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1.
Rev. Ciênc. Méd. Biol. (Impr.) ; 20(4): 601-609, fev 11, 2022. tab
Article in Portuguese | LILACS | ID: biblio-1359371

ABSTRACT

Introdução: doenças crônicas como asma brônquica, alergias respiratórias ou doenças agudas recorrentes, como gripes, frequentemente acometem as crianças. Tais condições exigem o uso de medicamentos, normalmente sob a forma de xaropes, que podem se apresentar como genéricos ou de referência. A alta concentração em sacarose e o baixo pH dessas formulações, assim como o uso noturno e a falta de higienização após sua administração, são alguns fatores que podem contribuir para o potencial cariogênico e erosivo desses medicamentos. Objetivo: o objetivo deste estudo foi avaliar in vitro o potencial cariogênico e erosivo de xaropes infantis, de referência e genéricos, a partir de suas propriedades físico-químicas e identificar seus principais componentes a partir da análise de bulas e rótulos. Metodologia: foram analisados oito medicamentos de referência e os oito genéricos equivalentes, os quais foram avaliados quanto ao pH, a acidez titulável, a presença de sólidos solúveis totais (ºBrix) e a composição em sacarose e conservantes através da análise de bulas e rótulos. Resultados: constatou-se que 75% da amostra apresentou pH abaixo do crítico para desmineralização do esmalte dentário. A presença da sacarose e do ácido cítrico foi observada em 43,75% dos medicamentos, especialmente entre aqueles com altos valores de titulação. Conclusão: a maioria dos medicamentos apresentou pH abaixo do pH crítico para dissolução do esmalte dentário, havendo uma ampla variação da acidez titulável. As bulas dos medicamentos não informavam quanto ao risco de erosão dentária e de cárie, apesar da presença de sacarose em algumas formulações.


Introduction: chronic illnesses such as bronchial asthma, respiratory allergies or recurrent acute illnesses, such as the flu, often affect children. Such conditions require the use of medications, usually in the form of syrups, which can be presented as generic or reference ones. The high concentration of sucrose and the low pH of these formulations, as well as the night use and the lack of hygiene after its administration, are some factors that can contribute to the cariogenic and erosive potential of these drugs. Objective: the aim of this study was to evaluate in vitro the cariogenic and erosive potential of infant reference and generic syrups, based on their physical and chemical properties and to identify their main components from the analysis of package inserts and labels. Methodology: eight reference drugs and eight generic equivalents were analyzed, which were evaluated for pH, titratable acidity, the presence of total soluble solids (ºBrix) and the composition in sucrose and preservatives through the analysis of package inserts and labels. Results: it was found that 75% of the sample had a pH below the critical level for tooth enamel demineralization. The presence of sucrose and citric acid was observed in 43.75% of the drugs, especially among those with high titration values. Conclusion: most drugs had pH below the critical pH for tooth enamel dissolution, with a wide range of titratable acidity between them. The package inserts of the medications did not inform about the risk of dental erosion and caries, despite the presence of sucrose in some formulations.


Subject(s)
Humans , Child , Asthma , Tooth Erosion , Bronchitis , Pharmaceutical Preparations , Chronic Disease , Dental Caries
2.
Acta otorrinolaringol. cir. cabeza cuello ; 49(2): 112-120, 2021. TAB, ILUS, GRAF
Article in Spanish | LILACS | ID: biblio-1253865

ABSTRACT

Resumen Introducción: actualmente los profesionales de la salud se enfrentan al manejo de las vías aéreas artificiales en grupos pediátricos, esto requiere de cuidados delicados y mucha atención para detectar, establecer y manejar situaciones apremiantes; por esta razón, existe un mayor riesgo de aparición de infecciones bacterianas traqueopulmonares. El objetivo del estudio fue analizar la caracterización de las infecciones en pacientes pediátricos portadores de cánula de traqueotomía en las diferentes publicaciones científicas. Materiales y métodos: se realizó una revisión sistemática mediante la búsqueda de la literatura existente entre los años 2015-2020 en las bases de datos Elsevier, PubMed, Google Académico y SciELO, teniendo en cuenta los criterios de inclusión artículos en idioma inglés, español y población de edad entre los 0-15 años con infección de cánula de traqueotomía en los años 2015-2020. Resultados: de 258 artículos distribuidos en las bases de datos, se seleccionaron 21 artículos que cumplían con los criterios de inclusión. Conclusiones: a pesar de que en la actualidad existan criterios clínicos, factores de riesgo y pruebas de laboratorio asociados a infecciones de la cánula postraqueotomía en pacientes pediátricos, se requiere mayor investigación para definir las guías clínicas de manejo en la toma de decisiones médicas. Asimismo, se consideró como limitación importante la cantidad de literatura existente con respecto al tema.


Abstract Introduction: Currently, health professionals face the management of artificial airways in pediatric groups, this requires delicate care and a lot of attention to detect, establish and manage pressing situations, which is why there is a greater risk of tracheo-pulmonary bacterial infections. The objective was to analyze the characterization of infections in pediatric patients with tracheostomy tubes in the different scientific publications. Method: A systematic review of the literature was carried out between the years 2015-2020 in Elsevier, PubMed, Google Academic and SciELO databases, taking into account the inclusion criteria of the population aged 0-15 years in the years 2015-2020. The amount of existing literature on the subject was considered an important limitation. Results: From 258 articles distributed in the databases, 21 articles were selected that met the inclusion criteria. Conclusions: Although there are currently clinical criteria, risk factors and laboratory tests associated with infections of the post-tracheotomy tube in pediatric patients, further research is required to define clinical guidelines for management in medical decision-making.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Bacterial Infections/etiology , Tracheitis/microbiology , Tracheotomy/adverse effects , Bronchitis/microbiology , Cannula/adverse effects , Respiration, Artificial/adverse effects , Bacterial Infections/diagnosis , Bacterial Infections/drug therapy , Tracheitis/diagnosis , Tracheitis/drug therapy , Bronchitis/diagnosis , Bronchitis/drug therapy
3.
Rev. am. med. respir ; 20(3): 270-272, sept. 2020. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1123091

ABSTRACT

Paciente de 88 años que consultó por presentar tos productiva con expectoración mucopurulenta de 15 días de evolución. Equivalentes febriles. No refirió pérdida de peso ni inapetencia. Al examen clínico, cicatriz de toracotomía en el hemitórax izquierdo. A la auscultación, hipoventilación generalizada en ambas playas pulmonares, con rales subcrepitantes húmedos en base derecha. La Rx. de Tórax solicitada reveló en la playa pulmonar derecha, retracción lobular superior y en la playa izquierda, múltiples imágenes circulares y geométricas, que ocupaban campos pulmonares superior y medio. Signo de la columna vertebral desnuda por retracción de la imagen cardiovascular hacia dicho hemitórax en el campo inferior


Subject(s)
Humans , Bronchitis , Physical Examination , Thorax
4.
Medicina (B.Aires) ; 80(4): 397-400, ago. 2020. graf
Article in Spanish | LILACS | ID: biblio-1154836

ABSTRACT

Resumen La traqueobronquitis aspergilar es una forma poco frecuente de aspergilosis invasiva reportada excepcionalmente en el paciente inmunocompetente. Su diagnóstico es difícil, y los tratamientos propuestos hasta ahora son de escasa efectividad, todo lo cual constituye un verdadero problema para el equipo de salud. Presentamos el caso de una paciente de 28 años, inmunocompetente y sin antecedentes epidemiológicos, que desarrolló traqueobronquitis necrotizante por aspergilosis invasiva y recibió tratamiento con voriconazol con instilación local por broncoscopia con buena respuesta.


Abstract Aspergillus tracheobronchitis is a rare form of invasive aspergillosis reported exceptionally in the immunocompetent patient. Its diagnosis is difficult, and the treatments proposed so far are of little effectiveness, all of which constitute a real problem for the health team. We present the case of an immunocompetent 28 yearsold woman, with no epidemiological background, who developed necrotizing tracheobronchitis due to invasive aspergillosis and received voriconazole with local instillation by bronchoscopy with a good response.


Subject(s)
Humans , Female , Adult , Aspergillosis , Respiratory Tract Infections , Tracheitis , Bronchitis , Bronchoscopy , Antifungal Agents
6.
Article in Chinese | WPRIM | ID: wpr-828727

ABSTRACT

OBJECTIVE@#To study the clinical features of severe type 7 adenovirus pneumonia in children.@*METHODS@#A retrospective analysis was performed for the clinical data of children who were diagnosed with severe type 7 adenovirus pneumonia from February to June, 2019.@*RESULTS@#Among the 45 children, the male/female ratio was 3:2 and the median age was 14 months. All children had repeated fever, cough, and pulmonary moist rales, and the mean duration of fever was 14±4 days. The median time from fever to dyspnea was 8 days, and the time from fever to mechanical ventilation was 11.6±2.5 d. There was no significant increase in white blood cell count, with neutrophils as the main type. There were slight reductions in hemoglobin and albumin, while platelet and fibrinogen remained normal. There were increases in aspartate aminotransferase, lactate dehydrogenase, procalcitonin, and C-reaction protein. The detection rate of mixed pathogens was 84%. Effusion in both lungs was the major change on chest imaging (64%). Bronchoscopic manifestations were endobronchitis, tracheomalacia, and plastic bronchitis. The incidence rate of respiratory complications was 100%, and extrapulmonary complications mainly involved the circulatory system (47%), digestive system (36%), and nervous system (31%). Among the 45 children, 16 were administered with 400 mg/kg intravenous immunoglobulin (IVIG) daily for 5 days, with a mean duration of fever of 16±5 days, and 29 were administered with 1 g/kg IVIG daily for 2 days, with a mean duration of fever of 13±4 days; there was a significant difference in the mean duration of fever between the two groups (P=0.046). The overall mortality rate was 11%.@*CONCLUSIONS@#Severe type 7 adenovirus pneumonia in children has severe conditions, with a high incidence rate of complications and a high mortality rate, so it should be diagnosed and treated as early as possible.


Subject(s)
Adenoviridae , Bronchitis , Female , Fever , Humans , Infant , Male , Pneumonia, Viral , Retrospective Studies
7.
Rev. bras. ter. intensiva ; 31(4): 541-547, out.-dez. 2019. tab
Article in Portuguese | LILACS | ID: biblio-1058050

ABSTRACT

RESUMO As infecções do trato respiratório inferior associadas à ventilação mecânica são uma das complicações mais frequentes em pacientes em ventilação mecânica. Há muitos anos, a traqueobronquite associada à ventilação mecânica tem sido considerada uma doença que não demanda antibioticoterapia. Na última década, diversos estudos demonstraram que a traqueobronquite associada à ventilação mecânica deve ser considerada um processo intermediário que leva à pneumonia associada à ventilação mecânica, uma vez que apesar de ter impacto limitado sobre a mortalidade dos pacientes gravemente enfermos internados nas unidades de terapia intensiva, em contrapartida, demonstra associação significativa com o aumento dos custos hospitalares desses pacientes, assim como do tempo de internação na unidade de terapia intensiva e hospitalar, do uso de antibióticos, e da duração da ventilação mecânica. Embora ainda necessitemos de evidências científicas mais robustas, especialmente no que tange às modalidades terapêuticas, os dados atuais a respeito da traqueobronquite associada à ventilação mecânica salientam que há desfechos suficientemente importantes que exigem vigilância epidemiológica e controle clínico adequados.


ABSTRACT Ventilator-associated lower respiratory tract infection is one of the most frequent complications in mechanically ventilated patients. Ventilator-associated tracheobronchitis has been considered a disease that does not warrant antibiotic treatment by the medical community for many years. In the last decade, several studies have shown that tracheobronchitis could be considered an intermediate process that leads to ventilator-associated pneumonia. Furthermore, ventilator-associated tracheobronchitis has a limited impact on overall mortality but shows a significant association with increased patient costs, length of stay, antibiotic use, and duration of mechanical ventilation. Although we still need clear evidence, especially concerning treatment modalities, the present study on ventilator-associated tracheobronchitis highlights that there are important impacts of including this condition in clinical management and epidemiological and infection surveillance.


Subject(s)
Humans , Respiration, Artificial/adverse effects , Tracheitis/etiology , Bronchitis/etiology , Respiration, Artificial/methods , Respiratory Tract Infections/etiology , Respiratory Tract Infections/epidemiology , Tracheitis/epidemiology , Bronchitis/epidemiology , Pneumonia, Ventilator-Associated/epidemiology , Anti-Bacterial Agents/administration & dosage
8.
Rev. medica electron ; 41(2): 445-453, mar.-abr. 2019.
Article in Spanish | LILACS, CUMED | ID: biblio-1004280

ABSTRACT

RESUMEN La tos crónica en los adultos puede ser causada por muchas causas, existen cuatro principales: el síndrome de tos de la vía aérea superior, enfermedad por reflujo gastroesofágico, reflujo laringofaríngeo, asma bronquial, y bronquitis eosinofílica no asmática. Todos los pacientes deben evaluarse clínicamente con espirometria, y comenzar con tratamiento empírico. Otras causas potenciales incluyen el uso de inhibidores de la enzima convertidora de la angiotensina, cambios medioambientales, uso del tabaco, enfermedad pulmonar obstructiva crónica, y la apnea obstructiva del sueño. La radiografía del tórax puede orientar hacia causas infecciosas, inflamatorias, y malignas. Los pacientes con tos crónica refractaria pueden remitirse a la consulta especializada de un neumólogo u otorrinolaringólogo, además de un ensayo terapéutico con gabapentin, pregabalin, y psicoterapia.


ABSTRACT Although chronic cough in adults can be caused by many etiologies, four conditions account for most cases: upper airway cough syndrome, gastro-esophageal reflux disease, also known as laryngo- pharyngeal reflux disease, bronchial asthma, and non-asthmatic eosinophilic bronchitis. All patients should be evaluated clinically with spirometry, and empiric treatment should be initiated. Other potential causes include angiotensin-converting enzyme inhibitor use, environmental triggers, tobacco use, chronic obstructive pulmonary disease, and obstructive sleep apnea. Chest radiography can rule out concerning infectious, inflammatory, and malignant thoracic conditions. Patients with refractory chronic cough should be referred to a pulmonologist or otolaryngologist in addition to a therapeutic trial of gabapentin, pregabalin, and psychotherapy.


Subject(s)
Humans , Adult , Chronic Disease/epidemiology , Evidence-Based Medicine , Cough/diagnosis , Cough/etiology , Cough/psychology , Cough/drug therapy , Cough/therapy , Cough/epidemiology , Asthma/diagnosis , Bronchitis/diagnosis , Gastroesophageal Reflux/diagnosis , Pulmonary Disease, Chronic Obstructive/diagnosis , Pregabalin/therapeutic use , /therapeutic use
9.
Article in English | WPRIM | ID: wpr-762167

ABSTRACT

PURPOSE: Chronic cough in allergic rhinitis (AR) patients is common with multiple etiologies including cough variant asthma (CVA), non-asthmatic eosinophilic bronchitis (NAEB), gastroesophageal reflux-related cough (GERC), and upper airway cough syndrome (UACS). Practical indicators that distinguish these categories are lacking. We aimed to explore the diagnostic value of the fraction of exhaled nitric oxide (FeNO) and forced expiratory flow at 25% and 75% of pulmonary volume (FEF(25–75)) in specifically identifying CVA and NAEB in these patients. METHODS: Consecutive AR patients with chronic cough were screened and underwent induced sputum, FeNO, nasal nitric oxide, spirometry, and methacholine bronchial provocation testing. All patients also completed gastroesophageal reflux disease questionnaires. RESULTS: Among 1,680 AR patients, 324 (19.3%) were identified with chronic cough, of whom 316 (97.5%) underwent etiology analyses. Overall, 87 (27.5%) patients had chronic cough caused by NAEB, 78 (24.7%) by CVA, 16 (5.1%) by GERC, and 81 (25.6%) by UACS. Patients with either NAEB or CVA (n = 165, in total) were further assigned to a common group designated as CVA/NAEB, because they both responded to corticosteroid therapy. Receiver operating characteristic curves of FeNO revealed obvious differences among CVA, NAEB, and CVA/NAEB (area under the curve = 0.855, 0.699, and 0.923, respectively). The cutoff values of FeNO at 43.5 and 32.5 ppb were shown to best differentiate CVA and CVA/NAEB, respectively. FEF(25–75) was significantly lower in patients with CVA than in those with other causes. A FEF(25–75) value of 74.6% showed good sensitivity and specificity for identifying patients with CVA. CONCLUSIONS: NAEB, CVA, and UACS are common causes of chronic cough in patients with AR. FeNO can first be used to discriminate patients with CVA/NAEB, then FEF(25–75) (or combined with FeNO) can further discriminate patients with CVA from those with CVA/NAEB.


Subject(s)
Asthma , Bronchial Provocation Tests , Bronchitis , Cough , Eosinophils , Gastroesophageal Reflux , Humans , Methacholine Chloride , Nitric Oxide , Rhinitis, Allergic , ROC Curve , Sensitivity and Specificity , Spirometry , Sputum
10.
Article in English | WPRIM | ID: wpr-760363

ABSTRACT

Two infectious bronchitis virus (IBV) K046-12 and K047-12 strains were isolated and the nearly complete genomes of them were sequenced. Sequence comparisons showed that the K046-12 genome was most similar to Korean IBV strains, and the K047-12 genome was most similar to QX-like IBV strains. Phylogenetic analysis showed that nearly all K046-12 and most K046-12 genes were placed in the same cluster as Korean IBV isolates, but the S1 region was placed in the same cluster as Mass-type IBVs. For K047-12, nearly all K047-12 and most K047-12 genes were located in the same cluster as QX-like IBVs, but the M region was located in the same cluster as Korean IBV isolates with K047-12. Recombination analysis confirmed that K046-12 is a recombinant strain with the primary parental sequence derived from Korean IBVs and minor parental sequence derived from Mass-type IBV, and K047-12 is a recombinant strain with the major parental sequence derived from QX-IBV and minor parental sequence derived from Korean IBVs. This study showed that new IBV recombinants are constantly generated among various IBVs, including those used for vaccination. Therefore, genetic analysis of new virus isolates should be performed for effective infectious bronchitis control and appropriate vaccine development.


Subject(s)
Bronchitis , Genome , Humans , Infectious bronchitis virus , Korea , Parents , Recombination, Genetic , Vaccination
11.
Rev. Paul. Pediatr. (Ed. Port., Online) ; 36(2): 123-131, abr.-jun. 2018. tab
Article in Portuguese | LILACS | ID: biblio-957381

ABSTRACT

RESUMO Objetivo: Descrever o perfil clínico e o tratamento realizado nas crianças da etnia Guarani menores de cinco anos hospitalizadas por infecção respiratória aguda baixa (IRAB), residentes em aldeias nos estados do Rio de Janeiro ao Rio Grande do Sul. Métodos: Das 234 crianças, 23 foram excluídas (dados incompletos), sendo analisadas 211. Os dados foram extraídos dos prontuários por meio de formulário. Com base no registro de sibilância e padrão radiológico, a IRAB foi classificada em: bacteriana, viral e viral-bacteriana. Foi utilizada regressão multinomial para análise bivariada. Resultados: A mediana de idade foi de 11 meses. Do total da amostra, os casos de IRAB foram assim distribuídos: viral (40,8%), bacteriana (35,1%) e viral-bacteriana (24,1%). Verificou-se que 53,1% das hospitalizações não possuíam evidências clínico-radiológico-laboratoriais que as justificassem. Na análise de regressão multinomial, ao comparar a IRAB bacteriana com a viral-bacteriana, a chance de ter tosse foi 3,1 vezes maior na primeira (intervalos de 95% de confiança - IC95% 1,11-8,70) e de ter tiragem 61,0% menor (Odds Ratio - OR 0,39, IC95% 0,16-0,92). Na comparação da IRAB viral com a viral-bacteriana, a chance de ser do sexo masculino foi 2,2 vezes maior na viral (IC95% 1,05-4,69) e de ter taquipneia, 58,0% menor (OR 0,42, IC95% 0,19-0,92) na mesma categoria. Conclusões: Identificou-se maior proporção de processos virais do que processos bacterianos, bem como a presença de infecção viral-bacteriana. A tosse foi um sintoma indicativo de infecção bacteriana, enquanto a tiragem e a taquipneia apontaram infecção viral-bacteriana. Parte da resolubilidade da IRAB não grave ocorreu em âmbito hospitalar; portanto, propõe-se que os serviços priorizem ações que visem à melhoria da assistência à saúde indígena na atenção primária.


ABSTRACT Objective: To describe the clinical profile and treatment of Brazilian Guarani indigenous children aged less than five years hospitalized for acute lower respiratory infection (ALRI), living in villages in the states from Rio de Janeiro to Rio Grande do Sul. Methods: Of the 234 children, 23 were excluded (incomplete data). The analysis was conducted in 211 children. Data were extracted from charts by a form. Based on record of wheezing and x-ray findings, ALRI was classified as bacterial, viral and viral-bacterial. A bivariate analysis was conducted using multinomial regression. Results: Median age was 11 months. From the total sample, the ALRI cases were classified as viral (40.8%), bacterial (35.1%) and viral-bacterial (24.1%). It was verified that 53.1% of hospitalizations did not have clinical-radiological-laboratorial evidence to justify them. In the multinomial regression analysis, the comparison of bacterial and viral-bacterial showed the likelihood of having a cough was 3.1 times higher in the former (95%CI 1.11-8.70), whereas having chest retractions was 61.0% lower (OR 0.39, 95%CI 0.16-0.92). Comparing viral with viral-bacterial, the likelihood of being male was 2.2 times higher in the viral (95%CI 1.05-4.69), and of having tachypnea 58.0% lower (OR 0.42, 95%CI 0.19-0.92). Conclusions: Higher proportion of viral processes was identified, as well as viral-bacterial co-infections. Coughing was a symptom indicative of bacterial infection, whereas chest retractions and tachypnea showed viral-bacterial ALRI. Part of the resolution of non-severe ALRI still occurs at hospital level; therefore, we concluded that health services need to implement their programs in order to improve indigenous primary care.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Pneumonia/microbiology , Bronchitis/microbiology , Indians, South American , Pneumonia/diagnosis , Pneumonia/therapy , Respiratory Tract Infections/diagnosis , Brazil , Bronchitis/diagnosis , Bronchitis/therapy , Acute Disease , Cross-Sectional Studies
12.
Cienc. Serv. Salud Nutr ; 9(2): 7-13, abr. 2018.
Article in Spanish | LILACS | ID: biblio-980543

ABSTRACT

Introducción: La frecuencia de las enfermedades respiratorias en general y en particular la de las crónico degenerativas ha incrementado notablemente en los últimos años en nuestro país. La ceniza volcanica podría estar relacionada con este incremento, haciéndonos más susceptibles a padecerlas. El objetivo del presente estudio fue determinar la frecuencia de las patologías respiratorias en la población más expuesta a los efectos de la ceniza y demás gases emanados por el volcán Tungurahua. Metodología: En el presente se incluyeron 100 personas residentes en las comunidades más afectadas por la ceniza del volcán Tungurahua (Penipe, Puela, Manzano, Bayushig, El Altar), quienes fueron sometidos a una evaluación clínica, radiológica y espirométrica. Resultados: 37 (37 %) de las personas estudiadas fueron de género masculino y 63 (63 %) femenino. 50 pacientes es decir el 50 % fue sintomático respiratorio. El 64 % de pacientes presentó cambios radiológicos sugerentes de cambios bronquíticos. En la espirometría el 23 % de pacientes presentó un patrón restrictivo de leve a moderado. Conclusiones: La población expuesta a la ceniza del volcán Tungurahua mostró cambios radiográficos, clínicos y espirométricos indicativos de enfermedades respiratorias que posiblemente se deben a la exposición a la ceniza volcánica.


Introduction: Frequency of respiratory diseases in general and in particular chronic degenerative diseases have notably increased in recent years in our country. Volcanic ashes could play a role in this incrementent, making us more suscpetible to suffer them. The objective of the present study was to determine frequency of respiratory pathologies in the population most exposed to the effects of ash and other gases emanated from the Tungurahua volcano. Methodology: In the present study there were included 100 people who were residents of the comunities most affected by the ashes of the Tungurahua volcano (Penipe, Puela, Manzano, Bayushig, El Altar). People were subjected to clinical, radiological and spirometric evaluation. Results: 37 (37%) of the studied population were men and 63 (63%) were women. 50 patients (50%) reported respiratory symptoms. 64% of patients showed radiological changes which suggested bronchitic changes. Spirometric evaluation showed a mild to moderate restrictive pattern in 23% of patients. Conclusions: Population exposed to ash of the Tunguraua volcano showed clinic, radiographic and spirometric changes that suggest respiratory diseases which possibly are due to exposition to volcanic ashes.


Subject(s)
Humans , Adult , Middle Aged , Aged , Young Adult , Respiratory Tract Diseases , Spirometry , Bronchitis , Volcanic Ash (Disasters) , Rural Health , Ecuador
13.
Rev. bras. ter. intensiva ; 30(1): 80-85, jan.-mar. 2018. tab, graf
Article in Portuguese | LILACS | ID: biblio-899551

ABSTRACT

RESUMO O conceito de traqueobronquite associada à ventilação mecânica é controverso, e sua definição não é unanimemente aceita, sobrepondo-se, muitas vezes, à da pneumonia associada à ventilação mecânica. A traqueobronquite associada à ventilação mecânica tem incidência semelhante à da pneumonia associada à ventilação mecânica, com elevada prevalência de agentes multirresistentes isolados, condicionando um aumento do tempo de ventilação mecânica e de internação, ainda que sem impacto na mortalidade. A realização de culturas quantitativas pode permitir melhor definição diagnóstica da traqueobronquite associada à ventilação mecânica, possivelmente evitando o sobrediagnóstico desta entidade. Uma das maiores dificuldades na diferenciação entre traqueobronquite associada à ventilação mecânica e pneumonia associada à ventilação mecânica reside na exclusão de um infiltrado pulmonar por meio da radiografia do tórax; também podem ser necessárias a tomografia computadorizada torácica, a ultrassonografia torácica ou ainda a colheita de amostras invasivas. A instituição de terapêutica antibiótica sistêmica não demonstrou melhorar o impacto clínico da traqueobronquite associada à ventilação mecânica, nomeadamente na redução do tempo de ventilação mecânica, de internação ou mortalidade, apesar da eventual menor progressão para pneumonia associada à ventilação mecânica, ainda que existam dúvidas relativas à metodologia utilizada. Deste modo, considerando a elevada prevalência da traqueobronquite associada à ventilação mecânica, o tratamento desta entidade, por rotina, resultaria em elevada prescrição antibiótica sem benefícios claros. No entanto, sugerimos a instituição de terapêutica antibiótica em doentes com traqueobronquite associada à ventilação mecânica e choque séptico e/ou agravamento da oxigenação, devendo ser realizados simultaneamente outros exames auxiliares de diagnóstico para exclusão da pneumonia associada à ventilação mecânica. Após esta revisão da literatura, entendemos que uma melhor diferenciação entre traqueobronquite associada à ventilação mecânica e pneumonia associada à ventilação mecânica pode diminuir, de forma significativa, a utilização de antibióticos em doentes críticos ventilados.


ABSTRACT The concept of ventilator-associated tracheobronchitis is controversial; its definition is not unanimously accepted and often overlaps with ventilator-associated pneumonia. Ventilator-associated tracheobronchitis has an incidence similar to that of ventilator-associated pneumonia, with a high prevalence of isolated multiresistant agents, resulting in an increase in the time of mechanical ventilation and hospitalization but without an impact on mortality. The performance of quantitative cultures may allow better diagnostic definition of tracheobronchitis associated with mechanical ventilation, possibly avoiding the overdiagnosis of this condition. One of the major difficulties in differentiating between ventilator-associated tracheobronchitis and ventilator-associated pneumonia is the exclusion of a pulmonary infiltrate by chest radiography; thoracic computed tomography, thoracic ultrasonography, or invasive specimen collection may also be required. The institution of systemic antibiotic therapy does not improve the clinical impact of ventilator-associated tracheobronchitis, particularly in reducing time of mechanical ventilation, hospitalization or mortality, despite the possible reduced progression to ventilator-associated pneumonia. However, there are doubts regarding the methodology used. Thus, considering the high prevalence of tracheobronchitis associated with mechanical ventilation, routine treatment of this condition would result in high antibiotic usage without clear benefits. However, we suggest the institution of antibiotic therapy in patients with tracheobronchitis associated with mechanical ventilation and septic shock and/or worsening of oxygenation, and other auxiliary diagnostic tests should be simultaneously performed to exclude ventilator-associated pneumonia. This review provides a better understanding of the differentiation between tracheobronchitis associated with mechanical ventilation and pneumonia associated with mechanical ventilation, which can significantly decrease the use of antibiotics in critically ventilated patients.


Subject(s)
Humans , Tracheitis/drug therapy , Bronchitis/drug therapy , Anti-Bacterial Agents/therapeutic use , Respiration, Artificial/adverse effects , Tracheitis/diagnosis , Tracheitis/etiology , Bronchitis/diagnosis , Bronchitis/etiology , Critical Illness , Drug Resistance, Multiple, Bacterial , Diagnosis, Differential , Pneumonia, Ventilator-Associated/diagnosis , Pneumonia, Ventilator-Associated/drug therapy
15.
Article in Korean | WPRIM | ID: wpr-716015

ABSTRACT

PURPOSE: Lower respiratory tract infection (LRTI) is one of the most common causes of hospitalization in the pediatric population. In this study, we investigated the clinical characteristics of LRTI, particularly in low birth weight children. METHODS: We reviewed medical records of children at ages 0–6 years with LRTI in Korea University Anam Hospital between January and December of 2014. Clinical data including age, sex, birth history, viral pathogens, blood test results, and clinical courses were collected. RESULTS: In the 828 eligible cases, 617 (74.5%) were pneumonia and followed by bronchiolitis 180 (21.7%) and bronchitis 31 (3.7%). The median age of the subjects was 17 months (interquartile range [IQR], 7–28 months), the median gestational age was 39.0 weeks (IQR, 38.0–40.0 weeks) and the median birth weight was 3,200 g (IQR, 2,900–3,480 g). Sixty-four children (7.7%) were low birth weight (< 2,500 g) and their median gestational age and birth weight were 33.0 weeks (IQR, 30.0–36.0 weeks) and 2,045 g (IQR, 1,565–2,300 g), respectively. The rates of oxygen supplement (17.2% vs. 4.6%, P < 0.001) and systemic steroid use (20.3% vs. 4.7%, P < 0.001) were significantly higher in low birth weight children than normal birth weight children. Respiratory viruses were identified in 82.6% (519 of 628 subjects); RSV was detected in 240 subjects (38.2%), followed by rhinovirus 168 (26.8%) and adenoviruses 75 (11.9%). The distribution of respiratory viruses was not different between normal birth weight children and low birth weight children. CONCLUSION: Low birth weight children show more severe clinical manifestations than normal birth weight children during hospitalization for LRTI, although respiratory viral pathogens were not different. Clinicians should be aware that the severity may be increased when low birth weight children were hospitalized due to low respiratory tract infection.


Subject(s)
Adenoviridae , Birth Weight , Bronchiolitis , Bronchitis , Child , Gestational Age , Hematologic Tests , Hospitalization , Humans , Infant, Low Birth Weight , Infant, Newborn , Korea , Medical Records , Oxygen , Pneumonia , Reproductive History , Respiratory System , Respiratory Tract Infections , Rhinovirus
16.
Article in English | WPRIM | ID: wpr-715739

ABSTRACT

BACKGROUND: Chronic bronchitis (CB) is an important phenotype in chronic obstructive pulmonary disease (COPD). The purpose of this study is to evaluate different pattern of COPD assessment test (CAT) score between CB and non-CB patients. METHODS: Patients were recruited from 45 centers in Korea, as part of the Korean COPD Subgroup Study cohort. CB was defined when sputum continued for at least 3 months. RESULTS: Total 958 patients with COPD were eligible for analysis. Among enrolled patients, 328 (34.2%) were compatible with CB. The CAT score was significantly higher in patients with CB than non-CB, and each component of CAT score showed a similar result. CB was significantly associated with CAT score when adjusted with age, sex, modified Medical Research Council, and post-bronchodilator forced expiratory volume in 1 second. Each component of CAT score between patients with CB and non-CB showed different pattern according to Global Initiative for Chronic Obstructive Lung Disease grade. CONCLUSION: CAT score is significantly higher in patients with CB than non-CB. Each component of CAT score was significantly different between two groups.


Subject(s)
Animals , Bronchitis , Bronchitis, Chronic , Cats , Cohort Studies , Forced Expiratory Volume , Humans , Korea , Phenotype , Pulmonary Disease, Chronic Obstructive , Quality of Life , Sputum
17.
Article in Chinese | WPRIM | ID: wpr-774016

ABSTRACT

Objective To investigate the risk factors of asthma attack.Methods In this open cohort study,74 492 initially healthy subjects aged 20 years or more in a longitudinal multi-center health management cohort in Shandong province from January 2007 to December 2015 were enrolled in this study. These subjects had no baseline bronchial asthma or other chronic airway disease and did not migrate to other provinces in the past 10 years. All subjects were followed up till 2016,and the asthma attack and its influencing factors were analyzed. The baseline data including sociodemographic data,smoking history,disease histories,and family disease histories were collected and analyzed by Poisson regression analysis.Results The regression analysis showed that age between 40 and 50 years(RR=3.3,95%CI=1.8-6.0),female(RR=1.6,95%CI=1.1-2.3),nasal polyps(RR=9.5,95%CI=2.3-39.6),pneumonia(RR=6.5,95%CI=3.7-11.2),bronchitis(RR=8.7,95%CI=5.1-14.7),and chronic obstructive pulmonary disease(RR=6.6,95%CI=3.1-13.8) significantly increased the risk of asthma attack.Conclusion Age,gender,and previous histories of certain respiratory tract diseases increase the risk of asthma attack.


Subject(s)
Adult , Age Factors , Asthma , Diagnosis , Bronchitis , Cohort Studies , Female , Humans , Male , Middle Aged , Nasal Polyps , Pneumonia , Pulmonary Disease, Chronic Obstructive , Risk Factors , Sex Factors
18.
Article in Korean | WPRIM | ID: wpr-740684

ABSTRACT

Aspergillus infection is the most common cause of death due to fungi in immunocompromised hosts. Aspergillus tracheobronchitis is an uncommon but severe form of invasive pulmonary aspergillosis, which is limited entirely or mainly to the tracheobronchial tree and can often be life-threatening. We report a case of a 54-year-old man who died from Aspergillus tracheobronchitis without an underlying disease. Autopsy revealed an extensive yellowish plaque adhering to the trachea and bronchial wall. The microscopic examination of the trachea and bronchus revealed septate branching hyphae of Aspergillus.


Subject(s)
Aspergillus , Autopsy , Bronchi , Bronchitis , Cause of Death , Fungi , Humans , Hyphae , Immunocompromised Host , Invasive Pulmonary Aspergillosis , Middle Aged , Trachea , Tracheitis , Trees
19.
Article in English | WPRIM | ID: wpr-741854

ABSTRACT

A 6-year-old boy with underlying hemolytic anemia of unknown etiology, atopic dermatitis, and recurrent urticaria visited our hospital because of acute respiratory failure induced by influenza A. Despite mechanical ventilation after endotracheal intubation along with inhalation of nitric oxide, respiratory acidosis and hypoxemia persisted. Veno-venous extracorporeal membrane oxygenation (VV ECMO) insertion was performed to provide respiratory support. After performing flexible bronchoscopy, we found that thick mucus plugs were obstructing the right bronchus intermedius and the upper lobe orifice. After bronchial washing and removal of the plugs, we were able to wean the patient off VV ECMO and transfer him to the general ward. He was discharged without any neurologic or pulmonary sequelae.


Subject(s)
Acidosis, Respiratory , Anemia, Hemolytic , Hypoxia , Bronchi , Bronchitis , Bronchoscopy , Child , Dermatitis, Atopic , Extracorporeal Membrane Oxygenation , Humans , Influenza A virus , Influenza, Human , Inhalation , Intubation, Intratracheal , Male , Mucus , Nitric Oxide , Patients' Rooms , Plastics , Pneumonia , Respiration, Artificial , Respiratory Insufficiency , Urticaria
20.
Article in English | WPRIM | ID: wpr-741520

ABSTRACT

As animal welfare issue becomes important, the European Union bans conventional cages for laying hens from 2012. So the alternative housing systems like floor pens, aviaries or free range systems have been suggested. From 2011 to 2014, we monitored 20 welfare-oriented laying hen farms in South Korea to figure out serological status of major viral diseases. During this period, total 3,219 blood samples were collected from the randomly selected chickens to test and evaluate the hemagglutination inhibition titers for low pathogenic avian influenza, Newcastle disease and egg drop syndrome '76. A total of 2,926 blood samples were tested through enzyme linked immunosorbent assay (ELISA) to assess the serological status of infectious bronchitis (IB). The distribution of ELISA titers for IB was various from almost 0 to 20,000 through the all weeks of age. Also, the antibody coefficient of variation for most of the diseases in this study was higher than those of typical cage layers. As this study was the first surveillance for major avian viral diseases of the animal welfare-oriented farms in South Korea, the results obtained from this study will help to determine what information and resources are needed to maintain better biosecurity and to improve the health and welfare of laying hen flocks.


Subject(s)
Agriculture , Animal Welfare , Animals , Bronchitis , Chickens , Enzyme-Linked Immunosorbent Assay , European Union , Hemagglutination , Housing , Influenza in Birds , Korea , Newcastle Disease , Ovum , Sentinel Surveillance , Virus Diseases
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