Effect of an upper respiratory tract infection on upper airway reactivity
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Respiratory tract
Reactivity
Rhinovirus
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The respiratory rates/minute of 97 children were monitored every 10-15 minutes over one hour, by an observer and by pneumogram, at which times two 30 second and one 60 second counts were obtained. The children were under 5 years of age with lower respiratory tract infections (n = 20), upper respiratory tract infections (n = 34), or controls without acute respiratory infection (n = 43). The difference between respiratory rate count determined simultaneously by observation and pneumogram in relation to their mean count was analysed for the 60 second counting period, 30 plus 30 second period, and the 30 second period doubled. The mean difference for the 60 second period was 1.79, for the 30 plus 30 second period 1.42, and for the 30 second period doubled 1.72. The variability between respiratory rate counts determined by observation and pneumogram was significantly lower in counts obtained when the subject was sleeping and higher when agitated compared with obtaining a count when the subject was awake and calm or feeding. The variability was also significantly lower in subjects with lower respiratory tract infections compared with those with upper respiratory tract infections and control subjects without respiratory symptoms. In the same patient, over the one hour, 50% of the 60 second counts varied by up to 14 breaths/minute and 75% by up to 21 breaths/minute. The least variability was seen in children with a lower respiratory tract infection, who tended to maintain their rapid breathing in contrast to those with an upper respiratory tract infection and controls without respiratory symptoms. About 10% of initial 30 second counts, 12% of 60 second, and 16% of initial and repeat 30 second attempts to obtain accurate counts failed. Failures occurred more frequently in children <2 months of age and those agitated. The data from this study suggest that one minute9s counting either at a stretch or in two blocks of 30 second intervals is better than counting the respiratory rate for 30 seconds, when the child is either awake and calm or when asleep.
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A link between exposure to the air pollutant nitrogen dioxide (NO2) and respiratory disease has been suggested. Viral infections are the major cause of asthma exacerbations. We aimed to assess whether there is a relation between NO2 exposure and the severity of asthma exacerbations caused by proven respiratory viral infections in children.
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In recent years, the incidence and mortality rate of pediatric respiratory infection have been increasing globally, with rhinovirus being of particular correlation to pediatric respiratory infection.In addition to upper respiratory tract infection, rhinovirus RNA is also found in the lower respiratory tract during the infection period.The epithelial cells of the upper respiratory tract are the target cells of rhinovirus.In recent years, studies done on the relationship between rhinovirus infection and upper respiratory tract infection have provided evidence for clinical treatment.Further investigation is needed on the pathological mechanisms of rhinovirus-induced respiratory infections.
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Rhinovirus; Respiratory tract infection; Children
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Chauhan AJ, Inskip HM, Linaker CH. Lancet. 2003;361:1939–1944Nitrogen dioxide (NO2) exposure has been linked to respiratory tract illness. This study examined the relationship between the level of personal exposure to NO2 and the severity of asthma exacerbations caused by respiratory viral infections.The subjects were 114 asthmatic children, 8 to 11 years of age (63 male subjects and 51 female subjects).The cohort of 114 children collected daily upper and lower respiratory tract symptom scores and peak expiratory flow (PEF) values for up to 13 months. During this time, NO2 collection tubes were worn on the children’s outer clothing, placed in the subjects’ bedrooms at night, and changed weekly. Symptom scores determined the likelihood of an upper respiratory tract infection and prompted the collection of nasal aspirates, for assessment of the presence of common respiratory viruses and atypical bacteria with reverse transcription-polymerase chain reaction assays. NO2 exposure levels were divided into tertiles of low (<7.5 μg/m3), medium (7.5–14 μg/m3), and high (>14 μg/m3). Exposure levels in the week before or after an upper respiratory tract infection were analyzed in relation to the severity of asthma in the week after an infection.Two hundred nineteen episodes of upper respiratory tract infection occurred among 99 subjects. Lower respiratory tract symptom scores were increased and PEF values were decreased with increasing personal exposure to NO2 in the week before infection for all upper respiratory tract infections combined and for piconavirus and respiratory syncytial virus individually. There was no significant change in lower respiratory tract symptom scores or PEF values with high NO2 exposure in the week after infection.Higher levels of NO2 exposure in the week before the beginning of a respiratory tract infection were associated with increases in the severity of resulting asthma exacerbations.NO2 exposure may be derived from indoor sources, such as gas-burning stoves or wood-burning fireplaces. The levels of NO2 in this study were well within the standards for air quality safety. NO2 exposure itself, in the range experienced by the study cohort, was not associated with adverse symptom scores or lower PEF values. The highest levels of exposure were associated with worsening of asthma symptoms and decreased PEF values in the presence of upper respiratory tract infection. The results should be interpreted with caution, however, because there were no control aspirates from subjects with stable symptom scores and PEF values.
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Purpose of the study was answering the question whether measles experienced in young children may lead to an increased susceptibility to respiratory infections. In order to verify the hypothesis, the analysis of the prospective study on respiratory morbidity in children has been carried out in Krakow. In the course of the study a detailed epidemiologic interview on current and past respiratory diseases diagnosed by physician was collected in consecutive years of the survey (1995-1997). Susceptibility to respiratory infections has been defined as excess number of respiratory episodes over the third quartile of the distribution of number of episodes in upper and lower respiratory tract. The results of the study showed that susceptibility to upper respiratory infections was about twice so high (OR = 1.97; 95%CI: 1.27-3.05) among those children who experienced measles. Amongst other factors potentially responsible for an increased susceptibility to respiratory infections, only atopy and fungal exposure within home were associated with the higher risk The analysis performed for lower respiratory episodes confirmed the findings obtained for upper respiratory tract infections, however, the effect of atopy was much higher pronounced.
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The objective of this study was to elucidate specific distribution patterns and manifestations of respiratory chlamydiosis affecting the upper respiratory tract in different groups of the patients (both children and adults) presenting with otorhinolaryngological problems. Chlamydia were detected with the use of a combination of laboratory methods including PCR, direct immunofluorescent and imunoenzymatic assays. The study included 1329 patients. The data obtained suggest the high prevalence of chlamydial infection of the upper respiratory tract in different groups of the population. The species composition of the identified bacteria was shown to depend on the age and sex of the affected subjects.
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