Endoscopic assessment of airway inflammation in horses.

BACKGROUND: Comprehensive endoscopic scoring of the upper and lower airways for inflammation has not been critically assessed among a large population of horses. The relationship between upper and lower airways described in humans by the "one airway, one disease" concept might also apply to horses. HYPOTHESIS/OBJECTIVES: To evaluate if an association exists between endoscopic inflammatory scores and mucus scores of upper and lower airways and to investigate if endoscopic findings correlate with the lower airway inflammation measured by bronchoalveolar lavage (BAL) cytology. METHODS: Prospective field study. Pharyngitis, pharyngeal mucus, tracheal mucus, tracheal septum thickness, and bronchial mucus were scored using new and previously described scoring systems on a convenience sample of 128 horses with and without lung inflammation. Based on BAL fluid cytology, horses were categorized as having normal, moderate, or severe inflammation of the lower airways. RESULTS: All 5 endoscopy scores showed excellent interobserver agreement. Tracheal mucus (P < .001), tracheal septum thickness (P = .036), and bronchial mucus (P = .037) were significantly increased in horses with severe inflammation BALs and were correlated among themselves but not with upper airways scores. BAL neutrophils percentage was correlated with tracheal mucus (r(s) = 0.41, P < .001), bronchial mucus (r(s) = 0.27, P = .003), and had a weak negative correlation with pharyngitis (r(s) = -0.25, P = .004). CONCLUSIONS AND CLINICAL IMPORTANCE: Lower airway endoscopy scores are reflective of lower airway inflammation; however, upper and lower airways are independent in terms of severity of inflammation. Therefore, observing upper airway inflammation is not an indication to test for lower airway inflammation.

[Chronic ENT pathology in employees of tobacco and pharmaceutical industries in conditions of small-dispersion pollution of the working zone air]. / KT visochnoi kosti v diagnostike priobretennoi kholesteatomy srednego ukha.

Incidence rate of chronic ENT diseases was compared in workers of tobacco and pharmaceutical industries. Using representative samples of workers employed in both industries exposed to industrial dust hazards, the rate and structure of chronic ENT pathology were compared. Damage to the upper airways (UA) consists in dystrophic changes in ENT mucosa (subatrophic isolated and combined forms). Chronic combined UA lesions in workers of the tobacco factories occur more frequently than in workers of pharmaceutical factories. It is necessary to conduct ENT examinations in applicants for jobs in factories with industrial dust hazards to detect basic diseases, especially in those with nasal septal defects and related respiratory problems.

[Serological assessment of destructive processes in the pharynx in conservative and cryosurgical treatment of patients with chronic hypertrophic laryngitis]. / Serologicheskaia otsenka destruktivnykh protsessov v glotke pri konservativnom i kriokhirurgicheskom lechenii bol'nykh khronicheskim gipertroficheskim faringitom.

The examination of 29 patients with chronic pharyngitis before the treatment, 10 and 30 days after treatment and 18 controls without ENT pathology revealed that the patients' blood and oral fluid contained the antigen inherent for pharyngeal tissue in 24.1 and 89.6% cases, respectively. This antigen was not found in the controls. The appearance of the tissue antigen in the blood and oral fluid may result from destruction of the inflammed tissue and may entail autoimmune reaction. 10 days after conservative anti-inflammatory treatment 12 patients exhibited a temporary clinical and serological effect--improvement of general condition, attenuation of destructive processes, blood and oral levels of the autoantigen and humoral autoimmune reaction to the tissue antigen. 20 days after the treatment clinical and laboratory manifestations renewed. 10 days after cryosurgery antigenemia and autoimmune reaction persisted but 30 days after the treatment the antigen was found neither in the blood nor in the oral fluid, autoimmune reaction declined. This indicates termination of the inflammation and correlates with clinical results.

Short course antibiotic therapy for respiratory infections: a review of the evidence.

BACKGROUND: The judicious use of antibiotics entails achieving the appropriate balance between prescribing them with sufficient frequency and duration to effect a clinical cure for bacterial infections and overprescribing them, a practice that increases prescription drug costs as well as the risks of bacterial resistance, noncompliance with therapy and side effects. The recognition that the traditional 10-day or greater duration of therapy for acute otitis media, tonsillopharyngitis and sinusitis does not derive from a strong scientific or medical rationale (with the exception of penicillin therapy for tonsillopharyngitis) and the increasing awareness of the adverse sequelae of long-duration antibiotic therapy have led some clinicians to call for shortening the duration of antibiotic therapy in these infections. The soundness of this recommendation hinges on the demonstration that shortened courses of antibiotic therapy are at least as effective as traditional courses of therapy. SYNOPSIS: Data relevant to determining the optimum duration of therapy in acute otitis media, tonsillopharyngitis and sinusitis are reviewed in this article. The review demonstrates particularly strong justification for shortening the duration of therapy from the standard 10 days to 5 days in acute otitis media, in which numerous open label and controlled studies have shown equivalent efficacy of the two durations of regimen. A growing body of evidence indicates that tonsillopharyngitis, too, can be effectively treated with non-penicillin antibiotics given for fewer than 10 days. Although sinusitis data are less plentiful than those for acute otitis media and tonsillopharyngitis, the results available to date are encouraging in suggesting that shortened courses of therapy may also be appropriate for acute maxillary sinusitis.