Acute Respiratory Infection In Patients Research Articles

Vitamin D supplementation for prevention of acute respiratory infections in older adults: A systematic review and meta-analysis.

Acute respiratory infections (ARIs) have a substantial impact on morbidity, healthcare utilization, and functional decline among older adults. Therefore, we systematically reviewed evidence from randomized controlled trials (RCTs) to evaluate the efficacy and safety of vitamin D supplementation in preventing ARIs in older adults. PubMed, Embase, the Cochrane Library, and ClinicalTrials.gov were searched until 1 February 2024. RCTs evaluating the use of vitamin D supplements to protect older adults from ARIs were included. Two reviewers independently screened papers, extracted the data and assessed the risk of bias. Data were summarised as relative risks (RRs) or odds ratios (ORs) with corresponding 95% confidence intervals (CIs). Random effects meta-analyses were used to synthesise the results. GRADE was used to evaluate the quality of evidence. All the analysis were performed with Stata version 17. Twelve trials (41552 participants) were included in the meta-analysis. It showed that vitamin D supplementation probably does not reduce the incidence of ARIs (RR, 0.99; 95% CI, 0.97-1.02, I2 = 0%; moderate certainty). No significant effect of vitamin D supplementation on the risk of ARI was observed for any of the subgroups defined by baseline 25(OH)D concentration, control treatments, dose frequency, study duration, and participants' condition. However, there was a possibility, although not statistically significant, that vitamin D may reduce the risk of ARI in patients with a baseline 25(OH)D concentration <50 nmol/L (OR, 0.90; 95% CI, 0.79-1.04, I2 = 14.7%). Additionally, vitamin D supplements might result in little to no difference in death due to any cause, any adverse event, hypercalcinemia, and kidney stones. Vitamin D supplementation among older adults probably results in little to no difference in the incidence of ARIs. However, further evidence is needed, particularly for individuals with vitamin D deficiency and populations residing in low and middle income countries. This study was registered on PROSPERO (CRD42023451265).

The economic burden of viral severe acute respiratory infections in the Kingdom of Saudi Arabia: A nationwide cost-of-illness study

ObjectivesThe authors conducted a study to estimate the rising disease and economic burden of viral severe acute respiratory infections and their management, including COVID-19, respiratory syncytial virus, and influenza types A and B, in early and delayed diagnosis scenarios in the Kingdom of Saudi Arabia from a national perspective. MethodsThis cross-sectional study was conducted in May 2022 using a de novo Excel-based universal cost-of-illness calculator model. The study used primary data, such as expert interviews, as well as secondary data from a thorough literature search. ResultsThe total economic burden of viral severe acute respiratory infections in patients with an early diagnosis was lower than those with a delayed diagnosis among patients with complications, both from the payer's (United States dollar [USD] 3846 million vs USD 4726 million) and societal (USD 4048 million vs USD 5020 million, respectively) perspectives. The major cost driver of the total economic burden for both early and delayed diagnosis was disease management costs: 49% (USD 1880 million) and 58% (USD 2730 million), respectively. ConclusionsIn the Kingdom of Saudi Arabia, the total economic burden for COVID-19, influenza (epidemic phase), and respiratory syncytial virus was higher with a delayed diagnosis vs an early diagnosis, emphasizing the importance of using a broader diagnostic method.

Medical Information Retrieval with Weighting Critical Score for Acute Respiratory Infection (ARI) Desease Detection

Medical Information Retrieval (Med-IR )is part of computer science that discusses the search for a medical document. Medical Information Retrieval is needed by patients to know the initial prediction of the symptoms they are experiencing. ARI (Acute Respiratory Infection) is a disease that almost everyone has experienced which can cause death. This study uses a dataset of ARI sufferers and user queries that contain symptoms in text form. Furthermore, the query data is processed with the Med-IR application using Bi-Gram, TF-IDF as the feature extraction and Cosine Similarity as the similarity method, so that a return document is produced which is expected to be used as an early prediction of ARI in patients. The research also uses a critical disease wighting process, so that the results of the Med-IR are complemented by predictions of the severity level of the disease. From the results of research conducted at the Assyafi'u Sentosa Lengkong Clinic, Nganjuk, the best results were obtained for precision values ​​of 85.5% and 52.9% for recall values ​. The evaluation of disease severity with Mean Absolute Percentage Error (MAPE) getting a low score of 2,529%. Keyword : Medical Information Retrieval, ARI, Weighting critical disease, Bi-Gram, TF-IDF, Cosine Similarity.

Vitamin D3 in acute respiratory infections in patients under age five in a health institution in Colombia

Aim. describe the clinical behavior in acute respiratory infections in patients under age five in a Colombian health institution after VD3 administration. Trial studies are required to determine this potential benefit. Material and Methods. A performed series of 38 patients of both genders, aged 0-60 months to whom 50,000 units of VD3 were orrally administered per month for three months is described. The number of episodes, visits to the emergency room, and hospitalizations due to acute respiratory infections (ARI) before and after VD3 administration were described. Results. The average age of the participants was 25.81 ± 17.50 months. The average number of ARI clinical events per month was 4.02 (95% CI 3.64-4.40) prior to VD3 administration. The number of episodes reduced at the end of the three cycles was 2.23/month (95% CI 1.81-2.65; p = 0.0230). The average number of emergency room visits during three months prior to the VD3 administration was 2.15 (95% CI 1.77-2.53). After three months of treatment, the average number of emergency room visits decreased to 0.52 (95% CI 0.32-0.72; p = 0.0180). Prior to VD3 administration, 31.58% required hospitalization. After the administration of three VD3 doses, only one patient required hospitalization (2.63%; x̄:0.026 (95% CI 0.02-0.03; p = 0.0368). Conclusions. Vitamin D3 administration could have a benefit in reducing the number of ARI episodes, emergency room visits, and hospitalalizations in children under age five.

Interferons alpha and gamma, pidotimod, and tilorone in the treatment of acute respiratory infections in patients with allergic rhinitis: a prospective, cohort clinical and immunological study

Aim. To compare the clinical efficacy and influence on interferon (IFN) production / sensing of drugs with immunemediated antiviral effects, which potentiate type 1 (T1) immune responses, in the treatment of acute respiratory infections (ARI) in patients with allergic rhinitis.Materials and methods.146 ARI patients with remission of seasonal allergic rhinitis were divided into 4 cohorts. In addition to symptomatic therapy, patients received either 2,000 IU of IFNγ in each nasal passage 5 times a day; or rectal suppositories containing 106 IU of IFN-α2b and antioxidants (AO) twice a day, and a gel with IFN-α2b and AO intranasally 3 times a day; or 400 mg of pidotimod per os twice a day; or 125 mg of tilorone per os on days 1, 2, 4, and 6. The severity of ARI was determined daily as the sum of 10-point scores for 15 symptoms. Serum concentrations of IFNα and IFNγ and the ability of blood cells to produce these cytokines ex vivo spontaneously and upon stimulation with Newcastle disease virus or phytohemagglutinin were studied using enzyme-linked immunosorbent assay (ELISA). The proportions of circulating lymphocytes expressing type I IFN receptor subunit 2 (CD118) or IFNγ receptor α-chain (CD119) were determined by flow cytometry.Results. ARI symptoms in all cohorts generally regressed in a similar way. However, from day 5 of the treatment, pidotimod relieved symptoms more effectively than other drugs. In patients treated with tilorone, the regression of ARI manifestations was delayed in the first two to three days, followed by rapid symptom reduction. An initial decrease in the induced production of IFNγ was found in patients treated with pidotimod, and a tendency to a decrease in this parameter was noted in other cohorts. The induced production of IFNγ after the treatment in all groups did not differ from that in healthy donors. No significant changes and differences in the proportions of CD118+ and CD119+ lymphocytes were found between the cohorts, except for a decrease in the number of CD118+ cells after the treatment with tilorone. In patients treated with IFN-α2b + AO, the proportions of CD119+ and CD118+ lymphocytes tended to increase slightly.Conclusion. Drugs that promote the development of T1 over T2 immune responses are a useful option for treating ARI in patients with allergic rhinitis.

The use of homeopathy to prevent symptoms of human flu and acute respiratory infections: a double-blind, randomized, placebo-controlled clinical trial with 600 children from Brazilian Public Health Service

In Brazil, homeopathy was implemented in the Public Health Service through the National Policy on Complementary and Integrative Practices of the Health Ministry, published in 2006. Homeopathy appears as a very interesting therapy to be used in the Public Health Services since its medicines are compounded at a very low cost. Considering this interesting scenario to develop research in the Public Health, the Family Health Program (FHP) in Petropolis and the Faculty of Pharmacy at UFRJ started a partnership with the Roberto Costa Institute. A homeopathy clinical trial, employing a control protocol (double-blind, randomized, placebo-controlled), was developed as a result of this partnership starting in April 2009 and ending in April 2010. This clinical trial, approved by the Ethics Committee at UFRJ, number 194/08, aimed to evaluate the efficacy of two types of biotherapics to prevent symptoms of both flu and acute respiratory infections, compared to placebo (ethanol 30%). The biotherapics tested were ARI (Acute Respiratory Infection) and InfluBio. ARI is a homeopathic complex containing three different microorganisms related to respiratory infection while InfluBio is a biotherapic compounded from infectious influenza A virus. Before the development of this clinical trial, ARI had been used routinely in FHP, in Petropolis, to prevent acute respiratory infections in patients. The qualitative results obtained from this application suggested that this medicine has a prophylactic potential in the treatment of respiratory diseases. Additionally, we evaluated the antiviral activity of InfluBio using in vitro methodology and the promising results obtained motivated our group to test it in a clinical trial. With this aim, 600 children, from 1 to 5 years of age, were selected by physicians in 21 units of FHP, following the inclusion/exclusion criteria. For 1 month (April 2009), the children received daily, in a blind manner, the test solutions (placebo, ARI, InfluBio) in the posology of 1 drop per year of age. After 30 days, the use of these solutions was interrupted, and the health agents monitored the children for the subsequent twelve months, registering, in a specific questionnaire, symptoms of flu and acute respiratory infections. The respiratory symptoms that were to be reported were: runny nose, fever, prostration, myalgia, cough and headache. In the occurrence of one or more of these symptoms, the health agents evaluated the necessity of intervention by the physician. Of the 600 children, 450 completed the planned monitoring. The main reasons why 150 quit the treatment were change of address and parents’ abandonment. Additionally, no death was recorded and all the children presented good clinical evolution. In the case of the children who received placebo, the frequency of episodes diagnosed as acute respiratory infection/flu was three times higher when compared to those that received the ARI and InfluBio samples, considering the superior limit of the interquartile interval. Moreover, children treated with these biotherapics did not present any or presented only a single episode of ARI/Flu. These results showed that both biotherapics tested were statistically higher (p

Etiology of severe acute respiratory infections in Ekaterinburg in different epidemic seasons

BACKGROUND: Acute respiratory viral infections are ubiquitous. Part of the cases are severe and require hospital treatment.&#x0D; AIM: Studying the etiology of severe acute respiratory infections in patients of Ekaterinburg hospitals in different epidemic seasons (from 2017 to 2020).&#x0D; MATERIALS AND METHODS: 1,132 cases of severe acute respiratory infection were assessed. The structure of laboratory-confirmed cases was determined.&#x0D; RESULTS: In the assessed seasons, the proportion of respiratory viruses in the etiological structure of severe acute respiratory infections was 56.0% on average. B/Yamagata lineage of influenza viruses was predominant in the season of 2017/2018 (23.9% from the total number of respiratory viruses), influenza А (H1N1)pdm09 viruses were predominant in the season of 2018/2019 (27.7%), and influenza A and B viruses were identified in 2019/2020 (39.4% and 31.7%, respectively).&#x0D; СONCLUSIONS: The obtained results confirm a key role of influenza viruses in the etiology of severe acute respiratory infections among the hospital patients in different epidemic seasons.

Respiratory viruses and clinical- epidemiological characteristics in episodes of acute respiratory infection.

The aim of the study was to determine the viral frequency and clinical-epidemiological characteristics in the episodes of acute respiratory infection in patients of the Instituto Nacional de Salud del Niño San Borja in Lima, the information of the episodes of patients who required at least one direct Immunofluorescence test from January 1, 2017 to December 31, 2018 was analyzed. 1153 episodes were identified in 707 patients. The median age was 1 year and 55% were male. The viral frequency was 13.4%; respiratory syncytial virus was identified in 10.7% of the episodies. The viral frequency was higher in children under 1 year of age (16.2%); in those with congenital disease respiratory (38.9%) and during the autumn (24.2%). The most common symptoms were cough (70.3%) and fever (53.4%); and the main diagnoses, viral pneumonia (31.8) and bronchiolitis (23.4%). It is concluded that the respiratory viral frequency was related to age, seasonality and pre-existing pathology.

Evaluation of antibiotic prescribing in emergency departments and urgent care centers across the Veterans’ Health Administration

Assessments of antibiotic prescribing in ambulatory care have largely focused on viral acute respiratory infections (ARIs). It is unclear whether antibiotic prescribing for bacterial ARIs should also be a target for antibiotic stewardship efforts. In this study, we evaluated antibiotic prescribing for viral and potentially bacterial ARIs in patients seen at emergency departments (EDs) and urgent care centers (UCCs). This retrospective cohort included all ED and UCC visits by patients who were not hospitalized and were seen during weekday, daytime hours during 2016-2018 in the Veterans Health Administration (VHA). Guideline concordance was evaluated for viral ARIs and for 3 potentially bacterial ARIs: acute exacerbation of COPD, pneumonia, and sinusitis. There were 3,182,926 patient visits across 129 sites: 80.7% in EDs and 19.3% in UCCs. Mean patient age was 60.2 years, 89.4% were male, and 65.6% were white. Antibiotics were prescribed during 608,289 (19.1%) visits, including 42.7% with an inappropriate indication. For potentially bacterial ARIs, guideline-concordant management varied across clinicians (median, 36.2%; IQR, 26.0-52.7) and sites (median, 38.2%; IQR, 31.7-49.4). For viral ARIs, guideline-concordant management also varied across clinicians (median, 46.2%; IQR, 24.1-68.6) and sites (median, 40.0%; IQR, 30.4-59.3). At the clinician and site levels, we detected weak correlations between guideline-concordant management for viral ARIs and potentially bacterial ARIs: clinicians (r = 0.35; P = .0001) and sites (r = 0.44; P < .0001). Our findings suggest that, across EDs and UCCs within VHA, there are major opportunities to improve management of both viral and potentially bacterial ARIs. Some clinicians and sites are more frequently adhering to ARI guideline recommendations on antibiotic use.

Strategy of Rational Therapy of Acute Respiratory Infections in Patients with Comorbidity

Abstract. The paper discusses specific features of acute respiratory infections (ARI) progression in patients with comorbidity. The relevance of this study is accounted for by severe progression of ARIs in this group of patients, as well as by specific considerations of combining causal treatment of infections with life-long treatment of chronic diseases.The aim of the study was to use a clinical case to substantiate an optimal treatment strategy for influenza and associated complications in a comorbid patient.Results: the analysis of the clinical case showed that an unfavourable course of ARI in the patient was due to the lack of timely antiviral therapy, adverse effects of paracetamol during statin therapy, exposure to pneumonia pathogen degradation products, general intoxication, and immune response. The compromised medical history contributed to the development of severe complications. The paper proposes a strategy for selecting the most eff ective and safe approach to the treatment of ARIs in a comorbid patient.Conclusions: ARIs in patients with chronic diseases entail increased risks of complications that may arise both due to specific characteristics of the infection and unfavourable combination of drugs. Treatment regimens for infl uenza and other ARIs in comorbid patients should be eff ective and timely. Early antiviral treatment is especially important in patients with comorbidity. When choosing a treatment regimen, it is necessary to assess potential benefi ts of pharmacotherapy as well as associated risks, including those related to previously prescribed medicines.

The role of influenza viruses in the development of severe acute respiratory infection in patients admitted to Yekaterinburg hospitals during 2017–2018 epidemic season

Objective. To study the role of influenza viruses in the development of severe acute respiratory infections (SARI) in patients admitted to Yekaterinburg hospitals during 2017-2018 epidemic season.Materials and Methods. A retrospective epidemiological analysis of influenza incidence in Yekaterinburg was conducted, 403 influenza and acute respiratory viral infections case sheets were studied, and PCR analysis of clinical samples from the patients for respiratory viral infections was performed.Results. During the epidemic period a total 27.0% of the Yekaterinburg population were reported with influenza and other SARI, with 1.8% patients hospitalized. 5.6% of the total number of patients admitted with influenza and SARI in Yekaterinburg hospitals were included in the study. The rate of the detection of influenza A and B viruses RNA in the clinical samples from the patients with SARI was 28.3%. The rates of the detection in PCR of influenza B/Yamagata, A(H1N1)pdm09 and A(H3N2) were 46.5, 20.2 and 10.5%, respectively.Conclusion. The study results indicated that influenza viruses remain significant pathogens of respiratory infections that required hospitalization. Among patients with SARI the highest incidence was observed in children of a younger age group and was mainly associated with influenza B virus of Yamagata lineage and influenza A virus (H1N1)pdm09. According to the results of a molecular genetic study, influenza A (H1N1) pdm09 viruses belonged to clade 6B.1, carried characteristic amino acid substitutions in hemagglutinin S84N, S162N (with the acquisition of a potential glycosylation site) and I216T and were similar to the A/Michigan/45/2015 vaccine strain. The influenza B viruses studied belonged to the Yamagata lineage, clade 3. The influenza B/Ekaterinburg /RII-4723S/2018 virus differed from the reference strain B/Phuket/3073/2013 by two amino acid substitutions in the hemagglutinin gene M251V and L172Q.

Tracheal Microbiota in Patients With a Tracheostomy Before, During and After an Acute Respiratory Infection.

Examining tracheal microbiota before, during and after acute respiratory infection in patients with a tracheostomy demonstrated large baseline intrapatient microbiota variability and a significant bloom of Haemophilus and Moraxella on day 1 of acute respiratory infection symptoms. The tracheal microbiota community composition changed significantly from baseline to 1 month after acute respiratory infection.

Evaluation of Anti-Infectives on Acute Respiratory Infection in Patients at Three Primary Health Cares Centres in Depok, Indonesia

Introduction: The high prevalence of Acute Respiratory Infection (ARI) in Indonesia can increase anti-infective use and affect their patterns of use. Objective: This study aimed to evaluate anti-infective use in 2015 at 3 primary health care centres, Limo Primary Health Care (LPHC), Bojongsari Primary Health Care (BPHC), and Cipayung Primary Health Care (CPHC). Material and methods: This study was descriptive analytic research using retrospective data. Samples consisted of 20,41 ARI patients’ prescriptions containing anti-infective drugs during 2015. Anti-infective drugs were classified using the anatomical therapeutic chemical (ATC) classification system. Drug use was measured as Daily Defined Dose (DDD)/1000 patients/day. Drug use 90% and adherence to the National Formulary was evaluated as an indicator of the quality of prescribing drugs. Results: The highest amount of anti-infective use for ARI patients was at CPHC with a total quantity of 0.95 DDD/1000 patient/day. While at the LPHC amount of anti-infective use was 0.76 DDD/1000 patients/day and at BPHC was only 0.65 DDD/1000 patients/day. The most anti-infectives use at all primary health cares was amoxicillin. Ten anti-infectives were use at LPHC, 11 at BPHC and 7 at CPHC. Anti-infectives in the DU 90% segment at LPHC were amoxicillin, co-trimoxazole, and cefadroxil while amoxicillin was the only DU90% anti-infective used at CPHC and BPHC. The adherence to National Formulary were 70.00% at LPHC, 71.43%, at BPHC, and 63.64% at CPHC. Conclusion: The use of anti-infective varied and it showed that some did not adhere to National Formulary guidelines. Key words: Adherence, Anti-infective, ATC/DDD, National Formulary, Primary health care

Efficacy and drug compliance for tilorone in preventing acute respiratory infection in patients with chronic obstructive pulmonary disease

The purpose of the study was to analyze drug compliance and efficacy of tilorone in preventing acute exacerbations and improving quality of life (QoL) in patients with moderate to severe COPD and a history of frequent acute respiratory viral infections (ARVI). Materials and methods. The study involved patients with moderate to severe COPD (n = 94; 35 females, 59 males; mean age, 61.8 ± 0.7 years). A comprehensive examination of patients included drug compliance assessment with a specially developed scale, clinical and laboratory parameters measured at inclusion and in 12 months. Twenty three patients with high compliance were treated with tilorone. A control group consisted of low-compliant patients who did not give a consent to take tilorone (n = 20). Results. The significant 1.95-fold reduction in ARVI episodes incidence within 12 months was registered in the tilorone group that resulted in reduction in COPD exacerbation and hospitalizations rates, improvement in physical component of QoL and decrease in a cost of the therapy by 84%. Conclusion. Six-week therapy with tilorone 125 mg once a week, two courses annually, aimed at prevention ARVI in patients with moderate to severe COPD and a previous history of frequent ARVI could significantly reduce a rate of ARVI episodes followed by reduction in the rate of acute exacerbations of COPD, hospitalizations due to COPD and in improvement in physical component of QoL. Tilorone did not change lung function and physical tolerance of COPD patients.

Clinical characteristics of hospitalized cases of severe acute respiratory infection with laboratory-confirmed influenza and the risk factors analysis of influenza infection for children under 15 years old in ten provinces in China during 2009-2014

To identify clinical characteristics of hospitalized laboratory-confirmed influenza cases of children under 15 years old, and their risk factors of influenza infection. Analyzing the reports of hospitalized laboratory-confirmed influenza cases of children under 15 years old who were detected by the sentinel surveillance systems in 10 provinces from December 2009 to June 2014. Such data as their demographic, medical history, clinical symptoms and signs, treatment and outcome were collected using questionnaires, with their clinical characteristics and their risk factors of influenza infection described. Of the 2 937 severe acute respiratory infection inpatients, 190 (6.5%) were laboratory-confirmed influenza cases. 123 (64.7%) of such confirmed cases were male, and 139 (73.2%) were children under 5 years old, with age median of 3.0 years (IQR: 1.0-5.0 years). 20 (10.5%) of them had at least one chronic medical condition, mostly chronic cardiovascular disease (3.2%), immunosuppressive disease (3.2%), and cancer/tumor (2.6%). Most common clinical symptoms of the cases were fever (92.6%) and cough (88.8%), of which abnormal pulmonary auscultation (51.1%) and abnormal chest X-ray performance (36.1%) were the most common clinical signs. 29 cases (15.8%) had complications, of which pneumonia (15.3%) was most common. 16 cases (8.6%) used antiviral drugs, and 4 cases (2.2%) were admitted into ICU. Risk factor analysis suggested that age < 6 months (OR = 0.406, 95% CI: 0.203-0.815) was a protective factor against influenza infection; and age 5-9 years old (OR = 2.535, 95% CI: 1.059-6.066) was a risk factor for influenza infection. Hospitalized laboratory-confirmed influenza cases were found mostly in children under 5 years old. Risk exposure for influenza infection varied among age groups.

The post‐infection outcomes of influenza and acute respiratory infection in patients above 50 years of age in Japan: an observational study

Please cite this paper as: Ikematsu et al. (2011) The post‐infection outcomes of influenza and acute respiratory infection in patients above 50 years of age in Japan: an observational study. Influenza and Other Respiratory Viruses 6(3), 211–217. Objectives Influenza can be a serious illness, especially for older people, and reducing the impact of influenza in elderly is important. The objective of this study was to estimate the prevalence and postinfection outcomes of influenza among the over‐50 population in Japan. Design An observational study was designed to ascertain the proportion of influenza cases in a population aged ≥50 years with acute respiratory infection (ARI) and to determine the postinfection outcomes of their illness during the 2008–09 influenza season in Japan. Respiratory specimens obtained from a total of 401 patients were tested by PCR for influenza viruses, respiratory syncytial virus (RSV) and human metapneumovirus (hMPV). The effectiveness of the seasonal trivalent influenza vaccine was estimated by a test‐negative case control analysis. Setting Seventeen outpatient clinics located in four separate areas of Japan. Sample Respiratory swab specimens from the ARI patients aged ≥50 years. Main outcome measures Laboratory confirmed influenza in patients presenting with ARI. Results In all, 89 (22.2%) of the patients were positive for one of the tested viruses; 70 (78.7%) with influenza, 17 (19.1%) with RSV, and 2 (2.2%) with hMPV. Cough (95.7% vs 73.4%), loss of appetite (67.1% vs 35.5%), absence from work (50.0% vs 23.0%), impact on daily activity (90.0% vs 62.5%), and caregiver absence from work (5.7% vs 0.6%) were observed higher in influenza patients. The duration of feeling weakness (6.3 ± 5.4 vs 3.6 ± 1.9 days) and average days of reduced activity (5.2 vs 3.6 days) were longer for influenza patients. Vaccine effectiveness was estimated to be 32.1% (95% CI: −14.9, 59.9%). Conclusions Influenza was the dominant ARI‐causing virus and the clinical and socio‐economic outcomes imposed on patients over 50 years of age was high for influenza.

Acute respiratory infection in patients with cystic fibrosis with mild pulmonary impairment: Comparison of two physiotherapy regimens

Chest physiotherapy is an essential part of the management of cystic fibrosis, yet comparatively few studies have investigated the commonly used forms of chest physiotherapy during acute respiratory exacerbations. Fifteen subjects with cystic fibrosis and predominantly mild pulmonary impairment completed a randomised cross-over trial with 24 hours between treatments. The active cycle of breathing techniques (ACBT) assisted by a physiotherapist was compared with the ACBT performed independently by the patient. Measurement outcomes included pulmonary function tests, indirect calorimetry and oximetry parameters. Energy expenditure was not significantly different between the two treatment regimens, though significant improvements in pulmonary function were apparent 24 hours following the therapist-assisted ACBT. In this group of subjects, neither form of treatment proved superior in terms of energy consumption, but a reduction in airways obstruction was observed as a carry-over effect following the therapist-assisted ACBT.

Essentials of An Intensive Respiratory Care Unit: Report of the Subcommittee and Committee on Emphysema American College of Chest Physicians

Recent experience has indicated that an intensive care unit designed and staffed to manage the many problems resulting in acute respiratory failure is highly effective in salvaging patients who otherwise would have died. The problem of acute respiratory failure encompasses a wide clinical spectrum of such magnitude that most community hospitals today are challenged to provide appropriate services. The most commonly encountered precipitating causes of acute respiratory failure are acute respiratory infections in patients with chronic obstructive lung disease, chest trauma, postoperative respiratory insufficiency, accidental or self-induced poisonings, reversible neurologic emergencies and hypoxemic states due to severe pneumonitis and the adult respiratory distress syndrome with its many causes. The overall problem is growing because of the increasing incidence of chronic obstructive lung disease, the increasing recognition of respiratory failure in nonobstructive states, the increasing use of surgery in older persons, as well as the alarming incidence of poisonings in our younger population.