition leads to an underestimation of respiratory effort for the implementation of the required depth of breathing. In cyclic flow the flow fields in acceleration and deceleration phases are, basically, the same as in the corresponding steady flow. At the same time taking into account of non-symmetry of respiratory cycle influences on deposition pattern of particles significantly.

Work, exercise, and space flight. 2: Modification of adaptation by exercise (exercise prescription)

NASA Technical Reports Server (NTRS)

Thornton, William

1989-01-01

The fundamentals of exercise theory on earth must be rigorously understood and applied to prevent adaptation to long periods of weightlessness. Locomotor activity, not weight, determines the capacity or condition of the largest muscles and bones in the body and usually also determines cardio-respiratory capacity. Absence of this activity results in rapid atrophy of muscle, bone, and cardio-respiratory capacity. Upper body muscle and bone are less affected depending upon the individual's usual, or 1-g, activities. Methodology is available to prevent these changes but space operations demand that it be done in the most efficient fashion, i.e., shortest time. At this point in time we can reasonably select the type of exercise and methods of obtaining it, but additional work in 1-g will be required to optimize the time.

Prediction of Chemical Respiratory and Contact Sensitizers by OX40L Expression in Dendritic Cells Using a Novel 3D Coculture System.

PubMed

Mizoguchi, Izuru; Ohashi, Mio; Chiba, Yukino; Hasegawa, Hideaki; Xu, Mingli; Owaki, Toshiyuki; Yoshimoto, Takayuki

2017-01-01

The use of animal models in chemical safety testing will be significantly limited due to the recent introduction of the 3Rs principle of animal experimentation in research. Although several in vitro assays to predict the sensitizing potential of chemicals have been developed, these methods cannot distinguish chemical respiratory sensitizers and skin sensitizers. In the present study, we describe a novel in vitro assay that can discriminate respiratory sensitizers from chemical skin sensitizers by taking advantage of the fundamental difference between their modes of action, namely the development of the T helper 2 immune response, which is critically important for respiratory sensitization. First, we established a novel three-dimensional (3D) coculture system of human upper airway epithelium using a commercially available scaffold. It consists of human airway epithelial cell line BEAS-2B, immature dendritic cells (DCs) derived from human peripheral blood CD14 + monocytes, and human lung fibroblast cell line MRC-5. Respective cells were first cultured in individual scaffolds and subsequently assembled into a 3D multi-cell tissue model to more closely mimic the in vivo situation. Then, three typical chemicals that are known respiratory sensitizers (ortho-phthaldialdehyde, hexamethylene diisocyanate, and trimellitic anhydride) and skin sensitizers (oxazolone, formaldehyde, and dinitrochlorobenzene) were added individually to the 3D coculture system. Immunohistochemical analysis revealed that DCs do not migrate into other scaffolds under the experimental conditions. Therefore, the 3D structure was disassembled and real-time reverse transcriptase-PCR analysis was performed in individual scaffolds to analyze the expression levels of molecules critical for Th2 differentiation such as OX40 ligand (OX40L), interleukin (IL)-4, IL-10, IL-33, and thymic stromal lymphopoietin. Both sensitizers showed similarly augmented expression of DC maturation markers (e.g., CD86), but among these molecules, OX40L expression in DCs was most consistently and significantly enhanced by respiratory sensitizers as compared to that by skin sensitizers. Thus, we have established a 3D coculture system mimicking the airway upper epithelium that may be successfully applied to discriminate chemical respiratory sensitizers from skin sensitizers by measuring the critical molecule for Th2 differentiation, OX40L, in DCs.

[Generalized microsporidiosis caused by Encephalitozoon sp. in a pediatric patient with Bruton's disease].

PubMed

Vásquez Tsuji, O; Rodríguez Herrera, R; Campos Rivera, T; Mora Tiscareño, M A; Aguirre Maldonado, E; Yamazaki Nakashimada, M A; Valencia Rojas, S; Martínez Barbosa, I

2001-01-01

We present the case of a four-year-old boy with a history of repeated upper respiratory tract infections and pyoderma. He presented fever, seizures, inability to talk, loss of swallowing, fine tremor in the upper extremities; positive bilateral Babinski reflex and quadriparesis. The diagnosis of Bruton's disease and generalized microporidiosis was based on immunologic analysis, smear tests with chromotrope R2 stain and indirect immunofluorescense with monoclonal 3B6 antibody for Encephalitozoon species in samples of spinal fluid, bronchial and paranasal sinus aspirates and stool, which were all positive. The patient was treated with albendazol during 72 days; he left the hospital in a good condition, walking, talking and able to swallow. His laboratory test controls were negative; he is followed up in the outpatient department.

The upper airway in sleep-disordered breathing: UA in SDB.

PubMed

Taranto Montemurro, L; Kasai, T

2014-02-01

Sleep disordered breathing (SDB) is a common condition and could be a risk factor for cardiovascular morbidity and mortality. However, the pathogenesis of SDB remains to be elucidated. In general, SDB is divided into two forms, obstructive and central sleep apnea (OSA and CSA, respectively). OSA results from the sleep-related collapse of the upper airway (UA) in association with multiple factors like race, gender, obesity and UA dimensions. CSA primarily results from a fall in PaCO2 to a level below the apnea threshold during sleep through the reflex inhibition of central respiratory drive. It has been reported that UA alterations (i.e., collapse or dilation) can be observed in CSA. This review highlights the roles of the UA in the pathogenesis and pathophysiology of SDB.

Congenital Lobar Emphysema: An Approach of Anesthetic Management.

PubMed

Mourya, Meenakshi; Meena, Dharam Singh

2016-08-01

Congenital Lobar Emphysema (CLE) is a medical condition which is quiet rarely seen especially in neonates. The disease is characterized by over inflation of lungs which is produced due to inhibition of escape of inspired air from lungs. This condition usually occurs in infants due to partial obstruction of the bronchus and can be reversed with timely and planned anaesthetic management. Here in, we are presenting a case of an infant who was merely four months of age. CLE was affecting his left upper lobe since birth which was being treated as lobar pneumonia outside at some peripheral health center. The case presented to hospital with the symptoms acute respiratory distress and was taken up for urgent surgical management. Left upper lobectomy was performed which relived his symptoms. Case was discharged from hospital after 10 days of uneventful hospital stay. The case was challenging, as it involved careful and planned anaesthetic management of lung separation as well as prevention of hyperventilation of the un-involved lung.

School attendance and daily respiratory symptoms in children: influence of moisture damage.

PubMed

Casas, L; Espinosa, A; Pekkanen, J; Asikainen, A; Borràs-Santos, A; Jacobs, J; Krop, E J M; Täubel, M; Hyvärinen, A; Heederik, D; Zock, J-P

2017-03-01

We investigated the effect of weekends and school holidays on the daily frequency and severity of respiratory and other symptoms among children attending schools with (index) or without (reference) moisture damage in Spain, the Netherlands, and Finland. Throughout 1 year, parents of 419 children with a respiratory condition attending index (n=15) or reference (n=10) primary schools completed three symptom diaries. We assessed associations between lower respiratory tract, upper respiratory tract or allergy, and other symptom scores and school day, weekend, or summer holiday using mixed regression models stratified by country and moisture damage. We evaluated interactions between moisture damage and type of day. We combined country-specific estimates (incidence rate ratios [IRRs] and 95% confidence interval [CI]) in meta-analyses. Symptom scores were lower during weekends and holiday. Lower respiratory tract symptoms were statistically significantly less common during holiday with strongest effect in index schools (IRR=0.7; CI=0.6-0.8). Reporting of other symptoms was more reduced during holiday in index (IRR=0.6; CI=0.4-0.9) than in reference (IRR=0.95; CI=0.8-1.2) schools (interaction P<.01). In conclusion, symptoms were less frequent and/or severe during summer holiday and weekends. This pattern was stronger among children attending moisture-damaged schools, suggesting potential improvement in moisture damage-related symptoms during school breaks. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Continuous on-line measurements of respiratory system, lung and chest wall mechanics during mechanic ventilation.

PubMed

Kárason, S; Søndergaard, S; Lundin, S; Stenqvist, O

2001-08-01

We present a concept of on-line, manoeuvre-free monitoring of respiratory mechanics during dynamic conditions, displaying calculated alveolar pressure/volume curves continuously and separating lung and chest wall mechanics. Prospective observational study. Intensive care unit of a university hospital. Ten ventilator-treated patients with acute lung injury. Different positive end-expiratory pressure (PEEP) and tidal volumes, low flow inflation. Previously validated methods were used to present a single-value dynostatic compliance for the whole breath and a dynostatic volume-dependent initial, middle and final compliance within the breath. A high individual variation of respiratory mechanics was observed. Reproducibility of repeated measurements was satisfactory (coefficients of variations for dynostatic volume-dependent compliance: < or =9.2% for total respiratory system, < or =18% for lung). Volume-dependent compliance showed a statistically significant pattern of successively decreasing compliance from the initial segment through the middle and final parts within each breath at all respiratory settings. This pattern became more prominent with increasing PEEP and tidal volume, indicating a greater distension of alveoli. No lower inflection point (LIP) was seen in patients with respiratory rate 20/min and PEEP at 4 cmH2O. A trial with low flow inflation in four of the patients showed formation of a LIP in three of them and an upper inflection in one. The monitoring concept revealed a constant pattern of successively decreasing compliance within each breath, which became more prominent with increasing PEEP and tidal volume. The monitoring concept offers a simple and reliable method of monitoring respiratory mechanics during ongoing ventilator treatment.

Environmental conditions associated with lesions in introduced free-ranging sheep in Hawai‘i

USGS Publications Warehouse

Powers, Jenny G.; Duncan, Colleen G.; Spraker, Terry R.; Schuler, Bridget A.; Hess, Steven C.; Faford, Jonathan K.J.; Sin, Hans

2014-01-01

Wildlife species which have been translocated between temperate and tropical regions of the world provide unique opportunities to understand how disease processes may be affected by environmental conditions. European mouflon sheep (Ovis gmelini musimon) from the Mediterranean Islands were introduced to the Hawaiian Islands for sport hunting beginning in 1954 and were subsequently hybridized with feral domestic sheep (O. aries), which had been introduced in 1793. Three isolated mouflon populations have become established in the Hawaiian Islands but diseases in these populations have been little studied. The objective of this study was to evaluate and compare gross and histologic lesions in respiratory, renal, and hepatic systems of free-ranging sheep in two isolated volcanic environments on Hawai‘i Island. Tissue and fecal samples were collected in conjunction with population reductions during February 2011. We found gross or histologic evidence of lungworm infection in 44/49 sheep from Mauna Loa which were exposed to gaseous emissions from Kīlauea Volcano. In contrast, only 7/50 sheep from Mauna Kea had lesions consistent with lungworm, but Mauna Kea sheep had significantly more upper respiratory tract inflammation and hyperplasia consistent with chronic antigenic stimulation, possibly associated with exposure to fine airborne particulates during extended drought conditions. We hypothesize that gasses from Kīlauea Volcano contributed to severity of respiratory disease principally associated with chronic lungworm infections at Mauna Loa; however, there were numerous other potentially confounding environmental factors and interactions that merit further investigation.

Sciatic Nerve Stimulation and its Effects on Upper Airway Resistance in the Anesthetized Rabbit Model Relevant to Sleep Apnea.

PubMed

Schiefer, Matthew; Gamble, Jenniffer; Strohl, Kingman Perkins

2018-06-07

Obstructive sleep apnea (OSA) is a disorder characterized by collapse of the velopharynx and/or oropharynx during sleep when drive to the upper airway is reduced. Here, we explore an indirect approach for activation of upper airway muscles which might affect airway dynamics- unilateral electrical stimulation of the afferent fibers of the sciatic nerve- in an anesthetized rabbit model. A nerve cuff electrode was placed around the sciatic and hypoglossal nerves to deliver stimulus while air flow, air pressure, and alae nasi electromyogram (EMG) were monitored both prior to and after sciatic transection. Sciatic nerve stimulation increased respiratory effort, rate, and alae nasi EMG, which persisted for seconds after stimulation; however, upper airway resistance was unchanged. Hypoglossal stimulation reduced resistance without altering drive. While sciatic nerve stimulation is not ideal for treating obstructive sleep apnea, it remains a target for altering respiratory drive.

THREE-DIMENSIONAL COMPUTER MODELING OF THE HUMAN UPPER RESPIRATORY TRACT

EPA Science Inventory

ABSTRACT
Computer simulations of airflow and particle transport phenomena within the human respiratory system have important applications to aerosol therapy (e.g., the targeted delivery of inhaled drugs) and inhalation toxicology (e.g., the risk assessment of air pollutants). ...

Acute respiratory infection case definitions for young children: a systematic review of community-based epidemiologic studies in South Asia.

PubMed

Roth, Daniel E; Gaffey, Michelle F; Smith-Romero, Evelyn; Fitzpatrick, Tiffany; Morris, Shaun K

2015-12-01

To explore the variability in childhood acute respiratory infection case definitions for research in low-income settings where there is limited access to laboratory or radiologic investigations. We conducted a systematic review of community-based, longitudinal studies in South Asia published from January 1990 to August 2013, in which childhood acute respiratory infection outcomes were reported. Case definitions were classified by their label (e.g. pneumonia, acute lower respiratory infection) and clinical content 'signatures' (array of clinical features that would be always present, conditionally present or always absent among cases). Case definition heterogeneity was primarily assessed by the number of unique case definitions overall and by label. We also compared case definition-specific acute respiratory infection incidence rates for studies reporting incidence rates for multiple case definitions. In 56 eligible studies, we found 124 acute respiratory infection case definitions. Of 90 case definitions for which clinical content was explicitly defined, 66 (73%) were unique. There was a high degree of content heterogeneity among case definitions with the same label, and some content signatures were assigned multiple labels. Within studies for which incidence rates were reported for multiple case definitions, variation in content was always associated with a change in incidence rate, even when the content differed by a single clinical feature. There has been a wide variability in case definition label and content combinations to define acute upper and lower respiratory infections in children in community-based studies in South Asia over the past two decades. These inconsistencies have important implications for the synthesis and translation of knowledge regarding the prevention and treatment of childhood acute respiratory infection. © 2015 John Wiley & Sons Ltd.

Work conditions and morbidity among coal miners in Guachetá, Colombia: The miners' perspective.

PubMed

Jiménez-Forero, Claudia P; Zabala, Ivonne T; Idrovo, Álvaro J

2015-08-01

Investigations in Colombia about work and health conditions in coal mining are scarce and few have focused on the perception of the exposed population and their behaviors in response to inherent risks. To determine the association between work conditions and the perception of morbidity among coal miners in Guachetá, Cundinamarca. A cross-sectional study was performed with 154 workers selected randomly from the total registered with the municipality. Information about social and demographic characteristics and work and health conditions in the mines was gathered. The prevalence was estimated for respiratory, musculoskeletal and auditory disorders. The associations between certain work conditions, and events with a prevalence over 30% were explored using bivariate and multivariate analyses with Poisson regressions with robust variance. Workers were mostly men. Ages ranged from 18 to 77 years. Most frequently reported health problems were: back pain (46.1 %), pain in an upper limb (40.3%), pain in a lower limb (34.4 %), and respiratory (17.5 %) and auditory problems (13.6 %). Significant differences in perception were found depending on time on the job and underground or ground work conditions. The most recognized risks were those associated with musculoskeletal disorders since they were closer in time to the work performed (time discount). Some actions to identify psychological traits are proposed in order to improve risk perception among coal miners.

Mechanical Properties of Respiratory Muscles

PubMed Central

Sieck, Gary C.; Ferreira, Leonardo F.; Reid, Michael B.; Mantilla, Carlos B.

2014-01-01

Striated respiratory muscles are necessary for lung ventilation and to maintain the patency of the upper airway. The basic structural and functional properties of respiratory muscles are similar to those of other striated muscles (both skeletal and cardiac). The sarcomere is the fundamental organizational unit of striated muscles and sarcomeric proteins underlie the passive and active mechanical properties of muscle fibers. In this respect, the functional categorization of different fiber types provides a conceptual framework to understand the physiological properties of respiratory muscles. Within the sarcomere, the interaction between the thick and thin filaments at the level of cross-bridges provides the elementary unit of force generation and contraction. Key to an understanding of the unique functional differences across muscle fiber types are differences in cross-bridge recruitment and cycling that relate to the expression of different myosin heavy chain isoforms in the thick filament. The active mechanical properties of muscle fibers are characterized by the relationship between myoplasmic Ca2+ and cross-bridge recruitment, force generation and sarcomere length (also cross-bridge recruitment), external load and shortening velocity (cross-bridge cycling rate), and cross-bridge cycling rate and ATP consumption. Passive mechanical properties are also important reflecting viscoelastic elements within sarcomeres as well as the extracellular matrix. Conditions that affect respiratory muscle performance may have a range of underlying pathophysiological causes, but their manifestations will depend on their impact on these basic elemental structures. PMID:24265238

Risk factors for invasive pneumococcal disease among children less than 5 years of age in a high HIV prevalence setting, South Africa, 2010 to 2012.

PubMed

von Mollendorf, Claire; Cohen, Cheryl; de Gouveia, Linda; Naidoo, Nireshni; Meiring, Susan; Quan, Vanessa; Lindani, Sonwabo; Moore, David P; Reubenson, Gary; Moshe, Mamokgethi; Eley, Brian; Hallbauer, Ute M; Finlayson, Heather; Madhi, Shabir A; Conklin, Laura; Zell, Elizabeth R; Klugman, Keith P; Whitney, Cynthia G; von Gottberg, Anne

2015-01-01

Invasive pneumococcal disease (IPD) causes significant disease burden, especially in developing countries, even in the era of pneumococcal conjugate vaccine and maternal-to-child HIV transmission prevention programs. We evaluated factors that might increase IPD risk in young children in a high HIV prevalence setting. We conducted a case-control study using IPD cases identified at 24 Group for Enteric, Respiratory and Meningeal disease Surveillance-South Africa program sites (2010-2012). At least 4 controls were matched by age, HIV status and hospital to each case. Potential risk factors were evaluated using multivariable conditional logistic regression. In total, 486 age-eligible cases were enrolled. Factors associated with IPD in HIV-uninfected children (237 cases, 928 controls) included siblings <5 years [adjusted odds ratio (aOR) = 1.68, 95% confidence interval (CI): 1.16-2.46], underlying medical conditions (aOR = 1.99, CI 1.22-3.22), preceding upper respiratory tract infection (aOR = 1.79, CI 1.19-2.69), day-care attendance (aOR = 1.58, CI 1.01-2.47), perinatal HIV exposure (aOR = 1.62, CI 1.10-2.37), household car ownership (aOR = 0.45, CI 0.25-0.83) and ≥2 7-valent pneumococcal conjugate vaccine doses (aOR = 0.67, CI 0.46-0.99). Among HIV-infected children (124 cases, 394 controls), IPD-associated factors included malnutrition (aOR = 2.68, CI 1.40-5.14), upper respiratory tract infection (aOR = 3.49, CI 1.73-7.03), tuberculosis in the last 3 months (aOR = 5.12, CI 1.69-15.50) and current antiretroviral treatment (aOR = 0.13, CI 0.05-0.38). Previously identified factors related to poverty, poor health and intense exposure continue to be risk factors for IPD in children. Ensuring delivery of pneumococcal conjugate vaccine and antiretroviral treatment are important for improving disease prevention.

Long-term exercising video-endoscopic examination of the upper airway following laryngoplasty surgery: a prospective cross-sectional study of 41 horses.

PubMed

Barnett, T P; O'Leary, J M; Parkin, T D H; Dixon, P M; Barakzai, S Z

2013-09-01

To investigate upper respiratory tract function in horses, previously undergoing laryngoplasty (LP), using exercising video-endoscopy. To evaluate arytenoid abduction and stability, diagnose any concurrent upper airway problems, and correlate these with the owners' perception of success. Horses undergoing LP during a 6-year period at one hospital were initially included. Those available for re-examination were exercised for a duration and intensity considered maximal for their discipline using an over-ground endoscope. Resting and exercising laryngeal and pharyngeal videos were analysed blindly. Multivariable analysis was used to test associations between resting and exercising endoscopic variables, and also between endoscopic variables and owner questionnaire findings. Forty-one horses were included and 78% had a form of upper airway collapse at exercise, with 41% having complex forms, despite 93% of owners reporting the surgery to have been beneficial. Horses with poor abduction (grades 4 or 5/5) were 6 times more likely to make respiratory noise compared with those with good (grades 2 or 3/5) abduction (P = 0.020; 95% confidence interval [CI] 1.3-27.0), and those not having a ventriculectomy were 4.9 times more likely to produce respiratory noise post operatively (P = 0.048; 95% CI 1.0-23.9). Palatal dysfunction was observed in 24% of horses at rest, and 56% at exercise, with the diagnosis at rest and exercise significantly associated (P = 0.001). Increasing severity of pharyngeal lymphoid hyperplasia (prevalence 61%) was significantly associated with increasing arytenoid abduction (P = 0.01). Thirty-four per cent of horses had aryepiglottic fold collapse and 22% of horses had vocal fold collapse. Many horses that had previously had LP were diagnosed with upper airway abnormalities, despite the procedure being considered as beneficial by most owners. When investigating cases of ongoing respiratory noise or poor performance following LP, exercising endoscopy must be considered. Continued respiratory noise may be associated with poor arytenoid abduction and not performing concurrent ventriculectomy. © 2012 EVJ Ltd.

Medicine use practices in management of symptoms of acute upper respiratory tract infections in children (≤12 years) in Kampala city, Uganda.

PubMed

Ocan, Moses; Aono, Mary; Bukirwa, Clare; Luyinda, Emmanuel; Ochwo, Cathy; Nsambu, Elastus; Namugonza, Stella; Makoba, Joseph; Kandaruku, Enock; Muyende, Hannington; Nakawunde, Aida

2017-09-21

Medicines are commonly accessed and used for management of illness in children without a prescription. This potentially increases the risk of unwanted treatment outcomes. We investigated medicine use practices in management of symptoms of acute upper respiratory tract infections among children (≤12 years) in households in Nakawa division, Kampala city. This was a cross-sectional study conducted among 390 randomly selected children. Data on use of medicines in children (≤12 years) during recent episode of acute upper respiratory tract infection was collected from their care takers using an interviewer administered questionnaire. A recall period of two weeks (14 days) was used in during data collection. The prevalence of giving children non-prescription antimicrobial medicines was 44.8% (38.3-52.2). The most common disease symptoms that the children reportedly had included flu, 84.9% (331/390), cough, 83.1% (324/390), and undefined fever, 69.7% (272/390). Medicines commonly given to children included, paracetamol 53.1% (207/390), Coartem 29.7% (116/390), cough linctus 20.8% (81/390), amoxicillin 18.9% (74/390), Co-trimoxazole 18.5% (72/390), and diphenhydramine 15.4% (60/390). The major sources of medicines given to the children was hospital/clinic, 57.26% (223/390). Most of the children, 81% were given more than one medicine at a time. The majority, 62.3% (243/390) of the care takers who gave the children medicine during the recent illness were not aware of any medicine (s) that should not be given to children. The predictors of non-prescription use of antimicrobial medicines in managing symptoms of acute upper respiratory tract infections in children included, medicines obtained from drug shop (PR: 1.45, CI: 1.14-1.85), medicines at home (PR: 1.8, CI: 0.83-1.198) and type of medicine (antimalarial) (PR: 2.8, CI: 1.17-6.68). Children are commonly given multiple medicines during episodes of acute upper respiratory tract infections with most antimicrobial agents accessed and used without a prescription in Kampala city, Uganda.

A mathematical model for human brain cooling during cold-water near-drowning.

PubMed

Xu, X; Tikuisis, P; Giesbrecht, G

1999-01-01

A two-dimensional mathematical model was developed to estimate the contributions of different mechanisms of brain cooling during cold-water near-drowning. Mechanisms include 1) conductive heat loss through tissue to the water at the head surface and in the upper airway and 2) circulatory cooling to aspirated water via the lung and via venous return from the scalp. The model accounts for changes in boundary conditions, blood circulation, respiratory ventilation of water, and head size. Results indicate that conductive heat loss through the skull surface or the upper airways is minimal, although a small child-sized head will conductively cool faster than a large adult-sized head. However, ventilation of cold water may provide substantial brain cooling through circulatory cooling. Although it seems that water breathing is required for rapid "whole" brain cooling, it is possible that conductive cooling may provide some advantage by cooling the brain cortex peripherally and the brain stem centrally via the upper airway.

Persistence of Respiratory-Swallowing Coordination after Laryngectomy.

ERIC Educational Resources Information Center

Charbonneau, Isabelle; Lund, James P.; McFarland, David H.

2005-01-01

The present study was designed to provide additional insights into the neural mechanisms underlying respiratory-swallowing coupling by studying potential alterations in movement coordination when upper airway protection is no longer necessary. Twelve laryngectomized participants, all at least 3 years postsurgery, were compared to age- and…

Mass mortality of eastern box turtles with upper respiratory disease following atypical cold weather.

PubMed

Agha, Mickey; Price, Steven J; Nowakowski, A Justin; Augustine, Ben; Todd, Brian D

2017-04-20

Emerging infectious diseases cause population declines in many ectotherms, with outbreaks frequently punctuated by periods of mass mortality. It remains unclear, however, whether thermoregulation by ectotherms and variation in environmental temperature is associated with mortality risk and disease progression, especially in wild populations. Here, we examined environmental and body temperatures of free-ranging eastern box turtles Terrapene carolina during a mass die-off coincident with upper respiratory disease. We recorded deaths of 17 turtles that showed clinical signs of upper respiratory disease among 76 adult turtles encountered in Berea, Kentucky (USA), in 2014. Of the 17 mortalities, 11 occurred approximately 14 d after mean environmental temperature dropped 2.5 SD below the 3 mo mean. Partial genomic sequencing of the major capsid protein from 1 sick turtle identified a ranavirus isolate similar to frog virus 3. Turtles that lacked clinical signs of disease had significantly higher body temperatures (23°C) than sick turtles (21°C) during the mass mortality, but sick turtles that survived and recovered eventually warmed (measured by temperature loggers). Finally, there was a significant negative effect of daily environmental temperature deviation from the 3 mo mean on survival, suggesting that rapid decreases in environmental temperature were correlated with mortality. Our results point to a potential role for environmental temperature variation and body temperature in disease progression and mortality risk of eastern box turtles affected by upper respiratory disease. Given our findings, it is possible that colder or more variable environmental temperatures and an inability to effectively thermoregulate are associated with poorer disease outcomes in eastern box turtles.

Efficacy and safety of Sultamicillin (Ampicillin/Sulbactan) and Amoxicillin/Clavulanic acid in the treatment of upper respiratory tract infections in adults--an open-label, multicentric, randomized trial.

PubMed

Ferreira, João Batista; Rapoport, Priscila Bogar; Sakano, Eulália; Kós, Arthur Octávio De Avila; Piltcher, Otávio B; Pignatari, Shirley Shizue Nagata; Pinheiro, Sebastião Diógenes; Mocellin, Marcos

2006-01-01

Upper respiratory tract infections are the most common causes of medical visits in children and adults, demanding massive use of antibiotics. Bacterial resistance caused by beta-lactamase is one of the most serious problems in this matter. Sultamicillin, a double pro-drug of Ampicillin/Sulbactan, is a potent beta-lactamase inhibitor which can face this challenge. Evaluate efficacy, safety and tolerability of Ampicillin/Sulbactan compared to Amoxicillin/Clavulanate in upper respiratory tract infections in adults. 102 patients were enrolled and randomized to receive Ampicillin/Sulbactan or Amoxicillin/Clavulanate during 10 days. They were evaluated 10 and 30 days after treatment to learn about the therapeutic response. There were no differences between the two groups respecting cure at the end of treatment (visit 2) or at the end of the study (visit 3). Cure ratio was 61.7% and 93.2% (visits 2 and 3) in the Amoxicillin/Clavulanate group compared to 64.4% and 97.4%, respectively, in Ampicillin/Sulbactan group. The adverse events ratio for the two groups was the same (p=0.940). The number of patients with diarrhea was greater in the group of patients receiving Amoxicillin/Clavulanate (70.6%) than in the group receiving Ampicillin/Sulbactan (29.4%) (p=0.0164). Ampicillin/Sulbactan is as safe and efficient as Amoxicillin/Clavulanate in the empiric treatment of upper respiratory infections in adults. The low occurrence of diarrhea in the group receiving Ampicillin/Sulbactan needs confirmation in other studies.

Congenital lobar emphysema: a case report

PubMed Central

2009-01-01

Congenital lobar emphysema is a rare variety of congenital malformation of lung characterized by over distension of a lobe of a lung due to partial obstruction of the bronchus. We are reporting a neonate admitted in the pediatric emergency ward with the respiratory distress since 16th day of life. Investigation revealed the overexpansion of the left upper lobe with mediastinal herniation, shifting of the mediastinum to the opposite side and collapse of the ipsilateral lower lobe. The baby was treated with conservative treatment and the condition of the baby was improved. PMID:19154591

The role of respiratory viruses in the etiology of bacterial pneumonia: An ecological perspective.

PubMed

Lee, Kyu Han; Gordon, Aubree; Foxman, Betsy

2016-02-15

Pneumonia is the leading cause of death among children less than 5 years old worldwide. A wide range of viral, bacterial and fungal agents can cause pneumonia: although viruses are the most common etiologic agent, the severity of clinical symptoms associated with bacterial pneumonia and increasing antibiotic resistance makes bacterial pneumonia a major public health concern. Bacterial pneumonia can follow upper respiratory viral infection and complicate lower respiratory viral infection. Secondary bacterial pneumonia is a major cause of influenza-related deaths. In this review, we evaluate the following hypotheses: (i) respiratory viruses influence the etiology of pneumonia by altering bacterial community structure in the upper respiratory tract (URT) and (ii) respiratory viruses promote or inhibit colonization of the lower respiratory tract (LRT) by certain bacterial species residing in the URT. We conducted a systematic review of the literature to examine temporal associations between respiratory viruses and bacteria and a targeted review to identify potential mechanisms of interactions. We conclude that viruses both alter the bacterial community in the URT and promote bacterial colonization of the LRT. However, it is uncertain whether changes in the URT bacterial community play a substantial role in pneumonia etiology. The exception is Streptococcus pneumoniae where a strong link between viral co-infection, increased carriage and pneumococcal pneumonia has been established. © The Author(s) 2016. Published by Oxford University Press on behalf of the Foundation for Evolution, Medicine, and Public Health.

Autoflora in the upper respiratory tract of Apollo astronauts.

PubMed Central

Decelle, J G; Taylor, G R

1976-01-01

The typical microbial inhabitants of the oral and nasal cavities of Apollo astronauts were identified before space flight and generally found to be similar to those previously reported for healthy male adults. Additional analyses of samples collected immediately after return of the Apollo 13, 14, 15, and 16 crew members to earth were performed to evaluate the effects of space travel on the microbial bioburden of the upper respiratory tract. In-flight cross-contamination and buildup of pathogens such as Staphylococcus aureus were noted, although significant increases in nonpathogenic species were absent. Other proposed alterations, such as dysbacteriosis (flooding of the mouth with a single species) and simplification of the autoflora, did not occur. Generally, the incidence and quantitation of each species after flight was within the preflight range, although the number of viable Haemophilus cells recovered from the mouth decreased significantly after space flight. Except for those minor alterations listed above, the aerobic and anaerobic bacterial components of the upper respiratory autoflora of Apollo astronauts was found to be stable after space flight of up to 295 h. PMID:984836

Human milk reduces outpatient upper respiratory symptoms in premature infants during their first year of life.

PubMed

Blaymore Bier, Jo-Ann; Oliver, Tanya; Ferguson, Anne; Vohr, Betty R

2002-01-01

To determine if ingestion of human milk after discharge reduces symptoms of infections in premature infants. Follow-up of 39 infants with birth weights <2000 g, 24 of whom received any amount of human milk and 15 of whom received only formula after discharge, was carried out. Mothers were given a calendar on which they recorded any signs of infections and feeding and day-care information. Data were collected at 1 month after discharge and at 3, 7, and 12 months corrected age. Results show no differences between groups in birth weight, gestation, gender, maternal age, parental tobacco use, number of siblings, and day-care attendance. Socioeconomic status score was higher in the human milk group. Infants who received human milk had fewer days of upper respiratory symptoms at 1 month after discharge (p<0.025) and at 7 months corrected age (p<0.025). Ingestion of human milk post discharge is associated with a reduction of upper respiratory symptoms in premature infants during their first year of life.

A chicken influenza virus recognizes fucosylated α2,3 sialoglycan receptors on the epithelial cells lining upper respiratory tracts of chickens.

PubMed

Hiono, Takahiro; Okamatsu, Masatoshi; Nishihara, Shoko; Takase-Yoden, Sayaka; Sakoda, Yoshihiro; Kida, Hiroshi

2014-05-01

Influenza viruses recognize sialoglycans as receptors. Although viruses isolated form chickens preferentially bind to sialic acid α2,3 galactose (SAα2,3Gal) glycans as do those of ducks, chickens were not experimentally infected with viruses isolated from ducks. A chicken influenza virus, A/chicken/Ibaraki/1/2005 (H5N2) (Ck/IBR) bound to fucose-branched SAα2,3Gal glycans, whereas the binding towards linear SAα2,3Gal glycans was weak. On the epithelial cells of the upper respiratory tracts of chickens, fucose-branched SAα2,3Gal glycans were detected, but not linear SAα2,3Gal glycans. The growth of Ck/IBR in MDCK-FUT cells, which were genetically prepared to express fucose-branched SAα2,3Gal glycans, was significantly higher than that in the parental MDCK cells. The present results indicate that fucose-branched SAα2,3Gal glycans existing on the epithelial cells lining the upper respiratory tracts of chickens are critical for recognition by Ck/IBR. Copyright © 2014 Elsevier Inc. All rights reserved.

Relationship between dental erosion and respiratory symptoms in patients with gastro-oesophageal reflux disease.

PubMed

Wang, Geng-Ru; Zhang, Hui; Wang, Zhong-Gao; Jiang, Guang-Shui; Guo, Cheng-Hao

2010-11-01

Both dental erosion and respiratory symptoms are extra-oesophageal manifestations of gastro-oesophageal reflux disease (GERD). The aim of this study was to determine whether dental erosion was correlated with respiratory symptoms in GERD patients. 88 GERD patients were recruited and assigned to three groups mainly according to the frequency of respiratory symptoms: Group I: never; Group II: occasional (1-2 days a week or less); Group III: frequent (3-5 days a week or more). All patients underwent medical evaluations, including medical history, questionnaire answering and alimentary tract examinations. Dental examinations were carried out on these patients and 36 healthy controls. Dental erosions were measured by modified method of Smith and Knight Tooth Wear Index (TWI). Location and severity of dental erosion were recorded. The prevalence of dental erosion in Group III (64.52%) was higher (p<0.05) than that in Groups I (36.67%) and II (44.44%). GERD patients were presented with dental erosion with TWI scores ranging from 1 to 4. Though proportion of dental erosion with Score 2 (7/20) in Group III was higher than that in Group I (2/11) and Group II (3/12), there was no statistical significance in the proportions of erosion scores among three patient groups. Correlation coefficient between airway symptoms and scores of dental erosion was 0.231 (p<0.05). Palatal erosion of upper incisor was seen in 8 persons (72.7%) in Group I, 9 persons (75%) in Group II and 16 persons (80%) in Group III (p>0.05). Labial erosion of upper incisors was found in 1 person in Groups I and II respectively and 4 persons in Group III. All patients with labial erosion on upper incisors had palatal erosion, except 1 patient in Group III. In GERD patients, dental erosions are more prevalent in patients with frequent respiratory symptoms than those in patients with occasional and without respiratory symptoms. Palatal erosion of upper incisor is the main manifestation in patients. Acid reflux is the main causative factor of dental erosion in GERD patients with airway symptoms. Copyright © 2010 Elsevier Ltd. All rights reserved.

Development of a New Army Standardized Physical Readiness Test: January 2012 through December 2013

DTIC Science & Technology

2015-06-30

that “Individual Service members must possess the cardio -respiratory endurance, muscular strength and muscular endurance, together with desirable...there appears to be less gender bias.  While fitness tests have been associated with different aspect of fitness ( cardio respiratory endurance...9. 1 min Push-up 10. (upper body muscular endurance) 11. 2-mile Run 12. ( cardio -respiratory endurance) Army Combat Readiness Test (ACRT) was

Severe acute respiratory syndrome vaccine efficacy in ferrets: whole killed virus and adenovirus-vectored vaccines.

PubMed

See, Raymond H; Petric, Martin; Lawrence, David J; Mok, Catherine P Y; Rowe, Thomas; Zitzow, Lois A; Karunakaran, Karuna P; Voss, Thomas G; Brunham, Robert C; Gauldie, Jack; Finlay, B Brett; Roper, Rachel L

2008-09-01

Although the 2003 severe acute respiratory syndrome (SARS) outbreak was controlled, repeated transmission of SARS coronavirus (CoV) over several years makes the development of a SARS vaccine desirable. We performed a comparative evaluation of two SARS vaccines for their ability to protect against live SARS-CoV intranasal challenge in ferrets. Both the whole killed SARS-CoV vaccine (with and without alum) and adenovirus-based vectors encoding the nucleocapsid (N) and spike (S) protein induced neutralizing antibody responses and reduced viral replication and shedding in the upper respiratory tract and progression of virus to the lower respiratory tract. The vaccines also diminished haemorrhage in the thymus and reduced the severity and extent of pneumonia and damage to lung epithelium. However, despite high neutralizing antibody titres, protection was incomplete for all vaccine preparations and administration routes. Our data suggest that a combination of vaccine strategies may be required for effective protection from this pathogen. The ferret may be a good model for SARS-CoV infection because it is the only model that replicates the fever seen in human patients, as well as replicating other SARS disease features including infection by the respiratory route, clinical signs, viral replication in upper and lower respiratory tract and lung damage.

Risk assessment for respiratory complications in paediatric anaesthesia: a prospective cohort study.

PubMed

von Ungern-Sternberg, Britta S; Boda, Krisztina; Chambers, Neil A; Rebmann, Claudia; Johnson, Chris; Sly, Peter D; Habre, Walid

2010-09-04

Perioperative respiratory adverse events in children are one of the major causes of morbidity and mortality during paediatric anaesthesia. We aimed to identify associations between family history, anaesthesia management, and occurrence of perioperative respiratory adverse events. We prospectively included all children who had general anaesthesia for surgical or medical interventions, elective or urgent procedures at Princess Margaret Hospital for Children, Perth, Australia, from Feb 1, 2007, to Jan 31, 2008. On the day of surgery, anaesthetists in charge of paediatric patients completed an adapted version of the International Study Group for Asthma and Allergies in Childhood questionnaire. We collected data on family medical history of asthma, atopy, allergy, upper respiratory tract infection, and passive smoking. Anaesthesia management and all perioperative respiratory adverse events were recorded. 9297 questionnaires were available for analysis. A positive respiratory history (nocturnal dry cough, wheezing during exercise, wheezing more than three times in the past 12 months, or a history of present or past eczema) was associated with an increased risk for bronchospasm (relative risk [RR] 8.46, 95% CI 6.18-11.59; p<0.0001), laryngospasm (4.13, 3.37-5.08; p<0.0001), and perioperative cough, desaturation, or airway obstruction (3.05, 2.76-3.37; p<0.0001). Upper respiratory tract infection was associated with an increased risk for perioperative respiratory adverse events only when symptoms were present (RR 2.05, 95% CI 1.82-2.31; p<0.0001) or less than 2 weeks before the procedure (2.34, 2.07-2.66; p<0.0001), whereas symptoms of upper respiratory tract infection 2-4 weeks before the procedure significantly lowered the incidence of perioperative respiratory adverse events (0.66, 0.53-0.81; p<0.0001). A history of at least two family members having asthma, atopy, or smoking increased the risk for perioperative respiratory adverse events (all p<0.0001). Risk was lower with intravenous induction compared with inhalational induction (all p<0.0001), inhalational compared with intravenous maintenance of anaesthesia (all p<0.0001), airway management by a specialist paediatric anaesthetist compared with a registrar (all p<0.0001), and use of face mask compared with tracheal intubation (all p<0.0001). Children at high risk for perioperative respiratory adverse events could be systematically identified at the preanaesthetic assessment and thus can benefit from a specifically targeted anaesthesia management. Department of Anaesthesia, Princess Margaret Hospital for Children, Swiss Foundation for Grants in Biology and Medicine, and the Voluntary Academic Society Basel. Copyright 2010 Elsevier Ltd. All rights reserved.

Laser vocal cordectomy fails to effectively reduce respiratory noise in horses with laryngeal hemiplegia.

PubMed

Brown, Jennifer A; Derksen, Frederik J; Stick, John A; Hartmann, William M; Robinson, N Edward

2005-01-01

To report the effect of unilateral laser vocal cordectomy on respiratory noise and airway function in horses with experimentally induced laryngeal hemiplegia (LH). Experimental study. Six Standardbred horses without upper airway abnormalities at rest or during high-speed treadmill exercise. Respiratory sounds and inspiratory trans-upper airway pressure (P(Ui)) were measured before (baseline) and 14 days after induction of LH by left recurrent laryngeal neurectomy, and again 30, 60, 90, and 120 days after endoscopically assisted laser cordectomy of the left vocal cord. Data were collected with the horses exercising on a treadmill at a speed producing maximum heart rate (HR(max)). In horses exercising at HR(max), induction of LH caused a significant increase in P(Ui), sound level (SL), and the sound intensity of formant 2 (F(2)) and 3 (F(3)). The sound intensity of formant 1 (F(1)) was unaffected by induction of LH. Laser vocal cordectomy had no effect on SL, or on the sound intensity of F(1) and F(3). At 30, 60, 90, and 120 days after surgery, P(Ui) and the sound intensity of F(2) were significantly reduced, but these variables remained significantly different from baseline values. Unilateral laser vocal cordectomy did not effectively improve upper airway noise in horses with LH. The procedure decreased upper airway obstruction to the same degree as bilateral ventriculocordectomy. Currently, laser vocal cordectomy cannot be recommended for the treatment of upper airway noise in horses with LH.

Etiology of Acute Respiratory Infections in Infants: A Prospective Birth Cohort Study.

PubMed

Kumar, Prawin; Medigeshi, Guruprasad R; Mishra, Vishnu S; Islam, Mojahidul; Randev, Shivani; Mukherjee, Aparna; Chaudhry, Rama; Kapil, Arti; Ram Jat, Kana; Lodha, Rakesh; Kabra, Sushil K

2017-01-01

There is paucity of studies on etiology of acute respiratory infections (ARI) in infants. The objective of this study is to document incidence and etiology of ARI in infants, their seasonal variability and association of clinical profile with etiology. A birth cohort was followed for the first year of life; for each episode of ARI, nasopharyngeal aspirates were collected to identify the causative respiratory virus(es) using multiplex real-time polymerase chain reaction assay. For lower respiratory tract infections blood culture, serum procalcitonin, serum antibodies to Mycoplasma and Chlamydia and urinary Streptococcus pneumoniae antigen were also assayed. A total of 503 ARI episodes were documented in 310 infants for an incidence rate of 1.8 episodes per infant per year. Of these, samples were processed in 395 episodes (upper respiratory tract infection: 377; lower respiratory tract infection: 18). One or more viruses were detected in 250 (63.3%) episodes and viral coinfections in 72 (18.2%) episodes. Rhinovirus was the most common virus [105 (42%)] followed by respiratory syncytial virus [50 (20%)], parainfluenza virus [42 (16.8%)] and coronavirus [44 (17.6%)]. In lower respiratory tract infections, viral infections were detected in 12 (66.7%) episodes, bacterial infections in 17 (94.4%) episodes and mixed bacterial-viral infections in 8 (44.4%) episodes. Peak incidence of viruses was observed during February-March and September-November. There was no significant difference in symptom duration with virus types. In this cohort of infants, ARI incidence was 1.8 episodes per year per infant; 95% were upper respiratory tract infections. Viruses were identified in 63.3% episodes, and the most common viruses detected were rhinovirus, respiratory syncytial virus and parainfluenza virus.

Nitrogen dioxide and respiratory illness in children. Part I: Health outcomes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Samet, J.M.; Lambert, W.E.; Skipper, B.J.

1993-06-01

We have carried out a prospective cohort study to test the hypothesis that exposure to nitrogen dioxide increases the incidence and severity of respiratory infections during the first 18 months of life. Between January 1988 and June 1990, 1,315 infants were enrolled into the study at birth and followed with prospective surveillance for the occurrence of respiratory infections and monitoring of nitrogen dioxide concentrations in their homes. The subjects were healthy infants from homes without smokers; they were selected with stratification by type of cooking stove at a ratio of four to one for gas and electric stoves. Illness experiencemore » was monitored by a daily diary of symptoms completed by the mother and a telephone interview conducted every two weeks. Illnesses with wheezing or wet cough were classified as involving the lower respiratory tract; all other respiratory illnesses were designated as involving the upper respiratory tract. Exposure to nitrogen dioxide was estimated by two-week average concentrations measured in the subjects' bedrooms with passive samplers. This analysis is limited to the 1,205 subjects completing at least one month of observation; of these, 823 completed the full protocol, contributing 82.8% of the total number of days during which the subjects were under observation. Incidence rates for all respiratory illnesses, all upper respiratory illness, all lower respiratory illnesses, and lower respiratory illness further divided into those with any wheezing, or wet cough without wheezing, were examined within strata of nitrogen dioxide exposure at the time of the illness, nitrogen dioxide exposure during the prior month, and type of cooking stove. Consistent trends of increasing illness incidence rates with increasing exposure to nitrogen dioxide were not evident for either the lagged or unlagged exposure variables.« less

Effect of Balloon Pulmonary Angioplasty on Respiratory Function in Patients With Chronic Thromboembolic Pulmonary Hypertension.

PubMed

Akizuki, Mina; Serizawa, Naoki; Ueno, Atsuko; Adachi, Taku; Hagiwara, Nobuhisa

2017-03-01

Balloon pulmonary angioplasty (BPA) in chronic thromboembolic pulmonary hypertension (CTEPH) improves hemodynamics and exercise capacity. However, its effect on respiratory function is unclear. Our objective was to investigate the effect of BPA on respiratory function. We enrolled patients with inoperable CTEPH who underwent BPA primarily in lower lobe arteries (first series) and upper and middle lobe arteries (second series). We compared changes in hemodynamics and respiratory function between different BPA fields. Sixty-two BPA sessions were performed in 13 consecutive patients. Mean pulmonary arterial pressure and pulmonary vascular resistance significantly improved from 44 ± 8 to 23 ± 5 mm Hg and 818 ± 383 to 311 ± 117 dyne/s/cm -5 . The percent predicted diffusion capacity of lung for carbon monoxide (Dlco) decreased after BPA in the lower lung field (from 60% ± 8% to 54% ± 8%) with no recovery. Percent Dlco increased after BPA in the upper middle lung field (from 53% ± 6% to 58% ± 6%) and continued to improve during the follow-up (from 58% ± 6% to 64% ± 11%). The ventilation/Co 2 production (V˙e/V˙co 2 ) slope significantly improved after BPA in the lower lung field (from 51 ± 13 to 41 ± 8) and continued to improve during the follow-up (from 41 ± 8 to 35 ± 7); however, the V˙e/V˙co 2 slope remained unchanged after BPA in the upper/middle lung field. Changes in % Dlco and the V˙e/V˙co 2 slope differed significantly between lower and upper/middle lung fields. The effect of BPA on respiratory function in patients with CTEPH differed depending on the lung field. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Computational Fluid Dynamics Modeling of Bacillus anthracis ...

EPA Pesticide Factsheets

Journal Article Three-dimensional computational fluid dynamics and Lagrangian particle deposition models were developed to compare the deposition of aerosolized Bacillus anthracis spores in the respiratory airways of a human with that of the rabbit, a species commonly used in the study of anthrax disease. The respiratory airway geometries for each species were derived from computed tomography (CT) or µCT images. Both models encompassed airways that extended from the external nose to the lung with a total of 272 outlets in the human model and 2878 outlets in the rabbit model. All simulations of spore deposition were conducted under transient, inhalation-exhalation breathing conditions using average species-specific minute volumes. Four different exposure scenarios were modeled in the rabbit based upon experimental inhalation studies. For comparison, human simulations were conducted at the highest exposure concentration used during the rabbit experimental exposures. Results demonstrated that regional spore deposition patterns were sensitive to airway geometry and ventilation profiles. Despite the complex airway geometries in the rabbit nose, higher spore deposition efficiency was predicted in the upper conducting airways of the human at the same air concentration of anthrax spores. This greater deposition of spores in the upper airways in the human resulted in lower penetration and deposition in the tracheobronchial airways and the deep lung than that predict

Humidification during mechanical ventilation in the adult patient.

PubMed

Al Ashry, Haitham S; Modrykamien, Ariel M

2014-01-01

Humidification of inhaled gases has been standard of care in mechanical ventilation for a long period of time. More than a century ago, a variety of reports described important airway damage by applying dry gases during artificial ventilation. Consequently, respiratory care providers have been utilizing external humidifiers to compensate for the lack of natural humidification mechanisms when the upper airway is bypassed. Particularly, active and passive humidification devices have rapidly evolved. Sophisticated systems composed of reservoirs, wires, heating devices, and other elements have become part of our usual armamentarium in the intensive care unit. Therefore, basic knowledge of the mechanisms of action of each of these devices, as well as their advantages and disadvantages, becomes a necessity for the respiratory care and intensive care practitioner. In this paper, we review current methods of airway humidification during invasive mechanical ventilation of adult patients. We describe a variety of devices and describe the eventual applications according to specific clinical conditions.

Molecular epidemiology of a post-influenza pandemic outbreak of acute respiratory infections in Korea caused by human adenovirus type 3.

PubMed

Lee, Wan-Ji; Jung, Hee-Dong; Cheong, Hyang-Min; Kim, Kisoon

2015-01-01

An outbreak of upper respiratory tract infections associated with human adenovirus (HAdV) occurred on a national scale in Korea from September to December 2010, following a major H1N1 influenza pandemic. Data from the Korea Influenza and Respiratory Surveillance System (KINRESS) showed an unusually high positive rate accounting for up to 20% of all diagnosed cases. To determine the principal cause of the outbreak, direct polymerase chain reaction (PCR) amplification followed by sequence analysis targeting parts of the hexon gene of HAdV was performed. Serotypes of 1,007 PCR-diagnosed HAdV-positive samples from patients with an acute upper respiratory tract illness were determined and epidemiological characteristics including major aged group and clinical symptoms were analyzed. The principal symptom of HAdV infections was fever and the vulnerable aged group was 1-5 years old. Based on sequence analysis, HAdV-3 was the predominant serotype in the outbreak, with an incidence of 74.3%. From the beginning of 2010 until May, the major serotypes were HAdV-1, 2, and 5 (70-100%) in any given period. However, an outbreak dominated by HAdV-3 started between July and August and peaked in September. Phylogenetic analysis revealed that there was no genetic variation in HAdV-3. The results demonstrated that an outbreak of upper respiratory illness followed by H1N1 influenza pandemic in Korea was caused mainly by emerged HAdV-3. J. © 2014 Wiley Periodicals, Inc.

Numerical study of dynamic glottis and tidal breathing on respiratory sounds in a human upper airway model

PubMed Central

Wang, Zhaoxuan; Talaat, Khaled; Glide-Hurst, Carri; Dong, Haibo

2018-01-01

Background Human snores are caused by vibrating anatomical structures in the upper airway. The glottis is a highly variable structure and a critical organ regulating inhaled flows. However, the effects of the glottis motion on airflow and breathing sound are not well understood, while static glottises have been implemented in most previous in silico studies. The objective of this study is to develop a computational acoustic model of human airways with a dynamic glottis and quantify the effects of glottis motion and tidal breathing on airflow and sound generation. Methods Large eddy simulation and FW-H models were adopted to compute airflows and respiratory sounds in an image-based mouth-lung model. User-defined functions were developed that governed the glottis kinematics. Varying breathing scenarios (static vs. dynamic glottis; constant vs. sinusoidal inhalations) were simulated to understand the effects of glottis motion and inhalation pattern on sound generation. Pressure distributions were measured in airway casts with different glottal openings for model validation purpose. Results Significant flow fluctuations were predicted in the upper airways at peak inhalation rates or during glottal constriction. The inhalation speed through the glottis was the predominating factor in the sound generation while the transient effects were less important. For all frequencies considered (20–2500 Hz), the static glottis substantially underestimated the intensity of the generated sounds, which was most pronounced in the range of 100–500 Hz. Adopting an equivalent steady flow rather than a tidal breathing further underestimated the sound intensity. An increase of 25 dB in average was observed for the life condition (sine-dynamic) compared to the idealized condition (constant-rigid) for the broadband frequencies, with the largest increase of approximately 40 dB at the frequency around 250 Hz. Conclusion Results show that a severely narrowing glottis during inhalation, as well as flow fluctuations in the downstream trachea, can generate audible sound levels. PMID:29101633

Numerical study of dynamic glottis and tidal breathing on respiratory sounds in a human upper airway model.

PubMed

Xi, Jinxiang; Wang, Zhaoxuan; Talaat, Khaled; Glide-Hurst, Carri; Dong, Haibo

2018-05-01

Human snores are caused by vibrating anatomical structures in the upper airway. The glottis is a highly variable structure and a critical organ regulating inhaled flows. However, the effects of the glottis motion on airflow and breathing sound are not well understood, while static glottises have been implemented in most previous in silico studies. The objective of this study is to develop a computational acoustic model of human airways with a dynamic glottis and quantify the effects of glottis motion and tidal breathing on airflow and sound generation. Large eddy simulation and FW-H models were adopted to compute airflows and respiratory sounds in an image-based mouth-lung model. User-defined functions were developed that governed the glottis kinematics. Varying breathing scenarios (static vs. dynamic glottis; constant vs. sinusoidal inhalations) were simulated to understand the effects of glottis motion and inhalation pattern on sound generation. Pressure distributions were measured in airway casts with different glottal openings for model validation purpose. Significant flow fluctuations were predicted in the upper airways at peak inhalation rates or during glottal constriction. The inhalation speed through the glottis was the predominating factor in the sound generation while the transient effects were less important. For all frequencies considered (20-2500 Hz), the static glottis substantially underestimated the intensity of the generated sounds, which was most pronounced in the range of 100-500 Hz. Adopting an equivalent steady flow rather than a tidal breathing further underestimated the sound intensity. An increase of 25 dB in average was observed for the life condition (sine-dynamic) compared to the idealized condition (constant-rigid) for the broadband frequencies, with the largest increase of approximately 40 dB at the frequency around 250 Hz. Results show that a severely narrowing glottis during inhalation, as well as flow fluctuations in the downstream trachea, can generate audible sound levels.

Does Exercise Alter Immune Function and Respiratory Infections?

ERIC Educational Resources Information Center

Nieman, David C.

2001-01-01

This paper examines whether physical activity influences immune function as a consequence risk of infection from the common cold and other upper respiratory tract infections (URTI) and whether the immune system responds differently to moderate versus intense physical exertion. Research indicates that people who participate in regular moderate…

Upper Airway Collapsibility During REM Sleep in Children with the Obstructive Sleep Apnea Syndrome

PubMed Central

Huang, Jingtao; Karamessinis, Laurie R.; Pepe, Michelle E.; Glinka, Stephen M.; Samuel, John M.; Gallagher, Paul R.; Marcus, Carole L.

2009-01-01

Study Objectives: In children, most obstructive events occur during rapid eye movement (REM) sleep. We hypothesized that children with the obstructive sleep apnea syndrome (OSAS), in contrast to age-matched control subjects, would not maintain airflow in the face of an upper airway inspiratory pressure drop during REM sleep. Design: During slow wave sleep (SWS) and REM sleep, we measured airflow, inspiratory time, inspiratory time/total respiratory cycle time, respiratory rate, tidal volume, and minute ventilation at a holding pressure at which flow limitation occurred and at 5 cm H2O below the holding pressure in children with OSAS and in control subjects. Setting: Sleep laboratory. Participants: Fourteen children with OSAS and 23 normal control subjects. Results: In both sleep states, control subjects were able to maintain airflow, whereas subjects with OSAS preserved airflow in SWS but had a significant decrease in airflow during REM sleep (change in airflow of 18.58 ± 12.41 mL/s for control subjects vs −44.33 ± 14.09 mL/s for children with OSAS, P = 0.002). Although tidal volume decreased, patients with OSAS were able to maintain minute ventilation by increasing the respiratory rate and also had an increase in inspiratory time and inspiratory time per total respiratory cycle time Conclusion: Children with OSAS do not maintain airflow in the face of upper-airway inspiratory-pressure drops during REM sleep, indicating a more collapsible upper airway, compared with that of control subjects during REM sleep. However, compensatory mechanisms exist to maintain minute ventilation. Local reflexes, central control mechanisms, or both reflexes and control mechanisms need to be further explored to better understand the pathophysiology of this abnormality and the compensation mechanism. Citation: Huang J; Karamessinis LR; Pepe ME; Glinka SM; Samuel JM; Gallagher PR; Marcus CL. Upper airway collapsibility during REM sleep in children with the obstructive sleep apnea syndrome. SLEEP 2009;32(9):1173-1181. PMID:19750922

Respiratory failure in diabetic ketoacidosis.

PubMed

Konstantinov, Nikifor K; Rohrscheib, Mark; Agaba, Emmanuel I; Dorin, Richard I; Murata, Glen H; Tzamaloukas, Antonios H

2015-07-25

Respiratory failure complicating the course of diabetic ketoacidosis (DKA) is a source of increased morbidity and mortality. Detection of respiratory failure in DKA requires focused clinical monitoring, careful interpretation of arterial blood gases, and investigation for conditions that can affect adversely the respiration. Conditions that compromise respiratory function caused by DKA can be detected at presentation but are usually more prevalent during treatment. These conditions include deficits of potassium, magnesium and phosphate and hydrostatic or non-hydrostatic pulmonary edema. Conditions not caused by DKA that can worsen respiratory function under the added stress of DKA include infections of the respiratory system, pre-existing respiratory or neuromuscular disease and miscellaneous other conditions. Prompt recognition and management of the conditions that can lead to respiratory failure in DKA may prevent respiratory failure and improve mortality from DKA.

Respiratory failure in diabetic ketoacidosis

PubMed Central

Konstantinov, Nikifor K; Rohrscheib, Mark; Agaba, Emmanuel I; Dorin, Richard I; Murata, Glen H; Tzamaloukas, Antonios H

2015-01-01

Respiratory failure complicating the course of diabetic ketoacidosis (DKA) is a source of increased morbidity and mortality. Detection of respiratory failure in DKA requires focused clinical monitoring, careful interpretation of arterial blood gases, and investigation for conditions that can affect adversely the respiration. Conditions that compromise respiratory function caused by DKA can be detected at presentation but are usually more prevalent during treatment. These conditions include deficits of potassium, magnesium and phosphate and hydrostatic or non-hydrostatic pulmonary edema. Conditions not caused by DKA that can worsen respiratory function under the added stress of DKA include infections of the respiratory system, pre-existing respiratory or neuromuscular disease and miscellaneous other conditions. Prompt recognition and management of the conditions that can lead to respiratory failure in DKA may prevent respiratory failure and improve mortality from DKA. PMID:26240698

Brugada syndrome in a patient with amyotrophic lateral sclerosis: a case report.

PubMed

Battineni, Anusha; Gummi, Rohit; Mullaguri, Naresh; Govindarajan, Raghav

2017-07-14

Amyotrophic lateral sclerosis is a fatal neuromuscular disorder characterized by progressive death of the upper and lower motor neurons in the central nervous system. Patients with this disease die mostly as a result of respiratory failure; however, owing to prolonged survival through assisted ventilation, cardiovascular causes are increasingly responsible for mortality. We report what is to the best of our knowledge the first case of type 2 Brugada syndrome causing ventricular tachyarrhythmia and cardiac arrest in a patient with upper limb onset amyotrophic lateral sclerosis. A 48-year-old Caucasian woman with a significant past medical history of papillary thyroid carcinoma status postresection, pulmonary embolism on anticoagulation, and a recent diagnosis of right upper limb-onset amyotrophic lateral sclerosis presented to the emergency department of our hospital with acute on chronic shortness of breath. On further evaluation, she was found to have hypoxic and hypercapnic respiratory failure and was placed on bilevel positive airway pressure ventilation. Her 12-lead electrocardiogram showed sinus rhythm with J-point elevation, saddle-shaped ST segment elevation, predominantly in V1 and V2 with no significant QTc prolongation. No troponin elevation was noted in her laboratory workup. Because she was unable to protect her airway, a decision was made to intubate her. After 1 minute of induction with etomidate and succinylcholine, she went into pulseless ventricular tachycardia and fibrillation requiring three cycles of cardiopulmonary resuscitation with high-quality chest compressions, three doses of epinephrine, and a loading dose of amiodarone prior to return of spontaneous circulation. She was further evaluated by cardiology services and was diagnosed with type 2 Brugada syndrome, for which she was started on quinidine. Her respiratory failure and the drugs she received for intubation likely caused her ventricular tachycardia to occur in conjunction with an underlying Brugada pattern seen on an electrocardiogram. The results of evaluation of her genetic panel for Brugada syndrome were negative. She was subsequently discharged to home in stable condition after a 10-day hospital stay. Amyotrophic lateral sclerosis is a progressive neuromuscular disorder with significant mortality. Respiratory failure is the leading cause of death, but lately, owing to increased survival associated with early tracheostomy and positive pressure ventilation, there has been an increasing trend in the identification of cardiovascular causes of mortality, especially arrhythmias, that may need periodic electrocardiographic surveillance.

Effects of upper respiratory tract illnesses, ibuprofen and caffeine on reaction time and alertness.

PubMed

Smith, Andrew P; Nutt, David J

2014-05-01

Compared with healthy individuals, those with upper respiratory tract illnesses (URTIs) report reduced alertness and have slower reaction times. It is important to evaluate medication that can remove this behavioural malaise. The aim of this study was to compare the effects of a combination of ibuprofen plus caffeine with ibuprofen and caffeine alone, and placebo on malaise associated with URTIs, as measured by psychomotor performance and mood testing. Volunteers were randomly assigned to one of four medication conditions as follows: 200 mg ibuprofen and 100 mg caffeine; 200 mg ibuprofen; 100 mg caffeine; placebo. A single oral dose was given and testing followed for 3 h. Efficacy variables were based on the volunteers' performance, measured by psychomotor performance and mood. The pre-drug results confirmed that those with an URTI had a more negative mood and impaired performance. Results from the simple reaction time task, at both 55- and 110-min post-dosing, showed that a single-dose of caffeinated products (I200/C100 and CAF100) led to significantly faster reaction times than IBU200 and placebo. These effects were generally confirmed with the other performance tasks. Subjective measures showed that the combination of ibuprofen and caffeine was superior to the other conditions. There were no serious adverse events reported, and study medication was well tolerated. The results from the post-drug assessments suggest that a combination of ibuprofen and caffeine was the optimum treatment for malaise associated with URTIs in that it had significant effects on objective performance and subjective measures.

Pediatric Tracheotomy: A 5-Year Experience in Düzce University Medical Faculty

PubMed Central

Ünlü, İlhan; İlhan, Ethem; Ünlü, Elif Nisa; Ateş, Hakan; Gün, Emrah; Yaman, Hüseyin; Güçlü, Ender

2015-01-01

Objective Tracheotomy is one of the oldest surgical procedures. Pediatric tracheotomy indications have changed in recent decades. Currently, tracheotomy is performed because of prolonged intubation, upper airway obstruction, neuromuscular, and craniofacial anomalies instead of acute airway infections. This study aims to present our experience regarding indications and complications of tracheotomy in pediatric patients. Methods We retrospectively evaluated 17 pediatric patients who underwent tracheotomy because of prolonged intubation, increased pulmonary secretions, and upper respiratory tract obstruction from June 2010 to June 2015. The patients’ age, gender, tracheotomy indications, duration of intubation, complications, and actual clinical condition were recorded. Results Tracheotomy was performed on 17 pediatric patients in our clinic. Discharged patients were followed with a 3-month routine check. Six patients (35.29%) had died because of a primary disease during follow-up, and one (5.88%) of them was a one-day-old newborn who had anomalies that were incompatible with life. In one patient, emergency tracheotomy was performed because of a tracheal trauma. None of the patients has been decannulated except one (5.88%). One (5.88%) patient had an accidental decannulation, while another had bleeding in the operation field. The total minor complication rate was 11.76%, and no major complication was observed. Two (11.76%) of the discharged patients underwent re-operation for widening of the tracheotomy stoma during their routine visit. Conclusion Currently, tracheotomy in pediatric patients is mostly performed for prolonged intubation and upper respiratory tract obstruction for which intubation is not possible. Tracheotomy enables the discharge of these patients after training their families. PMID:29391991

Incidence of Lower Respiratory Tract Infections and Atopic Conditions in Boys and Young Male Adults: Royal College of General Practitioners Research and Surveillance Centre Annual Report 2015-2016.

PubMed

de Lusignan, Simon; Correa, Ana; Pebody, Richard; Yonova, Ivelina; Smith, Gillian; Byford, Rachel; Pathirannehelage, Sameera Rankiri; McGee, Christopher; Elliot, Alex J; Hriskova, Mariya; Ferreira, Filipa Im; Rafi, Imran; Jones, Simon

2018-04-30

The Royal College of General Practitioners Research and Surveillance Centre comprises more than 150 general practices, with a combined population of more than 1.5 million, contributing to UK and European public health surveillance and research. The aim of this paper was to report gender differences in the presentation of infectious and respiratory conditions in children and young adults. Disease incidence data were used to test the hypothesis that boys up to puberty present more with lower respiratory tract infection (LRTI) and asthma. Incidence rates were reported for infectious conditions in children and young adults by gender. We controlled for ethnicity, deprivation, and consultation rates. We report odds ratios (OR) with 95% CI, P values, and probability of presenting. Boys presented more with LRTI, largely due to acute bronchitis. The OR of males consulting was greater across the youngest 3 age bands (OR 1.59, 95% CI 1.35-1.87; OR 1.13, 95% CI 1.05-1.21; OR 1.20, 95% CI 1.09-1.32). Allergic rhinitis and asthma had a higher OR of presenting in boys aged 5 to 14 years (OR 1.52, 95% CI 1.37-1.68; OR 1.31, 95% CI 1.17-1.48). Upper respiratory tract infection (URTI) and urinary tract infection (UTI) had lower odds of presenting in boys, especially those older than 15 years. The probability of presenting showed different patterns for LRTI, URTI, and atopic conditions. Boys younger than 15 years have greater odds of presenting with LRTI and atopic conditions, whereas girls may present more with URTI and UTI. These differences may provide insights into disease mechanisms and for health service planning. ©Simon de Lusignan, Ana Correa, Richard Pebody, Ivelina Yonova, Gillian Smith, Rachel Byford, Sameera Rankiri Pathirannehelage, Christopher McGee, Alex J. Elliot, Mariya Hriskova, Filipa IM Ferreira, Imran Rafi, Simon Jones. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 30.04.2018.

Influenza Virus A/Anhui/1/2013 (H7N9) Replicates Efficiently in the Upper and Lower Respiratory Tracts of Cynomolgus Macaques

PubMed Central

de Wit, Emmie; Rasmussen, Angela L.; Feldmann, Friederike; Bushmaker, Trenton; Martellaro, Cynthia; Haddock, Elaine; Okumura, Atsushi; Proll, Sean C.; Chang, Jean; Gardner, Don; Katze, Michael G.

2014-01-01

ABSTRACT In March 2013, three fatal human cases of infection with influenza A virus (H7N9) were reported in China. Since then, human cases have been accumulating. Given the public health importance of this virus, we performed a pathogenicity study of the H7N9 virus in the cynomolgus macaque model, focusing on clinical aspects of disease, radiographic, histological, and gene expression profile changes in the upper and lower respiratory tracts, and changes in systemic cytokine and chemokine profiles during infection. Cynomolgus macaques developed transient, mild to severe disease with radiographic evidence of pulmonary infiltration. Virus replicated in the upper as well as lower respiratory tract, with sustained replication in the upper respiratory tract until the end of the experiment at 6 days after inoculation. Virus shedding occurred mainly via the throat. Histopathological changes in the lungs were similar to those observed in humans, albeit less severe, with diffuse alveolar damage, infiltration of polymorphonuclear cells, formation of hyaline membranes, pneumocyte hyperplasia, and fibroproliferative changes. Analysis of gene expression profiles in lung lesions identified pathways involved in tissue damage during H7N9 infection as well as leads for development of therapeutics targeting host responses rather than virus replication. Overall, H7N9 infection was not as severe in cynomolgus macaques as in humans, supporting the possible role of underlying medical complications in disease severity as discussed for human H7N9 infection (H. N. Gao et al., N. Engl. J. Med. 368:2277–2285, 2013, doi:10.1056/NEJMoa1305584). PMID:25118237

How to avoid the inappropriate use of antibiotics in upper respiratory tract infections? A position statement from an expert panel.

PubMed

Piltcher, Otávio Bejzman; Kosugi, Eduardo Macoto; Sakano, Eulalia; Mion, Olavo; Testa, José Ricardo Gurgel; Romano, Fabrizio Ricci; Santos, Marco Cesar Jorge; Di Francesco, Renata Cantisani; Mitre, Edson Ibrahim; Bezerra, Thiago Freire Pinto; Roithmann, Renato; Padua, Francini Greco; Valera, Fabiana Cardoso Pereira; Lubianca Neto, José Faibes; Sá, Leonardo Conrado Barbosa; Pignatari, Shirley Shizue Nagata; Avelino, Melissa Ameloti Gomes; Caixeta, Juliana Alves de Souza; Anselmo-Lima, Wilma Terezinha; Tamashiro, Edwin

Bacterial resistance burden has increased in the past years, mainly due to inappropriate antibiotic use. Recently it has become an urgent public health concern due to its impact on the prolongation of hospitalization, an increase of total cost of treatment and mortality associated with infectious disease. Almost half of the antimicrobial prescriptions in outpatient care visits are prescribed for acute upper respiratory infections, especially rhinosinusitis, otitis media, and pharyngotonsillitis. In this context, otorhinolaryngologists play an important role in orienting patients and non-specialists in the utilization of antibiotics rationally and properly in these infections. To review the most recent recommendations and guidelines for the use of antibiotics in acute otitis media, acute rhinosinusitis, and pharyngotonsillitis, adapted to our national reality. A literature review on PubMed database including the medical management in acute otitis media, acute rhinosinusitis, and pharyngotonsillitis, followed by a discussion with a panel of specialists. Antibiotics must be judiciously prescribed in uncomplicated acute upper respiratory tract infections. The severity of clinical presentation and the potential risks for evolution to suppurative and non-suppurative complications must be taken into 'consideration'. Periodic revisions on guidelines and recommendations for treatment of the main acute infections are necessary to orient rationale and appropriate use of antibiotics. Continuous medical education and changes in physicians' and patients' behavior are required to modify the paradigm that all upper respiratory infection needs antibiotic therapy, minimizing the consequences of its inadequate and inappropriate use. Copyright © 2018 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Role of Orexin in Respiratory and Sleep Homeostasis during Upper Airway Obstruction in Rats

PubMed Central

Tarasiuk, Ariel; Levi, Avishag; Berdugo-Boura, Nilly; Yahalom, Ari; Segev, Yael

2014-01-01

Study Objectives: Chronic upper airway obstruction (UAO) elicits a cascade of complex endocrine derangements that affect growth, sleep, and energy metabolism. We hypothesized that elevated hypothalamic orexin has a role in maintaining ventilation during UAO, while at the same time altering sleep-wake activity and energy metabolism. Here, we sought to explore the UAO-induced changes in hypothalamic orexin and their role in sleep-wake balance, respiratory activity, and energy metabolism. Interventions: The tracheae of 22-day-old Sprague-Dawley rats were surgically narrowed; UAO and sham-operated control animals were monitored for 7 weeks. We measured food intake, body weight, temperature, locomotion, and sleep-wake activity. Magnetic resonance imaging was used to quantify subcutaneous and visceral fat tissue volumes. In week 7, the rats were sacrificed and levels of hypothalamic orexin, serum leptin, and corticosterone were determined. The effect of dual orexin receptor antagonist (almorexant 300 mg/kg) on sleep and respiration was also explored. Measurements and Results: UAO increased hypothalamic orexin mRNA and protein content by 64% and 65%, respectively. UAO led to 30% chronic sleep loss, excessive active phase sleepiness, decreased body temperature, increased food intake, reduction of abdominal and subcutaneous fat tissue volume, and growth retardation. Administration of almorexant normalized sleep but induced severe breathing difficulties in UAO rats, while it had no effect on sleep or on breathing of control animals. Conclusions: In upper airway obstruction animals, enhanced orexin secretion, while crucially important for respiratory homeostasis maintenance, is also responsible for chronic partial sleep loss, as well as considerable impairment of energy metabolism and growth. Citation: Tarasiuk A, Levi A, Berdugo-Boura N, Yahalom A, Segev Y. Role of orexin in respiratory and sleep homeostasis during upper airway obstruction in rats. SLEEP 2014;37(5):987-998. PMID:24790278

Deregulation of sale of over-the-counter drugs outside of pharmacies in the Republic of Korea: interrupted-time-series analysis of outpatient visits before and after the policy.

PubMed

Chun, Sung-Youn; Park, Hye-Ki; Han, Kyu-Tae; Kim, Woorim; Lee, Hyo-Jung; Park, Eun-Cheol

2017-07-12

We evaluated the effectiveness of a policy allowing for the sale of over-the-counter drugs outside of pharmacies by examining its effect on number of monthly outpatient visits for acute upper respiratory infections, dyspepsia, and migraine. We used medical claims data extracted from the Korean National Health Insurance Cohort Database from 2009 to 2013. The Korean National Health Insurance Cohort Database comprises a nationally representative sample of claims - about 2% of the entire population - obtained from the medical record data held by the Korean National Health Insurance Corporation (which has data on the entire nation). The analysis included26,284,706 person-months of 1,042,728 individuals. An interrupted-time series analysis was performed. Outcome measures were monthly outpatient visits for acute upper respiratory infections, dyspepsia, and migraine. To investigate the effect of the policy, we compared the number of monthly visits before and after the policy's implementation in 2012. For acute upper respiratory infections, monthly outpatient visits showed a decreasing trend before the policy (ß = -0.0003);after it, a prompt change and increasing trend in monthly outpatient visits were observed, but these were non-significant. For dyspepsia, the trend was increasing before implementation (ß = -0.0101), but this reversed after implementation(ß = -0.007). For migraine, an increasing trend was observed before the policy (ß = 0.0057). After it, we observed a significant prompt change (ß = -0.0314) but no significant trend. Deregulation of selling over-the-counter medication outside of pharmacies reduced monthly outpatient visits for dyspepsia and migraine symptoms, but not acute upper respiratory infections.

Respiratory Infections and Antibiotic Usage in Common Variable Immunodeficiency.

PubMed

Sperlich, Johannes M; Grimbacher, Bodo; Workman, Sarita; Haque, Tanzina; Seneviratne, Suranjith L; Burns, Siobhan O; Reiser, Veronika; Vach, Werner; Hurst, John R; Lowe, David M

Patients with common variable immunodeficiency (CVID) suffer frequent respiratory tract infections despite immunoglobulin replacement and are prescribed significant quantities of antibiotics. The clinical and microbiological nature of these exacerbations, the symptomatic triggers to take antibiotics, and the response to treatment have not been previously investigated. To describe the nature, frequency, treatment, and clinical course of respiratory tract exacerbations in patients with CVID and to describe pathogens isolated during respiratory tract exacerbations. We performed a prospective diary card exercise in 69 patients with CVID recruited from a primary immunodeficiency clinic in the United Kingdom, generating 6210 days of symptom data. We collected microbiology (sputum microscopy and culture, atypical bacterial PCR, and mycobacterial culture) and virology (nasopharyngeal swab multiplex PCR) samples from symptomatic patients with CVID. There were 170 symptomatic exacerbations and 76 exacerbations treated by antibiotics. The strongest symptomatic predictors for commencing antibiotics were cough, shortness of breath, and purulent sputum. There was a median delay of 5 days from the onset of symptoms to commencing antibiotics. Episodes characterized by purulent sputum responded more quickly to antibiotics, whereas sore throat and upper respiratory tract symptoms responded less quickly. A pathogenic virus was isolated in 56% of respiratory exacerbations and a potentially pathogenic bacteria in 33%. Patients with CVID delay and avoid treatment of symptomatic respiratory exacerbations, which could result in structural lung damage. However, viruses are commonly represented and illnesses dominated by upper respiratory tract symptoms respond poorly to antibiotics, suggesting that antibiotic usage could be better targeted. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. All rights reserved.

[Pulmonary rehabilitation after total laryngectomy using a heat and moisture exchanger (HME)].

PubMed

Lorenz, K J; Maier, H

2009-08-01

A complete removal of the larynx has profound consequences for a patient. Since laryngectomy involves the separation of the upper airway from the lower airway, it not only implies a loss of the voice organ but also leads to chronic lung problems such as increased coughing, mucus production and expectoration. In addition, laryngectomees complain of fatigue, sleeping problems, a reduced sense of smell and taste, and a loss of social contact. A heat and moisture exchanger (HME) cassette can replace a function of the upper airway which consists in conditioning inspired air. It can improve pulmonary symptoms in three ways. 1. An HME cassette heats and moisturises inhaled air and thus creates nearly physiological conditions in the region of the deep airway. 2. The use of an HME cassette leads to an increase in breathing resistance, thereby reducing dynamic airway compression and improving lung ventilation. 3. An HME cassette acts as a filter and removes larger particles from incoming air. This review examines the current understanding of lung physiology after laryngectomy and assesses the effects of HME cassettes on the conditioning of respiratory air, lung function and psychosocial problems. Georg Thieme Verlag KG Stuttgart, New York.

Gender and respiratory findings in workers occupationally exposed to organic aerosols: a meta analysis of 12 cross-sectional studies.

PubMed

Schachter, E Neil; Zuskin, Eugenija; Moshier, Erin L; Godbold, James; Mustajbegovic, Jadranka; Pucarin-Cvetkovic, Jasna; Chiarelli, Angelo

2009-01-12

Gender related differences in respiratory disease have been documented. The aim of this study was to investigate gender related differences in respiratory findings by occupation. We analyzed data from 12 of our previously published studies. Three thousand and eleven (3011) workers employed in "organic dust" industries (1379 female and 1632 male) were studied. A control group of 806 workers not exposed to any kind of dust were also investigated (male = 419, female = 387). Acute and chronic respiratory symptoms and lung function were measured. The weighted average method and the Mantel-Haentszel method were used to calculate the odds ratios of symptoms. Hedge's unbiased estimations were used to measure lung function differences between men and women. There were high prevalences of acute and chronic respiratory symptoms in all the "dusty" studied groups compared to controls. Significantly less chronic cough, chronic phlegm as well as chronic bronchitis were found among women than among men after the adjustments for smoking, age and duration of employment. Upper respiratory tract symptoms by contrast were more frequent in women than in men in these groups. Significant gender related lung function differences occurred in the textile industry but not in the food processing industry or among farmers. The results of this study suggest that in industries processing organic compounds there are gender differences in respiratory symptoms and lung function in exposed workers. Whether these findings represent true physiologic gender differences, gender specific workplace exposures or other undefined gender variables not defined in this study cannot be determined. These data do not suggest that special limitations for women are warranted for respiratory health reasons in these industries, but the issue of upper respiratory irritation and disease warrants further study.

A parent‐completed respiratory questionnaire for 1‐year‐old children: repeatability

PubMed Central

Strippoli, Marie‐Pierre F; Silverman, Michael; Michel, Gisela; Kuehni, Claudia E

2007-01-01

Background and aims There are few standardised questionnaires for the assessment of respiratory symptoms in preschool children. We have developed and tested the short‐term repeatability of a postal questionnaire on respiratory symptoms for 1‐year‐old children. Methods A newly developed postal questionnaire for the assessment of wheeze and other respiratory symptoms was sent to parents of a population‐based random sample of 4300 children aged 12–24 months. After an interval of 3 months, a random sample of 800 respondents received the questionnaire a second time. The responses were compared using Cohen's kappa (κ) to assess agreement corrected for chance. Results The first questionnaire was returned by 3194 (74%) families, the second one by 460/800 (58%). Repeatability was excellent (κ 0.80–0.96) for questions on household characteristics, environmental exposures and family history, good (κ 0.61–0.80) for questions on prevalence, severity and treatment of wheeze, and moderate (κ 0.39–0.66) for chronic cough and upper respiratory symptoms. Conclusions This short postal questionnaire designed for use in population‐based studies has excellent repeatability for family and household characteristics and good repeatability for questions on wheeze. Short‐term changes in symptom status might be responsible for variable answers on recent chronic cough and upper respiratory symptoms. Overall, the questionnaire is a valuable instrument for community‐based research on respiratory symptoms in 1 to 2‐year‐old children. PMID:17502330

The peculiarities of food allergies in accordance with the level of injury of respiratory tract in children of Eastern Siberia.

PubMed

Borisova, Irina V; Smirnova, Svetlana V

2013-01-01

To determine the course of food allergy in accordance with the level of respiratory tract injury in children of Eastern Siberia. We have examined 70 children aged 2-16 , who have food sensibilization. We divided them into 2 groups: group I (n = 32) with diseases of the upper and middle respiratory tract; and group II (n = 38) with diseases of the lower respiratory tract. Allergological medical history, clinical laboratory examination and immunological examination, including the determination of IgA, IgM, IgG and IgE in blood serum. In cases where causal allergens were found, elimination diets were recommended. Onset of upper respiratory tract injury in group I was more often registered in children aged 0-1; in group II, it was in the 3-7 age group. Isolated food sensibilization was more often marked in group I as compared to group II. Atopic mechanisms of respiratory tract injuries were more often registered in group II children. In the course of the elimination diet, we marked positive dynamics in 100% of group I and in 75% of group II. The most frequent allergens that cause respiratory forms of food allergy are hen eggs, cow milk, nutritive cereals, vegetables and fruit. Indices of a humoral link of immunity in the examined patients were more often registered as normal or their level is increased. Timely etiotropic therapy in the majority of cases allows for a stabilization of allergic inflammation.

MRI artifact reduction and quality improvement in the upper abdomen with PROPELLER and prospective acquisition correction (PACE) technique.

PubMed

Hirokawa, Yuusuke; Isoda, Hiroyoshi; Maetani, Yoji S; Arizono, Shigeki; Shimada, Kotaro; Togashi, Kaori

2008-10-01

The purpose of this study was to evaluate the effectiveness of the periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER [BLADE in the MR systems from Siemens Medical Solutions]) with a respiratory compensation technique for motion correction, image noise reduction, improved sharpness of liver edge, and image quality of the upper abdomen. Twenty healthy adult volunteers with a mean age of 28 years (age range, 23-42 years) underwent upper abdominal MRI with a 1.5-T scanner. For each subject, fat-saturated T2-weighted turbo spin-echo (TSE) sequences with respiratory compensation (prospective acquisition correction [PACE]) were performed with and without the BLADE technique. Ghosting artifact, artifacts except ghosting artifact such as respiratory motion and bowel movement, sharpness of liver edge, image noise, and overall image quality were evaluated visually by three radiologists using a 5-point scale for qualitative analysis. The Wilcoxon's signed rank test was used to determine whether a significant difference existed between images with and without BLADE. A p value less than 0.05 was considered to be statistically significant. In the BLADE images, image artifacts, sharpness of liver edge, image noise, and overall image quality were significantly improved (p < 0.001). With the BLADE technique, T2-weighted TSE images of the upper abdomen could provide reduced image artifacts including ghosting artifact and image noise and provide better image quality.

Active Surveillance of Birth Defects Among US Department of Defense Beneficiaries: A Feasibility Study

DTIC Science & Technology

1999-05-01

cleft palate / lip , upper alimentary, male reproductive, and urinary tract birth defects than the active surveillance database. Prevalence for the...the passive CEIS surveillance contained a smaller number of cleft palate / lip , upper alimentary, male reproductive, and urinary tract birth defects...Cardiovascular 33 29 8 63 Respiratory 4 3 0 4 Cleft palate / lip 12 4 3 14 Upper alimentary

Risks for upper respiratory infections in infants during their first months in day care included environmental and child-related factors.

PubMed

Laursen, Rikke Pilmann; Larnkjaer, Anni; Ritz, Christian; Hojsak, Iva; Michaelsen, Kim; Mølgaard, Christian

2018-03-14

We examined the frequency and potential risk factors for respiratory infections, diarrhoea and absences in infants during their first months in day care. This prospective cohort study comprised 269 Danish infants aged eight months to 14 months and was part of a study that examined how probiotics affected absences from day care due to respiratory and gastrointestinal infections. The risk factors examined were the household, child characteristics and type of day care facility. Parents registered upper respiratory tract infections (URTIs), lower respiratory tract infections (LRTIs), diarrhoea and day care absences on web-based questionnaires. Over a mean of 5.6 months in day care, 36% and 20% of the infants had at least one URTI or LRTI, and 60% had diarrhoeal episodes. The risk of at least one URTI was increased by previous respiratory infections, with an odds ratio (OR) of 2.65, but was inversely associated with having a pet (OR: 0.43), being cared for by registered child minders compared to day care centres (OR: 0.36), birthweight (OR 0.40) and age at day care enrolment (OR: 0.64). No significant risk factors for LRTIs and diarrhoea were found. Infection risks were associated with environmental factors and factors related to the child. ©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Sleep Related Breathing Disorders in Adults with Down Syndrome.

ERIC Educational Resources Information Center

Resta, Onofrio; Barbaro, Maria Pia Foschino; Giliberti, Tiziana; Caratozzolo, Gennaro; Cagnazzo, Maria Grazia; Scarpelli, Franco; Nocerino, Maria Cristina

2003-01-01

This study evaluated sleep-related breathing disorders in six adults with Down syndrome. Five were found to have respiratory events justifying the diagnosis of sleep apnea syndrome. Results suggest that the nocturnal respiratory pattern of adults with Down syndrome depends on several pathogenetic factors such as age, severity of upper airway…

An Exercise in Molecular Epidemiology: Human Rhinovirus Prevalence and Genetics

ERIC Educational Resources Information Center

Albright, Catherine J.; Hall, David J.

2011-01-01

Human rhinovirus (HRV) is one of the most common human respiratory pathogens and is responsible for the majority of upper respiratory illnesses. Recently, a phylogeny was constructed from all known American Type Culture Collection (ATCC) HRV sequences. From this study, three HRV classifications (HRVA, HRVB, and HRVC) were determined and techniques…

Identification of the pan and core genomes for Mannheimia haemolytica genotypes 1 and 2

USDA-ARS?s Scientific Manuscript database

Mannheimia haemolytica normally populates the upper respiratory tract of cattle and is recognized as a major cause of bovine respiratory disease. Recently, two major genotypes (1 and 2) of M. haemolytica were identified from whole genome sequencing and analyses of 1,145 North American isolates. On...

UPTAKE AND INTERNAL DOSIMETRY OF INHALED CHLORINE IN THE ISOLATED UPPER RESPIRATORY TRACT (URT) OF F344 RATS.

EPA Science Inventory

Due to large-volume commercial uses as an intermediate and for water disinfection, chlorine (Cl₂) is an important hazardous air pollutant (HAP). Inhaled Cl₂ causes irritant effects in the respiratory tract. We conducted studies to characterize determinants...

How to use: bacterial cultures in diagnosing lower respiratory tract infections in cystic fibrosis.

PubMed

Ahmed, Bushra; Bush, Andrew; Davies, Jane C

2014-10-01

Respiratory infections are the leading cause of morbidity and mortality in cystic fibrosis. Certain bacteria, such as Pseudomonas aeruginosa, are associated with a worse clinical outcome than others, but can be completely eradicated if identified and treated early. The diagnosis of lower respiratory tract infections can be challenging in the non-expectorating patient, in whom upper airway samples, such as cough swabs, are a surrogate for lower airway sampling. However, the results of these often do not fit with the clinical picture, presenting a management dilemma. Frequently, clinicians are faced with a negative culture result in a progressively symptomatic patient and vice versa. When judging the clinical significance of a positive upper airway culture result in an asymptomatic patient, it is important to consider the prognostic significance of the organism cultured. Given that the reported sensitivity of upper airway swabs (which includes throat swabs) is variable, ranging from 35.7% to 71% for Pseudomonas aeruginosa, 50% to 86% for Staphylococcus aureus and 11% to 92% for Haemophilus influenza, upper airway samples may fail to identify lower airway infections. Therefore, in symptomatic children, a repeatedly negative upper airway swab should not be considered as reassuring, and alternative sampling methods, such as induced sputum or bronchoalveolar lavage, should be considered. Here we use some examples of common scenarios to illustrate how best to use bacterial cultures to aid management decisions in cystic fibrosis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Mechanisms of Bacterial Colonization of the Respiratory Tract

PubMed Central

Siegel, Steven J.; Weiser, Jeffrey N.

2016-01-01

Respiratory tract infections are an important cause of morbidity and mortality worldwide. Chief among these are infections involving the lower airways. The opportunistic bacterial pathogens responsible for most cases of pneumonia can cause a range of local and invasive infections. However, bacterial colonization (or carriage) in the upper airway is the prerequisite of all these infections. Successful colonizers must attach to the epithelial lining, grow on the nutrient-limited mucosal surface, evade the host immune response, and transmit to a susceptible host. Here, we review the molecular mechanisms underlying these conserved stages of carriage. We also examine how the demands of colonization influence progression to disease. A range of bacteria can colonize the upper airway; nevertheless, we focus on strategies shared by many respiratory tract opportunistic pathogens. Understanding colonization opens a window to the evolutionary pressures these pathogens face within their animal hosts and that have selected for attributes that contribute to virulence and pathogenesis. PMID:26488280

Assisting the Adult with a Respiratory Condition. Care of the Adult.

ERIC Educational Resources Information Center

Anoka-Hennepin Area Vocational Technical Inst., MN.

These three units for students in a practical nursing program provide supplemental instruction in caring for adult patients with respiratory conditions. Unit titles are Introduction to Care of the Patient with a Respiratory Condition, Infectious Respiratory Conditions, and Chronic Lung Conditions. Each unit contains the following: objectives, an…

Effectiveness of Interventions in Reducing Antibiotic Use for Upper Respiratory Infections in Ambulatory Care Practices

PubMed Central

Linkin, Darren R.; Localio, A. Russell; Leonard, Charles E.; Teal, Valerie L.; Fishman, Neil O.; Hennessy, Sean

2013-01-01

Abstract The objective was to evaluate the effect of separate interventions on antimicrobial prescribing for uncomplicated upper respiratory tract infections. The authors conducted a quasi-experimental pre-post study with concurrent control groups for each intervention. Academic detailing led to a significant reduction in unnecessary antibiotic prescribing. However, there was no significant change in antibiotic prescribing in response to educational mailings to providers or to provider involvement in patient mailings. Organizations that seek to reduce inappropriate use of antibiotics should use proven approaches, even when they are more expensive. (Population Health Management 2013;16:22–27) PMID:23113630

Anaerobic bacteria in upper respiratory tract and head and neck infections: microbiology and treatment.

PubMed

Brook, Itzhak

2012-04-01

Anaerobes are the predominant components of oropharyngeal mucous membranes bacterial flora, and are therefore a common cause of bacterial infections of endogenous origin of upper respiratory tract and head and neck. This review summarizes the aerobic and anaerobic microbiology and antimicrobials therapy of these infections. These include acute and chronic otitis media, mastoiditis and sinusitis, pharyngo-tonsillitis, peritonsillar, retropharyngeal and parapharyngeal abscesses, suppurative thyroiditis, cervical lymphadenitis, parotitis, siliadenitis, and deep neck infections including Lemierre Syndrome. The recovery from these infections depends on prompt and proper medical and when indicated also surgical management. Copyright © 2012 Elsevier Ltd. All rights reserved.

Heat and moisture exchange capacity of the upper respiratory tract and the effect of tracheotomy breathing on endotracheal climate.

PubMed

Scheenstra, Renske J; Muller, Sara H; Vincent, Andrew; Hilgers, Frans J M

2011-01-01

The aim of this study was to assess the heat and moisture exchange (HME) capacity of the upper respiratory tract and the effect of tracheotomy breathing on endotracheal climate in patients with head and neck cancer. We plotted the subglottic temperature and humidity measurements in 10 patients with head and neck cancer with a temporary precautionary tracheotomy during successive 10-minute periods of nose, mouth, and tracheotomy breathing in a randomized sequence. End-inspiratory temperatures of nose, mouth, and tracheotomy breathing were 31.1, 31.3, and 28.3°C, respectively. End-inspiratory humidity measurements of nose, mouth, and tracheotomy breathing were 29.3, 28.6, and 21.1 mgH₂O/L, respectively. There was a trend toward lower end-inspiratory humidity in patients with radiotherapy or with large surgery-induced oropharyngeal mucosal defects, whereas temperatures were similar. This study gives objective information about the HME capacity of the upper respiratory tract in patients with head and neck cancer with precautionary tracheotomy, and thus provides target values for HMEs for laryngectomized and tracheotomized patients. © 2010 Wiley Periodicals, Inc. Head Neck, 2011.

Antigenic characterization of intermediate adenovirus 14-11 strains associated with upper respiratory illness in a military camp.

PubMed Central

Hierholzer, J C; Pumarola, A

1976-01-01

An unusual variant of adenovirus (AV) 11 was isolated from throat and rectal swabs from six persons with upper respiratory illness in a Spanish military camp in March 1969. The same strain was serologically related to the upper respiratory illness of seven other men among 25 sample cases studied in detail. After strain purification, the virus was grouped as an AV by standard biological tests; it possessed the usual titers of group-specific hexon antigen but only low hemagglutinin titers (1:4 to 1:8) with erythrocytes from selected rhesus monkeys. The virus gave little reaction in hemagglutination inhibition (HI) tests with antisera to AV 1 through 35, but was neutralized to homologous titers by AV 11 antiserum. Reciprocally, rabbit and guinea pig antisera to the isolates possessed high HI antibody titers to prototype AV 14 and high serum neutralization (SN) antibody titers to prototype AV 11. On this basis, the variants were classified as AV 14-11 intermediates. Sequential serum specimens from the patients with and without positive cultures showed diagnostic rises in HI and SN antibody levels to the AV 14-11 intermediate and to prototype AV 11, but little response to AV 14. PMID:177365

Influence of mouth opening on oropharyngeal humidification and temperature in a bench model of neonatal continuous positive airway pressure.

PubMed

Fischer, Hendrik S; Ullrich, Tim L; Bührer, Christoph; Czernik, Christoph; Schmalisch, Gerd

2017-02-01

Clinical studies show that non-invasive respiratory support by continuous positive airway pressure (CPAP) affects gas conditioning in the upper airways, especially in the presence of mouth leaks. Using a new bench model of neonatal CPAP, we investigated the influence of mouth opening on oropharyngeal temperature and humidity. The model features the insertion of a heated humidifier between an active model lung and an oropharyngeal head model to simulate the recurrent expiration of heated, humidified air. During unsupported breathing, physiological temperature and humidity were attained inside the model oropharynx, and mouth opening had no significant effect on oropharyngeal temperature and humidity. During binasal CPAP, the impact of mouth opening was investigated using three different scenarios: no conditioning in the CPAP circuit, heating only, and heated humidification. Mouth opening had a strong negative impact on oropharyngeal humidification in all tested scenarios, but heated humidification in the CPAP circuit maintained clinically acceptable humidity levels regardless of closed or open mouths. The model can be used to test new equipment for use with CPAP, and to investigate the effects of other methods of non-invasive respiratory support on gas conditioning in the presence of leaks. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Transendoscopic Nd:YAG ablation of cystic lesions in 27 large animals: 1986-1995

NASA Astrophysics Data System (ADS)

Tate, Lloyd P.

1997-05-01

Hospital medical surgery records and laser logs were examined to determine the population of large animals presented to the College of Veterinary Medicine treated by laser and conventional means for cystic lesions. Cystic lesions were most frequently found in 2 anatomical locations: endometrial cysts and upper respiratory cysts. The majority of endometrial cysts were considered to be acquired, whereas the most frequently encountered upper respiratory cysts were believed to be congenital due to the fact they were most frequently seen in young animals. Nine mares, totaling 42 endometrial cysts, were presented to the Veterinary Teaching Hospital (VTH), all of which had been treated by transendoscopic Nd:YAG laser ablation. Eighteen of the respiratory cysts in the same time period were presented to the VTH, of which 10 received conventional surgery and 8 were laser photoablated. Respiratory cysts treated by conventional surgery were generally found in locations inaccessible to visualization by transendoscopic technique, and thus required a surgical approach under general anesthesia. All mares with endometrial cysts were presented with a history of conception failure. After laser ablation, a majority of the mares were able to carry a foal to term and none represented with recurrence of endometrial cysts. Horses that presented with upper respiratory cysts also did not experience recurrence of cysts; although several horses, 1 treated by laser ablation and 4 treated by conventional surgery for frontal and/or maxillary sinus cysts, had transitory sinusitis. Transendoscopic Nd:YAG photoablation of cysts appears to be a very satisfactory means of treating this particular form of lesion in large animals with minimal complications and it can be performed with the animal in a standing position as an outpatient.

Air pollution and acute respiratory infections among children 0-4 years of age: an 18-year time-series study.

PubMed

Darrow, Lyndsey A; Klein, Mitchel; Flanders, W Dana; Mulholland, James A; Tolbert, Paige E; Strickland, Matthew J

2014-11-15

Upper and lower respiratory infections are common in early childhood and may be exacerbated by air pollution. We investigated short-term changes in ambient air pollutant concentrations, including speciated particulate matter less than 2.5 μm in diameter (PM2.5), in relation to emergency department (ED) visits for respiratory infections in young children. Daily counts of ED visits for bronchitis and bronchiolitis (n = 80,399), pneumonia (n = 63,359), and upper respiratory infection (URI) (n = 359,246) among children 0-4 years of age were collected from hospitals in the Atlanta, Georgia, area for the period 1993-2010. Daily pollutant measurements were combined across monitoring stations using population weighting. In Poisson generalized linear models, 3-day moving average concentrations of ozone, nitrogen dioxide, and the organic carbon fraction of particulate matter less than 2.5 μm in diameter (PM2.5) were associated with ED visits for pneumonia and URI. Ozone associations were strongest and were observed at low (cold-season) concentrations; a 1-interquartile range increase predicted a 4% increase (95% confidence interval: 2%, 6%) in visits for URI and an 8% increase (95% confidence interval: 4%, 13%) in visits for pneumonia. Rate ratios tended to be higher in the 1- to 4-year age group compared with infants. Results suggest that primary traffic pollutants, ozone, and the organic carbon fraction of PM2.5 exacerbate upper and lower respiratory infections in early life, and that the carbon fraction of PM2.5 is a particularly harmful component of the ambient particulate matter mixture. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The role of lipooligosaccharide phosphorylcholine in colonization and pathogenesis of Histophilus somni in cattle.

PubMed

Elswaifi, Shaadi F; Scarratt, William K; Inzana, Thomas J

2012-06-07

Histophilus somni is a Gram-negative bacterium and member of the Pasteurellaceae that is responsible for respiratory disease and other systemic infections in cattle. One of the bacterium's virulence factors is antigenic phase variation of its lipooligosaccharide (LOS). LOS antigenic variation may occur through variation in composition or structure of glycoses or their substitutions, such as phosphorylcholine (ChoP). However, the role of ChoP in the pathogenesis of H. somni disease has not been established. In Haemophilus influenzae ChoP on the LOS binds to platelet activating factor on epithelial cells, promoting bacterial colonization of the host upper respiratory tract. However, ChoP is not expressed in the blood as it also binds C-reactive protein, resulting in complement activation and killing of the bacteria. In order to simulate the susceptibility of calves with suppressed immunity due to stress or previous infection, calves were challenged with bovine herpes virus-1 or dexamethazone 3 days prior to challenge with H. somni. Following challenge, expression of ChoP on the LOS of 2 different H. somni strains was associated with colonization of the upper respiratory tract. In contrast, lack of ChoP expression was associated with bacteria recovered from systemic sites. Histopathology of cardiac tissue from myocarditis revealed lesions containing bacterial clusters that appeared similar to a biofilm. Furthermore, some respiratory cultures contained substantial numbers of Pasteurella multocida, which were not present on preculture screens. Subsequent biofilm experiments have shown that H. somni and P. multocida grow equally well together in a biofilm, suggesting a commensal relationship may exist between the two species. Our results also showed that ChoP contributed to, but was not required for, adhesion to respiratory epithelial cells. In conclusion, expression of ChoP on H. somni LOS contributed to colonization of the bacteria to the host upper respiratory tract, but phase variable loss of ChoP expression may help the bacteria survive systemically.

The role of lipooligosaccharide phosphorylcholine in colonization and pathogenesis of Histophilus somni in cattle

PubMed Central

2012-01-01

Histophilus somni is a Gram-negative bacterium and member of the Pasteurellaceae that is responsible for respiratory disease and other systemic infections in cattle. One of the bacterium’s virulence factors is antigenic phase variation of its lipooligosaccharide (LOS). LOS antigenic variation may occur through variation in composition or structure of glycoses or their substitutions, such as phosphorylcholine (ChoP). However, the role of ChoP in the pathogenesis of H. somni disease has not been established. In Haemophilus influenzae ChoP on the LOS binds to platelet activating factor on epithelial cells, promoting bacterial colonization of the host upper respiratory tract. However, ChoP is not expressed in the blood as it also binds C-reactive protein, resulting in complement activation and killing of the bacteria. In order to simulate the susceptibility of calves with suppressed immunity due to stress or previous infection, calves were challenged with bovine herpes virus-1 or dexamethazone 3 days prior to challenge with H. somni. Following challenge, expression of ChoP on the LOS of 2 different H. somni strains was associated with colonization of the upper respiratory tract. In contrast, lack of ChoP expression was associated with bacteria recovered from systemic sites. Histopathology of cardiac tissue from myocarditis revealed lesions containing bacterial clusters that appeared similar to a biofilm. Furthermore, some respiratory cultures contained substantial numbers of Pasteurella multocida, which were not present on preculture screens. Subsequent biofilm experiments have shown that H. somni and P. multocida grow equally well together in a biofilm, suggesting a commensal relationship may exist between the two species. Our results also showed that ChoP contributed to, but was not required for, adhesion to respiratory epithelial cells. In conclusion, expression of ChoP on H. somni LOS contributed to colonization of the bacteria to the host upper respiratory tract, but phase variable loss of ChoP expression may help the bacteria survive systemically. PMID:22676226

Influenza virus A/Anhui/1/2013 (H7N9) replicates efficiently in the upper and lower respiratory tracts of cynomolgus macaques.

PubMed

de Wit, Emmie; Rasmussen, Angela L; Feldmann, Friederike; Bushmaker, Trenton; Martellaro, Cynthia; Haddock, Elaine; Okumura, Atsushi; Proll, Sean C; Chang, Jean; Gardner, Don; Katze, Michael G; Munster, Vincent J; Feldmann, Heinz

2014-08-12

In March 2013, three fatal human cases of infection with influenza A virus (H7N9) were reported in China. Since then, human cases have been accumulating. Given the public health importance of this virus, we performed a pathogenicity study of the H7N9 virus in the cynomolgus macaque model, focusing on clinical aspects of disease, radiographic, histological, and gene expression profile changes in the upper and lower respiratory tracts, and changes in systemic cytokine and chemokine profiles during infection. Cynomolgus macaques developed transient, mild to severe disease with radiographic evidence of pulmonary infiltration. Virus replicated in the upper as well as lower respiratory tract, with sustained replication in the upper respiratory tract until the end of the experiment at 6 days after inoculation. Virus shedding occurred mainly via the throat. Histopathological changes in the lungs were similar to those observed in humans, albeit less severe, with diffuse alveolar damage, infiltration of polymorphonuclear cells, formation of hyaline membranes, pneumocyte hyperplasia, and fibroproliferative changes. Analysis of gene expression profiles in lung lesions identified pathways involved in tissue damage during H7N9 infection as well as leads for development of therapeutics targeting host responses rather than virus replication. Overall, H7N9 infection was not as severe in cynomolgus macaques as in humans, supporting the possible role of underlying medical complications in disease severity as discussed for human H7N9 infection (H. N. Gao et al., N. Engl. J. Med. 368:2277-2285, 2013, doi:10.1056/NEJMoa1305584). Influenza A virus H7N9 emerged early in 2013, and human cases have continued to emerge since then. Although H7N9 virus-induced disease in humans is often very severe and even lethal, the majority of reported H7N9 cases occurred in older people and people with underlying medical conditions. To better understand the pathogenicity of this virus, healthy cynomolgus macaques were inoculated with influenza A virus H7N9. Cynomolgus macaques were used as a model because the receptor distribution for H7N9 virus in macaques was recently shown to be more similar to that in humans than that of other frequently used animal models. From comparison with previous studies, we conclude that the emerging H7N9 influenza virus was more pathogenic in cynomolgus macaques than seasonal influenza A viruses and most isolates of the pandemic H1N1 virus but less pathogenic than the 1918 Spanish influenza virus or highly pathogenic avian influenza (HPAI) H5N1 virus. Copyright © 2014 de Wit et al.

THE ASSOCIATION OF PNEUMOCOCCI, HEMOPHILUS INFLUENZAE, AND STREPTOCOCCUS HEMOLYTICUS WITH CORYZA, PHARYNGITIS, AND SINUSITIS IN MAN.

PubMed

Webster, L T; Clow, A D

1932-02-29

Pneumococci, H. influenzae, and S. hemolyticus are known to be frequent inhabitants of the upper respiratory tract, but most workers have not recognized any definite relationships between their presence and coryza, sore throat, influenzal, and sinusitis attacks (2-5). Dochez, Shibley, and Mills, however, in their experimental studies of common cold, state that in both the spontaneous and experimentally induced "colds" in anthropoid apes, the "most significant change observed has been the increase of activity on the part of the potential pathogens habitually present in the throat flora. Coincident with the appearance of symptoms, pneumococci, S. hemolyticus, and B. pfeifferi have developed in greatly increased numbers and have spread over a wide area of the nasopharyngeal mucous membranes. These organisms became at this time conspicuous even in the nose, where they are seldom or never present under normal conditions. The same phenomena have not been observed in human beings" (6, 7). The essential facts of the present observations are that persons free of pneumococci, H. influenzae, and S. hemolyticus are in general free of coryza, sore throat, influenzal and sinus attacks; that persons who are occasional or periodic carriers of these organisms may be negative on tests over long healthy periods, but generally become positive during or following attacks and subsequently become negative again; finally, that persons who are chronic carriers show during these illnesses increasing numbers of organisms in the throat and extension of the organisms to the nose. That these organisms may be the actual incitants has been claimed by Park (8); that they are secondary invaders is the view of Shibley, Mills, and Dochez who state as a result of their experimental work on this subject that "the most important significance of viruses of this type [common cold] seems to lie in their capacity to incite activity on the part of the more dangerous pathogenic organisms that infect the upper respiratory tract" (7). The present observations bring out the intimate relationship between these pathogens and upper respiratory tract symptoms, but do not disclose the nature of this relationship. Finally, an addition has been made to the knowledge of the mode of spread of these organisms. A focus of growth and dissemination has been determined in the nasal passages and throat of individuals with chronic upper respiratory tract disease and increases in numbers of the organisms at the focus and their spread to contacts have been related to the winter season and to the occurrence of symptoms in the carrier. The observations suggest that the dosage of these organisms in a community is controlled by the resistance of the carrier and of the contacts. This view is in agreement with the facts derived from studies of native animal infections (9).

Recurrent adult onset Henoch-Schonlein Purpura: a case report.

PubMed

Gaskill, Neil; Guido, Bruce; Magro, Cynthia

2016-08-15

Henoch-Schonlein purpura is an immunoglobulin A (IgA)-immune complex mediated leukocytoclastic vasculitis that classically manifests with palpable purpura, abdominal pain, arthritis, and hematuria or proteinuria. The condition is much more predominant in children (90% of cases) and commonly follows an upper respiratory infection. We present a case of recurrent Henoch-Schonlein purpura (HSP) complicated by nephritis in an adult female initially categorized as IgA nephropathy (IgAN). We review the pathophysiologic basis of HSP nephritis as the variant of HSP accompanied by renal involvement and its pathogenetic commonality with IgA nephropathy.

Post-infectious persistent cough: pathogenesis and therapeutic options.

PubMed

Capristo, Carlo; Rossi, Giovanni A

2017-10-01

Post-infectious cough is a common symptom associated with common colds and/or upper respiratory tract infection. This cough is expected to last for only for few days and resolve spontaneously, whilst when persists for longer than three weeks is defined "persistent" and is associated tickling or an irritating sensation in the throat which often leads to paroxysms of coughing. Persistent post-infectious cough can cause morbidity since it may interfere with usual living. Despite the recent advances in understanding the mechanisms that regulate cough, in physiological and pathological conditions, current therapeutic options for post-infectious cough are little or only moderately effective.

Numerical simulations of targeted delivery of magnetic drug aerosols in the human upper and central respiratory system: a validation study.

PubMed

Kenjereš, Saša; Tjin, Jimmy Leroy

2017-12-01

In the present study, we investigate the concept of the targeted delivery of pharmaceutical drug aerosols in an anatomically realistic geometry of the human upper and central respiratory system. The geometry considered extends from the mouth inlet to the eighth generation of the bronchial bifurcations and is identical to the phantom model used in the experimental studies of Banko et al. (2015 Exp. Fluids 56 , 1-12 (doi:10.1007/s00348-015-1966-y)). In our computer simulations, we combine the transitional Reynolds-averaged Navier-Stokes (RANS) and the wall-resolved large eddy simulation (LES) methods for the air phase with the Lagrangian approach for the particulate (aerosol) phase. We validated simulations against recently obtained magnetic resonance velocimetry measurements of Banko et al. (2015 Exp. Fluids 56 , 1-12. (doi:10.1007/s00348-015-1966-y)) that provide a full three-dimensional mean velocity field for steady inspiratory conditions. Both approaches produced good agreement with experiments, and the transitional RANS approach is selected for the multiphase simulations of aerosols transport, because of significantly lower computational costs. The local and total deposition efficiency are calculated for different classes of pharmaceutical particles (in the 0.1 μm≤ d p ≤10 μm range) without and with a paramagnetic core (the shell-core particles). For the latter, an external magnetic field is imposed. The source of the imposed magnetic field was placed in the proximity of the first bronchial bifurcation. We demonstrated that both total and local depositions of aerosols at targeted locations can be significantly increased by an applied magnetization force. This finding confirms the possible potential for further advancement of the magnetic drug targeting technique for more efficient treatments for respiratory diseases.

Proximity to natural gas wells and reported health status: results of a household survey in Washington County, Pennsylvania.

PubMed

Rabinowitz, Peter M; Slizovskiy, Ilya B; Lamers, Vanessa; Trufan, Sally J; Holford, Theodore R; Dziura, James D; Peduzzi, Peter N; Kane, Michael J; Reif, John S; Weiss, Theresa R; Stowe, Meredith H

2015-01-01

Little is known about the environmental and public health impact of unconventional natural gas extraction activities, including hydraulic fracturing, that occur near residential areas. Our aim was to assess the relationship between household proximity to natural gas wells and reported health symptoms. We conducted a hypothesis-generating health symptom survey of 492 persons in 180 randomly selected households with ground-fed wells in an area of active natural gas drilling. Gas well proximity for each household was compared with the prevalence and frequency of reported dermal, respiratory, gastrointestinal, cardiovascular, and neurological symptoms. The number of reported health symptoms per person was higher among residents living < 1 km (mean ± SD, 3.27 ± 3.72) compared with > 2 km from the nearest gas well (mean ± SD, 1.60 ± 2.14; p = 0.0002). In a model that adjusted for age, sex, household education, smoking, awareness of environmental risk, work type, and animals in house, reported skin conditions were more common in households < 1 km compared with > 2 km from the nearest gas well (odds ratio = 4.1; 95% CI: 1.4, 12.3; p = 0.01). Upper respiratory symptoms were also more frequently reported in persons living in households < 1 km from gas wells (39%) compared with households 1-2 km or > 2 km from the nearest well (31 and 18%, respectively) (p = 0.004). No equivalent correlation was found between well proximity and other reported groups of respiratory, neurological, cardiovascular, or gastrointestinal conditions. Although these results should be viewed as hypothesis generating, and the population studied was limited to households with a ground-fed water supply, proximity of natural gas wells may be associated with the prevalence of health symptoms including dermal and respiratory conditions in residents living near natural gas extraction activities. Further study of these associations, including the role of specific air and water exposures, is warranted.

Effects on asthma and induction of interleukin-8 caused by Asian dust particles collected in western Japan.

PubMed

Watanabe, Masanari; Kurai, Jun; Tomita, Katsuyuki; Sano, Hiroyuki; Abe, Satoshi; Saito, Rumiko; Minato, Sayaka; Igishi, Tadashi; Burioka, Naoto; Sako, Takanori; Yasuda, Kazuhito; Mikami, Masaaki; Kurita, Shinichi; Tokuyasu, Hirokazu; Ueda, Yasuto; Konishi, Tatsuya; Yamasaki, Akira; Aiba, Setsuya; Oshimura, Mitsuo; Shimizu, Eiji

2014-08-01

Asian dust storms (ADS) contain various airborne particles that may augment airway inflammation by increasing the level of interleukin-8. The objective of the study was to investigate the association of exposure to an ADS with worsening of symptoms of adult asthma and the effect of ADS particles on interleukin-8 transcriptional activity. The subjects were 112 patients with mild to moderate asthma who recorded scores for their daily upper and lower respiratory tract symptoms and measured morning peak expiratory flow (PEF) from March to May 2011. Interleukin-8 transcriptional activity was assessed in THP-G8 cells that were exposed to airborne particles collected during days of ADS exposure. Of the 112 patients, 31 had comorbid allergic rhinitis (AR) and/or chronic sinusitis (CS), and had worsened scores for upper respiratory tract symptoms on ADS days compared to non-ADS days. Scores for lower respiratory tract symptoms during ADS days were higher than non-ADS days in all patients. Three patients also had unscheduled hospital visits for exacerbation of asthma on ADS days. However, there was no significant difference in daily morning PEF between ADS and non-ADS days. Airborne particles collected on ADS days induced interleukin-8 transcriptional activity in THP-G8 cells compared to the original soil of the ADS. Exposure to an ADS aggravates upper and lower tract respiratory symptoms in patients with adult asthma. ADS airborne particles may increase airway inflammation through enhancement of interleukin-8 transcriptional activity.

Respiratory diagnostic possibilities during closed circuit anesthesia.

PubMed

Verkaaik, A P; Erdmann, W

1990-01-01

An automatic feed back controlled totally closed circuit system (Physioflex) has been developed for quantitative practice of inhalation anesthesia and ventilation. In the circuit system the gas is moved unidirectionally around by a blower at 70 l/min. In the system four membrane chambers are integrated for ventilation. Besides end-expiratory feed back control of inhalation anesthetics, and inspiratory closed loop control of oxygen, the system offers on-line registration of flow, volume and respiratory pressures as well as a capnogram and oxygen consumption. Alveolar ventilation and static compliance can easily be derived. On-line registration of oxygen consumption has proven to be of value for determination of any impairment of tissue oxygen supply when the oxygen delivery has dropped to critical values. Obstruction of the upper or lower airways are immediately detected and differentiated. Disregulations of metabolism, e.g. in malignant hyperthermia, are seen in a pre-crisis phase (increase of oxygen consumption and of CO2 production), and therapy can be started extremely early and before a disastrous condition has developed. Registration of compliance is only one of the continuously available parameters that guarantee a better and adequate control of lung function (e.g. atalectasis is early detected). The newly developed sophisticated anesthesia device enlarges tremendously the monitoring and respiratory diagnostic possibilities of artificial ventilation, gives new insights in the (patho)physiology and detects disturbances of respiratory parameters and metabolism in an early stage.

[Sliding traсheal plasty in children under extracorporeal membrane oxygenation (first experience in Russia)].

PubMed

Razumovskiĭ, A Iu; Afukov, I I; Kulaev, A D; Alkhasov, A B; Mitupov, Z B; Kulikova, N V; Stepanenko, N S

2015-01-01

To improve the results of surgical treatment of children with extended tracheal stenosis. Since 2013 slidingtraсheal plasty under extracorporeal membrane oxygenation was performed in 4 children aged 1 year 2 months - 4.5 years with extended tracheal stenosis in Children's City Clinical Hospital №13. Patients' weight was from 10,5 to 16 kg. Extended tracheal stenosis and complete cartilag inousrings were confirmed in all patients after peoperative survey. Indications for surgery were based on medical history data, the severity of respiratory failure and survey data. Sliding traсheal plasty by different approach esunder extracorporeal membrane oxygenation was applied in all patients. There were no intraoperative complications. In the study group 1 patient died in remote postoperative period after discharge due to deterioration of his condition caused by upper respiratory tract infection and acute respiratory failure. In immediate postoperative period 1 patient had pronounced growth of granulation tissue in the area of anastomosis followed laser photocoagulation and prolonged intubation. The average ICU-stay was 24 days, the duration of mechanical ventilation - 11 days. Follow-up carefor patients was conducted on terms of 4-6 and 12 months after surgery. In 2 patients moderate complaints of recurrent bronchitis without signs of respiratory insufficiency during 6-8 months postoperatively were observed. In one child complaints were completely absent.

A population-based prospective cohort study examining the influence of early-life respiratory tract infections on school-age lung function and asthma.

PubMed

van Meel, Evelien R; den Dekker, Herman T; Elbert, Niels J; Jansen, Pauline W; Moll, Henriëtte A; Reiss, Irwin K; de Jongste, Johan C; Jaddoe, Vincent W V; Duijts, Liesbeth

2018-02-01

Early-life respiratory tract infections could affect airway obstruction and increase asthma risk in later life. However, results from previous studies are inconsistent. We examined the associations of early-life respiratory tract infections with lung function and asthma in school-aged children. This study among 5197 children born between April 2002 and January 2006 was embedded in a population-based prospective cohort study. Information on physician-attended upper and lower respiratory tract infections until age 6 years (categorised into ≤ 3 and >3-6 years) was obtained by annual questionnaires. Spirometry measures and physician-diagnosed asthma were assessed at age 10 years. Upper respiratory tract infections were not associated with adverse respiratory outcomes. Compared with children without lower respiratory tract infections ≤3 years, children with lower respiratory tract infections ≤3 years had a lower FEV 1 , FVC, FEV 1 :FVC and forced expiratory flow at 75% of FVC (FEF 75 ) (Z-score (95% CI): ranging from -0.22 (-0.31 to -0.12) to -0.12 (-0.21 to -0.03)) and an increased risk of asthma (OR (95% CI): 1.79 (1.19 to 2.59)). Children with lower respiratory tract infections >3-6 years had an increased risk of asthma (3.53 (2.37 to 5.17)) only. Results were not mediated by antibiotic or paracetamol use and not modified by inhalant allergic sensitisation. Cross-lagged modelling showed that results were not bidirectional and independent of preschool wheezing patterns. Early-life lower respiratory tract infections ≤3 years are most consistently associated with lower lung function and increased risk of asthma in school-aged children. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The B. bronchiseptica type III secretion system does not negatively affect the protective immunity induced by influenza A virus vaccines

USDA-ARS?s Scientific Manuscript database

B. bronchiseptica is a widely prevalent respiratory bacterial pathogen that infects a variety of wild and domesticated animals, including swine. Infection results in long-term colonization of the upper respiratory tract resulting in a range of clinical outcomes from asymptomatic carriage to lethal p...

Supplemental Carbon Dioxide Stabilizes the Upper Airway in Volunteers Anesthetized with Propofol.

PubMed

Ruscic, Katarina Jennifer; Bøgh Stokholm, Janne; Patlak, Johann; Deng, Hao; Simons, Jeroen Cedric Peter; Houle, Timothy; Peters, Jürgen; Eikermann, Matthias

2018-05-10

Propofol impairs upper airway dilator muscle tone and increases upper airway collapsibility. Preclinical studies show that carbon dioxide decreases propofol-mediated respiratory depression. We studied whether elevation of end-tidal carbon dioxide (PETCO2) via carbon dioxide insufflation reverses the airway collapsibility (primary hypothesis) and impaired genioglossus muscle electromyogram that accompany propofol anesthesia. We present a prespecified, secondary analysis of previously published experiments in 12 volunteers breathing via a high-flow respiratory circuit used to control upper airway pressure under propofol anesthesia at two levels, with the deep level titrated to suppression of motor response. Ventilation, mask pressure, negative pharyngeal pressure, upper airway closing pressure, genioglossus electromyogram, bispectral index, and change in end-expiratory lung volume were measured as a function of elevation of PETCO2 above baseline and depth of propofol anesthesia. PETCO2 augmentation dose-dependently lowered upper airway closing pressure with a decrease of 3.1 cm H2O (95% CI, 2.2 to 3.9; P < 0.001) under deep anesthesia, indicating improved upper airway stability. In parallel, the phasic genioglossus electromyogram increased by 28% (23 to 34; P < 0.001). We found that genioglossus electromyogram activity was a significant modifier of the effect of PETCO2 elevation on closing pressure (P = 0.005 for interaction term). Upper airway collapsibility induced by propofol anesthesia can be reversed in a dose-dependent manner by insufflation of supplemental carbon dioxide. This effect is at least partly mediated by increased genioglossus muscle activity.

How air pollution influences clinical management of respiratory diseases. A case-crossover study in Milan.

PubMed

Santus, Pierachille; Russo, Antonio; Madonini, Enzo; Allegra, Luigi; Blasi, Francesco; Centanni, Stefano; Miadonna, Antonio; Schiraldi, Gianfranco; Amaducci, Sandro

2012-10-18

Environmental pollution is a known risk factor for multiple diseases and furthermore increases rate of hospitalisations. We investigated the correlation between emergency room admissions (ERAs) of the general population for respiratory diseases and the environmental pollutant levels in Milan, a metropolis in northern Italy. We collected data from 45770 ERAs for respiratory diseases. A time-stratified case-crossover design was used to investigate the association between air pollution levels and ERAs for acute respiratory conditions. The effects of air pollutants were investigated at lag 0 to lag 5, lag 0-2 and lag 3-5 in both single and multi-pollutant models, adjusted for daily weather variables. An increase in ozone (O(3)) levels at lag 3-5 was associated with a 78% increase in the number of ERAs for asthma, especially during the warm season. Exposure to carbon monoxide (CO) proved to be a risk factor for pneumonia at lag 0-2 and in the warm season increased the risk of ERA by 66%. A significant association was found between ERAs for COPD exacerbation and levels of sulphur dioxide (SO(2)), CO, nitrate dioxide (NO(2)), and particulate matter (PM(10) and PM(2.5)). The multipollutant model that includes all pollutants showed a significant association between CO (26%) and ERA for upper respiratory tract diseases at lag 0-2. For chronic obstructive pulmonary disease (COPD) exacerbations, only CO (OR 1.19) showed a significant association. Exposure to environmental pollution, even at typical low levels, can increase the risk of ERA for acute respiratory diseases and exacerbation of obstructive lung diseases in the general population.

Difficult identification of Haemophilus influenzae, a typical cause of upper respiratory tract infections, in the microbiological diagnostic routine

PubMed Central

Hinz, Rebecca; Zautner, Andreas Erich; Hagen, Ralf Matthias

2015-01-01

Haemophilus influenzae is a key pathogen of upper respiratory tract infections. Its reliable discrimination from nonpathogenic Haemophilus spp. is necessary because merely colonizing bacteria are frequent at primarily unsterile sites. Due to close phylogenetic relationship, it is not easy to discriminate H. influenzae from the colonizer Haemophilus haemolyticus. The frequency of H. haemolyticus isolations depends on factors like sampling site, patient condition, and geographic region. Biochemical discrimination has been shown to be nonreliable. Multiplex PCR including marker genes like sodC, fucK, and hpd or sequencing of the 16S rRNA gene, the P6 gene, or multilocus-sequence-typing is more promising. For the diagnostic routine, such techniques are too expensive and laborious. If available, matrix-assisted laser-desorption–ionization time-of-flight mass spectrometry is a routine-compatible option and should be used in the first line. However, the used database should contain well-defined reference spectra, and the spectral difference between H. influenzae and H. haemolyticus is small. Fluorescence in-situ hybridization is an option for less well-equipped laboratories, but the available protocol will not lead to conclusive results in all instances. It can be used as a second line approach. Occasional ambiguous results have to be resolved by alternative molecular methods like 16S rRNA gene sequencing. PMID:25883794

Difficult identification of Haemophilus influenzae, a typical cause of upper respiratory tract infections, in the microbiological diagnostic routine.

PubMed

Hinz, Rebecca; Zautner, Andreas Erich; Hagen, Ralf Matthias; Frickmann, Hagen

2015-03-01

Haemophilus influenzae is a key pathogen of upper respiratory tract infections. Its reliable discrimination from nonpathogenic Haemophilus spp. is necessary because merely colonizing bacteria are frequent at primarily unsterile sites. Due to close phylogenetic relationship, it is not easy to discriminate H. influenzae from the colonizer Haemophilus haemolyticus. The frequency of H. haemolyticus isolations depends on factors like sampling site, patient condition, and geographic region. Biochemical discrimination has been shown to be nonreliable. Multiplex PCR including marker genes like sodC, fucK, and hpd or sequencing of the 16S rRNA gene, the P6 gene, or multilocus-sequence-typing is more promising. For the diagnostic routine, such techniques are too expensive and laborious. If available, matrix-assisted laser-desorption-ionization time-of-flight mass spectrometry is a routine-compatible option and should be used in the first line. However, the used database should contain well-defined reference spectra, and the spectral difference between H. influenzae and H. haemolyticus is small. Fluorescence in-situ hybridization is an option for less well-equipped laboratories, but the available protocol will not lead to conclusive results in all instances. It can be used as a second line approach. Occasional ambiguous results have to be resolved by alternative molecular methods like 16S rRNA gene sequencing.

Therapeutic options for acute cough due to upper respiratory infections in children.

PubMed

Paul, Ian M

2012-02-01

Cough due to upper respiratory tract infections (URIs) is one of the most frequent complaints encountered by pediatric health-care providers, and one of the most disruptive symptoms for children and families. Despite the frequency of URIs, there is limited evidence to support the few therapeutic agents currently available in the United States (US) to treat acute cough due to URI. Published, well-designed, contemporary research supporting the efficacy of narcotics (codeine, hydrocodone) and US Food and Drug Administration (FDA)-approved over-the-counter (OTC) oral antitussives and expectorants (dextromethorphan, diphenhydramine, chlophedianol, and guaifenesin) is absent for URI-associated pediatric cough. Alternatively, honey and topically applied vapor rubs may be effective antitussives.

[Upper respiratory tract infections and sports].

PubMed

Boffi El Amari, Emmanuelle

2010-08-11

Upper respiratory tract infections are frequent in athletes. Mainly of viral origin, they are treated symptomatically. Infectious mononucleosis is associated with an estimated 2% per hundred risk of splenic rupture, which occurs between day four and twenty one of the illness. Therefore return to play guidelines recommend avoiding, exercice during the first twenty one days. Physical exercise seems to influence the immune system, depending on the intensity and length of it. But the relationship between physical exercise and risk of infections remains controversial: some articles showing an increase in risk, whereas others suggesting a certain degree of protection, in athletes. The actual generally accepted working theory is the J-curve proposed by Nieman. This model remains to be formally proven.

Upper Ottawa street landfill site health study.

PubMed Central

Hertzman, C; Hayes, M; Singer, J; Highland, J

1987-01-01

This report describes the design and conduct of two sequential historical prospective morbidity surveys of workers and residents from the Upper Ottawa Street Landfill Site in Hamilton, Ontario. The workers study was carried out first and was a hypothesis-generating study. Workers and controls were administered a health questionnaire, which was followed by an assessment of recall bias through medical chart abstraction. Multiple criteria were used to identify health problems associated with landfill site exposure. Those problems with highest credibility included clusters of respiratory, skin, narcotic, and mood disorders. These formed the hypothesis base in the subsequent health study of residents living adjacent to the landfill site. In that study, the association between mood, narcotic, skin, and respiratory conditions with landfill site exposure was confirmed using the following criteria: strength of association; consistency with the workers study; risk gradient by duration of residence and proximity to the landfill; absence of evidence that less healthy people moved to the area; specificity; and the absence of recall bias. The validity of these associations were reduced by three principal problems: the high refusal rate among the control population; socioeconomic status differences between the study groups; and the fact that the conditions found in excess were imprecisely defined and potentially interchangeable with other conditions. Offsetting these problems were the multiple criteria used to assess each hypothesis, which were applied according to present rules. Evidence is presented that supports the hypothesis that vapors, fumes, or particulate matter emanating from the landfill site, as well as direct skin exposure, may have lead to the health problems found in excess. Evidence is also presented supporting the hypothesis that perception of exposure and, therefore, of risk, may explain the results of the study. However, based on the analyses performed, it is the conclusion of the authors that the adverse effects seen were more likely the result of chemical exposure than of perception of risk. PMID:3691438

Hyperventilation of pregnancy presenting with flaccid quadriparesis due to hypokalaemia secondary to respiratory alkalosis.

PubMed

Santra, Gouranga; Paul, Rudrajit; Das, Shubhabrata; Pradhan, Sourav

2014-06-01

Hyperventilation in pregnancy is a cause of chronic respiratory alkalosis. Alkalosis either metabolic or respiratory may cause intracellular shift of potassium ions that may lead to hypokalaemia. However, the resultant hypokalaemia in respiratory alkalosis is usually mild and does not cause much clinical features. A five-months-pregnant female of the age 25 years presented with sudden onset flaccid weakness of both lower limbs associated with thigh muscle pain followed by weakness of both upper limbs within three days. Subsequent investigation revealed severe hypokalaemia due to acute exacerbation of chronic respiratory alkalosis secondary to hyperventilation of pregnancy, other causes of hypokalaemia being ruled out. Respiratory alkalosis causes tetany and other clinical manifestations. But hypokalaemia and such weakness is rarely found. Thisis probably the first report of this type from India.

Association between breast-feeding and severity of acute viral respiratory tract infection.

PubMed

Vereen, Shanda; Gebretsadik, Tebeb; Hartert, Tina V; Minton, Patricia; Woodward, Kimberly; Liu, Zhouwen; Carroll, Kecia N

2014-09-01

In a cross-sectional analysis of 629 mother-infants dyads, breast-feeding (ever vs. never) was associated with decreased relative odds of a lower versus upper respiratory tract infection (adjusted odds ratio: 0.64; 95% confidence interval: 0.42-0.99). There was not a significant association between breast-feeding and bronchiolitis severity score or length of hospital stay.

42 CFR 482.57 - Condition of participation: Respiratory care services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Respiratory care... HOSPITALS Optional Hospital Services § 482.57 Condition of participation: Respiratory care services. The... following requirements apply if the hospital provides respiratory care service. (a) Standard: Organization...

42 CFR 482.57 - Condition of participation: Respiratory care services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 5 2011-10-01 2011-10-01 false Condition of participation: Respiratory care... HOSPITALS Optional Hospital Services § 482.57 Condition of participation: Respiratory care services. The... following requirements apply if the hospital provides respiratory care service. (a) Standard: Organization...

42 CFR 482.57 - Condition of participation: Respiratory care services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 5 2012-10-01 2012-10-01 false Condition of participation: Respiratory care... HOSPITALS Optional Hospital Services § 482.57 Condition of participation: Respiratory care services. The... following requirements apply if the hospital provides respiratory care service. (a) Standard: Organization...

42 CFR 482.57 - Condition of participation: Respiratory care services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 5 2013-10-01 2013-10-01 false Condition of participation: Respiratory care... HOSPITALS Optional Hospital Services § 482.57 Condition of participation: Respiratory care services. The... following requirements apply if the hospital provides respiratory care service. (a) Standard: Organization...

42 CFR 482.57 - Condition of participation: Respiratory care services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 5 2014-10-01 2014-10-01 false Condition of participation: Respiratory care... HOSPITALS Optional Hospital Services § 482.57 Condition of participation: Respiratory care services. The... following requirements apply if the hospital provides respiratory care service. (a) Standard: Organization...

Response of the macaque nasal epithelium to ambient levels of ozone. A morphologic and morphometric study of the transitional and respiratory epithelium.

PubMed Central

Harkema, J. R.; Plopper, C. G.; Hyde, D. M.; St George, J. A.; Wilson, D. W.; Dungworth, D. L.

1987-01-01

Although ozone (O3)-induced bronchiolitis has been morphologically characterized, effects of O3 on the upper respiratory tract have not been thoroughly investigated. The purpose of this study was to determine whether exposures to ambient levels of O3 induce lesions in the nasal mucosa. Bonnet monkeys were exposed to 0.00, 0.15, or 0.30 ppm O3 for 6 or 90 days, 8 hours/day. After exposure, nasal mucosa was processed for light and electron microscopy. Quantitative changes were evident in the nasal transitional and respiratory epithelium. At 6 or 90 days of exposure to 0.15 or 0.30 ppm O3 lesions consisted of ciliated cell necrosis, shortened cilia, and secretory cell hyperplasia. Inflammatory cell influx was only present at 6 days of exposure. Ultrastructural changes in goblet cells were evident at 90 days. Ambient levels of O3 can induce significant nasal epithelial lesions, which may compromise upper respiratory defense mechanisms. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 PMID:3605312

A Nasal Brush-based Classifier of Asthma Identified by Machine Learning Analysis of Nasal RNA Sequence Data.

PubMed

Pandey, Gaurav; Pandey, Om P; Rogers, Angela J; Ahsen, Mehmet E; Hoffman, Gabriel E; Raby, Benjamin A; Weiss, Scott T; Schadt, Eric E; Bunyavanich, Supinda

2018-06-11

Asthma is a common, under-diagnosed disease affecting all ages. We sought to identify a nasal brush-based classifier of mild/moderate asthma. 190 subjects with mild/moderate asthma and controls underwent nasal brushing and RNA sequencing of nasal samples. A machine learning-based pipeline identified an asthma classifier consisting of 90 genes interpreted via an L2-regularized logistic regression classification model. This classifier performed with strong predictive value and sensitivity across eight test sets, including (1) a test set of independent asthmatic and control subjects profiled by RNA sequencing (positive and negative predictive values of 1.00 and 0.96, respectively; AUC of 0.994), (2) two independent case-control cohorts of asthma profiled by microarray, and (3) five cohorts with other respiratory conditions (allergic rhinitis, upper respiratory infection, cystic fibrosis, smoking), where the classifier had a low to zero misclassification rate. Following validation in large, prospective cohorts, this classifier could be developed into a nasal biomarker of asthma.

Allergic reactions to indoor air pollutants.

PubMed Central

Karol, M H

1991-01-01

Inhalation of airborne chemicals can result in allergic sensitization with episodic pulmonary responses occurring on subsequent exposures. Responses may occur in the upper respiratory tract (rhinitis), the lower respiratory tract (wheeze, bronchospasm) or systemically, for example, a febrile response. The mechanisms underlying these responses are not always clear but include production of reaginic antibody, activation of T-lymphocyte subsets, and release of spasmogenic and inflammatory mediators from pulmonary cell populations. A variety of agents have been associated with elicitation of these reactions including chemical vapors, dusts and particulates, and microbial organisms. As a result of the widespread occurrence of allergy in indoor environments, conditions conducive to development of allergy have received close attention. Agent-related factors include the nature of the chemical, its concentration, and the frequency and length of exposure to the agent. Host-related factors include the sex, age, and race of the host, as well as the general physical well being. The interactive nature of the host's immune system with the environment is the ultimate determinant of allergic disease. PMID:1821377

Humidification during Mechanical Ventilation in the Adult Patient

PubMed Central

Al Ashry, Haitham S.; Modrykamien, Ariel M.

2014-01-01

Humidification of inhaled gases has been standard of care in mechanical ventilation for a long period of time. More than a century ago, a variety of reports described important airway damage by applying dry gases during artificial ventilation. Consequently, respiratory care providers have been utilizing external humidifiers to compensate for the lack of natural humidification mechanisms when the upper airway is bypassed. Particularly, active and passive humidification devices have rapidly evolved. Sophisticated systems composed of reservoirs, wires, heating devices, and other elements have become part of our usual armamentarium in the intensive care unit. Therefore, basic knowledge of the mechanisms of action of each of these devices, as well as their advantages and disadvantages, becomes a necessity for the respiratory care and intensive care practitioner. In this paper, we review current methods of airway humidification during invasive mechanical ventilation of adult patients. We describe a variety of devices and describe the eventual applications according to specific clinical conditions. PMID:25089275

The prevalence of childhood dysphonia: a cross-sectional study.

PubMed

Carding, Paul N; Roulstone, Sue; Northstone, Kate

2006-12-01

There is only very limited information on the prevalence of voice disorders, particularly for the pediatric population. This study examined the prevalence of dysphonia in a large cohort of children (n = 7389) at 8 years of age. Data were collected within a large prospective epidemiological study and included a formal assessment by one of five research speech and language therapists as well as a parental report of their child's voice. Common risk factors that were also analyzed included sex, sibling numbers, asthma, regular conductive hearing loss, and frequent upper respiratory infection. The research clinicians identified a dysphonia prevalence of 6% compared with a parental report of 11%. Both measures suggested a significant risk of dysphonia for children with older siblings. Other measures were not in agreement between clinician and parental reports. The clinician judgments also suggested significant risk factors for sex (male) but not for any common respiratory or otolaryngological conditions that were analyzed. Parental report suggested significant risk factors with respect to asthma and tonsillectomy. These results are discussed in detail.

[Improvement of QOL by advance in the management of respiratory disorders, dysphagia and upper gastrointestinal disorders in children with severe cerebral palsy].

PubMed

Kitazumi, E

1998-05-01

In children with severe cerebral palsy, the daily use of naso-pharyngeal airway, daily chest physiotherapy and adequate posture control markedly improve respiratory disorders and their consequent complications. Non-invasive ventiratory support methods such as nasal IPPV and nasal CPAP can be also effective. Enteral feeding through a naso-jejunal catheter can successfully manage feeding difficulty due to gastroesophageal reflux when surgical treatment is difficult. Exact assessment of aspiration by adequately performed video-fluoroscopic swallowing examination leads to national management of dysphagia. Tube feeding by intermittent oro-gastric catheterization combined with oral feeding is useful way in many dysphagic children. Surgical treatment for prevention of aspiration markedly improves the general condition. These treatments and managements have markedly improved the QOL, of children with severe cerebral palsy in many aspects. Cooperation of pediatricians, parents, school teachers and other community staffs is necessary for appropriate daily management of medical problems of these children.

Immunology and Homeopathy. 4. Clinical Studies—Part 2

PubMed Central

Bellavite, Paolo; Ortolani, Riccardo; Pontarollo, Francesco; Piasere, Valeria; Benato, Giovanni; Conforti, Anita

2006-01-01

The clinical studies on the effectiveness of homeopathy in respiratory allergy (18 randomized trials and 9 observational studies) are described. The literature of common immunologic disorders including also upper respiratory tract infections (URTI) and otorhinolaryngology (reported in part 1), is evaluated and discussed. Most of initial evidence-based research was addressed to the question of whether homeopathic high dilutions are placebos or possess specific effects, but this question has been often equivocal and is still a matter of debate. The evidence demonstrates that in some conditions homeopathy shows significant promise, e.g. Galphimia glauca (low dilutions/potencies) in allergic oculorhinitis, classical individualized homeopathy in otitis and possibly in asthma and allergic complaints, and a few low-potency homeopathic complexes in sinusitis and rhinoconjunctivitis. A general weakness of evidence derives from lack of independent confirmation of reported trials and from presence of conflicting results, as in case of homeopathic immunotherapy and of classical homeopathy for URTI. The suitable methods to evaluate homeopathy effectiveness, without altering the setting of cure, are also analyzed. PMID:17173103

The aetiology of paediatric inflammatory vulvovaginitis.

PubMed

Cuadros, Juan; Mazón, Ana; Martinez, Rocío; González, Pilar; Gil-Setas, Alberto; Flores, Uxua; Orden, Beatriz; Gómez-Herruz, Peña; Millan, Rosario

2004-02-01

Vulvovaginitis is the most common gynaecological problem in prepubertal girls and clear-cut data on the microbial aetiology of moderate to severe infections are lacking. Many microorganisms have been reported in several studies, but frequently the paediatrician does not know the pathogenic significance of an isolate reported in vaginal specimens of girls with vulvovaginitis. A multicentre study was performed, selecting 74 girls aged 2 to 12 years old with a clinical picture of vulvovaginitis and inflammatory cells on Gram stain. All the specimens were cultured following standard microbiological techniques and the paediatricians completed a questionnaire to highlight risk factors after interviewing the parents or tutors. The data were compared with those obtained in a control group of 11 girls without vulvovaginitis attending a clinic. Streptococcus pyogenesand Haemophilus spp.were isolated in 47 and 12 cases, respectively. Upper respiratory infection in the previous month ( P<0.001) and vulvovaginitis in the previous year ( P<0.05) were identified as significant risk factors. Foreign bodies, sexual abuse, poor hygiene and bad socioeconomic situation were not identified as risk factors for the infection. Paediatric inflammatory vulvovaginitis is mainly caused by pathogens of the upper respiratory tract and the most common risk factor for this infection is to have suffered an upper respiratory tract infection in the previous month.

Understanding Phenotypes of Obstructive Sleep Apnea: Applications in Anesthesia, Surgery, and Perioperative Medicine

PubMed Central

Subramani, Yamini; Singh, Mandeep; Wong, Jean; Kushida, Clete A.; Malhotra, Atul; Chung, Frances

2017-01-01

Obstructive sleep apnea (OSA) is a prevalent sleep-disordered breathing with potential long-term major neurocognitive and cardiovascular sequelae. The pathophysiology of OSA varies between individuals and is composed of different underlying mechanisms. Several components including the upper airway anatomy, effectiveness of the upper airway dilator muscles such as the genioglossus, arousal threshold of the individual, and inherent stability of the respiratory control system determine the pathogenesis of OSA. Their recognition may have implications for the perioperative health care team. For example, OSA patients with a high arousal threshold are likely to be sensitive to sedatives and narcotics with a higher risk of respiratory arrest in the perioperative period. Supplemental oxygen therapy can help to stabilize breathing in OSA patients with inherent respiratory instability. Avoidance of supine position can minimize airway obstruction in patients with a predisposition to upper airway collapse in this posture. In this review, the clinically relevant endotypes and phenotypes of OSA are described. Continuous positive airway pressure (CPAP) therapy is the treatment of choice for most patients with OSA but tolerance and adherence can be a problem. Patient-centered individualized approaches to OSA management will be the focus of future research into developing potential treatment options that will help decrease the disease burden and improve treatment effectiveness. PMID:27861433

Second ventilatory threshold from heart-rate variability: valid when the upper body is involved?

PubMed

Mourot, Laurent; Fabre, Nicolas; Savoldelli, Aldo; Schena, Federico

2014-07-01

To determine the most accurate method based on spectral analysis of heart-rate variability (SA-HRV) during an incremental and continuous maximal test involving the upper body, the authors tested 4 different methods to obtain the heart rate (HR) at the second ventilatory threshold (VT(2)). Sixteen ski mountaineers (mean ± SD; age 25 ± 3 y, height 177 ± 8 cm, mass 69 ± 10 kg) performed a roller-ski test on a treadmill. Respiratory variables and HR were continuously recorded, and the 4 SA-HRV methods were compared with the gas-exchange method through Bland and Altman analyses. The best method was the one based on a time-varying spectral analysis with high frequency ranging from 0.15 Hz to a cutoff point relative to the individual's respiratory sinus arrhythmia. The HR values were significantly correlated (r(2) = .903), with a mean HR difference with the respiratory method of 0.1 ± 3.0 beats/min and low limits of agreements (around -6 /+6 beats/min). The 3 other methods led to larger errors and lower agreements (up to 5 beats/min and around -23/+20 beats/min). It is possible to accurately determine VT(2) with an HR monitor during an incremental test involving the upper body if the appropriate HRV method is used.

Respiratory symptoms as health status indicators in workers at ceramics manufacturing facilities.

PubMed

Rondon, Edilaura Nunes; Silva, Regina Maria Veras Gonçalves da; Botelho, Clovis

2011-01-01

To assess the prevalence of respiratory symptoms and their association with sociodemographic variables and with the characteristics of the work environment. A cross-sectional study comprising 464 workers employed at ceramics manufacturing facilities located in the city of Várzea Grande, Brazil. Data were collected by means of a questionnaire comprising questions regarding sociodemographic variables, work environment characteristics, and respiratory symptoms. Data were analyzed by means of prevalence ratios and their respective 95% CIs between the dependent variable (respiratory symptoms) and the other explanatory variables. In the multivariate analysis, two hierarchical models were built, the response variables being "all respiratory symptoms" and "severe respiratory symptoms". In the sample studied, the prevalence of "all respiratory symptoms" was 78%, whereas that of "severe respiratory symptoms" was 35%. The factors associated with "all respiratory symptoms" were gender, age bracket, level of education, type of occupation, exposure to dust, and exposure to chemical products. The factors associated with "severe respiratory symptoms" were level of education, exposure to dust, and exposure to chemical products. Our results indicate the presence of upper and lower airway disease in the population studied.

Interaction Between Allergy and Middle Ear Infection.

PubMed

Oh, Jeong-Hoon; Kim, Woo Jin

2016-09-01

Recent studies have attempted to identify interactions among the causes of otitis media with effusion (OME). This review discusses the interaction between allergy and infection with regard to host and environmental factors in terms of the development of OME. Protection of the upper airway against microbial invasion requires active interaction between the defense mechanisms of the respiratory epithelium, including innate and adaptive immunity, and mechanical factors. The impairment of these defenses due to allergy and/or increased bacterial resistance may lead to increased susceptibility to infectious organisms in the respiratory tract and middle ear mucosa. Recent genetic studies have provided valuable information about the association of Toll-like receptor signaling variations with clinical phenotypes and the risk of infection in the middle ear. Among the causal factors of OME, allergy not only induces an inflammatory reaction in the middle ear cavity but also facilitates the invasion of infectious pathogens. There is also evidence that allergy can affect the susceptibility of patients to infection of the upper respiratory tract, including the middle ear cavity.

Use of a chain écraseur for excision of a pharyngeal granuloma in a cow.

PubMed

Boileau, Mélanie J; Jann, Henry W; Confer, Anthony W

2009-04-01

A 10-year-old Longhorn cow pregnant with a valuable fetus was evaluated because of progressive inspiratory dyspnea of 6 weeks' duration. Physical examination findings were consistent with upper respiratory tract obstruction. A large pedunculated soft tissue mass was evident in the mid-dorsal aspect of the pharynx during palpation and endoscopic examination. Results of microscopic examination of transendoscopic fine-needle aspirates and a biopsy specimen were suggestive of a bacterial granuloma. Transtracheal intubation was performed, and the mass was excised with a chain écraseur. Results of histologic examination were consistent with a diagnosis of actinobacillosis. The owner reported that the cow was doing well without any recurrence of respiratory distress 8 months after surgery. Findings suggested that pharyngeal granuloma resulting from actinobacillosis should be included in the differential diagnoses when examining mature cattle with upper respiratory tract obstruction and that a chain écraseur may be useful for excising soft tissue pharyngeal masses in cattle.

Cortical Drive to Breathe during Wakefulness in Patients with Obstructive Sleep Apnea Syndrome.

PubMed

Launois, Claire; Attali, Valérie; Georges, Marjolaine; Raux, Mathieu; Morawiec, Elise; Rivals, Isabelle; Arnulf, Isabelle; Similowski, Thomas

2015-11-01

The obstructive sleep apnea syndrome (OSAS) involves recurrent sleep-related upper airways (UA) collapse. UA mechanical properties and neural control are altered, imposing a mechanical load on inspiration. UA collapse does not occur during wakefulness, hence arousal-dependent compensation. Experimental inspiratory loading in normal subjects elicits respiratory-related cortical activity. The objective of this study was to test whether awake OSAS patients would exhibit a similar cortical activity. Descriptive physiology study. Sleep laboratory in a large university affiliated tertiary hospital. 26 patients with moderate OSAS according to polysomnography (5 < apnea-hypopnea index [AHI] ≤ 30, n = 14) or severe OSAS (AHI > 30, n = 12); 13 non-OSAS patients for comparison. None. Respiratory time-locked electroencephalographic segments ensemble averaged and analyzed for slow premotor potentials preceding inspiration ("pre-inspiratory potentials" [PIPs]). PIPs were present in 1/13 controls and 11/26 patients (P = 0.0336; 4/14 "moderate" and 7/12 "severe" patients). Awake OSAS patients therefore exhibit respiratory-related cortical activity during quiet breathing significantly more frequently than non-OSAS individuals. The corresponding PIPs resemble those observed during prepared voluntary inspirations and in response to experimental inspiratory loads in normal subjects, which involve a cortical network comprising the supplementary motor area. A respiratory-related cortical activity could contribute to the increased neural drive to upper airway and to inspiratory muscles that has previously been described in obstructive sleep apnea, and could therefore contribute to the arousal-dependent compensation of upper airway abnormalities. Whether or not such cortical compensatory mechanisms have cognitive consequences remains to be determined. © 2015 Associated Professional Sleep Societies, LLC.

Post-160-km race illness rates and decreases in granulocyte respiratory burst and salivary IgA output are not countered by quercetin ingestion.

PubMed

Henson, D; Nieman, D; Davis, J M; Dumke, C; Gross, S; Murphy, A; Carmichael, M; Jenkins, D P; Quindry, J; McAnulty, S; McAnulty, L; Utter, A; Mayer, E

2008-10-01

This study measured the influence of the flavonoid quercetin on immune changes and incidence rates of upper respiratory tract infections in ultramarathoners competing in the 160-km Western States Endurance Run. Sixty-three runners were randomized to quercetin and placebo groups, and under double-blinded methods ingested 1000 mg/day quercetin for 3 wks before, during, and 2 wks after the race. Thirty-nine of the 63 subjects (n = 18 for quercetin, n = 21 for placebo) finished the race and provided blood and saliva samples the morning before the race and 15 - 30 min postrace. Upper respiratory tract infections were assessed during the week before and the 2-wk period after the race using an illness symptom checklist. Race times did not differ significantly between quercetin and placebo groups. Significant pre- to postrace decreases were measured for natural killer cells (43 %), granulocyte respiratory burst activity (55 %), and salivary IgA output (48 %), and increases for neutrophil (288 %) and monocyte (211 %) cell counts, with no significant group differences. Postrace illness rates did not differ between groups. In conclusion, quercetin supplementation for 3 wks before and 2 wks after the Western States Endurance Run had no effect on illness rates, perturbations in leukocyte subset counts, or decreases in granulocyte respiratory burst activity and salivary IgA.

Antimicrobial usage in ambulatory patients with respiratory infections in Taiwan, 2001.

PubMed

Ho, Monto; Hsiung, Chao Agnes; Yu, Hui-Tzu; Chi, Cheng-Liang; Yin, Hsiao-Chuan; Chang, Hong-Jen

2004-02-01

Excess use of antimicrobials by ambulatory patients is a determinant of antimicrobial resistance. This study investigated the types of illnesses for which antimicrobials were prescribed and the amounts prescribed with special emphasis on respiratory infections for the year in which the Bureau of National Health Insurance (BNHI) enforced a policy to restrict antimicrobials for upper respiratory infections. The number of ambulatory patients seen and the types of ambulatory facilities in Taiwan were also described. Raw data were obtained from the BNHI database on every 500 th visit in 2001. Medical diagnoses were categorized according to the ICD-9-CM system. Antimicrobial consumption was expressed in defined daily doses per 1000 population per day (DDD/1000/day). Among the population of 22.3 million in Taiwan, there were 285.8 million ambulatory patient visits (12.8 per person), including 108.9 million visits (4.9 per person) for respiratory infections, of which 62.7 million (2.8 per person) were for upper respiratory infections (URI). Antimicrobial consumption was 19.83 DDD/1000/day [standard error (SE), 0.00055], of which 9.97 DDD/1000/day (SE, 0.00047) were for respiratory infections and 4.03 DDD/1000/day (0.00055) were for URI. 23.6% of visits for URI entailed a prescription for antimicrobials. About two-thirds (66.5%) of ambulatory patients were seen in clinics, mostly private ones, and 67.6% of all antimicrobials were received there. Aminopenicillins and cephalosporins constituted 35.2% and 19.5%, respectively, of antimicrobials prescribed. Despite the new BNHI rule restricting antimicrobial usage for URI, Taiwan still has an excessive number of ambulatory patient visits, especially for respiratory infections and URI. The majority of antimicrobials used were for URI. They were mostly prescribed in private clinics rather than hospital outpatient departments.

Prevention and Treatment of Influenza, Influenza-Like Illness, and Common Cold by Herbal, Complementary, and Natural Therapies.

PubMed

Mousa, Haider Abdul-Lateef

2017-01-01

In recent years viral respiratory tract infections, especially influenza viruses, have had a major impact on communities worldwide as a result of unavailability of effective treatment or vaccine. The frequent alterations in the antigenic structures of respiratory viruses, particularly for RNA viruses, pose difficulties in production of effective vaccines. The unavailability of optimal medication and shortage of effective vaccines suggests the requirement for alternative natural therapies. Several herbal remedies were used for prevention and treatment viral respiratory illnesses. Among those that were found effective included maoto, licorice roots, antiwei, North American ginseng, berries, Echinacea, plants extracted carnosic acid, pomegranate, guava tea, and Bai Shao. There is scientific evidence regarding the effectiveness of several complementary therapies for colds. Oral zinc may reduce the length and severity of a cold. Taking vitamin C supplements on a regular basis only slightly reduces the length and severity of colds. Probiotics were found better than placebo in reducing the number episodes of acute upper respiratory tract infections, the rate of episodes of acute upper respiratory tract infection and reducing antibiotic use. Alkaline diets or drinks might have antiviral properties as in vitro studies demonstrated inactivation effect of alkaline medium on respiratory virus. Earthing might have a natural anti-inflammatory effect for human body. It is now accepted that an overwhelming inflammatory response is the cause of human deaths from avian H5N1 influenza infection. Earthing accelerates immune response following vaccination, as demonstrated by increases of gamma globulin concentration. No in vivo or clinical studies were found that investigate the role of alkalization or earthing on respiratory viral infections. Thus, future studies are recommended to reveal any potential curative effects. © The Author(s) 2016.

Comparative analysis of replication characteristics of BoHV-1 subtypes in bovine respiratory and genital mucosa explants: a phylogenetic enlightenment

PubMed Central

2011-01-01

In general, members of the Alphaherpesvirinae use the epithelium of the upper respiratory and/or genital tract as a preferential site for primary replication. Bovine herpesvirus type 1 (BoHV-1) may replicate at both sites and cause two major clinical entities designated as infectious bovine rhinotracheitis (IBR) and infectious pustular vulvovaginitis/balanoposthitis (IPV/IPB) in cattle. It has been hypothesized that subtype 1.1 invades preferentially the upper respiratory mucosa whereas subtype 1.2 favors replication at the peripheral genital tract. However, some studies are in contrast with this hypothesis. A thorough study of primary replication at both mucosae could elucidate whether or not different BoHV-1 subtypes show differences in mucosa tropism. We established bovine respiratory and genital organ cultures with emphasis on maintenance of tissue morphology and viability during in vitro culture. In a next step, bovine respiratory and genital mucosa explants of the same animals were inoculated with several BoHV-1 subtypes. A quantitative analysis of viral invasion in the mucosa was performed at 0 h, 24 h, 48 h and 72 h post inoculation (pi) by measuring plaque latitude and penetration depth underneath the basement membrane. All BoHV-1 subtypes exhibited a more profound invasion capacity in respiratory tissue compared to that in genital tissue at 24 h pi. However, at 24 h pi plaque latitude was found to be larger in genital tissue compared to respiratory tissue and this for all subtypes. These similar findings among the different subtypes take the edge off the belief of the existence of specific mucosa tropisms of different BoHV-1 subtypes. PMID:21324115

Methemoglobinemia and benzocaine.

PubMed

Moos, Daniel D; Cuddeford, James D

2007-01-01

Benzocaine administration to facilitate upper endoscopic procedures can result in the relatively uncommon but potentially fatal complication known as methemoglobinemia. For this reason, the Veterans Health Administration (VA) announced on February 8, 2006, that they would stop using benzocaine-containing sprays for procedures involving the mouth and throat. Methemoglobinemia should be considered in any patient who demonstrates cyanosis, respiratory distress, headache, lightheadedness, and a dark, chocolate-colored blood after receiving pharyngeal anesthesia. Prompt recognition of this rare (but potentially fatal) condition is important. Once identified, treatment is generally rapid with methylene blue. The patient should be monitored in the intensive care setting for recurrence. Knowledge of this adverse medication reaction is essential for all gastroenterology nurses.

Acute inflammatory edema of the uvula (uvulitis) as a cause of respiratory distress: a case report.

PubMed

Hawke, M; Kwok, P

1987-06-01

Acute inflammatory edema of the uvula (uvulitis) is a relatively rare cause of upper airway distress or obstruction. The authors present a case report of a 37-year-old man who developed an acute cellulitis and edema of the uvula with upper airway distress, which was managed by an emergency uvulectomy.

Replication and Transmission of the Novel Bovine Influenza D Virus in a Guinea Pig Model

PubMed Central

Sreenivasan, Chithra; Thomas, Milton; Sheng, Zizhang; Hause, Ben M.; Collin, Emily A.; Knudsen, David E. B.; Pillatzki, Angela; Nelson, Eric; Wang, Dan; Kaushik, Radhey S.

2015-01-01

ABSTRACT Influenza D virus (FLUDV) is a novel influenza virus that infects cattle and swine. The goal of this study was to investigate the replication and transmission of bovine FLUDV in guinea pigs. Following direct intranasal inoculation of animals, the virus was detected in nasal washes of infected animals during the first 7 days postinfection. High viral titers were obtained from nasal turbinates and lung tissues of directly inoculated animals. Further, bovine FLUDV was able to transmit from the infected guinea pigs to sentinel animals by means of contact and not by aerosol dissemination under the experimental conditions tested in this study. Despite exhibiting no clinical signs, infected guinea pigs developed seroconversion and the viral antigen was detected in lungs of animals by immunohistochemistry. The observation that bovine FLUDV replicated in the respiratory tract of guinea pigs was similar to observations described previously in studies of gnotobiotic calves and pigs experimentally infected with bovine FLUDV but different from those described previously in experimental infections in ferrets and swine with a swine FLUDV, which supported virus replication only in the upper respiratory tract and not in the lower respiratory tract, including lung. Our study established that guinea pigs could be used as an animal model for studying this newly emerging influenza virus. IMPORTANCE Influenza D virus (FLUDV) is a novel emerging pathogen with bovine as its primary host. The epidemiology and pathogenicity of the virus are not yet known. FLUDV also spreads to swine, and the presence of FLUDV-specific antibodies in humans could indicate that there is a potential for zoonosis. Our results showed that bovine FLUDV replicated in the nasal turbinate and lungs of guinea pigs at high titers and was also able to transmit from an infected animal to sentinel animals by contact. The fact that bovine FLUDV replicated productively in both the upper and lower respiratory tracts of guinea pigs, similarly to virus infection in its native host, demonstrates that guinea pigs would be a suitable model host to study the replication and transmission potential of bovine FLUDV. PMID:26378161

Replication and Transmission of the Novel Bovine Influenza D Virus in a Guinea Pig Model.

PubMed

Sreenivasan, Chithra; Thomas, Milton; Sheng, Zizhang; Hause, Ben M; Collin, Emily A; Knudsen, David E B; Pillatzki, Angela; Nelson, Eric; Wang, Dan; Kaushik, Radhey S; Li, Feng

2015-12-01

Influenza D virus (FLUDV) is a novel influenza virus that infects cattle and swine. The goal of this study was to investigate the replication and transmission of bovine FLUDV in guinea pigs. Following direct intranasal inoculation of animals, the virus was detected in nasal washes of infected animals during the first 7 days postinfection. High viral titers were obtained from nasal turbinates and lung tissues of directly inoculated animals. Further, bovine FLUDV was able to transmit from the infected guinea pigs to sentinel animals by means of contact and not by aerosol dissemination under the experimental conditions tested in this study. Despite exhibiting no clinical signs, infected guinea pigs developed seroconversion and the viral antigen was detected in lungs of animals by immunohistochemistry. The observation that bovine FLUDV replicated in the respiratory tract of guinea pigs was similar to observations described previously in studies of gnotobiotic calves and pigs experimentally infected with bovine FLUDV but different from those described previously in experimental infections in ferrets and swine with a swine FLUDV, which supported virus replication only in the upper respiratory tract and not in the lower respiratory tract, including lung. Our study established that guinea pigs could be used as an animal model for studying this newly emerging influenza virus. Influenza D virus (FLUDV) is a novel emerging pathogen with bovine as its primary host. The epidemiology and pathogenicity of the virus are not yet known. FLUDV also spreads to swine, and the presence of FLUDV-specific antibodies in humans could indicate that there is a potential for zoonosis. Our results showed that bovine FLUDV replicated in the nasal turbinate and lungs of guinea pigs at high titers and was also able to transmit from an infected animal to sentinel animals by contact. The fact that bovine FLUDV replicated productively in both the upper and lower respiratory tracts of guinea pigs, similarly to virus infection in its native host, demonstrates that guinea pigs would be a suitable model host to study the replication and transmission potential of bovine FLUDV. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

Oral Probiotics Alter Healthy Feline Respiratory Microbiota.

PubMed

Vientós-Plotts, Aida I; Ericsson, Aaron C; Rindt, Hansjorg; Reinero, Carol R

2017-01-01

Probiotics have been advocated as a novel therapeutic approach to respiratory disease, but knowledge of how oral administration of probiotics influences the respiratory microbiota is needed. Using 16S rRNA amplicon sequencing of bacterial DNA our objective was to determine whether oral probiotics changed the composition of the upper and lower airway, rectal, and blood microbiota. We hypothesized that oral probiotics would modulate the respiratory microbiota in healthy cats, demonstrated by the detection and/or increased relative abundance of the probiotic bacterial species and altered composition of the microbial population in the respiratory tract. Six healthy young research cats had oropharyngeal (OP), bronchoalveolar lavage fluid (BALF), rectal, and blood samples collected at baseline and 4 weeks after receiving oral probiotics. 16S rRNA gene amplicon libraries were sequenced, and coverage, richness, and relative abundance of representative operational taxonomic units (OTUs) were determined. Hierarchical and principal component analyses (PCA) demonstrated relatedness of samples. Mean microbial richness significantly increased only in the upper and lower airways. The number of probiotic OTUs (out of 5 total) that significantly increased in relative abundance vs. baseline was 5 in OP, 3 in BAL and 2 in feces. Using hierarchical clustering, BALF and blood samples grouped together after probiotic administration, and PERMANOVA supported that these two sites underwent significant changes in microbial composition. PERMANOVA revealed that OP and rectal samples had microbial population compositions that did not significantly change. These findings were visualized via PCA, which revealed distinct microbiomes in each site; samples clustered more tightly at baseline and had more variation after probiotic administration. This is the first study describing the effect of oral probiotics on the respiratory microbiota via detection of probiotic species in the airways. Finding bacterial species present in the oral probiotics in the upper and lower airways provides pilot data suggesting that oral probiotics could serve as a tool to target dysbiosis occurring in inflammatory airway diseases such as feline asthma, a disease in which cats serve as an important comparative and translational model for humans.

Oral Probiotics Alter Healthy Feline Respiratory Microbiota

PubMed Central

Vientós-Plotts, Aida I.; Ericsson, Aaron C.; Rindt, Hansjorg; Reinero, Carol R.

2017-01-01

Probiotics have been advocated as a novel therapeutic approach to respiratory disease, but knowledge of how oral administration of probiotics influences the respiratory microbiota is needed. Using 16S rRNA amplicon sequencing of bacterial DNA our objective was to determine whether oral probiotics changed the composition of the upper and lower airway, rectal, and blood microbiota. We hypothesized that oral probiotics would modulate the respiratory microbiota in healthy cats, demonstrated by the detection and/or increased relative abundance of the probiotic bacterial species and altered composition of the microbial population in the respiratory tract. Six healthy young research cats had oropharyngeal (OP), bronchoalveolar lavage fluid (BALF), rectal, and blood samples collected at baseline and 4 weeks after receiving oral probiotics. 16S rRNA gene amplicon libraries were sequenced, and coverage, richness, and relative abundance of representative operational taxonomic units (OTUs) were determined. Hierarchical and principal component analyses (PCA) demonstrated relatedness of samples. Mean microbial richness significantly increased only in the upper and lower airways. The number of probiotic OTUs (out of 5 total) that significantly increased in relative abundance vs. baseline was 5 in OP, 3 in BAL and 2 in feces. Using hierarchical clustering, BALF and blood samples grouped together after probiotic administration, and PERMANOVA supported that these two sites underwent significant changes in microbial composition. PERMANOVA revealed that OP and rectal samples had microbial population compositions that did not significantly change. These findings were visualized via PCA, which revealed distinct microbiomes in each site; samples clustered more tightly at baseline and had more variation after probiotic administration. This is the first study describing the effect of oral probiotics on the respiratory microbiota via detection of probiotic species in the airways. Finding bacterial species present in the oral probiotics in the upper and lower airways provides pilot data suggesting that oral probiotics could serve as a tool to target dysbiosis occurring in inflammatory airway diseases such as feline asthma, a disease in which cats serve as an important comparative and translational model for humans. PMID:28744273

Acute respiratory infections among returning Hajj pilgrims-Jordan, 2014.

PubMed

Al-Abdallat, Mohammad Mousa; Rha, Brian; Alqasrawi, Sultan; Payne, Daniel C; Iblan, Ibrahim; Binder, Alison M; Haddadin, Aktham; Nsour, Mohannad Al; Alsanouri, Tarek; Mofleh, Jawad; Whitaker, Brett; Lindstrom, Stephen L; Tong, Suxiang; Ali, Sami Sheikh; Dahl, Rebecca Moritz; Berman, LaShondra; Zhang, Jing; Erdman, Dean D; Gerber, Susan I

2017-04-01

The emergence of Middle East Respiratory Syndrome coronavirus (MERS-CoV) has prompted enhanced surveillance for respiratory infections among pilgrims returning from the Hajj, one of the largest annual mass gatherings in the world. To describe the epidemiology and etiologies of respiratory illnesses among pilgrims returning to Jordan after the 2014 Hajj. Surveillance for respiratory illness among pilgrims returning to Jordan after the 2014 Hajj was conducted at sentinel health care facilities using epidemiologic surveys and molecular diagnostic testing of upper respiratory specimens for multiple respiratory pathogens, including MERS-CoV. Among the 125 subjects, 58% tested positive for at least one virus; 47% tested positive for rhino/enterovirus. No cases of MERS-CoV were detected. The majority of pilgrims returning to Jordan from the 2014 Hajj with respiratory illness were determined to have a viral etiology, but none were due to MERS-CoV. A greater understanding of the epidemiology of acute respiratory infections among returning travelers to other countries after Hajj should help optimize surveillance systems and inform public health response practices. Published by Elsevier B.V.

Physical examination of the respiratory system.

PubMed

Sharp, Claire R; Rozanski, Elizabeth A

2013-08-01

This article reviews the approach to a patient with respiratory distress, with a focus on clues obtained from the physical examination. Respiratory distress is a common reason for presentation of a companion animal to a veterinarian on an emergency basis, and thus the clinician should have a comfort level with the approach to these patients. Our discussion includes a basic review of respiratory pathophysiology and the differential diagnoses for hypoxemia. In the majority of cases, physical examination should allow localization of the cause of the respiratory problem to the upper airways, lower airways, pleural space, or pulmonary parenchyma. Such localization, coupled with signalment and historical clues, guides additional diagnostics and therapeutics based on the most likely differential diagnoses. Although managing a patient with respiratory distress can be challenging, a systematic approach such as the one presented here should ensure appropriate intervention in a timely fashion and maximize the chance of a good outcome. © 2013 Published by Elsevier Inc.

Treatment of Adenoviral Acute Respiratory Distress Syndrome Using Cidofovir With Extracorporeal Membrane Oxygenation.

PubMed

Lee, Minhyeok; Kim, Seulgi; Kwon, Oh Jung; Kim, Ji Hye; Jeong, Inbeom; Son, Ji Woong; Na, Moon Jun; Yoon, Yoo Sang; Park, Hyun Woong; Kwon, Sun Jung

2017-03-01

Adenovirus infections are associated with respiratory (especially upper respiratory) infection and gastrointestinal disease and occur primarily in infants and children. Although rare in adults, severe lower respiratory adenovirus infections including pneumonia are reported in specific populations, such as military recruits and immunocompromised patients. Antiviral treatment is challenging due to limited clinical experience and lack of well-controlled randomized trials. Several previously reported cases of adenoviral pneumonia showed promising efficacy of cidofovir. However, few reports discussed the efficacy of cidofovir in acute respiratory distress syndrome (ARDS). We experienced 3 cases of adenoviral pneumonia associated with ARDS and treated with cidofovir and respiratory support, including extracorporeal membrane oxygenation (ECMO). All 3 patients showed a positive clinical response to cidofovir and survival at 28 days. Cidofovir with early ECMO therapy may be a therapeutic option in adenoviral ARDS. A literature review identified 15 cases of adenovirus pneumonia associated with ARDS.

Sleep disordered breathing in children with achondroplasia.

PubMed

Zaffanello, Marco; Cantalupo, Gaetano; Piacentini, Giorgio; Gasperi, Emma; Nosetti, Luana; Cavarzere, Paolo; Ramaroli, Diego Alberto; Mittal, Aliza; Antoniazzi, Franco

2017-02-01

Children with achondroplasia often have breathing problems, especially during sleep. The most important treatments are adenotonsillectomy (for treating upper obstruction) and/or neurosurgery (for resolving cervicomedullar junction stenosis). We reviewed the scientific literature on polysomnographic investigations which assessed the severity of respiratory disorders during sleep. Recent findings have highlighted the importance of clinical investigations in patients with achondroplasia, differentiating between those that look for neurological patterns and those that look for respiratory problems during sleep. In particular, magnetic resonance imaging (MRI) and somatosensory evoked potentials are the main tools to evaluate necessary neurosurgery and over myelopathy, respectively. The use of polysomnography enables clinicians to identify children with upper airway obstruction and to quantify disease severity; it is not suitable for MRI and/or neurosurgery considerations.

[Epidemiology of secretory otitis media in children examined at the Otolaryngologic Clinic in Wrocław in 1996-1999].

PubMed

Pośpiech, Lucyna; Rak, Jerzy; Jaworska, Marzena; Klempous, Joanna

2002-01-01

The aim of the work was an evaluation of epidemiological factors in otitis media with effusion (OME) in children. Material consisted of 191 children treated surgically in Wroclaw ENT Clinic. The control group consisted of 95 healthy children. The evaluation was based on detailed history of the patients and physical ORL examination. The factors taken into considerations were: age, sex, birth factors, breast feeding, attending to kindergarten, passive smoking, social and environmental factors, incidents of upper respiratory airways and middle ear infections before OME being diagnosed. Frequent upper respiratory infections, acute and recurrent middle ear infections, staying with other children (kindergarten) and passive smoking increase the risk of OME incidence.

Upper airway sleep-disordered breathing in women.

PubMed

Guilleminault, C; Stoohs, R; Kim, Y D; Chervin, R; Black, J; Clerk, A

1995-04-01

To investigate the various clinical presentations of sleep-disordered breathing in women. A retrospective case-control study. A sleep disorders clinic. 334 women, aged 18 years and older, seen between 1988 and 1993, who were diagnosed with upper airway sleep-disordered breathing. Controls were 60 women with insomnia and 100 men with sleep-disordered breathing. Clinical, anatomic, and polygraphic information. The mean lag time (+/- SD) in women between the appearance of symptoms and a positive diagnosis was 9.7 +/- 3.1 years; among participants 30 to 60 years of age, the duration of untreated symptoms differed (P < 0.001) between women and men. Sleep-disordered breathing was blamed for divorce or social isolation by 40% of the case patients. Abnormal maxillomandibular features were noted in 45% of the women with disordered breathing. Dysmenorrhea and amenorrhea (which disappeared after treatment with nasal continuous positive airway pressure) were reported in 43% of premenopausal women compared with 13% of persons in the control group of women with insomnia. Thirty-eight women (11.4%) with upper airway sleep-disordered breathing had a respiratory disturbance index of less than 5 and were significantly younger, had a smaller neck circumference, and had a lower body mass index than women with a respiratory disturbance index of 5 or more. Physicians should revise their understanding of upper airway sleep-disordered breathing so that they notice women with certain craniofacial features, a low body mass index, a small neck circumference, and a respiratory disturbance index of less than 5. These revisions may enable more rapid diagnosis and treatment of women with sleep-disordered breathing.

REM sleep-like episodes of motoneuronal depression and respiratory rate increase are triggered by pontine carbachol microinjections in in situ perfused rat brainstem preparation.

PubMed

Brandes, Ivo F; Stettner, Georg M; Mörschel, Michael; Kubin, Leszek; Dutschmann, Mathias

2011-05-01

Hypoglossal nerve activity (HNA) controls the position and movements of the tongue. In persons with compromised upper airway anatomy, sleep-related hypotonia of the tongue and other pharyngeal muscles causes increased upper airway resistance, or total upper airway obstructions, thus disrupting both sleep and breathing. Hypoglossal nerve activity reaches its nadir, and obstructive episodes are longest and most severe, during rapid eye movement stage of sleep (REMS). Microinjections of a cholinergic agonist, carbachol, into the pons have been used in vivo to investigate the mechanisms of respiratory control during REMS. Here, we recorded inspiratory-modulated phrenic nerve activity and HNA and microinjected carbachol (25-50 nl, 10 mm) into the pons in an in situ perfused working heart-brainstem rat preparation (WHBP), an ex vivo model previously validated for studies of the chemical and reflex control of breathing. Carbachol microinjections were made into 40 sites in 33 juvenile rat preparations and, at 24 sites, they triggered depression of HNA with increased respiratory rate and little change of phrenic nerve activity, a pattern akin to that during natural REMS in vivo. The REMS-like episodes started 151 ± 73 s (SD) following microinjections, lasted 20.3 ± 4.5 min, were elicited most effectively from the dorsal part of the rostral nucleus pontis oralis, and were prevented by perfusion of the preparation with atropine. The WHBP offers a novel model with which to investigate cellular and neurochemical mechanisms of REMS-related upper airway hypotonia in situ without anaesthesia and with full control over the cellular environment.

A retrospective observational analysis of post-pandemic influenza-related outcomes in the United Kingdom, 2010-2014.

PubMed

Rajaram, Sankarasubramanian; Wiecek, Witold; Lawson, Richard; Blak, Betina; Zhao, Yanli; Hackett, Judith; Brody, Robert; Salimi, Tehseen; Amzal, Billy; Patel, Vishal

2018-02-01

This study set out to evaluate influenza- and respiratory-related illnesses recorded during primary care physician consultations in England following the H1N1 pandemic in 2009 and to enable the development of a dynamic disease model. Data were obtained from the Clinical Practice Research Datalink of primary care records over four influenza seasons (2010-2014). The primary outcome of the study was incidence of influenza- and respiratory-related diagnoses, calculated per practice and by season and age group. Upper respiratory tract infection diagnoses were most frequently recorded (mean seasonal practice level incidence; 3,762 consultations per 100,000 [SD = 1,989]), and influenza-related diagnoses were least frequently recorded across all seasons, except one. Incidence rates for the under 18 population were higher than those for the general population, in particular for upper respiratory tract infection (range of 8,024-9,950 versus 3,228-4,120, respectively) and otitis media diagnoses (2,668-3,652 versus 782-1,057, respectively). For influenza-related diagnoses, the 65+ age group, the 0 to <2 and 2 to <4 groups had a higher risk (risk ratio = 1.33, 1.12 and 1.16, respectively) than other age groups. This study provides valuable insight into the incidence of influenza- and respiratory-related diagnoses in the primary care setting in England, and suggests a higher burden of disease in young children and the elderly. The study also indicates that some influenza illness is likely to be reported under respiratory-related diagnoses, given the low incidence of influenza-related diagnoses in the study.

Descriptive epidemiology of deployment-related medical conditions and shipboard training-related injuries in a Chinese Navy population.

PubMed

Qi, R-R; Wang, J-Q; Pan, L-L; Zhou, W; Liu, J-L; Ju, J-T; Cai, Y-L

2016-12-01

To investigate the deployment-related medical conditions and shipboard tactical training-related injuries in a Chinese Navy population. A retrospective study with the Chinese Navy was conducted. The medical records of 1543 Navy crewmembers from 2011 to 2015 were collected. The distribution and incidence rate (IR) of different types of medical conditions were provided and compared between the Aden Gulf deployment and nondeployment periods. The occurrence of military training-related injuries in crewmembers receiving 12-week shipboard tactical training was compared with that of 956 marines and 4371 recruits receiving combat and physical training, respectively. The anatomic locations and types of training-related injury were analyzed. Compared with the nondeployment period, the percentages of the following injuries were significantly higher during deployment: injuries and certain other consequences of external causes (16.97% vs 7.76%), diseases of the musculoskeletal system and connective tissue (15.40% vs 10.34%) and mental and behavioral disorders (11.23% vs 3.45%); however, respiratory system diseases had a lower percentage (19.84% vs 28.35%). Far seas deployment significantly increased the IRs of acute upper respiratory infection, skin and eye infection, sprains and low back pain as well as aphthous ulcer, insomnia, and seasickness (P < 0.05, 0.01 or 0.001). Shipboard training induced higher IRs of injuries to the upper extremities, spine and back and head and face than physical training and a higher incidence of head and face injury than combat training (P < 0.05 or 0.001). Physical training had higher IRs of overuse injuries than shipboard and combat training (P < 0.001). The IR of fracture was higher during combat and physical training than shipboard training (P < 0.01 and 0.001). The Chinese Navy has experienced novel health issues in crewmembers in recent years. Corresponding countermeasures should be taken to address deployment-related medical conditions and shipboard training-related injuries in the future. Copyright © 2016. Published by Elsevier Ltd.

Risk factors in heating, ventilating, and air-conditioning systems for occupant symptoms in US office buildings: the US EPA BASE study.

PubMed

Mendell, M J; Lei-Gomez, Q; Mirer, A G; Seppänen, O; Brunner, G

2008-08-01

Building-related symptoms in office workers worldwide are common, but of uncertain etiology. One cause may be contaminants related to characteristics of heating, ventilating, and air-conditioning (HVAC) systems. We analyzed data from 97 representative air-conditioned US office buildings in the Building Assessment and Survey Evaluation (BASE) study. Using logistic regression models with generalized estimating equations, we estimated odds ratios (OR) and 95% confidence intervals for associations between building-related symptom outcomes and HVAC characteristics. Outdoor air intakes less than 60 m above ground level were associated with significant increases in most symptoms: e.g. for upper respiratory symptoms, OR for intake heights 30 to 60 m, 0 to <30 m, and below ground level were 2.7, 2.0, and 2.1. Humidification systems with poor condition/maintenance were associated with significantly increased upper respiratory symptoms, eye symptoms, fatigue/difficulty concentrating, and skin symptoms, with OR = 1.5, 1.5, 1.7, and 1.6. Less frequent cleaning of cooling coils and drain pans was associated with significantly increased eye symptoms and headache, with OR = 1.7 and 1.6. Symptoms may be due to microbial exposures from poorly maintained ventilation systems and to greater levels of vehicular pollutants at air intakes nearer the ground level. Replication and explanation of these findings is needed. These findings support current beliefs that moisture-related HVAC components such as cooling coils and humidification systems, when poorly maintained, may be sources of contaminants that cause adverse health effects in occupants, even if we cannot yet identify or measure the causal exposures. While finding substantially elevated risks for poorly maintained humidification systems, relative to no humidification systems, the findings do not identify important (symptom) benefits from well-maintained humidification systems. Findings also provide an initial suggestion, needing corroboration, that outdoor air intakes lower than 18 stories in office buildings may be associated with substantial increases in many symptoms. If this is corroborated and linked to ground-level vehicle emissions, urban ventilation air intakes may need to be located as far above ground level as possible or to incorporate air cleaners that remove gaseous pollutants.

Numerical tool development of fluid-structure interactions for investigation of obstructive sleep apnea

NASA Astrophysics Data System (ADS)

Huang, Chien-Jung; White, Susan; Huang, Shao-Ching; Mallya, Sanjay; Eldredge, Jeff

2016-11-01

Obstructive sleep apnea (OSA) is a medical condition characterized by repetitive partial or complete occlusion of the airway during sleep. The soft tissues in the upper airway of OSA patients are prone to collapse under the low pressure loads incurred during breathing. The ultimate goal of this research is the development of a versatile numerical tool for simulation of air-tissue interactions in the patient specific upper airway geometry. This tool is expected to capture several phenomena, including flow-induced vibration (snoring) and large deformations during airway collapse of the complex airway geometry in respiratory flow conditions. Here, we present our ongoing progress toward this goal. To avoid mesh regeneration, for flow model, a sharp-interface embedded boundary method is used on Cartesian grids for resolving the fluid-structure interface, while for the structural model, a cut-cell finite element method is used. Also, to properly resolve large displacements, non-linear elasticity model is used. The fluid and structure solvers are connected with the strongly coupled iterative algorithm. The parallel computation is achieved with the numerical library PETSc. Some two- and three- dimensional preliminary results are shown to demonstrate the ability of this tool.

Imported case of Middle East respiratory syndrome coronavirus (MERS-CoV) infection from Oman to Thailand, June 2015

PubMed Central

Plipat, Tanarak; Buathong, Rome; Wacharapluesadee, Supaporn; Siriarayapon, Potjaman; Pittayawonganon, Chakrarat; Sangsajja, Chariya; Kaewpom, Thongchai; Petcharat, Sininat; Ponpinit, Teerada; Jumpasri, Jaruphan; Joyjinda, Yutthana; Rodpan, Apaporn; Ghai, Siriporn; Jittmittraphap, Akanitt; Khongwichit, Sarawut; Smith, Duncan R; Corman, Victor M; Drosten, Christian; Hemachudha, Thiravat

2017-01-01

Thailand reported the first Middle East respiratory syndrome (MERS) case on 18 June 2015 (day 4) in an Omani patient with heart condition who was diagnosed with pneumonia on hospital admission on 15 June 2015 (day 1). Two false negative RT-PCR on upper respiratory tract samples on days 2 and 3 led to a 48-hour diagnosis delay and a decision to transfer the patient out of the negative pressure unit (NPU). Subsequent examination of sputum later on day 3 confirmed MERS coronavirus (MERS-CoV) infection. The patient was immediately moved back into the NPU and then transferred to Bamrasnaradura Infectious Disease Institute. Over 170 contacts were traced; 48 were quarantined and 122 self-monitored for symptoms. High-risk close contacts exhibiting no symptoms, and whose laboratory testing on the 12th day after exposure was negative, were released on the 14th day. The Omani Ministry of Health (MOH) was immediately notified using the International Health Regulation (IHR) mechanism. Outbreak investigation was conducted in Oman, and was both published on the World Health Organization (WHO) intranet and shared with Thailand’s IHR focal point. The key to successful infection control, with no secondary transmission, were the collaborative efforts among hospitals, laboratories and MOHs of both countries. PMID:28840828

Limited Interactions between Streptococcus Suis and Haemophilus Parasuis in In Vitro Co-Infection Studies

PubMed Central

Mathieu-Denoncourt, Annabelle; Letendre, Corinne; Auger, Jean-Philippe; Segura, Mariela; Aragon, Virginia; Lacouture, Sonia; Gottschalk, Marcelo

2018-01-01

Streptococcus suis and Haemophilus parasuis are normal inhabitants of the porcine upper respiratory tract but are also among the most frequent causes of disease in weaned piglets worldwide, causing inflammatory diseases such as septicemia, meningitis and pneumonia. Using an in vitro model of infection with tracheal epithelial cells or primary alveolar macrophages (PAMs), it was possible to determine the interaction between S. suis serotype 2 and H. parasuis strains with different level of virulence. Within H. parasuis strains, the low-virulence F9 strain showed higher adhesion levels to respiratory epithelial cells and greater association levels to PAMs than the high-virulence Nagasaki strain. Accordingly, the low-virulence F9 strain induced, in general, higher levels of pro-inflammatory cytokines than the virulent Nagasaki strain from both cell types. In general, S. suis adhesion levels to respiratory epithelial cells were similar to H. parasuis Nagasaki strain. Yet, S. suis strains induced a significantly lower level of pro-inflammatory cytokine expression from epithelial cells and PAMs than those observed with both H. parasuis strains. Finally, this study has shown that, overall and under the conditions used in the present study, S. suis and H. parasuis have limited in vitro interactions between them and use probably different host receptors, regardless to their level of virulence. PMID:29316613

Extracellular DNA Is Essential for Maintaining Bordetella Biofilm Integrity on Abiotic Surfaces and in the Upper Respiratory Tract of Mice

PubMed Central

Deora, Rajendar

2011-01-01

Bacteria form complex and highly elaborate surface adherent communities known as biofilms which are held together by a self-produced extracellular matrix. We have previously shown that by adopting a biofilm mode of existence in vivo, the Gram negative bacterial pathogens Bordetella bronchiseptica and Bordetella pertussis are able to efficiently colonize and persist in the mammalian respiratory tract. In general, the bacterial biofilm matrix includes polysaccharides, proteins and extracellular DNA (eDNA). In this report, we investigated the function of DNA in Bordetella biofilm development. We show that DNA is a significant component of Bordetella biofilm matrix. Addition of DNase I at the initiation of biofilm growth inhibited biofilm formation. Treatment of pre-established mature biofilms formed under both static and flow conditions with DNase I led to a disruption of the biofilm biomass. We next investigated whether eDNA played a role in biofilms formed in the mouse respiratory tract. DNase I treatment of nasal biofilms caused considerable dissolution of the biofilm biomass. In conclusion, these results suggest that eDNA is a crucial structural matrix component of both in vitro and in vivo formed Bordetella biofilms. This is the first evidence for the ability of DNase I to disrupt bacterial biofilms formed on host organs. PMID:21347299

Upper arm anthropometrics versus DXA scan in survivors of acute respiratory distress syndrome.

PubMed

Chan, Kitty S; Mourtzakis, Marina; Aronson Friedman, Lisa; Dinglas, Victor D; Hough, Catherine L; Ely, E Wesley; Morris, Peter E; Hopkins, Ramona O; Needham, Dale M

2018-04-01

Survivors of acute respiratory distress syndrome (ARDS) experience severe muscle wasting. Upper arm anthropometrics can provide a quick, non-invasive estimate of muscle status, but its accuracy is unknown. This study examines the accuracy of upper arm percent muscle area (UAMA) with reference measures of lean mass from dual energy X-ray absorptiometry (DXA). Data are from 120 ARDS survivors participating in a multicenter national study. Receiver operating characteristic (ROC) curves, by patient sex, demonstrated that UAMA did no better than chance in discriminating low appendicular skeletal muscle mass identified using DXA findings (c-statistics, 6 months: 0.50-0.59, 12 months: 0.54-0.57). Modest correlations of UAMA with DXA measures (whole-body: r = 0.46-0.49, arm-specific: r = 0.50-0.51, p < 0.001) and Bland-Altman plots indicate poor precision. UAMA is not an appropriate screening measure for estimating muscle mass when compared to a DXA reference standard. Alternate screening measures should be evaluated in ARDS survivors.

Molecular pathology of emerging coronavirus infections

PubMed Central

Gralinski, Lisa E; Baric, Ralph S

2015-01-01

Respiratory viruses can cause a wide spectrum of pulmonary diseases, ranging from mild, upper respiratory tract infections to severe and life-threatening lower respiratory tract infections, including the development of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). Viral clearance and subsequent recovery from infection require activation of an effective host immune response; however, many immune effector cells may also cause injury to host tissues. Severe acute respiratory syndrome (SARS) coronavirus and Middle East respiratory syndrome (MERS) coronavirus cause severe infection of the lower respiratory tract, with 10% and 35% overall mortality rates, respectively; however, >50% mortality rates are seen in the aged and immunosuppressed populations. While these viruses are susceptible to interferon treatment in vitro, they both encode numerous genes that allow for successful evasion of the host immune system until after high virus titres have been achieved. In this review, we discuss the importance of the innate immune response and the development of lung pathology following human coronavirus infection. PMID:25270030

Parainfluenza

MedlinePlus

Human parainfluenza virus; HPIVs ... There are four types of parainfluenza virus. They can all cause lower or upper respiratory infections in adults and children. The virus can cause croup , bronchiolitis , bronchitis and certain ...

Effects of Clinical Pathways for Common Outpatient Infections on Antibiotic Prescribing

PubMed Central

Jenkins, Timothy C.; Irwin, Amy; Coombs, Letoynia; DeAlleaume, Lauren; Ross, Stephen E.; Rozwadowski, Jeanne; Webster, Brian; Dickinson, L. Miriam; Sabel, Allison L.; MacKenzie, Thomas D.; West, David R.; Price, Connie S.

2013-01-01

Background Antibiotic overuse in the primary care setting is common. Our objective was to evaluate the effect of a clinical pathway-based intervention on antibiotic use. Methods Eight primary care clinics were randomized to receive clinical pathways for upper respiratory infection, acute bronchitis, acute rhinosinusitis, pharyngitis, acute otitis media, urinary tract infection, skin infections, and pneumonia and patient education materials (study group) versus no intervention (control group). Generalized linear mixed effects models were used to assess trends in antibiotic prescriptions for non-pneumonia acute respiratory infections and broad-spectrum antibiotic use for all eight conditions during a 2-year baseline and 1-year intervention period. Results In the study group, antibiotic prescriptions for non-pneumonia acute respiratory infections decreased from 42.7% of cases at baseline to 37.9% during the intervention period (11.2% relative reduction) (p <.0001) and from 39.8% to 38.7%, respectively, in the control group (2.8% relative reduction) (p=0.25). Overall use of broad-spectrum antibiotics in the study group decreased from 26.4% to 22.6% of cases, respectively, (14.4% relative reduction) (p <.0001) and from 20.0% to 19.4%, respectively, in the control group (3.0% relative reduction) (p=0.35). There were significant differences in the trends of prescriptions for acute respiratory infections (p<.0001) and broad-spectrum antibiotic use (p=0.001) between the study and control groups during the intervention period, with greater declines in the study group. Conclusions This intervention was associated with declining antibiotic prescriptions for non-pneumonia acute respiratory infections and use of broad-spectrum antibiotics over the first year. Evaluation of the impact over a longer study period is warranted. PMID:23507206

Occupational allergic diseases in kitchen and health care workers: an underestimated health issue.

PubMed

Bilge, Ugur; Unluoglu, Ilhami; Son, Nazan; Keskin, Ahmet; Korkut, Yasemin; Unalacak, Murat

2013-01-01

This study evaluated the frequencies of allergic symptoms and rate of upper respiratory infections during the past year in the general population, kitchen workers (KW) and health care workers (HCW). The European Community Respiratory Health Survey (ECRHS) was used to inquire retrospectively about asthma and asthma-like symptoms and the number of treatments required for previous upper respiratory tract infections (URTI: acute pharyngitis, acute sinusitis, etc.) during the past year for health care workers, kitchen workers, and members of the general population. Adjusted odds ratios by gender, age, and smoking status were calculated. 579 subjects (186 from the general population, 205 KW, and 188 HCW; 263 females, 316 males) participated in the study. Noninfectious (allergic) rhinitis was significantly higher in the HCW and KW groups than in the general population (P < 0.001). Cumulative asthma was significantly higher only in the HCW group (P < 0.05). In addition, the HCW and KW groups had significantly higher risks of ≥2/year URTI (OR: 1.59, 95% CI: 1.07-2.38 versus OR: 1.57, 95% CI: 1.05-2.38) than the general population. Occupational allergic respiratory diseases are an important and growing health issue. Health care providers should become familiar with workplace environments and environmental causes of occupational rhinitis and asthma.

Perioperative respiratory adverse events in children with active upper respiratory tract infection who received general anesthesia through an orotracheal tube and inhalation agents.

PubMed

Kim, So Yeon; Kim, Jeong Min; Lee, Jae Hoon; Kang, Young Ran; Jeong, Seung Ho; Koo, Bon-Nyeo

2013-08-01

Active upper respiratory tract infection (URI), orotracheal intubation and use of inhalation anesthetics are known risk factors for perioperative respiratory adverse events (RAE). This study investigated the risk factors of perioperative RAE in children with these risk factors. The records of 159 children who underwent general anesthesia with an orotracheal tube and inhalation were reviewed. These patients also had at least one of the following URI symptoms on the day of surgery: clear or green nasal secretion, dry or moist cough, nasal congestion, or fever. RAE such as laryngospasm, bronchospasm, oxygen desaturation and sustained cough were collected before induction, during intubation, during extubation, after extubation and in the postanesthesia care unit. Forty-five patients had RAE. The patients with RAE were younger than those without RAE. There were more passive smokers and a greater number of intubation attempts in patients with RAE than in those without RAE. The type of surgery and type of inhalation agents were not different between patients with and without RAE. Passive smoking was the only independent risk factor for RAE. In children with an active URI using orotracheal tube and inhalation anesthetics, passive smoking is an important risk factor for RAE.

21 CFR 341.3 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... COLD, COUGH, ALLERGY, BRONCHODILATOR, AND ANTIASTHMATIC DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE... used for the relief of the symptoms of hay fever and upper respiratory allergies (allergic rhinitis...

[Primary health care and hospitalizations in ambulatory care sensitive conditions in Catalonia].

PubMed

Caminal Homar, J; Starfield, B; Sánchez Ruiz, E; Hermosilla Pérez, E; Martín Mateo, M

2001-09-01

Ambulatory Care Sensitive Conditions (ACSC) are a set of selected codes of hospital discharge diagnosis intended to measure avoidable hospitalizations. Primary Health Care Services may avoid the hospitalizations due to ACSC by applying any of the following interventions, that are characteristics of this level of care: a) primary prevention; b) secondary prevention, and c) tertiary prevention and rehabilitation. Observational, cross-sectional pilot study on 248,174 hospital discharges, from a population of 2,248,704 inhabitants in 161 Basic Health Care Units (BHCU), recorded in the minimum basic set of hospital discharge data in Catalonia during 1996. The complete list of diagnostic codes of ACSC, identified in the literature search, has been used. Crude and age-standardised hospitalisation rates have been estimated. Standardised hospitalisation ratio (SHR) has been computed to compare hospitalisation rates between BHCU. To analyse the effect of variables associated with high ACSC admission rates, multivariate analysis has been carried out by means of Poisson's regression. Hospitalisation due to ACSC account for 13% of all hospitalizations and 16% of hospital stay days. Acute and chronic diseases of the lower respiratory tract are the first cause of hospitalisation at any age group (< 5, 15-64 and > or = 65 years). The most common diagnostic groups, for all ages are respiratory disorders (acute and chronic diseases of the lower respiratory tract and pneumonia) and urinary tract conditions (pyelonephritis/urinary tract infection). The so-called self-limited health problems (ear, nose and throat mild infections/infections of the upper respiratory tract, febrile convulsions in children and gastroenteritis) account for more than 10% of all hospitalizations by ACSC, 45% of which occur in children. The overall crude hospitalisation rate by ACSC is 146.9/10,000 inhabitants (range: 12.4/10,000-239.9/10,000). SHR ranges from 0.01 to 1.85. "Hospital admissions due to ACSC" is a valid indicator to assess global performance of Primary Health Care and it identifies a part of hospital activity that is amenable to be cared for at Primary Health Care level and therefore potentially avoidable.

Replication of H9 influenza viruses in the human ex vivo respiratory tract, and the influence of neuraminidase on virus release.

PubMed

Chan, Renee W Y; Chan, Louisa L Y; Mok, Chris K P; Lai, Jimmy; Tao, Kin P; Obadan, Adebimpe; Chan, Michael C W; Perez, Daniel R; Peiris, J S Malik; Nicholls, John M

2017-07-24

H9N2 viruses are the most widespread influenza viruses in poultry in Asia. We evaluated the infection and tropism of human and avian H9 influenza virus in the human respiratory tract using ex vivo respiratory organ culture. H9 viruses infected the upper and lower respiratory tract and the majority of H9 viruses had a decreased ability to release virus from the bronchus rather than the lung. This may be attributed to a weak neuraminidase (NA) cleavage of carbon-6-linked sialic acid (Sia) rather than carbon-3-linked Sia. The modified cleavage of N-acetlylneuraminic acid (Neu5Ac) and N-glycolylneuraminic acid (Neu5Gc) by NA in H9 virus replication was observed by reverse genetics, and recombinant H9N2 viruses with amino acids (38KQ) deleted in the NA stalk, and changing the amino acid at position 431 from Proline-to-Lysine. Using recombinant H9 viruses previously evaluated in the ferret, we found that viruses which replicated well in the ferret did not replicate to the same extent in the human ex vivo cultures. The existing risk assessment models for H9N2 viruses in ferrets may not always have a strong correlation with the replication in the human upper respiratory tract. The inclusion of the human ex vivo cultures would further strengthen the future risk-assessment strategies.

Prediction of inspiratory flow shapes during sleep with a mathematic model of upper airway forces.

PubMed

Aittokallio, Tero; Gyllenberg, Mats; Saaresranta, Tarja; Polo, Olli

2003-11-01

To predict the airflow dynamics during sleep using a mathematic model that incorporates a number of static and dynamic upper airway forces, and to compare the numerical results to clinical flow data recorded from patients with sleep-disordered breathing on and off various treatment options. Upper airway performance was modeled in virtual subjects characterized by parameter settings that describe common combinations of risk factors predisposing to upper airway collapse during sleep. The treatments effect were induced by relevant changes of the initial parameter values. Computer simulations at our website (http://www.utu.fi/ml/sovmat/bio/). Risk factors considered in the simulation settings were sex, obesity, pharyngeal collapsibility, and decreased phasic activity of pharyngeal muscles. The effects of weight loss, pharyngeal surgery, nasal continuous positive airway pressure, and respiratory stimulation on the inspiratory flow characteristics were tested with the model. Numerical predictions were investigated by means of 3 measurable inspiratory airflow characteristics: initial slope, total volume, and flow shape. The model was able to reproduce the inspiratory flow shape characteristics that have previously been described in the literature. Simulation results also supported the observations that a multitude of factors underlie the pharyngeal collapse and, therefore, certain medical therapies that are effective in some conditions may prove ineffective in others. A mathematic model integrating the current knowledge of upper airway physiology is able to predict individual treatment responses. The model provides a framework for designing novel and potentially feasible treatment alternatives for sleep-disordered breathing.

A Time-Stratified Case-Crossover Study of Ambient Ozone Exposure and Emergency Department Visits for Specific Respiratory Diagnoses in California (2005–2008)

PubMed Central

Malig, Brian J.; Pearson, Dharshani L.; Chang, Yun Brenda; Broadwin, Rachel; Basu, Rupa; Green, Rochelle S.; Ostro, Bart

2015-01-01

Background: Studies have explored ozone’s connection to asthma and total respiratory emergency department visits (EDVs) but have neglected other specific respiratory diagnoses despite hypotheses relating ozone to respiratory infections and allergic responses. Objective: We examined relationships between ozone and EDVs for respiratory visits, including specifically acute respiratory infections (ARI), asthma, pneumonia, chronic obstructive pulmonary disease (COPD), and upper respiratory tract inflammation (URTI). Methods: We conducted a multi-site time-stratified case-crossover study of ozone exposures for approximately 3.7 million respiratory EDVs from 2005 through 2008 among California residents living within 20 km of an ozone monitor. Conditional logistic regression was used to estimate associations by climate zone. Random effects meta-analysis was then applied to estimate pooled excess risks (ER). Effect modification by season, distance from the monitor and individual demographic characteristics (i.e., age, race/ethnicity, sex, and payment method), and confounding by other gaseous air pollutants were also investigated. Meta-regression was utilized to explore how climate zone–level meteorological, demographic, and regional differences influenced estimates. Results: We observed ozone-associated increases in all respiratory, asthma, and ARI visits, which were slightly larger in the warm season [asthma ER per 10-ppb increase in mean of same and previous 3 days ozone exposure (lag03) = 2.7%, 95% CI: 1.5, 3.9; ARI ERlag03 = 1.4%, 95% CI: 0.8, 1.9]. EDVs for pneumonia, COPD, and URTI were also significantly associated with ozone exposure over the whole year, but typically more consistently so during the warm season. Conclusions: Short-term ozone exposures among California residents living near an ozone monitor were positively associated with EDVs for asthma, ARI, pneumonia, COPD, and URTI from 2005 through 2008. Those associations were typically larger and more consistent during the warm season. Our findings suggest that these outcomes should be considered when evaluating the potential health benefits of reducing ozone concentrations. Citation: Malig BJ, Pearson DL, Chang YB, Broadwin R, Basu R, Green RS, Ostro B. 2016. A time-stratified case-crossover study of ambient ozone exposure and emergency department visits for specific respiratory diagnoses in California (2005–2008). Environ Health Perspect 124:745–753; http://dx.doi.org/10.1289/ehp.1409495 PMID:26647366

Differential suppression of upper airway motor activity during carbachol-induced, REM sleep-like atonia.

PubMed

Fenik, V; Davies, R O; Pack, A I; Kubin, L

1998-10-01

Microinjections of carbachol into the pontine tegmentum of decerebrate cats have been used to study the mechanisms underlying the suppression of postural and respiratory motoneuronal activity during the resulting rapid eye movement (REM) sleep-like atonia. During REM sleep, distinct respiratory muscles are differentially affected; e.g., the activity of the diaphragm shows little suppression, whereas the activity of some upper airway muscles is quite strong. To determine the pattern of the carbachol-induced changes in the activity of different groups of upper airway motoneurons, we simultaneously recorded the efferent activity of the recurrent laryngeal nerve (RL), pharyngeal branch of the vagus nerve (Phar), and genioglossal branch of the hypoglossal (XII) and phrenic (Phr) nerves in 12 decerebrate, paralyzed, vagotomized, and artificially ventilated cats. Pontine carbachol caused a stereotyped suppression of the spontaneous activity that was significantly larger in Phar expiratory (to 8.3% of control) and XII inspiratory motoneurons (to 15%) than in Phr inspiratory (to 87%), RL inspiratory (to 79%), or RL expiratory motoneurons (to 72%). The suppression in upper airway motor output was significantly greater than the depression caused by a level of hypocapnia that reduced Phr activity as much as carbachol. We conclude that pontine carbachol evokes a stereotyped pattern of suppression of upper airway motor activity. Because carbachol evokes a state having many neurophysiological characteristics similar to those of REM sleep, it is likely that pontine cholinoceptive neurons have similar effects on the activity of upper airway motoneurons during both states.

Outbreak of respiratory syncytial virus (RSV) infection in immunocompromised adults on a hematology ward.

PubMed

Jensen, Tomas Ostergaard; Stelzer-Braid, Sacha; Willenborg, Christiana; Cheung, Carol; Andresen, David; Rawlinson, William; Clezy, Kate

2016-10-01

We describe an outbreak of respiratory syncytial virus (RSV) infection on a hematology ward without allogeneic stem cell transplant patients. Twelve patients and one staff member infected with RSV were identified from the laboratory database. Five patients had lower respiratory tract infection, seven had upper respiratory tract infection, one was asymptomatic, and there were two (15.4%) deaths. Most patients had overlapping periods of potential infectiousness on the ward. Sequencing was possible on eight specimens and five of these had identical sequences. Results were consistent with transmission occurring both on the ward and by introduction of RSV from the community. J. Med. Virol. 88:1827-1831, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Physiological changes in women during exercise in cold environments

NASA Astrophysics Data System (ADS)

Murray, S. J.; Shephard, R. J.; Radomski, M. W. M.

1986-12-01

Both the stress of exercise and the stress of a cold environment have been shown to increase the mobilization and utilization of body fat, thereby reducing body fat stores. Much of the research has been done on either rats or male human subjects. The purpose of this research was to show the physiological changes which occur to young, relatively obese, women who exercised during five consecutive days, for 200 min per day, in each of three environmental, chamber conditions: (1) warm-warm (WW), +15‡C; (2) cold-cold (CC), -20‡C; and (3) cold-warm (CW), -20‡C ambient temperature, with +18‡C air pumped to face masks for warmed air breathing. Oxygen cost of exercise, respiratory quotients, energy intake and utilization, and body composition changes were measured before, during, and after each environmental condition. While the respiratory quotients and the skinfold measurements decreased in the colder conditions, the underwater weighing determined percentage body fat did not show the same decrement as the skinfold measures, indicating a possible translocation of body fat from the subcutaneous depots to the deep body fat depots. Body mass loss was significant (P<0.05) only in the WW condition. Thermogenesis would have been centred in the skeletal muscle and liver during the CW condition; however, with facial and upper airway cooling in the CC condition; brown adipose tissue (BAT) hypertrophy may be postulated at this more intense level of cold stress. Due to a greater stability of depot fat in the female, a longer cold exposure would be required to observe the fully developed BAT thermogenesis which would follow after the consequences of fat translocation which we have documented.

Craniofacial embryology and postnatal development of relevant parts of the upper respiratory system.

PubMed

Halewyck, S; Louryan, S; Van Der Veken, P; Gordts, F

2012-01-01

To compare historical and current knowledge relating to the development of the paranasal sinuses, the nose and face, the Eustachian tube and temporal bones, particularly with respect to chronic inflammation during childhood. Traditional literature data, mainly emanating from text books, were supplemented with information based on a non-structured PubMed search covering the last two decades. Historical knowledge has most often been confirmed, sometimes supplemented and only rarely challenged by present-day studies. Recent studies focus mainly on the clinical application of modern imaging techniques. Interest in the development of relevant parts of the upper respiratory system remains as lively as ever. Imaging techniques with low or absent radiation exposure may give rise to a novel field of research, especially with respect to paediatric rhinosinusitis.

Tracheal intubation prevented with administration of Fab antivenom after severe crotaline envenomation.

PubMed

Bebarta, Vikhyat S; Ferre, Robinson M; Peck, Michael

2010-07-01

Crotaline snake envenomations are common, but severe crotaline envenomations are infrequent. Death from severe envenomation is usually from upper airway edema and respiratory failure. Published reports of severe respiratory compromise and anaphylactoid reactions are rare. Currently, FabAV (Crotalidae polyvalent immune Fab [Ovine] [CroFab]) is the mainstay of crotaline envenomation treatment; however, FabAV has been approved for only mild and moderate envenomations. We describe a case of a male with severe systemic effects and airway compromise after crotaline envenomation. The patient's systemic effects and upper airway edema substantially improved after antivenom infusion and before epinephrine administration. Endotracheal intubation was averted, clinical deterioration was avoided, and improvement occurred after prompt FabAV use. Fab antivenom likely prevented endotracheal intubation in our case of severe crotaline envenomation. Published by Elsevier Inc.

Rothia mucilaginosa pneumonia in an immunocompetent patient.

PubMed

Baeza Martínez, Carlos; Zamora Molina, Lucia; García Sevila, Raquel; Gil Carbonell, Joan; Ramos Rincon, José Manuel; Martín Serrano, Concepción

2014-11-01

Rothia mucilaginosa is a gram-postive coccus that occurs as part of the normal flora of the oropharynx and upper respiratory tract. Lower respiratory tract infections caused by this organism are rare and usually occur in immunocompromised patients. This is the case of an immunocompetent 47-year-old woman with right upper lobe pneumonia in which R.mucilaginosa was isolated in sputum and bronchial aspirate. Infections caused by this agent in the last four years in our hospital were reviewed. The most common predisposing factor was COPD with bronchiectasis. R.mucilaginosa was identified as the causative agent for pneumonia in only two cases, of which one was our case and the other was a patient with lung cancer. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

Intervertebral discitis caused by nontypeable Haemophilus influenzae in an adult: Case report.

PubMed

Boulton, R; Swayamprakasam, A; Raza, M

2012-01-01

Haemophilus influenzae is a common cause of bacterial meningitis in children and can cause upper respiratory tract infections in adults, but has yet to be reported solely involving intervertebral discitis. A 67-year-old builder presenting with fever, myalgia and back pain is found to have intervertebral discitis (confirmed on MRI) caused by H. influenzae (identified on blood cultures). A nontypeable form of H. influenzae has not been reported causing discitis. We describe a case in a relatively fit individual who was treated successfully with antimicrobial treatment. A preceding upper respiratory tract infection is the presumed source of infection, predisposed by long-term low-dose steroid therapy. H. influenzae is a rare, but treatable cause of discitis. Copyright © 2012 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Infant anthropometry, early life infection, and subsequent risk of type 1 diabetes mellitus: a prospective birth cohort study.

PubMed

Ponsonby, Anne-Louise; Pezic, Angela; Cochrane, Jennifer; Cameron, Fergus J; Pascoe, Mark; Kemp, Andrew; Dwyer, Terence

2011-06-01

Higher birthweight is associated with increased type 1 diabetes mellitus (T1DM) risk, but the contribution of higher adiposity or lean mass is unclear. In this Tasmanian infant cohort, early upper respiratory infection has been associated with higher asthma risk. Eligible infants represented one-fifth of live births in Tasmania, 1988-1995. Hospital interview data (day 6) were obtained on 96.3% (10 628/11 040), home (5 wk) visit data (38 d) on 92.9% (9876/10 628) of those, then a phone (12 wk) interview (87 d). Tricep and subscapular skinfold measures and upper arm circumference were recorded at the first two interviews. T1DM cases (n = 26) arising from the age of 16 or under in Tasmania from 1988 to 2006 were ascertained. Higher birthweight [adjusted odds ratio (AOR) 2.82 (95% CI 1.31-6.09)], lean mid-upper arm circumference [AOR 1.76 (95% CI 1.16-2.66)], not skinfold measures, were associated with T1DM risk. Children with an early upper respiratory tract infection by 5-wk visit [AOR 2.74 (95% CI 1.19-6.32)] or ear infection by 12-wk interview [AOR 3.44 (95% CI 1.00-11.79)] were also at higher risk. Putative markers of altered microbial exposure such as resident density were not associated with T1DM risk but the effect of increasing birth order on T1DM risk differed for older (AOR 0.41, p = 0.02) than young mother (AOR 2.45, p = 0.01); difference in effect, p = 0.001. In this cohort, early upper respiratory tract infection was associated with T1DM risk, as had been previously found for asthma, consistent with immunoinflammatory upregulation. Using the detailed anthropometric measures available, the link between higher birthweight and T1DM did not appear to reflect increased adiposity. © 2011 John Wiley & Sons A/S.

Assessing the impact of a respiratory diagnosis on smoking cessation.

PubMed

Jones, Alexandra

2017-07-27

The aim of this study was to assess the impact of respiratory diagnoses on smoking cessation. A total of 229 current and former smokers, with and without respiratory diagnoses completed an anonymous online questionnaire assessing how their smoking habit changed when diagnosed with various respiratory conditions. Among all participants the most common reason for quitting smoking was to reduce the risk of health problems in general. In those with a chronic respiratory diagnosis, this was their most common reason for quitting. Motivation to quit smoking, scored by participants on a scale of 0-10, increased at the time of diagnosis then further increased after diagnosis of a chronic respiratory condition but declined after diagnosis of an acute respiratory condition. The research had a small sample size so further research is required. However, important themes are highlighted with the potential to influence clinical practice. All clinicians should receive training to promote cessation at the time of diagnosing respiratory conditions.

Managing respiratory problems in athletes.

PubMed

Hull, James H; Ansley, Les; Robson-Ansley, Paula; Parsons, Jonathan P

2012-08-01

Respiratory problems are common in athletes of all abilities and can significantly impact upon their health and performance. In this article, we provide an overview of respiratory physiology in athletes. We also discuss the assessment and management of common clinical respiratory conditions as they pertain to athletes, including airways disease, respiratory tract infection and pneumothorax. We focus on providing a pragmatic approach and highlight important caveats for the physician treating respiratory conditions in this highly specific population.

Comparison of the FilmArray Respiratory Panel and Prodesse Real-Time PCR Assays for Detection of Respiratory Pathogens ▿ †

PubMed Central

Loeffelholz, M. J.; Pong, D. L.; Pyles, R. B.; Xiong, Y.; Miller, A. L.; Bufton, K. K.; Chonmaitree, T.

2011-01-01

We compared the diagnostic performance and overall respiratory pathogen detection rate of the premarket version of the FilmArray Respiratory Panel (RP) multiplex PCR assay (Idaho Technology, Inc., Salt Lake City, UT) with those of the Food and Drug Administration (FDA)-cleared Prodesse ProFlu+, ProFAST+, ProParaflu+, Pro hMPV+, and ProAdeno+ real-time PCR assays (Gen-Probe, San Diego, CA). The assays were performed on a panel of 192 nasopharyngeal-secretion specimens collected from 81 children under 1 year of age with upper respiratory tract symptoms. To resolve discordant results and confirm pathogens detected only by the larger FilmArray panel, we performed laboratory-developed real-time PCR assays. Among viruses detectable by both commercial assays (adenovirus, human metapneumovirus, influenza A virus, influenza B virus, parainfluenza viruses 1 to 3, and respiratory syncytial virus), the FilmArray and Prodesse assays showed good overall agreement (181/192 [94.3%]; kappa = 0.87; 95% CI, 0.79 to 0.94). FilmArray RP detected more parainfluenza viruses 1 and 3 than ProParaflu+ (18 versus 13) while ProAdeno+ detected more adenoviruses (11 versus 6), but these differences were not statistically significant. Additionally, FilmArray RP detected 138 pathogens (confirmed as true positives) not included in the Prodesse assays (rhinovirus [RV]/enterovirus [EV], 118; bocavirus, 8; coronavirus, 7; parainfluenza virus 4, 4; Mycoplasma pneumoniae, 1). FilmArray RP was cleared by the FDA following the completion of this study. The FDA-cleared version includes the following targets: adenovirus, coronaviruses HKU1 and NL63, human metapneumovirus (hMPV), influenza A virus (to type level only), influenza A H1 seasonal virus, influenza A H3 seasonal virus, influenza A virus H1-2009, influenza B virus, parainfluenza viruses 1 to 4, respiratory syncytial virus (RSV), and RV/EV (no differentiation). The larger panel in the FilmArray RP assay allowed the detection of additional respiratory pathogens compared to the Prodesse assays. In this population of young children with upper respiratory tract infection, RV/EV accounted for the majority of the additional pathogens detected by FilmArray RP. PMID:21998418

Throat swabs in children with respiratory tract infection: associations with clinical presentation and potential targets for point-of-care testing.

PubMed

Thornton, Hannah V; Hay, Alastair D; Redmond, Niamh M; Turnbull, Sophie L; Christensen, Hannah; Peters, Tim J; Leeming, John P; Lovering, Andrew; Vipond, Barry; Muir, Peter; Blair, Peter S

2017-08-01

Diagnostic uncertainty over respiratory tract infections (RTIs) in primary care contributes to over-prescribing of antibiotics and drives antibiotic resistance. If symptoms and signs predict respiratory tract microbiology, they could help clinicians target antibiotics to bacterial infection. This study aimed to determine relationships between symptoms and signs in children presenting to primary care and microbes from throat swabs. Cross-sectional study of children ≥3 months to <16 years presenting with acute cough and RTI, with subset follow-up. Associations and area under receiver operating curve (AUROC) statistics sought between clinical presentation and baseline microbe detection. Microbe prevalence compared between baseline (symptomatic) and follow-up (asymptomatic) visits. At baseline, ≥1 bacteria was detected in 1257/2113 (59.5%) children and ≥1 virus in 894/2127 (42%) children. Clinical presentation was not associated with detection of ≥1 bacteria [AUROC 0.54 (95% CI 0.52-0.56)] or ≥1 virus [0.64 (95% CI 0.61-0.66)]. Individually, only respiratory syncytial virus (RSV) was associated with clinical presentation [AUROC 0.80 (0.77-0.84)]. Prevalence fell between baseline and follow-up; more so in viruses (68% versus 26%, P < 0.001) than bacteria (56% versus 40%, P = 0.01); greatest reductions seen in RSV, influenza B and Haemophilus influenzae. Findings demonstrate that clinical presentation cannot distinguish the presence of bacteria or viruses in the upper respiratory tract. However, individual and overall microbe prevalence was greater when children were unwell than when well, providing some evidence that upper respiratory tract microbes may be the cause or consequence of the illness. If causal, selective microbial point-of-care testing could be beneficial. © The Author 2017. Published by Oxford University Press.

Respiratory muscle function in patients with cystic fibrosis.

PubMed

Dassios, Theodore; Katelari, Anna; Doudounakis, Stavros; Mantagos, Stefanos; Dimitriou, Gabriel

2013-09-01

Respiratory muscle function in patients with cystic fibrosis (CF) can be assessed by measurement of maximal inspiratory pressure (Pimax ), maximal expiratory pressure (Pemax ), and pressure-time index of the respiratory muscles (PTImus ). We investigated the differences in maximal respiratory pressures and PTImus between CF patients with no gross hyperinflation and healthy controls and described the effects of pulmonary function and nutrition impairment on respiratory muscle function in this group of CF patients. Forced expiratory volume in 1 sec (FEV1 ), forced vital capacity (FVC) and maximal expiratory flow between 25% and 75% of VC (MEF25-75 ), body mass index (BMI), upper arm muscle area (UAMA), Pimax , Pemax , and PTImus were assessed in 140 CF patients and in a control group of 140 healthy subjects matched for age and gender. Median Pimax and Pemax were significantly lower in CF patients compared to the controls [Pimax  = 74 (57-94) in CF vs. 84 (66-102) in controls, P = 0.009], [Pemax  = 71 (50-95) in CF vs. 84 (66-102) in controls, P < 0.001]. Median PTImus in CF patients compared to controls was significantly increased [PTImus  = 0.110 (0.076-0.160) in CF vs. 0.094 (0.070-0.137) in controls, P = 0.049] and it was significantly higher in CF patients with impaired pulmonary function. In CF patients, PTImus was significantly negatively related to upper arm muscle area (r = 0.184, P = 0.031). These findings suggest that CF patients with no severe lung disease compared to healthy subjects exhibit impaired respiratory muscle function, while CF patients with impaired pulmonary function and nutrition indices exhibit higher PTImus values. Copyright © 2012 Wiley Periodicals, Inc.

[Analysis of related factors of recurrent otitis media with effusion in children].

PubMed

Zhu, Z; Zheng, G X; Li, Q; Shi, Q L; Zhou, H G; Fang, R P

2017-08-05

Objective: To investigate the influencing factors of recurrent episodes of otitis media with effusion in children. Method: A retrospective summary of the clinical data of 210 cases of children with otitis media with effusion, 75 cases of recurrence after treatment, 135 cases were recovered, the recurrence of the related factors and after symptomatic treatment effect is analyzed. Result: Logistic regression analysis results found that adenoid hypertrophy (Ⅲ°, Ⅳ°), tonsil hypertrophy (Ⅳ°) and sinusitis (including choanal polyp), a positive allergens, upper respiratory tract infection, the stomach esophagus regurgitation, cleft palate, younger age has significant effect on recurrence of otitis media with effusion, have significant difference ( P < 0.05). And the influence of duration, gender, passive smoking history and previous medical history of otitis media with effusion has no obvious statistical significance ( P > 0.05). Through the comparison among different age groups, adenoidectomy Ⅲ °, Ⅳ ° hypertrophy tract infections in > 3-6 years old group has significant effect ( P < 0.05), recurrent respiratory tract infections in less than 3 years old group and the group of children aged > 3-6 years OME recurrence has significant effect ( P < 0.05). By tympanocentesis or tympanostomy tube insertion and according to different conditions to take symptomatic treatment, 75 cases (123 ears) were cured 96 ears (78.05%), 19 ears were improved (15.45%), the total effective rate was 93.50%, ineffective in 8 ears (6.50%). Conclusion: Adenoid hypertrophy (Ⅲ°, Ⅳ°), tonsil hypertrophy (Ⅳ°), sinusitis, nasal polyps, allergic diseases and upper respiratory tract infection gastroesophageal reflux, cleft palate and younger age may be adverse factors related to recurrent otitis media with effusion in children, the clinical doctors should pay attention to these symptoms, according to different causes, adopt individualized treatment plan, make children get the best treatment as soon as possible. Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.

Methyl methacrylate and respiratory sensitization: A Critical review

PubMed Central

Borak, Jonathan; Fields, Cheryl; Andrews, Larry S; Pemberton, Mark A

2011-01-01

Methyl methacrylate (MMA) is a respiratory irritant and dermal sensitizer that has been associated with occupational asthma in a small number of case reports. Those reports have raised concern that it might be a respiratory sensitizer. To better understand that possibility, we reviewed the in silico, in chemico, in vitro, and in vivo toxicology literature, and also epidemiologic and occupational medicine reports related to the respiratory effects of MMA. Numerous in silico and in chemico studies indicate that MMA is unlikely to be a respiratory sensitizer. The few in vitro studies suggest that MMA has generally weak effects. In vivo studies have documented contact skin sensitization, nonspecific cytotoxicity, and weakly positive responses on local lymph node assay; guinea pig and mouse inhalation sensitization tests have not been performed. Cohort and cross-sectional worker studies reported irritation of eyes, nose, and upper respiratory tract associated with short-term peaks exposures, but little evidence for respiratory sensitization or asthma. Nineteen case reports described asthma, laryngitis, or hypersensitivity pneumonitis in MMA-exposed workers; however, exposures were either not well described or involved mixtures containing more reactive respiratory sensitizers and irritants.The weight of evidence, both experimental and observational, argues that MMA is not a respiratory sensitizer. PMID:21401327

REM sleep-like episodes of motoneuronal depression and respiratory rate increase are triggered by pontine carbachol microinjections in in situ perfused rat brainstem preparation

PubMed Central

Brandes, Ivo F.; Stettner, Georg M.; Mörschel, Michael; Kubin, Leszek; Dutschmann, Mathias

2015-01-01

Hypoglossal nerve activity (HNA) controls the position and movements of the tongue. In persons with compromised upper airway anatomy, sleep-related hypotonia of the tongue and other pharyngeal muscles causes increased upper airway resistance, or total upper airway obstructions, thus disrupting both sleep and breathing. Hypoglossal nerve activity reaches its nadir, and obstructive episodes are longest and most severe, during rapid eye movement stage of sleep (REMS). Microinjections of a cholinergic agonist, carbachol, into the pons have been used in vivo to investigate the mechanisms of respiratory control during REMS. Here, we recorded inspiratory-modulated phrenic nerve activity and HNA and microinjected carbachol (25–50 nl, 10 mm) into the pons in an in situ perfused working heart–brainstem rat preparation (WHBP), an ex vivo model previously validated for studies of the chemical and reflex control of breathing. Carbachol microinjections were made into 40 sites in 33 juvenile rat preparations and, at 24 sites, they triggered depression of HNA with increased respiratory rate and little change of phrenic nerve activity, a pattern akin to that during natural REMS in vivo. The REMS-like episodes started 151±73 s (SD) following microinjections, lasted 20.3±4.5 min, were elicited most effectively from the dorsal part of the rostral nucleus pontis oralis, and were prevented by perfusion of the preparation with atropine. The WHBP offers a novel model with which to investigate cellular and neurochemical mechanisms of REMS-related upper airway hypotonia in situ without anaesthesia and with full control over the cellular environment. PMID:21335420

Runny Nose

MedlinePlus

... congestion causes trouble nursing or makes breathing difficult. Self-care Until you see your doctor, try these ... Upper respiratory tract infections. In: Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, Pa.: Saunders ...

Meningitis and septicemia caused by nontypeable Haemophilus influenzae in a previously healthy 2-year-old girl.

PubMed

Ito, Takao; Shibata, Hironori; Nakazawa, Mie; Myokai, Michiko; Ikegaya, Kazuko; Tsuchiya, Ken; Kamimaki, Tsutomu

2011-08-01

Nontypeable Haemophilus influenzae (NTHi) commonly colonizes the upper respiratory tract of children and causes otitis media, sinusitis, and bronchitis. Invasive NTHi diseases such as meningitis and septicemia have rarely been reported, especially in children with underlying predisposing conditions such as head trauma and immune compromise. However, we report a previously healthy 2-year-old girl who developed meningitis and septicemia caused by NTHi biotype ΙΙΙ. She was treated with dexamethasone, meropenem, and ceftriaxone, and recovered uneventfully. We wish to emphasize that NTHi should be borne in mind as a potential pathogen that can cause meningitis and septicemia, even in previously healthy children.

Correlation Between Occurrence and Deterioration of Respiratory Diseases and Air Pollution Within the Legally Permissible Limits.

PubMed

Trnjar, Kristina; Pintarić, Sanja; Mornar Jelavić, Marko; Nesek, Višnja; Ostojić, Jelena; Pleština, Sanja; Šikić, Aljoša; Pintarić, Hrvoje

2017-06-01

The aim of the study was to investigate the unknown effect of air pollutants on the occurrence or deterioration of respiratory diseases in the area with a humid continental climate. This retrospective study included 5868 patients with respiratory symptomatology (upper respiratory tract infection (URTI), pneumonia, acute bronchitis, chronic obstructive pulmonary disease (COPD), and asthma) admitted to emergency department (ED). The number of patients, values of meteorological parameters (mean daily values of air temperature pressure and relative humidity) and concentrations of air pollution particles (≤10 μm (PM10), ozone (O3) and nitrogen dioxide (NO2)) were collected during a two-year ( July 2008 - June 2010) period. There were 1839 (31.3%), 1712 (29.2%), 1313 (22.4%), 614 (10.5%) and 390 (6.6%) patients with pneumonia, COPD, URTI, acute bronchitis and asthma, respectively. The mean daily concentrations of NO2 (25.9 (1.7-89.7) μg/m3), O3 (47.1 (4.7-135.4) μg/m3) and PM10 particles (25.7 (4.6-146.6) μg/m3) were below the legally defined thresholds. Among other results, the occurrence of respiratory diseases showed positive Spearman's correlation with the values of air humidity (days 0-3, r=0.15 to 0.19), PM10(days 0-3, r=0.10 to 0.13) and NO2 concentrations (day 0, r=0.11), and negative correlation with the values of air temperature (days 0-3, r=-0.36 to -0.34), pressure (day 0, r=-0.10) and O3 concentrations (days 0-3, r=-0.21 to -0.22) (p<0.05 all). In conclusion, the occurrence of respiratory diseases showed correlation with weather conditions and air pollutants despite the legally permitted values in the region with a humid continental climate.

Limited pathogenicity and transmissibility of Korean highly pathogenic avian influenza H5N6 clade 2.3.4.4 in ferrets.

PubMed

Noh, J-Y; Lee, D-H; Yuk, S-S; Kwon, J-H; Tseren-Ochir, E-O; Hong, W-T; Jeong, J-H; Jeong, S; Song, C-S

2018-04-19

The pathogenicity and transmissibility of a reassortant clade 2.3.4.4 avian influenza A (H5N6) virus were evaluated in ferrets. Virus excretion was detected in the upper respiratory tract, but the ferrets did not show any clinical signs of infection. Transmission did not occur between cohoused or respiratory droplet-contact ferrets. © 2018 Blackwell Verlag GmbH.

Housing and respiratory health at older ages.

PubMed

Webb, E; Blane, D; de Vries, Robert

2013-03-01

A large proportion of the population of England live in substandard housing. Previous research has suggested that poor-quality housing, particularly in terms of cold temperatures, mould, and damp, poses a health risk, particularly for older people. The present study aimed to examine the association between housing conditions and objectively measured respiratory health in a large general population sample of older people in England. Data on housing conditions, respiratory health and relevant covariates were obtained from the second wave of the English Longitudinal Study of Ageing. Multivariate regression methods were used to test the association between contemporary housing conditions and respiratory health while accounting for the potential effect of other factors; including social class, previous life-course housing conditions and childhood respiratory health. Older people who were in fuel poverty or who did not live in a home they owned had significantly worse respiratory health as measured by peak expiratory flow rates. After accounting for covariates, these factors had no effect on any other measures of respiratory health. Self-reported housing problems were not consistently associated with respiratory health. The housing conditions of older people in England, particularly those associated with fuel poverty and living in rented accommodation, may be harmful to some aspects of respiratory health. This has implications for upcoming UK government housing and energy policy decisions.

Plastic wall materials in the home and respiratory health in young children.

PubMed Central

Jaakkola, J J; Verkasalo, P K; Jaakkola, N

2000-01-01

OBJECTIVES: The relation between the presence of plastic wall materials in the home and respiratory health in children was assessed. METHODS: This population-based cross-sectional study involved 2568 Finnish children aged 1 to 7 years. RESULTS: In logistic regression models, lower respiratory tract symptoms--persistent wheezing (adjusted odds ratio [OR] = 3.42, 95% confidence interval [CI] = 1.13, 10.36), cough (OR = 2.41, 95% CI = 1.04, 5.63), and phlegm (OR = 2.76, 95% CI = 1.03, 7.41)--were strongly related to the presence of plastic wall materials, whereas upper respiratory symptoms were not. The risk of asthma (OR = 1.52, 95% CI = 0.35, 6.71) and pneumonia (OR = 1.81, 95% CI = 0.62, 5.29) was also increased in children exposed to such materials. CONCLUSIONS: Emissions from plastic materials indoors may have adverse effects on the lower respiratory tracts of small children. PMID:10800434

Control of abdominal muscles by brain stem respiratory neurons in the cat

NASA Technical Reports Server (NTRS)

Miller, Alan D.; Ezure, Kazuhisa; Suzuki, Ichiro

1985-01-01

The nature of the control of abdominal muscles by the brain stem respiratory neurons was investigated in decerebrate unanesthetized cats. First, it was determined which of the brain stem respiratory neurons project to the lumbar cord (from which the abdominal muscles receive part of their innervation), by stimulating the neurons monopolarly. In a second part of the study, it was determined if lumbar-projecting respiratory neurons make monosynaptic connections with abdominal motoneurons; in these experiments, discriminate spontaneous spikes of antidromically acivated expiratory (E) neurons were used to trigger activity from both L1 and L2 nerves. A large projection was observed from E neurons in the caudal ventral respiratory group to the contralateral upper lumber cord. However, cross-correlation experiments found only two (out of 47 neuron pairs tested) strong monosynaptic connections between brain stem neurons and abdominal motoneurons.

Incentive spirometry for prevention of postoperative pulmonary complications in upper abdominal surgery.

PubMed

do Nascimento Junior, Paulo; Módolo, Norma S P; Andrade, Sílvia; Guimarães, Michele M F; Braz, Leandro G; El Dib, Regina

2014-02-08

This is an update of a Cochrane Review first published in The Cochrane Library 2008, Issue 3.Upper abdominal surgical procedures are associated with a high risk of postoperative pulmonary complications. The risk and severity of postoperative pulmonary complications can be reduced by the judicious use of therapeutic manoeuvres that increase lung volume. Our objective was to assess the effect of incentive spirometry compared to no therapy or physiotherapy, including coughing and deep breathing, on all-cause postoperative pulmonary complications and mortality in adult patients admitted to hospital for upper abdominal surgery. Our primary objective was to assess the effect of incentive spirometry (IS), compared to no such therapy or other therapy, on postoperative pulmonary complications and mortality in adults undergoing upper abdominal surgery.Our secondary objectives were to evaluate the effects of IS, compared to no therapy or other therapy, on other postoperative complications, adverse events, and spirometric parameters. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 8), MEDLINE, EMBASE, and LILACS (from inception to August 2013). There were no language restrictions. The date of the most recent search was 12 August 2013. The original search was performed in June 2006. We included randomized controlled trials (RCTs) of IS in adult patients admitted for any type of upper abdominal surgery, including patients undergoing laparoscopic procedures. Two authors independently assessed trial quality and extracted data. We included 12 studies with a total of 1834 participants in this updated review. The methodological quality of the included studies was difficult to assess as it was poorly reported, so the predominant classification of bias was 'unclear'; the studies did not report on compliance with the prescribed therapy. We were able to include data from only 1160 patients in the meta-analysis. Four trials (152 patients) compared the effects of IS with no respiratory treatment. We found no statistically significant difference between the participants receiving IS and those who had no respiratory treatment for clinical complications (relative risk (RR) 0.59, 95% confidence interval (CI) 0.30 to 1.18). Two trials (194 patients) IS compared incentive spirometry with deep breathing exercises (DBE). We found no statistically significant differences between the participants receiving IS and those receiving DBE in the meta-analysis for respiratory failure (RR 0.67, 95% CI 0.04 to 10.50). Two trials (946 patients) compared IS with other chest physiotherapy. We found no statistically significant differences between the participants receiving IS compared to those receiving physiotherapy in the risk of developing a pulmonary condition or the type of complication. There was no evidence that IS is effective in the prevention of pulmonary complications. There is low quality evidence regarding the lack of effectiveness of incentive spirometry for prevention of postoperative pulmonary complications in patients after upper abdominal surgery. This review underlines the urgent need to conduct well-designed trials in this field. There is a case for large RCTs with high methodological rigour in order to define any benefit from the use of incentive spirometry regarding mortality.

Ear Infection (Middle Ear)

MedlinePlus

... secretions from the middle ear Swelling, inflammation and mucus in the eustachian tubes from an upper respiratory ... your baby for at least six months. Breast milk contains antibodies that may offer protection from ear ...

Cardiovascular risk and mortality in end-stage renal disease patients undergoing dialysis: sleep study, pulmonary function, respiratory mechanics, upper airway collapsibility, autonomic nervous activity, depression, anxiety, stress and quality of life: a prospective, double blind, randomized controlled clinical trial.

PubMed

dos Reis Santos, Israel; Danaga, Aline Roberta; de Carvalho Aguiar, Isabella; Oliveira, Ezequiel Fernandes; Dias, Ismael Souza; Urbano, Jessica Julioti; Martins, Aline Almeida; Ferraz, Leonardo Macario; Fonsêca, Nina Teixeira; Fernandes, Virgilio; Fernandes, Vinicius Alves Thomaz; Lopes, Viviane Cristina Delgado; Leitão Filho, Fernando Sérgio Studart; Nacif, Sérgio Roberto; de Carvalho, Paulo de Tarso Camillo; Sampaio, Luciana Maria Malosá; Giannasi, Lílian Christiane; Romano, Salvatore; Insalaco, Giuseppe; Araujo, Ana Karina Fachini; Dellê, Humberto; Souza, Nadia Karina Guimarães; Giannella-Neto, Daniel; Oliveira, Luis Vicente Franco

2013-10-08

Chronic kidney disease (CKD) is one of the most serious public health problems. The increasing prevalence of CKD in developed and developing countries has led to a global epidemic. The hypothesis proposed is that patients undergoing dialysis would experience a marked negative influence on physiological variables of sleep and autonomic nervous system activity, compromising quality of life. A prospective, consecutive, double blind, randomized controlled clinical trial is proposed to address the effect of dialysis on sleep, pulmonary function, respiratory mechanics, upper airway collapsibility, autonomic nervous activity, depression, anxiety, stress and quality of life in patients with CKD. The measurement protocol will include body weight (kg); height (cm); body mass index calculated as weight/height(2); circumferences (cm) of the neck, waist, and hip; heart and respiratory rates; blood pressures; Mallampati index; tonsil index; heart rate variability; maximum ventilatory pressures; negative expiratory pressure test, and polysomnography (sleep study), as well as the administration of specific questionnaires addressing sleep apnea, excessive daytime sleepiness, depression, anxiety, stress, and quality of life. CKD is a major public health problem worldwide, and its incidence has increased in part by the increased life expectancy and increasing number of cases of diabetes mellitus and hypertension. Sleep disorders are common in patients with renal insufficiency. Our hypothesis is that the weather weight gain due to volume overload observed during interdialytic period will influence the degree of collapsibility of the upper airway due to narrowing and predispose to upper airway occlusion during sleep, and to investigate the negative influences of haemodialysis in the physiological variables of sleep, and autonomic nervous system, and respiratory mechanics and thereby compromise the quality of life of patients. The protocol for this study is registered with the Brazilian Registry of Clinical Trials (ReBEC RBR-7yhr4w and World Health Organization under Universal Trial Number UTN: U1111-1127-9390 [http://www.ensaiosclinicos.gov.br/rg/RBR-7yhr4w/]).

Reflection of the State of Hunger in Impulse Activity of Nose Wing Muscles and Upper Esophageal Sphincter during Search behavior in Rabbits.

PubMed

Kromin, A A; Dvoenko, E E; Zenina, O Yu

2016-07-01

Reflection of the state of hunger in impulse activity of nose wing muscles and upper esophageal sphincter muscles was studied in chronic experiments on rabbits subjected to 24-h food deprivation in the absence of locomotion and during search behavior. In the absence of apparent behavioral activity, including sniffing, alai nasi muscles of hungry rabbits constantly generated bursts of action potentials synchronous with breathing, while upper esophageal sphincter muscles exhibited regular aperiodic low-amplitude impulse activity of tonic type. Latent form of food motivation was reflected in the structure of temporal organization of impulse activity of alai nasi muscles in the form of bimodal distribution of interpulse intervals and in temporal structure of impulse activity of upper esophageal sphincter muscles in the form of monomodal distribution. The latent form of food motivation was manifested in the structure of temporal organization of periods of the action potentials burst-like rhythm, generated by alai nasi muscles, in the form of monomodal distribution, characterized by a high degree of dispersion of respiratory cycle periods. In the absence of physical activity hungry animals sporadically exhibited sniffing activity, manifested in the change from the burst-like impulse activity of alai nasi muscles to the single-burst activity type with bimodal distribution of interpulse intervals and monomodal distribution of the burst-like action potentials rhythm periods, the maximum of which was shifted towards lower values, which was the cause of increased respiratory rate. At the same time, the monomodal temporal structure of impulse activity of the upper esophageal sphincter muscles was not changed. With increasing food motivation in the process of search behavior temporal structure of periods of the burst-like action potentials rhythm, generated by alai nasi muscles, became similar to that observed during sniffing, not accompanied by animal's locomotion, which is typical for the increased respiratory rhythm frequency. Increased hunger motivation was reflected in the temporal structure of impulse activity of upper esophageal sphincter muscles in the form of a shift to lower values of the maximum of monomodal distribution of interpulse intervals on the histogram, resulting in higher impulse activity frequency. The simultaneous increase in the frequency of action potentials bursts generation by alai nasi muscles and regular impulse activity of upper esophageal sphincter muscles is a reliable criterion for enhanced food motivation during search behavior in rabbits.

A nonpolio enterovirus with respiratory tropism causes poliomyelitis in intercellular adhesion molecule 1 transgenic mice.

PubMed

Dufresne, Andrew T; Gromeier, Matthias

2004-09-14

Coxsackievirus A21 (CAV21) is classified within the species Human enterovirus C (HEV-C) of the Enterovirus genus of picornaviruses. HEV-C share striking homology with the polioviruses (PV), their closest kin among the enteroviruses. Despite a high level of sequence identity, CAV21 and PV cause distinct clinical disease typically attributed to their differential use of host receptors. PV cause poliomyelitis, whereas CAV21 shares a receptor and a propensity to cause upper respiratory tract infections with the major group rhinoviruses. As a model for CAV21 infection, we have developed transgenic mice that express human intercellular adhesion molecule 1, the cell-surface receptor for CAV21. Surprisingly, CAV21 administered to these mice via the intramuscular route causes a paralytic condition consistent with poliomyelitis. The virus appears to invade the CNS by retrograde axonal transport, as has been demonstrated to occur in analogous PV infections. We detected human intercellular adhesion molecule 1 expression on both transgenic mouse and human spinal cord anterior horn motor neurons, indicating that members of HEV-C may share PV's potential to elicit poliomyelitis in humans.

Histophilus somni Stimulates Expression of Antiviral Proteins and Inhibits BRSV Replication in Bovine Respiratory Epithelial Cells

PubMed Central

Lin, C.; Agnes, J. T.; Behrens, N.; Tagawa, Y.; Gershwin, L. J.; Corbeil, L. B.

2016-01-01

Our previous studies showed that bovine respiratory syncytial virus (BRSV) followed by Histophilus somni causes more severe bovine respiratory disease and a more permeable alveolar barrier in vitro than either agent alone. However, microarray analysis revealed the treatment of bovine alveolar type 2 (BAT2) epithelial cells with H. somni concentrated culture supernatant (CCS) stimulated up-regulation of four antiviral protein genes as compared with BRSV infection or dual treatment. This suggested that inhibition of viral infection, rather than synergy, may occur if the bacterial infection occurred before the viral infection. Viperin (or radical S-adenosyl methionine domain containing 2—RSAD2) and ISG15 (IFN-stimulated gene 15—ubiquitin-like modifier) were most up-regulated. CCS dose and time course for up-regulation of viperin protein levels were determined in treated bovine turbinate (BT) upper respiratory cells and BAT2 lower respiratory cells by Western blotting. Treatment of BAT2 cells with H. somni culture supernatant before BRSV infection dramatically reduced viral replication as determined by qRT PCR, supporting the hypothesis that the bacterial infection may inhibit viral infection. Studies of the role of the two known H. somni cytotoxins showed that viperin protein expression was induced by endotoxin (lipooligosaccharide) but not by IbpA, which mediates alveolar permeability and H. somni invasion. A naturally occurring IbpA negative asymptomatic carrier strain of H. somni (129Pt) does not cause BAT2 cell retraction or permeability of alveolar cell monolayers, so lacks virulence in vitro. To investigate initial steps of pathogenesis, we showed that strain 129Pt attached to BT cells and induced a strong viperin response in vitro. Thus colonization of the bovine upper respiratory tract with an asymptomatic carrier strain lacking virulence may decrease viral infection and the subsequent enhancement of bacterial respiratory infection in vivo. PMID:26859677

Histophilus somni Stimulates Expression of Antiviral Proteins and Inhibits BRSV Replication in Bovine Respiratory Epithelial Cells.

PubMed

Lin, C; Agnes, J T; Behrens, N; Shao, M; Tagawa, Y; Gershwin, L J; Corbeil, L B

2016-01-01

Our previous studies showed that bovine respiratory syncytial virus (BRSV) followed by Histophilus somni causes more severe bovine respiratory disease and a more permeable alveolar barrier in vitro than either agent alone. However, microarray analysis revealed the treatment of bovine alveolar type 2 (BAT2) epithelial cells with H. somni concentrated culture supernatant (CCS) stimulated up-regulation of four antiviral protein genes as compared with BRSV infection or dual treatment. This suggested that inhibition of viral infection, rather than synergy, may occur if the bacterial infection occurred before the viral infection. Viperin (or radical S-adenosyl methionine domain containing 2--RSAD2) and ISG15 (IFN-stimulated gene 15--ubiquitin-like modifier) were most up-regulated. CCS dose and time course for up-regulation of viperin protein levels were determined in treated bovine turbinate (BT) upper respiratory cells and BAT2 lower respiratory cells by Western blotting. Treatment of BAT2 cells with H. somni culture supernatant before BRSV infection dramatically reduced viral replication as determined by qRT PCR, supporting the hypothesis that the bacterial infection may inhibit viral infection. Studies of the role of the two known H. somni cytotoxins showed that viperin protein expression was induced by endotoxin (lipooligosaccharide) but not by IbpA, which mediates alveolar permeability and H. somni invasion. A naturally occurring IbpA negative asymptomatic carrier strain of H. somni (129Pt) does not cause BAT2 cell retraction or permeability of alveolar cell monolayers, so lacks virulence in vitro. To investigate initial steps of pathogenesis, we showed that strain 129Pt attached to BT cells and induced a strong viperin response in vitro. Thus colonization of the bovine upper respiratory tract with an asymptomatic carrier strain lacking virulence may decrease viral infection and the subsequent enhancement of bacterial respiratory infection in vivo.

Pulmonary function and respiratory symptoms in a population of airport workers.

PubMed

Tunnicliffe, W S; O'Hickey, S P; Fletcher, T J; Miles, J F; Burge, P S; Ayres, J G

1999-02-01

To assess the prevalence of respiratory symptoms and to measure spirometry in a sample of employees of Birmingham International Airport, United Kingdom, to examine whether occupational exposure to aircraft fuel or jet stream exhaust might be associated with respiratory symptoms or abnormalities of lung function. Cross sectional survey by questionnaire and on site measurement of lung function, skin prick tests, and exhaled carbon monoxide concentrations. Occupational exposure was assigned by job title, between group comparison were made by logistic regression analysis. 222/680 full time employees were studied (mean age 38.6 y, 63% male, 28% current smokers, 6% self reported asthma, 19% self reported hay fever). Upper and lower respiratory tract symptoms were common and 51% had one or more positive skin tests. There were no significant differences in lung function tests between exposure groups. Between group comparisons of respiratory symptoms were restricted to male members of the medium and high exposure groups. The adjusted odds ratio (OR) for cough with phlegm and runny nose were found to be significantly associated with high exposure (OR 3.5, 95% confidence interval (95% CI) 1.23 to 9.74 and 2.9, 1.32 to 6.40 respectively) when the measured confounding effects of age and smoking, and in the case of runny nose, self reported hay fever had been taken into account. There was no obvious association between high exposure and the presence of shortness of breath or wheeze, or for the symptoms of watering eyes or stuffy nose. These findings support an association in male airport workers, between high occupational exposures to aviation fuel or jet stream exhaust and excess upper and lower respiratory tract symptoms, in keeping with a respiratory irritant. It is more likely that these effects reflect exposure to exhaust rather than fuel, although the effects of an unmeasured agent cannot be discounted.

Pulmonary function and respiratory symptoms in a population of airport workers

PubMed Central

Tunnicliffe, W. S.; O'Hickey, S. P.; Fletcher, T. J.; Miles, J. F.; Burge, P. S.; Ayres, J. G.

1999-01-01

OBJECTIVES: To assess the prevalence of respiratory symptoms and to measure spirometry in a sample of employees of Birmingham International Airport, United Kingdom, to examine whether occupational exposure to aircraft fuel or jet stream exhaust might be associated with respiratory symptoms or abnormalities of lung function. METHODS: Cross sectional survey by questionnaire and on site measurement of lung function, skin prick tests, and exhaled carbon monoxide concentrations. Occupational exposure was assigned by job title, between group comparison were made by logistic regression analysis. RESULTS: 222/680 full time employees were studied (mean age 38.6 y, 63% male, 28% current smokers, 6% self reported asthma, 19% self reported hay fever). Upper and lower respiratory tract symptoms were common and 51% had one or more positive skin tests. There were no significant differences in lung function tests between exposure groups. Between group comparisons of respiratory symptoms were restricted to male members of the medium and high exposure groups. The adjusted odds ratio (OR) for cough with phlegm and runny nose were found to be significantly associated with high exposure (OR 3.5, 95% confidence interval (95% CI) 1.23 to 9.74 and 2.9, 1.32 to 6.40 respectively) when the measured confounding effects of age and smoking, and in the case of runny nose, self reported hay fever had been taken into account. There was no obvious association between high exposure and the presence of shortness of breath or wheeze, or for the symptoms of watering eyes or stuffy nose. CONCLUSIONS: These findings support an association in male airport workers, between high occupational exposures to aviation fuel or jet stream exhaust and excess upper and lower respiratory tract symptoms, in keeping with a respiratory irritant. It is more likely that these effects reflect exposure to exhaust rather than fuel, although the effects of an unmeasured agent cannot be discounted.   PMID:10448317

The respiratory-vocal system of songbirds: anatomy, physiology, and neural control.

PubMed

Schmidt, Marc F; Martin Wild, J

2014-01-01

This wide-ranging review presents an overview of the respiratory-vocal system in songbirds, which are the only other vertebrate group known to display a degree of respiratory control during song rivalling that of humans during speech; this despite the fact that the peripheral components of both the respiratory and vocal systems differ substantially in the two groups. We first provide a brief description of these peripheral components in songbirds (lungs, air sacs and respiratory muscles, vocal organ (syrinx), upper vocal tract) and then proceed to a review of the organization of central respiratory-related neurons in the spinal cord and brainstem, the latter having an organization fundamentally similar to that of the ventral respiratory group of mammals. The second half of the review describes the nature of the motor commands generated in a specialized "cortical" song control circuit and how these might engage brainstem respiratory networks to shape the temporal structure of song. We also discuss a bilaterally projecting "respiratory-thalamic" pathway that links the respiratory system to "cortical" song control nuclei. This necessary pathway for song originates in the brainstem's primary inspiratory center and is hypothesized to play a vital role in synchronizing song motor commands both within and across hemispheres. © 2014 Elsevier B.V. All rights reserved.

The respiratory-vocal system of songbirds: Anatomy, physiology, and neural control

PubMed Central

Schmidt, Marc F.; Wild, J. Martin

2015-01-01

This wide-ranging review presents an overview of the respiratory-vocal system in songbirds, which are the only other vertebrate group known to display a degree of respiratory control during song rivalling that of humans during speech; this despite the fact that the peripheral components of both the respiratory and vocal systems differ substantially in the two groups. We first provide a brief description of these peripheral components in songbirds (lungs, air sacs and respiratory muscles, vocal organ (syrinx), upper vocal tract) and then proceed to a review of the organization of central respiratory-related neurons in the spinal cord and brainstem, the latter having an organization fundamentally similar to that of the ventral respiratory group of mammals. The second half of the review describes the nature of the motor commands generated in a specialized “cortical” song control circuit and how these might engage brainstem respiratory networks to shape the temporal structure of song. We also discuss a bilaterally projecting “respiratory-thalamic” pathway that links the respiratory system to “cortical” song control nuclei. This necessary pathway for song originates in the brainstem’s primary inspiratory center and is hypothesized to play a vital role in synchronizing song motor commands both within and across hemispheres. PMID:25194204

How I treat respiratory viral infections in the setting of intensive chemotherapy or hematopoietic cell transplantation

PubMed Central

Waghmare, Alpana; Englund, Janet A.

2016-01-01

The widespread use of multiplex molecular diagnostics has led to a significant increase in the detection of respiratory viruses in patients undergoing cytotoxic chemotherapy and hematopoietic cell transplantation (HCT). Respiratory viruses initially infect the upper respiratory tract and then progress to lower respiratory tract disease in a subset of patients. Lower respiratory tract disease can manifest itself as airflow obstruction or viral pneumonia, which can be fatal. Infection in HCT candidates may require delay of transplantation. The risk of progression differs between viruses and immunosuppressive regimens. Risk factors for progression and severity scores have been described, which may allow targeting treatment to high-risk patients. Ribavirin is the only antiviral treatment option for noninfluenza respiratory viruses; however, high-quality data demonstrating its efficacy and relative advantages of the aerosolized versus oral form are lacking. There are significant unmet needs, including data defining the virologic characteristics and clinical significance of human rhinoviruses, human coronaviruses, human metapneumovirus, and human bocavirus, as well as the need for new treatment and preventative options. PMID:26968533

Whooping cough.

PubMed

Danthis, Michael

2014-05-13

The CPD article was relevant to my practice because most upper respiratory tract infections exhibit similar symptoms initially. It is essential to be able to diagnose whooping cough because it is an acute and highly contagious disease.

A rare cause of acute flaccid paralysis: Human coronaviruses

PubMed Central

Turgay, Cokyaman; Emine, Tekin; Ozlem, Koken; Muhammet, S. Paksu; Haydar, A. Tasdemir

2015-01-01

Acute flaccid paralysis (AFP) is a life-threatening clinical entity characterized by weakness in the whole body muscles often accompanied by respiratory and bulbar paralysis. The most common cause is Gullian–Barre syndrome, but infections, spinal cord diseases, neuromuscular diseases such as myasthenia gravis, drugs and toxins, periodic hypokalemic paralysis, electrolyte disturbances, and botulism should be considered as in the differential diagnosis. Human coronaviruses (HCoVs) cause common cold, upper and lower respiratory tract disease, but in the literature presentation with the lower respiratory tract infection and AFP has not been reported previously. In this study, pediatric case admitted with lower respiratory tract infection and AFP, who detected for HCoV 229E and OC43 co-infection by the real-time polymerase chain reaction, has been reported for the first time. PMID:26557177

A rare cause of acute flaccid paralysis: Human coronaviruses.

PubMed

Turgay, Cokyaman; Emine, Tekin; Ozlem, Koken; Muhammet, S Paksu; Haydar, A Tasdemir

2015-01-01

Acute flaccid paralysis (AFP) is a life-threatening clinical entity characterized by weakness in the whole body muscles often accompanied by respiratory and bulbar paralysis. The most common cause is Gullian-Barre syndrome, but infections, spinal cord diseases, neuromuscular diseases such as myasthenia gravis, drugs and toxins, periodic hypokalemic paralysis, electrolyte disturbances, and botulism should be considered as in the differential diagnosis. Human coronaviruses (HCoVs) cause common cold, upper and lower respiratory tract disease, but in the literature presentation with the lower respiratory tract infection and AFP has not been reported previously. In this study, pediatric case admitted with lower respiratory tract infection and AFP, who detected for HCoV 229E and OC43 co-infection by the real-time polymerase chain reaction, has been reported for the first time.

The effect of environmental pollution on the respiratory system of lignite miners: a diachronic study.

PubMed

Sichletidis, L; Tsiotsios, I; Chloros, D; Daskalopoulou, E; Ziomas, I; Michailidis, K; Kottakis, I; Konstantinidis, T H; Palladas, P

2004-01-01

It is not known whether working in surface lignite mines can cause x-ray lesions or disorders of respiratory function. The aim of the study was to investigate the diachronic impact of environmental pollution on the respiratory system of lignite miners at mines in Eordea, Greece. Cases of 199 workers (Group A) residing permanently in the Eordea valley and 151 (Group B) living outside the Eordea valley were studied during Phase I and then re-examined after three years (Phase II). These cases were compared to those of 71 office workers living in Eordea valley (Group C) and to 96 living in Grevena, a region without pollution (Group D). The study included the completion of the MRC questionnaire for the detection of respiratory diseases, pulmonary function tests, measurement of diffusion capacity, otorhinolaryngologic examination, rhinomanonetry as well as chest and paranasal cavity X-rays. Chronic bronchitis was reported by 26.8%, 24.8%, 17.9% and 10.6% respectively of the subjects of groups A, B, C and D according to the answers of the questionnaire (p<0.001). The spirometry and diffusion capacity findings presented no considerable differences either in the 4 groups or between phases I and II of the study. The main problems were detected in the upper airways. A very high prevalence of severe nasal obstruction (73%, 71.2%, 55.7% and 19.3% in Groups A, B, C and D respectively) was detected. Furthermore, a high percentage of atrophic rhinitis (14%) was detected both among workers (Groups A and B) and subjects living in the Eordea valley who participated as controls (Group C). From the X-rays, hypertrophy of nasal turbinates-cartilage and polyposis was observed as follows: Group A: 53.9%, Group B: 48.1%, Group C: 46.5% and Group D: 20.3% (p<0.001). The findings related to the upper respiratory system may be due to excessive pollution by airborne particles (fly ash) pollution in the region and particularly to chromium, nickel, cobalt and lead found at high concentration levels in airborne dust. A marked association between the total air-flow in the nose and the mid-expiratory flow (p<0.01) was detected. We conclude that subjects working in lignite mines under conditions of excessive pollution by airborne contaminants have a high prevalence of atrophic rhinitis and, in addition to other standard examinations, should undergo rhinomanometry testing and X-ray imaging of the paranasal cavities.

Non-chemosensitive parafacial neurons simultaneously regulate active expiration and airway patency under hypercapnia in rats.

PubMed

de Britto, Alan A; Moraes, Davi J A

2017-03-15

Hypercapnia or parafacial respiratory group (pFRG) disinhibition at normocapnia evokes active expiration in rats by recruitment of pFRG late-expiratory (late-E) neurons. We show that hypercapnia simultaneously evoked active expiration and exaggerated glottal dilatation by late-E synaptic excitation of abdominal, hypoglossal and laryngeal motoneurons. Simultaneous rhythmic expiratory activity in previously silent pFRG late-E neurons, which did not express the marker of ventral medullary CO 2 -sensitive neurons (transcription factor Phox2b), was also evoked by hypercapnia. Hypercapnia-evoked active expiration, neural and neuronal late-E activities were eliminated by pFRG inhibition, but not after blockade of synaptic excitation. Hypercapnia produces disinhibition of non-chemosensitive pFRG late-E neurons to evoke active expiration and concomitant cranial motor respiratory responses controlling the oropharyngeal and upper airway patency. Hypercapnia produces active expiration in rats and the recruitment of late-expiratory (late-E) neurons located in the parafacial respiratory group (pFRG) of the ventral medullary brainstem. We tested the hypothesis that hypercapnia produces active expiration and concomitant cranial respiratory motor responses controlling the oropharyngeal and upper airway patency by disinhibition of pFRG late-E neurons, but not via synaptic excitation. Phrenic nerve, abdominal nerve (AbN), cranial respiratory motor nerves, subglottal pressure, and medullary and spinal neurons/motoneurons were recorded in in situ preparations of juvenile rats. Hypercapnia evoked AbN active expiration, exaggerated late-E discharges in cranial respiratory motor outflows, and glottal dilatation via late-E synaptic excitation of abdominal, hypoglossal and laryngeal motoneurons. Simultaneous rhythmic late-E activity in previously silent pFRG neurons, which did not express the marker of ventral medullary CO 2 -sensitive neurons (transcription factor Phox2b), was also evoked by hypercapnia. In addition, hypercapnia-evoked AbN active expiration, neural and neuronal late-E activities were eliminated by pFRG inhibition, but not after blockade of synaptic excitation. On the other hand, pFRG inhibition did not affect either hypercapnia-induced inspiratory increases in respiratory motor outflows or CO 2 sensitivity of the more medial Phox2b-positive neurons in the retrotrapezoid nucleus (RTN). Our data suggest that neither RTN Phox2b-positive nor other CO 2 -sensitive brainstem neurons activate Phox2b-negative pFRG late-E neurons under hypercapnia to produce AbN active expiration and concomitant cranial motor respiratory responses controlling the oropharyngeal and upper airway patency. Hypercapnia produces disinhibition of non-chemosensitive pFRG late-E neurons in in situ preparations of juvenile rats to activate abdominal, hypoglossal and laryngeal motoneurons. © 2016 The Authors. The Journal of Physiology © 2016 The Physiological Society.

RESPIRATORY MODULATION OF LINGUAL MUSCLE ACTIVITY ACROSS SLEEP-WAKE STATES IN RATS

PubMed Central

Stettner, Georg M.; Rukhadze, Irma; Mann, Graziella L.; Lei, Yanlin; Kubin, Leszek

2013-01-01

In obstructive sleep apnea (OSA) patients, inspiratory activation (IA) of lingual muscles protects the upper airway from collapse. We aimed to determine when rats’ lingual muscles exhibit IA. In 5 Sprague-Dawley and 3 Wistar rats, we monitored cortical EEG and lingual, diaphragmatic and nuchal electromyograms (EMGs), and identified segments of records when lingual EMG exhibited IA. Individual segments lasted 2.4–269 s (median: 14.5 s), most (89%) occurred during slow-wave sleep (SWS), and they collectively occupied 0.3–6.1% of the total recording time. IA usually started to increase with a delay after SWS onset and ended with an arousal, or declined prior to rapid eye movement sleep. IA of lingual EMG was not accompanied by increased diaphragmatic activity or respiratory rate changes, but occurred when cortical EEG power was particularly low in a low beta-1 frequency range (12.5–16.4 Hz). A deep SWS-related activation of upper airway muscles may be an endogenous phenomenon designed to protect the upper airway against collapse. PMID:23732510

Radon-enriched hot spring water therapy for upper and lower respiratory tract inflammation.

PubMed

Passali, Desiderio; Gabelli, Giacomo; Passali, Giulio Cesare; Mösges, Ralph; Bellussi, Luisa Maria

2017-08-31

Background Radon-222-enriched hot spring therapy, which is characterized by a safe level of radioactivity, is used for the treatment of rheumatic disorders, and its efficacy has already been studied in several clinical trials. Radon-water inhalation therapy for the treatment of upper and lower airway inflammatory diseases is used in many hot springs centers. However, its application has not been reviewed to date. Methods We systematically searched the PubMed and Scopus databases for clinical trials published in the last 20 years in which objective parameters of upper and lower airway function had been tested before and after radon-enriched inhalation treatment. Results Four prospective studies were found: 1 asthma trial, 1 placebo-controlled chronic rhinosinusitis trial, 1 upper respiratory tract inflammation with nasal obstruction trial, and 1 case-control allergic rhinitis trial. Patients were treated with nasal inhalations of radon-enriched water for 12 to 28 days and were assessed at baseline and after therapy. After 2 weeks of treatment, nasal resistance decreased, flow increased, mucociliary clearance was enhanced, ciliated-to-muciparous cell ratio increased, and %FEV1 increased in asthmatic patients. Conclusion Radon-enriched inhalation therapy improves objective indicators of nasal function in allergic rhinitis and chronic rhinosinusitis, and causes relief of pulmonary obstruction in asthma.

Measles Virus Infection of Epithelial Cells in the Macaque Upper Respiratory Tract Is Mediated by Subepithelial Immune Cells

PubMed Central

Ludlow, Martin; Lemon, Ken; de Vries, Rory D.; McQuaid, Stephen; Millar, Emma L.; van Amerongen, Geert; Yüksel, Selma; Verburgh, R. Joyce; Osterhaus, Albert D. M. E.; Duprex, W. Paul

2013-01-01

Measles virus (MV), one of the most contagious viruses infecting humans, causes a systemic infection leading to fever, immune suppression, and a characteristic maculopapular rash. However, the specific mechanism or mechanisms responsible for the spread of MV into the respiratory epithelium in the late stages of the disease are unknown. Here we show the crucial role of PVRL4 in mediating the spread of MV from immune to epithelial cells by generating a PVRL4 “blind” recombinant wild-type MV and developing a novel in vitro coculture model of B cells with primary differentiated normal human bronchial epithelial cells. We utilized the macaque model of measles to analyze virus distribution in the respiratory tract prior to and at the peak of MV replication. Expression of PVRL4 was widespread in both the lower and upper respiratory tract (URT) of macaques, indicating MV transmission can be facilitated by more than only epithelial cells of the trachea. Analysis of tissues collected at early time points after experimental MV infection demonstrated the presence of MV-infected lymphoid and myeloid cells contacting respiratory tract epithelium in the absence of infected epithelial cells, suggesting that these immune cells seed the infection in vivo. Thereafter, lateral cell-to-cell spread of MV led to the formation of large foci of infected cells in the trachea and high levels of MV infection in the URT, particularly in the nasal cavity. These novel findings have important implications for our understanding of the high transmissibility of measles. PMID:23365435

Henoch-Schonlein purpura on an infant's foot (image)

MedlinePlus

... children than adults and often occurs after an upper respiratory infection. It causes skin rashes that bleed into the skin (petechiae and purpura). Bleeding may also occur from the gastrointestinal tract and kidneys.

Henoch-Schonlein purpura on an infant's legs (image)

MedlinePlus

... children than adults and often occurs after an upper respiratory infection. It causes skin rashes that bleed into the skin (petechiae and purpura). Bleeding may also occur from the gastrointestinal tract and kidneys.

Henoch-Schonlein purpura on the legs (image)

MedlinePlus

... children than adults and often occurs after an upper respiratory infection. It causes skin rashes that bleed into the skin (petechiae and purpura). Bleeding may also occur from the gastrointestinal tract and kidneys.

Expression of the transcription factor FOXP2 in brainstem respiratory circuits of adult rat is restricted to upper-airway pre-motor areas.

PubMed

Stanić, Davor; Dhingra, Rishi R; Dutschmann, Mathias

2018-04-01

Expression of the transcription factor FOXP2 is linked to brain circuits that control motor function and speech. Investigation of FOXP2 protein expression in respiratory areas of the ponto-medullary brainstem of adult rat revealed distinct rostro-caudal expression gradients. A high density of FOXP2 immunoreactive nuclei was observed within the rostral pontine Kölliker-Fuse nucleus, compared to low densities in caudal pontine and rostral medullary respiratory nuclei, including the: (i) noradrenergic A5 and parafacial respiratory groups; (ii) Bötzinger and pre-Bötzinger complex and; (iii) rostral ventral respiratory group. Moderate densities of FOXP2 immunoreactive nuclei were observed in the caudal ventral respiratory group and the nucleus retroambiguus, with significant density levels found in the caudal half of the dorsal respiratory group and the hypoglossal pre-motor area lateral around calamus scriptorius. FOXP2 immunoreactivity was absent in all cranial nerve motor nuclei. We conclude that FOXP2 expression in respiratory brainstem areas selectively delineates laryngeal and hypoglossal pre-motor neuron populations essential for the generation of sound and voice. Copyright © 2018 Elsevier B.V. All rights reserved.

Guidelines for the Antibiotic Use in Adults with Acute Upper Respiratory Tract Infections

PubMed Central

Park, Chan-Soon; Kim, Jae Wook; Hwang, Kyurin; Lee, Sei Young; Kim, Tae Hoon; Park, Do-Yang; Kim, Hyun Jun; Kim, Dong-Young; Lee, Hyun Jong; Shin, Hyun-Young; You, Yong Kyu; Park, Dong-Ah

2017-01-01

These guidelines were developed as part of the 2016 Policy Research Servicing Project by the Korea Centers for Disease Control and Prevention. A multidisciplinary approach was taken to formulate this guideline to provide practical information about the diagnosis and treatment of adults with acute upper respiratory tract infection, with the ultimate aim to promote the appropriate use of antibiotics. The formulation of this guideline was based on a systematic literature review and analysis of the latest research findings to facilitate evidence-based practice, and focused on key questions to help clinicians obtain solutions to clinical questions that may arise during the care of a patient. These guidelines mainly cover the subjects on the assessment of antibiotic indications and appropriate selection of antibiotics for adult patients with acute pharyngotonsillitis or acute sinusitis. PMID:29299900

Maximum sustained fin-kick thrust in underwater swimming.

PubMed

Yamaguchi, H; Shidara, F; Naraki, N; Mohri, M

1995-09-01

We examined the upper limit of a diver's fin-kick thrust force using a stationary-swimming ergometer. Heart rate, respiratory minute volume, oxygen uptake, and performance rate were measured in four male subjects who swam constantly for 8 min to maintain a horizontal position against an applied force at a depth of 0.7 m. The water temperature was controlled at 26 degrees +/- 1 degree C. The performance rate, which was the parameter of how well the subjects compensated for the applied load, showed an upper limit around 64 N of sustainable thrust force. This meant that the diver could generate the swimming thrust force within 64 N continuously for 8 min in a steady state. Heart rate, respiratory minute volume, and O2 uptake showed almost proportional increases to the applied load within 64 N and tended to plateau about 69 N.

Diagnostic Accuracy of FebriDx: A Rapid Test to Detect Immune Responses to Viral and Bacterial Upper Respiratory Infections.

PubMed

Self, Wesley H; Rosen, Jeffrey; Sharp, Stephan C; Filbin, Michael R; Hou, Peter C; Parekh, Amisha D; Kurz, Michael C; Shapiro, Nathan I

2017-10-07

C-reactive protein (CRP) and myxovirus resistance protein A (MxA) are associated with bacterial and viral infections, respectively. We conducted a prospective, multicenter, cross-sectional study of adults and children with febrile upper respiratory tract infections (URIs) to evaluate the diagnostic accuracy of a rapid CRP/MxA immunoassay to identify clinically significant bacterial infection with host response and acute pathogenic viral infection. The reference standard for classifying URI etiology was an algorithm that included throat bacterial culture, upper respiratory PCR for viral and atypical pathogens, procalcitonin, white blood cell count, and bandemia. The algorithm also allowed for physician override. Among 205 patients, 25 (12.2%) were classified as bacterial, 53 (25.9%) as viral, and 127 (62.0%) negative by the reference standard. For bacterial detection, agreement between FebriDx and the reference standard was 91.7%, with FebriDx having a sensitivity of 80% (95% CI: 59-93%), specificity of 93% (89-97%), positive predictive value (PPV) of 63% (45-79%), and a negative predictive value (NPV) of 97% (94-99%). For viral detection, agreement was 84%, with a sensitivity of 87% (75-95%), specificity of 83% (76-89%), PPV of 64% (63-75%), and NPV of 95% (90-98%). FebriDx may help to identify clinically significant immune responses associated with bacterial and viral URIs that are more likely to require clinical management or therapeutic intervention, and has potential to assist with antibiotic stewardship.

Exercising videoendoscopic evaluation of 45 horses with respiratory noise and/or poor performance after laryngoplasty.

PubMed

Davidson, Elizabeth J; Martin, Benson B; Rieger, Randall H; Parente, Eric J

2010-12-01

To (1) assess upper airway function by videoendoscopy in horses performing poorly after laryngoplasty and (2) establish whether dynamic collapse of the left arytenoid can be predicted by the degree of resting postsurgical abduction. Case series. Horses that had left laryngoplasty (n=45). Medical records (June 1993-December 2007) of horses evaluated for abnormal respiratory noise and/or poor performance after laryngoplasty were reviewed. Horses with video recordings of resting and exercising upper airway endoscopy were included and postsurgical abduction categorized. Horses with immediate postoperative endoscopy recordings were also evaluated and postsurgical abduction categorized. Relationships between resting postsurgical abduction and historical information with exercising endoscopic findings were examined. Dynamic collapse of the left arytenoid cartilage was probable in horses with no postsurgical abduction and could not be predicted in horses with grade 3 or 4 postsurgical abduction. Respiratory noise was associated with upper airway obstruction but was not specific for arytenoid collapse. Most horses with a left vocal fold had billowing of the fold during exercise. Other forms of dynamic collapse involved the right vocal fold, aryepiglottic folds, corniculate process of left arytenoid cartilage, dorsal displacement of soft palate, and pharyngeal collapse. Complex obstructions were observed in most examinations and in all horses with exercising collapse of the left arytenoid cartilage. There was no relationship between exercising collapse of the left arytenoid cartilage and grade 3 or 4 postsurgical abduction but was likely in horses with no abduction. © Copyright 2010 by The American College of Veterinary Surgeons.

The effect of hand hygiene on illness rate among students in university residence halls.

PubMed

White, Cindy; Kolble, Robin; Carlson, Rebecca; Lipson, Natasha; Dolan, Mike; Ali, Yusuf; Cline, Mojee

2003-10-01

Several studies have indicated a connection between hand sanitization and infection control in numerous settings such as extended care facilities, schools, and hospitals. The purpose of this study was to assess the effectiveness of both a hand-hygiene message campaign and the use of an alcohol gel hand sanitizer in decreasing the incidence of upper-respiratory illness among students living in university residence halls. This study involved a total of 430 students recruited from 4 residence halls during the fall semester at the University of Colorado at the Boulder campus. Dormitories were paired into control and product groups. In the product groups, alcohol gel hand-sanitizer dispensers were installed in every room, bathroom, and dining hall. The data were statistically analyzed for the differences between product and control groups in reported symptoms, illness rates, and absenteeism from classes. The overall increase in hand-hygiene behavior and reduction in symptoms, illness rates, and absenteeism between the product group and control group was statistically significant. Reductions in upper respiratory-illness symptoms ranged from 14.8% to 39.9%. Total improvement in illness rate was 20%. The product group had 43% less missed school/work days. Hand-hygiene practices were improved with increased frequency of handwashing through increasing awareness of the importance of hand hygiene, and the use of alcohol gel hand sanitizer in university dormitories. This resulted in fewer upper respiratory-illness symptoms, lower illness rates, and lower absenteeism.

Upper airway obstruction in Norwich Terriers: 16 cases.

PubMed

Johnson, L R; Mayhew, P D; Steffey, M A; Hunt, G B; Carr, A H; McKiernan, B C

2013-01-01

Norwich Terriers have grown increasingly popular as show animals and pets, and awareness of respiratory problems within the breed is growing. To describe components of obstructive upper airway syndrome in a nonbrachycephalic terrier breed. Sixteen Norwich Terriers; 12 with and 4 without clinical signs of respiratory disease. Prospective case series. Physical and laryngoscopic examinations were performed by 1 investigator in all dogs. Medical and surgical interventions were summarized and results of follow-up examination or owner reports were recorded. The study population was comprised of 9 females (6 intact) and 7 males (5 intact). Median age was 3.0 years (range, 0.5-11 years). Of 12 dogs presented for a respiratory complaint, physical examination was normal in 4 dogs. Laryngoscopic examination was abnormal in 11/12 dogs with redundant supra-arytenoid folds, laryngeal collapse, everted laryngeal saccules, and a narrowed laryngeal opening in most. Of 4 dogs lacking clinical signs, all had normal physical examination; however, 3/4 dogs had similar appearance of the larynx to dogs with clinical signs. Response to surgical intervention was minimal to moderate in all dogs. Norwich Terriers suffer from an upper airway obstructive syndrome that differs from that encountered in brachycephalic breeds. Affected dogs are difficult to identify without laryngoscopic examination because of the lack of clinical signs and abnormalities in physical examination findings, despite severe airway obstruction. Care is warranted when anesthetizing Norwich Terriers because of the small size of the laryngeal opening. Copyright © 2013 by the American College of Veterinary Internal Medicine.

Medical Surveillance Monthly Report

DTIC Science & Technology

2016-04-01

diseases 50,913 (35) 29,810 (36) 22 (118) Contact dermatitis 49,907 (36) 36,087 (31) 81 (100) Respiratory infections Upper respiratory infections...and abscess 694 74.4 Pilonidal cyst 65 7.0 Cellulitis and abscess of fi nger and toe 57 6.1 Contact dermatitis and other eczema 22 2.4 Disorders...and hair follicles 38,888 18.0 Contact dermatitis and other eczema 32,437 15.0 Other cellulitis and abscess 28,644 13.3 Diseases of sebaceous glands

Clinical validation of 3 commercial real-time reverse transcriptase polymerase chain reaction assays for the detection of Middle East respiratory syndrome coronavirus from upper respiratory tract specimens.

PubMed

Mohamed, Deqa H; AlHetheel, AbdulKarim F; Mohamud, Hanat S; Aldosari, Kamel; Alzamil, Fahad A; Somily, Ali M

2017-04-01

Since discovery of Middle East respiratory syndrome coronavirus (MERS-CoV), a novel betacoronavirus first isolated and characterized in 2012, MERS-CoV real-time reverse transcriptase polymerase chain reaction (rRT-PCR) assays represent one of the most rapidly expanding commercial tests. However, in the absence of extensive evaluations of these assays on positive clinical material of different sources, evaluating their diagnostic effectiveness remains challenging. We describe the diagnostic performance evaluation of 3 common commercial MERS-CoV rRT-PCR assays on a large panel (n = 234) of upper respiratory tract specimens collected during an outbreak episode in Saudi Arabia. Assays were compared to the RealStar® MERS-CoV RT-PCR (Alton Diagnostics, Hamburg, Germany) assay as the gold standard. Results showed i) the TIB MolBiol® LightMix UpE and Orf1a assays (TIB MolBiol, Berlin, Germany) to be the most sensitive, followed by ii) the Anyplex™ Seegene MERS-CoV assay (Seegene, Seoul, Korea), and finally iii) the PrimerDesign™ Genesig® HCoV_2012 assay (PrimerDesign, England, United Kingdom). We also evaluate a modified protocol for the PrimerDesign™ Genesig® HCoV_2012 assay. Copyright © 2017 Elsevier Inc. All rights reserved.

Stimulation of abdominal and upper thoracic muscles with surface electrodes for respiration and cough: Acute studies in adult canines.

PubMed

Walter, James S; Posluszny, Joseph; Dieter, Raymond; Dieter, Robert S; Sayers, Scott; Iamsakul, Kiratipath; Staunton, Christine; Thomas, Donald; Rabbat, Mark; Singh, Sanjay

2018-05-01

To optimize maximal respiratory responses with surface stimulation over abdominal and upper thorax muscles and using a 12-Channel Neuroprosthetic Platform. Following instrumentation, six anesthetized adult canines were hyperventilated sufficiently to produce respiratory apnea. Six abdominal tests optimized electrode arrangements and stimulation parameters using bipolar sets of 4.5 cm square electrodes. Tests in the upper thorax optimized electrode locations, and forelimb moment was limited to slight-to-moderate. During combined muscle stimulation tests, the upper thoracic was followed immediately by abdominal stimulation. Finally, a model of glottal closure for cough was conducted with the goal of increased peak expiratory flow. Optimized stimulation of abdominal muscles included three sets of bilateral surface electrodes located 4.5 cm dorsal to the lateral line and from the 8 th intercostal space to caudal to the 13 th rib, 80 or 100 mA current, and 50 Hz stimulation frequency. The maximal expired volume was 343 ± 23 ml (n=3). Optimized upper thorax stimulation included a single bilateral set of electrodes located over the 2 nd interspace, 60 to 80 mA, and 50 Hz. The maximal inspired volume was 304 ± 54 ml (n=4). Sequential stimulation of the two muscles increased the volume to 600 ± 152 ml (n=2), and the glottal closure maneuver increased the flow. Studies in an adult canine model identified optimal surface stimulation methods for upper thorax and abdominal muscles to induce sufficient volumes for ventilation and cough. Further study with this neuroprosthetic platform is warranted.

Guidelines for the field evaluation of desert tortoise health and disease

USGS Publications Warehouse

Berry, Kristin H.; Christopher, Mary M.

2001-01-01

Field evaluation of free-ranging wildlife requires the systematic documentation of a variety of environmental conditions and individual parameters of health and disease, particularly in the case of rare or endangered species. In addition, defined criteria are needed for the humane salvage of ill or dying animals. The purpose of this paper is to describe, in detail, the preparation, procedures, and protocols we developed and tested for the field evaluation of wild desert tortoises (Gopherus agassizii). These guidelines describe: preparations for the field, including developing familiarity with tortoise behavior and ecology, and preparation of standardized data sheets; journal notes to document background data on weather conditions, temperature, rainfall, locality, and historic and recent human activities; procedures to prevent the spread of disease and parasites; data sheets for live tortoises to record tortoise identification, location, sex, body measurements and activity; health profile forms for documenting and grading physical abnormalities of tortoise posture and movements, general condition (e.g., lethargy, cachexia), external parasites, and clinical abnormalities associated with shell and upper respiratory diseases; permanent photographic records for the retrospective analysis of progression and regression of upper respiratory and eye diseases, analysis of shell lesions and evaluation of growth and age; and indications and methods for salvaging ill or dying tortoises for necropsy evaluation. These guidelines, tested on 5,000 to 20,000 tortoises over a 10 to 27 yr period, were designed to maximize acquisition of data for demographic, ecological, health and disease research projects; to reduce handling and stress of individual animals; to avoid spread of infectious disease; to promote high quality and consistent data sets; and to reduce the duration and number of field trips. The field methods are adapted for desert tortoise life cycle, behavior, anatomy, physiology, and pertinent disease; however the model is applicable to other species of reptiles. Comprehensive databases of clinical signs of disease and health are crucial to research endeavors and essential to decisions on captive release, epidemiology of disease, translocation of wild tortoises, breeding programs, and euthanasia.

Flavocoxid, a Nutraceutical Approach to Blunt Inflammatory Conditions

PubMed Central

Squadrito, Francesco; Mecchio, Anna

2014-01-01

Flavonoids, from Scutellaria baicalensis (Chinese skullcap) and Acacia catechu (black catechu), have been shown to exert a variety of therapeutic effects, including anti-inflammatory, antiviral, antibacterial, and anticancer activities. Flavocoxid is a mixed extract containing baicalin and catechin and it acts as a dual balanced inhibitor of cyclooxygenase-1 (COX-1) and COX-2 peroxidase enzyme activities with a significant inhibition of 5-lipoxygenase (5-LOX) enzyme activity in vitro. Flavocoxid downregulates gene or protein expression of several inflammatory markers and exerts also strong antioxidant activity in several experimental models. Controlled clinical trials and a postmarketing study have clearly shown that flavocoxid is as effective as naproxen in managing the signs and symptoms of osteoarthritis of the knee and it has better upper gastrointestinal, renal, and respiratory safety profile than naproxen. Flavocoxid may therefore provide a potential therapeutic approach to the treatment of chronic inflammatory conditions. PMID:25242871

Flavocoxid, a nutraceutical approach to blunt inflammatory conditions.

PubMed

Bitto, Alessandra; Squadrito, Francesco; Irrera, Natasha; Pizzino, Gabriele; Pallio, Giovanni; Mecchio, Anna; Galfo, Federica; Altavilla, Domenica

2014-01-01

Flavonoids, from Scutellaria baicalensis (Chinese skullcap) and Acacia catechu (black catechu), have been shown to exert a variety of therapeutic effects, including anti-inflammatory, antiviral, antibacterial, and anticancer activities. Flavocoxid is a mixed extract containing baicalin and catechin and it acts as a dual balanced inhibitor of cyclooxygenase-1 (COX-1) and COX-2 peroxidase enzyme activities with a significant inhibition of 5-lipoxygenase (5-LOX) enzyme activity in vitro. Flavocoxid downregulates gene or protein expression of several inflammatory markers and exerts also strong antioxidant activity in several experimental models. Controlled clinical trials and a postmarketing study have clearly shown that flavocoxid is as effective as naproxen in managing the signs and symptoms of osteoarthritis of the knee and it has better upper gastrointestinal, renal, and respiratory safety profile than naproxen. Flavocoxid may therefore provide a potential therapeutic approach to the treatment of chronic inflammatory conditions.

Cervical hemorrhage due to spontaneous rupture of the superior thyroid artery: Case report and review of the literature.

PubMed

Stenner, Markus; Helmstaedter, Victor; Spuentrup, Elmar; Quante, Gero; Huettenbrink, Karl-Bernd

2010-09-01

Beneath the different reasons for cervical masses, a spontaneous hemorrhage presents a rare and life-threatening condition. We present the rare case of a 62-year-old man who was presented with a dramatically enlarging cervical mass causing respiratory distress because of upper airway compression. An endotracheal intubation was lifesaving and avoided tracheotomy. A CT scan revealed a hematoma in the region of the left external carotid artery. An emergency angiography embolized a ruptured branch of the superior thyroid artery and surgery evacuated the hematoma. We discuss the rarity of the condition, reasons for a spontaneous rupture of the artery, and the diagnostic and treatment strategy. In addition, we review the literature on spontaneous thyroid artery hemorrhages, which, up to now, have been described only for the inferior thyroid artery. We conclude that the optimal management for cases of cervical hematoma is intubation, diagnosis, and angiography before surgery.

Streptococcus suis - The "Two Faces" of a Pathobiont in the Porcine Respiratory Tract.

PubMed

Vötsch, Désirée; Willenborg, Maren; Weldearegay, Yenehiwot B; Valentin-Weigand, Peter

2018-01-01

Streptococcus (S.) suis is a frequent early colonizer of the upper respiratory tract of pigs. In fact, it is difficult to find S. suis -free animals under natural conditions, showing the successful adaptation of this pathogen to its porcine reservoir host. On the other hand, S. suis can cause life-threatening diseases and represents the most important bacterial cause of meningitis in pigs worldwide. Notably, S. suis can also cause zoonotic infections, such as meningitis, septicemia, endocarditis, and other diseases in humans. In Asia, it is classified as an emerging zoonotic pathogen and currently considered as one of the most important causes of bacterial meningitis in adults. The "two faces" of S. suis , one of a colonizing microbe and the other of a highly invasive pathogen, have raised many questions concerning the interpretation of diagnostic detection and the definition of virulence. Thus, one major research challenge is the identification of virulence-markers which allow differentiation of commensal and virulent strains. This is complicated by the high phenotypic and genotypic diversity of S. suis , as reflected by the occurrence of (at least) 33 capsular serotypes. In this review, we present current knowledge in the context of S. suis as a highly diverse pathobiont in the porcine respiratory tract that can exploit disrupted host homeostasis to flourish and promote inflammatory processes and invasive diseases in pigs and humans.

Streptococcus suis – The “Two Faces” of a Pathobiont in the Porcine Respiratory Tract

PubMed Central

Vötsch, Désirée; Willenborg, Maren; Weldearegay, Yenehiwot B.; Valentin-Weigand, Peter

2018-01-01

Streptococcus (S.) suis is a frequent early colonizer of the upper respiratory tract of pigs. In fact, it is difficult to find S. suis-free animals under natural conditions, showing the successful adaptation of this pathogen to its porcine reservoir host. On the other hand, S. suis can cause life-threatening diseases and represents the most important bacterial cause of meningitis in pigs worldwide. Notably, S. suis can also cause zoonotic infections, such as meningitis, septicemia, endocarditis, and other diseases in humans. In Asia, it is classified as an emerging zoonotic pathogen and currently considered as one of the most important causes of bacterial meningitis in adults. The “two faces” of S. suis, one of a colonizing microbe and the other of a highly invasive pathogen, have raised many questions concerning the interpretation of diagnostic detection and the definition of virulence. Thus, one major research challenge is the identification of virulence-markers which allow differentiation of commensal and virulent strains. This is complicated by the high phenotypic and genotypic diversity of S. suis, as reflected by the occurrence of (at least) 33 capsular serotypes. In this review, we present current knowledge in the context of S. suis as a highly diverse pathobiont in the porcine respiratory tract that can exploit disrupted host homeostasis to flourish and promote inflammatory processes and invasive diseases in pigs and humans. PMID:29599763

A computer program for the simulation of fiber deposition in the human respiratory tract.

PubMed

Sturm, Robert; Hofmann, Werner

2006-11-01

As inhaled fibers may lead to a variety of lung diseases, detailed information on their deposition in the human respiratory tract is an indispensable requirement in medical science. In the work presented here, a Visual Basic((R)) computer program, termed FIBROS, is described which enables the simulation of fibrous particle deposition in both the extrathoracic region and different parts of the lung itself, including the results of published numerical studies on inertial/interceptional as well as diffusional and gravitational deposition. The input window of FIBROS includes the selection of specific breathing conditions by variation of the tidal volume and breathing cycle. Furthermore, the user is able to determine fiber properties such as diameter, aspect ratio, specific weight, and fiber orientation with respect to the air stream in the upper and lower airways of the lungs. Besides the offer of various deposition formulae for each region of the respiratory tract, thereby also allowing a distinction between mouth and nose breathing, the user may select between different morphometric datasets of the lung and respective airway scaling procedures. Analysis routines of FIBROS include the estimation of regional deposition fractions, thereby distinguishing between extrathoracic, bronchial, and acinar compartments, and a calculation of generation-by-generation deposition probabilities within tubular and alveolar structures. Preliminary results presented here should demonstrate the effects on fiber deposition due to variations of the breathing behaviour and the particle properties.

Imported case of Middle East respiratory syndrome coronavirus (MERS-CoV) infection from Oman to Thailand, June 2015.

PubMed

Plipat, Tanarak; Buathong, Rome; Wacharapluesadee, Supaporn; Siriarayapon, Potjaman; Pittayawonganon, Chakrarat; Sangsajja, Chariya; Kaewpom, Thongchai; Petcharat, Sininat; Ponpinit, Teerada; Jumpasri, Jaruphan; Joyjinda, Yutthana; Rodpan, Apaporn; Ghai, Siriporn; Jittmittraphap, Akanitt; Khongwichit, Sarawut; Smith, Duncan R; Corman, Victor M; Drosten, Christian; Hemachudha, Thiravat

2017-08-17

Thailand reported the first Middle East respiratory syndrome (MERS) case on 18 June 2015 (day 4) in an Omani patient with heart condition who was diagnosed with pneumonia on hospital admission on 15 June 2015 (day 1). Two false negative RT-PCR on upper respiratory tract samples on days 2 and 3 led to a 48-hour diagnosis delay and a decision to transfer the patient out of the negative pressure unit (NPU). Subsequent examination of sputum later on day 3 confirmed MERS coronavirus (MERS-CoV) infection. The patient was immediately moved back into the NPU and then transferred to Bamrasnaradura Infectious Disease Institute. Over 170 contacts were traced; 48 were quarantined and 122 self-monitored for symptoms. High-risk close contacts exhibiting no symptoms, and whose laboratory testing on the 12th day after exposure was negative, were released on the 14th day. The Omani Ministry of Health (MOH) was immediately notified using the International Health Regulation (IHR) mechanism. Outbreak investigation was conducted in Oman, and was both published on the World Health Organization (WHO) intranet and shared with Thailand's IHR focal point. The key to successful infection control, with no secondary transmission, were the collaborative efforts among hospitals, laboratories and MOHs of both countries. This article is copyright of The Authors, 2017.

Sudden onset odontoid fracture caused by cervical instability in hypotonic cerebral palsy.

PubMed

Shiohama, Tadashi; Fujii, Katsunori; Kitazawa, Katsuhiko; Takahashi, Akiko; Maemoto, Tatsuo; Honda, Akihito

2013-11-01

Fractures of the upper cervical spine rarely occur but carry a high rate of mortality and neurological disabilities in children. Although odontoid fractures are commonly caused by high-impact injuries, cerebral palsy children with cervical instability have a risk of developing spinal fractures even from mild trauma. We herein present the first case of an odontoid fracture in a 4-year-old boy with cerebral palsy. He exhibited prominent cervical instability due to hypotonic cerebral palsy from infancy. He suddenly developed acute respiratory failure, which subsequently required mechanical ventilation. Neuroimaging clearly revealed a type-III odontoid fracture accompanied by anterior displacement with compression of the cervical spinal cord. Bone mineral density was prominently decreased probably due to his long-term bedridden status and poor nutritional condition. We subsequently performed posterior internal fixation surgically using an onlay bone graft, resulting in a dramatic improvement in his respiratory failure. To our knowledge, this is the first report of an odontoid fracture caused by cervical instability in hypotonic cerebral palsy. Since cervical instability and decreased bone mineral density are frequently associated with cerebral palsy, odontoid fractures should be cautiously examined in cases of sudden onset respiratory failure and aggravated weakness, especially in hypotonic cerebral palsy patients. Copyright © 2012 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Impact of nasopharyngeal microbiota on the development of respiratory tract diseases.

PubMed

Esposito, S; Principi, N

2018-01-01

Knowledge of whether and how respiratory microbiota composition can prime the immune system and provide colonisation resistance, limiting consecutive pathobiont overgrowth and infections, is essential to improving the prevention and therapy of respiratory disorders. Modulation of dysbiotic ecosystems or reconstitution of missing microbes might be a possible measure to reduce respiratory diseases. The aim of this review is to analyse the role of nasopharyngeal microbiota in the development of respiratory tract disease in paediatric-age subjects. PubMed was used to search for all studies published over the last 15 years using the following key words: "microbiota" or "microbioma" and "nasopharyngeal" or "respiratory" or "nasal" and "children" or "paediatric" or "infant". Analysis of the literature showed that respiratory microbiota can regulate health and disease development in the respiratory tract. Like the gut microbiota, the respiratory microbiota is established at birth, and early respiratory microbiota composition determines bacterial succession patterns and respiratory health in children. Protective and dangerous bacteria have been identified, and this can be considered the base for developing new approaches to diseases that respond poorly to traditional interventions. Reconstitution of missing microbes can be achieved by the administration of pre- and probiotics. Modulation of respiratory microbiota by favouring colonisation of the upper respiratory tract by beneficial commensals can interfere with the proliferation and activity of resident pathobionts and is a possible new measure to reduce the risk of disease. However, further studies are needed because a deeper understanding of these and related issues can be transferred to clinical practice.

Evidence based position paper on physical and rehabilitation medicine (PRM) professional practice for people with respiratory conditions. The European PRM position (UEMS PRM Section).

PubMed

Oral, Aydan; Juocevicius, Alvydas; Lukmann, Aet; Takáč, Peter; Tederko, Piotr; Hāznere, Ilze; Aguiar-Branco, Catarina; Lazovic, Milica; Negrini, Stefano; Varela Donoso, Enrique; Christodoulou, Nicolas

2018-05-02

Chronic respiratory conditions are among the top causes of death and disability. The aim of the paper is to improve Physical and Rehabilitation Medicine (PRM) physicians' professional practice for persons with chronic respiratory conditions in order to promote their functioning properties and to reduce activity limitations and/or participation restrictions. A systematic review of the literature and a Consensus procedure by means of a Delphi process has been performed involving the delegates of all European countries represented in the UEMS PRM Section. The systematic literature review is reported together with twenty-three recommendations resulting from the Delphi procedure. The professional role of PRM physicians having expertise in the rehabilitation of chronic respiratory conditions is to lead pulmonary rehabilitation programmes in multiprofessional teams, working in collaboration with other disciplines in a variety of settings to improve functioning of people with chronic respiratory conditions. This EBPP represents the official position of the European Union through the UEMS PRM Section and designates the professional role of PRM physicians for people with respiratory conditions.

Neostigmine but not sugammadex impairs upper airway dilator muscle activity and breathing

PubMed Central

Eikermann, M.; Zaremba, S.; Malhotra, A.; Jordan, A. S.; Rosow, C.; Chamberlin, N. L.

2008-01-01

Background Cholinesterase inhibitor-based reversal agents, given in the absence of neuromuscular block, evoke a partial upper airway obstruction by decreasing skeletal upper airway muscle function. Sugammadex reverses neuromuscular block by encapsulating rocuronium. However, its effects on upper airway integrity and breathing are unknown. Methods Fifty-one adult male rats were anaesthetized with isoflurane, tracheostomized, and a femoral artery and vein were cannulated. First, we compared the efficacy of sugammadex 15 mg kg−1 and neostigmine 0.06 mg kg−1 to reverse respiratory effects of rocuronium-induced partial paralysis [train-of-four ratio (T4/T1)=0.5]. Subsequently, we compared the safety of sugammadex and neostigmine given after recovery of the T4/T1 to 1, by measuring phasic genioglossus activity and breathing. Results During partial paralysis (T4/T1=0.5), time to recovery of minute volume to baseline values was 10.9 (2), 75.8 (18), and 153 (54) s with sugammadex, neostigmine, and placebo, respectively (sugammadex was significantly faster than neostigmine and placebo, P<0.05). Recovery of T4/T1 was also faster for sugammadex than neostigmine and placebo. Neostigmine administration after complete recovery of T4/T1 decreased upper airway dilator muscle activity to 64 (30)% of baseline and decreased tidal volume (P<0.05 for both variables), whereas sugammadex had no effect on either variable. Conclusions In contrast to neostigmine, which significantly impairs upper airway dilator muscle activity when given after recovery from neuromuscular block, a reversal dose of sugammadex given under the same conditions does not affect genioglossus muscle activity and normal breathing. Human studies will be required to evaluate the clinical relevance of our findings. PMID:18559352

Prevalence and risk factors associated with nonspecific building-related symptoms in office employees in Japan: relationships between work environment, Indoor Air Quality, and occupational stress.

PubMed

Azuma, K; Ikeda, K; Kagi, N; Yanagi, U; Osawa, H

2015-10-01

A nationwide cross-sectional study of 3335 employees was conducted in 320 offices in Japan to estimate the prevalence of building-related symptoms (BRSs) and determine the risk factors related to work environment, Indoor Air Quality, and occupational stress. Data were collected through self-administered questionnaires. The prevalences of general symptoms, eye irritation, and upper respiratory symptoms were 14.4%, 12.1%, and 8.9%, respectively. Multiple logistic regression analyses revealed that eye irritation was significantly associated with carpeting [odds ratio (OR), 1.73; 95% confidence interval (CI), 1.24-2.41], coldness perception (OR, 1.28; 95% CI, 1.13-1.45), and air dryness perception (OR, 1.61; 95% CI, 1.42-1.82). General symptoms were significantly associated with unpleasant odors (OR, 1.37; 95% CI, 1.13-1.65), amount of work (OR, 1.24; 95% CI, 1.06-1.45), and interpersonal conflicts (OR, 1.44; 95% CI, 1.23-1.69). Upper respiratory symptoms were significantly associated with crowded workspaces (OR, 1.36; 95% CI, 1.13-1.63), air dryness perception (OR, 2.07; 95% CI, 1.79-2.38), and reported dustiness on the floor (OR, 1.39; 95% CI, 1.16-1.67). Although psychosocial support is important to reduce and control BRSs, maintaining appropriate air-conditioning and a clean and uncrowded workspace is of equal importance. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Cochlear implantation in chronic demyelinating inflammatory polyneuropathy.

PubMed

Mowry, Sarah E; King, Sarah

2017-03-01

To describe a case of chronic inflammatory demyelinating polyneuropathy (CDIP) with bilateral sudden sensorineural hearing loss who subsequently benefited from unilateral cochlear implantation. case history review and review of the literature for the terms CDIP, hearing loss, cochleovestibular dysfunction, and cochlear implantation. A 49-year-old woman presented with bilateral rapidly progressive sensorineural hearing loss (SNHL) 1 month after an upper respiratory tract infection. Hearing loss was not responsive to high-dose steroids and there were no other laboratory abnormalities or physical findings. Within 1 month, she developed ascending motor palsy, requiring long-term ventilator support. This neurologic condition was diagnosed as CDIP and she was successfully treated with plasmapheresis and intravenous immunoglobulin. Her hearing never recovered. At the time of cochlear implant, she had no response at the limits of the audiometer and obtained 0% on AzBio testing. No ABR could be recorded preoperatively. She underwent uneventful cochlear implantation with a perimodilar electrode. One year after activation, she had a PTA of 20 dB and 40% on AzBio sentence testing. Her eABR demonstrated a neuropathy pattern. Only two other cases of CDIP associated with dysfunction of the eighth nerve have been described, and neither had documented profound hearing loss. Severe SNHL associated with CDIP is rare. Although this patient has good access to sound, speech discrimination is poor at 1-year post implantation. This outcome may be due to incomplete recovery of myelination of the eighth nerve. Other possibilities include loss of peripheral nerve fibers due to the initial viral upper respiratory infection, which may lead to less neural substrate to stimulate.

Biofilm formation by virulent and non-virulent strains of Haemophilus parasuis.

PubMed

Bello-Ortí, Bernardo; Deslandes, Vincent; Tremblay, Yannick D N; Labrie, Josée; Howell, Kate J; Tucker, Alexander W; Maskell, Duncan J; Aragon, Virginia; Jacques, Mario

2014-11-27

Haemophilus parasuis is a commensal bacterium of the upper respiratory tract of healthy pigs. It is also the etiological agent of Glässer's disease, a systemic disease characterized by polyarthritis, fibrinous polyserositis and meningitis, which causes high morbidity and mortality in piglets. The aim of this study was to evaluate biofilm formation by well-characterized virulent and non-virulent strains of H. parasuis. We observed that non-virulent strains isolated from the nasal cavities of healthy pigs formed significantly (p < 0.05) more biofilms than virulent strains isolated from lesions of pigs with Glässer's disease. These differences were observed when biofilms were formed in microtiter plates under static conditions or formed in the presence of shear force in a drip-flow apparatus or a microfluidic system. Confocal laser scanning microscopy using different fluorescent probes on a representative subset of strains indicated that the biofilm matrix contains poly-N-acetylglucosamine, proteins and eDNA. The biofilm matrix was highly sensitive to degradation by proteinase K. Comparison of transcriptional profiles of biofilm and planktonic cells of the non-virulent H. parasuis F9 strain revealed a significant number of up-regulated membrane-related genes in biofilms, and genes previously identified in Actinobacillus pleuropneumoniae biofilms. Our data indicate that non-virulent strains of H. parasuis have the ability to form robust biofilms in contrast to virulent, systemic strains. Biofilm formation might therefore allow the non-virulent strains to colonize and persist in the upper respiratory tract of pigs. Conversely, the planktonic state of the virulent strains might allow them to disseminate within the host.

Respiratory symptoms and conditions related to occupational exposures in machine shops.

PubMed

Jaakkola, Maritta S; Suuronen, Katri; Luukkonen, Ritva; Järvelä, Merja; Tuomi, Timo; Alanko, Kristiina; Mäkelä, Erja A; Jolanki, Riitta

2009-01-01

Since there are few data on the effects of metalworking in populations representing a variety of metal companies or on dose-response relationships concerning metalworking, this study investigated the relationship between occupational exposures in machine shops and the occurrence of upper and lower respiratory symptoms, asthma, and chronic bronchitis. A cross-sectional study of 726 male machine workers and 84 male office workers from 64 companies was conducted in southern Finland. All of the participants filled out a questionnaire, and aerosol measurements were performed in 57 companies. Exposure to metalworking fluids (MWF) showed a greater risk [odds ratio (OR)>or=2) for upper-airway symptoms, cough, breathlessness, and current asthma than exposures in office work did. Exposure to aerosol levels above the median (>or=0.17 mg/m3 in the general workshop air) was related to an increased risk (OR>or=2) of nasal and throat symptoms, cough, wheezing, breathlessness, chronic bronchitis, and current asthma. Machine workers with a job history of >or=15 years experienced increased throat symptoms, cough, and chronic bronchitis. This large study representing machine shops in southern Finland showed that machine workers experience increased nasal and throat symptoms, cough, wheezing, breathlessness, and asthma even in environments with exposure levels below the current occupational exposure limit for oil mists. The study suggests that improving machine shop environments could benefit the health of this workforce. It also suggests that it is time to consider reducing the current Finnish occupational exposure limit for oil mist or introducing the use of other health-relevant indicators of exposure.

Airway recovery after face transplantation.

PubMed

Fischer, Sebastian; Wallins, Joe S; Bueno, Ericka M; Kueckelhaus, Maximilian; Chandawarkar, Akash; Diaz-Siso, J Rodrigo; Larson, Allison; Murphy, George F; Annino, Donald J; Caterson, Edward J; Pomahac, Bohdan

2014-12-01

Severe facial injuries can compromise the upper airway by reducing airway volume, obstructing or obliterating the nasal passage, and interfering with oral airflow. Besides the significant impact on quality of life, upper airway impairments can have life-threatening or life-altering consequences. The authors evaluated improvements in functional airway after face transplantation. Between 2009 and 2011, four patients underwent face transplantation at the authors' institution, the Brigham and Women's Hospital. Patients were examined preoperatively and postoperatively and their records reviewed for upper airway infections and sleeping disorders. The nasal mucosa was biopsied after face transplantation and analyzed using scanning electron microscopy. Volumetric imaging software was used to evaluate computed tomographic scans of the upper airway and assess airway volume changes before and after transplantation. Before transplantation, two patients presented an exposed naked nasal cavity and two suffered from occlusion of the nasal passage. Two patients required tracheostomy tubes and one had a prosthetic nose. Sleeping disorders were seen in three patients, and chronic cough was diagnosed in one. After transplantation, there was no significant improvement in sleeping disorders. The incidence of sinusitis increased because of mechanical interference of the donor septum and disappeared after surgical correction. All patients were decannulated after transplantation and were capable of nose breathing. Scanning electron micrographs of the respiratory mucosa revealed viable tissue capable of mucin production. Airway volume significantly increased in all patients. Face transplantation successfully restored the upper airway in four patients. Unhindered nasal breathing, viable respiratory mucosa, and a significant increase in airway volume contributed to tracheostomy decannulation.

Anesthetic challenges of a patient with the communicating bulla coming for nonthoracic surgery.

PubMed

Theodare, Bernice; Nissy, Vinolia Victory; Sahajanandan, Raj; Mariappan, Ramamani

2018-01-01

Management of a patient with a giant bulla coming for a nonthoracic surgery is rare, and its anesthetic management is very challenging. It is imperative to isolate only the subsegmental bronchus, in which the bulla communicates to avoid respiratory morbidities such as pneumothorax, emphysema or atelectasis of the surrounding lung parenchyma, and postoperative respiratory failure. Herewith, we want to report the anesthetic challenges of a patient with giant bulla communicating into one of the subsegmental right upper lobe bronchus for splenectomy.

Management of respiratory problems in people with neurodegenerative conditions: a narrative review.

PubMed

Jones, U; Enright, S; Busse, M

2012-03-01

Respiratory failure and dysfunction are common problems in many neurodegenerative conditions. Although physiotherapists manage these problems, it is not known which treatments have been studied and their efficacy. To review evidence on the management of respiratory problems in people with neurodegenerative conditions using the PRISMA approach. Comprehensive searches were conducted using the following electronic databases from inception to May 2010: HUGEnet, SIGLE, British Library Direct, CINAHL, Medline, AMED and Web of Knowledge. Bibliographies of all studies and systematic reviews were searched by hand. Studies were selected based on: self-ventilating participants with neurodegenerative conditions; interventions aimed at improving respiratory function; and any valid and reliable measures of respiratory function as outcomes. Studies were appraised by one reviewer using the Critical Appraisal Skills Programme. Data were synthesised using a narrative approach. Thirty-five studies were included in the review. The strongest evidence was for the use of non-invasive ventilation for people with amyotrophic lateral sclerosis, although this was weak. The evidence for the use of respiratory muscle training and methods to increase peak cough flow showed a positive effect, but was also weak. There is weak evidence for the positive effects of physiotherapeutic interventions for respiratory problems in people with neurodegenerative conditions. Further work is necessary in specific neurodegenerative conditions to identify why respiratory problems occur, and larger scale studies should be undertaken to investigate management of these problems. Copyright © 2011 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Should We Prescribe Antibiotics to This Patient With Persistent Upper Respiratory Symptoms?: Grand Rounds Discussion From Beth Israel Deaconess Medical Center.

PubMed

Libman, Howard; Brockmeyer, Diane M; Gold, Howard S

2017-02-07

The American College of Physicians (ACP) and the Centers for Disease Control and Prevention (CDC) recently published advice for high-value care on the appropriate use of antibiotics for acute respiratory tract infections. They conducted a narrative literature review of evidence for antibiotic use in this setting that included recent clinical guidelines from professional societies supplemented by randomized, controlled trials; meta-analyses; and systematic reviews. They concluded that clinicians should reserve antibiotic treatment for acute rhinosinusitis in patients with persistent symptoms for more than 10 days, high fever and purulent nasal discharge or facial pain lasting for at least 3 consecutive days, or worsening symptoms after a typical viral illness that lasted 5 days and had initially improved ("double-sickening"). In this Grand Rounds, 2 prominent clinicians debate whether to initiate antibiotic treatment in a 62-year-old man with a history of recurrent sinusitis who presents with persistent upper respiratory symptoms. They review the data on which the ACP/CDC recommendations are based and discuss the potential benefits and risks, as well as the challenges and controversies, of prescribing antibiotic therapy in this setting.

Infection of the upper respiratory tract of hamsters by the bovine parainfluenza virus type 3 BN-1 strain expressing enhanced green fluorescent protein.

PubMed

Ohkura, Takashi; Minakuchi, Moeko; Sagai, Mami; Kokuho, Takehiro; Konishi, Misako; Kameyama, Ken-Ichiro; Takeuchi, Kaoru

2015-02-01

Bovine parainfluenza virus type 3 (BPIV3) is an important pathogen associated with bovine respiratory disease complex (BRDC). We have generated a recombinant BPIV3 expressing enhanced green fluorescent protein (rBPIV3-EGFP) based on the BN-1 strain isolated in Japan. After intranasal infection of hamsters with rBPIV3-EGFP, EGFP fluorescence was detected in the upper respiratory tract including the nasal turbinates, pharynx, larynx, and trachea. In the nasal turbinates, rBPIV3-EGFP attained high titers (>10(6) TCID50/g of tissue) 2-4 days after infection. Ciliated epithelial cells in the nasal turbinates and trachea were infected with rBPIV3-EGFP. Histopathological analysis indicated that mucosal epithelial cells in bronchi were shed by 6 days after infection, leaving non-ciliated cells, which may have increased susceptibility to bacterial infection leading to the development of BRDC. These data indicate that rBPIV3-EGFP infection of hamsters is a useful small animal model for studying the development of BPIV3-associated BRDC. Copyright © 2014 Elsevier Inc. All rights reserved.

Impacts of upper respiratory tract disease on olfactory behavior of the Mojave desert tortoise

USGS Publications Warehouse

Germano, Jennifer; Van Zerr, Vanessa E.; Esque, Todd C.; Nussear, Ken E.; Lamberski, Nadine

2014-01-01

Upper respiratory tract disease (URTD) caused by Mycoplasma agassizii is considered a threat to desert tortoise populations that should be addressed as part of the recovery of the species. Clinical signs can be intermittent and include serous or mucoid nasal discharge and respiratory difficulty when nares are occluded. This nasal congestion may result in a loss of the olfactory sense. Turtles are known to use olfaction to identify food items, predators, and conspecifics; therefore, it is likely that URTD affects not only their physical well-being but also their behavior and ability to perform necessary functions in the wild. To determine more specifically the impact nasal discharge might have on free-ranging tortoises (Gopherus agassizii), we compared the responses of tortoises with and without nasal discharge and both positive and negative for M. agassizii antibodies to a visually hidden olfactory food stimulus and an empty control. We found that nasal discharge did reduce sense of smell and hence the ability to locate food. Our study also showed that moderate chronic nasal discharge in the absence of other clinical signs did not affect appetite in desert tortoises.

Prevalence of tidal expiratory flow limitation in preschool children with and without respiratory symptoms: application of the negative expiratory pressure (NEP) method.

PubMed

JIRICKOVA, A; SULC, J; POHUNEK, P; KITTNAR, O; DOHNALOVA, A; KOFRANEK, J

2009-01-01

Negative expiratory pressure (NEP) applied at the mouth during tidal expiration provides a non-invasive method for detecting expiratory flow limitation. Forty-two children were studied, i.e. 25 children with different respiratory symptoms (R) and 17 without any respiratory symptoms (NR). Children were examined without any sedation. A preset NEP of -5 cm H(2)O was applied; its duration did not exceed duration of tidal expiration. A significance of FL was judged by determining of a flow-limited range (in % of tidal volume). FL was found in 48 % children of R group. No patient of the NR group elicited FL (P<0.001 R vs. NR). The frequency of upper airway collapses was higher in R group (12 children) than in NR group (5 children). In conclusion, a high frequency of tidal FL in the R group was found, while it was not present in NR group. A relatively high frequency of expiratory upper airway collapses was found in both groups, but it did not differ significantly. NEP method represents a reasonable approach for tidal flow limitation testing in non-sedated preschool children.

Upper airway surgery of obstructive sleep apnea in pycnodysostosis: case report and literature review.

PubMed

Testani, Elisa; Scarano, Emanuele; Leoni, Chiara; Dittoni, Serena; Losurdo, Anna; Colicchio, Salvatore; Gnoni, Valentina; Vollono, Catello; Zampino, Giuseppe; Paludetti, Gaetano; Della Marca, Giacomo

2014-08-01

Pycnodysostosis is an autosomal recessive disorder due to a mutation in the cathepsin K gene, which causes a decrease of the bone turnover; a review of the literature suggests that pycnodysostosis is frequently associated with severe respiratory obstruction, which needs surgical treatment. The aim of this paper is to describe the surgical treatment of a 3½-year-old girl affected by Pycnodysostosis complicated by a severe sleep-related respiratory disorder. The surgical treatment, consisting of adenotonsillectomy and palatoplasty, resulted in a striking amelioration of respiratory parameters and increased posterior airway space, and allowed the patient to avoid tracheotomy while awaiting for maxillo-mandibular surgery. © 2014 Wiley Periodicals, Inc.

[Effects of recent upper respiratory-tract infections on incidence of the perioperative respiratory adverse events in children: a prospective cohort study].

PubMed

Li, C Q; Wang, D X; Cheng, T; Zheng, X Y

2017-10-18

To investigate the effects of the recent upper respiratory tract infections (URI) on the incidence of perioperative respiratory adverse events in children scheduled to undergo general anesthesia and elective surgery. In the study, 232 children undergoing general anesthesia with laryngeal mask airway (LMA) for elective ophthalmic surgeries at Peking University First Hospital, Beijing, China, from Nov. 1, 2015 to May 10, 2016 were enrolled. On the day of the surgery, the parents of the children were preoperatively asked to fill out a questionnaire regarding the baseline characteristics and medical history of the children, including gender, age, height, weight, history of URI within the last 2 weeks before anesthesia, history of premature, long-term passive smoking exposure, habitual sleep snoring, and history of asthma. In addition, all adverse respiratory events throughout the perioperative periods (oxygen desaturation, cough, copious secretions, laryngospasm and bronchospasm) as well as peri-operative variables (number of attempts to insert the LMA successfully, anesthesia duration and so on) were recorded. Multivariate Logistic regression analysis was applied to identify independent risk factors of perioperative respiratory adverse events. Among the 232 children included in the study, 28.0% (65/232) presented with a history of a recent URI within the last 2 weeks before anesthesia. The presence of the recent URI increased the incidence of oxygen desaturation (23.1% vs.12.0%, P=0.034), copious secretions (15.4% vs. 6.6%, P=0.036) and any of all the adverse respiratory events (32.3% vs. 18.6%, P=0.024). Multivariate Logistic regression analysis identified two independent risk factors of perioperative adverse respiratory events: a history of URI within the last 2 weeks before general anesthesia (OR=2.021, 95%CI: 1.023-3.994, P=0.043) and habitual sleep snoring (OR=3.660, 95%CI: 1.517-8.832, P=0.004). A history of a recent URI within 2 weeks before general anesthesia was associated with a higher incidence of oxygen desaturation, copious secretions and the overall respiratory adverse events. For the children with recent URI, we recommend the general anesthesia and elective surgery should be postponed for at least 2 weeks after the URI.

[Midface alterations in childhood as pathogenesis of obstructive sleep apnea syndrome].

PubMed

Rangel Chávez, José de Jesús; Espinosa Martínez, Cynthia; Medina Serpa, Aldo Uzziel

The onset of nasal breathing sets a genetically determined impulse to aerate the face cavities or paranasal sinuses, which in turn initiate its growth creating the useful trafficable space for air during the development of the midface. Considering the evidence that the upper airway obstruction has a primary role in the pathogenesis of respiratory sleep disorders, any condition that causes a permanent difficulty to the nasal airflow during breathing will cause hypo-development of the required amplitude in this airway, reducing the growth stimulation of the sinus cavities and altering the development of the midface as a whole. Copyright © 2016 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

The LIPPSMAck POP (Lung Infection Prevention Post Surgery - Major Abdominal - with Pre-Operative Physiotherapy) trial: study protocol for a multi-centre randomised controlled trial.

PubMed

Boden, Ianthe; Browning, Laura; Skinner, Elizabeth H; Reeve, Julie; El-Ansary, Doa; Robertson, Iain K; Denehy, Linda

2015-12-15

Post-operative pulmonary complications are a significant problem following open upper abdominal surgery. Preliminary evidence suggests that a single pre-operative physiotherapy education and preparatory lung expansion training session alone may prevent respiratory complications more effectively than supervised post-operative breathing and coughing exercises. However, the evidence is inconclusive due to methodological limitations. No well-designed, adequately powered, randomised controlled trial has investigated the effect of pre-operative education and training on post-operative respiratory complications, hospital length of stay, and health-related quality of life following upper abdominal surgery. The Lung Infection Prevention Post Surgery - Major Abdominal- with Pre-Operative Physiotherapy (LIPPSMAck POP) trial is a pragmatic, investigator-initiated, bi-national, multi-centre, patient- and assessor-blinded, parallel group, randomised controlled trial, powered for superiority. Four hundred and forty-one patients scheduled for elective open upper abdominal surgery at two Australian and one New Zealand hospital will be randomised using concealed allocation to receive either i) an information booklet or ii) an information booklet, plus one additional pre-operative physiotherapy education and training session. The primary outcome is respiratory complication incidence using standardised diagnostic criteria. Secondary outcomes include hospital length of stay and costs, pneumonia diagnosis, intensive care unit readmission and length of stay, days/h to mobilise >1 min and >10 min, and, at 6 weeks post-surgery, patient reported complications, health-related quality of life, and physical capacity. The LIPPSMAck POP trial is a multi-centre randomised controlled trial powered and designed to investigate whether a single pre-operative physiotherapy session prevents post-operative respiratory complications. This trial standardises post-operative assisted ambulation and physiotherapy, measures many known confounders, and includes a post-discharge follow-up of complication rates, functional capacity, and health-related quality of life. This trial is currently recruiting. Australian New Zealand Clinical Trials Registry number: ACTRN12613000664741 , 19 June 2013.

Patient-reported outcomes to assess the efficacy of extended-release guaifenesin for the treatment of acute respiratory tract infection symptoms.

PubMed

Albrecht, Helmut; Vernon, Margaret; Solomon, Gail

2012-12-27

Guaifenesin is a component of medicines used to improve symptoms associated with upper respiratory tract infections. Patient-reported outcome instruments are valuable for evaluating symptom improvements; however, a validated tool to assess efficacy of mucoactive drugs does not exist. We compared the efficacy of extended-release guaifenesin with placebo for treatment of symptoms of upper respiratory tract infection using subjective efficacy assessments in a pilot study and confirmed precision of assessments in a validation study. The pilot study was a randomized, double-blind study where patients were dosed with either 1200 mg extended-release guaifenesin (n = 188) or placebo (n = 190), every 12 hours for 7 days. Efficacy was assessed using subjective measures including the Daily Cough and Phlegm Diary, the Spontaneous Symptom Severity Assessment and the Wisconsin Upper Respiratory Symptom Survey. End-of-study assessments were completed by patients and investigator. The validation study consisted of two phases. In Phase I, subjects completed interviews to gather evidence to support the content validity of the Daily Cough and Phlegm Diary, the Spontaneous Symptom Severity Assessment and Patient's End-of-Treatment Assessment. Phase II examined the psychometric properties of assessments evaluated in Phase I of the validation study using data from the pilot study. Subjective measures of efficacy at Day 4 showed the most prominent difference between treatment groups, in favor of guaifenesin. The 8-symptom related questions (SUM8) in the Daily Cough and Phlegm Diary, analyzed as a composite score appeared to be the strongest candidate endpoint for further evaluation. Results from the interviews in Phase I supported the content of the assessments which were validated during Phase II. Treatments were well tolerated. Results from the clinical pilot and validation studies showed that the SUM8 diary scores were robust and reliable for use as efficacy endpoints in studies of mucoactive drugs. The study was registered with clinicaltrials.gov (NCT01046136).

Upper airway viruses and bacteria and clinical outcomes in children with cough.

PubMed

O'Grady, Kerry-Ann F; Grimwood, Keith; Sloots, Theo P; Whiley, David M; Acworth, Jason P; Phillips, Natalie; Marchant, Julie; Goyal, Vikas; Chang, Anne B

2017-03-01

Cough is symptomatic of a broad range of acute and chronic pediatric respiratory illnesses. No studies in children have tested for an extended panel of upper airway respiratory viruses and bacteria to identify whether they predict cough outcomes, irrespective of clinical diagnosis at the time of acute respiratory illness (ARI). We therefore determined whether upper airway microbes independently predicted hospitalization and persistent cough 28-days later in children presenting with an ARI, including cough as a symptom. A cohort study of children aged <15-years were followed for 28-days after presenting to a pediatric emergency department with an ARI where cough was also a symptom. Socio-demographic factors, presenting clinical features and a bilateral anterior nasal swab were collected at enrolment. Polymerase chain reaction assays tested for seven respiratory bacteria and 17 viruses. Predictors of hospitalization and persistent cough at day-28 were evaluated in logistic regression models. Eight hundred and seventeen children were included in the analysis; median age 27.7-months. 116 (14.2%, 95%CI 11.8, 16.6) children were hospitalized and 163 (20.0%, 95%CI 17.2, 22.7) had persistent cough at day-28. Hospitalized children were more likely to have RSV A or B detected on nasal swab than those not admitted (adjusted relative risk (aRR) 1.8, 95%CI 1.0, 3.3). M. catarrhalis was the only microbial difference between children with and without cough persistence (aRR for those with cough at day 28: 2.1, 95%CI 1.3, 3.1). An etiologic role for M. catarrhalis in the pathogenesis of persistent cough post-ARI is worth exploring, especially given the burden of chronic cough in children and its relationship with chronic lung disease. Pediatr Pulmonol. 2017;52:373-381. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Patient-reported outcomes to assess the efficacy of extended-release guaifenesin for the treatment of acute respiratory tract infection symptoms

PubMed Central

2012-01-01

Background Guaifenesin is a component of medicines used to improve symptoms associated with upper respiratory tract infections. Patient-reported outcome instruments are valuable for evaluating symptom improvements; however, a validated tool to assess efficacy of mucoactive drugs does not exist. We compared the efficacy of extended-release guaifenesin with placebo for treatment of symptoms of upper respiratory tract infection using subjective efficacy assessments in a pilot study and confirmed precision of assessments in a validation study. Methods The pilot study was a randomized, double-blind study where patients were dosed with either 1200 mg extended-release guaifenesin (n = 188) or placebo (n = 190), every 12 hours for 7 days. Efficacy was assessed using subjective measures including the Daily Cough and Phlegm Diary, the Spontaneous Symptom Severity Assessment and the Wisconsin Upper Respiratory Symptom Survey. End-of-study assessments were completed by patients and investigator. The validation study consisted of two phases. In Phase I, subjects completed interviews to gather evidence to support the content validity of the Daily Cough and Phlegm Diary, the Spontaneous Symptom Severity Assessment and Patient’s End-of-Treatment Assessment. Phase II examined the psychometric properties of assessments evaluated in Phase I of the validation study using data from the pilot study. Results Subjective measures of efficacy at Day 4 showed the most prominent difference between treatment groups, in favor of guaifenesin. The 8-symptom related questions (SUM8) in the Daily Cough and Phlegm Diary, analyzed as a composite score appeared to be the strongest candidate endpoint for further evaluation. Results from the interviews in Phase I supported the content of the assessments which were validated during Phase II. Treatments were well tolerated. Conclusions Results from the clinical pilot and validation studies showed that the SUM8 diary scores were robust and reliable for use as efficacy endpoints in studies of mucoactive drugs. Trial registration The study was registered with clinicaltrials.gov (NCT01046136). PMID:23270519

Laryngitis

MedlinePlus

... laryngitis: Try to avoid people who have upper respiratory infections during cold and flu season. Wash your hands often. DO NOT strain your voice. Stop smoking. This can help prevent tumors of the head and neck or lungs, which can lead to hoarseness.

21 CFR 520.90b - Ampicillin trihydrate tablets.

Code of Federal Regulations, 2012 CFR

2012-04-01

... mirabilis, and Pasteurella spp., urinary tract infections (cystitis) due to Streptococcus spp., Staphylococcus spp., E., coli, P. mirabilis, and Enterococcus spp.; gastrointestinal infections due to... treatment of infections caused by susceptible organisms as follows: Upper respiratory infections...

21 CFR 522.88 - Amoxicillin.

Code of Federal Regulations, 2014 CFR

2014-04-01

..., tracheobronchitis) due to Staphylococcus aureus, Streptococcus spp., Escherichia coli, and Proteus mirabilis...: Upper respiratory infections due to S. aureus, Staphylococcus spp., Streptococcus spp., Haemophilus spp..., lacerations, and wounds) due to S. aureus, Staphylococcus spp., Streptococcus spp., E. coli, and Pasteurella...

Acupuncture therapy for fever induced by viral upper respiratory tract infection (URTI) in military medical service: a case series.

PubMed

Kwon, SeungWon; Shin, KyoungHo; Jung, WooSang; Moon, SangKwan; Cho, KiHo

2014-12-01

We report the cases of eight military patients with fever (≥38°C) induced by viral upper respiratory tract infection (URTI) who requested treatment with acupuncture in the military medical service room. All patients were treated immediately after diagnosis with classical acupuncture (GV14, GB20, TE8 points) and a new type of acupuncture, equilibrium acupuncture (Feibing and Ganmao points). After one treatment session (20 min), reduction of body temperature was confirmed in all patients. Accompanying symptoms such as headache, myalgia and nasal obstruction also showed a tendency to decrease. Within 3 days of treatment, six of the eight patients had recovered from the URTI. No adverse effects of acupuncture treatment were reported. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Rare upper gastrointestinal hemorrhage of cetuximab: A case report.

PubMed

Duan, Shi-Jie; Gao, Zi-Ming; Wang, Peng-Liang; Gong, Bao-Cheng; Huang, Han-Wei; Luo, Lei; Wang, Xin; Xing, Ya-Nan; Xu, Hui-Mian; Liu, Fu-Nan

2017-12-01

cetuximab, an epidermal growth factor receptor inhibitor, is a targeted therapeutic regimen of colorectal cancers. Several common adverse effects have been found, such as cutaneous or gastrointestinal toxicity. However, according to the articles had been published, upper gastrointestinal bleeding (UGIB) is considered to be rare and its mechanism remains unclear. In this report, we presented a 42-year-old male patient with advanced recto-sigmoid cancer. After palliative operation, the patient suffered from complete upper gastrointestinal (GI) obstruction, which was induced by extensive abdominal metastasis of the tumor. Considering his poor condition, we chose the targeted drug, cetuximab, as his further treatment. But after the application of cetuximab, the UGIB immediately happened twice in this patient. UGIB, as a rare complication of cetuximab, occured to the patient. We stopped the bleeding with thrombin, hemocoagulase and somatostatin and suspended the subsequent treatment plan of cetuximab. At the same time, anti-shock treatment was given immediately. He was died of respiratory and circulatory failure caused by UGIB and advanced tumor eventually. UGIB should be considered as a rare but severe complication of cetuximab. When cetuximab is applied for patients with advanced colon tumors, more cautions should be required if the patients are accompanied by upper gastrointestinal obstruction. In addition, for those patients who suffered from UGIB recently, cetuximab should be prohibited if the Rockall score ranged > 5 points. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Intermittent hypoxia, respiratory plasticity and sleep apnea in humans: present knowledge and future investigations.

PubMed

Mateika, Jason H; Syed, Ziauddin

2013-09-15

This review examines the role that respiratory plasticity has in the maintenance of breathing stability during sleep in individuals with sleep apnea. The initial portion of the review considers the manner in which repetitive breathing events may be initiated in individuals with sleep apnea. Thereafter, the role that two forms of respiratory plasticity, progressive augmentation of the hypoxic ventilatory response and long-term facilitation of upper airway and respiratory muscle activity, might have in modifying breathing events in humans is examined. In this context, present knowledge regarding the initiation of respiratory plasticity in humans during wakefulness and sleep is addressed. Also, published findings which reveal that exposure to intermittent hypoxia promotes breathing instability, at least in part, because of progressive augmentation of the hypoxic ventilatory response and the absence of long-term facilitation, are considered. Next, future directions are presented and are focused on the manner in which forms of plasticity that stabilize breathing might be promoted while diminishing destabilizing forms, concurrently. These future directions will consider the potential role of circadian rhythms in the promotion of respiratory plasticity and the role of respiratory plasticity in enhancing established treatments for sleep apnea. Published by Elsevier B.V.

[Efficacy and tolerance of fenspiride in adult patients with acute respiratory tract infections].

PubMed

Płusa, T; Nawacka, D

1998-12-01

Fenspiride is an antiinflammatory drug targeted for the respiratory tract. In our study clinical efficacy and tolerance of drug were evaluated in 392 adult patients with acute respiratory tract infections. According to clinical criteria all observed symptoms were classified as mild, moderate and severe. The most of observed patients were included into moderate symptom score. Cough and nose obturation were dominant symptoms. All noticed changes in the upper respiratory tract were decreased after fenspiride therapy in 7 days trial. In 168 observed patients systemic and in 60 local acting antibiotics were successfully applied. Excellent tolerance of fenspiride was documented in 59% and good tolerance --in 34% of patients. Observed adverse reactions were classified as mild and in 20 patients fenspiride was rejected. Authors suggest that fenspiride therapy is save and successful in patient with acute respiratory tract infection. Good results in patients with bronchitis in decreasing of bronchospasm indicate fenspiride as a good tool in bronchial infection.

[Specific aspects and care of lung involvement in adults with cystic fibrosis].

PubMed

Pin, I; Grenet, D; Scheid, P; Domblides, P; Stern, M; Hubert, D

2000-08-01

Respiratory impairment is present in almost all adult cystic fibrosis patients and makes the prognosis. Viscous, infected and abundant secretions, inflammation and bronchial oedema, bronchoconstriction and respiratory muscle fatigue lead to airway obstruction, bronchiectasis and respiratory failure. The disease is preferentially located in the upper lobes. Exacerbations of the disease are due to bronchial infections and are often responsible for drops of the respiratory function. Regular spirometric surveillance is fundamental for the prognosis and the assessment of the effects of the treatment. Among adult patients chronic colonisation with mucoid and often multiresistant strains of Pseudomonas Aeruginosa are common. It is treated with i.v. high doses antibiotic courses and nebulized antibiotics between i.v. courses. Respiratory failure may require long term oxygen and non invasive mechanical ventilation. Systemic hypervascularization around the bronchiectasis may lead to moderate to severe hemoptysis, which may require embolization. Pneumothorax are associated with poor prognosis and are treated by pleural drainage and if failure by thoracoscopy.

Pattern of deposition of stainless steel welding fume particles inhaled into the respiratory systems of Sprague-Dawley rats exposed to a novel welding fume generating system.

PubMed

Yu, I J; Kim, K J; Chang, H K; Song, K S; Han, K T; Han, J H; Maeng, S H; Chung, Y H; Park, S H; Chung, K H; Han, J S; Chung, H K

2000-07-27

In order to investigate occupational diseases related to welding fume exposure, such as nasal septum perforation, pneumoconiosis and manganese intoxication, we built a welding fume exposure system that included a welding fume generator, exposure chamber and fume collector. The fume concentrations in the exposure chamber were monitored every 15 min during a 2-h exposure. Fume (mg/m(3)) concentrations of major metals, including Fe, Mn, Cr, and Ni were found to be consistently maintained. An acute inhalation toxicity study was conducted by exposing male Sprague-Dawley rats to the welding fumes generated in this apparatus by stainless steel arc welding. The rats were exposed in the inhalation chamber to a welding fume with a concentration of 62 mg/m(3) total suspended particulates for 4 h. Animals were sacrificed at 4 h and at 1, 3, 7, 10, and 14 days after exposure. Histopathological examinations were conducted on the animals' upper respiratory tracts, including the nasal pathway and the conducting airway, and on the gas exchange region including the alveolar ducts, alveolar sacs, and alveoli. Diameters of fume particles varied from 0.02 to 0.81 microm and were distributed log normally, with a mean diameter of 0.1 microm and geometric standard deviation of 1.42. Rats exposed to the welding fume for 4 h did not show any significant respiratory system toxicity. The mean particle diameter of 0.1 microm resulted in little adsorption of the welding fume particles in the upper respiratory tract. Particle adsorption took place principally in the lower respiratory tracts, including bronchioles, alveolar ducts, alveolar sacs, and alveoli.

High prevalence of acute respiratory tract infections among Warao Amerindian children in Venezuela in relation to low immunization coverage and chronic malnutrition.

PubMed

Verhagen, Lilly M; Warris, Adilia; Hermans, Peter W M; del Nogal, Berenice; de Groot, Ronald; de Waard, Jacobus H

2012-03-01

Higher prevalence rates of acute respiratory tract infections (ARTIs) have been described in Australian and Canadian indigenous populations than in nonindigenous age-matched counterparts. Few studies on ARTIs in South American indigenous populations have been published. We performed a cross-sectional survey to describe the prevalence of upper respiratory tract infections and acute lower respiratory tract infections (ALRTIs) and associations with malnutrition and immunization status. From December 1, 2009 to May 31, 2010, 487 Warao Amerindian children 0 to 59 months of age living in the Delta Amacuro in Venezuela were included in a cross-sectional survey. Data were obtained through parent questionnaires, vaccination cards, and physical examinations including anthropometric measurements. Of the 487 children, 47% presented with an ARTI. Of these, 60% had upper respiratory tract infections and 40% were ALRTI. Immunization coverage was low, with only 27% of all children presenting a vaccination card being fully immunized. The prevalence of malnutrition was high (52%), with stunting (height-for-age <-2 standard deviations) being the most frequent presentation affecting 45% of children. ARTI and ALRTI prevalence diminished with increasing age (odds ratio for ALRTI in children 25-59 months of age vs. children younger than 12 months, 0.49; 95% confidence interval, 0.26-0.93). Furthermore, significant differences in ARTI prevalence were seen between villages. No significant associations between immunization status or malnutrition and ARTI or ALRTI prevalence were identified. A high prevalence of ARTIs and chronic malnutrition in combination with a low immunization status highlights the need for an integrated approach to improve the health status of indigenous Venezuelan children.

Quantitative detection of Moraxella catarrhalis in nasopharyngeal secretions by real-time PCR.

PubMed

Greiner, Oliver; Day, Philip J R; Altwegg, Martin; Nadal, David

2003-04-01

The recognition of Moraxella catarrhalis as an important cause of respiratory tract infections has been protracted, mainly because it is a frequent commensal organism of the upper respiratory tract and the diagnostic sensitivity of blood or pleural fluid culture is low. Given that the amount of M. catarrhalis bacteria in the upper respiratory tract may change during infection, quantification of these bacteria in nasopharyngeal secretions (NPSs) by real-time PCR may offer a suitable diagnostic approach. Using primers and a fluorescent probe specific for the copB outer membrane protein gene, we detected DNA from serial dilutions of M. catarrhalis cells corresponding to 1 to 10(6) cells. Importantly, there was no difference in the amplification efficiency when the same DNA was mixed with DNA from NPSs devoid of M. catarrhalis. The specificity of the reaction was further confirmed by the lack of amplification of DNAs from other Moraxella species, nontypeable Haemophilus influenzae, H. influenzae type b, Streptococcus pneumoniae, Streptococcus oralis, Streptococcus pyogenes, Bordetella pertussis, Corynebacterium diphtheriae, and various Neisseria species. The assay applied to NPSs from 184 patients with respiratory tract infections performed with a sensitivity of 100% and a specificity of up to 98% compared to the culture results. The numbers of M. catarrhalis organisms detected by real-time PCR correlated with the numbers detected by semiquantitative culture. This real-time PCR assay targeting the copB outer membrane protein gene provided a sensitive and reliable means for the rapid detection and quantification of M. catarrhalis in NPSs; may serve as a tool to study changes in the amounts of M. catarrhalis during lower respiratory tract infections or following vaccination against S. pneumoniae, H. influenzae, or N. meningitidis; and may be applied to other clinical samples.

Quantitative Detection of Moraxella catarrhalis in Nasopharyngeal Secretions by Real-Time PCR

PubMed Central

Greiner, Oliver; Day, Philip J. R.; Altwegg, Martin; Nadal, David

2003-01-01

The recognition of Moraxella catarrhalis as an important cause of respiratory tract infections has been protracted, mainly because it is a frequent commensal organism of the upper respiratory tract and the diagnostic sensitivity of blood or pleural fluid culture is low. Given that the amount of M. catarrhalis bacteria in the upper respiratory tract may change during infection, quantification of these bacteria in nasopharyngeal secretions (NPSs) by real-time PCR may offer a suitable diagnostic approach. Using primers and a fluorescent probe specific for the copB outer membrane protein gene, we detected DNA from serial dilutions of M. catarrhalis cells corresponding to 1 to 106 cells. Importantly, there was no difference in the amplification efficiency when the same DNA was mixed with DNA from NPSs devoid of M. catarrhalis. The specificity of the reaction was further confirmed by the lack of amplification of DNAs from other Moraxella species, nontypeable Haemophilus influenzae, H. influenzae type b, Streptococcus pneumoniae, Streptococcus oralis, Streptococcus pyogenes, Bordetella pertussis, Corynebacterium diphtheriae, and various Neisseria species. The assay applied to NPSs from 184 patients with respiratory tract infections performed with a sensitivity of 100% and a specificity of up to 98% compared to the culture results. The numbers of M. catarrhalis organisms detected by real-time PCR correlated with the numbers detected by semiquantitative culture. This real-time PCR assay targeting the copB outer membrane protein gene provided a sensitive and reliable means for the rapid detection and quantification of M. catarrhalis in NPSs; may serve as a tool to study changes in the amounts of M. catarrhalis during lower respiratory tract infections or following vaccination against S. pneumoniae, H. influenzae, or N. meningitidis; and may be applied to other clinical samples. PMID:12682118

Photodynamic therapy for recurrent respiratory papillomatosis.

PubMed

Lieder, Anja; Khan, Muhammad K; Lippert, Burkard M

2014-06-05

Recurrent respiratory papillomatosis (RRP) is a benign condition of the mucosa of the upper aerodigestive tract. It is characterised by recurrent papillomatous lesions and is associated with human papillomavirus (HPV). Frequent recurrence and rapid papilloma growth are common and in part responsible for the onset of potentially life-threatening symptoms. Most patients afflicted by the condition will require repeated surgical treatments to maintain their airway, and these may result in scarring and voice problems. Photodynamic therapy introduces a light-sensitising agent, which is administered either orally or by injection. This substance (called a photo-sensitiser) is selectively retained in hyperplastic and neoplastic tissue, including papilloma. It is then activated by light of a specific wavelength and may be used as a sole or adjuvant treatment for RRP. To assess the effects of photodynamic therapy in the management of recurrent respiratory papillomatosis (RRP) in children and adults. We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; CINAHL; Web of Science; Cambridge Scientific Abstracts; ICTRP and additional sources for published and unpublished trials. The date of the search was 27 January 2014. Randomised controlled trials utilising photodynamic therapy as sole or adjuvant therapy in participants of any age with proven RRP versus control intervention. Primary outcome measures were symptom improvement (respiratory distress/dyspnoea and voice quality), quality of life improvement and recurrence-free interval. Secondary outcomes included reduction in the frequency of surgical intervention, reduction in disease volume and adverse effects of treatment.   We used the standard methodological procedures expected by The Cochrane Collaboration. Meta-analysis was not possible and results are presented descriptively. We included one trial with a total of 23 participants. This study was at high risk of bias. None of our primary outcomes and only one of our secondary outcomes (reduction in volume of disease, assessed endoscopically) was measured in the study. There was no significant difference between the groups (very low-quality evidence). Adverse effects reported included airway swelling requiring intubation in a child with severe RRP a few hours after photodynamic therapy. There is insufficient evidence from high-quality randomised controlled trials to determine whether photodynamic therapy alters the course of disease or provides an added benefit to surgery in patients with recurrent respiratory papillomatosis. Multicentre randomised controlled trials with appropriate sample sizes and long-term follow-up are required to evaluate whether photodynamic therapy is of benefit. Outcomes such as improvement in symptoms (respiratory function and voice quality) and quality of life should be measured in future trials.

Endoscopy of the upper respiratory tract during treadmill exercise: a clinical study of 100 horses.

PubMed

Kannegieter, N J; Dore, M L

1995-03-01

Endoscopy of the upper respiratory tract was performed in 100 horses during high speed treadmill exercise. Reasons for endoscopy were a history of an abnormal noise during exercise in 75 horses, poor performance in 17 horses and to evaluate the results of upper respiratory tract surgery in 8 horses. Of the 75 horses with a history of an abnormal noise during exercise the cause was determined in 67 (89%). Endoscopic abnormalities were detected at rest in 40 of these 75 horses (53%). In these 40 horses, a similar diagnosis as to the cause of the abnormal noise was made at rest and during exercise on the treadmill in 19 cases, while in the remaining 21 the endoscopic findings during exercise varied from that seen at rest. This included 3 horses in which a diagnosis was made at rest but no abnormalities were detected during exercise. Some of the findings during treadmill endoscopy included laryngeal dysfunction, grades 3, 4 and 5 (22 cases), dorsal displacement of the soft palate (20), epiglottic entrapment (8), epiglottic flutter (4), aryepiglottic fold flutter (4), pharyngeal collapse (3), arytenoiditis (3), vocal cord flutter (3), false nostril noise (2), pharyngeal lymphoid hyperplasia (2), soft palate haemorrhage (1) and positional arytenoid collapse (1). More than one abnormality was observed during exercise in 7 horses. A complete and correct diagnosis based on the resting endoscopy findings alone was made in 19 (25%) of these 75 cases. In the 17 horses examined because of poor performance, no abnormalities were detected during treadmill endoscopy that were not evident at rest.(ABSTRACT TRUNCATED AT 250 WORDS)

Human milk probiotic Lactobacillus fermentum CECT5716 reduces the incidence of gastrointestinal and upper respiratory tract infections in infants.

PubMed

Maldonado, José; Cañabate, Francisco; Sempere, Luis; Vela, Francisco; Sánchez, Ana R; Narbona, Eduardo; López-Huertas, Eduardo; Geerlings, Arjan; Valero, Antonio D; Olivares, Mónica; Lara-Villoslada, Federico

2012-01-01

The aim of the study was to examine the effects of a follow-on formula containing Lactobacillus fermentum CECT5716 (L. fermentum) on the incidence of infections in infants between the ages of 6 and 12 months. A randomized double-blinded controlled study including infants at the age of 6 months was conducted. Infants were assigned randomly to either follow-on formula supplemented with L. fermentum plus galactooligosaccharide (experimental group, EG), or the same formula supplemented with only galactooligosaccharide (control group, CG). The main outcome was the incidence of infections for the 6-month duration of the study. The EG showed a significant 46% reduction in the incidence rate (IR) of gastrointestinal infections (EG: 0.196 ± 0.51, CG: 0.363 ± 0.53, IR ratio 0.54, 95% confidence interval [CI] 0.307-0.950, P = 0.032), 27% reduction in the incidence of upper respiratory tract infections (EG: 0.969 ± 0.96, CG: 1.330 ± 1.23, IR ratio 0.729, 95% CI 0.46-1.38, P = 0.026), and 30% reduction in the total number of infections (EG: 1.464 ± 1.15, CG: 2.077 ± 1.59, IR ratio 0.70, 95% CI 0.46-1.38, P = 0.003), at the end of the study period compared with CG. Administration of a follow-on formula with L. fermentum CECT5716 may be useful for the prevention of community-acquired gastrointestinal and upper respiratory infections.

Role of orexin in respiratory and sleep homeostasis during upper airway obstruction in rats.

PubMed

Tarasiuk, Ariel; Levi, Avishag; Berdugo-Boura, Nilly; Yahalom, Ari; Segev, Yael

2014-05-01

Chronic upper airway obstruction (UAO) elicits a cascade of complex endocrine derangements that affect growth, sleep, and energy metabolism. We hypothesized that elevated hypothalamic orexin has a role in maintaining ventilation during UAO, while at the same time altering sleep-wake activity and energy metabolism. Here, we sought to explore the UAO-induced changes in hypothalamic orexin and their role in sleep-wake balance, respiratory activity, and energy metabolism. The tracheae of 22-day-old Sprague-Dawley rats were surgically narrowed; UAO and sham-operated control animals were monitored for 7 weeks. We measured food intake, body weight, temperature, locomotion, and sleep-wake activity. Magnetic resonance imaging was used to quantify subcutaneous and visceral fat tissue volumes. In week 7, the rats were sacrificed and levels of hypothalamic orexin, serum leptin, and corticosterone were determined. The effect of dual orexin receptor antagonist (almorexant 300 mg/kg) on sleep and respiration was also explored. UAO increased hypothalamic orexin mRNA and protein content by 64% and 65%, respectively. UAO led to 30% chronic sleep loss, excessive active phase sleepiness, decreased body temperature, increased food intake, reduction of abdominal and subcutaneous fat tissue volume, and growth retardation. Administration of almorexant normalized sleep but induced severe breathing difficulties in UAO rats, while it had no effect on sleep or on breathing of control animals. In upper airway obstruction animals, enhanced orexin secretion, while crucially important for respiratory homeostasis maintenance, is also responsible for chronic partial sleep loss, as well as considerable impairment of energy metabolism and growth.

Pharmacists' Knowledge and Attitudes Towards Upper Respiratory Infections (URI) in Iran: A Cross Sectional Study.

PubMed

Eslami, Neda; Eshraghi, Azadeh; Vaseghi, Golnaz; Mehdizadeh, Mona; Masjedi, Moein; Mehrpooya, Maryam

2016-01-01

To identify the knowledge and attitudes of community pharmacists towards upper respiratory infections. The pharmacists, who participated in an annual clinical pharmacy congress in Tehran, were enrolled in this study. We conducted a cross-sectional descriptive study to assess the knowledge and attitudes of 72 community pharmacists towards upper respiratory infections (URI) using a questionnaire. We investigated the knowledge and attitudes of pharmacists towards rational antibiotics use in URI in Iran. Also we tried to detect causes of irrational antibiotic use. The response rate of our study was 72%. Of all respondents, 98.61% answered the knowledge question" inappropriate use of antibiotics could lead to drug resistance and would increase drug allergy" correctly. More than half (55.56%) of the community pharmacists believed that pharmacists can be affected by patients' expectations for antibiotics prescription. A majority of pharmacists gave a correct response to questions about beneficial use of corticosteroid in URI (90.28%) and symptoms persistent after 10-14 days even with antibiotic therapy (86.11%). More than half of all pharmacists had misconceptions on antibiotic use for URI in children under 2 years old. More than half of all pharmacists believed that most cases of URI are viral infections. Also, 90.28% of all pharmacists believed that guidelines for antibiotics prescribing may be beneficial in appropriate antibiotic use. According to a high response rate for the question about efficiency of antibiotics prescription guidelines, reliable information on the appropriate use of antibiotics should be more widely available for pharmacists.

Respiratory and general health impairments of workers employed in a municipal solid waste disposal at an open landfill site in Delhi.

PubMed

Ray, Manas Ranjan; Roychoudhury, Sanghita; Mukherjee, Gopeshwar; Roy, Senjuti; Lahiri, Twisha

2005-01-01

The objective of this study was to examine the respiratory and general health of workers employed in a municipal solid waste (MSW) disposal at an open landfill site in India. Ninety-six landfill workers of Okhla landfill site, Delhi, and 90 controls matched for age, sex, and socioeconomic conditions were enrolled. Health data was obtained from questionnaire surveys, clinical examination and laboratory investigations. Lung function was evaluated by spirometry. Compared with matched controls, landfill workers had significantly higher prevalences of both upper and lower respiratory symptoms, and they suffered more often from diarrhea, fungal infection and ulceration of the skin, burning sensation in the extremities, tingling or numbness, transient loss of memory, and depression. Spirometry revealed impairment of lung function in 62% of the landfill workers compared to 27% of the controls. Sputum cytology showed squamous metaplasia, abundance of inflammatory cells, alveolar macrophages (AM) and siderophages (macrophages with iron deposits), and high elastase enzyme activity in neutrophils and AM of a majority of landfill workers, indicating adverse cellular lung reaction. Hematological profiles of these workers depicted low hemoglobin and erythrocyte levels with high total leukocyte, eosinophil and monocyte counts. Erythrocytes with target cell morphology were abundant in 42% of the landfill workers compared to 10% of the controls. Toxic granulation in neutrophils, an indication of infection and inflammation, was recorded in 94% of the landfill workers and in 49% of the controls. The results demonstrated higher prevalence of respiratory symptoms, inflammation of the airways, lung function decrement and a wide range of general health problems in MSW disposal workers.

Home-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: a randomized clinical trial

PubMed Central

Dias, Fernanda Dultra; Sampaio, Luciana Maria Malosá; da Silva, Graziela Alves; Gomes, Évelim LF Dantas; do Nascimento, Eloisa Sanches Pereira; Alves, Vera Lucia Santos; Stirbulov, Roberto; Costa, Dirceu

2013-01-01

Introduction Pulmonary rehabilitation (PR) is a multidisciplinary program of care for patients with chronic obstructive pulmonary disease (COPD) with the goal of improving the functional capacity and quality of life, as well as maintaining the clinical stability of COPD sufferers. However, not all patients are available for such a program despite discomfort with their condition. The aim of this study was to evaluate the effects of a home-based PR (HBPR) program on functional ability, quality of life, and respiratory muscle strength and endurance. Patients and methods Patients with COPD according to the Global Initiative of Chronic Obstructive Lung Disease were randomized (double-blind) into two groups. One group performed a protocol at home with aerobic and muscle strength exercises and was called the intervention group; the other group received only instructions to perform breathing and stretching exercises, characterizing it as the control group (CG). We assessed the following variables at baseline and 2 months: exercise tolerance (incremental shuttle walk test and upper limb test), respiratory muscle (strength and endurance test), and health-related quality of life (Airways Questionnaire 20). Results There were no significant changes after the intervention in either of the two groups in exercise tolerance and quality of life. However, the intervention group had improved respiratory endurance compared with the CG, while the CG presented a decrease in the load sustained by the respiratory muscles after the HBPR. Conclusion A program of HBPR with biweekly supervision (although not enough to provide significant improvements in physical capacity or quality of life) played an important role in maintaining the stability of the clinical features of patients with COPD; the patients had no worsening of symptoms during the intervention period according to the daily log. PMID:24235824

Effect of nasal noninvasive respiratory support methods on pharyngeal provocation-induced aerodigestive reflexes in infants.

PubMed

Jadcherla, Sudarshan R; Hasenstab, Kathryn A; Sitaram, Swetha; Clouse, Brian J; Slaughter, Jonathan L; Shaker, Reza

2016-06-01

The pharynx is a locus of provocation among infants with aerodigestive morbidities manifesting as dysphagia, life-threatening events, aspiration-pneumonia, atelectasis, and reflux, and such infants often receive nasal respiratory support. We determined the impact of different oxygen delivery methods on pharyngeal stimulation-induced aerodigestive reflexes [room air (RA), nasal cannula (NC), and nasal continuous positive airway pressure (nCPAP)] while hypothesizing that the sensory motor characteristics of putative reflexes are distinct. Thirty eight infants (28.0 ± 0.7 wk gestation) underwent pharyngoesophageal manometry and respiratory inductance plethysmography to determine the effects of graded pharyngeal stimuli (n = 271) on upper and lower esophageal sphincters (UES, LES), swallowing, and deglutition-apnea. Comparisons were made between NC (n = 19), nCPAP (n = 9), and RA (n = 10) groups. Importantly, NC or nCPAP (vs. RA) had: 1) delayed feeding milestones (P < 0.05), 2) increased pharyngeal waveform recruitment and duration, greater UES nadir pressure, decreased esophageal contraction duration, decreased distal esophageal contraction amplitude, and decreased completely propagated esophageal peristalsis (all P < 0.05), and 3) similarly developed UES contractile and LES relaxation reflexes (P > 0.05). We conclude that aerodigestive reflexes were similarly developed in infants using noninvasive respiratory support with adequate upper and lower aerodigestive protection. Increased concern for GERD is unfounded in this population. These infants may benefit from targeted oromotor feeding therapies and safe pharyngeal bolus transit to accelerate feeding milestones. Copyright © 2016 the American Physiological Society.

Effect of nasal noninvasive respiratory support methods on pharyngeal provocation-induced aerodigestive reflexes in infants

PubMed Central

Hasenstab, Kathryn A.; Sitaram, Swetha; Clouse, Brian J.; Slaughter, Jonathan L.; Shaker, Reza

2016-01-01

The pharynx is a locus of provocation among infants with aerodigestive morbidities manifesting as dysphagia, life-threatening events, aspiration-pneumonia, atelectasis, and reflux, and such infants often receive nasal respiratory support. We determined the impact of different oxygen delivery methods on pharyngeal stimulation-induced aerodigestive reflexes [room air (RA), nasal cannula (NC), and nasal continuous positive airway pressure (nCPAP)] while hypothesizing that the sensory motor characteristics of putative reflexes are distinct. Thirty eight infants (28.0 ± 0.7 wk gestation) underwent pharyngoesophageal manometry and respiratory inductance plethysmography to determine the effects of graded pharyngeal stimuli (n = 271) on upper and lower esophageal sphincters (UES, LES), swallowing, and deglutition-apnea. Comparisons were made between NC (n = 19), nCPAP (n = 9), and RA (n = 10) groups. Importantly, NC or nCPAP (vs. RA) had: 1) delayed feeding milestones (P < 0.05), 2) increased pharyngeal waveform recruitment and duration, greater UES nadir pressure, decreased esophageal contraction duration, decreased distal esophageal contraction amplitude, and decreased completely propagated esophageal peristalsis (all P < 0.05), and 3) similarly developed UES contractile and LES relaxation reflexes (P > 0.05). We conclude that aerodigestive reflexes were similarly developed in infants using noninvasive respiratory support with adequate upper and lower aerodigestive protection. Increased concern for GERD is unfounded in this population. These infants may benefit from targeted oromotor feeding therapies and safe pharyngeal bolus transit to accelerate feeding milestones. PMID:27012774

Neck and shoulder muscle activity and thorax movement in singing and speaking tasks with variation in vocal loudness and pitch.

PubMed

Pettersen, Viggo; Bjørkøy, Kåre; Torp, Hans; Westgaard, Rolf Harald

2005-12-01

The aim of this study was to examine respiratory phasing and loading levels of sternocleidomastoideus (STM), scalenus (SC), and upper trapezius (TR) muscles in vocalization tasks with variation in vocal loudness and pitch. Eight advanced singing students, aged 22 to 28 years, participated. Surface electromyographic (EMG) activity was recorded from STM, SC, and TR. Thorax movement was detected by two strain gauge sensors placed around the upper (upper TX) and lower (lower TX) thorax. A glissando and simplified singing and speaking tasks were performed. Sustained vowels /a:-i-ae-o:/ were sung in a glissando from lowest to highest pitch (mixed voice/falsetto) back to lowest pitch and in short singing sequences at comfortable, low, and high pitches. The same vowels were spoken softly and loudly for about the same length. The subjects inhaled between the vowels. It was concluded that the inspiratory phased STM and SC muscles produced a counterforce to compression of upper TX at high pitches in glissando. STM and SC were activated to higher levels during phonation than in inhalation. As breathing demands were reduced, STM and SC activity was lowered and the respiratory phasing of peak amplitude changed to inhalation. TR contributed to exhalation in demanding singing with long breathing cycles, but it was less active in singing tasks with short breathing cycles and was essentially inactive in simplified speaking tasks.

Sensory regulation of swallowing and airway protection: a role for the internal superior laryngeal nerve in humans

PubMed Central

Jafari, Samah; Prince, Rebecca A; Kim, Daniel Y; Paydarfar, David

2003-01-01

During swallowing, the airway is protected from aspiration of ingested material by brief closure of the larynx and cessation of breathing. Mechanoreceptors innervated by the internal branch of the superior laryngeal nerve (ISLN) are activated by swallowing, and connect to central neurones that generate swallowing, laryngeal closure and respiratory rhythm. This study was designed to evaluate the hypothesis that the ISLN afferent signal is necessary for normal deglutition and airway protection in humans. In 21 healthy adults, we recorded submental electromyograms, videofluoroscopic images of the upper airway, oronasal airflow and respiratory inductance plethysmography. In six subjects we also recorded pressures in the hypopharynx and upper oesophagus. We analysed swallows that followed a brief infusion (4–5 ml) of liquid barium onto the tongue, or a sip (1–18 ml) from a cup. In 16 subjects, the ISLN was anaesthetised by transcutaneous injection of bupivacaine into the paraglottic compartment. Saline injections using the identical procedure were performed in six subjects. Endoscopy was used to evaluate upper airway anatomy, to confirm ISLN anaesthesia, and to visualise vocal cord movement and laryngeal closure. Comparisons of swallowing and breathing were made within subjects (anaesthetic or saline injection vs. control, i.e. no injection) and between subjects (anaesthetic injection vs. saline injection). In the non-anaesthetised condition (saline injection, 174 swallows in six subjects; no injection, 522 swallows in 20 subjects), laryngeal penetration during swallowing was rare (1.4 %) and tracheal aspiration was never observed. During ISLN anaesthesia (16 subjects, 396 swallows), all subjects experienced effortful swallowing and an illusory globus sensation in the throat, and 15 subjects exhibited penetration of fluid into the larynx during swallowing. The incidence of laryngeal penetration in the anaesthetised condition was 43 % (P < 0.01, compared with either saline or no injection) and of these penetrations, 56 % led to tracheal aspiration (without adverse effects). We further analysed the swallow cycle to evaluate the mechanism(s) by which fluid entered the larynx. Laryngeal penetration was not caused by premature spillage of oral fluid into the hypopharynx, delayed clearance of fluid from the hypopharynx, or excessive hypopharyngeal pressure generated by swallowing. Furthermore, there was no impairment in the ability of swallowing to halt respiratory airflow during the period of pharyngeal bolus flow. Rather, our observations suggest that loss of airway protection was due to incomplete closure of the larynx during the pharyngeal phase of swallowing. In contrast to the insufficient closure during swallowing, laryngeal closure was robust during voluntary challenges with the Valsalva, Müller and cough manoeuvres under ISLN anaesthesia. We suggest that an afferent signal arising from the ISLN receptor field is necessary for normal deglutition, especially for providing feedback to central neural circuits that facilitate laryngeal closure during swallowing. The ISLN afferent signal is not essential for initiating and sequencing the swallow cycle, for co-ordinating swallowing with breathing, or for closing the larynx during voluntary manoeuvres. PMID:12754311

Spatial contrast sensitivity at twilight: luminance, monocularity, and oxygenation.

PubMed

Connolly, Desmond M

2010-05-01

Visual performance in dim light is compromised by lack of oxygen (hypoxia). The possible influence of altered oxygenation on foveal contrast sensitivity under mesopic (twilight) viewing conditions is relevant to aircrew flying at night, including when using night vision devices, but is poorly documented. Foveal contrast sensitivity was measured binocularly and monocularly in 12 subjects at 7 spatial frequencies, ranging from 0.5 to approximately 16 cycles per degree, using sinusoidal Gabor patch gratings. Hypoxic performance breathing 14.1% oxygen, equivalent to altitude exposure at 3048 m (10,000 ft), was compared with breathing air at sea level (normoxia) at low photopic (28 cd x m(-2)), borderline upper mesopic (approximately 2.1 cd x m(-2)) and midmesopic (approximately 0.26 cd x m(-2)) luminance. Mesopic performance was also assessed breathing 100% oxygen (hyperoxia). Typical 'inverted U' log/log plots of the contrast sensitivity function were obtained, with elevated thresholds (reduced sensitivity) at lower luminance. Binocular viewing enhanced sensitivity by a factor approximating square root of 2 for most conditions, supporting neural summation of the contrast signal, but had greater influence at the lowest light level and highest spatial frequencies (8.26 and 16.51 cpd). Respiratory challenges had no effect. Contrast sensitivity is poorer when viewing monocularly and especially at midmesopic luminance, with relevance to night flying. The foveal contrast sensitivity function is unaffected by respiratory disturbance when twilight conditions favor cone vision, despite known effects on retinal illumination (pupil size). The resilience of the contrast sensitivity function belies the vulnerability of foveal low contrast acuity to mild hypoxia at mesopic luminance.

Particulate matter from re-suspended mineral dust and emergency cause-specific respiratory hospitalizations in Hong Kong

NASA Astrophysics Data System (ADS)

Pun, Vivian C.; Tian, Linwei; Ho, Kin-fai

2017-09-01

While contribution from non-exhaust particulate matter (PM) emissions towards traffic-related emissions is increasing, few epidemiologic evidence of their health impact is available. We examined the association of short-term exposure to PM10 apportioned to re-suspended mineral dust with emergency hospitalizations for three major respiratory causes in Hong Kong between 2001 and 2008. Time-series regression model was constructed to examine association of PM10 from re-suspended mineral dust with emergency hospitalizations for upper respiratory infection (URI), chronic obstructive pulmonary disease (COPD) and asthma at exposure lag 0-5 days, adjusting for time trends, seasonality, temperature and relative humidity. An interquartile range (6.8 μg/m3) increment in re-suspended mineral dust on previous day was associated with 0.66% (95% CI: 0.12, 0.98) increase in total respiratory hospitalizations, and 1.01% (95% CI: 0.14, 1.88) increase in URI hospitalizations. A significant 0.66%-0.80% increases in risk of COPD hospitalizations were found after exposure to re-suspended mineral dust at lag 3 or later. Exposure to mineral dust at lag 4 was linked to 1.71% increase (95% CI: 0.14, 2.22) in asthma hospitalizations. Associations from single-pollutant models remained significant in multi-pollutant models, which additionally adjusted for PM10 contributing from vehicle exhaust, regional combustion, residual oil, fresh sea salt, aged sea salt, secondary nitrate and secondary sulfate, or gaseous pollutants (i.e., nitrogen dioxide, sulfur dioxide, or ozone), respectively. Our findings provide insight into the biological mechanism by which non-exhaust pollution may be associated with risk of adverse respiratory outcomes, and also stress the needs for strategies to reduce emission and re-suspension of mineral dust. More research is warranted to assess the health effects of different non-exhaust PM emissions under various roadway conditions and vehicle fleets.

Theoretical deposition of carcinogenic particle aggregates in the upper respiratory tract.

PubMed

Sturm, Robert

2013-10-01

Numerous particles suspended in the atmosphere are composed of smaller particular components that form aggregates with highly irregular shape. Such aggregates, among which dusts and soot are the most prominent examples, may be taken up into the respiratory tract and, in the worst case, initiate a malignant transformation of lung cells. Particle aggregates were theoretically modelled by using small spheres with equal diameters (1 nm) and arranging them randomly. This procedure resulted in the generation of various aggregate shapes (chain-like, loose, compact), for which essential parameters such as dynamic shape factors, χ, and aerodynamic diameters, dae , were computed. Deposition of aggregates consisting of 10, 50, 100, and 1,000 nano-spheres was simulated for the uppermost parts of the human respiratory system (extrathoracic region and airway generation 0 to 4), thereby distinguishing between sitting and light-work breathing as well as between nasal and oral inhalation. Based upon the modelling results, aggregate deposition in the human respiratory system can be described as a function of (I) aerodynamic diameter; (II) inhaled particle position within the airway system; and (III) breathing conditions. Therefore, highest deposition values were obtained for nano-scale aggregates (<10 nm), whereas larger aggregates exhibited slightly to significantly reduced deposition probabilities. Extrathoracic regions and uppermost bronchi (generations 0 to 1) were marked by most effective particle capture. Any increase of inhaled air volumes and reduction of breathing times resulted in an enhancement of deposition probabilities of larger particles. Based on the results derived from this study it may be concluded that small particle aggregates are accumulated in the uppermost compartments of the human respiratory tract, where they may unfold their unwholesome potential. In the case of carcinogenic particles being stored in epithelial cells for a longer time span, malignant transformations starting with the formation of cancerous cells and ending with the growth of a tumour have to be assumed.

Colds and the flu - what to ask your doctor - adult

MedlinePlus

... to ask your doctor about colds and the flu - adult; Influenza - what to ask your doctor - adult; Upper respiratory ... what to ask your doctor - adult; H1N1 (Swine) flu - what to ask your doctor - adult

[X-linked immunodeficiency with magnesium defect, Epstein-Barr virus infection, and neoplasia: report of a family and literature review].

PubMed

He, T Y; Xia, Y; Li, C G; Li, C R; Qi, Z X; Yang, J

2018-01-02

Objective: To investigate the clinical features and genetic characteristics of cases with X-linked immunodeficiency with magnesium defect, Epstein-Barr virus (EBV) infection, and neoplasia (XMEN). Methods: Characteristics of clinical material, immunological data and gene mutation of two cases with XMEN in the same family in China were retrospectively analyzed. The related reports literature were searched by using search terms'MAGT1 gene'or'XMEN'. Results: The proband, a 2-year-eight-month old boy, was admitted due to 'Urine with deepened color for two days and yellow stained skin for one day'. He had suffered from recurrent upper respiratory tract infection and sinusitis previously. Hemoglobin level was 38 g/L. The absolute count of reticulocytes was 223.2×10(9)/L. Urobilinogen level was 38 μmol/L (3-16 μmol/L). Coomb's test was positive. Both total (77.2 μmol/L) and indirect bilirubin (66 μmol/L) levels were elevated. There was an inverted CD4(+)/CD8(+)T cell ratio (0.89). The gene sequencing results showed MAGT1 gene c.472delG, p.D158Mfs*6 mutation. His 1-year-6-month old brother, was also identified to have MAGT1 gene c.472delG, p.D158Mfs*6 mutation.The younger brother mainly suffered from recurrent upper respiratory tract infection, accompanied by an inverted CD4(+)/CD8(+)T cell ratio (0.45), an elevated ratio and number of total B cells (45.7%). A total of 7 reports were retrieved including 11 male cases caused by MAGT1 gene mutation. These 11 cases were characterized by EBV viremia (11 cases), recurrent upper respiratory tract infection, otitis media or sinusitis (10 cases), secondary neoplasia diseases (8 cases), reduction of CD4(+)/CD8(+) T cell ratio (7 cases),and autoimmune thrombocytopenia or hemolytic anemia (2 cases). Conclusion: XMEN often manifests as male onset, recurrent upper respiratory tract infection, otitis media or sinusitis, EBV viremia, lymphoproliferative disease or lymphoma, autoimmune diseases and reduction of CD4(+)/CD8 (+)T cell ratio. NKG2D expression in NK cells is significantly reduced, and gene sequencing analysis shows a pathogenic mutation in MAGT1 gene.

Effect of gentle stroking and vocalization on behaviour, mucosal immunity and upper respiratory disease in anxious shelter cats.

PubMed

Gourkow, Nadine; Hamon, Sara C; Phillips, Clive J C

2014-11-01

Emotional, behavioural, and health benefits of gentle stroking and vocalizations, otherwise known as gentling, have been documented for several species, but little is known about the effect of gentling on cats in stressful situations. In this study, 139 cats rated as anxious upon admission to an animal shelter were allocated to either a Gentled or Control group. Cats were gentled four times daily for 10 min over a period of 10 days, with the aid of a tool for cats that were too aggressive to handle. The cats' mood, or persistent emotional state, was rated daily for 10 d as Anxious, Frustrated or Content. Gentled cats were less likely to have negatively valenced moods (Anxious or Frustrated) than Control cats (Incidence Rate Ratio [IRR]=0.61 CI 0.42-0.88, P=0.007). Total secretory immunoglobulin A (S-IgA) was quantified from faeces by enzyme-linked immunosorbent assay. Gentled cats had increased S-IgA (6.9 ± 0.7 logeμg/g) compared to Control cats (5.9 ± 0.5 logeμg/g) (P<0.0001). Within the Gentled group of cats, S-IgA values were higher for cats that responded positively to gentling (7.03 ± 0.6, logeμg/g), compared with those that responded negatively (6.14 ± 0.8, logeμg/g). Combined conjunctival and oropharyngeal swab specimens were tested by quantitative real-time polymerase chain reaction (rPCR) for feline herpesvirus type 1 (FHV-1), feline calicivirus (FCV), Mycoplasma felis, Chlamydophila felis, and Bordetella bronchiseptica. There was a significant increase in shedding over time in Control cats (23%, 35%, 52% on days 1, 4 and 10, respectively), but not in gentled cats (32%, 26%, 30% on days 1, 4 and 10, respectively) (P=0.001). Onset of upper respiratory disease was determined by veterinary staff based on clinical signs, in particular ocular and/or nasal discharge. Control cats were 2.4 (CI: 1.35-4.15) times more likely to develop upper respiratory disease over time than gentled cats (P<0.0001). It is concluded that gentling anxious cats in animal shelters can induce positive affect (contentment), increase production of S-IgA, and reduce the incidence of upper respiratory disease. Copyright © 2014 Elsevier B.V. All rights reserved.

Respiratory alkalosis

MedlinePlus

Alkalosis - respiratory ... leads to shortness of breath can also cause respiratory alkalosis (such as pulmonary embolism and asthma). ... Treatment is aimed at the condition that causes respiratory alkalosis. Breathing into a paper bag -- or using ...

B lymphocyte lineage cells and the respiratory system

PubMed Central

Kato, Atsushi; Hulse, Kathryn E.; Tan, Bruce K.; Schleimer, Robert P.

2013-01-01

Adaptive humoral immune responses in the airways are mediated by B cells and plasma cells that express highly evolved and specific receptors and produce immunoglobulins of most isotypes. In some cases, such as autoimmune diseases or inflammatory diseases caused by excessive exposure to foreign antigens, these same immune cells can cause disease by virtue of overly vigorous responses. This review discusses the generation, differentiation, signaling, activation and recruitment pathways of B cells and plasma cells, with special emphasis on unique characteristics of subsets of these cells functioning within the respiratory system. The primary sensitization events that generate B cells responsible for effector responses throughout the airways usually occur in the upper airways, in tonsils and adenoid structures that make up Waldeyer’s Ring. Upon secondary exposure to antigen in the airways, antigen-processing dendritic cells migrate into secondary lymphoid organs such as lymph nodes that drain the upper and lower airways and further B cell expansion takes place at those sites. Antigen exposure in the upper or lower airways can also drive expansion of B lineage cells in the airway mucosal tissue and lead to the formation of inducible lymphoid follicles or aggregates that can mediate local immunity or disease. PMID:23540615

Impact of whole-body rehabilitation in patients receiving chronic mechanical ventilation.

PubMed

Martin, Ubaldo J; Hincapie, Luis; Nimchuk, Mark; Gaughan, John; Criner, Gerard J

2005-10-01

To evaluate the prevalence and magnitude of weakness in patients receiving chronic mechanical ventilation and the impact of providing aggressive whole-body rehabilitation on conventional weaning variables, muscle strength, and overall functional status. Retrospective analysis of 49 consecutive patients. Multidisciplinary ventilatory rehabilitation unit in an academic medical center. Forty-nine consecutive chronic ventilator-dependent patients referred to a tertiary care hospital ventilator rehabilitation unit. None. Patients were 58 +/- 7 yrs old with multiple etiologies for respiratory failure. On admission, all patients were bedridden and had severe weakness of upper and lower extremities measured by a 5-point muscle strength score and a 7-point Functional Independence Measurement. Postrehabilitation, patients had increases in upper and lower extremity strength (p < .05) and were able to stand and ambulate. All weaned from mechanical ventilation, but three required subsequent intermittent support. Six patients died before hospital discharge. Upper extremity strength on admission inversely correlated with time to wean from mechanical ventilation (R = .72, p < .001). : Patients receiving chronic ventilation are weak and deconditioned but respond to aggressive whole-body and respiratory muscle training with an improvement in strength, weaning outcome, and functional status. Whole-body rehabilitation should be considered a significant component of their therapy.

Nationwide survey of the development of drug resistance in the pediatric field in 2007, 2010, and 2012: drug sensitivity of Haemophilus influenzae serotype b strain in Japan.

PubMed

Baba, Hiroaki; Sato, Yoshitake; Toyonaga, Yoshikiyo; Hanaki, Hideaki; Sunakawa, Keisuke

2015-04-01

Based on the results of surveillance in the pediatric field conducted in 2007, 2010, and 2012, we examined the frequency of Haemophilus influenzae serotype b (Hib) strains, the susceptibility for Hib strains to various types of antimicrobial agent, and the relations to patients' background factors. Among all of Haemophilus influenzae, the frequency of Hib strains was 3.6% (14/386 strains) in 2007, 4.8% (23/484 strains) in 2010, 1.2% (5/411 strains) in 2012, and decreasing in 2012. Hib strains were isolated in patients with the following infections: nine patients with respiratory tract infections (upper respiratory tract infection, bronchitis, and pneumonia), three patients with sepsis, one patient with meningitis, and one patient with purulent inflammation of a tendon sheath in 2007; 11 patients with respiratory tract infections (upper respiratory tract infection, bronchitis, and pneumonia), four patients with sepsis, and eight patients with meningitis in 2010, demonstrating a relatively high frequency in patients with invasive infections. However, in 2012, Hib strains were isolated in only four patients with respiratory tract infections (upper respiratory tract infection) and one patient with bronchial asthma. Evaluation of background factors with pediatric patients in whom Hib strains were isolated showed that approximately 70% were male; majority was children under three years of age; and higher detection rates were also related to the background of patients who were attendant to daycare center, had siblings, had received no antimicrobial agents within the previous one month before collecting specimens. Throughout the surveillance between 2007 and 2012, antimicrobial agents with all phases' MICs ≤ 1 μg/mL were cefditoren, cefcapene, and cefteram in the oral β-lactams; tazobactam/piperacillin, ceftriaxone, cefotaxime, and meropenem in the injectable β-lactams; azithromycin in the macrolide; and levofloxacin in the quinolone. After 2010, MIC ranges were evaluated for tebipenem in the oral β-lactam (≤ 0.063-0.25 μg/mL), doripenem in the injectable β-lactam (≤ 0.063-0.5 μg/mL), and tosufloxacin in the quinolone (≤ 0.063 μg/mL). Throughout the surveillance, Hib strains were highly susceptible to the above mentioned antimicrobial agents, and there was no significant change in the susceptibility. Copyright © 2014 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Multiple Viral Infection Detected from Influenza-Like Illness Cases in Indonesia.

PubMed

Adam, Kindi; Pangesti, Krisna Nur Andriana; Setiawaty, Vivi

2017-01-01

Influenza is one of the common etiologies of the upper respiratory tract infection (URTI). However, influenza virus only contributes about 20 percent of influenza-like illness patients. The aim of the study is to investigate the other viral etiologies from ILI cases in Indonesia. Of the 334 samples, 266 samples (78%) were positive at least for one virus, including 107 (42%) cases of multiple infections. Influenza virus is the most detected virus. The most frequent combination of viruses identified was adenovirus and human rhinovirus. This recent study demonstrated high detection rate of several respiratory viruses from ILI cases in Indonesia. Further studies to determine the relationship between viruses and clinical features are needed to improve respiratory disease control program.

Surveillance study of health effects associated with cleanup of a hazardous waste site, Ralph Gray Trucking Company (a/k/a Westminster Tract Number 2633), Westminster, Orange County, California, Region 9: CERCLIS number CAD981995947

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hoshiko, S.; Underwood, M.C.; Smith, D.

1999-04-01

Excavation of a Superfund site, the Ralph Gray Truncking Company located in Westminster Orange County, California was anticipated to release sulfur dioxide and other chemicals. The California Department of Health Services, under cooperative agreement with the Agency for Toxic Substances and Disease Registry, conducted a surveillance study to assess whether illnesses were associated with cleanup activities. A panel primarily composed of more sensitive persons (n = 36) was selected to report daily respiratory symptoms and odors. Exposures included sulfur dioxide (SO{sub 2}) measurements and daily tonnage of waste removed. Analysis used Conditional Likelihood Regression and Generalized Estimating Equations (GEE) methods.more » Levels of SO{sub 2} were generally higher than usual ambient air, at times exceeding levels which can cause health effects among asthmatics in laboratory settings. Wheeze and cough were significantly associated with tonnage of waste removed, especially on days when the highest amounts of waste were removed. Upper respiratory symptoms were found to be associated with SO{sub 2}, and weak relationships were found with nausea and burning nose and SO{sub 2}.« less

Provision of food and water in rodent whole body plethysmography safety pharmacology respiratory studies - Impact on animal welfare and data quality.

PubMed

Grant, Claire; Marks, Louise; Prior, Helen

2017-11-01

We evaluated the feasibility of providing food and water to rodents during whole body plethysmography (WBP) studies as a welfare improvement to standard conditions. Male Han Wistar rats or CD1 mice (n=8) were placed in WBP chambers and respiratory parameters recorded for approximately 6h on four separate occasions. On each occasion the animals were exposed to a different plethysmography chamber environment using a randomised design: no food/water (the standard conditions), water bottle, hydrating gel and wet food. In a further session, rats (n=8) were administered theophylline, or vehicle and respiratory parameters measured in the plethysmography chamber containing wet food. Respiratory parameters of rats were not significantly altered by the provision of water or food. Providing wet food resulted in reduced body weight loss. Administration of theophylline caused the expected increase in respiratory rate. When mice were given access to hydrating gel or wet food the respiratory parameters were significantly affected; respiratory rate and tidal volume were increased. Providing wet food resulted in reduced bodyweight loss. The provision of food and water did not impact on respiratory parameters in rats placed in WBP chambers. When provided with wet food, rats lost less bodyweight. Therefore, to improve welfare conditions for rats during WBP respiratory studies wet food should be provided when appropriate to the study design. In mice, provision of food and water led to changes in respiratory parameters, therefore these improvements in welfare conditions are not suitable for mice. Copyright © 2017. Published by Elsevier Inc.

Antibiotic treatment of acute respiratory infections in acute care settings.

PubMed

Gonzales, Ralph; Camargo, Carlos A; MacKenzie, Thomas; Kersey, Ayanna S; Maselli, Judith; Levin, Sara K; McCulloch, Charles E; Metlay, Joshua P

2006-03-01

To examine the patterns of antibiotic use for acute respiratory tract infections (ARIs) in acute care settings. Chart reviews were performed retrospectively on a random sample of adult ARI visits to seven Veterans Affairs (VA) and seven non-VA emergency departments (EDs) for the period of November 2003 to February 2004. Visits were limited to those discharged to home and those with primary diagnoses of antibiotic-responsive (pneumonia, acute exacerbation of chronic bronchitis, pharyngitis, sinusitis) and antibiotic-nonresponsive conditions (acute bronchitis, nonspecific upper respiratory tract infection [URI]). Results are expressed as adjusted odds ratios with 95% confidence intervals. Of 2,270 ARI visits, 62% were for antibiotic-nonresponsive diagnoses. Seventy-two percent of acute bronchitis and 38% of URI visits were treated with antibiotics (p < 0.001). Stratified analyses show that antibiotic prescription rates were similar among attending-only and housestaff-associated visits for antibiotic-responsive diagnoses (p = 0.11), and acute bronchitis (76% vs. 59%; p = 0.31). However, the antibiotic prescription rate for URIs was greater for attending-only visits compared with housestaff-associated visits (48% vs. 15%; p = 0.01). Antibiotic prescription rates for total ARIs varied between sites, ranging from 42% to 89%. Patient age, gender, race and ethnicity, smoking status, comorbidities, and clinical setting (VA vs. non-VA) were not independently associated with antibiotic prescribing. Acute care settings are important targets for reducing inappropriate antibiotic prescribing. The mechanisms accounting for lower antibiotic prescription rates observed with housestaff-associated visits merit further study.

Radiology of sarcoidosis.

PubMed

James, D G; Timmis, B; Barter, S; Carstairs, S

1989-03-01

This review of the radiology of sarcoidosis encompasses intrathoracic involvement, upper respiratory tract sarcoidosis, pleural disease, and involvement of bone, joint, neurological system, heart, kidney and alimentary tract. Attention is drawn to the value of CT scans, magnetic resonance imaging, gallium, and neutron activation analysis.

Colds and the flu - what to ask your doctor - child

MedlinePlus

... to ask your doctor about colds and the flu - child; Influenza - what to ask your doctor - child; Upper respiratory ... URI - what to ask your doctor - child; Swine flu (H1N1) - what to ask your doctor - child

Bordetellosis

USDA-ARS?s Scientific Manuscript database

Bordetellosis, also known as turkey coryza, is an acute, highly contagious disease of the upper respiratory tract of young turkeys. In the 1980’s, following initial disagreement as to the etiology, the bacterium Bordetella avium was proven to be the causative agent. Mortality in uncomplicated outb...

21 CFR 520.88a - Amoxicillin trihydrate film-coated tablets.

Code of Federal Regulations, 2013 CFR

2013-04-01

... tissues (abscesses, lacerations, wounds), caused by susceptible strains of Staphylococcus aureus, Streptococcus spp., Escherichia coli, Proteus mirabilis, and bacterial dermatitis caused by S. aureus... infections caused by susceptible organisms as follows: upper respiratory tract due to S. aureus...

21 CFR 520.88a - Amoxicillin trihydrate film-coated tablets.

Code of Federal Regulations, 2014 CFR

2014-04-01

... tissues (abscesses, lacerations, wounds), caused by susceptible strains of Staphylococcus aureus, Streptococcus spp., Escherichia coli, Proteus mirabilis, and bacterial dermatitis caused by S. aureus... infections caused by susceptible organisms as follows: upper respiratory tract due to S. aureus...

21 CFR 520.88a - Amoxicillin trihydrate film-coated tablets.

Code of Federal Regulations, 2012 CFR

2012-04-01

... tissues (abscesses, lacerations, wounds), caused by susceptible strains of Staphylococcus aureus, Streptococcus spp., Escherichia coli, Proteus mirabilis, and bacterial dermatitis caused by S. aureus... infections caused by susceptible organisms as follows: upper respiratory tract due to S. aureus...

Health effects of urea formaldehyde foam insulation: evidence of causation.

PubMed Central

Norman, G R; Newhouse, M T

1986-01-01

Studies of health effects of urea formaldehyde foam insulation (UFFI) were critically reviewed by means of accepted rules for evidence of causation. Three categories of health effects were examined: reported symptoms, primarily of the upper respiratory tract, lower respiratory tract disease and cancer. Most of the studies purporting to demonstrate health effects of UFFI failed to meet minimal methodologic criteria for evidence of causation. Evidence from the adequate studies provides little support for the hypothesis of a causative role of UFFI in health problems. PMID:3512066

Associations between respiratory illness and PM{sub 10} air pollution

DOE Office of Scientific and Technical Information (OSTI.GOV)

Choudhury, A.H.; Gordian, M.E.; Morris, S.S.

In this study, the association between daily morbidity and respirable particulate pollution (i.e., particles with a mass median aerodynamic diameter of {le} 10 microns [PM{sub 10}]) was evaluated in the general population of Anchorage, Alaska. Using insurance claims data for state employees and their dependents who lived in Anchorage, Alaska, the authors determined the number of medical visits for asthma, bronchitis, and upper respiratory infections. The number of visits were related to the level of particulate pollution in ambient air measured at air-monitoring sites. 17 refs., 2 figs., 4 tabs.

Effect of ventriculectomy versus ventriculocordectomy on upper airway noise in draught horses with recurrent laryngeal neuropathy.

PubMed

Cramp, P; Derksen, F J; Stick, J A; Nickels, F A; Brown, K E; Robinson, P; Robinson, N E

2009-11-01

Little is known about the efficacy of bilateral ventriculectomy (VE) or bilateral ventriculocordectomy (VCE) in draught horses. To compare the effect of VE and VCE on upper airway noise in draught horses with recurrent laryngeal neuropathy (RLN) by use of quantitative sound analysis techniques. In competitive draught horses with grade 4 RLN, VE and VCE reduce upper airway noise during exercise, but VCE is more effective. Thirty competitive hitch or pulling draught horses with grade 4 RLN were evaluated for upper airway sound during exercise. Respiratory rate (RR), inspiratory (Ti) and expiratory time (Te), the ratio between Ti and Te (Ti/Te), inspiratory (Sli) and expiratory sound levels (Sle), the ratio between Sli and Sle (Sli/Sle), and peak sound intensity of the second formant (F2) were calculated. Eleven horses were treated with VE and 19 with VCE. After 90 days of voice and physical rest and 30 days of work, the horses returned for post operative upper airway sound evaluation and resting videoendoscopy. VE significantly reduced Ti/Te, Sli, Sli/Sle and the sound intensity of F2. Respiratory rate, Ti, Te and Sle were unaffected by VE. VCE significantly reduced Ti/Te, Ti, Te, Sli, Sli/Sle and the sound intensity of F2, while RR and Sle were unaffected. The reduction in sound intensity of F2 following VCE was significantly greater than following VE. After VE and VCE, 7/11 (64%) and 15/18 (83%) owners, respectively, concluded that the surgery improved upper airway sound in their horses sufficiently for successful competition. VE and VCE significantly reduce upper airway noise and indices of airway obstruction in draught horses with RLN, but VCE is more effective than VE. The procedures have few post operative complications. VCE is recommended as the preferred treatment for RLN in draught horses. Further studies are required to evaluate the longevity of the procedure's results.

Physiotherapy in upper abdominal surgery - what is current practice in Australia?

PubMed

Patman, Shane; Bartley, Alice; Ferraz, Allex; Bunting, Cath

2017-01-01

Upper abdominal surgery (UAS) has the potential to cause post-operative pulmonary complications (PPCs). In the absence of high-quality research regarding post-operative physiotherapy management, consensus-based best practice guidelines formulated by Hanekom et al. (2012) are available to clinicians providing recommendations for post-UAS treatment. Such best practice guidelines have recommended that physiotherapists should be using early mobilisation and respiratory intervention to minimise risk of PPCs. However, recent evidence supports the implementation of mobilisation as a standalone treatment in PPC prevention, though the diversity in literature poses questions regarding ideal current practice. This project aimed to document and report the assessment measures and interventions physiotherapists are utilising following UAS, establishing whether current management is reflective of best practice guidelines and recent evidence. An online survey was completed by 57 experienced Australian physiotherapists working with patients following UAS (35% survey response rate, 63% completion rate). On day one following UAS, when a patient's condition is not medically limited, most physiotherapists routinely mobilise. Additionally, routine chest treatment continues to be implemented, with only 23% ( n  = 11/47) of physiotherapists mobilising patients without accompanying specific respiratory intervention. Variability of screening tools used to identify post-operative patients at high risk of PPC development was evident. Patient-dependent factors such as 'fatigue' and 'non-compliance' were among those identified as barriers to treatment, all influencing the commencement of treatment. Physiotherapists indicated that early mobilisation away from the bedside was the preferred post-operative treatment within the UAS patient population. Many continue to perform routine respiratory interventions despite recent literature suggesting it may provide no additional benefit to preventing PPCs. Current intervention choice is reflective of guidelines [1], however, recent literature has called this into question and more research needs to be done to establish if these recommendations are the most effective at reducing PPCs. Continued research is necessary to promote translation of knowledge to ensure physiotherapists are mobilising patients day one post-UAS. Likewise, future work should focus on identification of barriers, the strategies used to overcome limitations and the creation of a reliable and validated screening tool to ensure appropriate prioritisation and allocation of physiotherapy resources within the UAS patient population.

Quality of MR thermometry during palliative MR-guided high-intensity focused ultrasound (MR-HIFU) treatment of bone metastases.

PubMed

Lam, Mie K; Huisman, Merel; Nijenhuis, Robbert J; van den Bosch, Maurice Aaj; Viergever, Max A; Moonen, Chrit Tw; Bartels, Lambertus W

2015-01-01

Magnetic resonance (MR)-guided high-intensity focused ultrasound has emerged as a clinical option for palliative treatment of painful bone metastases, with MR thermometry (MRT) used for treatment monitoring. In this study, the general image quality of the MRT was assessed in terms of signal-to-noise ratio (SNR) and apparent temperature variation. Also, MRT artifacts were scored for their occurrence and hampering of the treatment monitoring. Analyses were performed on 224 MRT datasets retrieved from 13 treatments. The SNR was measured per voxel over time in magnitude images, in the target lesion and surrounding muscle, and was averaged per treatment. The standard deviation over time of the measured temperature per voxel in MRT images, in the muscle outside the heated region, was defined as the apparent temperature variation and was averaged per treatment. The scored MRT artifacts originated from the following sources: respiratory and non-respiratory time-varying field inhomogeneities, arterial ghosting, and patient motion by muscle contraction and by gross body movement. Distinction was made between lesion type, location, and procedural sedation and analgesic (PSA). The average SNR was highest in and around osteolytic lesions (21 in lesions, 27 in surrounding muscle, n = 4) and lowest in the upper body (9 in lesions, 16 in surrounding muscle, n = 4). The average apparent temperature variation was lowest in osteolytic lesions (1.2°C, n = 4) and the highest in the upper body (1.7°C, n = 4). Respiratory time-varying field inhomogeneity MRT artifacts occurred in 85% of the datasets and hampered treatment monitoring in 81%. Non-respiratory time-varying field inhomogeneities and arterial ghosting MRT artifacts were most frequent (94% and 95%) but occurred only locally. Patient motion artifacts were highly variable and occurred less in treatments of osteolytic lesions and using propofol and esketamine as PSA. In this study, the general image quality of MRT was observed to be higher in osteolytic lesions and lower in the upper body. Respiratory time-varying field inhomogeneity was the most prominent MRT artifact. Patient motion occurrence varied between treatments and seemed to be related to lesion type and type of PSA. Clinicians should be aware of these observed characteristics when interpreting MRT images.

Efficacy of a homeopathic complex on acute viral tonsillitis.

PubMed

Malapane, Eunice; Solomon, Elizabeth M; Pellow, Janice

2014-11-01

Acute viral tonsillitis is an upper respiratory tract infection prevalent in school-aged children. Because this condition is self-limiting, conventional treatment options are usually palliative. Homeopathic remedies are a useful alternative to conventional medications in acute uncomplicated upper respiratory tract infections in children, offering earlier symptom resolution, cost-effectiveness, and fewer adverse effects. This study aimed to determine the efficacy of a homeopathic complex on the symptoms of acute viral tonsillitis in African children in South Africa. This was a randomized, double-blind, placebo-controlled, 6-day pilot study. Thirty children, age 6 to 12 years, with acute viral tonsillitis were recruited from a primary school in Gauteng, South Africa. Participants took two tablets of the medication four times daily. The treatment group received lactose tablets medicated with the homeopathic complex (Atropa belladonna D4, Calcarea phosphoricum D4, Hepar sulphuris D4, Kalium bichromat D4, Kalium muriaticum D4, Mercurius protoiodid D10, and Mercurius biniodid D10). The placebo consisted of the unmedicated vehicle only. The Wong-Baker FACES Pain Rating Scale measured pain intensity, and a Symptom Grading Scale assessed changes in tonsillitis signs and symptoms. The treatment group had a statistically significant improvement in the following symptoms compared with the placebo group: pain associated with tonsillitis, pain on swallowing, erythema and inflammation of the pharynx, and tonsil size. The homeopathic complex used in this study exhibited significant anti-inflammatory and pain-relieving qualities in children with acute viral tonsillitis. No patients reported any adverse effects. These preliminary findings are promising; however, the sample size was small and therefore a definitive conclusion cannot be reached. A larger, more inclusive research study should be undertaken to verify the findings of this study.

Prevalence of allergy and upper respiratory tract symptoms in runners of the London marathon.

PubMed

Robson-Ansley, Paula; Howatson, Glyn; Tallent, Jamie; Mitcheson, Kelly; Walshe, Ian; Toms, Chris; DU Toit, George; Smith, Matt; Ansley, Les

2012-06-01

The prevalence of self-reported upper respiratory tract (URT) symptoms in athletes has been traditionally associated with opportunistic infection during the temporal suppression of immune function after prolonged exercise. There is little evidence for this, and a competing noninfectious hypothesis has been proposed, whereby the exercise-induced immune system modulations favor the development of atopy and allergic disease, which manifests as URT symptoms. The aim of this study was to examine the association between allergy and URT symptoms in runners after an endurance running event. Two hundred eight runners from the 2010 London Marathon completed the validated Allergy Questionnaire for Athletes (AQUA) and had serum analyzed for total and specific immunoglobulin E response to common inhalant allergens. Participants who completed the marathon and nonrunning controls who lived in the same household were asked to complete a diary on URT symptoms. Forty percent of runners had allergy as defined by both a positive AQUA and elevated specific immunoglobulin E. Forty-seven percent of runners experienced URT symptoms after the marathon. A positive AQUA was a significant predictor of postmarathon URT symptoms in runners. Only 19% of nonrunning controls reported symptoms. The prevalence of allergy in recreational marathon runners was similar to that in elite athletes and higher than that in the general population. There was a strong association between a positive AQUA and URT symptoms. The low proportion of households in which both runners and nonrunners were symptomatic suggests that the nature of symptoms may be allergic or inflammatory based rather than infectious. Allergy is a treatable condition, and its potential effect on performance and health may be avoided by accurate clinical diagnosis and management. Both athletes' and coaches' awareness of the potential implications of poorly managed allergy needs to be raised.

Intra- and interobserver reliability estimates for identification and grading of upper respiratory tract abnormalities recorded in horses at rest and during overground endoscopy.

PubMed

McGivney, C L; Sweeney, J; David, F; O'Leary, J M; Hill, E W; Katz, L M

2017-07-01

Previous studies support good intra- and interobserver agreements for endoscopic evaluation of various upper respiratory tract (URT) diseases in horses. However, these studies mainly assessed resting endoscopic examination videos and/or focussed on a single URT abnormality. To estimate intra- and interobserver agreement for identification and grading of all URT abnormalities from resting and overground endoscopy (OGE) videos of Thoroughbreds. Blinded, fully crossed design. Resting and OGE URT videos for n = 43 Thoroughbreds were retrospectively chosen based on identification of common URT disorders. The videos were randomly evaluated in duplicate by 4 raters blinded to all information including prior URT disorder(s) diagnosis. Abnormalities were graded using well-described ordinal scales. Intra- and interobserver agreements were estimated using Cohen's weighted κ and Krippendorff's α, respectively. Intraobserver agreement was perfect/nearly perfect for arytenoid symmetry at exercise, epiglottic entrapment and epiglottic retroversion, substantial for arytenoid asymmetry at rest, palatal dysfunction (PD), medial deviation of the aryepiglottic folds (MDAF), pharyngeal mucus and epiglottic grade at exercise and moderate for vocal fold collapse (VFC), ventromedial luxation of the apex of the corniculate process of the arytenoid (VLAC), nasopharyngeal collapse (NPC) and epiglottic grade at rest. Interobserver agreement was substantial for arytenoid symmetry at exercise and PD and moderate for arytenoid asymmetry at rest, MDAF, VLAC and epiglottic entrapment. It was only fair for VFC, epiglottic grade at exercise, epiglottic retroversion, pharyngeal mucus and NPC and poor for epiglottic grade at rest. Sample size was insufficient to allow assessment of the effect of one abnormality on the grading of another abnormality. Observers were consistent in grading URT disorders. However, significant disparity in grading existed between observers for some conditions affecting reliability. © 2016 EVJ Ltd.

Relative prevalence of upper respiratory tract obstructive disorders in two breeds of harness racehorses (185 cases: 1998-2006).

PubMed

Strand, E; Fjordbakk, C T; Sundberg, K; Spangen, L; Lunde, H; Hanche-Olsen, S

2012-09-01

Two genetically and phenotypically distinct horse breeds are used for harness racing in Scandinavia: the Standardbred (SB) and Coldblooded Trotter. These racehorses have identical environmental, management and racing conditions. Therefore, this study was undertaken to identify and compare the relative prevalence of upper respiratory tract (URT) obstructive disorders in these 2 breeds. To determine whether these 2 phenotypically different breeds of harness racehorses have different predispositions for URT disorders. Retrospective study of 88 Norwegian Coldblooded Trotters (NCT) and 97 SBs referred to this hospital for URT evaluation between 1998 and 2006. Case records of all horses diagnosed with an URT disorder during resting endoscopy, and all horses undergoing high-speed treadmill videoendoscopy (HSTV) with one or more periods of induced poll flexion were evaluated. The relative prevalence of URT disorders between the 2 breeds was analysed using a Fisher's exact test. There was a significant (P<0.05) breed predisposition regarding 6 URT disorders. Bilateral dynamic laryngeal collapse associated with poll flexion and flaccid epiglottis was significantly more frequent in the NCT. Alar fold collapse and nasopharyngeal collapse were significantly more frequent in SBs. Epiglottic entrapment and nasal flutter were only diagnosed in the SBs. Dynamic disorders were more common than resting disorders in both breeds. URT obstructive disorders (dynamic laryngeal collapse associated with poll flexion, flaccid epiglottis, pharyngeal collapse, alar fold collapse, nasal flutter and epiglottic entrapment) are breed related, indicating an anatomic or functional cause. Periods of induced poll flexion during HSTV was essential to declare harness racehorses free of URT disorders. Further anatomic or physiological studies comparing these breeds could potentially provide insight into the pathogenesis of certain URT obstructive disorders. Induced poll flexion should be included in routine HSTV examinations of all harness racehorses. © 2011 EVJ Ltd.

The Impact of General Medical Conditions in Obsessive-Compulsive Disorder

PubMed Central

Aguglia, Andrea; Signorelli, Maria Salvina; Albert, Umberto; Maina, Giuseppe

2018-01-01

Objective The co-occurrence of general medical conditions (GMCs) and major psychiatric disorders is well documented. The aim of this study was to assess the prevalence of GMCs in patients with a primary diagnosis of obsessive-compulsive disorder (OCD) and, secondly, to investigate which clinical variables are associated with the presence of a GMC. Methods Subjects with a primary diagnosis of OCD were included. Socio-demographic and clinical characteristics were collected. GMCs were classified using the ICD-10 and grouped according to the Cumulative Illness Rating Scale (CIRS) in: cardiac, vascular, hematopoietic, respiratory, ear/nose/throat, upper and lower gastrointestinal, hepatic, renal, genitourinary, musculoskeletal, neurologic, endocrine/metabolic. The association between the presence of GMCs and demographic/clinical variables of OCD was investigated. Results A total of 162 patients with OCD were included. 78 (48.1%) patients had at least one comorbid GMC. Most frequent GMCs were endocrine/metabolic diseases (25.9%), followed by upper/lower gastrointestinal (20.5%) and cardio-vascular diseases (13.6%). The presence of a GMC was significantly associated with female gender, older age, duration of untreated illness (DUI), and absence of physical activity. Conclusion Patients with OCD have high rates of comorbid GMCs. A longer DUI is associated with having at least one GMCs; this might be due to the long-lasting adoption of unhealthy lifestyles, not counterbalanced by appropriate treatment and psychoeducation. PMID:29475243

Instantaneous Respiratory Estimation from Thoracic Impedance by Empirical Mode Decomposition.

PubMed

Wang, Fu-Tai; Chan, Hsiao-Lung; Wang, Chun-Li; Jian, Hung-Ming; Lin, Sheng-Hsiung

2015-07-07

Impedance plethysmography provides a way to measure respiratory activity by sensing the change of thoracic impedance caused by inspiration and expiration. This measurement imposes little pressure on the body and uses the human body as the sensor, thereby reducing the need for adjustments as body position changes and making it suitable for long-term or ambulatory monitoring. The empirical mode decomposition (EMD) can decompose a signal into several intrinsic mode functions (IMFs) that disclose nonstationary components as well as stationary components and, similarly, capture respiratory episodes from thoracic impedance. However, upper-body movements usually produce motion artifacts that are not easily removed by digital filtering. Moreover, large motion artifacts disable the EMD to decompose respiratory components. In this paper, motion artifacts are detected and replaced by the data mirrored from the prior and the posterior before EMD processing. A novel intrinsic respiratory reconstruction index that considers both global and local properties of IMFs is proposed to define respiration-related IMFs for respiration reconstruction and instantaneous respiratory estimation. Based on the experiments performing a series of static and dynamic physical activates, our results showed the proposed method had higher cross correlations between respiratory frequencies estimated from thoracic impedance and those from oronasal airflow based on small window size compared to the Fourier transform-based method.

Instantaneous Respiratory Estimation from Thoracic Impedance by Empirical Mode Decomposition

PubMed Central

Wang, Fu-Tai; Chan, Hsiao-Lung; Wang, Chun-Li; Jian, Hung-Ming; Lin, Sheng-Hsiung

2015-01-01

Impedance plethysmography provides a way to measure respiratory activity by sensing the change of thoracic impedance caused by inspiration and expiration. This measurement imposes little pressure on the body and uses the human body as the sensor, thereby reducing the need for adjustments as body position changes and making it suitable for long-term or ambulatory monitoring. The empirical mode decomposition (EMD) can decompose a signal into several intrinsic mode functions (IMFs) that disclose nonstationary components as well as stationary components and, similarly, capture respiratory episodes from thoracic impedance. However, upper-body movements usually produce motion artifacts that are not easily removed by digital filtering. Moreover, large motion artifacts disable the EMD to decompose respiratory components. In this paper, motion artifacts are detected and replaced by the data mirrored from the prior and the posterior before EMD processing. A novel intrinsic respiratory reconstruction index that considers both global and local properties of IMFs is proposed to define respiration-related IMFs for respiration reconstruction and instantaneous respiratory estimation. Based on the experiments performing a series of static and dynamic physical activates, our results showed the proposed method had higher cross correlations between respiratory frequencies estimated from thoracic impedance and those from oronasal airflow based on small window size compared to the Fourier transform-based method. PMID:26198231

The airway antigen sampling system: respiratory M cells as an alternative gateway for inhaled antigens.

PubMed

Kim, Dong-Young; Sato, Ayuko; Fukuyama, Satoshi; Sagara, Hiroshi; Nagatake, Takahiro; Kong, Il Gyu; Goda, Kaoru; Nochi, Tomonori; Kunisawa, Jun; Sato, Shintaro; Yokota, Yoshifumi; Lee, Chul Hee; Kiyono, Hiroshi

2011-04-01

In this study, we demonstrated a new airway Ag sampling site by analyzing tissue sections of the murine nasal passages. We revealed the presence of respiratory M cells, which had the ability to take up OVA and recombinant Salmonella typhimurium expressing GFP, in the turbinates covered with single-layer epithelium. These M cells were also capable of taking up respiratory pathogen group A Streptococcus after nasal challenge. Inhibitor of DNA binding/differentiation 2 (Id2)-deficient mice, which are deficient in lymphoid tissues, including nasopharynx-associated lymphoid tissue, had a similar frequency of M cell clusters in their nasal epithelia to that of their littermates, Id2(+/-) mice. The titers of Ag-specific Abs were as high in Id2(-/-) mice as in Id2(+/-) mice after nasal immunization with recombinant Salmonella-ToxC or group A Streptococcus, indicating that respiratory M cells were capable of sampling inhaled bacterial Ag to initiate an Ag-specific immune response. Taken together, these findings suggest that respiratory M cells act as a nasopharynx-associated lymphoid tissue-independent alternative gateway for Ag sampling and subsequent induction of Ag-specific immune responses in the upper respiratory tract.

The capsaicin cough reflex in eczema patients with respiratory symptoms elicited by perfume.

PubMed

Elberling, Jesper; Dirksen, Asger; Johansen, Jeanne Duus; Mosbech, Holger

2006-03-01

Respiratory symptoms elicited by perfume are common in the population but have unclear pathophysiology. Increased capsaicin cough responsiveness has been associated with the symptoms, but it is unknown whether the site of the symptoms in the airways influences this association. The aim of this study was to investigate the association between the site of airway symptoms elicited by perfume and cough responsiveness to bronchial challenge with capsaicin. 21 eczema patients with respiratory symptoms elicited by perfume were compared with 21 healthy volunteers in a sex- and age-matched case control study. The participants completed a symptom questionnaire and underwent a bronchial challenge with capsaicin. Lower, but not upper, respiratory symptoms elicited by perfume were associated with increased capsaicin cough responsiveness. Having severe symptoms to perfume (n=11) did not relate to the site of the symptoms in the airways and was not associated with increased capsaicin cough responsiveness. In conclusion, respiratory symptoms elicited by perfume may reflect local hyperreactivity related to defensive reflexes in the airways, and measurements of the capsaicin cough reflex are relevant when patients with lower respiratory symptoms related to environmental perfume exposures are investigated.

Brain stem sites mediating specific and non-specific temperature effects on thermoregulation in the pekin duck.

PubMed Central

Martin, R; Simon, E; Simon-Oppermann, C

1981-01-01

1. Thermodes were chronically implanted into various levels of the brain stem of sixteen Pekin ducks. The effects of local thermal stimulation on metabolic heat production, core temperature, peripheral skin temperature and respiratory frequency were investigated. 2. Four areas of thermode positions were determined according to the responses observed and were histologically identified at the end of the investigation. 3. Thermal stimulation of the lower mid-brain/upper pontine brain stem (Pos. III) elicited an increase in metabolic heat production, cutaneous vasoconstriction and rises in core temperature in response to cooling at thermoneutral and cold ambient conditions and, further, inhibition of panting by cooling and activation of panting by heating at warm ambient conditions. The metabolic response to cooling this brain stem section amounted to -0.1 W/kg. degrees C as compared with -7 W/kg. degrees C in response to total body cooling. 4. Cooling of the anterior and middle hypothalamus (Pos. II) caused vasodilatation in the skin and did not elicit shivering. The resulting drop in core temperature at a given degree of cooling was greater than the rise in core temperature in response to equivalent cooling of the lower mid-brain/upper pontine brain stem. 5. Cooling of the preoptic forebrain (Pos. I) and of the myelencephalon (Pos. IV) did not elicit thermoregulatory reactions. 6. It is concluded that the duck's brain stem contains thermoreceptive structures in the lower mid-brain/upper pontine section. However, the brain stem as a whole appears to contribute little to cold defence during general hypothermia because of the inhibitory effects originating in the anterior and middle hypothalamus. Cold defence in the duck, which is comparable in strength to that in mammals, has to rely on extracerebral thermosensory structures. PMID:7310688

Common respiratory conditions of the newborn

PubMed Central

Gallacher, David J.; Hart, Kylie

2016-01-01

Key points Respiratory distress is a common presenting feature among newborn infants. Prompt investigation to ascertain the underlying diagnosis and appropriate subsequent management is important to improve outcomes. Many of the underlying causes of respiratory distress in a newborn are unique to this age group. A chest radiograph is crucial to assist in diagnosis of an underlying cause. Educational aims To inform readers of the common respiratory problems encountered in neonatology and the evidence-based management of these conditions. To enable readers to develop a framework for diagnosis of an infant with respiratory distress. The first hours and days of life are of crucial importance for the newborn infant as the infant adapts to the extra-uterine environment. The newborn infant is vulnerable to a range of respiratory diseases, many unique to this period of early life as the developing fluid-filled fetal lungs adapt to the extrauterine environment. The clinical signs of respiratory distress are important to recognise and further investigate, to identify the underlying cause. The epidemiology, diagnostic features and management of common neonatal respiratory conditions are covered in this review article aimed at all healthcare professionals who come into contact with newborn infants. PMID:27064402

The respiratory local lymph node assay as a tool to study respiratory sensitizers.

PubMed

Arts, Josje H E; de Jong, Wim H; van Triel, Jos J; Schijf, Marcel A; de Klerk, Arja; van Loveren, Henk; Kuper, C Frieke

2008-12-01

The local lymph node assay (LLNA) is used to test the potential of low molecular weight (LMW) compounds to induce sensitization via the skin. In the present study, a respiratory LLNA was developed. Male BALB/c mice were exposed head/nose-only during three consecutive days for 45, 90, 180, or 360 min/day to various LMW allergens. Ear application (skin LLNA) was used as a positive control. Negative controls were exposed to the vehicle. Three days after the last exposure, proliferation was determined in the draining mandibular lymph nodes, and the respiratory tract was examined microscopically. Upon inhalation, the allergens trimellitic anhydride, phthalic anhydride, hexamethylene diisocyanate, toluene diisocyanate, isophorone diisocyanate (IPDI), dinitrochlorobenzene, and oxazolone were positive and showed stimulation indices (SIs) up to 11, whereas trimeric IPDI, formaldehyde, and methyl salicylate were negative (viz. SI < 3). All compounds, except trimeric IPDI, induced histopathological lesions predominantly in the upper respiratory tract. Exposure by inhalation is a realistic approach to test respiratory allergens. However, based on the local toxicity, the dose that can be applied is (generally) much lower than can be achieved by skin application. It is concluded that strong LMW allergens, regardless their immunological nature, besides the skin can also sensitize the body via the respiratory tract. In addition, the contact allergens were as potent as the respiratory allergens, although the potency ranking differed from that in a skin LLNA.

The Association between Air Pollution and Population Health Risk for Respiratory Infection: A Case Study of Shenzhen, China.

PubMed

Xia, Xiaolin; Zhang, An; Liang, Shi; Qi, Qingwen; Jiang, Lili; Ye, Yanjun

2017-08-23

Nowadays, most of the research on air pollution and its adverse effects on public health in China has focused on megacities and heavily-polluted regions. Fewer studies have focused on cities that are slightly polluted. Shenzhen used to have a favorable air environment, but its air quality has deteriorated gradually as a result of development in recent years. So far, no systematic investigations have been conducted on the adverse effects of air pollution on public health in Shenzhen. This research has applied a time series analysis model to study the possible association between different types of air pollution and respiratory hospital admission in Shenzhen in 2013. Respiratory hospital admission was divided into two categories for comparison analysis among various population groups: acute upper respiratory infection and acute lower respiratory infection. The results showed that short-term exposure to ambient air pollution was significantly associated with acute respiratory infection hospital admission in Shenzhen in 2013. Children under 14 years old were the main susceptible population of acute respiratory infection due to air pollution. PM 10 , PM 2.5 and NO₂ were the primary air pollutants threatening respiratory health in Shenzhen. Though air pollution level is generally relatively low in Shenzhen, it will benefit public health to control the pollution of particulate matter as well as other gaseous pollutants.

An isolated right hypoglossal nerve palsy in association with infectious mononucleosis.

PubMed Central

Wright, G. D.; Lee, K. D.

1980-01-01

Following an upper respiratory tract infection, a teenage girl developed an isolated right XII nerve palsy; subsequently she was shown to have infectious mononucleosis. After 24 weeks her tongue had virtually recovered. Images Fig. 1 Fig. 2 PMID:6248842

[Status of the upper respiratory tract of workers in the synthetic detergent industry].

PubMed

Artamonova, V G; Barsukov, A F; Galzhiev, A S

1991-01-01

Otorhinolaryngologic examinations and functional studies were performed among 99 workers engaged in the production of synthetic detergents. The studies revealed disorders in the barrier and decontamination functions of the nasal ciliary epithelium caused by synthetic detergent dusts.

Metapneumovirus infections

USDA-ARS?s Scientific Manuscript database

Avian metapneumovirus (aMPV) causes turkey rhinotracheitis (TRT), an acute upper respiratory tract infection of turkeys, and is also associated with swollen head syndrome (SHS) in chickens and egg production losses in layers. Since the first TRT reported in the late 1970s in South Africa, the virus...

Minor Illnesses, Temperament, and Toddler Social Functioning

ERIC Educational Resources Information Center

Kolak, Amy M.; Frey, Tara J.; Brown, Chloe A.; Vernon-Feagans, Lynne

2013-01-01

Research Findings: Minor illnesses, such as upper respiratory infections, stomachaches, and fevers, have been associated with children's decreased activity and increased irritability. This multi-method investigation of 110 day care-attending children examined whether experience with recurrent, minor illnesses and negative emotionality worked…

Reliability and Validity of Wisconsin Upper Respiratory Symptom Survey, Korean Version

PubMed Central

Yang, Su-Young; Kang, Weechang; Yeo, Yoon; Park, Yang-Chun

2011-01-01

Background The Wisconsin Upper Respiratory Symptom Survey (WURSS) is a self-administered questionnaire developed in the United States to evaluate the severity of the common cold and its reliability has been validated. We developed a Korean language version of this questionnaire by using a sequential forward and backward translation approach. The purpose of this study was to validate the Korean version of the Wisconsin Upper Respiratory Symptom Survey (WURSS-K) in Korean patients with common cold. Methods This multicenter prospective study enrolled 107 participants who were diagnosed with common cold and consented to participate in the study. The WURSS-K includes 1 global illness severity item, 32 symptom-based items, 10 functional quality-of-life (QOL) items, and 1 item assessing global change. The SF-8 was used as an external comparator. Results The participants were 54 women and 53 men aged 18 to 42 years. The WURSS-K showed good reliability in 10 domains, with Cronbach’s alphas ranging from 0.67 to 0.96 (mean: 0.84). Comparison of the reliability coefficients of the WURSS-K and WURSS yielded a Pearson correlation coefficient of 0.71 (P = 0.02). Validity of the WURSS-K was evaluated by comparing it with the SF-8, which yielded a Pearson correlation coefficient of −0.267 (P < 0.001). The Guyatt’s responsiveness index of the WURSS-K ranged from 0.13 to 0.46, and the correlation coefficient with the WURSS was 0.534 (P < 0.001), indicating that there was close correlation between the WURSS-K and WURSS. Conclusions The WURSS-K is a reliable, valid, and responsive disease-specific questionnaire for assessing symptoms and QOL in Korean patients with common cold. PMID:21691034

Effect of Lactobacillus rhamnosus LGG® and Bifidobacterium animalis ssp. lactis BB-12® on health-related quality of life in college students affected by upper respiratory infections.

PubMed

Smith, Tracey J; Rigassio-Radler, Diane; Denmark, Robert; Haley, Timothy; Touger-Decker, Riva

2013-06-01

College students are susceptible to upper respiratory infections (URI) due to inadequate sleep, stress and close living quarters. Certain probiotic strains modulate immune function and may improve health-related quality of life (HRQL) during URI. The present study recruited apparently healthy college students and assessed the effect of probiotics on HRQL outcomes (i.e. self-reported duration, symptom severity and functional impairment of URI) in those who developed URI. Missed school and work days due to URI were also considered. Subjects (n 231) were apparently healthy college students living on campus in residence halls at the Framingham State University (Framingham, MA, USA), and were randomised to receive placebo (n 117) or probiotic-containing powder (daily dose of minimum 1 billion colony-forming units of each Lactobacillus rhamnosus LGG® (LGG®) and Bifidobacterium animalis ssp. lactis BB-12® (BB-12®); n 114) for 12 weeks. Subjects completed The Wisconsin Upper Respiratory Symptom Survey-21 to assess HRQL during URI. The final analyses included 198 subjects (placebo, n 97 and probiotics, n 101). The median duration of URI was significantly shorter by 2 d and median severity score was significantly lower by 34% with probiotics v. placebo (P,0·001), indicating a higher HRQL during URI. Number of missed work days was not different between groups (P=0·429); however, the probiotics group missed significantly fewer school days (mean difference = 0·2 d) compared to the placebo group (P=0·002). LGG® and BB-12® may be beneficial among college students with URI for mitigating decrements in HRQL. More research is warranted regarding mechanisms of action associated with these findings and the cost-benefit of prophylactic supplementation.

Mucosal immunity and upper respiratory tract symptoms in recreational endurance runners.

PubMed

Ihalainen, Johanna K; Schumann, Moritz; Häkkinen, Keijo; Mero, Antti A

2016-01-01

The present study investigated the effects of a 12-week endurance-training intervention on salivary proteins and upper respiratory tract symptoms (URS) in 25 young men. Saliva samples of 25 recreational male endurance runners (age 34.6 years, body mass index = 23.8 kg·m(-2), peak aerobic capacity = 47.2 mL·kg(-1)·min(-1)) were collected before (PRE) and after (POST) the training intervention, in a fasting state, as well as both before and after a maximal incremental treadmill run. The training consisted of both continuous and interval training sessions, 4-6 times per week based on the polarized training approach. Participants filled in Wisconsin Upper Respiratory Symptom Survey-21 and were retrospectively divided into 2 groups according to whether they reported URS (URS group, n = 13) or not (HEALTHY group, n = 12). Basal salivary immunoglobulin A (sa-sIgA) levels were significantly higher (+70%, p < 0.05) in the HEALTHY group both at PRE and POST whereas no significant differences were observed in salivary immunoglobulin M, salivary immunoglobulin G, lysozyme, or salivary α-amylase activity (sAA). Sa-sIgA concentration at PRE significantly correlated with the number of sick-days (R = -0.755, p < 0.001) in all subjects. The incremental treadmill run acutely increased sAA significantly (p < 0.05) at PRE (200%) and POST (166%) in the HEALTHY group but not in the URS group. This study demonstrated that subjects, who experienced URS during the 12 weeks of progressive endurance training intervention, had significantly lower basal sa-sIgA levels both before and after the experimental endurance training period. In addition to sa-sIgA, acute sAA response to exercise might be a possible determinant of susceptibility to URS in endurance runners.

Upper respiratory tract infection and mucosal immunity in young ice hockey players during the pre-tournament training period.

PubMed

Orysiak, Joanna; Witek, Konrad; Malczewska-Lenczowska, Jadwiga; Zembron-Lacny, Agnieszka; Pokrywka, Andrzej; Sitkowski, Dariusz

2018-02-27

The aim of this study was to determine the effects of 17 days of training during preparation for the Ice Hockey Under 18 World Championship of the Polish ice hockey national team on the mucosal immune function and monitor upper respiratory tract infection (URTI) incidence before, during and after the competition. Twelve male ice hockey players (age 17.7±0.5 years) were recruited for this study. The first saliva/blood collection took place at the beginning of the training camp (without training at the training camp), the second one was conducted on the 9th day of the training camp immediately after the intensification of training, and the third collection was carried out on the 13th day of training (4 days before leaving for the World Championship) in the tapering phase. To assess the mucosal immune function, concentrations of secretory immunoglobulin A (sIgA), sIgA1, and sIgA2 were analyzed in saliva. Cortisol concentration and creatine kinase activity were determined in blood, as indicators of stress and muscle damage, respectively. The Wisconsin Upper Respiratory Symptom Survey-21 questionnaire was used to assess URTI symptoms. A significant increase in the sIgA1 and sIgA2 concentrations was observed in the third collection compared with the second time point (114.45±33.00 vs 77.49±27.29 and 88.97±25.33 vs 71.65±32.44 U, respectively). There were no statistically significant correlations between the URTI incidence and saliva variables. In conclusion, the tapering period positively affects the mucosal immune function, especially sIgA1 and sIgA2 concentrations, with no significant change in frequency of URTI in young ice hockey players.

Modeling the association between HR variability and illness in elite swimmers

PubMed Central

Hellard, Philippe; Guimaraes, Fanny; Avalos, Marta; Houel, Nicolas; Hausswirth, Christophe; Toussaint, Jean François

2011-01-01

Purpose To determine whether heart rate variability, an indirect measure of autonomic control, is associated with upper respiratory tract and pulmonary infections, muscular affections and all-type pathologies in elite swimmers. Methods Seven elite international and 11 national swimmers were followed weekly for two years. The indexes of cardiac autonomic regulation in supine and orthostatic position were assessed as explanatory variables by time-domain (SD1, SD2) and spectral analyses (high frequency- HF; 0.15 Hz-0.40Hz, low frequency-LF; 0.04-0.15 Hz and HF/LF ratio) of heart rate variability. Logistic mixed models described the relationship between the explanatory variables and the risk of upper respiratory tract and pulmonary infections, muscular affections and all-type pathologies. Results The risk of all-type pathologies was higher for national swimmers and in winter (p<0.01). An increase in the parasympathetic indexes (HF, SD1) in supine position assessed one week earlier was linked to a higher risk of upper respiratory tract and pulmonary infections (p<0.05), and to a higher risk of muscular affections (increase in HF, p<0.05). Multivariate analyses showed: (1) a higher all-type pathologies risk in winter, and for an increase in the total power of heart rate variability associated with a decline SD1 in supine position; (2) a higher all-type pathologies risk in winter associated with a decline in HF assessed one week earlier in orthostatic position; and (3) a higher risk of muscular affections in winter associated with a decrease SD1 and an increase LF in orthostatic position. Conclusion Swimmers’ health maintenance requires particular attention when autonomic balance shows a sudden increase in parasympathetic indices in supine position assessed one week earlier evolving toward sympathetic predominance in supine and orthostatic positions. PMID:21085039

Inter-Rater Agreement of Auscultation, Palpable Fremitus, and Ventilator Waveform Sawtooth Patterns Between Clinicians.

PubMed

Berry, Marc P; Martí, Joan-Daniel; Ntoumenopoulos, George

2016-10-01

Clinicians often use numerous bedside assessments for secretion retention in participants who are receiving invasive mechanical ventilation. This study aimed to evaluate inter-rater agreement between clinicians when using standard clinical assessments of secretion retention and whether differences in clinician experience influenced inter-rater agreement. Seventy-one mechanically ventilated participants were assessed by a research clinician and by one of 13 ICU clinicians. Each clinician conducted a standardized assessment of lung auscultation, palpation for chest-wall (rhonchal) fremitus, and ventilator inspiratory/expiratory flow-time waveforms for the sawtooth pattern. On the presence of breath sounds, agreement ranged from absolute to moderate in the upper zones and the lower zones, respectively. Kappa values for abnormal and adventitious lung sounds achieved moderate agreement in the upper zones, less than chance agreement to substantial agreement in the middle zones, and moderate agreement to almost perfect agreement in the lower zones. Moderate to almost perfect agreement was established for palpable fremitus in the upper zones, moderate to substantial agreement in the middle zones, and less than chance to moderate agreement in the lower zones. Inter-rater agreement on the presence of expiratory sawtooth pattern identification showed moderate agreement. The level of percentage agreement between the research and ICU clinicians for each respiratory assessment studied did not relate directly to level of clinical experience. Inter-rater agreement for all assessments showed variability between lung regions but maintained reasonable percentage agreement in mechanically ventilated participants. The level of percentage agreement achieved between clinicians did not directly relate to clinical experience for all respiratory assessments. Therefore, these respiratory assessments should not necessarily be viewed in isolation but interpreted within the context of a full clinical assessment. Copyright © 2016 by Daedalus Enterprises.

Antipyretic and analgesic effects of zaltoprofen for the treatment of acute upper respiratory tract infection: verification of a noninferiority hypothesis using loxoprofen sodium.

PubMed

Azuma, Arata; Kudoh, Shoji; Nakashima, Mitsuyoshi; Nagatake, Tsuyoshi

2011-01-01

A multicenter, placebo-controlled, double-dummy, randomized, parallel-group, double-blind study was conducted to verify the hypothesis of noninferiority for single-dose administration of zaltoprofen 160 mg, a nonsteroidal anti-inflammatory drug, compared with loxoprofen sodium 60 mg (loxoprofen), in terms of antipyretic and analgesic effects in patients with acute upper respiratory tract infection. The eligible 330 patients were assigned to one of 3 groups: zaltoprofen 160 mg, loxoprofen 60 mg and placebo. The analysis set consisted of 322 patients. Antipyretic effects were assessed by measuring body temperature, and analgesic effects were evaluated using a visual analog scale (VAS) for 4 h under the control of study staff. A detection kit for influenza virus A and B antigens was used to determine the presence of influenza virus infection. Compared with immediately before administration and with the placebo group, significant decreases in body temperature and summary VAS pain scores were noted in both the zaltoprofen and loxoprofen groups at 4 h after drug administration. Based on the degree of decrease in body temperature and the summary VAS pain scores up to 4 h after administration, noninferiority in terms of antipyretic and analgesic effects of zaltoprofen compared with those of loxoprofen was confirmed after single administration. Similar antipyretic and analgesic effects were also confirmed in influenza virus antigen-positive patients (73 patients). No clinical concerns were identified regarding safety. Zaltoprofen and loxoprofen are confirmed to be safe and useful for patients with acute upper respiratory tract infection, including those with influenza infection. Copyright © 2011 S. Karger AG, Basel.

Roles of Clinician, Patient, and Community Characteristics in the Management of Pediatric Upper Respiratory Tract Infections.

PubMed

Yaeger, Jeffrey P; Temte, Jonathan L; Hanrahan, Lawrence P; Martinez-Donate, P

2015-11-01

Prior studies have evaluated factors predictive of inappropriate antibiotic prescription for upper respiratory tract infections (URIs). Community factors, however, have not been examined. The aim of this study was to evaluate the roles of patient, clinician, and community factors in predicting appropriate management of URIs in children. We used a novel database exchange, linking electronic health record data with community statistics, to identify all patients aged 3 months to 18 years in whom URI was diagnosed in the period from 2007 to 2012. We followed the Healthcare Effectiveness Data and Information Set (HEDIS) quality measurement titled "Appropriate treatment for children with upper respiratory infection" to determine the rate of appropriate management of URIs. We then stratified data across individual and community characteristics and used multiple logistic regression modeling to identify variables that independently predicted antibiotic prescription. Of 20,581 patients, the overall rate for appropriate management for URI was 93.5%. Family medicine clinicians (AOR = 1.5; 95% CI 1.31, 1.71; reference = pediatric clinicians), urgent care clinicians (AOR = 2.23; 95% CI 1.93, 2.57; reference = pediatric clinicians), patients aged 12 to 18 years (AOR = 1.44; 95% CI 1.25, 1.67; reference = age 3 months to 4 years), and patients of white race/ ethnicity (AOR = 1.83; 95% CI 1.41, 2.37; reference = black non-Hispanic) were independently predictive of antibiotic prescription. No community factors were independently predictive of antibiotic prescription. Results correlate with prior studies in which non-pediatric clinicians and white race/ethnicity were predictive of antibiotic prescription, while association with older patient age has not been previously reported. Findings illustrate the promise of linking electronic health records with community data to evaluate health care disparities. © 2015 Annals of Family Medicine, Inc.

A Mechanistic Role for Type III IFN-λ1 in Asthma Exacerbations Mediated by Human Rhinoviruses

PubMed Central

Miller, E. Kathryn; Hernandez, Johanna Zea; Wimmenauer, Vera; Shepherd, Bryan E.; Hijano, Diego; Libster, Romina; Serra, M. Elina; Bhat, Niranjan; Batalle, Juan P.; Mohamed, Yassir; Reynaldi, Andrea; Rodriguez, Andrea; Otello, Monica; Pisapia, Nestor; Bugna, Jimena; Bellabarba, Miguel; Kraft, David; Coviello, Silvina; Ferolla, F. Martin; Chen, Aaron; London, Stephanie J.; Siberry, George K.; Williams, John V.

2012-01-01

Rationale: Human rhinoviruses (HRV) are the leading cause of upper respiratory infections and have been postulated to trigger asthma exacerbations. However, whether HRV are detected during crises because upper respiratory infections often accompany asthma attacks, or because they specifically elicit exacerbations, is unclear. Moreover, although several hypotheses have been advanced to explain virus-induced exacerbations, their mechanism remains unclear. Objectives: To determine the role of HRV in pediatric asthma exacerbations and the mechanisms mediating wheezing. Methods: We prospectively studied 409 children with asthma presenting with upper respiratory infection in the presence or absence of wheezing. Candidate viral and immune mediators of illness were compared among children with asthma with different degrees of severity of acute asthma. Measurements and Main Results: HRV infections specifically associated with asthma exacerbations, even after adjusting for relevant demographic and clinical variables defined a priori (odds ratio, 1.90; 95% confidence interval, 1.21–2.99; P = 0.005). No difference in virus titers, HRV species, and inflammatory or allergic molecules was observed between wheezing and nonwheezing children infected with HRV. Type III IFN-λ1 levels were higher in wheezing children infected with HRV compared with nonwheezing (P < 0.001) and increased with worsening symptoms (P < 0.001). Moreover, after adjusting for IFN-λ1, children with asthma infected with HRV were no longer more likely to wheeze than those who were HRV-negative (odds ratio, 1.18; 95% confidence interval, 0.57–2.46; P = 0.66). Conclusions: Our findings suggest that HRV infections in children with asthma are specifically associated with acute wheezing, and that type III IFN-λ1 responses mediate exacerbations caused by HRV. Modulation of IFN- λ1 should be studied as a therapeutic target for exacerbations caused by HRV. PMID:22135341

Frequency of respiratory viruses among patients admitted to 26 Intensive Care Units in seven consecutive winter-spring seasons (2009-2016) in Northern Italy.

PubMed

Piralla, Antonio; Mariani, Bianca; Rovida, Francesca; Baldanti, Fausto

2017-07-01

The role of respiratory viruses in the etiology of community-acquired pneumonia (CAP) is still debated. The advent of molecular assays has improved the identification of viruses in patients with CAP and according to published studies, viruses account for 11-55% of adult CAP cases. In the present study, the frequency of respiratory viruses was evaluated in respiratory samples collected from 414 patients with CAP admitted to 26 ICUs in the Lombardy Region (10 million inhabitants) during seven winter-spring seasons (2009-2016). In 226 (54.6%) patients one or more respiratory viruses were identified, while 188 (45.4%) patients were negative. A single virus infection was observed in 214/226 (94.7%) patients; while, in 12/226 (5.3%) at least two respiratory viruses were detected. Influenza A was the most common virus in 140/226 patients (61.9%) followed by rhinoviruses (33/226, 14.6%), respiratory syncytial virus (13/226, 5.8%), influenza B virus (9/226, 4.0%), human coronaviruses (9/226, 4.0%), cytomegalovirus (9/226, 4.0%) and human metapneumovirus (1/226, 0.4%). Viral infections are present in a consistent proportion of patients admitted to the ICU for CAP. Influenza A and rhinovirus accounted for three-quarters of all CAP in ICU patients. The use of lower respiratory instead of upper respiratory samples might be useful in the diagnosis of viral CAP. Copyright © 2017 Elsevier B.V. All rights reserved.

Respiratory symptoms in Lancashire textile weavers.

PubMed

Raza, S N; Fletcher, A M; Pickering, C A; Niven, R M; Faragher, E B

1999-08-01

To investigate a large population of cotton textile weavers for reported respiratory symptoms relative to occupational factors, smoking, and exposure to dust. Cotton processing is known to produce a respiratory disease known as byssinosis particularly in the early processes of cotton spinning. Relatively little is known about the respiratory health of the cotton weavers who produce cloth from spun cotton. By the time cotton is woven many of the original contaminants have been removed. 1295 operatives from a target population of 1428 were given an interviewer led respiratory questionnaire. The presence of upper and lower respiratory tract symptoms were sought and the work relatedness of these symptoms determined by a stem questionnaire design. Also occupational and demographic details were obtained and spirometry and personal dust sampling performed. Byssinosis was present in only four people (0.3%). Chronic bronchitis had a moderate overall prevalence of about 6% and was related predominantly to smoking. There were several other work related respiratory symptoms (persistent cough 3.9%, chronic production of phlegm 3.6%, chest tightness 4.8%, wheezing 5.4%, and breathlessness 2.3%). All of these were predicted predominantly by smoking (either past or present), with no consistent independent effect of exposure to dust. Work related eye and nasal symptoms were more common (10.4% and 16.9% respectively). Byssinosis is a rare respiratory symptom in cotton weaving. Other work related respiratory symptoms were reported but their presence was predominantly related to smoking with no consistent effects of exposure to dust.

COMPARISON OF CURRENT METHODS FOR THE DETECTION OF CHRONIC MYCOPLASMAL URTD IN WILD POPULATIONS OF THE MOJAVE DESERT TORTOISE (GOPHERUS AGASSIZII).

PubMed

Sandmeier, Franziska C; Weitzman, Chava L; Maloney, K Nichole; Tracy, C Richard; Nieto, Nathan; Teglas, Mike B; Hunter, Kenneth W; DuPré, Sally; Gienger, C M; Tuma, Michael W

2017-01-01

Pathogens that cause subclinical diseases or exhibit low infection intensities are difficult to quantify in wild populations. Mojave desert tortoises ( Gopherus agassizii ) have been the focus of much research aimed at measuring the presence of upper respiratory disease (URTD) and URTD-associated pathogens, and techniques used to quantify disease in Gopherus species have also been used for disease surveillance in other species of turtles and tortoises of conservation concern. Published surveys of G. agassizii populations have found a relatively low prevalence of URTD, with most URTD-positive animals exhibiting moderate, intermittent signs of morbidity. Therefore, multiple tests have been developed to quantify URTD including genetic detection of the pathogens Mycoplasma agassizii and Mycoplasma testudineum , detection of M. agassizii -specific antibodies, and standardized quantification of clinical signs of URTD and body condition. These diagnostic tests have only been compared in diseased or moribund, semicaptive animals. We compared diagnostic techniques (TaqMan® and SYBR™ Green qPCR, serology, and visible examination) to detect M. agassizii -associated URTD in 126 wild desert tortoises sampled in Nevada and California, US in 2010. All had healthy body condition indices and none exhibited more than mild-to-moderate visual signs of URTD. Pairwise comparisons of diagnostic techniques indicated poor performance in diagnosing disease in individual animals. We found stronger, but inconsistent, statistical associations among diagnostic techniques at the population level. Our findings have implications for quantifying subclinical respiratory disease in tortoises.

Outbreaks of human metapneumovirus in two skilled nursing facilities -West Virginia and Idaho, 2011-2012.

PubMed

2013-11-22

During January and February 2012, state and local public health agencies in West Virginia and Idaho, with assistance from facility staff members and CDC, investigated outbreaks of unexplained respiratory illness characterized by high proportions of lower respiratory tract infections (LRTIs) at two skilled nursing facilities (SNFs). Investigations were conducted to determine the extent and etiology of each outbreak and make recommendations to prevent further spread. During both outbreaks, influenza was initially suspected; however, human metapneumovirus (hMPV) was identified as the etiologic agent. Among 57 cases of respiratory illness from both facilities, 45 (79%) patients had evidence of LRTI, of whom 25 (56%) had radiologically confirmed pneumonia; five (9%) had evidence of upper respiratory tract infection (URTI), and seven (12%) could not be classified. Six patients (11%) died. These outbreaks demonstrate that hMPV, a recently described pathogen that would not have been detected without the use of molecular diagnostics in these outbreaks, is associated with severe LRTI and should be considered as a possible etiology of respiratory outbreaks in SNFs.

Mechanical model for simulating the conditioning of air in the respiratory tract.

PubMed

Bergonse Neto, Nelson; Von Bahten, Luiz Carlos; Moura, Luís Mauro; Coelho, Marlos de Souza; Stori Junior, Wilson de Souza; Bergonse, Gilberto da Fontoura Rey

2007-01-01

To create a mechanical model that could be regulated to simulate the conditioning of inspired and expired air with the same normal values of temperature, pressure, and relative humidity as those of the respiratory system of a healthy young man on mechanical ventilation. Using several types of materials, a mechanical device was built and regulated using normal values of vital capacity, tidal volume, maximal inspiratory pressure, positive end-expiratory pressure, and gas temperature in the system. The device was submitted to mechanical ventilation for a period of 29.8 min. The changes in the temperature of the air circulating in the system were recorded every two seconds. The statistical analysis of the data collected revealed that the device was approximately as efficient in the conditioning of air as is the respiratory system of a human being. By the study endpoint, we had developed a mechanical device capable of simulating the conditioning of air in the respiratory tract. The device mimics the conditions of temperature, pressure, and relative humidity seen in the respiratory system of healthy individuals.

Respiratory Health Effects of Large Animal Farming Environments

PubMed Central

May, Sara; Romberger, Debra J.; Poole, Jill A.

2014-01-01

With increases in large animal-feeding operations to meet consumer demand, adverse upper and lower respiratory health effects in exposed agriculture workers is a concern. The aim of this study was to review large animal confinement feeding operational exposures associated with respiratory disease with focus on recent advances in the knowledge of causative factors and cellular and immunological mechanisms. A PubMed search was conducted with the following keywords: airway, farm, swine, dairy, horse, cattle inflammation, organic dust, endotoxin, and peptidoglycan that were published between 1980 and current. Articles were selected based on their relevance to environmental exposure and reference to airway diseases. Airway diseases included rhinitis, sinusitis, mucus membrane inflammation syndrome, asthma, chronic bronchitis, chronic obstructive pulmonary disease, hypersensitivity pneumonitis, and organic dust toxic syndrome. There is lower prevalence of IgE-mediated asthma and atopy in farmers and their children, but organic dust worsens existing asthma. Multiple etiologic factors are linked to disease including allergens, organic dusts, endotoxins, peptidoglycans and gases. Large animal confinement feeding operations contain a wide-diversity of microbes with increasing focus on Gram-positive bacteria and archeabacteria as opposed to Gram-negative bacteria in mediating disease. Toll-like receptors (TLR) and nucleotide oligomerization domain (NOD)-like innate immune pathways respond to these exposures. Finally, a chronic inflammatory adaptation, tolerance-like response in chronically exposed workers occurs. Large animal confinement farming exposures produces a wide spectrum of upper and lower respiratory tract diseases due to the complex diversity of organic dust, particulates, microbial cell wall components and gases and resultant activation of various innate immune receptor signaling pathways. PMID:23199220

Variations in respiratory sounds in relation to fluid accumulation in the upper airways.

PubMed

Yadollahi, Azadeh; Rudzicz, Frank; Montazeri, Aman; Bradley, T Douglas

2013-01-01

Obstructive sleep apnea (OSA) is a common disorder due to recurrent collapse of the upper airway (UA) during sleep that increases the risk for several cardiovascular diseases. Recently, we showed that nocturnal fluid accumulation in the neck can narrow the UA and predispose to OSA. Our goal is to develop non-invasive methods to study the pathogenesis of OSA and the factors that increase the risks of developing it. Respiratory sound analysis is a simple and non-invasive way to study variations in the properties of the UA. In this study we examine whether such analysis can be used to estimate the amount of neck fluid volume and whether fluid accumulation in the neck alters the properties of these sounds. Our acoustic features include estimates of formants, pitch, energy, duration, zero crossing rate, average power, Mel frequency power, Mel cepstral coefficients, skewness, and kurtosis across segments of sleep. Our results show that while all acoustic features vary significantly among subjects, only the variations in respiratory sound energy, power, duration, pitch, and formants varied significantly over time. Decreases in energy and power over time accompany increases in neck fluid volume which may indicate narrowing of UA and consequently an increased risk of OSA. Finally, simple discriminant analysis was used to estimate broad classes of neck fluid volume from acoustic features with an accuracy of 75%. These results suggest that acoustic analysis of respiratory sounds might be used to assess the role of fluid accumulation in the neck on the pathogenesis of OSA.

[Monitoring of neopterin and INF-gamma in children with recurrent respiratory tract infection].

PubMed

Shervashidze, M R; Barabadze, K A; Vekua, M V; Akhvlediani, I K

2006-07-01

The upper and lover respiratory tract infections are usually mild and self-limited. Owing to their frequency recurrent upper and lower respiratory tract infection in children and adults constitute a major global health problem. The goal of our study was to observe 30 children with recurrent respiratory tract infection, 17 boy and 13 girl, they were treated with Ribomunyl. The control group consisted of 15 children who received only basic therapy (10 boys and 5 girls). The age of the children ranged between 8 months and 6 years. The study was conducted by the simply randomization method. Clinical and laboratory examinations were evaluated before and after treatment. The concentration of INF-gamma was rather low in study group in comparison with control group before the beginning of the treatment, that indicates insufficient stimulation of T-lymphocytes in children with recurrent infection. INF-gamma lever significantly increased after treatment (Statistically significantly P<0.05) in study group in comparison with control group. Neopterin level unlike INF-gamma in study group was higher than in the control group, before and after treatment. This fact can be explained that neopterin as a slowly acting biologically active substance remains high during the presence of recurrent infections. Ribomunyl treatment significantly increased the level of neopterin. The efficacy of the product is primarily confirmed by significant reductions in the number of recurrent infections episodes and the use of antibacterials. Combined immunostimulating effect of Ribomunyl makes it possible to use Ribomunyl to create a longterm postvaccinal protection of the child.

Increased Protection against Pneumococcal Disease by Mucosal Administration of Conjugate Vaccine plus Interleukin-12

PubMed Central

Lynch, Joyce M.; Briles, David E.; Metzger, Dennis W.

2003-01-01

Streptococcus pneumoniae is a common cause of respiratory tract infections, its main entry route being the nasal mucosa. The recent development of pneumococcal polysaccharide conjugate vaccines has led to a dramatic improvement in protection against invasive disease in infants and children, but these vaccines have been found to be only 50 to 60% protective against bacterial carriage. In this study, we investigated the efficacy of intranasal (i.n.) conjugate vaccine delivery using interleukin-12 (IL-12) as a mucosal adjuvant. Immunized mice treated with IL-12 demonstrated increased expression of lung and splenic gamma interferon and IL-10 mRNAs; high levels of antibody, particularly serum immunoglobulin G2a (IgG2a) and respiratory IgA; and significantly increased opsonic activity. After intraperitoneal challenge with type 3 pneumococci, there was 75% survival of i.n. vaccinated mice compared to 0% survival of unvaccinated mice. In addition, after i.n. challenge with type 14 pneumococci, vaccinated mice possessed fewer bacterial colonies in the upper respiratory tract than unvaccinated mice. However, no significant difference in type 14 carriage was observed between vaccinated and unvaccinated groups following intramuscular vaccination, the typical route of vaccination in humans. Using mice with a genetic disruption in IgA expression, it was found that pneumococcus-specific IgA played a significant role in the clearance of bacteria from the upper respiratory tract. We conclude that i.n vaccination in the presence of IL-12 is able to enhance systemic and mucosal immune responses to pneumococci and efficiently protect against both invasive infection and bacterial carriage. PMID:12874361

Offspring of parents who were separated and not speaking to one another have reduced resistance to the common cold as adults

PubMed Central

Cohen, Sheldon; Janicki-Deverts, Denise; Doyle, William J.

2017-01-01

Exposure to parental separation or divorce during childhood has been associated with an increased risk for physical morbidity during adulthood. Here we tested the hypothesis that this association is primarily attributable to separated parents who do not communicate with each other. We also examined whether early exposure to separated parents in conflict is associated with greater viral-induced inflammatory response in adulthood and in turn with increased susceptibility to viral-induced upper respiratory disease. After assessment of their parents’ relationship during their childhood, 201 healthy volunteers, age 18–55 y, were quarantined, experimentally exposed to a virus that causes a common cold, and monitored for 5 d for the development of a respiratory illness. Monitoring included daily assessments of viral-specific infection, objective markers of illness, and local production of proinflammatory cytokines. Adults whose parents lived apart and never spoke during their childhood were more than three times as likely to develop a cold when exposed to the upper respiratory virus than adults from intact families. Conversely, individuals whose parents were separated but communicated with each other showed no increase in risk compared with those from intact families. These differences persisted in analyses adjusted for potentially confounding variables (demographics, current socioeconomic status, body mass index, season, baseline immunity to the challenge virus, affectivity, and childhood socioeconomic status). Mediation analyses were consistent with the hypothesis that greater susceptibility to respiratory infectious illness among the offspring of noncommunicating parents was attributable to a greater local proinflammatory response to infection. PMID:28584098

Offspring of parents who were separated and not speaking to one another have reduced resistance to the common cold as adults.

PubMed

Murphy, Michael L M; Cohen, Sheldon; Janicki-Deverts, Denise; Doyle, William J

2017-06-20

Exposure to parental separation or divorce during childhood has been associated with an increased risk for physical morbidity during adulthood. Here we tested the hypothesis that this association is primarily attributable to separated parents who do not communicate with each other. We also examined whether early exposure to separated parents in conflict is associated with greater viral-induced inflammatory response in adulthood and in turn with increased susceptibility to viral-induced upper respiratory disease. After assessment of their parents' relationship during their childhood, 201 healthy volunteers, age 18-55 y, were quarantined, experimentally exposed to a virus that causes a common cold, and monitored for 5 d for the development of a respiratory illness. Monitoring included daily assessments of viral-specific infection, objective markers of illness, and local production of proinflammatory cytokines. Adults whose parents lived apart and never spoke during their childhood were more than three times as likely to develop a cold when exposed to the upper respiratory virus than adults from intact families. Conversely, individuals whose parents were separated but communicated with each other showed no increase in risk compared with those from intact families. These differences persisted in analyses adjusted for potentially confounding variables (demographics, current socioeconomic status, body mass index, season, baseline immunity to the challenge virus, affectivity, and childhood socioeconomic status). Mediation analyses were consistent with the hypothesis that greater susceptibility to respiratory infectious illness among the offspring of noncommunicating parents was attributable to a greater local proinflammatory response to infection.