scholarly journals Key signs of infectious pathology, those proceeds with the defeat of the respiratory tract (the formulation a clinical diagnosis)

2021 ◽  
Vol 10 (1) ◽  
pp. 79-88
Author(s):  
M.G. Kulagina ◽  
◽  
A.L. Vertkin ◽  
O.V. Zayratyants ◽  
A.V. Nosova ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Clinical Diagnosis

scholarly journals Comparison of nebulized Salbutamol versus Adrenaline in the treatment of wheeze associated respiratory tract infection

2017 ◽  
Vol 5 (1) ◽  
pp. 169
Author(s):  
Sireesha S. ◽  
B. S. Prasad ◽  
Suresh J.
Keyword(s):  
Respiratory Tract ◽  
Clinical Diagnosis ◽  
Early Life ◽  
Respiratory Infections ◽  
The Other ◽  
Age Group ◽  
Adrenergic Agonist ◽  
Viral Origin ◽  
Pediatric Department ◽  
Nebulized Salbutamol

Background: Wheezing related to respiratory infections is common in infancy and early child hood. In 1-3% of all infants these infections are severe enough to require hospitalization. Most episodes of wheezing in early life are of viral origin and form a heterogeneous group with different outcomes. The objectives of this study were to assess the efficacy of bronchodilators in wheeze associated respiratory infection and to comparing the efficacy of a nebulized nonspecific adrenergic agonist -1 adrenaline with a nebulized beta-2 specific agonist salbutamol for the treatment of the wheeze associated respiratory tract infection.Methods: The study was conducted in children reporting to the Pediatric Department Government General Hospital in Kakinada. The study period was 6 months from January to June 2014. Children between the ages of two months to two years attending the hospital with the clinical diagnosis of bronchiolitis were enrolled. Results: 30 children were enrolled. 22 (73.3) were in age group of 2 months to 1 year and 8 (26.7%) were in age group of 1-2 years. There is no added advantage of decreasing the respiratory rates, wheezing and retractions of one over the other groups.Conclusions: It can be inferred that bronchodilators, both nebulized adrenalin and salbutamol are useful in relieving symptoms and improving oxygenation in wheezy infants with clinical diagnosis of WRTI. No drug is said to be better over the other.

scholarly journals Broad Range Detection of Viral and Bacterial Pathogens in Bronchoalveolar Lavage Fluid of Children to Identify the Cause of Lower Respiratory Tract Infections

2020 ◽  
Author(s):  
Heping Wang ◽  
Jiali Gu ◽  
Xiaonan Li ◽  
Christa E. van der Gaast de Jongh ◽  
Wenjian Wang ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Clinical Diagnosis ◽  
Pathogen Detection ◽  
Bacterial Pathogens ◽  
Clinical Diagnostics ◽  
Large Set ◽  
Detection Rates ◽  
Multiplex Qpcr ◽  
Accurate Treatment ◽  
Tract Infections

Abstract OBJECTIVES: Knowledge on the etiology of LRTIs is essential for improvement of the clinical diagnosis and accurate treatment. Molecular detection methods were applied to identify a broad range of bacterial and viral pathogens in a large set of bronchial alveolar lavage (BAL) fluid samples. The patterns of detected pathogens were correlated to the clinical symptoms.METHODS: BAL fluid samples and clinical data were collected from 573 hospitalized children between 1 month and 14 years of age with LRTIs, enrolled from January to December 2018. Pathogens were detected using standardized clinical diagnostics, with a sensitive, high-throughput GeXP-based multiplex PCR and with multiplex qPCR. Data were analyzed to describe the correlation between the severity of respiratory tract disease and the pathogens identified.RESULTS: The pathogen detection rate with GeXP-based PCR and multiplex qPCR was significantly higher than by clinical routine diagnostics (76.09% VS 36.13%,χ2 = 8.191, P=0.004). The most frequently detected pathogens in the BAL fluid were human adenovirus (HADV)(21.82%), Mycoplasma pneumoniae (20.24%), human rhinovirus (13.96%), Streptococcus pneumoniae (8.90%) and Haemophilus influenzae (8.90%). In 16.4 % of the cases co-infection with two or three different pathogens was found. Viral detection rates declined with age, while atypical pathogen detection rates increased with age. Oxygen supply in the HADV and Influenza H1N1 infected patients was more frequent (49.43%) than in patients infected with other pathogens.CONCLUSION: Broad range detection of viral and bacterial pathogens using molecular methods is a promising and implementable approach to improve clinical diagnosis and accurate treatment of LRTI in children.

scholarly journals Sensitivity of RT-PCR testing of upper respiratory tract samples for SARS-CoV-2 in hospitalised patients: a retrospective cohort study

2020 ◽  
Author(s):  
Thomas C Williams ◽  
Elizabeth Wastnedge ◽  
Gina McAllister ◽  
Ramya Bhatia ◽  
Kate Cuschieri ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Clinical Diagnosis ◽  
Gold Standard ◽  
Upper Respiratory Tract ◽  
Repeated Testing ◽  
Rt Pcr ◽  
Hospitalised Patients ◽  
Human Rnase ◽  
Increased Sensitivity ◽  
Upper Respiratory

ABSTRACTObjectivesTo determine the sensitivity and specificity of RT-PCR testing of upper respiratory tract (URT) samples from hospitalised patients with COVID-19, compared to the gold standard of a clinical diagnosis.MethodsAll URT RT-PCR testing for SARS-CoV-2 in NHS Lothian, Scotland, United Kingdom between the 7th of February and 19th April 2020 (inclusive) was reviewed, and hospitalised patients were identified. All URT RT-PCR tests were analysed for each patient to determine the sequence of negative and positive results. For those who were tested twice or more but never received a positive result, case records were reviewed, and a clinical diagnosis of COVID-19 allocated based on clinical features, discharge diagnosis, and radiology and haematology results. For those who had negative URT RT-PCR tests but a clinical diagnosis of COVID-19, respiratory samples were retested using a multiplex respiratory panel, a second SARS-CoV-2 RT-PCR assay, and a human RNase P control.ResultsCompared to the gold standard of a clinical diagnosis of COVID-19, the sensitivity of an initial URT RT-PCR for COVID-19 was 82.2% (95% confidence interval 79.0-85.1%). Two consecutive URT RT-PCR tests increased sensitivity to 90.6% (CI 88.0-92.7%). A further 2.2% and 0.9% of patients who received a clinical diagnosis of COVID-19 were positive on a third and fourth test.ConclusionsThe sensitivity of a single RT-PCR test of an URT sample in hospitalised patients is 82.2%. Sensitivity increases to 90.6% when patients are tested twice. A proportion of cases with clinically defined COVID-19 never test positive on URT RT-PCR despite repeated testing.

scholarly journals Efficacy and safety of Aviron Rapid® in 18-60-year-old patients with clinical diagnosis of acute respiratory viral infection: a multicenter, randomized, double-blind, placebo-controlled clinical trial

Folia Medica ◽  
2021 ◽  
Vol 63 (1) ◽  
pp. 129-137
Author(s):  
Georgi Popov ◽  
Margarita Gospodinova-Bliznakova ◽  
Zlatko Kalvatchev ◽  
Andrey Tchorbanov
Keyword(s):  
Respiratory Tract ◽  
Viral Infection ◽  
Clinical Diagnosis ◽  
Symptomatic Therapy ◽  
Upper Respiratory Tract ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Duration Of Disease ◽  
Upper Respiratory ◽  
Tract Infections

Aim: Prevention and treatment of upper respiratory tract infections are given the highest priority because of the tremendous health and economic impact of these diseases. Development of novel effective and safe options for treatment can contribute considerably to decrease the burden of disease. Materials and methods: We designed a multicenter, randomized, double-blind, placebo-controlled study in ambulatory-treated adult patients with a clinical diagnosis of acute upper respiratory tract viral infection. The patients (18-60 years old) were randomized into two groups and followed-up for 5 days. Group 1 received the standard symptomatic therapy + Aviron Rapid®, and Group 2 received the standard symptomatic therapy + placebo. The primary endpoint of the study was defined as the duration of disease measured by the percentages of disease-free patients for every 12-hour period of the study.  Results: Treating clinically relevant patients with the natural product Aviron Rapid® for 5 days decreases the duration of disease, the intake of antipyretics and the severity of symptoms. Significant difference between the tested groups for most of studied parameters was found as soon as 12 or 24 hours after initiation of administration in favour of active arm and was the most prominent on days 3 and 4. Significant decrease in the total score of symptoms severity was achieved on day 4 and extended to the end of study. There were no dif-ferences in the adverse events between the groups and the tested product demonstrated excellent safety profile.  Conclusions: This study is a clinical confirmation of well documented antiviral activity of the product targeting multiple points in viral replication and covering broad spectrum viral pathogens.

scholarly journals Sensitivity of RT-PCR testing of upper respiratory tract samples for SARS-CoV-2 in hospitalised patients: a retrospective cohort study

2020 ◽  
Vol 5 ◽  
pp. 254
Author(s):  
Thomas C. Williams ◽  
Elizabeth Wastnedge ◽  
Gina McAllister ◽  
Ramya Bhatia ◽  
Kate Cuschieri ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Clinical Diagnosis ◽  
Gold Standard ◽  
Upper Respiratory Tract ◽  
Rt Pcr ◽  
Reverse Transcription Pcr ◽  
Hospitalised Patients ◽  
Increased Sensitivity ◽  
Upper Respiratory ◽  
Pcr Test

Background: This study aimed to determine the sensitivity and specificity of reverse transcription PCR (RT-PCR) testing of upper respiratory tract (URT) samples from hospitalised patients with coronavirus disease 2019 (COVID-19), compared to the gold standard of a clinical diagnosis. Methods: All URT RT-PCR testing for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in NHS Lothian, Scotland, United Kingdom between the 7th of February and 19th April 2020 (inclusive) was reviewed, and hospitalised patients were identified. All URT RT-PCR tests were analysed for each patient to determine the sequence of negative and positive results. For those who were tested twice or more but never received a positive result, case records were reviewed, and a clinical diagnosis of COVID-19 allocated based on clinical features, discharge diagnosis, and radiology and haematology results. For those who had a negative RT-PCR test but a clinical diagnosis of COVID-19, respiratory samples were retested using a multiplex respiratory panel, a second SARS-CoV-2 RT-PCR assay, and a human RNase P control. Results: Compared to the gold standard of a clinical diagnosis of COVID-19, the sensitivity of a single upper respiratory tract RT-PCR for COVID-19 was 82.2% (95% confidence interval 79.0-85.1%).   The sensitivity of two upper respiratory tract RT-PCR tests increased sensitivity to 90.6% (CI 88.0-92.7%). A further 2.2% and 0.9% of patients who received a clinical diagnosis of COVID-19 were positive on a third and fourth test; this may be an underestimate of the value of further testing as the majority of patients 93.0% (2999/3226) only had one or two URT RT-PCR tests. Conclusions: The sensitivity of a single RT-PCR test of URT samples in hospitalised patients is 82.2%. Sensitivity increases to 90.6% when patients are tested twice.  A proportion of cases with clinically defined COVID-19 never test positive on URT RT-PCR despite repeat testing.

scholarly journals Broad range detection of viral and bacterial pathogens in bronchoalveolar lavage fluid of children to identify the cause of lower respiratory tract infections

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Heping Wang ◽  
Jiali Gu ◽  
Xiaonan Li ◽  
Christa E. van der Gaast-de Jongh ◽  
Wenjian Wang ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Clinical Diagnosis ◽  
Pathogen Detection ◽  
Bacterial Pathogens ◽  
Clinical Diagnostics ◽  
Large Set ◽  
Detection Rates ◽  
Multiplex Qpcr ◽  
Accurate Treatment ◽  
Tract Infections

Abstract Background Knowledge on the etiology of LRTIs is essential for improvement of the clinical diagnosis and accurate treatment. Molecular detection methods were applied to identify a broad range of bacterial and viral pathogens in a large set of bronchial alveolar lavage (BAL) fluid samples. The patterns of detected pathogens were correlated to the clinical symptoms. Methods BAL fluid samples and clinical data were collected from 573 hospitalized children between 1 month and 14 years of age with LRTIs, enrolled from January to December 2018. Pathogens were detected using standardized clinical diagnostics, with a sensitive, high-throughput GeXP-based multiplex PCR and with multiplex qPCR. Data were analyzed to describe the correlation between the severity of respiratory tract disease and the pathogens identified. Results The pathogen detection rate with GeXP-based PCR and multiplex qPCR was significantly higher than by clinical routine diagnostics (76.09% VS 36.13%,χ2 = 8.191, P = 0.004). The most frequently detected pathogens in the BAL fluid were human adenovirus (HADV)(21.82%), Mycoplasma pneumoniae (20.24%), human rhinovirus (13.96%), Streptococcus pneumoniae (8.90%) and Haemophilus influenzae (8.90%). In 16.4% of the cases co-detection with two or three different pathogens was found. Viral detection rates declined with age, while atypical pathogen detection rates increased with age. Oxygen supply in the HADV and Influenza H1N1 infected patients was more frequent (49.43%) than in patients infected with other pathogens. Conclusion Broad range detection of viral and bacterial pathogens using molecular methods is a promising and implementable approach to improve clinical diagnosis and accurate treatment of LRTI in children.

scholarly journals Clinical diagnosis and treatment of common respiratory tract infections in relation to microbiological profiles in rural health facilities in China: implications for antibiotic stewardship

2020 ◽  
Author(s):  
Xingrong Shen ◽  
Jilu Shen ◽  
Yaping Pan ◽  
Jing Cheng ◽  
Jing Chai ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Clinical Diagnosis ◽  
Antibiotic Stewardship ◽  
Rural China ◽  
Tier 2 ◽  
Residential Areas ◽  
Microbiological Testing ◽  
Township Health Center ◽  
Tract Infections ◽  
Structured Questionnaire

Abstract Background This paper tries to describe prevalence and patterns of antibiotics prescription and bacteria detection and sensitivity to antibiotics in rural China and implications for future antibiotic stewardship.Methods The study was implemented in one village clinic and one township health center in each of four rural residential areas in Anhui Province, China. Observations was conducted to record clinical diagnosis and antibiotic prescription. Semi-structured questionnaire survey was used to collected patient’s sociodemographic information and symptoms. Sputum and throat swabs were collected for bacterial culture and susceptibility testing.Results A total of 1068 (51.0% male vs 49.0% female) patients completed the study with diagnosis of respiratory tract infection (326,30.5%), bronchitis/tracheitis (249,23.3%), pharyngitis (119,11.1%) and others (374, 35.0%). They provided 683 sputum and 385 throat swab specimens. Antibiotics were prescribed for 88% of the RTI patients. Of all the specimens tested, 329 (31%) were isolated with bacteria. The most frequently detected bacteria were K. pneumonia (24% in all specimens), H. influenza (16%), H. parainfluenzae (15%), P. aeruginosa (6%), S.aureus (5%), M. catarrhalis (3%) and S. pneumoniae (2%).Conclusions The study establishes the feasibility of conducting microbiological testing outside Tier 2 and 3 hospitals in rural China. It reveals that prescription of antibiotics, especially broad spectrum and combined antibiotics, is still very common and there is a clear need for stewardship programs aimed at both reducing the number of prescriptions and promoting single and narrow-spectrum antibiotics.

New Ultrastructural Observations on Injury and Regeneration of Cilia in Mammalian Conducting Airway Epithelium

1981 ◽  
Vol 39 ◽  
pp. 624-625
Author(s):  
J.L. Carson ◽  
A.M. Collier
Keyword(s):  
Respiratory Tract ◽  
Airway Epithelium ◽  
Defense Mechanisms ◽  
Normal Growth ◽  
Fetal Lung ◽  
Secretory Cells ◽  
Airway Epithelial ◽  
Ciliated Cells ◽  
Conducting Airway ◽  
Conducting Airways

The ciliated cells lining the conducting airways of mammals are integral to the defense mechanisms of the respiratory tract, functioning in coordination with secretory cells in the removal of inhaled and cellular debris. The effects of various infectious and toxic agents on the structure and function of airway epithelial cell cilia have been studied in our laboratory, both of which have been shown to affect ciliary ultrastructure.These observations have led to questions about ciliary regeneration as well as the possible induction of ciliogenesis in response to cellular injury. Classical models of ciliogenesis in the conducting airway epithelium of the mammalian respiratory tract have been based primarily on observations of the developing fetal lung. These observations provide a plausible explanation for the embryological generation of ciliary beds lining the conducting airways but do little to account for subsequent differentiation of ciliated cells and ciliogenesis during normal growth and development.

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