Multiple Births and Congenital Anomalies in Tokyo Metropolitan Hospitals, 1979-1990

AbstractThe rate of multiple births and the incidence of congenital anomalies in Tokyo Metropolitan Hospitals were studied during the period 1979-1990. The number of twins was 968 pairs (8.23 per 1,000 deliveries) and of triplets 18 sets (15.3 per 100,000 deliveries) among 117,672 deliveries including 1,587 stillbirths after 16 weeks gestation. Multiple birth rates increased yearly. Stillbirth rates in twins and triplets were 5.5% and 16.7% respectively, which were both significantly higher than that in singletons (1.3%). The number of congenital anomalies was 42 in 1,936 twins (2.17%), 2 in 54 triplets (3.7%) and 1721 in 116,686 singletons (1.47%). The most common defects in twins were those of the cardiovascular system (0.72% in twins vs 0.52% in singletons) and of the musculoskeletal system (0.72% in twins vs 0.50% in singletons), followed by upper respiratory tract and/or mouth conditions (0.67% in twins vs 0.35% in singletons), all of which had no significant difference in frequency between twins and singletons. Though some anomalies had a significantly higher frequency in twins than in singletons, the concordance rate in the like-sexed twins was very low.

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A comparative analysis of outcomes after surgical reconstruction of stenoses in the upper respiratory tract in children

Russian Journal of Pediatric Surgery ◽

10.18821/1560-9510-2021-25-4-235-243 ◽

2021 ◽

Vol 25 (4) ◽

pp. 235-243

Author(s):

A. Yu. Razumovsky ◽

Z. B. Mitupov ◽

V. E. Rachkov ◽

N. S. Stepanenko ◽

A. V. Adler ◽

...

Keyword(s):

Respiratory Tract ◽

Plastic Surgery ◽

Costal Cartilage ◽

Treatment Technique ◽

Upper Respiratory Tract ◽

Surgical Time ◽

Significant Difference ◽

Upper Respiratory ◽

Group 2 ◽

Group 1

Introduction. Definition " upper respiratory tract stenosis " (URTS) includes a large number of nosologies. The most common are cicatricial stenoses, in particular, post-intubation ones as well as bilateral paralysis of the larynx. An important issue for nowadays is choosing the curative modality for such patients.Purpose. To compare outcomes after treating children with URTS.Material and methods. The authors have assessed results of treatment of 110 patients who had reconstructive surgery in 2010-2019. Patients were divided into two groups depending on the nosology: stenosis of the upper respiratory tract (n = 71) and bilateral paralysis of the larynx (n-39). In each group, four types of surgeries were performed: costal cartilage plasty, plasty with T-tube (TT), a modified version of plasty with TT, plasty with a stent. The choice of treatment technique was determined mostly by the tendency to make this or that type of surgery in authors' departments, as well as by the nosology, severity of the disease and patient's age. Decannulation terms, surgical time, early and late postoperative complications as well as relapse-free period were assessed.Results. 66% patients were decannulated in Group 1; in Group 2 - 69%. Group 1 a statistically reliable comparison was possible between the following techniques: costal cartilage plasty and laryngeal stent plasty (p > 0.005) as well as plasty with TT implantation and the proposed modified technique (p > 0.005). While using Mann-Whitney test and Log Rank, the authors found out that in Group 1 there were no significant difference in surgical time, relapse-free period and stenosis degree (p > 0.005). However, decannulation terms after plastic surgery of the larynx with costal cartilage implantation are longer than after plastic surgery with stent implantation (p < 0.005). In Group 2, the authors compared three abovementioned curative modalities, excluding laryngeal plasty with TT implantation. Thus, surgical time for costal cartilage plasty is longer, if to compare to other two techniques (p < 0.005). There is also no significant difference in decannulation terms and relapse-free periods between all three techniques (p > 0.005).Conclusion. The results obtained have demonstrated the effectiveness of long-term stenting with TT placement in children, mainly with cicatricial stenoses, and in older children. The trial also revealed that laryngoplasty with costal cartilage in children with bilateral laryngeal paralysis is an effectiveness choice too.

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A RANDOMISED CONTROL STUDY TO COMPARE THE EFFICACY OF CEFUROXIME, CLARITHROMYCIN, AND LEVOFLOXACIN IN THE MANAGEMENT OF PAEDIATRIC UPPER RESPIRATORY TRACT INFECTION

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2021.v14i10.42957 ◽

2021 ◽

pp. 103-106

Author(s):

GOUTHAMI PADUGUNDLA ◽

JYOTHIRMAYEE V ◽

BETHALA RAVALI ◽

JAGILLAPURAM ARUNDHATHI ◽

THAKUR SRILATHA ◽

...

Keyword(s):

Respiratory Tract ◽

Age Distribution ◽

Age Groups ◽

Efficacy Rate ◽

Pool Data ◽

Upper Respiratory Tract ◽

Cure Rate ◽

Significant Difference ◽

Upper Respiratory ◽

Tract Infections

Background: The upper respiratory infections cause considerable morbidity mainly in children due to the fact that they mainly affect children. Accordingly, a study was conducted on antibiotics to compare the effectiveness of clarithromycin, cefuroxime, and levofloxacin for treating upper respiratory tract infections (URTI) in children. Methods: A prospective observational study for a period of 6 months was conducted in the pediatrics department of RVM hospital. Outpatients under the age of 14 years given antibiotics for the treatment of URTI were included in the study. A total of 99 study subjects were included in the study, divided into three groups each containing 33 sample sizes (clarithromycin, cefuroxime, and levofloxacin). Patient data was collected using a form and verbal consent was obtained from patients/patient representatives, and drugs were given using the lottery method. Follow-up was done and noted for the 3rd, 5th, 7th day through telephonic calls, and the collected data were evaluated using statistical analysis. Results: Pool data from 99 patients shows that many patients belong to 0–5 years age groups (age distribution), and males were more than female (gender distribution). Clarithromycin (cure rate 3 days) and cefuroxime (cure rate 5 days) showed an equal rate of cure percentage (94%), while levofloxacin for 3–5 days with a 3% failure rate. A significant difference of p<0.05 (p=0.000) was observed and no adverse events were noted. Conclusion: The study findings showed, out of 3 drugs, clarithromycin and cefuroxime showed an equal efficacy rate of 94%, but clarithromycin showed shorter duration of outcome, i.e., 3 days. Hence, clarithromycin is effective than the other two drugs in the treatment of URTI.

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RELATIONSHIP BETWEEN CLASS I-II MALOCCLUSIONS AND UPPER RESPIRATORY TRACT DISEASES

Актуальні проблеми сучасної медицини Вісник Української медичної стоматологічної академії ◽

10.31718/2077-1096.21.3.173 ◽

2021 ◽

Vol 21 (3) ◽

pp. 173-177

Author(s):

А. Stasiuk ◽

Е.Е. Vyzhenko ◽

Yu. K. Sokolohorska-Nykina ◽

V. D. Kuroyedova

Keyword(s):

Respiratory Tract ◽

Morphological Changes ◽

Class I ◽

Upper Respiratory Tract ◽

Average Value ◽

Group I ◽

Significant Difference ◽

Upper Respiratory ◽

Group 2 ◽

Distal Occlusion

In recent years, there has been an increase in the prevalence of dental anomalies among children, and sagittal occlusion anomalies range from 33 to 67% of them. Quite high prevalence of distal occlusion causes morphological changes in the structure of the dentition that lead not only to functional impairment in the dentofacial system, but also in the entire oropharyngeal area. This forces scientists to search for new methods for the diagnosis and differential diagnosis of the conditions. The purpose of this study is to determine and compare anatomical dimensions (anteroposterior size and volume) of the upper respiratory tract in patients with occlusion pathology class I and II on the basis of cone-beam computed tomography. We measured the width of the upper, lower part of the pharynx according to the McNamara method, and the volume on 46 tomograms of patients with dentoalveolar anomalies aged from 8 to 29 years, who were divided into two groups according to the ANB angle into classes I and II. The patients of the group I had the average volume of 10.1 ± 1.27 cm3. According to the McNamara method, the width of the upper pharynx was 17.41 ± 0.44 mm, and width of the lower pharynx was 10.1 ± 0.73 mm. The patients of group 2 showed that the average value of the airpassageways volume was 9.3 ± 0.71 cm3. There was a statistically significant difference in the reduction of the width of the upper pharynx (р˂0, 05). Decrease in the width of the lower respiratory tract in the 1st and 2nd groups in the patients aged 15-29 years may be associated with changes in the cervical spine, resulting from postural disorders of the locomotive apparatus, which increases with age and affects the severity of the dental anomaly and the narrowing of the airways in the lower part.

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Comparison of the upper respiratory tract width at the level of the adenoid in patients with normal and abnormal breathing route

Forum Ortodontyczne ◽

10.5604/01.3001.0012.2030 ◽

2018 ◽

Vol 14 (2) ◽

pp. 13-26

Author(s):

Anna Duda ◽

Wojciech Stós

Keyword(s):

Respiratory Tract ◽

Control Group ◽

Study Group ◽

Upper Respiratory Tract ◽

Control Groups ◽

Limit Values ◽

Significant Difference ◽

Abnormal Breathing ◽

Upper Respiratory ◽

And Control

This study assesses the upper respiratory tract width at the level of the adenoid in patients with a normal (nasal) and abnormal (oral or mixed) breathing route. Aim. To compare the upper respiratory tract width in the study group (abnormal breathing route) and control group (normal breathing route) and to determine the cut-off point and mean limit values in order to conduct a differential diagnosis between a habitual and constitutional breathing route. Material and methods. The study included 221 patients treated at the Aquadent-Ortoestetyka Clinic in Kielce. Based on the medical history taken, clinical examination and subjective evaluation of the upper respiratory tract width according to Holmberg 112 patients were enrolled into the study group and 109 patients into the control group. The upper respiratory tract width was measured with two different linear methods: a modified method by Holmberg. and Linder-Aronson, and the Linder-Aronson and Henricson method (AD1-PNS, AD2-PNS). Results. In the study group the mean value of the Holmberg measurement is 4.25 mm, and in the control group – 14.1 mm. Mean values of AD1- PNS and AD2-PNS measurements in the study group are 8.1 mm and 9.5 mm, respectively, and they can be regarded as mean limit values. The 6 mm Holmberg measurement is the cut-off value between the study and control groups, and it should be monitored. In relation to the Holmberg measurement a difference between the study and control groups is 9.85 mm. Regarding AD1-PNS and AD2-PNS measurements a difference between the study and control groups is 11.4 mm and 10.0 mm, respectively. Conclusions. The upper respiratory tract width at the level of the adenoid shows a statistically significant difference between the study and control groups. It may indicate significant narrowing of the upper respiratory tract at the level of the adenoid in the study group or a different type of morphology of the facial skeleton. Limit values obtained in the study allow differentiation of a habitual and constitutional breathing route. (Duda A, Stós W. Comparison of the upper respiratory tract width at the level of the adenoid in patients with normal and abnormal breathing route. Orthod Forum 2018; 14: 106-18).

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Increased Protection against Pneumococcal Disease by Mucosal Administration of Conjugate Vaccine plus Interleukin-12

Infection and Immunity ◽

10.1128/iai.71.8.4780-4788.2003 ◽

2003 ◽

Vol 71 (8) ◽

pp. 4780-4788 ◽

Cited By ~ 74

Author(s):

Joyce M. Lynch ◽

David E. Briles ◽

Dennis W. Metzger

Keyword(s):

Respiratory Tract ◽

Conjugate Vaccine ◽

Interleukin 12 ◽

Invasive Infection ◽

Dramatic Improvement ◽

Upper Respiratory Tract ◽

Opsonic Activity ◽

Significant Difference ◽

Upper Respiratory ◽

Tract Infections

ABSTRACT Streptococcus pneumoniae is a common cause of respiratory tract infections, its main entry route being the nasal mucosa. The recent development of pneumococcal polysaccharide conjugate vaccines has led to a dramatic improvement in protection against invasive disease in infants and children, but these vaccines have been found to be only 50 to 60% protective against bacterial carriage. In this study, we investigated the efficacy of intranasal (i.n.) conjugate vaccine delivery using interleukin-12 (IL-12) as a mucosal adjuvant. Immunized mice treated with IL-12 demonstrated increased expression of lung and splenic gamma interferon and IL-10 mRNAs; high levels of antibody, particularly serum immunoglobulin G2a (IgG2a) and respiratory IgA; and significantly increased opsonic activity. After intraperitoneal challenge with type 3 pneumococci, there was 75% survival of i.n. vaccinated mice compared to 0% survival of unvaccinated mice. In addition, after i.n. challenge with type 14 pneumococci, vaccinated mice possessed fewer bacterial colonies in the upper respiratory tract than unvaccinated mice. However, no significant difference in type 14 carriage was observed between vaccinated and unvaccinated groups following intramuscular vaccination, the typical route of vaccination in humans. Using mice with a genetic disruption in IgA expression, it was found that pneumococcus-specific IgA played a significant role in the clearance of bacteria from the upper respiratory tract. We conclude that i.n vaccination in the presence of IL-12 is able to enhance systemic and mucosal immune responses to pneumococci and efficiently protect against both invasive infection and bacterial carriage.

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A comparison of the distribution of pneumococcal types in systemic disease and the upper respiratory tract in adults and children

Epidemiology and Infection ◽

10.1017/s0950268800061926 ◽

1987 ◽

Vol 98 (2) ◽

pp. 203-209 ◽

Cited By ~ 6

Author(s):

L. E. Smart ◽

D. J. Platt ◽

M. C. Timbury

Keyword(s):

Streptococcus Pneumoniae ◽

Respiratory Tract ◽

School Children ◽

Older Patients ◽

Systemic Disease ◽

Upper Respiratory Tract ◽

Serotype Distribution ◽

Significant Difference ◽

Adults And Children ◽

Upper Respiratory

SUMMARYThe serotype distribution of 874 strains ofStreptococcus pneumoniaewas determined in relation to patients' age and to frequency of isolation from systemic disease. Types 14 and 18, in pre-school children, and types 1, 4, 7, 8 and 12 in patients over 5 years of age were significantly associated with systemic disease whereas type 23 in pre-school children, and type 6 in older patients was associated with upper respiratory tract carriage. No significant difference was found in the incidence of other types in systemic disease compared to upper respiratory tract carriage.Fifteen diagnostic pneumococcal antisera (to types 1, 3, 4, 6, 7, 8, 9, 11, 12, 14, 17, 18, 19, 22 and 23) sufficed for typing 87% of strains.

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Efficacy of Montelukast for Prevention of Upper Respiratory Tract Infection in Children: A Randomized, Placebo-Controlled Trial

Pharmaceutical Sciences ◽

10.34172/ps.2020.7 ◽

2020 ◽

Vol 26 (2) ◽

pp. 193-197

Author(s):

Fatemeh Dorreh ◽

Mohammad Hasan Esmaili ◽

Parsa Yousefhajian ◽

Mahdieh Naziri ◽

Aziz Eghbali ◽

...

Keyword(s):

Tract Infection ◽

Young Children ◽

Respiratory Tract ◽

Respiratory Tract Infection ◽

Controlled Trial ◽

Upper Respiratory Tract Infection ◽

Healthy Children ◽

Upper Respiratory Tract ◽

Significant Difference ◽

Upper Respiratory

Background: Upper Respiratory tract infection (URTI) or common cold is very prevalent in children particularly in young children. Leukotriene receptor antagonists (LTRAs) like montelukast are effective drugs in asthma and some other respiratory diseases. Our purpose was to study preventive effects of montelukast on pediatric URTI. Methods: This randomized, placebo-controlled, and double blind trial was performed on 450 healthy children aged 1-5 year in Amir Kabir Hospital, Arak, Iran. Children were randomized 1:1 to placebo group or montelukast group for 12 weeks. Number of URTI episodes and duration were the primary end points and were compared at baseline and after termination of treatment. Results: Mean age was 28 ± 12.3 months. Mean of URTI episodes was 0.7 ± 0.57 in children treated with montelukast and 1.27 ± 0.72 in children treated with placebo, respectively. Differences were statistically significant (P =0.01). A significant difference was seen in URTI duration between two study groups (6.3 ± 6.1 vs 4.1 ± 3.9, P = 0.05). In addition, duration of fever was shorter in children receiving montelukast (P=0.001). Conclusion: Our study indicates that 3 month treatment with montelukast is effective for reducing the incidence of URTI in young children. This treatment has an acceptable safety without any serious concern.

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Optimal upper respiratory tract sampling time for novel coronavirus pneumonia suspects

10.1101/2020.05.06.20069302 ◽

2020 ◽

Author(s):

Jing Zhou ◽

Lin Chen ◽

Dehe Zhang ◽

Haijun Chen ◽

Qiyue Sheng ◽

...

Keyword(s):

Nucleic Acid ◽

Respiratory Tract ◽

Median Time ◽

Sampling Time ◽

Nucleic Acid Detection ◽

Upper Respiratory Tract ◽

Definite Diagnosis ◽

Significant Difference ◽

Upper Respiratory ◽

Novel Coronavirus

AbstractObjectiveExplore best upper respiratory tract sampling time of suspected novel coronavirus pneumonia cases.MethodsWe collected dates of patients from Hangzhou, Shenzhen, Jinhua city and so on who had the clear exposure history of a novel coronavirus pneumonia(COVID-19). We retrospected demographic data, exposure time, onset time, visiting time and positive time for novel coronavirus nucleic acid detection in respiratory specimens. There were 256 patients from January 20,2020-February 12,2020 from eight cities included in our study. 106 cases appeared symptoms before January 25th and 150 after.ResultsThere were 136(53.1%)male infected cases. The mean age of all patients was 43.80±14.85. The median time from exposure to onset was 5(3,8) days. The median time of the first time of positive nucleic acid detection was 11(9,14)days and mode number was 13. The median time from onset to the first time of positive nucleic acid detection was 6(4,8)days and mode number was 5. The time from onset to definite diagnosis was 5(3,7) days before January 25th while it was 7.5(5,10)days after which was significantly shorter before January 25th(U=3885.5,P<0.001). The time from exposure to definite diagnosis was 11(9,14)days and 11(9,14)days before January 25th and after and without significant difference. The time from exposure to definite diagnosis was 11(9,13)days in first-tier cities and 13(11,15)days in second and third-tier cities. The difference was significantly shorter of first-tier cities(U=1355.5, P=0.039). And also the time was short from visiting to definite diagnosis which was 2(2,3)days in first-tier cities and 3(2,4)days in second and third-tier cities but without significant difference(U=842.5, P=0.054).ConclusionsFrom our study we found that the best upper respiratory tract sampling time for novel coronavirus pneumonia suspects was 13days after exposure. The time from onset to definite diagnosis was shorter after January 25th. The patients were diagnosed faster in the first-tier cities after exposure.

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