scholarly journals Microaspiration in GER as one of the causes of bronchial asthma exacerbation and the occurrence of chronic cough in children. History of the problem and diagnostics

2021 ◽  
Vol 20 (1) ◽  
pp. 97-102
Author(s):  
I. A. Fedorov ◽  
O. G. Rybakova ◽  
E. A. Goreva
Keyword(s):  
Gastroesophageal Reflux ◽  
Respiratory Tract ◽  
Bronchial Asthma ◽  
Chronic Cough ◽  
Lower Respiratory Tract ◽  
Evidence Base ◽  
Non Invasive ◽  
Medical Library ◽  
Invasive Method ◽  
History Of

The purpose of the review: to analyze the evolution of the views of clinicians and researchers on the relationship between gastroesophageal reflux and is extraesophageal bronchial manifestations, and the stages of the formation of the diagnosis of microaspiration of the lower respiratory tract in children.Materials and methods. Sarch in electronic databases: Elibrary, Federal Electronic Medical Library of the Ministry of Health of the Russian Federation, bibliographic database of articles on medical sciences, created by the US National Library of Medicine MEDLINE.Main statements. Diagnostics and treatment of gastroesophageal reflux and its extraesophageal manifestations both in the 20th century and at the beginning of the 21-st century present certain difficulties for pediatricians and pulmonologists. Currently, there are numerous domestic and foreign clinical guidelines created with the aim f improving diagnostics and approaches to the treatment of gastroesophageal reflux and "silent" microaspiration of the lower respiratory tract of the respiratory tract. However, the evidence base for the problem under discussion is rather limited, due to the lack of specificity of the symptoms of the disease and the absence of a "gold standard" diagnostics.Conclusion. The presented review gives information about non-invasive diagnosis of microaspiration in children with bronchial asthma and chronic cough what will help us decide on treatment, taking into account the concomitant gastroesophageal reflux. A non-invasive method for detecting lactose in the induced sputum of the respiratory tract and also an additional determination of the average cytochemical coefficient of macrophages can serve as an effective alternative to the verification of "silent" microaspiration in children with bronchial asthma and chronic cough.

A palpable chest wall mass in a 4-year-old boy

2021 ◽  
pp. e20200053
Author(s):  
Jakob M Domm ◽  
Joanne M Langley
Keyword(s):  
Chest Pain ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Chest Wall ◽  
Respiratory Infection ◽  
Lower Respiratory Tract ◽  
Atypical Presentation ◽  
History Of ◽  
Wall Mass ◽  
Chest Wall Mass

Empyema necessitans (EN) is a rare but dangerous complication of a lower respiratory tract infection. The diagnosis can be difficult to make and therefore delayed. We describe a case of a child with an atypical presentation of EN. He was afebrile and without chest pain and presented with a palpable chest wall mass after a history of recent respiratory infection. The threshold of suspicion for EN should be low, and it must be suspected in all children with a chest wall mass and recent history of respiratory infection.

scholarly journals FEATURES OF BRONCHIAL ASTHMA CONTROL AND COURSE IN CHILDREN WITH AN ALTERNATIVE ONSET OF THE DISEASE

2020 ◽  
Vol 8 (4) ◽  
pp. 383-392
Author(s):  
О.К. Koloskova ◽  
Т.М. Bilous ◽  
N.O. Shevchenko ◽  
V.V. Bilous
Keyword(s):  
Quality Of Life ◽  
Respiratory Tract ◽  
Medical Care ◽  
Asthma Control ◽  
Bronchial Asthma ◽  
Diagnostic Procedures ◽  
Individualized Treatment ◽  
Economic Losses ◽  
Non Invasive

Despite the large number of studies on the diagnosis and treatment of asthma and the constant updating of recommendations for the provision of medical care to patients with asthma, this disease still has a significant impact on the quality of life of patients and their families and significant economic losses. However, the peculiarities of bronchial asthma and the diagnosis of certain phenotypes of the disease in children, depending on biomarkers of inflammatory activity in the airways, require greater use of non-invasive diagnostic procedures and optimization of individualized treatment depending on the nature and intensity of inflammation in the respiratory tract.

Approach to the Patient with Cough

2018 ◽  
Author(s):  
Christopher H. Fanta
Keyword(s):  
Respiratory Tract ◽  
Chronic Cough ◽  
Lower Respiratory Tract ◽  
Airflow Obstruction ◽  
Sensory Nerve ◽  
Lung Parenchyma ◽  
Flow Volume ◽  
Respiratory Compromise ◽  
Cough Reflex ◽  
Persistent Cough

The cough reflex is critically important in the clearance of abnormal airway secretions and protection of the lower respiratory tract from aspirated foreign matter. A weak or ineffective cough can lead to respiratory compromise from even a relatively minor bronchial infection. Persistent cough is often one of a constellation of symptoms indicative of respiratory disease—a potential clue in the differential diagnosis of the patient’s illness. Given the widespread distribution of sensory nerve endings of the cough reflex throughout the upper and lower respiratory tract, it is not surprising that myriad respiratory diseases, involving lung parenchyma and airways, can manifest with cough. Sometimes cough is the sole or predominant symptom in a patient who is otherwise well. Evaluating and treating the patient with persistent cough who has few, if any, other respiratory symptoms is a common challenge for the practicing physician. This review covers the normal cough mechanism, impaired cough, pathologic cough, cough suppressant therapy, and new developments. Figures show a flow-volume loop during cough, a posteroanterior chest x-ray in a patient presenting with chronic cough, flow-volume curves and spirograms documenting expiratory airflow obstruction, and the approach to the patient with chronic cough. The table lists selected examples of extrapulmonary physical findings of potential importance in the assessment of cough. This review contains 4 highly rendered figures, 1 table, and 94 references.

scholarly journals Vaccine Effectiveness Against Influenza-Associated Lower Respiratory Tract Infections in Hospitalized Adults, Louisville, Kentucky, 2010–2013

2020 ◽  
Vol 7 (7) ◽  
Author(s):  
Eric J Chow ◽  
Melissa A Rolfes ◽  
Ruth L Carrico ◽  
Stephen Furmanek ◽  
Julio A Ramirez ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Community Acquired Pneumonia ◽  
Vaccine Effectiveness ◽  
Self Report ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Radiographic Findings ◽  
History Of ◽  
Tract Infections

Abstract Background Preventing severe complications of influenza such as hospitalization is a public health priority; however, estimates of influenza vaccine effectiveness (VE) against influenza-associated acute lower respiratory tract infection (LRTI) hospitalizations are limited. We examined influenza VE against influenza-associated LRTIs in hospitalized adult patients. Methods We retrospectively analyzed data from a randomized trial of oseltamivir treatment in adults hospitalized with LRTI in Louisville, Kentucky, from 2010 to 2013. Patients were systematically tested for influenza at the time of enrollment. We estimated VE as 1 – the adjusted odds ratio (aOR) of antecedent vaccination in influenza-positives vs negatives × 100%. Vaccination status was obtained by patient self-report. Using logistic regression adjusting for age, sex, season, timing of illness, history of chronic lung disease, and activities of daily living, we estimated VE against hospitalized influenza-associated LRTIs and community-acquired pneumonia (CAP) with radiographic findings of infiltrate. Results Of 810 patients with LRTI (median age, 62 years), 184 (23%) were influenza-positive and 57% had radiographically confirmed CAP. Among influenza-positives and -negatives, respectively, 61% and 69% were vaccinated. Overall, 29% were hospitalized in the prior 90 days and >80% had comorbidities. Influenza-negatives were more likely to have a history of chronic obstructive pulmonary disease than influenza-positives (59% vs 48%; P = .01), but baseline medical conditions were otherwise similar. Overall, VE was 35% (95% CI, 4% to 56%) against influenza-associated LRTI and 51% (95% CI, 13% to 72%) against influenza-associated radiographically confirmed CAP. Conclusions Vaccination reduced the risk of hospitalization for influenza-associated LRTI and radiographically confirmed CAP. Clinicians should maintain high rates of influenza vaccination to prevent severe influenza-associated complications.

scholarly journals On respiratory manifestations of gastroesophageal reflux disease

2018 ◽  
Vol 90 (8) ◽  
pp. 131-136
Author(s):  
V N Abrosimov ◽  
I B Ponomareva ◽  
A A Nizov ◽  
M V Solodun
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Respiratory Tract ◽  
Respiratory System ◽  
Reflux Disease ◽  
Lower Respiratory Tract ◽  
Respiratory Symptoms ◽  
Clinical Course ◽  
Current Information ◽  
Extraesophageal Symptoms

One of the manifestations of gastroesophageal reflux disease (GERD) is extraesophageal symptoms, in particular, from the upper and lower respiratory tract. Gastroesophageal reflux is capable of both causing respiratory symptoms independently and aggravating the course of already existing diseases of the respiratory system. The article presents available in the literature current information on the pathogenesis of GERD respiratory symptoms, their clinical course, considerations of diagnosis and treatment.

scholarly journals The long road to protect infants against severe RSV lower respiratory tract illness

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 610 ◽  
Author(s):  
Sofia Jares Baglivo ◽  
Fernando P Polack
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Vaccine Development ◽  
The Elderly ◽  
Recurrent Wheezing ◽  
Maternal Immunization ◽  
Current Vaccine ◽  
History Of ◽  
Respiratory Tract Illness ◽  
Syncytial Virus

Severe respiratory syncytial virus (RSV) lower respiratory tract illness (LRTI) in infants has proven challenging to prevent. In the last 50 years, conceptually different approaches failed to evolve into viable preventive alternatives for routine use. Inactivated RSV vaccine (that is, formalin-inactivated RSV) elicited severe LRTI in RSV-infected toddlers pre-immunized as infants; early purified F protein approaches in pregnant women failed to elicit sufficient immunity more than a decade ago; a second-generation monoclonal antibody (mAb) of high potency against the virus (that is, motavizumab) caused severe adverse reactions in the skin, and owing to lack of efficacy against RSV subgroup B, an extended half-life mAb targeting site V in the RSV fusion protein (that is, REG2222) did not meet its primary endpoint. In the meantime, two protein F vaccines failed to prevent medically attended LRTI in the elderly. However, palivizumab and the recent results of the Novavax maternal immunization trial with ResVax demonstrate that severe RSV LRTI can be prevented by mAb and by maternal immunization (at least to a certain extent). In fact, disease prevention may also decrease the rates of recurrent wheezing and all-cause pneumonia for at least 180 days. In this review, we discuss the history of RSV vaccine development, previous and current vaccine strategies undergoing evaluation, and recent information about disease burden and its implications for the effects of successful preventive strategies.

scholarly journals A Rare Case of Hypersensitivity Pneumonitis due to Florida Red Tide

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Raju Reddy ◽  
Nupur Verma ◽  
Tan-Lucien Mohammed
Keyword(s):  
Respiratory Tract ◽  
Algal Blooms ◽  
Lower Respiratory Tract ◽  
Hypersensitivity Pneumonitis ◽  
Red Tide ◽  
Upper Airway ◽  
Ground Glass ◽  
Red Tides ◽  
Airway Symptoms ◽  
History Of

Florida red tides occur annually due to proliferation of the marine dinoflagellate Karenia brevis, which produces neurotoxins known as brevotoxins. Inhalational exposure to brevotoxins usually results in upper airway symptoms only. Rarely does exposure lead to lower respiratory tract symptoms as in our case. We report a case of a 50-year-old man who presented with a 4-week history of dyspnea after exposure to the red tide. Computed tomography (CT) of the chest showed diffuse bilateral ground glass opacities and interstitial thickening. Bronchoalveolar lavage cultures and cytology were negative. The patient was started on steroids. Over the next few weeks, the patient’s symptoms resolved. Repeat CT chest showed complete resolution of the ground glass opacities. Steroids were then tapered. Most patients who are exposed to algal blooms have self-limiting symptoms. Patients with asthma are particularly susceptible to worsening respiratory symptoms after exposure to brevotoxin aerosols. This case highlights that, in rare cases, exposure to red tide can results in severe lower respiratory tract symptoms.

Approach to the Patient with Cough

2018 ◽  
Author(s):  
Christopher H. Fanta
Keyword(s):  
Respiratory Tract ◽  
Chronic Cough ◽  
Lower Respiratory Tract ◽  
Airflow Obstruction ◽  
Sensory Nerve ◽  
Lung Parenchyma ◽  
Flow Volume ◽  
Respiratory Compromise ◽  
Cough Reflex ◽  
Persistent Cough

The cough reflex is critically important in the clearance of abnormal airway secretions and protection of the lower respiratory tract from aspirated foreign matter. A weak or ineffective cough can lead to respiratory compromise from even a relatively minor bronchial infection. Persistent cough is often one of a constellation of symptoms indicative of respiratory disease—a potential clue in the differential diagnosis of the patient’s illness. Given the widespread distribution of sensory nerve endings of the cough reflex throughout the upper and lower respiratory tract, it is not surprising that myriad respiratory diseases, involving lung parenchyma and airways, can manifest with cough. Sometimes cough is the sole or predominant symptom in a patient who is otherwise well. Evaluating and treating the patient with persistent cough who has few, if any, other respiratory symptoms is a common challenge for the practicing physician. This review covers the normal cough mechanism, impaired cough, pathologic cough, cough suppressant therapy, and new developments. Figures show a flow-volume loop during cough, a posteroanterior chest x-ray in a patient presenting with chronic cough, flow-volume curves and spirograms documenting expiratory airflow obstruction, and the approach to the patient with chronic cough. The table lists selected examples of extrapulmonary physical findings of potential importance in the assessment of cough. This review contains 4 highly rendered figures, 1 table, and 94 references.

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