Standing upper airway surgery: what can be done?

UK-Vet Equine ◽  
2021 ◽  
Vol 5 (3) ◽  
pp. 115-120
Author(s):  
Philip Cramp
Keyword(s):  
Respiratory Tract ◽  
General Anaesthesia ◽  
Upper Airway ◽  
Upper Respiratory Tract ◽  
Upper Airway Surgery ◽  
Airway Surgery ◽  
Increased Risk ◽  
Upper Respiratory

Performing a number of different upper respiratory tract surgeries in the standing sedated horse is advantageous because it improves accessibility and the anatomy is in a more appropriate location. Standing surgery avoids the risk of general anaesthesia, affording a significant advantage to the horse and owner. However, this has to be weighed up against the increased risk of performing surgery in the standing sedated horse to the surgeon and the rest of the surgery team. Often, specialist facilities and equipment are required as well as a more in-depth knowledge of the anatomy and the procedure, along with a move advanced skill set. This article describes the procedures of upper airway surgery that lend themselves to being performed in the standing sedated horse.

Otolaryngological Surgery and Upper Respiratory Tract Infections in Children: An Epidemiological Study

2002 ◽  
Vol 111 (11) ◽  
pp. 1034-1039 ◽  
Author(s):  
Kari J. Kværner ◽  
Per Nafstad ◽  
Jouni J. K. Jaakkola
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Maternal Education ◽  
Upper Airway ◽  
Upper Respiratory Tract Infections ◽  
Upper Respiratory Tract ◽  
Upper Airway Surgery ◽  
Airway Surgery ◽  
Upper Respiratory ◽  
Tract Infections

The objective of the study was to assess the occurrence of different procedures of upper airway surgery and estimate their relationship to specific upper respiratory tract infections and constitutional factors. In a population-based cross-sectional study in Oslo, Norway, of 3,763 preschool children 3 to 4 years of age, the otolaryngological surgeries adenoidectomy, tonsillectomy, myringotomy, ventilation tube insertion, and combinations of these were the outcome measures. The results showed that by 4 years of age, 13% (n = 501) had undergone operation, and approximately Two thirds of the operations involved middle ear surgery. Although surgery was related to the occurrence of upper respiratory tract infections, the type of surgery was not related to the specific infection. In the children with operations, the occurrence of recurrent otitis media (≥3 infections in the previous 12 months) was almost fivefold higher than in children without operations (adjusted adds ratio [ORadj] = 5.19 [3.15 to 8.54]). A low level of maternal education (ORadj = 1.61 [1.05 to 2.7] compared to the group with a high level of education) and atopy on the part of the child (ORadj = 1.58 [1.20 to 2.07]) increased the probability for upper airway surgery independently of the experience of infections. In conclusion, early pediatric otolaryngological surgery is common. The decisions for surgical treatment vary substantially and are not closely related to the specific infections. The influence of other factors such as maternal education indicates that decisions for surgery are not entirely based on medical evidence.

Do Children Who Experience Laryngospasm Have an Increased Risk of Upper Respiratory Tract Infection?

1996 ◽  
Vol 85 (3) ◽  
pp. 475-480. ◽  
Author(s):  
Mark S. Schreiner ◽  
Irene O'Hara ◽  
Dorothea A. Markakis ◽  
George D. Politis
Keyword(s):  
Confidence Interval ◽  
Respiratory Infection ◽  
Odds Ratio ◽  
Signs And Symptoms ◽  
Control Group ◽  
Upper Respiratory Tract ◽  
Upper Respiratory Infection ◽  
Airway Surgery ◽  
Increased Risk ◽  
Upper Respiratory

Background Laryngospasm is the most frequently reported respiratory complication associated with upper respiratory infection and general anesthesia in retrospective studies, but prospective studies have failed to demonstrate any increase in risk. Methods A case-control study was performed to examine whether children with laryngospasm were more likely to have an upper respiratory infection on the day of surgery. The parents of all patients (N = 15,183) who were admitted through the day surgery unit were asked if their child had an active or recent (within 2 weeks of surgery) upper respiratory infection and were questioned about specific signs and symptoms to determine if the child met Tait and Knight's definition of an upper respiratory infection. Control subjects were randomly selected from patients whose surgery had occurred within 1 day of the laryngospasm event. Results Patients who developed laryngospasm (N = 123) were 2.05 times (95% confidence interval 1.21-3.45) more likely to have an active upper respiratory infection as defined by their parents than the 492 patients in the control group (P < or = 0.01). The development of laryngospasm was not related to Tait and Knight's definition for an upper respiratory infection or to recent upper respiratory infection. Children with laryngospasm were more likely to be younger (odds ratio = 0.92, 95% confidence interval 0.87-0.99), to be scheduled for airway surgery (odds ratio = 2.08, 95% confidence interval 1.21-3.59), and to have their anesthesia supervised by a less experienced anesthesiologist (odds ratio = 1.69, 95% confidence interval 1.04-2.7) than children in the control group. Conclusion Laryngospasm was more likely to occur in children with an active upper respiratory infection, children who were younger, children who were undergoing airway surgery, and children whose anesthesia were supervised by less experienced anesthesiologists. Understanding the risk factors and the magnitude of the likely risk should help clinicians make the decision as to whether to anesthetize children with upper respiratory infection.

scholarly journals The association between training load indices and upper respiratory tract infections (URTIs) in elite soccer players

2021 ◽  
pp. 174795412110204
Author(s):  
Caoimhe Tiernan ◽  
Thomas Comyns ◽  
Mark Lyons ◽  
Alan M Nevill ◽  
Giles Warrington
Keyword(s):  
Respiratory Tract ◽  
Signs And Symptoms ◽  
Training Load ◽  
Soccer Players ◽  
Upper Respiratory Tract ◽  
Increased Risk ◽  
Upper Respiratory ◽  
Tract Infections ◽  
Load Indices ◽  
And Training

This study aimed to investigate the association between training load indices and Upper Respiratory Tract Infection (URTI) across different lag periods in elite soccer players. Internal training load was collected from 15 elite soccer players over one full season (40 weeks). Acute, chronic, Acute:Chronic Workload Ratio (ACWR), Exponentially Weighted Moving Averages (EWMA) ACWR, 2, 3 and 4-week cumulative load, training strain and training monotony were calculated on a rolling weekly basis. Players completed a daily illness log, documenting any signs and symptoms, to help determine an URTI. Multilevel logistic regression was used to analyze the associations between training load indices and URTIs across different lag periods (1 to 7-days). The results found a significant association between 2-week cumulative load and an increased likelihood of a player contracting an URTI 3 days later (Odds Ratio, 95% Confidence Interval: OR = 2.07, 95% CI = 0.026-1.431). Additionally, a significant association was found between 3-week cumulative load and a players’ increased risk of contracting an URTI 4 days later (OR = 1.66, 95% CI = 0.013–1.006). These results indicate that accumulated periods of high training load (2- and 3-week) associated with an increased risk of a player contracting an URTI, which may lead to performance decrements, missed training sessions or even competitions.

Exercise and resistance to infection

1998 ◽  
Vol 76 (5) ◽  
pp. 573-580 ◽  
Author(s):  
David C Nieman
Keyword(s):  
Immune Response ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Killer Cell ◽  
Cell Activity ◽  
Upper Respiratory Tract Infection ◽  
Upper Respiratory Tract ◽  
Increased Risk ◽  
Upper Respiratory

Epidemiological data suggest that endurance athletes are at increased risk for upper respiratory tract infection (URTI) during periods of heavy training and the 1- to 2-week period following race events. Moderate exercise training has been associated with a reduction in incidence of URTI. There is growing evidence that for several hours subsequent to heavy exertion, several components of both the innate (e.g., natural killer cell activity and neutrophil oxidative burst activity) and adaptive (e.g., T and B cell function) immune system exhibit suppressed function. The immune response to heavy exertion is transient, and further research on the mechanisms underlying the immune response to prolonged and intensive endurance exercise is necessary before meaningful clinical applications can be drawn. Some attempts have been made through chemical or nutritional means (e.g., indomethacin, glutamine, vitamin C, and carbohydrate supplementation) to attenuate immune changes following intensive exercise to lower the risk of infection.Key words: upper respiratory tract infection, immunity, running, lymphocyte, neutrophil.

scholarly journals Bacterial Phosphorylcholine Decreases Susceptibility to the Antimicrobial Peptide LL-37/hCAP18 Expressed in the Upper Respiratory Tract

2000 ◽  
Vol 68 (3) ◽  
pp. 1664-1671 ◽  
Author(s):  
Elena S. Lysenko ◽  
Jane Gould ◽  
Robert Bals ◽  
James M. Wilson ◽  
Jeffrey N. Weiser
Keyword(s):  
Cell Surface ◽  
Respiratory Tract ◽  
Antimicrobial Peptide ◽  
Membrane Lipids ◽  
Upper Airway ◽  
Phase Variable ◽  
Upper Respiratory Tract ◽  
Epithelial Surface ◽  
Host Membrane ◽  
Upper Respiratory

ABSTRACT A number of pathogens of the upper respiratory tract express an unusual prokaryotic structure, phosphorylcholine (ChoP), on their cell surface. We tested the hypothesis that ChoP, also found on host membrane lipids in the form of phosphatidylcholine, acts so as to decrease killing by antimicrobial peptides that target differences between bacterial and host membranes. In Haemophilus influenzae, ChoP is a phase-variable structure on the oligosaccharide portion of the lipopolysaccharide (LPS). There was a bactericidal effect of the peptide LL-37/hCAP18 on a nontypeableH. influenzae strain, with an increasing selection for the ChoP+ phase as the concentration of the peptide was raised from 0 to 10 μg/ml. Moreover, constitutive ChoP-expressing mutants of unrelated strains showed up to 1,000-fold-greater survival compared to mutants without ChoP. The effect of ChoP on resistance to killing by LL-37/hCAP18 was dependent on the salt concentration and was observed only when bacteria were grown in the presence of environmental choline, a requirement for the expression of ChoP on the LPS. Further studies established that there is transcription of the LL-37/hCAP18 gene on the epithelial surface of the human nasopharynx in situ and inducible transcription in epithelial cells derived from the upper airway. The presence of highly variable amounts of LL-37/hCAP18 in normal nasal secretions (<1.2 to >80 μg/ml) was demonstrated with an antibody against this peptide. It was concluded that ChoP alters the bacterial cell surface so as mimic host membrane lipids and decrease killing by LL-37/hCAP18, an antimicrobial peptide that may be expressed on the mucosal surface of the nasopharynx in bactericidal concentrations.

Consumption of gold kiwifruit reduces severity and duration of selected upper respiratory tract infection symptoms and increases plasma vitamin C concentration in healthy older adults

2011 ◽  
Vol 108 (7) ◽  
pp. 1235-1245 ◽  
Author(s):  
Denise C. Hunter ◽  
Margot A. Skinner ◽  
Frances M. Wolber ◽  
Chris L. Booth ◽  
Jacelyn M. S. Loh ◽  
...  
Keyword(s):  
Vitamin C ◽  
Respiratory Tract ◽  
Immune Function ◽  
Washout Period ◽  
Community Dwelling ◽  
Plasma Vitamin ◽  
Upper Respiratory Tract ◽  
Increased Risk ◽  
Upper Respiratory ◽  
Tract Infections

In the elderly, immunosenescence and malnourishment can contribute to increased risk and severity of upper respiratory tract infections (URTI). Gold kiwifruit (Actinidia chinensis ‘Hort16A’) contains nutrients important for immune function and mitigation of symptoms of infection, including vitamins C and E, folate, polyphenols and carotenoids. The objective of the present study was to evaluate whether regular consumption of gold kiwifruit reduces symptoms of URTI in older people, and determine the effect it has on plasma antioxidants, and markers of oxidative stress, inflammation and immune function. A total of thirty-two community-dwelling people ( ≥ 65 years) participated in a randomised crossover study, consuming the equivalent of four kiwifruit or two bananas daily for 4 weeks, with treatments separated by a 4-week washout period. Participants completed the Wisconsin Upper Respiratory Symptom Survey-21 daily, and blood samples were collected at baseline and at the end of each treatment and washout period. Gold kiwifruit did not significantly reduce the overall incidence of URTI compared with banana, but significantly reduced the severity and duration of head congestion, and the duration of sore throat. Gold kiwifruit significantly increased plasma vitamin C, α-tocopherol and lutein/zeaxanthin concentrations, and erythrocyte folate concentrations, and significantly reduced plasma lipid peroxidation. No changes to innate immune function (natural killer cell activity, phagocytosis) or inflammation markers (high-sensitivity C-reactive protein, homocysteine) were detected. Consumption of gold kiwifruit enhanced the concentrations of several dietary plasma analytes, which may contribute to reduced duration and severity of selected URTI symptoms, offering a novel tool for reducing the burden of URTI in older individuals.

scholarly journals Upper airway.4: Sarcoidosis of the upper respiratory tract (SURT)

Thorax ◽  
2010 ◽  
Vol 65 (2) ◽  
pp. 181-186 ◽  
Author(s):  
R. P. Baughman ◽  
E. E. Lower ◽  
T. Tami
Keyword(s):  
Respiratory Tract ◽  
Upper Airway ◽  
Upper Respiratory Tract ◽  
Upper Respiratory

scholarly journals Intranasal HD-Ad vaccine protects the upper and lower respiratory tracts of hACE2 mice against SARS-CoV-2

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Huibi Cao ◽  
Juntao Mai ◽  
Zhichang Zhou ◽  
Zhijie Li ◽  
Rongqi Duan ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Receptor Binding ◽  
Intramuscular Injection ◽  
Upper Airway ◽  
Viral Transmission ◽  
Spike Protein ◽  
Receptor Binding Domain ◽  
Upper Respiratory Tract ◽  
Complete Protection ◽  
Upper Respiratory

Abstract Background The ongoing COVID-19 pandemic has resulted in 185 million recorded cases and over 4 million deaths worldwide. Several COVID-19 vaccines have been approved for emergency use in humans and are being used in many countries. However, all the approved vaccines are administered by intramuscular injection and this may not prevent upper airway infection or viral transmission. Results Here, we describe a novel, intranasally delivered COVID-19 vaccine based on a helper-dependent adenoviral (HD-Ad) vector. The vaccine (HD-Ad_RBD) produces a soluble secreted form of the receptor binding domain (RBD) of the SARS-CoV-2 spike protein and we show it induced robust mucosal and systemic immunity. Moreover, intranasal immunization of K18-hACE2 mice with HD-Ad_RBD using a prime-boost regimen, resulted in complete protection of the upper respiratory tract against SARS-CoV-2 infection. Conclusion Our approaches provide a powerful platform for constructing highly effective vaccines targeting SARS-CoV-2 and its emerging variants.

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