Symptoms Of Respiratory Tract Disease Research Articles

Normative Data and Predictive Equation of Interrupter Airway Resistance in Preschool Children in Japan.

Measurement of interrupter airway resistance (Rint) is a convenient alternative to standard spirometry for assessing respiratory function in uncooperative young children. The aim of the present prospective study was to establish the normative data and predictive equation of Rint in Japanese preschool children. A total of 214 children were enrolled from a single kindergarten; however, 129 were excluded because they met at least 1 of the exclusion criteria, such as wheezing history or recent common cold. Expiratory Rint values were assessed in 85 of the children, but technically unsatisfactory measurements were obtained in 5 of them. Thus, 80 healthy Japanese children (39 boys and 41 girls) without any history or symptoms of respiratory tract diseases were evaluated. Their age, body height, and body weight ranges (median) were 1.67 to 6.42 (4.38) years, 79.8 to 120.9 (102.5) cm, and 10.4 to 24.9 (15.8) kg, respectively. The mean Rint was 0.93±0.25 kPa/L/s (range=0.46-1.49 kPa/L/s). The Rint tended to decrease with increasing age and body height (r=-0.65; P<0.01), but sex played no significant role (P=0.71). The predictive equation based on body height derived by linear regression was expiratory Rint (kPa/L/s) =2.513-0.01567×body height (cm) (multiple correlation coefficient=0.653). Because 79 of the 80 measured Rint values were within 140% of the predictive Rint value, we calculated a 140% cut-off for predicting bronchoconstriction. Our results provide a reference value for evaluating the degree of airway obstruction in young Japanese children.

MEDICAL DRUGS IN COUGH TREATMENT IN CHILDREN: COMPARATIVE CHARACTERISTICS

Cough is one of the most common symptoms of respiratory tract diseases, especially — of infectious etiology, various types of airways and pleura disorders. Cough can accompany cardiovascular, gastrointestinal and metabolic disorders. Correct interpretation of cough and establishment of its cause can contribute to appropriate treatment of underlying diseases.. Phytotherapy in cough treatment is very spread in Russia. But administration of such drugs requires pathogenesis-based approach. The article deals with the issue of herbal drugs of secretomotoric expectorant group, allowed to use in children older than 2 years. The author gives comparative characteristics of these drugs, covers pharmacological action of the drugs components and discusses the questions of their efficacy and safety.

Respiratory disease and nasal immunoglobulin concentrations in phenytoin-treated epileptic patients.

Symptoms of respiratory tract disease were recorded for half a year in 32 epileptic patients receiving phenytoin, and in 25 controls. There were 16 patients with normal IgA concentration in serum and nasal secretion, and 16 with a reduced concentration of IgA either in serum or in nasal secretion, or in both. Both groups of patients had significantly more frequent respiratory symptoms than did the controls (P less than 0.01). There was no difference when the patient group with decreased IgA concentrations was compared to that with normal IgA levels. All the four patients with IgA deficiency both in serum and nasal secretion had, however, more frequent symptoms than any of the controls. There was no difference regarding respiratory tract disease in patients taking phenytoin only, compared to those combining phenytoin and other anticonvulsants. IgG and IgM levels in nasal secretion showed no direct relationship to the frequency of respiratory symptoms.

Rhinoviruses Are a Major Cause of Wheezing and Hospitalization in Children Less Than 2 Years of Age

Human rhinoviruses (HRV) are now considered major respiratory pathogens. We sought to determine whether HRV are a cause of wheezing and/or hospitalization in children <2 years old. A polymerase chain reaction assay was used to screen for HRV infection in 4 categories of children <2 years old: (1) with symptoms of respiratory tract disease without wheezing; (2) with wheezing with or without other symptoms; (3) who were asymptomatic and; (4) who had a respiratory specimen submitted to a diagnostic laboratory. All specimens were collected between January and December 2004. Phylogenetic analyses were performed on most HRV isolates. Twenty-eight (17%) of 165 children with symptoms of respiratory infection without wheezing; 21 (26.3%) of 80 children with wheezing; 3 (3%) of 93 asymptomatic children; and 47 (23.3%) of 202 children with specimens submitted to the diagnostic laboratory tested positive for HRV. The difference between the rates of infection in the asymptomatic group and in each of the 3 other categories was statistically significant (P </= 0.01). Among HRV-positive children with samples submitted to the diagnostic laboratory, 55% were hospitalized, which was similar to that observed for respiratory syncytial virus (52.7%) among children of a similar age group and time period (P = 0.85). Diverse groups of HRV were circulating during the 1-year study period. HRV are important pathogens among children <2 years old and are responsible for a significant proportion of wheezing this age group. The hospitalization rates of HRV-positive children seem to be similar to that of respiratory syncytial virus.

Environmental tobacco smoke exposure in school children: parent report and urine cotinine measures

Environmental tobacco smoke (ETS) in the home continues to be a major health risk for children around the world. Measuring ETS is a central feature of clinical and epidemiological studies, with children's exposure often assessed through parental estimates. The authors examined the relationship between parent-reported estimates of children's exposure to ETS and children's urinary cotinine levels and evaluated the ETS exposure and its effect on respiratory health in children. A total of 188 school children were included in the study. Parents were asked to complete a questionnaire about their smoking habits, their children's respiratory morbidity status and housing conditions. Urinary cotinine levels were measured in children. According to the responses, 72.3% of the children came from households with smokers, and 34.6% had daily exposure to ETS. When urine cotinine levels of >10 ng/mL were used as the yardstick of exposure, 76% of the children were identified as ETS exposed. No relation was detected between the symptoms of respiratory tract diseases and ETS exposure. To determine the amount of ETS exposure, the contribution of parental reports was low. To evaluate the level of ETS exposure of children, the parents' reports were not reliable. The addition of a biological measure results in a more informative estimate of ETS exposure in children.

The occurrences of chest pains and frequent coughing among residents living within the Selebi Phikwe Ni-Cu mine area, Botswana

This study aimed at establishing occurrences of chest pains and frequent coughing among different classes of residents within Selebi Phikwe, Botswana where there are on going nickel-copper (Ni-Cu) mining and smelting activities. Through the administration of questionnaires and structured questions to 600 individuals, 7 health service providers, 200 business enterprises, and 30 educational institutions, attempts were made to establish and verify the existing human health status at Selebi Phikwe by focusing on chest pains and frequent coughing which are considered to be some of the respiratory tract related symptoms of sicknesses and diseases. With the aid of statistical package for social sciences (SPSS), interpreted results from respondents indicated that 33 % of the individuals complained of persistent chest pains; and 27 % of educational institutions, 45 % business enterprises, and all health service providers had learners, workers, and patients who complained of chest pains. Furthermore, 49 % of the individuals complained of persistent frequent coughing; and 70 % of educational institutions, 45 % business enterprises, and all health service providers had learners, workers, and patients who complained of frequent coughing. According to study sites, respondents living in sites closest to the mine and smelter / concentrator plant reported a higher incidence of chest pains and frequent coughing, compared to those living in other parts of the study area. Residents associate fumes and dust from mining activities to the frequent coughing and persistent chest pains, which could be symptoms of respiratory tract diseases. This baseline investigation calls for further studies to establish relations of mining activities to human health at Selebi Phikwe.

The presence of eosinophil cationic protein in middle ear effusion.

Eosinophil cationic protein (ECP) is probably responsible for the underlying inflammatory mechanisms seen in asthma. It can be modulated in vivo by immunotherapy or steroids, with an appropriate reduction in symptoms of respiratory tract diseases. ECP is an identifiable mediator in additional target organs involved in allergic reactions, making it of potential interest in the study of otitis media with effusion. A qualitative prospective study was designed to discover the relationship of ECP and serum IgE in patients with middle ear effusion and allergy, as demonstrated by RAST and skin testing. The concentrations of ECP in the middle ear fluid from 23 consecutive patients with otitis media with effusion undergoing the placement of tympanostomy tubes ranged from 2 to 1248 micrograms (normal serum ECP, 5 to 15 micrograms), with 87% being abnormally elevated. There was no correlation between an individual's ear and serum levels of ECP (r = 0.1672; p = 0.6232), suggesting a more localized process. There was no relation between effusion ECP and serum IgE (p = 0.0040). ECP from middle ear effusion did correlate with a patient's having allergy, as confirmed by RAST and skin testing (p = 0.0095). Mechanisms involving immune mediated disease in the middle ear, of which the eosinophil may be one participant, are presented.

Respiratory disease in patients with epilepsy on single-drug therapy with carbamazepine or phenobarbital.

IgA, IgG and IgM concentrations were determined in sera and nasal washings from 20 patients with epilepsy on single-drug treatment with carbamazepine, in 20 patients on single-drug treatment with phenobarbital and in 26 healthy subjects. There were no significant differences in immunoglobulin concentrations between the groups of patients and the controls. Symptoms of respiratory tract disease were recorded daily during 6 months both in patients and in controls. The mean number of days with symptoms from the respiratory tract was 38.5, 36.6 and 27.9 in the patients on carbamazepine, phenobarbital and the controls, respectively. The differences were not statistically significant. The individuals with the lowest immunoglobulin concentrations did not have more frequent symptoms of respiratory disease than those with higher immunoglobulin concentrations.

Relation between Abnormalities of Human Sperm Flagella and Respiratory Tract Disease

Nineteen men with viable spermatozoa of a reduced motility were divided into two groups according to the morphology as seen in light microscopy; one with less (group A) and one with more (group B) than 50 % abnormal sperm tails. These men were eamined with regard to history and symptoms of respiratory tract diseases. Spermatozoa and cilia from the respiratory tract were examined with electron microscopy. Tracheobronchial clearance was evaluated with labelled teflon particles. Five men (group C) with the “immotile‐cilia syndrome”, primarily selected because of respiratory tract symptoms, were also studied with regard to sperm motility and morphology.There was a close correlation between immotility or very poor motility of the spermatozoa and ciliary dysfunction only when the spermatozoa had a normal configuration. Poor sperm motility coupled with abnormalities in the sperm tails, as evaluated with light microscopy, was rarely associated with ciliary dysfunction. The reason for this could be that the spermatozoa from these men (in group B) all had abnormal fibrous sheath and/or mitochondria: structures not present in cilia from the respiratory tract.Nine of the 12 men with immotile sperm tails (group A, B, and C) had the immotile‐cilia syndrome and a complete or partial lack of dynein arms in the sperm tails. Two other men with the immotile‐cilia syndrome had spermatozoa with some motility; spermatozoa from one had both inner and outer dynein arms and spermatozoa from the other lacked the outer arms.Respiratory tract cilia were studied in four men with the immotile‐cilia syndrome (from groups A and C). Inner and outer dynein arms were missing in the spermatozoa and cilia from three men, but in the same cells from the fourth man only the inner arms were absent.

Bacterial filters — are they necessary on anaesthetic machines?

At the Vancouver General Hospital the effectiveness of the system for decontamination of anaesthetic equipment was evaluated to determine the need for bacterial filters on anaesthetic machines. Two groups of patients were studied. Group I consisted of 33 patients, none of whom had clinical symptoms of respiratory tract disease. Group II consisted of 17 patients who had lower respiratory tract secretions. In the latter group 16 had chronic bronchitis and had cystic fibrosis. Of 550 bacterial cultures taken from the anaesthetic equipment immediately before and after anaesthesia in our 50 patients, only five yielded a growth of non-pathogenic bacteria. The results of this study indicate that bacterial colonization of anaesthetic equipment is of a low order and is adequately controlled by pasteurization even after use in patients with chronic lower respiratory tract disease. The use of bacterial filters does not appear justified if a strict regimen of cleaning and pasteurization is followed.