RESUMEN
Wheezing in acute respiratory infections is a rule rather than exception. A large proportion of children (up to 75%) having ‘pneumonia’ or ‘severe pneumonia’ as per WHO definitions have associated wheezing. The current strategies to diagnose and manage wheeze in the community need to be updated, as audible wheeze is present in only less than one-third of wheezy children, and can not be relied upon solely. A history of previous episodes of respiratory distress has a high sensitivity to diagnose wheezy disorders. In a significant proportion of children, the respiratory rate comes back to normal and the chest indrawing disappear after two to three cycles of inhaled bronchodilator medications. Operational research is needed to evaluate the feasibility of including management of wheezing in the community based ARI management programs.
RESUMEN
Objective To investigate the relationship between bronchoalveolar lavage fluid (BALF) levels of interleukin (IL)-6, IL-8 and child bacterial pneumonia. Methods BALF levels of IL-6, IL-8 were detected by enzyme linked immunosorbent assay (ELISA) in 26 patients with bacterial pneumonia and 14 controls. Neutrophils and alveolar macrophages (AMs) of BALF were examined. Results BALF levels of IL-6, IL-8, total cell count and neutrophils of child bacterial pneumonia before treatment were significantly higher than those of pneumonia after treatment and controls (P<0.01). BALF levels of IL-6, IL-8 were significantly higher in Gram-negative infection than those in Gram-positive infection (P<0.01). BALF level of IL-6 showed positive correlation with AMs in pneumonia (r=0.7615, P<0.01). BALF level of IL-8 was correlated positively with neutrophils and AMs respectively in pneumonia (r=0.8956, r=0.6018, P<0.01). Conclusions IL-6 and IL-8 play the roles in the development of airway inflammation in child bacterial pneumonia. Detection of BALF levels of IL-6 and IL-8 is valuable to predict the state of child bacterial pneumonia.
RESUMEN
OBJECTIVE To investigate the pathogenic causes of community acquired pneumonia(CAP) in the elderly and to guide experience antibiotic therapy.METHODS An etiological study was performed on 204 elder patients with CAP in the Cadres Medical Department of Beijing Shijitan Hospital from May 2005 to Apr 2008.The count scores were by CURB-65 scoring system.RESULTS Pathogens were identified in 204 patients: there were Mycoplasma pneumoniae(42,20.6%),Streptococcus pneumoniae(30,14.7%),Haemophilus influenzae(24,11.8%),Chlamydia pneumoniae(17,8.3%),Klebsiella pneumoniae(14,6.9%),Escherichia coli(7,3.4%),Pseudomonas aeruginosa(5,2.5%),Staphylococcus aureus(4,2.0%),Legionella pneumophila(2,1.0%),and Acinetobacter baumannii(1,0.5%).The score,by CURB-65 scoring system,of mixed infected patients was higher than single infections.CONCLUSIONS Atypical pathogens have important role in elderly CAP,the most common pathogenare Gram-negative bacilli,S.aureusand fungi.Mixed infection couldn′t be ignored.