A 12-month follow-up of an influenza vaccination campaign based on voluntary adherence: report on upper-respiratory symptoms among volunteers and non-volunteers

CONTEXT: Routine immunization of groups at high risk for influenza has been progressively implemented as a matter of Brazilian public health policy. Although the benefits of the vaccination for healthy young adults are still controversial, it has been offered yearly to hundreds of thousands of Brazilian workers, generally as part of wellness initiatives in the workplace. OBJECTIVE: To study the characteristics of subjects that accepted or refused to be vaccinated against influenza and to report on respiratory symptoms in both groups, one year after the campaign date. DESIGN: A prospective observational study. SETTING: Workers at a subsidiary of an international bank in São Paulo, Brazil. PARTICIPANTS: 124 persons that did not accept and 145 that voluntarily accepted the vaccine completed 12 months of follow-up. MAIN MEASUREMENTS: Data concerning gender, age, tobacco use, and any history of chronic respiratory illness such as asthma, bronchitis, rhinitis, and repetitive upper-respiratory infections, were recorded at the time of vaccination. After that, workers were asked monthly by questionnaire or telephone about respiratory symptoms, days of work lost and medical consultations. RESULTS: The results showed statistically significant differences regarding age (P = 0.004) with the vaccinated group (V) being younger than the non-vaccinated (NV) one, and with reference to previous repetitive upper-respiratory infections being higher among the V group (P < 0.0001). During the follow-up, the V group reported more occurrences of upper respiratory symptoms (P < 0.0001), due to both non-influenza (P < 0.0001) and influenza-like illness (P = 0.045). Differences were also found between V and NV groups concerning days off work and number of medical consultations due to upper-respiratory symptoms and non-influenza illness. Gender and history of repetitive upper-respiratory infections were the best predictors of influenza-like illness-related events. CONCLUSIONS: The making of previous reference to repetitive upper-respiratory infections was a major difference between those who accepted or rejected the vaccine. The vaccination itself was not sufficient to reduce the number of occurrences of respiratory symptoms and related absenteeism to levels similar to those found among non-vaccinated people.

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Bilateral Cavitary Disease with a History of Recurrent Upper Respiratory Infections

CHEST Journal ◽

10.1378/chest.80.5.629 ◽

1981 ◽

Vol 80 (5) ◽

pp. 629-630

Author(s):

Robert A. Boedecker ◽

Henry J. Bradley ◽

John R. Sty

Keyword(s):

Respiratory Infections ◽

Upper Respiratory Infections ◽

Cavitary Disease ◽

History Of ◽

Upper Respiratory

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Intramuscular Corticosteroids for Acute Upper Respiratory Infections Affects Healthcare Utilization

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489420929717 ◽

2020 ◽

Vol 129 (10) ◽

pp. 988-995 ◽

Cited By ~ 1

Author(s):

Sean M Parsel ◽

Alaa E Mohammed ◽

Daniel Fort ◽

Blair M Barton ◽

Edward D McCoul

Keyword(s):

Healthcare Utilization ◽

Respiratory Infections ◽

Acute Otitis Media ◽

Patient Characteristics ◽

Urgent Care ◽

Upper Respiratory Infections ◽

Regional Health Care ◽

Repeat Visit ◽

Upper Respiratory

Objective: To examine the use of intramuscular corticosteroid (IMCS) injections for treatment of acute upper respiratory infections (URI) and the influence on healthcare utilization. Methods: This retrospective cohort study used patient encounter data from a large multicenter regional health care system between 2013 and 2017. Adult patients diagnosed with acute URI (acute pharyngitis, acute sinusitis, acute otitis media, and URI not otherwise specified) during ambulatory encounters were included. Follow-up encounters for a diagnosis of acute URI within 60 days were identified and patient characteristics, encounter details, and procedure codes were retrieved. Frequency data was used to calculate IMCS injection administration prevalence, utilization trends, and associations with covariates. Follow-up data for return encounters within 60 days for the same diagnosis was examined. Results: Of the 153 848 initial encounters, 34 600 (22.5%) patients received IMCS injection for acute URI. Injection rates varied from 0.85% to 49.1% depending on specialty and practitioner type. Internal medicine, family medicine, urgent care, and otorhinolaryngology clinics most commonly administered IMCS. 3788 patients returned for a second encounter of which 751 (19.8%) received an injection. IMCS injection during the first encounter was associated with increased odds of repeat visit within 60 days (OR: 1.74; 95% CI: 1.61–1.88). Conclusion: IMCS use in the treatment of acute URI is highly prevalent despite lack of evidence for impact and safety. Prevalence is variable across multiple medical and surgical specialties including otorhinolaryngology. Administration of IMCS injection may contribute to the likelihood of a subsequent healthcare visit for the same indication.

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Adenotonsillar Hypertrophy as a Cause of Failure to Thrive

Canadian Journal of Gastroenterology ◽

10.1155/1990/161796 ◽

1990 ◽

Vol 4 (8) ◽

pp. 485-488

Author(s):

Ann G Sheehan ◽

R Brent Scott ◽

Helen M Machida

Keyword(s):

Respiratory Symptoms ◽

Upper Airway ◽

Failure To Thrive ◽

Adenotonsillar Hypertrophy ◽

Cause Of Failure ◽

History Of ◽

Laboratory Investigations ◽

Upper Respiratory ◽

Partial Upper Airway Obstruction ◽

Upper Respiratory Symptoms

Two infant aged 11 and 15 months presented to the Gastroenterology Clinic at Alberta Children's Hospital because of failure to thrive. Clinical and laboratory investigations excluded any underlying abnormality of 1he gastrointestinal tract. Because of a history of obstructive upper respiratory symptoms, both were referred for ear, nose and throat evaluation, and both were found to have partial upper airway obstruction secondary to adenotonsillar hypertrophy. Subsequent adenotonsillectomy led to resolution of obstructive upper respiratory symptoms and dramatic increases in weight gain and growth. Adenotonsillar hypertrophy should be included among the potential causes of failure to thrive in infancy, especially if the child has a history of obstructive upper respiratory symptoms.

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A clinical prediction tool to predict urinary tract infection in pediatric febrile patients younger than 2 years old: a retrospective analysis of a fever registry

Clinical and Experimental Emergency Medicine ◽

10.15441/ceem.20.134 ◽

2021 ◽

Vol 8 (4) ◽

pp. 314-324

Author(s):

Yun Seong Park ◽

Jin Hee Lee ◽

Young Ho Kwak ◽

Jae Yun Jung ◽

Hyuksool Kwon ◽

...

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Viral Infection ◽

Respiratory Symptoms ◽

Past History ◽

Clinical Prediction ◽

History Of ◽

Upper Respiratory ◽

Upper Respiratory Symptoms

Objective Urinary tract infection (UTI) is a significant issue in young febrile patients due to potential long-term complications. Early detection of UTI is crucial in pediatric emergency departments (PEDs). We developed a tool to predict UTIs in children.Methods Clinical data of patients <24 months of age with a fever and UTI or viral infection were extracted from the fever registry collected in two PEDs. Stepwise multivariate logistic regression was performed to establish predictors of identified eligible clinical variables for the derivation of the prediction model.Results A total of 1,351 patients were included in the analysis, 643 patients from A hospital (derivation set) and 708 patients from B hospital (validation set). In the derivation set, there were more girls and a lower incidence of a past history of UTI, older age, less fever without source, and more family members with upper respiratory symptoms in the viral infection group. The stepwise regression analysis identified sex (uncircumcised male), age (≤12 months), a past history of UTI, and family members with upper respiratory symptoms as significant variables.Conclusion Young febrile patients in the PED were more likely to have UTIs if they were uncircumcised boys, were younger than 12 months of age, had a past history of UTIs, or did not have families with respiratory infections. This clinical prediction model may help determine whether to perform urinalysis in the PED.

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