Prevention Of Upper Respiratory Infections Research Articles

Individualized Supplementation of Immunoactive Micronutrients and Severity of Upper Respiratory Infection Symptoms-A Randomized Intervention Study.

Certain micronutrients exhibit immunomodulatory effects. However, no intervention has yet investigated the effect of individualized supplementation on the severity of upper respiratory tract infections (URIs). Therefore, we investigated whether a personalized supplementation moderates the incidence and severity of URI. Selenium, zinc, and vitamin D were measured in dried blood spots from 59 healthy participants. Accordingly, a personalized supplement was provided with or without the respective micronutrients. We used WURSS-21 questionnaires to assess the disease status. The blood values converged during the intervention and micronutrients no longer differed between treated and untreated volunteers at the end of the intervention period. The incidence and severity of the illness did not significantly differ between the groups. However, when analyzing the WURSS-21 scores by the intention to treat, the initially randomized treatment arm revealed a significantly higher score than the placebo arm. Upon acute administration, individualized combinations of selenium, zinc and vitamin D do not reduce the number, or contribute to a milder course of URIs. Therefore, supplementation in acute infectious situations seems questionable. Further studies must address the habitual diet in more detail, to better understand the impact of individual micronutrient status on the prevention of URI.

Sputum pathogen spectrum and clinical outcomes of upper respiratory tract infection in bronchiectasis exacerbation: a prospective cohort study

ABSTRACT Upper respiratory tract infection (URTI) is common in humans. We sought to profile sputum pathogen spectrum and impact of URTI on acute exacerbation of bronchiectasis (AE). Between March 2017 and December 2021, we prospectively collected sputum from adults with bronchiectasis. We stratified AEs into events related (URTI-AE) and unrelated to URTI (non-URTI-AE). We captured URTI without onset of AE (URTI-non-AE). We did bacterial culture and viral detection with polymerase chain reaction, and explored the pathogen spectrum and clinical impacts of URTI-AE via longitudinal follow-up. Finally, we collected 479 non-AE samples (113 collected at URTI-non-AE and 225 collected at clinically stable) and 170 AE samples (89 collected at URTI-AE and 81 collect at non-URTI-AE). The viral detection rate was significantly higher in URTI-AE (46.1%) than in non-URTI-AE (4.9%) and URTI-non-AE (11.5%) (both P < 0.01). Rhinovirus [odds ratio (OR): 5.00, 95% confidence interval (95%CI): 1.06–23.56, P = 0.03] detection was independently associated with URTI-AE compared with non-URTI-AE. URTI-AE tended to yield higher viral load and detection rate of rhinovirus, metapneumovirus and bacterial shifting compared with URTI-non-AE. URTI-AE was associated with higher initial viral loads (esp. rhinovirus, metapneumovirus), greater symptom burden (higher scores of three validated questionnaires) and prolonged recovery compared to those without. Having experienced URTI-AE predicted a greater risk of future URTI-AE (OR: 10.90, 95%CI: 3.60–33.05). In summary, URTI is associated with a distinct pathogen spectrum and aggravates bronchiectasis exacerbation, providing the scientific rationale for the prevention of URTI to hinder bronchiectasis progression.

The effect of echinacea in the prevention of upper respiratory infections in children with acute lymphoblastic leukemia

Background: The efficacy of echinacea products to treat upper respiratory tract infections (URTI) has been shown in some studies, however, there are few studies considering the efficacy of echinacea to prevent URTI. Therefore this study aimed to assess the effect of echinacea in the prevention of URTI in these children.&#x0D; Materiala and Methods: This retrospective cross-sectional study was conducted on 60 children with ALL in Shahid Sadoughi hospital from September 2020 to September 2021. These Children were divided into two groups (n=30). The case group received immunogen syrup, containing echinacea purpura root extract (200 mg/ml). This syrup was prescribed in the intervention group as 2 ml for children in the age range of 2-8 years and 0.5 ml for children in the age range of 1-2 years old for 3 months. The control group did not receive echinacea syrup. These patients were followed for 3 months regarding URTI.&#x0D; Results: The frequency of URTI in the case and control groups was 40% and 66.7%, respectively, and a significant difference was noted between the two groups in terms of the frequency of URTI (P&lt;0.05). Moreover, 23.3% of patients who received echinacea developed a second URTI, while 53.3% of patients who did not receive echinacea developed a second URTI (P&lt;0.05). The mean time for the second URTI in the case and the control groups was 42.3±13.93, and 48.3±13.96 days, respectively (P=0.086). Regarding reducing the duration of URTS symptoms, there was no significant difference between the two groups (P&gt;0.05).&#x0D; Conclusion: According to the results, echinacea can be effective in decreasing the occurrence of URTI in these children. Therefore, regarding the efficacy of echinacea in decreasing URTI, it is recommended to use echinacea in the prevention of URTI.

Personal and Household Hygiene Measures for Preventing Upper Respiratory Tract Infections among Children: A Cross-Sectional Survey of Parental Knowledge, Attitudes, and Practices.

Personal and household hygiene measures are important for preventing upper respiratory tract infections (URTIs) and other infectious diseases, including coronavirus disease 2019 (COVID-19). An online survey recruited 414 eligible parents in Hong Kong to study their hygiene knowledge, attitudes, and practices (KAPs) regarding the prevention of URTIs among their children. The average knowledge score was high (10.2/12.0), but some misconceptions were identified. The majority of the participants agreed that good personal hygiene (93.5%) and good environmental hygiene (92.8%) can prevent URTIs. The average score for hand hygiene practices was high (3.78/4.00), but only 56.8% of the parents always performed hand hygiene before touching their mouths, noses, or eyes. In terms of environmental hygiene, only some household items were disinfected with disinfectants (door handles in 69.8% of the households, toilet seats in 60.4% of the households, the floor in 42.8% of the households, dining chairs in 24.2% of the households, and dining tables in 20.5% of the households). A higher knowledge score was associated with parents having tertiary educational levels or above, working as healthcare professionals, living in private residential flats or staff quarters, or having household incomes of HKD 70,000 or above. The results of multiple regression analyses also indicated that parents who were healthcare professionals and with higher household income had a better parental knowledge of hygiene measures after adjusting the attitude score. For hand hygiene, parents who achieved higher attitude scores obtained higher practice scores. Under the fifth wave of the COVID-19 epidemic, there were some misconceptions regarding hygiene among parents. Any health promotion program should target parents regarding taking proper personal and household hygienic measures, especially for those who had relatively lower socio-economic status and/or from a non-healthcare background. Motivating attitudes toward hand hygiene can lead to better practices.

The Effectiveness of Saltwater Gargling on the Prevention of Upper Respiratory Tract Infections

Upper respiratory tract infections (URI) are prevalent in the United States. URIs can also be debilitating and costly. The most common etiology for an URI is viral, and there are currently no antiviral medications for the common cold. Therefore, cost-effective preventative measures are essential in the prevention of URIs. This literature review intends to compare the few studies evaluating the effectiveness of saltwater gargle for preventing URIs. The goals of this review include commenting on the potential for a saltwater gargle in preventing URIs, shortcomings of the few studies performed and recommendations for further research in evaluating saltwater gargle as an effective prevention method. This review looks explicitly at three studies evaluating the effectiveness of saltwater gargling and the prevention of URIs. Conclusions derived from this review include both physiological and clinical evidence of the potential for saltwater gargling in URI prevention. The first two studies demonstrate patient-derived evidence for saltwater gargling, potentially providing a decreased risk of URI when used preventatively. The third study demonstrates the potential for polymerase chain reaction (PCR) in evaluating the effectiveness of saltwater gargling in reducing the duration of illness. Additionally, in the wake of the COVID-19 pandemic, cost-effective treatment options targeting viral URIs, such as SARS-CoV-2, warrant further evaluation and discussion.

Probiotics for Preventing Upper Respiratory Tract Infections in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Background Upper respiratory tract infections (URTIs) are common and burdensome infectious illness. Several trials have reported that probiotics can prevent URTIs in adults. Objectives To evaluate the efficacy and safety of probiotics in the prevention of URTIs in adults. Methods PubMed, Web of Science, Embase, and Cochrane Library were searched for reports published from database inception to May 14, 2020. Randomized controlled trials (RCTs) comparing probiotics with placebo for the prevention of URTIs in adults were included. Results Six RCTs with 1551 participants were included. Compared with the placebo group, the probiotics intervention group significantly reduced the incidence of URTI episodes (RR: 0.77; 95% CI: 0.68 to 0.87; P < 0.0001; I2 = 26%), the episode rate of URTIs (rate ratio: 0.72; 95% CI: 0.60 to 0.86; P = 0.0002; I2 = 99%), and the mean duration of one episode of URTI (MD: −2.66; 95% CI: −4.79 to −0.54; P = 0.01; I2 = 80%). The adverse events of probiotics were mainly mild gastrointestinal symptoms. There were no significant differences in occurrence rate of adverse effects between probiotics intervention and placebo group (rate ratio: 1.01; 95% CI: 0.80 to 1.26; P = 0.96; I2 = 99%). Conclusion Low-quality evidence provides support that probiotics have potential efficacy for preventing URTI episodes in adults. More trials are required to confirm this conclusion.

Multicentric study on the efficacy and tolerability of Streptococcus salivarius 24SMB and Streptococcus oralis 89a in respiratory tract infections

Abstract BACKGROUND. Bacteriocins are peptides with antimicrobial efficacy produced by certain bacterial species. Probiotics indeed seem a promising method in the prevention of upper respiratory infections and our study would like to contribute to the results available in the literature, in order to underlie their true therapeutic potential role. MATERIAL AND METHODS. Our multicenter pilot prospective study investigates 366 patients from September 2015 to February 2016. All the patients were treated with a topical device made up of a suspension of two specific bacterial strains: Streptococcus salivarius 24SMB and Streptococcus oralis 89a to be administered as nasal spray. The nasal spray was administered twice daily for 7 days per month for three consecutive months. A questionnaire about the subjective efficacy of the therapy correlated to an improvement of symptoms was also collected from patients. RESULTS. After one year from the enrolment, a 70.07% reduction in the number of events compared with the number of expected episodes was observed. CONCLUSION. The aim of our data is to propose a new therapeutic approach to treat the recurrence of upper airway infection and to support an adequate therapy in all cases where the traditional antibiotic therapeutic protocol did not obtain completely efficient results in terms of recurrence.

Are probiotics effective for the prevention of upper respiratory infections in children?

Are probiotics effective for the prevention of upper respiratory infections in children?

The Relationship Between Dust Quality and Home Ventilation with the Incidence of Upper Respiratory Tract Infection (URI) in The Ex-place of Final Processing (TPA) Keputih

Abstract: Upper Respiratory Track Infections (URI) is a kind of respiratory disease which is closely related to the quality of housing and the quality of ambient air. Ventilation is one component of a residential environmental health assessment. The dust may cause dryness of mucous in the respiratory tract so that a person may suffer or feel the symptoms of respiratory infection. This study aimed to analyze the relationship between ambient air dust and ventilation in the former place of fi nal processing (TPA) Keputih with URI (Upper Respiratory Tract Infection). This research is a cross sectional analytical and observational. The sample in this study is the ambient air concentration of dust particles and housewives from 77 families in RW VIII Keputih Area. To determine the relationship of ambient air dust and ventilation with respiratorydisease using Chi Square test. The results showed that respondents who had experienced respiratory infection as much as 89,6%. Levels of dust particles measured at the point I exceeded the quality standard that is equal to 0,3223 mg/Nm3. Home ventilation that do not appropiate the requirements of a healthy home is at 93.5%.There’s a relationship between the use of home ventilation with URI (p = 0.000) and the levels of ambient air dust particles with URI (p = 0.003). This study concludes that the two variables associated with the incidence of respiratory infection so the need for community empowerment and proactive attitude of the various instruments of government in the area of research on the prevention of URI and the presence of a good control of the quality of environmental health VIII RW Keputih Area.Keywords: dust quality, home ventilation, the ex-place of fi nal processing, URI

Probiotics for the prevention of pediatric upper respiratory tract infections: a systematic review

Background: Acute upper respiratory tract infections (URTIs) contribute substantially to pediatric morbidity and mortality worldwide. Prevention of these infections in childhood is a very important public health challenge. Previous systematic reviews, including both adult and childhood populations, have reported that probiotics seem promising, but with modest evidence. This study aimed to focus on prophylactic probiotic use in the prevention of URTIs in childhood.Methods: Relevant trials on two databases were identified in a systematic review, from inception to June 2014. Study selection, data extraction and quality assessment were carried out by two reviewers. In this review, the effects of probiotics, particularly the Lactobacillus and Bifidobacterium strains, on the incidence and symptom scores of URTI in otherwise healthy children were evaluated for the first time. This review comprises 14 randomized controlled trials (RCTs) applied to a pediatric population with high-quality methodology.Results: This systematic review suggests that probiotics in immunocompetent children have a modest effect both in diminishing the incidence of URTIs and the severity of the infection symptoms.Conclusions: At least one beneficial effect of prophylactic probiotic was observed in the majority of RCTs. Even a minimal reduction of 5 – 10% in the incidence of URTIs would have an important clinical and economic mpact on societies. Furthermore, the long-term administration of probiotics appeared to have a good safety profile in childhood and none of the studies reported any serious adverse events related to the probiotic strain.

Efektywność szczepienia przeciwko pneumokokom a częstość występowania infekcji dróg oddechowych oraz ostrego zapalenia ucha środkowego w populacji zdrowych dzieci w wieku 0–24 miesięcy, w zależności od sposobu ich karmienia

Pneumococcal vaccination, despite the effort of the medical community aimed at introducing it as obligatory, still remains in the Polish vaccination schedule as recommended, and thus have to be paid by parents. 490 healthy children (47.55% boys, 52.45% girls) were observed for the first two years of life. From those, 86 were vaccinated against pneumococcal infection.The chi-square test and odds ratio (OR) were performed for intergroup comparison of the prevalence of upper respiratory tract infections (URTIs), lower respiratory tract infections (LRTIs), and acute otitis media (AOM). Logistic regression models and the Mantel-Haenszel test for repeated tests for independence were applied for URTI, LRTI, and AOM risk assessment vs. the analysed variables. The results were presented in the raw form and adjusted for breastfeeding, OR and 95% confidence intervals.Pneumococcal vaccination statistically significantly reduced the incidence of URTIs where OR=0.53 (0.17–0.9); p=0.03 and of LRTIs where OR=0.59 (0.35–0.97); p=0.04. Moreover, hospitalization and antibiotic therapy were less frequent in vaccinated children (26.7% vs. 88.98% and 80.23% vs. 88.61% respectively).Breastfeeding longer than 6 months significantly reduced the occurrence of URTIs where OR=0.53 (0.36–0.78); p=0.001 and of AOM where OR=0.59 (0.37–0.94); p=0.02 as well as frequency of antibiotic therapy during first 24 months of life where OR=0.26 (0.15–0.46); p<0.001. Both pneumococcal vaccination and breastfeeding have additive beneficial effects, especially in prevention of URTIs where p=0.02 and LRTIs where p=0.08.Pneumococcal vaccination was broadly expected to become included in the compulsory vaccination schedule. Obtained results seem to formulate another argument in favour of introducing the pneumococcal vaccination as compulsory in the Polish vaccination schedule and promoting breastfeeding.

Vitamin D3 and gargling for the prevention of upper respiratory tract infections: a randomized controlled trial.

BackgroundWe undertook a 2X2 factorial, randomized controlled trial (RCT) to assess whether vitamin D3 supplementation (10,000 international units per week) versus placebo and gargling versus no gargling could prevent viral, clinical upper respiratory tract infection (URTI) in university students.MethodsWe randomized 600 students into 4 treatment arms: 1) vitamin D3 and gargling, 2) placebo and gargling, 3) vitamin D3 and no gargling, and 4) placebo and no gargling. Students completed weekly electronic surveys and submitted self-collected mid-turbinate nasal flocked swabs during September and October in 2010 or 2011. Symptomatic students also completed an electronic symptom diary. The primary and secondary outcomes were the occurrence of symptomatic clinical URTI and laboratory confirmed URTI respectively.ResultsOf 600 participants, 471 (78.5%) completed all surveys while 43 (7.2%) completed none; 150 (25.0%) reported clinical URTI. Seventy participants (23.3%) randomized to vitamin D3 reported clinical URTI compared to 80 (26.7%) randomized to placebo (RR:0.79, CI95:0.61-1.03, p = 0.09). Eighty-five participants (28.3%) randomized to gargling reported clinical URTI compared to 65 participants (21.7%) randomized to the no gargling arm (RR:1.3, CI95:0.92-1.57, p = 0.19). Laboratory testing identified 70 infections (46.7 per 100 URTIs). Vitamin D3 treatment was associated with a significantly lower risk for laboratory confirmed URTI (RR: 0.54, CI95:0.34-0.84, p = 0.007) and with a significantly lower mean viral load measured as log10 viral copies/mL (mean difference: -0.89, CI95: -1.7, -0.06, p = 0.04). Fewer students assigned to gargling experienced laboratory confirmed URTI, however this was not statistically significant (RR:0.82, CI95:0.53-1.26, p = 0.36).ConclusionsThese results suggest that vitamin D3 is a promising intervention for the prevention of URTI. Vitamin D3 significantly reduced the risk of laboratory confirmed URTI and may reduce the risk of clinical infections.Trial registrationClinical Trials Registration: NCT01158560.

Probiotics for Prevention and Treatment of Diarrhea

Probiotics have been extensively studied over the past several years in the prevention and, to a larger extent, in the treatment of diarrheal diseases, especially in pediatric populations. Diarrhea is a symptom, and not a disease. This review will not address chronic disorders associated with diarrhea, or Clostridium difficile-induced diarrhea. Rather it will focus on published clinical trials performed on acute-onset, likely infectious diarrhea occurring in the settings of day-care centers, in the community, acquired in the hospital, antibiotic-associated diarrhea, and treatment of acute infectious diarrhea. For prevention of diarrhea acquired in day-care centers, 9 randomized and placebo-controlled trials have been published, conducted in different parts of the world. Probiotics tested were Lactobacillus GG, Bifidobacterium lactis (alone or in combination with Streptococcus thermophilus, and Lactobacillus reuteri, Lactobacillus rhamnosus (not GG), and Lactobacillus acidophilus, in various trials either alone or in comparison with each other. The evidence of their efficacy in these settings is only modest for the prevention of diarrhea, although somewhat better for prevention of upper respiratory infections. In the community, new trails conducted in underprivileged areas of India, again with modest efficacy. Previous trials that examined the potential role of probiotics in preventing the spreading of diarrhea in hospitalized children had yielded conflicting results. More recently, a large trial in Poland showed, however, rather good evidence of efficacy for Lactobacillus GG. The prevention of antibiotic-associated diarrhea has been the subject of many investigations, both in children and in adults. Most commonly used probiotics were Lactobacillus GG, Lactobacillus acidophilus, Lactobacillus casei, Bifidobacterium ssp, Streptococcus ssp, and the yeast Saccharomyces boulardii. In general, most of these trials do show clear evidence of efficacy, with the 2 most effective strains being Lactobacillus GG and S. boulardii. Evidence is also emerging on the importance of the dose in reducing the incidence of this type of diarrhea, and the incidence of Clostridium difficile-associated postantibiotic diarrhea. As for treatment, a large body of data is available, especially in children, on the effect of several strains of probiotics in treating sporadic infectious diarrhea. The vast majority of the published trials show a statistically significant benefit and moderate clinical benefit of a few, well-identified probiotic strains-mostly Lactobacillus GG and S. boulardii-in the treatment of acute watery diarrhea, and particularly those due to rotavirus. Such a beneficial effect results, on average, in a reduction of diarrhea duration of approximately 1 day. The effect is strain-dependent and dose-dependent.

Efficacy and Safety of CVT-E002, a Proprietary Extract of Panax quinquefolius in the Prevention of Respiratory Infections in Influenza-Vaccinated Community-Dwelling Adults: A Multicenter, Randomized, Double-Blind, and Placebo-Controlled Trial

CVT-E002 (a proprietary extract) was found to be effective in the prevention of upper respiratory infections (URIs) in healthy adults, and institutionalized and community-dwelling seniors. A multicenter, randomized, double-blind, placebo-controlled trial was carried out to determine effects of CVT-E002 in the prevention of URIs in influenza-vaccinated community-dwelling adults. 783 community-dwelling adults were randomized to receive placebo, 400 mg or 800 mg treatment/d (1 : 1 : 1) for 6 months. Primary analysis on the incidence of laboratory-confirmed-clinical URIs (LCCUs), including influenza A and B, was performed on those receiving at least one dose. Secondary analysis was performed on study completers and included incidence, severity, and duration of URIs meeting a Jackson-based criteria and safety of CVT-E002. The incidence of LCCUs in the ITT group was 5.5%, 5.2%, and 4.6% in the placebo, 400 mg and 800 mg groups, respectively (P = 0.89). Jackson-confirmed URIs were significantly lower in the treated groups (P < 0.04). CVT-E002 supplementation reduced the severity and duration of Jackson-confirmed URIs. The results indicate that CVT-E002 can be safely used by similar groups and may prevent symptoms of URIs; larger sample size is warranted.

COLD-FX® Stimulates Cell Mediated Immune Response of Peripheral Leukocytes ex-vivo to Influenza Virus in National Hockey League Players

A proprietary extract from North American ginseng (Panax quinquefolium), COLD-FX ® (CVT-E002), has been found to be effective in the prevention of upper respiratory infections in a number of different groups including institutionalized seniors, community-dwelling seniors and healthy adults. These effects of COLD-FX are thought to be mediated by its ability to stimulate both the natural and acquired immune systems. Excessive exercise has been known to induce immune suppression and to increase the susceptibility for contracting recurrent upper respiratory tract infections. The purpose of the present study, therefore, was to determine if COLD-FX supplementation to players of National Hockey League caliber would be effective in altering the response of their leukocytes to influenza virus ex vivo. Periph- eral blood leukocytes (PBLs) were isolated from 2 groups of NHL players and immediately cultured for 2.5 days in the presence of 3 strains of influenza virus. One group (n=18) had been taking COLD-FX (400 mg/day) for 30 days, while the control group (n=19) was supplement free. Cultured PBLs isolated from those taking COLD-FX (400 mg/day) and stimulated with 3 strains of influenza virus released more TNF-α and IL-2, however, moderated granzyme-B release. This indicates that COLD-FX supplementation enhanced cell-mediated immune response of PBLs to influenza viruses and likely moderated the levels of cytotoxic T-cell effector molecules, sustained release of which may lead to autoimmune conditions. Additional studies on elite athletes, whose immune systems may be compromised, are warranted.

Investigation in awareness of prevention of upper respiratory tract infection in parents of leukemia children and the effect of health education

Objective To explore the effect of health education on improving awareness of preven-tion of upper respiratory tract infection of parents of leukemia children. Methods 25 parents were ran-domly chosen, and comprehensive health education interventions were provided, including lectures, advisory guidance and brochures. The awareness of prevention of upper respiratory tract infection of parents was e-valuated before and after health education,and the results underwent χ test. Results After health educa-tion, the awareness of prevention of upper respiratory tract infection of parents significantly improved com-pared with that before. Conclusions Health education can improve awareness of prevention of upper res-piratory tract infection of parents and decrease the incidence of upper respiratory tract infections. Key words: Leukemia; Upper respiratory tract infection; Health education

Use of surgical face masks to reduce the incidence of the common cold among health care workers in Japan: A randomized controlled trial

Health care workers outside surgical suites in Asia use surgical-type face masks commonly. Prevention of upper respiratory infection is one reason given, although evidence of effectiveness is lacking. Health care workers in a tertiary care hospital in Japan were randomized into 2 groups: 1 that wore face masks and 1 that did not. They provided information about demographics, health habits, and quality of life. Participants recorded symptoms daily for 77 consecutive days, starting in January 2008. Presence of a cold was determined based on a previously validated measure of self-reported symptoms. The number of colds between groups was compared, as were risk factors for experiencing cold symptoms. Thirty-two health care workers completed the study, resulting in 2464 subject days. There were 2 colds during this time period, 1 in each group. Of the 8 symptoms recorded daily, subjects in the mask group were significantly more likely to experience headache during the study period (P < .05). Subjects living with children were more likely to have high cold severity scores over the course of the study. Face mask use in health care workers has not been demonstrated to provide benefit in terms of cold symptoms or getting colds. A larger study is needed to definitively establish noninferiority of no mask use.

Nutritional modulation of exercise-induced immunodepression in athletes: a systematic review and meta-analysis

Heavy exercise induces marked immunodepression that is multifactorial in origin. Nutrition can modulate normal immune function. To assess the efficacy of nutritional supplements in exercise-induced immunodepression in athletes. Systematic review. Randomised and/or controlled trials of athletes undertaking nutritional supplements to minimise the immunodepression after exercise were retrieved. The primary outcome measure was incidence of upper respiratory tract (URT) illness symptoms after exercise, and secondary outcomes included cortisol, cell counts, plasma cytokine concentration, cell proliferative response, oxidative burst, natural killer cell activity and immunoglobulins. When data were available for a pooled estimate of the effect of intervention, meta-analyses were conducted for direct comparisons. Forty-five studies were included (1603 subjects). The studies were heterogeneous in terms of exercise interventions, selection of athletes, settings and outcomes. The overall methodological quality of most of the trials was poor. Twenty studies addressed carbohydrate supplementation, eight glutamine, 13 vitamin C and four others interventions. Three trials assessed the effect of intervention on prevention of URT infections. The pooled rate ratio for URT infections after vitamin C supplementation against placebo was 0.49 (0.34-0.71). Carbohydrate supplementation attenuated the increase in cortisol and neutrophils after exercise; vitamin C attenuated the decrease in lymphocytes after exercise. No other interventions had significant or consistent effect on any of the studied outcomes. Although the prevention of URT infections by vitamin C was supported by two trials, further studies are needed. The available evidence failed to support a role for other nutritional supplements in preventing exercise-induced immune suppression. Larger trials with clinically relevant and uniform end points are necessary to clarify the role of these nutritional interventions.

Homeopathic care for the prevention of upper respiratory tract infections in children: A pragmatic, randomised, controlled trial comparing individualised homeopathic care and waiting-list controls

To investigate whether individualised treatment by homeopaths is effective in preventing childhood upper respiratory tract infection (URTI). Open, pragmatic, randomised parallel-group trial with waiting-list group as control. One hundred and sixty-nine children below the age of 10 years, recruited by post from children previously diagnosed with URTI, were randomly assigned to receive either pragmatic homeopathic care from one of five homeopaths for 12 weeks or to a waiting-list control using self-selected, conventional health care. There was a significant difference in median total symptom score in favour of homeopathic care (24 points) compared to the control group (44 points) (p = 0.026). The difference in the median number of days with URTI symptoms was statistically significant with 8 days in the homeopathic group and 13 days in the control group (p = 0.006). There was no statistical difference in the use of conventional medication or care between the two groups. In this study, there was a clinically relevant effect of individualised homeopathic care in the prevention of URTI in children.

A field trial for evaluating the safety of recombinant human interferon alpha-2b for nasal spray

To evaluate the safety of recombinant human interferon alpha-2b for nasal spray for the prevention of SARS and other upper respiratory viral infections. Field epidemiologic evaluation was conducted, the design was randomized and had a synchronously parallel control group. In the study, the drugs were given for five days and all subjects were followed up for ten days. During the period of using interferon, body temperature of the experimental group was normal compared to the control group. Experimental group had more influenza-like symptoms than the control group (P < 0.05), such as headache (4.83%-7.09%), dizziness (7.17%-11.63%), lassitude (8.55%-15.06%), muscular soreness (4.43%-7.09%), pharynx dryness (12.10%-17.85%), angina (6.25%-8.72%), abdominal pain (2.30%-5.50%) and diarrhea (2.45%-5.66%). Most of side effects reached their peak with in the first 3 days. Except for pharynx dryness, the incidences of all other side effects declined after completion of the use of the trial drug, and incidences of some symptoms in experimental group were lower than those of the control group. There were no significant differences in the symptoms of cough and expectoration between the experimental group and the control group. The incidence of exanthem in the control group was significantly higher than that in the experimental group. The side effect of bloody nasal mucus was not observed in experimental group, which had been reported by other authors in several volunteer studies. Using recombinant human interferon alpha-2b for nasal spray could lead to some influenza-like symptoms, however, all those symptoms were mild , reversible, and relieved after completion of the use of the trial drug. No serious side effects were found during the period of following up. The authors conclude that the drug is safe.