scholarly journals Upper respiratory tract diseases in patients with cystic fibrosis

2021 ◽  
Vol 23 (9) ◽  
pp. 441-444
Author(s):  
Eduard V. Sinkov ◽  
Keyword(s):  
Cystic Fibrosis ◽  
Respiratory Tract ◽  
Chronic Rhinosinusitis ◽  
Lower Respiratory Tract ◽  
Inflammatory Process ◽  
Bronchial Tree ◽  
Respiratory Epithelium ◽  
Upper Respiratory Tract ◽  
Respiratory Pathology ◽  
Upper Respiratory

Among ENT organ diseases in patients with cystic fibrosis, chronic rhinosinusitis is leading. The respiratory epithelium lining the surface of the upper and lower respiratory tract has the same structure. And as a result, in patients with cystic fibrosis, along with the bronchial tree, the upper respiratory tract is involved in the inflammatory process, while chronic rhinosinusitis develops. Impaired drainage leads to stagnation of infected thick mucus. Timely examination and treatment of upper respiratory pathology in patients with cystic fibrosis is needed. In surgical treatment, the method of choice is extended FESS. Observation by an ENT physician and conservative treatment of polypose rhinosinusitis should be carried out throughout the life of a patient with cystic fibrosis.

scholarly journals Concordance between upper and lower airway microbiota in infants with cystic fibrosis

2017 ◽  
Vol 49 (3) ◽  
pp. 1602235 ◽  
Author(s):  
Sabine M.P.J. Prevaes ◽  
Wouter A.A. de Steenhuijsen Piters ◽  
Karin M. de Winter-de Groot ◽  
Hettie M. Janssens ◽  
Gerdien A. Tramper-Stranders ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Lower Airway ◽  
Upper Respiratory Tract ◽  
Lower Respiratory Tract Infections ◽  
Rrna Sequencing ◽  
Upper Respiratory ◽  
Tract Infections

Nasopharyngeal and oropharyngeal samples are commonly used to direct therapy for lower respiratory tract infections in non-expectorating infants with cystic fibrosis (CF).We aimed to investigate the concordance between the bacterial community compositions of 25 sets of nasopharyngeal, oropharyngeal and bronchoalveolar lavage (BAL) samples from 17 infants with CF aged ∼5 months (n=13) and ∼12 months (n=12) using conventional culturing and 16S-rRNA sequencing.Clustering analyses demonstrated that BAL microbiota profiles were in general characterised by a mixture of oral and nasopharyngeal bacteria, including commensals like Streptococcus, Neisseria, Veillonella and Rothia spp. and potential pathogens like Staphylococcus aureus, Haemophilus influenzae and Moraxella spp. Within each individual, however, the degree of concordance differed between microbiota of both upper respiratory tract niches and the corresponding BAL.The inconsistent intra-individual concordance between microbiota of the upper and lower respiratory niches suggests that the lungs of infants with CF may have their own microbiome that seems seeded by, but is not identical to, the upper respiratory tract microbiome.

scholarly journals Viral etiology and epidemiology of pediatric patients hospitalized for acute respiratory tract infections in Macao: a retrospective study from 2014 to 2017

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Cheng Lei ◽  
Lisong Yang ◽  
Cheong Tat Lou ◽  
Fan Yang ◽  
Kin Ian SiTou ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Pediatric Patients ◽  
Respiratory Infections ◽  
Upper Respiratory Tract ◽  
Viral Etiology ◽  
Upper Respiratory ◽  
Syncytial Virus ◽  
Tract Infections

Abstract Background Acute respiratory infections (ARIs) are among the leading causes of hospitalization in children. Understanding the local dominant viral etiologies is important to inform infection control practices and clinical management. This study aimed to investigate the viral etiology and epidemiology of respiratory infections among pediatric inpatients in Macao. Methods A retrospective study using electronic health records between 2014 and 2017 at Kiang Wu Hospital was performed. Nasopharyngeal swab specimens were obtained from hospitalized children aged 13 years or younger with respiratory tract diseases. xMAP multiplex assays were employed to detect respiratory agents including 10 respiratory viruses. Data were analyzed to describe the frequency and seasonality. Results Of the 4880 children enrolled in the study, 3767 (77.1%) were positive for at least one of the 13 viral pathogens tested, of which 2707 (55.5%) being male and 2635 (70.0%) under 2 years old. Among the positive results, there were 3091 (82.0%) single infections and 676 (18.0%) multiple infections. The predominant viruses included human rhinovirus/enterovirus (HRV/EV 27.4%), adenovirus (ADV, 15.8%), respiratory syncytial virus B (RSVB, 7.8%) and respiratory syncytial virus A (RSVA, 7.8%). The detection of viral infection was the most prevalent in autumn (960/1176, 81.6%), followed by spring (1095/1406, 77.9%), winter (768/992, 77.4%), and summer (944/1306, 72.3%), with HRV/EV and ADV being most commonly detected throughout the 4 years of study period. The detection rate of viral infection was highest among ARI patients presented with croup (123/141, 87.2%), followed by lower respiratory tract infection (1924/2356, 81.7%) and upper respiratory tract infection (1720/2383, 72.2%). FluA, FluB and ADV were positive factors for upper respiratory tract infections. On the other hand, infection with RSVA, RSVB, PIV3, PIV4, HMPV, and EV/RHV were positively associated with lower respiratory tract infections; and PIV1, PIV2, and PIV3 were positively associated with croup. Conclusions This is the first study in Macao to determine the viral etiology and epidemiology of pediatric patients hospitalized for ARIs. The study findings can contribute to the awareness of pathogen, appropriate preventative measure, accurate diagnosis, and proper clinical management of respiratory viral infections among children in Macao.

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.

MIST THERAPY RECONSIDERED; AN EVALUATION OF THE RESPIRATORY DEPOSITION OF LABELLED WATER AEROSOLS PRODUCED BY JET AND ULTRASONIC NEBULIZERS

PEDIATRICS ◽  
1969 ◽  
Vol 43 (5) ◽  
pp. 799-808
Author(s):  
Jack Wolfsdorf ◽  
David L. Swift ◽  
Mary Ellen Avery
Keyword(s):  
Standard Deviation ◽  
Respiratory Tract ◽  
Propylene Glycol ◽  
Lower Respiratory Tract ◽  
Aerosol Deposition ◽  
Geometric Standard Deviation ◽  
Upper Respiratory Tract ◽  
Nasal Breathing ◽  
Upper Respiratory ◽  
Mass Median

Aerosol deposition in the upper and lower respiratory tract using technetium-labelled water aerosol, produced by jet and ultrasonic nebulizers, with and without 10% propylene glycol, was examined under conditions of nasal, normal mouth, and tube breathing in 15 normal adults. With nasal breathing, 91.5% (± 5.5) and 83.2% (± 6.3) of the mass of the aerosol produced by the jet and ultrasonic nebulizers, respectively, was deposited in the upper respiratory tract. Similar fractional depositions were observed with the addition of 10% propylene glycol. When breathing was carried out via a mouth tube, 43% to 59% of the mass of the aerosol produced by the nebulizers was deposited in the upper respiratory tract. The mass median diameters of the available aerosols produced by the jet and ultrasonic nebulizers were 6.0 µ (geometric standard deviation = 2.5) and 2.8 µ (geometric standard deviation = 2.1), respectively; the densities of the aerosols produced were 8 and 34 µl/liter air. With nasal or normal mouth breathing, the volume of water, in aerosol form, that could be deposited per 24 hours in the lower respiratory tract of an adult was calculated to be about 6 ml and 49 ml for the jet and ultrasonic nebulizer, respectively.

scholarly journals Diagnosis of influenza from lower respiratory tract sampling after negative upper respiratory tract sampling

Virulence ◽  
2013 ◽  
Vol 4 (1) ◽  
pp. 82-84 ◽  
Author(s):  
Isaac I. Bogoch ◽  
Jason R. Andrews ◽  
Kimon C. Zachary ◽  
Elizabeth L. Hohmann
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Upper Respiratory Tract ◽  
Upper Respiratory

scholarly journals Effects of upper respiratory tract infections in patients with cystic fibrosis.

Thorax ◽  
1996 ◽  
Vol 51 (11) ◽  
pp. 1115-1122 ◽  
Author(s):  
J Collinson ◽  
K G Nicholson ◽  
E Cancio ◽  
J Ashman ◽  
D C Ireland ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Upper Respiratory Tract Infections ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Tract Infections

scholarly journals Electron microscopic changes in the nasal membrane of patients with COVID-19 depending on the clinical form and the period of the disease

2021 ◽  
Vol 13 (2) ◽  
pp. 5-13
Author(s):  
E. V. Kryukov ◽  
K. V. Zhdanov ◽  
K. V. Kozlov ◽  
V. Yu. Kravtsov ◽  
O. V. Mal’tsev ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Respiratory Tract ◽  
Mucous Membrane ◽  
Structural Changes ◽  
Public Health Problem ◽  
Respiratory Epithelium ◽  
Upper Respiratory Tract ◽  
Clinical Form ◽  
Upper Respiratory ◽  
Tract Infections

Given that COVID-19 is a global public health problem and that almost all countries in the world have been severely affected by the COVID-19 pandemic, research is being actively pursued to better understand the effects of the virus on human cells. However, it is not clear what changes are observed in the cells of the main gate of infection – the mucosa of the mouth and the nose at different clinical forms and at different periods of disease. Understanding the ultra-structural cell changes of SARS-CoV-2 targets may help clarify the pathogenic aspects of infection in the lower respiratory tract. In this study, the elements of the life cycle of SARS-CoV-2 virus in the cells of the respiratory epithelium of the nose in patients with COVID-19 were evaluated using electron microscopy for the purpose of detecting the peculiarities of viral activity depending on the form and period of disease. Bioptats of the nasal mucous membrane were taken from COVID-19 patients and subsequently examined by electron microscopy. The severity of structural changes in tissue samples, presence of SARSCoV-2 virus in cells were determined, then bioptats were grouped according to the clinical form of the infection process (inapparent, acute upper respiratory tract infections, viral lung disease) and period of disease. It has been established that the most characteristic changes in the mucous membrane of the nose were observed in the first week of infection caused by SARS-CoV-2 and occurring in the form of acute respiratory disease, while viral lung infections have had the highest virus density in vesicles within cells, the formation of smooth virus-free vesicles is most common in inapparent forms. The data obtained may indicate that the formation of classical virus-induced changes in the respiratory epithelium of the nose mucous (vesicles with viral particles and signs of their release from the cell) is characteristic of localized forms of infection caused by SARS-CoV-2 (respiratory infection of the upper respiratory tract) and in cases of generalized infection (viral infection of the lungs and probably other organs and systems) accumulation of the infectious agent in high concentrations in vesicles. 

scholarly journals Paired nasopharyngeal and deep lung testing for SARS-CoV2 reveals a viral gradient in critically ill patients: a multi-centre study

2020 ◽  
Author(s):  
Islam Hamed ◽  
Nesreen Shaban ◽  
Marwan Nassar ◽  
Sam Love ◽  
Martin D Curran ◽  
...  
Keyword(s):  
Viral Load ◽  
Respiratory Tract ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Lower Respiratory Tract ◽  
Limit Of Detection ◽  
Upper Respiratory Tract ◽  
Rt Pcr ◽  
Multi Centre Study ◽  
Upper Respiratory

Introduction Samples for diagnostic tests for SARS-CoV-2 can be obtained from the upper (nasopharyngeal/oropharyngeal swabs) or lower respiratory tract (sputum or tracheal aspirate or broncho-alveolar lavage - BAL). Data from different testing sites indicates different rates of positivity. Reverse-transcriptase polymerase chain reaction (RT-PCR) allows for semi-quantitative estimates of viral load as time to crossing threshold (Ct) is inversely related to viral load. Objectives The objective of our study was to evaluate SARS-CoV2 RNA loads between paired nasopharyngeal (NP) and deep lung (endotracheal aspirate or BAL) samples from critically ill patients. Methods SARS-CoV-2 RT-PCR results were retrospectively reviewed for 51 critically ill patients from 5 intensive care units in 3 hospitals ; Addenbrookes Hospital Cambridge (3 units), Royal Papworth Cambridge (1 unit), and Royal Sunderland Hospital (1 unit). At the times when paired NP and deep lung samples were obtained, one patient had been on oxygen only, 6 patients on non-invasive ventilation, 18 patients on ECMO, and 26 patients mechanically ventilated. Results Results collected showed significant gradient between NP and deep lung viral loads. Median Ct value was 29 for NP samples and 24 for deep lung samples. Of 51 paired samples, 16 were negative (below limit of detection) on NP swabs but positive (above limit of detection) on deep lung sample, whilst 2 were negative on deep sample but positive on NP (both patients were on ECMO). Conclusions It has been suggested that whilst SARS-CoV1 tends to replicate in the lower respiratory tract, SARS-CoV2 replicates more vigorously in the upper respiratory tract. These data challenge that assumption. These data suggest that viral migration to, and proliferation in, the lower respiratory tract may be a key factor in the progression to critical illness and the development of severe acute respiratory syndrome (SARS). Factors which promote this migration should be examined for association with severe COVID-19. From a practical point of view, patients with suspected severe COVID-19 should have virological samples obtained from the lower respiratory tract where-ever possible, as upper respiratory samples have a significant negative rate.

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