scholarly journals Streptococcal school outbreaks: a method of investigation and control

1966 ◽  
Vol 64 (2) ◽  
pp. 221-230 ◽  
Author(s):  
Joan M. Boissard ◽  
R. M. Fry
Keyword(s):  
Respiratory Tract ◽  
Streptococcal Infection ◽  
Boarding Schools ◽  
Upper Respiratory Tract ◽  
Initial Investigation ◽  
Upper Respiratory ◽  
And Control ◽  
Nose And Throat

A method of controlling outbreaks of streptococcal infection of the upper respiratory tract in communities such as boarding schools is described.It is suggested that, in a search for carriers, nose and mouth swabs should be taken in place of the customary nose and throat swabs. These swabs will detect those who are dispersing streptococci into the environment, as distinct from the carriers who are not dispersers. It is essential that infections of the skin and ears should also be looked for.It is recommended that all dispersers, whether nose or mouth positive, should receive sulphanilamide insufflation in both nostrils twice daily for a week, or longer if necessary, without exclusion from school. In addition, penicillin lozenges for 2 days may be recommended for the mouth positives only.The history is considered to be an important factor in deciding the extent of the initial investigation, and examples are given to illustrate this. When mass swabbing is considered necessary, it is highly desirable that the whole community should be swabbed at the same time, as early as possible in the outbreak. It is also desirable that bacteriological follow-up should be available to check that control has been effected.

Effects of procalcitonin testing on antibiotic use and clinical outcomes in patients with upper respiratory tract infections. An individual patient data meta-analysis

2017 ◽  
Vol 56 (1) ◽  
Author(s):  
Jonas Odermatt ◽  
Natalie Friedli ◽  
Alexander Kutz ◽  
Matthias Briel ◽  
Heiner C. Bucher ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Antibiotic Therapy ◽  
Respiratory Tract Infections ◽  
Meta Analysis ◽  
Antibiotic Exposure ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Restricted Activity ◽  
Tract Infections

AbstractBackground:Several trials found procalcitonin (PCT) helpful for guiding antibiotic treatment in patients with lower respiratory tract infections and sepsis. We aimed to perform an individual patient data meta-analysis on the effects of PCT guided antibiotic therapy in upper respiratory tract infections (URTI).Methods:A comprehensive search of the literature was conducted using PubMed (MEDLINE) and Cochrane Library to identify relevant studies published until September 2016. We reanalysed individual data of adult URTI patients with a clinical diagnosis of URTI. Data of two trials were used based on PRISMA-IPD guidelines. Safety outcomes were (1) treatment failure defined as death, hospitalization, ARI-specific complications, recurrent or worsening infection at 28 days follow-up; and (2) restricted activity within a 14-day follow-up. Secondary endpoints were initiation of antibiotic therapy, and total days of antibiotic exposure.Results:In total, 644 patients with a follow up of 28 days had a final diagnosis of URTI and were thus included in this analysis. There was no difference in treatment failure (33.1% vs. 34.0%, OR 1.0, 95% CI 0.7–1.4; p=0.896) and days with restricted activity between groups (8.0 vs. 8.0 days, regression coefficient 0.2 (95% CI –0.4 to 0.9), p=0.465). However, PCT guided antibiotic therapy resulted in lower antibiotic prescription (17.8% vs. 51.0%, OR 0.2, 95% CI 0.1–0.3; p<0.001) and in a 2.4 day (95% CI –2.9 to –1.9; p<0.001) shorter antibiotic exposure compared to control patients.Conclusions:PCT guided antibiotic therapy in the primary care setting was associated with reduced antibiotic exposure in URTI patients without compromising outcomes.

scholarly journals STUDIES ON EXPERIMENTAL PNEUMONIA

1920 ◽  
Vol 32 (6) ◽  
pp. 719-744 ◽  
Author(s):  
Russell L. Cecil ◽  
Francis G. Blake
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Acute Inflammation ◽  
Early Stage ◽  
Acute Stage ◽  
Cebus Capucinus ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Lymphoid Structures ◽  
Nose And Throat

1. Virulent influenza bacilli, when injected into the nose and throat of monkeys (Cebus capucinus and Macacus syrichtus), excite an acute inflammation of the upper respiratory tract, characterized by swelling and hyperemia of the mucous membrane, infiltration of the mucosa and subrnucosa with leucocytes, desquamation of epithelial cells, and the production of a mucopurulent exudate. The accessory sinuses are often implicated in the infection. 2. Experimental Bacillus influenzæ infections of the upper respiratory tract are frequently accompanied or followed by bronchiolitis, peribronchial infiltration, and bronchopneumonia with hemorrhage and edema in the early stage, emphysema and bronchiectasis in the later stages. In general, the process closely resembles uncomplicated Bacillus influenzæ pneumonia in man. 3. The injection of virulent influenza bacilli directly into the trachea of monkeys induces in them an experimental bronchiolitis and hemorrhagic bronchopneumonia, similar in all respects to spontaneous Bacillus influenzæ pneumonia. 4. In experimental Bacillus influenzæinfections of either the upper or lower respiratory tract the influenza bacillus can usually be recovered during .the acute stage by culture, either pure or in association with other bacteria. 5. In experimental Bacillus influenzæ infections in monkeys characteristic changes occur in the thymus gland—hyperplasia of the follicles, distention of the lymphatic channels, and infiltration of the parenchyma with leucocytes. This enlargement appears to be merely part of a general hyperplasia of the lymphoid structures in the cervical and thoracic regions.

scholarly journals THE FREQUENCY OF BACILLUS INFLUENZÆ IN THE NOSE AND THROAT IN ACUTE LOBAR PNEUMONIA

1922 ◽  
Vol 35 (1) ◽  
pp. 7-15 ◽  
Author(s):  
Ernest G. Stillman
Keyword(s):  
Respiratory Tract ◽  
Upper Respiratory Tract ◽  
Lobar Pneumonia ◽  
Upper Respiratory ◽  
Nose And Throat

1. Bacillus influenza is frequently found in association with lobar pneumonia. 2. In lobar pneumonia both Bacillus influenza and pneumococcus are frequently found in the nose. 3. The influenza bacilli found in the upper respiratory tract of cases of lobar pneumonia are of various types. 4. The exact significance of these findings is at the present time not clear.

scholarly journals Effects of the upper respiratory tract cross-section on the vertical and sagittal dimension and the facial axis according to Ricketts

2018 ◽  
Vol 14 (3) ◽  
pp. 178-191
Author(s):  
Anna Duda ◽  
Wojciech Stós ◽  
Magdalena Wiosna
Keyword(s):  
Respiratory Tract ◽  
Subjective Evaluation ◽  
Threshold Value ◽  
Control Group ◽  
Upper Respiratory Tract ◽  
Facial Skeleton ◽  
Basic Parameters ◽  
Upper Respiratory ◽  
And Control ◽  
Anterior Angle

This study assesses the effects of the upper respiratory tract width at the level of the adenoid in patients with a normal and abnormal breathing route on basic parameters of the morphology of the facial skeleton. <b>Aim.</b> Comparison of skeletal parameters determining vertical (SNL/ML, NL/ML, NL/ML), sagittal (SNA, SNB) dimensions and type of facial rotation (the angle of the facial axis according to Ricketts) in the study and control groups and determination of the threshold value (a cut-off point) of width according to Holmberg, at which there is a deviation from the average values of basic parameters of morphology of the facial skeleton. <b>Material and methods.</b> The study included 221 patients treated at an orthodontic 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 width of the upper respiratory tract was measured using the modified Holmberg method and parameters assessing the vertical (SNL/ML, NL/ML) and sagittal (SNA, SNB) dimensions, as well as the anterior angle of the Ricketts’ axis were measured using the analysis of lateral teleroentgenograms of the head. <b>Results.</b> All compared skeletal parameters indicated significant statistical differences between the study and control group. These differences were: Ricketts’ angle 6.5°, SNL/ML 8.5°, NL/ML 9.7°, SNA 2.4°, SNB 1.4°. <b>Conclusions.</b> The width of the upper respiratory tract at the level of the adenoid significantly affects values of skeletal parameters evaluating the vertical (SNL/ML, NL/ML) and sagittal (SNA, SNB) dimensions and the type of rotation of the facial axis. There is a correlation between a gradual decrease in the airway dimension according to Holmberg and an increase in the vertical dimension (SNL/ML, NL/ML) and anterior angle of the Ricketts’ facial axis (posterior rotation of the mandible) and a decrease in the sagittal dimension (SNA, SNB).

scholarly journals Adequate mucociliary clearance as a factor in the prevention and control of purulent-inflammatory pathology of the ENT organs

2021 ◽  
pp. 29-34
Author(s):  
A. V. Gurov ◽  
M. A. Yushkina
Keyword(s):  
Respiratory Tract ◽  
Mucous Membrane ◽  
Mucociliary Clearance ◽  
Clinical Medicine ◽  
Inflammatory Diseases ◽  
Upper Respiratory Tract ◽  
High Prevalence ◽  
Upper Respiratory ◽  
Acute And Chronic Inflammation ◽  
And Control

Purulent-inflammatory diseases of the upper respiratory tract and ENT organs are an urgent problem of modern clinical medicine. The high prevalence of this pathology is due to the active effect of pathogenic microflora on the mucous membrane of the respiratory tract, the increasing role of opportunistic and atypical microorganisms in the genesis of infection of the upper respiratory tract, as well as disorders in the mucociliary clearance. Limitations in the mobility of cilia of ciliated cells, as well as their partial or complete absence, a change in the composition of mucous secretions and a slowdown in the speed of mucus movement are the mechanisms that determine the possibility of an acute inflammation focus on the mucous membrane of the upper respiratory tract, and also increase the risk of developing chronic inflammatory diseases of the ENT organs. The accumulated data on the peculiarities of the existence of microbial biocenoses in the human body, as well as the steady widespread growth of the problem of antibiotic resistance, dictate the need to search for new solutions in the treatment of purulent-inflammatory pathology of the ENT organs. A well-established principle of therapy for such conditions is the topical use of combined drugs that combine mucolytic and antibacterial components that actively affect the main links in the pathogenesis of acute and chronic inflammation of the upper respiratory tract. These tasks are most effectively solved by the drug, which contains the mucolytic N-acetylcysteine, which potentiates the effect of another component – the antibiotic thiamphenicol. An important aspect in favor of choosing this drug as a monotherapy or combination therapy for purulent-inflammatory diseases of the upper respiratory tract is a convenient form of release for aerosol administration.

scholarly journals Outcome of upper respiratory tract infections in healthy children: Antibiotic stewardship in treatment of acute upper respiratory tract infections

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Ejaz Ahmed Khan ◽  
Mazhar Hussain Raja ◽  
Shehla Chaudhry ◽  
Tehreem Zahra ◽  
Salman Naeem ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Antibiotic Stewardship ◽  
Respiratory Tract Infections ◽  
Upper Respiratory Tract Infections ◽  
Healthy Children ◽  
Supportive Treatment ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Tract Infections

Objective: The objective of the study was to assess the outcome of upper respiratory tract infections (URTI) in healthy children. Methods: This descriptive study was conducted on 314 children aged 3-36 months in the paediatric outpatient clinic and emergency department with symptoms of URTI (fever, cough, rhinorrhoea) for ≤5 days. Patient’s demographics, clinical features, laboratory data and outcome were recorded. Follow up phone calls were made to parents on day 7 (response 93.6%) and day 14 (response 94.6%) to record outcome. Results: A total of 314 children with URTIs were included. Majority (57.6%) were males and <1year of age (40%). Common manifestations of URTI were fever (89%), cough (79%), rhinorrhoea (62%), pharyngitis (79%) and conjunctivitis (46%). More than half (53%) had history of contact with URTI in a family member. Mean duration of symptoms was 2.7±1.3 days. Majority (93%) of children were given supportive treatment and only 6.7% received antibiotics initially. Most of children (76%) recovered within one week and 91.8% within two weeks with supportive care only. Only 4% children were hospitalized and 12% required follow up visit of which 16% needed oral antibiotics. Complications or deaths did not occur. Conclusions: Majority of URTIs in healthy children resolved with supportive treatment and do not require antibiotics. Antibiotic stewardship in simple URTIs should be practiced using awareness and advocacy campaigns. doi: https://doi.org/10.12669/pjms.36.4.1420 How to cite this:Khan EA, Raja MH, Chaudhry S, Zahra T, Naeem S, Anwar M. Outcome of upper respiratory tract infections in healthy children: Antibiotic stewardship in treatment of acute upper respiratory tract infections. Pak J Med Sci. 2020;36(4):---------.  doi: https://doi.org/10.12669/pjms.36.4.1420 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

ERYTHROMYCIN IN THE TREATMENT OF DIPHTHERIA AND DIPHTHERIA CARRIER STATE

PEDIATRICS ◽  
1955 ◽  
Vol 16 (3) ◽  
pp. 335-344
Author(s):  
M. W. Beach ◽  
W. B. Gamble ◽  
C. H. Zemp ◽  
Margaret Q. Jenkins
Keyword(s):  
Clinical Trial ◽  
Respiratory Tract ◽  
Carrier State ◽  
Considerable Importance ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Nose And Throat ◽  
Active Disease ◽  
Primary Form

The treatment of acute diphtheria has not been drastically changed by the use of antibiotics. Antitoxin remains the primary form of therapy. However, the eradication of virulent diphtheria bacilli from the upper respiratory tract of patients with the active disease and of carriers is of considerable importance in the control of the disease. Streptomycin is effective in vitro and in infections produced experimentally but it has not been clinically evaluated in acute diphtheria or in the carrier state. Chlortetracycline, chloramphenicol, and oxytetracyline, although active against the causative organisms, have not had sufficient clinical trial to permit evaluation in the control of diphtheria and the carrier state. Penicillin eradicates C. diphtheriae from the nasopharynx in 75 per cent of patients within a period of 3 to 4 days. In this study erythromycin eradicated the C. diptheriae from the nose and throat in all of the cases in an average of 2 days in the active cases and in an average of 3 days in the carrier state. In the treatment of diphtheria erythromycin appears on the basis of the present and of previous studies to be the most promising antibiotic developed to date. Erythromycin is advocated as an adjunct to and not as a substitute for antitoxin in the treatment of acute diphtheria.

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

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. <b>Aim</b>. 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. <b>Material and methods</b>. 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).<b> Results</b>. 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.<b> Conclusions</b>. 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. <b>(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)</b>.

scholarly journals Fruit and vegetable intake and risk of upper respiratory tract infection in pregnant women

2009 ◽  
Vol 13 (2) ◽  
pp. 276-282 ◽  
Author(s):  
Lin Li ◽  
Martha M Werler
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Fruits And Vegetables ◽  
Vegetable Intake ◽  
Fruit And Vegetable Intake ◽  
Upper Respiratory Tract ◽  
Fruit And Vegetable ◽  
Upper Respiratory

AbstractObjectiveThe present study evaluated the association between fruit and vegetable intake and the incidence of upper respiratory tract infection (URTI) during pregnancy.DesignIn a cohort of 1034 North American women, each subject was asked retrospectively about their fruit and vegetable intake during the six months before the pregnancy and their occurrences of URTI during the first half of pregnancy. Multivariable-adjusted hazard ratios (HR) were calculated with Cox proportional hazards models.ResultsThe adjusted HR of URTI for women in the highest quartile (median 8·54 servings/d)v. the lowest quartile (median 1·91 servings/d) of total fruit and vegetable intake was 0·74 (95 % CI 0·53, 1·05) for the 5-month follow-up period and 0·61 (95 % CI 0·39, 0·97) for the 3-month follow-up period, respectively. A dose-related reduction of URTI risk according to quartile of intake was found in the 3-month (Pfor trend = 0·03) but not the 5-month follow-up. No association was found between either fruit or vegetable intake alone in relation to the 5-month or the 3-month risk of URTI.ConclusionsWomen who consume more fruits and vegetables have a moderate reduction in risk of URTI during pregnancy, and this benefit appears to be derived from both fruits and vegetables instead of either alone.

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