RESUMEN
The role of atypical bacteria and the effect of antibiotic treatments in acute bronchitis are still not clear. This study was conducted at 22 hospitals (17 primary care clinics and 5 university hospitals) in Korea. Outpatients (aged > or = 18 yr) who had an acute illness with a new cough and sputum (< or = 30 days) were enrolled in 2013. Multiplex real-time polymerase chain reaction (RT-PCR) was used to detect five atypical bacteria. A total of 435 patients were diagnosed as having acute bronchitis (vs. probable pneumonia, n = 75), and 1.8% (n = 8) were positive for atypical pathogens (Bordetella pertussis, n = 3; B. parapertussis, n = 0; Mycoplasma pneumoniae, n = 1; Chlamydophila pneumoniae, n = 3; Legionella pneumophila, n = 1). Among clinical symptoms and signs, only post-tussive vomiting was more frequent in patients with atypical pathogens than those without (P = 0.024). In all, 72.2% of the enrolled patients received antibiotic treatment at their first visits, and beta-lactams (29.4%) and quinolones (20.5%) were the most commonly prescribed agents. In conclusion, our study demonstrates that the incidence of atypical pathogens is low in patients with acute bronchitis, and the rate of antibiotic prescriptions is high.
Asunto(s)
Femenino , Humanos , Masculino , Persona de Mediana Edad , Antibacterianos/uso terapéutico , Bordetella parapertussis/genética , Bordetella pertussis/genética , Bronquitis/tratamiento farmacológico , Chlamydophila pneumoniae/genética , Infecciones Comunitarias Adquiridas/microbiología , Hipertensión/complicaciones , Legionella pneumophila/genética , Mycoplasma pneumoniae/genética , Reacción en Cadena en Tiempo Real de la Polimerasa , República de Corea , Esputo/microbiologíaRESUMEN
It is well known that olfactory dysfunction relates to many etiologies such as obstructive nasal and sinus diseases, upper respiratory tract infections, head trauma, aging, congenital anomalies, endocrine diseases, drugs and so forth. Chronic paranasal sinusitis is the most common etiology of olfactory dysfunction. So, We studied the effect of the surgery on olfaction in patients with chronic paranasal sinusitis. A preoperative and postoperative evaluation of the olfactory function was carried out in 80 patients using the T and T olfactometer. All patients were divided into two groups-chronic paranasal sinusitis and chronic paranasal sinusitis with polyposis. According to the preoperative recognition threshold, olfactory function of all patients were divided into five groups. The group 1 was normal, group 2 was mild decreased, group 3 was moderate decreased, group 4 was severe decreased and group 5 was anosmia. Almost patients were improved on olfaction in the postoperative state. The olfactory fissure was usually closed in patients with nasal polyp. In the patients with closed olfactory fissure, recognition threshold was 4.9+/-1.5 and in opened olfactory fissure, 1.9+/-1.8. Therefore the olfactory fissure was the one of the most important factors on olfaction.