Hospital Admissions For Respiratory Diseases Research Articles

Chest illness in infancy and chronic respiratory disease in later life: an analysis by month of birth.

Cohorts born at different times of year differ in their risk of exposure to seasonal respiratory infections in early life, but are likely to have similar socioeconomic status and lifestyle thereafter. We investigated the long-term consequences of acute chest illness in infancy for later development of chronic respiratory disease by analysing variations by month of birth in hospital admissions for respiratory illness (total n = 49,866), chronic respiratory symptoms and ventilatory function among British school children (n = 11,482) and middle-aged adults (total n = 55,829). Admission for bronchiolitis in the first year of life was three times more common for infants born September to November (autumn) than those born March to May, yet people born in the autumn experienced fewer respiratory symptoms and had better ventilatory function. In two surveys of middle-aged men, forced expiratory volume in one second/forced ventilatory capacity (FEV1/FVC) was significantly (P = 0.025) higher among autumn births. Hospital admissions for chronic bronchitis/emphysema and pneumonia varied little with season of birth. Admissions for asthma were significantly (P < 0.05) more common among children and young adults born in the autumn. These findings do not support the hypothesis of a causal link between chest illness in infancy and the later development of chronic bronchitis and emphysema. The variation in asthma admissions with month of birth deserves further investigation.

Nonlinear regression models for correlated count data

AbstractIn this article, nonlinear regression models for correlated count data are examined. Correlation within clusters is modelled by a multivariate Gaussian mixing process on the log‐expectation scale. The regression parameters and the variance‐covariance parameters of the mixing process are estimated using quasi‐likelihood methods. An example involving temporal trends in hospital admissions for respiratory disease is used to illustrate the methods proposed.

The Ontario Air Pollution Study: identification of the causative agent.

Previously published data from the Ontario Air Pollution study are reviewed. It has been shown that there is a consistent association in summer between hospital admissions for respiratory disease in Southern Ontario, and daily levels of SO4, O3, and temperature. No association exists for a group nonrespiratory conditions. Multiple regression analyses are presented that show all environmental variables account for 5.6% of the variability in respiratory admissions and that if temperature is forced into the analysis first, it accounts for 0.89% of the variability only. Distribution plots of standardized residuals are presented. In June of 1983, there were an exceptional number of ozone episodes (defined as occasions when ozone was greater than 82 ppb for 3 or more hours in a calendar day) in this region. A separate analysis of hospital admissions for acute respiratory diseases for the month of June for several years shows no demonstrable excess in June of 1983; previously regional analyses have indicated that ozone is associated with increased levels in July and August over a 9-year period. It has also been found that daily SO4 data collected at one monitoring site in the center of the region are not correlated with respiratory admissions, whereas the SO4 values collected every sixth day, on different days of the week, at 17 stations in the region had the highest correlation with respiratory admissions.(ABSTRACT TRUNCATED AT 250 WORDS)

Respiratory Syncytial Virus

Respiratory syncytial virus (RSV) is the most important cause of lower respiratory tract infection in outpatients, as well as the major viral cause of nosocomial illness in pediatric inpatients. Immunity to this common pathogen is short lived and reinfection can occur later in life, even into adulthood. Virtually all children have one infection before 24 months and 50% experience two or more episodes of infection. The attack rate is substantial with about half of all infants in a community becoming ill during the season's first epidemic. About 100,000 children in the US each year become ill enough to require hospitalization, the hospitalization rate being 1411,000 during epidemic periods. In certain locations, RSV accounts for about 45% of hospital admissions for respiratory disease in children under two years of age.

Respiratory syncytial virus.

RSV is now understood to be the most significant viral respiratory pathogen of infants and is capable of causing both bronchiolitis and pneumonia. It is a particular risk to hospitalized infants as the virus is easily spread through close contact. The most vulnerable infants are those who suffer with either congenital heart disease or bronchopulmonary dysplasia who easily fall prey to pulmonary complications of infection. Strict environmental control and the use of protective clothing and eyewear should be implemented to decrease the nosocomial spread of RSV. Available diagnostic studies include viral isolation, fluorescent antibody stains, and enzyme immunoassays. Treatment of the disease is usually supportive but hospitalized patients frequently benefit from aerosolized ribavirin therapy. Hopefully, current vaccine trials will be successful and this pathogen will not only be treatable but will also be preventable.

Long-term Results of Continuous Oxygen Therapy at Sea Level

Twelve patients with hypoxemia associated with severe chronic obstructive pulmonary disease were treated with continuous portable oxygen therapy and have been followed up for a mean period of 25.2 months at sea level. Pulmonary function testing has revealed no further significant deterioration at long-term follow-up (17 months). After oxygen therapy was initiated, arterial carbon dioxide tension increased slightly, but decreased to pretreatment levels when patients were allowed to breathe room air. The electrocardiogram, which was unchanged at one month, has shown some reversal of cor pulmonale in five patients. Six patients have died, yielding a 56 percent survival rate at two-and-one-half years by the life table analysis. Five patients were autopsied, with possible oxygen toxicity being present in only one. The quality of life in our patients was improved and was especially represented by a reduction in hospital admissions for respiratory illness. We believe that continuous oxygen therapy is beneficial and worthwhile economically in certain patients.

Estimation of hospital admission respiratory disease cases attributed to exposure to SO2 and NO2 in two different sectors of Egypt

Air Q2.2.3 was used to predicted hospital admissions respiratory disease cases due to SO2 and NO2 exposure in two sectors of Egypt during December 2015 to November 2016. Levels were 19, 22 µg/m3 at Ain Sokhna sector and 92, 78 µg/m3 at Shoubra El-Khaima sector for SO2 and NO2, respectively. These levels were less than the Egyptian Permissible limits (125 µg/m3 in urban and 150 µg/m3 in industrial for SO2, 150 µg/m3 in urban and industrial for NO2). Results showed that relative risks were 1.0330 (1.0246 - 1.0414) and 1.0229 (1.0171 - 1.0287) at Ain Sokhna sector while they were 1.0261 (1.0195 - 1.0327) and 1.0226 (1.0169 - 1.0283) at Shoubra El-Khaima sector for SO2 and NO2, respectively. The highest cases of HARD were found in Shoubra El-Khaima sector; 311 cases at 120 - 129 µg/m3 of SO2 and 234 cases at 120 - 129 µg/m3 of NO2. While, in Ain Sokhna, HARD were 18 cases at 50 - 59 µg/m3 of SO2 and 15 cases at 60 - 69 µg/m3 of NO2. The excess cases found in Shoubra El-Khaima sector as compared to those in Ain Sokhna sector, may be attributed to the higher density of population and industries in Shoubra El-Khaima sector.