Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 5.172
Filtrar
1.
Ann Otol Rhinol Laryngol ; 129(1): 82-86, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31522522

RESUMO

OBJECTIVE: The identification of rare sources of laryngeal infection in immunocompetent patients. Recovered organisms were Mycobacterium tuberculosis (laryngeal tuberculosis [LTB]), Mycobacterium fortuitum (laryngeal Mycobacterium fortuitum [LMF]), and Blastomyces dermatiditis (laryngeal blastomycosis [LB]). METHOD: Single institution retrospective case series of three patients over a 2.5-year period and review of the literature on laryngeal infections by three atypical organisms. RESULTS: Three patients presented with hoarseness and cough; one additionally had throat pain (LTB). Indirect laryngoscopy demonstrated diffuse laryngeal ulceration (LTB, LMF) and an exophytic, contiguous glottic mass (LB). Direct microlaryngoscopic biopsies and cultures established the diagnoses, including a frozen section in one case (LB), which prevented a simultaneously planned surgical resection. Appropriate antimicrobial therapy yielded dramatic laryngeal and corresponding vocal improvement, for which we provide unique photo and audio documentation. In the last 10 years, fewer than 500 cases of LTB have been reported in the English language medical literature, principally outside the United States. To date, there have been reports of only 34 LB and no cases of LMF. CONCLUSION: Atypical infections of the larynx may be localized and mimic laryngeal cancer on endoscopy. Tissue examination as well as microbiologic samples are diagnostic and complementary.


Assuntos
Blastomicose/diagnóstico , Neoplasias Laríngeas/diagnóstico , Laringoscopia , Infecções por Micobactéria não Tuberculosa/diagnóstico , Tuberculose Laríngea/diagnóstico , Adulto , Biópsia , Blastomyces , Blastomicose/complicações , Blastomicose/patologia , Tosse/etiologia , Técnicas de Cultura , Diagnóstico Diferencial , Feminino , Rouquidão/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Micobactéria não Tuberculosa/complicações , Infecções por Micobactéria não Tuberculosa/patologia , Mycobacterium fortuitum , Infecções Respiratórias/complicações , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/patologia , Tuberculose Laríngea/complicações , Tuberculose Laríngea/patologia
2.
BMC Infect Dis ; 19(1): 976, 2019 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-31747890

RESUMO

BACKGROUND: Diagnosing pneumonia can be challenging in general practice but is essential to distinguish from other respiratory tract infections because of treatment choice and outcome prediction. We determined predictive signs, symptoms and biomarkers for the presence of pneumonia in patients with acute respiratory tract infection in primary care. METHODS: From March 2012 until May 2016 we did a prospective observational cohort study in three radiology departments in the Leiden-The Hague area, The Netherlands. From adult patients we collected clinical characteristics and biomarkers, chest X ray results and outcome. To assess the predictive value of C-reactive protein (CRP), procalcitonin and midregional pro-adrenomedullin for pneumonia, univariate and multivariate binary logistic regression were used to determine risk factors and to develop a prediction model. RESULTS: Two hundred forty-nine patients were included of whom 30 (12%) displayed a consolidation on chest X ray. Absence of runny nose and whether or not a patient felt ill were independent predictors for pneumonia. CRP predicts pneumonia better than the other biomarkers but adding CRP to the clinical model did not improve classification (- 4%); however, CRP helped guidance of the decision which patients should be given antibiotics. CONCLUSIONS: Adding CRP measurements to a clinical model in selected patients with an acute respiratory infection does not improve prediction of pneumonia, but does help in giving guidance on which patients to treat with antibiotics. Our findings put the use of biomarkers and chest X ray in diagnosing pneumonia and for treatment decisions into some perspective for general practitioners.


Assuntos
Biomarcadores/análise , Pneumonia/diagnóstico , Infecções Respiratórias/diagnóstico , Adulto , Idoso , Antibacterianos/uso terapêutico , Proteína C-Reativa/análise , Calcitonina/análise , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Países Baixos , Pneumonia/complicações , Pneumonia/tratamento farmacológico , Atenção Primária à Saúde , Prognóstico , Estudos Prospectivos , Infecções Respiratórias/complicações , Infecções Respiratórias/tratamento farmacológico , Tórax/diagnóstico por imagem
3.
Medicine (Baltimore) ; 98(44): e17797, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689857

RESUMO

RATIONALE: Acute necrotizing encephalopathy (ANE) is a rapidly progressing disease associated with frequent neurologic sequelae and has poor prognosis. Currently, the diagnosis and treatment of ANE rely on neuroradiologic findings and offering supportive care. Here, we report the successful treatment of a teenager diagnosed with ANE using combination of high-dose methylprednisolone and oseltamivir. PATIENT CONCERNS: The patient, a 15-year-old female, presented with impaired consciousness and seizures secondary to acute upper respiratory tract infection. A series of brain magnetic resonance images (MRIs) were obtained toward establishing a possible diagnosis. DIAGNOSIS: Based on the history of presenting illness and subsequent brain MRI scans, the patient was diagnosed to be suffering from ANE. INTERVENTIONS: Following the diagnosis, the patient was placed on therapy comprising of high-dose methylprednisolone and oseltamivir. OUTCOMES: After treatment with methylprednisolone and oseltamivir for 15 days, the patient recovered nearly completely from ANE as confirmed by subsequent brain MRI scans. No complications or other emerging clinical symptoms were noted for the duration of follow-up that lasted 6 months. LESSONS: Contrary to common reports, ANE can occur beyond pediatric populations and its treatment should not be restricted to supportive care. Our case suggests that the use of high-dose corticosteroids and oseltamivir leads to promising prognosis.


Assuntos
Encéfalo/diagnóstico por imagem , Encefalite Viral/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Infecções Respiratórias/complicações , Convulsões/diagnóstico por imagem , Adolescente , Corticosteroides/uso terapêutico , Antivirais/uso terapêutico , Encéfalo/patologia , Encéfalo/virologia , China , Encefalite Viral/tratamento farmacológico , Encefalite Viral/virologia , Feminino , Humanos , Necrose/diagnóstico por imagem , Necrose/virologia , Oseltamivir/uso terapêutico , Prognóstico , Infecções Respiratórias/virologia , Convulsões/patologia , Convulsões/virologia
4.
BMC Infect Dis ; 19(1): 862, 2019 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-31623573

RESUMO

BACKGROUND: Idiopathic CD4 lymphocytopenia (ICL) is a rare clinical disease with relative CD4 deficiency in the absence of HIV infection. The pathogenicity of ICL is poorly understood with an unclear incidence rate in the general population. Sequelae of ICL includes AIDS-defining infections, which most commonly includes Cryptococcus neoformans. Typically, C. neoformans infections present with CNS involvement but rarely with extra-CNS manifestations. Here, we present a rare case of ICL with exclusively primary pulmonary cryptococcus and a review of the literature. CASE PRESENTATION: A 56-year-old female presented to our tertiary care hospital requiring a right hip open reduction intervention. The patient became febrile during admission, prompting a work-up that included a chest X-ray showing a peripheral pulmonary solitary nodule. Transthoracic biopsy revealed encapsulated yeast forms in keeping with C. neoformans. CD4 counts, repeated at least one month apart, were < 200 cells/mm3, with negative HIV testing. Flow cytometry and genetic testing were completed to elucidate the etiology of the immune deficiency, both of which were unremarkable. She was subsequently treated with 12 months of posaconazole with clinical resolution. CONCLUSIONS: Our patient highlights a rare clinical disease, which a review of literature revealed only five cases in the literature with exclusive pulmonary Cryptococcus in ICL/ This case demonstrates the strong clinical acumen required to properly diagnose and ultimately manage the patient.


Assuntos
Criptococose/diagnóstico , Cryptococcus neoformans/isolamento & purificação , Linfopenia/diagnóstico , Infecções Respiratórias/diagnóstico , Antifúngicos/uso terapêutico , Contagem de Linfócito CD4 , Criptococose/tratamento farmacológico , Criptococose/microbiologia , Feminino , Humanos , Pulmão/microbiologia , Pulmão/patologia , Linfopenia/etiologia , Pessoa de Meia-Idade , Infecções Respiratórias/complicações , Infecções Respiratórias/tratamento farmacológico , Infecções Respiratórias/microbiologia , Tórax/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Triazóis/uso terapêutico
5.
Vestn Otorinolaringol ; 84(4): 17-21, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31579051

RESUMO

The purpose of the study is an experimental-theoretical study of the mechanisms of structuring the secretion of the nasal cavity, in the process of its dehydration in inflammatory diseases of the upper respiratory tract. The work shows the general patterns of dehydration of natural biological fluids and their model solutions. Simulation of dehydration of the secret allowed us to identify the most informative parameters of changes in its composition in pathology and to develop criteria for diagnosing the inflammatory process of the VDP using the wedge-shaped dehydration method. The study clarified the mechanisms of dehydration of biological fluid, which expanded the possibilities of diagnosing diseases of the VDP.


Assuntos
Desidratação , Inflamação , Cavidade Nasal , Infecções Respiratórias/complicações , Humanos , Laringe , Cavidade Nasal/fisiopatologia , Traqueia
6.
Zhonghua Er Ke Za Zhi ; 57(9): 705-709, 2019 Sep 02.
Artigo em Chinês | MEDLINE | ID: mdl-31530357

RESUMO

Objective: To characterize the clinical features and outcomes of scimitar syndrome (SS) to aid the understanding of this syndrome. Methods: This retrospective study included 6 children who were diagnosed with SS at the pediatric cardiovascular center of Beijing Anzhen Hospital from January 2012 to September 2018. SS was diagnosed by echocardiography and confirmed by cardiac computed tomography angiography(CTA) or surgery. All data were collected to analyze the clinical and imaging characteristics and prognosis. Results: Among the 6 SS children (aged 2 months to 15 years; 5 males) weighed 5.6-17.1 kg. Three cases were infant type, the clinical manifestations were recurrent respiratory tract infection with growth retardation, including 2 cases with severe pulmonary hypertension, while 3 cases with adult type, were asymptomatic. Cardiac CTA imaging showed that the right single or all pulmonary veins descended through the diaphragm and converged into the inferior vena cava. One case was isolated infracardiac partial anomalous pulmonary venous connection (PAPVC) without other malformations. The remaining 5 cases complicated with atrial septal defect, different vascular and trachea malformations as well as spinal malformations. Vascular malformations included pulmonary veins stenosis, abnormal origin of pulmonary artery branches, collateral branches of systemic artery supplying local lung tissue, and persistent left superior vena cava. The treatment varied according to the specific location of anomalous pulmonary venous connection, the degree of pulmonary hypertension and the severity of clinical symptoms. Four cases underwent one-stage radical surgery, one case accepted intervention to occlude the collateral artery which was supplying the right lower lung and received stage Ⅱ radical surgery half a year later, and the remaining one case died from pulmonary hypertension crisis preoperation. Conclusions: Isolated SS can easily miss diagnosis due to mild clinical symptoms. Patients with complicated malformations can benefit from combination therapy. SS associated with severe pulmonary hypertension can lead to early death. Therefore, early diagnosis and appropriate treatment can improve the prognosis of patients.


Assuntos
Anormalidades Múltiplas/diagnóstico , Síndrome de Cimitarra/diagnóstico , Adolescente , Criança , Pré-Escolar , Cardiopatias Congênitas/complicações , Cardiopatias Congênitas/diagnóstico , Comunicação Interatrial/complicações , Humanos , Lactente , Masculino , Artéria Pulmonar/anormalidades , Veias Pulmonares/anormalidades , Infecções Respiratórias/complicações , Estudos Retrospectivos , Síndrome de Cimitarra/etiologia , Síndrome de Cimitarra/mortalidade , Síndrome de Cimitarra/terapia
7.
Tuberk Toraks ; 67(2): 124-130, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31414643

RESUMO

Introduction: Exacerbations of chronic obstructive pulmonary disease (COPD) are often caused by respiratory tract infections. The aim of this study was to investigate the clinical, laboratory and computed tomography features of patients with hospitalized COPD exacerbations in which respiratory viruses were detected using a real-time polymerase chain reaction (PCR) technique. Materials and Methods: This retrospectively planned study included patients hospitalized in the chest diseases clinic due to exacerbation of COPD between November 2018-February 2019. The study included patients who had virus-specific real-time PCR, and computed tomography scans of the chest. Result: A total of 110 patients were included in the study. Respiratory viruses were identified in the nasopharyngeal swabs of 50 patients (45.5%) using the real-time PCR method, with rhinovirus (25%), influenza A (13.1%) and coronavirus (11.8%) being the most commonly isolated agents. The mean age of the patients was 68.28 ± 9.59 years in the virus-positive group and 68.20 ± 8.27 years in the virus-negative group (p= 0.963). Gender distribution, rate of smokers, exposure to biofuels, blood leukocyte count, neutrophil percentage, C-reactive protein (CRP) level, FEV1/FVC ratio did not significantly differ between the two groups (p> 0.05). Procalcitonin (PCT) and FEV1 values were significantly lower (p= 0.001 and p= 0.028, respectively) and the number of exacerbations was significantly higher in the virus-positive group (p= 0.001). The length of hospital stay was longer in the virus-positive group than in the virus-negative group (p= 0.012). Among the findings of computed tomography (CT) of the chest, bronchial wall thickening, cystic bronchiectasis, and emphysema did not differ significantly (p> 0.05). The rate of infiltrative lesions (tree-in-bud opacity, ground-glass opacity, atypical pneumonia) was significantly higher in the virus-positive group (p= 0.020). Conclusions: Viral respiratory tract infections should be considered in hospitalized patients with an exacerbation of COPD who have a history of frequent exacerbations, normal PCT value, and the absence of consolidation in CT scan of the chest. The use of broadspectrum antibiotic therapy should be avoided in patients with these features.


Assuntos
Doença Pulmonar Obstrutiva Crônica/complicações , Infecções Respiratórias/complicações , Viroses/complicações , Idoso , Bronquiectasia , Coronavirus/isolamento & purificação , Feminino , Humanos , Vírus da Influenza A/isolamento & purificação , Influenza Humana/complicações , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Nasofaringe/virologia , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Doença Pulmonar Obstrutiva Crônica/virologia , Reação em Cadeia da Polimerase em Tempo Real , Testes de Função Respiratória , Infecções Respiratórias/virologia , Estudos Retrospectivos , Rhinovirus/isolamento & purificação , Tomografia Computadorizada por Raios X , Viroses/virologia
8.
Arkh Patol ; 81(4): 39-42, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31407716

RESUMO

OBJECTIVE: To study placental morphometric parameters in women who have experienced mono- and mixed viral respiratory infections during pregnancy. SUBJECT AND METHODS: Three groups of placentas were studied. Group 1 consisted of 25 placentas from women with physiological pregnancy; Group 2 included 25 placentas from those who had experienced parainfluenza type 3; and Group 3 comprised 25 placentas from those who had mixed respiratory viral infection (parainfluenza type 3 concurrent with influenza A (H3N2)) in the second trimester of pregnancy. The weight of the placenta and its morphometric parameters were determined on hematoxylin and eosin stained tissue sections using a square multifaceted stereometric grid placed in the microscopic eyepiece (magnification 15×20). RESULTS: Group 3 versus Group 2 exhibited a reduction in placental weights along with an increase in the stroma, fibrinoid around the villi and in the stroma, pseudonecroses, calcification, intermediate immature villi, small avascular villi, and hemorrhages in the intervillous space and a decrease the volume of the circulatory bed. CONCLUSION: In women in the second trimester of pregnancy, mixed viral respiratory infection has a more pronounced negative impact on the formation of the placenta.


Assuntos
Placenta , Complicações Infecciosas na Gravidez , Infecções Respiratórias , Feminino , Humanos , Vírus da Influenza A Subtipo H3N2 , Placenta/patologia , Gravidez , Complicações Infecciosas na Gravidez/patologia , Infecções Respiratórias/complicações
9.
Acta otorrinolaringol. esp ; 70(4): 192-199, jul.-ago. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-185395

RESUMO

Introduction and objectives: Children up to 2 years old are at high risk of respiratory infections and nasal irrigation is often prescribed. Yet, to date there is no sufficient knowledge about its immediate effects on the nasopharynx and middle ear. Therefore, this study aimed to analyze the effect of a rhino-pharyngeal clearance intervention protocol on nasal obstruction and middle ear condition in children under 3 years of age with URTI. Materials and methods: Randomized controlled trial in a day-care centre of Porto, including 44 children randomized to Intervention Group (IG) and Control Group (CG). Nasal auscultation and tympanometry were performed at baseline (M0) as well as after the intervention (M1), which consisted of nasal irrigation (NaCl .9%) followed by a forced nasal inspiration in the IG, and after 30 min of normal activities, in the CG. Results: In M1 there was a lower frequency of children classified as having an obstructed nasal sound in the IG when compared to the CG (IG = 33.3%; CG = 68.4%; p = 0.042). We also observed an improvement of mean peak pressure (PP) in the IG (Left ear: M0 = -124daPa; M1 = -92daPa; p = 0.022. Right ear: M0 = -102daPa; M1 = -77daPa; p = 0.021), which was not observed in the CG (Left ear: M0 = -105daPa; M1 = -115daPa; p = 0.485. Right ear: M0 = -105daPa; M1 = -131daPa; p = 0.105). There were no significant results concerning the compliance of the tympanic membrane. Conclusions: The rhino-pharyngeal clearance improved the nasal obstruction and PP of the middle ear of children under 3 years of age with URTI


Introducción y objetivos: Los niños corren un alto riesgo de infecciones respiratorias superiores (IRS) y con frecuencia se prescriben irrigaciones nasales. Hasta hoy no hay suficiente conocimiento sobre sus efectos inmediatos en la nasofaringe y el oído medio. Por lo tanto, este estudio tuvo como objetivo analizar el efecto de un protocolo de intervención de limpieza nasal en la obstrucción y en el estado del oído medio de niños menores de 3 años con IRS. Material y métodos: Ensayo controlado aleatorizado en una guardería de Oporto, incluidos 44 niños asignados al Grupo de intervención (IG) y al Grupo de control (CG). La auscultación nasal y la timpanometría se realizaron al inicio (M0) y después de la intervención (M1), que consistió en irrigación nasal (NaCl 0,9%) seguido de una inspiración nasal forzada en IG, y después de 30 min de actividades normales en CG. Resultados: En M1 hubo una menor frecuencia de niños clasificados como con un sonido nasal obstruido en IG en comparación con CG (IG = 33,3%; CG = 68,4%; p = 0,042). También se observó una mejora de la presión máxima media (PP) en IG (oído izquierdo: M0 = -124daPa; M1 = -92daPa; p = 0,022; oído derecho: M0 = -102daPa; M1 = -77daPa; p = 0,021), que no se observó en CG (oído izquierdo: M0 = -105daPa; M1 = -115daPa; p = 0,485; oído derecho: M0 = -105daPa; M1 = -131daPa; p = 0,105). No hubo resultados significativos con respecto al cumplimiento de la membrana timpánica. Conclusiones: La limpieza nasal mejoró la obstrucción y la PP del oído medio de niños menores de 3 años con IRS


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Lavagem Nasal/métodos , Obstrução Nasal/terapia , Otite Média/terapia , Testes de Impedância Acústica , Lavagem Nasal/instrumentação , Obstrução Nasal/etiologia , Otite Média/diagnóstico , Otite Média/etiologia , Projetos Piloto , Infecções Respiratórias/complicações , Solução Salina/administração & dosagem , Índice de Gravidade de Doença , Resultado do Tratamento
10.
J Med Case Rep ; 13(1): 215, 2019 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-31303177

RESUMO

BACKGROUND: Recurrent respiratory papillomatosis is a chronic disease of viral origin affecting the larynx, trachea, and lower airways. Inverted papilloma, most commonly originating from the lateral nasal wall, is typically a single, expansile, locally aggressive tumor that remodels bone around the site of origin. CASE PRESENTATION: We report a case of histopathologically proven inverted papilloma occurring in a 50-year-old Caucasian man with recurrent respiratory papillomatosis affecting his nasal cavity, larynx, and trachea. This constitutes the first report of nasal involvement in recurrent respiratory papillomatosis. Viral in situ hybridization studies demonstrated evidence of human papillomavirus in both the septum and middle turbinate subsites. Repeat nasal excision with margin analysis is planned. CONCLUSIONS: This report emphasizes the importance of considering a broad differential diagnosis in patients with papillomata, and obtaining comprehensive histopathologic evaluation of lesions in multiple subsites in order to rule out inverted papilloma or overt malignant transformation, particularly if high-risk human papillomavirus (HPV) subtypes are identified. LEVEL OF EVIDENCE: 4.


Assuntos
Neoplasias Nasais/complicações , Papiloma Invertido/complicações , Infecções por Papillomavirus/complicações , Infecções Respiratórias/complicações , Transformação Celular Neoplásica/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Septo Nasal/patologia , Septo Nasal/cirurgia , Neoplasias Nasais/patologia , Neoplasias Nasais/cirurgia , Papiloma Invertido/patologia , Papiloma Invertido/cirurgia , Papillomaviridae/isolamento & purificação , Conchas Nasais/patologia , Conchas Nasais/cirurgia
11.
Intern Med ; 58(17): 2459-2465, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31178508

RESUMO

Objective Kikyo-to (KKT) is a fixed combination of glycyrrhiza root and platycodon root extracts. It is an herbal medicine traditionally used in Japan for relieving sore throat associated with acute upper respiratory tract infection (URTI). No controlled studies have yet demonstrated its effect, however. We investigated the efficacy of KKT on sore throat associated with acute URTI. Methods Patients with sore throat who were diagnosed with URTI at the General Medicine Department Office, Akashi Medical Center Hospital, between December 2017 and May 2018 were enrolled. Participants were randomly assigned to two groups at a 1:1 ratio, with stratification by age and sore throat score on a Visual Analogue Scale (VAS), to receive 2.5 g of either KKT or a placebo. Participants and investigators were blinded to group allocation. The primary outcome was the change in sore throat score on VAS 10 minutes after KKT administration. Secondary outcomes were the impact of the sore throat on daily life (none, mild, moderate, and severe) at 10 minutes after administration. Results Thirty-five participants were assigned to each group (n=70, total). The difference in the mean change of sore throat score according to VAS within 10 minutes between the two groups was not statistically significant (KKT 14.40 vs. placebo 17.00; p=0.39). The proportion of patients with a moderate or greater impact of their sore throat on their daily life was also not significantly different between the groups (KKT 22.9% vs. placebo 40.0%; p=0.20). Patients reported no side effects. Conclusion KKT did not significantly relieve sore throat associated with acute URTI compared with placebo.


Assuntos
Medicina Tradicional do Leste Asiático/métodos , Faringite/tratamento farmacológico , Faringite/etiologia , Preparações de Plantas/uso terapêutico , Infecções Respiratórias/complicações , Adulto , Método Duplo-Cego , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Fitoterapia , Preparações de Plantas/administração & dosagem , Preparações de Plantas/efeitos adversos , Fatores de Tempo
12.
Nat Microbiol ; 4(8): 1328-1336, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31110359

RESUMO

Epidemiological observations and animal models have long shown synergy between influenza virus infections and bacterial infections. Influenza virus infection leads to an increase in both the susceptibility to secondary bacterial infections and the severity of the bacterial infections, primarily pneumonias caused by Streptococcus pneumoniae or Staphylococcus aureus. We show that, in addition to the widely described immune modulation and tissue-remodelling mechanisms of bacterial-viral synergy, the virus interacts directly with the bacterial surface. Similar to the recent observation of direct interactions between enteric bacteria and enteric viruses, we observed a direct interaction between influenza virus on the surface of Gram-positive, S. pneumoniae and S. aureus, and Gram-negative, Moraxella catarrhalis and non-typeable Haemophilus influenzae, bacterial colonizers and pathogens in the respiratory tract. Pre-incubation of influenza virus with bacteria, followed by the removal of unbound virus, increased bacterial adherence to respiratory epithelial cells in culture. This result was recapitulated in vivo, with higher bacterial burdens in murine tissues when infected with pneumococci pre-incubated with influenza virus versus control bacteria without virus. These observations support an additional mechanism of bacteria-influenza virus synergy at the earliest steps of pathogenesis.


Assuntos
Aderência Bacteriana/fisiologia , Coinfecção , Interações Microbianas/fisiologia , Infecções Respiratórias/microbiologia , Infecções Respiratórias/virologia , Infecções Estafilocócicas/microbiologia , Infecções Estafilocócicas/virologia , Células A549 , Animais , Bactérias , Infecções Bacterianas/complicações , Infecções Bacterianas/microbiologia , Infecções Bacterianas/virologia , Modelos Animais de Doenças , Feminino , Humanos , Influenza Humana , Camundongos , Camundongos Endogâmicos BALB C , Infecções por Orthomyxoviridae/complicações , Infecções Respiratórias/complicações , Infecções Estafilocócicas/complicações , Staphylococcus aureus , Streptococcus pneumoniae
13.
Acta Otolaryngol ; 139(7): 643-646, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31124736

RESUMO

Background: Olfactory dysfunction is a common symptom during otolaryngology outpatient service. Objective: To explore the clinical effect of olfactory training on olfactory dysfunction after upper respiratory tract infection (URTI), and its influence factors. Material and methods: A total of 60 confirmed cases of URTI-induced olfactory dysfunction were enrolled into the present study. The olfactory training lasted for 24 weeks. These patients were tested using Sniffin' Sticks and threshold-discrimination-identification (TDI) composite scoring before treatment, and at 1, 3 and 6 months after treatment. Results: It was found that URTI-induced olfactory dysfunction patients had more evident deterioration in odor identification ability. The effective rates of olfactory training on olfactory dysfunction at 1, 3 and 6 months after treatment were 1.67%, 26.67% and 41.67%, respectively. The TDI scores at the 3rd and 6th months, but not at the 1st month, were significantly higher, when compared to those before treatment. The course of diseases was a significant influence factor on the therapeutic effect of olfactory training (OR = 0.805, 95% CI: 0.696-0.931). Conclusions: Olfactory training can efficiently cure URTI-induced olfactory dysfunction, and in particular, significantly improve the odor discrimination ability and odor identification ability. Significance: Providing useful data for further research regarding olfactory dysfunction.


Assuntos
Transtornos do Olfato/etiologia , Transtornos do Olfato/terapia , Educação de Pacientes como Assunto/métodos , Infecções Respiratórias/complicações , Adulto , Assistência Ambulatorial/métodos , Estudos de Coortes , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Transtornos do Olfato/fisiopatologia , Prognóstico , Recuperação de Função Fisiológica , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/tratamento farmacológico , Estudos Retrospectivos , Medição de Risco , Índice de Gravidade de Doença , Fatores de Tempo , Resultado do Tratamento
14.
Nutr Hosp ; 36(3): 538-544, 2019 Jul 01.
Artigo em Espanhol | MEDLINE | ID: mdl-30958689

RESUMO

Introduction: Introduction: obesity is related to a higher morbidity and mortality in adults with respiratory infections but in children the evidence is limited. Objective: to study the association between overweight and clinical course in children younger than two years of age, hospitalized for lower respiratory tract infections (LRTI). Methods: retrospective study reviewing clinical records of children hospitalized by LRTI from 2009 to 2015. Demographic data, anthropometry, nutritional status (World Health Organization [OMS] 2006 reference) and clinical course. Results: we included 678 patients with a median age of 9.9 (range: 6.4 to 14.7) months, 55% were boys and 67% had viral pneumonia (67%). Treatment: 54.7% received basic care, 98.7% oxygen therapy, 35.4% noninvasive ventilation (NIV), 26.1% antibiotics and 47.5% corticosteroids. Regarding nutritional status, 10% had undernutrition (W/Az ≤ -1 in infants or W/Hz in the older ones), 55.2% were eutrophic and 34.8% were overweight (ME, W/Hz ≥ +1). Boys with overweight had higher frequency of viral pneumonia (75.4% vs 60.2%, p = 0.014), need for more complex care (27.7% vs 19.9%, p = 0.018) and length of NIV (4,5 [3-5.5] vs. [2-5.5] days, p = 0.007) than eutrophic. Infants had longer time of NIV than the older ones. In girls, no associations were found between nutritional status and clinical course. Conclusions: in this sample of young children hospitalized with LRTI,obesity and overweight, masculine sex and younger age were associated to worse clinical outcomes.


Assuntos
Sobrepeso/epidemiologia , Infecções Respiratórias/epidemiologia , Antropometria , Progressão da Doença , Feminino , Hospitalização , Humanos , Lactente , Tempo de Internação , Masculino , Desnutrição/mortalidade , Estado Nutricional , Obesidade , Sobrepeso/complicações , Sobrepeso/mortalidade , Infecções Respiratórias/complicações , Infecções Respiratórias/mortalidade , Estudos Retrospectivos , Caracteres Sexuais
15.
BMC Bioinformatics ; 20(1): 191, 2019 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-30991939

RESUMO

BACKGROUND: Respiratory viral infections are a leading cause of mortality worldwide. As many as 40% of patients hospitalized with influenza-like illness are reported to be infected with more than one type of virus. However, it is not clear whether these infections are more severe than single viral infections. Mathematical models can be used to help us understand the dynamics of respiratory viral coinfections and their impact on the severity of the illness. Most models of viral infections use ordinary differential equations (ODE) that reproduce the average behavior of the infection, however, they might be inaccurate in predicting certain events because of the stochastic nature of viral replication cycle. Stochastic simulations of single virus infections have shown that there is an extinction probability that depends on the size of the initial viral inoculum and parameters that describe virus-cell interactions. Thus the coinfection dynamics predicted by the ODE might be difficult to observe in reality. RESULTS: In this work, a continuous-time Markov chain (CTMC) model is formulated to investigate probabilistic outcomes of coinfections. This CTMC model is based on our previous coinfection model, expressed in terms of a system of ordinary differential equations. Using the Gillespie method for stochastic simulation, we examine whether stochastic effects early in the infection can alter which virus dominates the infection. CONCLUSIONS: We derive extinction probabilities for each virus individually as well as for the infection as a whole. We find that unlike the prediction of the ODE model, for similar initial growth rates stochasticity allows for a slower growing virus to out-compete a faster growing virus.


Assuntos
Coinfecção , Modelos Biológicos , Modelos Estatísticos , Infecções Respiratórias , Viroses , Vírus , Biologia Computacional , Simulação por Computador , Humanos , Infecções Respiratórias/complicações , Infecções Respiratórias/virologia , Processos Estocásticos , Viroses/complicações , Viroses/virologia
16.
Int Rev Immunol ; 38(2): 70-78, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30939053

RESUMO

Asthma is a heterogeneous chronic respiratory disease characterized by an increased burden of infections. Respiratory tract infections associated with an increased risk for asthma especially when occurring in the first months of life, also represent the most common cause of asthma exacerbations. The association between asthma and the increased frequency of infections and microbiota dysbiosis might be explained by a common mechanism, such as an underlying immune system defect. Apart from the well-established association between primary immunodeficiencies and asthma, several alterations in the immune response following infection have also been observed in asthmatic patients. An impairment in lung epithelial barrier integrity exists and is associated with both an increased susceptibility to infections and the development of asthma. Asthmatic patients are also found to have a deficient interferon (IFN) response upon infection. Additionally, defects in Toll-like receptor (TLR) signaling are observed in asthma and are correlated with both recurrent infections and asthma development. In this review, we summarize the common pathophysiological background of asthma and infections, highlighting the importance of an underlying immune system defect that predispose individuals to recurrent infections and asthma.


Assuntos
Asma/etiologia , Síndromes de Imunodeficiência/complicações , Animais , Asma/metabolismo , Biomarcadores , Citocinas/metabolismo , Suscetibilidade a Doenças , Humanos , Mediadores da Inflamação/metabolismo , Infecções Respiratórias/complicações , Infecções Respiratórias/etiologia
17.
PLoS One ; 14(4): e0214647, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30934017

RESUMO

OBJECTIVE: To investigate the feasibility of CT-based quantitative airway and air-trapping measurements and to assess their correlation with pulmonary function in children with post-infectious bronchiolitis obliterans (PIBO). MATERIALS AND METHODS: This retrospective study approved by the institutional review board included chest CT scans and pulmonary function tests (PFT) completed between January 2005 and December 2016 in children diagnosed with PIBO. The quantitative analysis of segmental and subsegmental bronchi was performed on each chest CT scan, measuring the areas or diameters of lumens, walls, or the entire airway. The air-trapping volume (ATV), the volume of lung area exhibiting lower attenuation than the mean attenuation of normal and air-trapping areas, was also measured in each lobe. Comparison analyses between CT parameters and PFT results were performed with Pearson or Spearman correlation. RESULTS: In total, 23 patients were enrolled (mean age 7.0 ± 3.3 years; range, 4-15 years). We successfully measured 89.6% of all segmental bronchi. In the airway analysis, wall area showed a negative correlation with forced expiratory volume in one second (FEV1) in the majority of the pulmonary lobes. Air-trapping analyses demonstrated that ATV was negatively correlated with FEV1 and positively correlated with reactance at 5 Hz. CONCLUSION: Quantitative airway and air-trapping measurements from chest CT are feasible and correlate with pulmonary function in pediatric PIBO patients.


Assuntos
Bronquiolite Obliterante/diagnóstico , Bronquiolite Obliterante/etiologia , Pulmão/fisiologia , Infecções Respiratórias/complicações , Tomografia Computadorizada por Raios X/métodos , Adolescente , Bronquiolite Obliterante/fisiopatologia , Criança , Pré-Escolar , Estudos de Viabilidade , Feminino , Humanos , Pulmão/diagnóstico por imagem , Masculino , Valor Preditivo dos Testes , Radiografia Torácica/métodos , Testes de Função Respiratória/métodos , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/fisiopatologia , Estudos Retrospectivos
18.
Neumol. pediátr. (En línea) ; 14(1): 55-59, abr. 2019. graf, tab, ilus
Artigo em Espanhol | LILACS | ID: biblio-995747

RESUMO

Post-infectious bronchiolitis obliterans (PIBO) is a chronic obstructive bronchial disease that develops after a viral respiratory infection, acquired before 2 years of age. In Bogotá, Colombia our group published in 2017 the description and follow-up of 21 cases of this pathology. The purpose of this publication is to describe the evolution of 38 children with PIBO living in Bogotá, Colombia at 2640 m above sea level, with an average of 6.5 years of follow-up. The estimated prevalence of PIBO in the population group in the group studied here was at least 1 case per 10,526 children under 15 years of age. The highest frequency of oxygen dependence and pulmonary hypertension are highlighted in this group of children living at high altitude…


La bronquiolitis obliterante post-infecciosa (BOPI) es una enfermedad bronquial obstructiva crónica, que se desarrolla luego de una infección respiratoria viral, adquirida antes de los 2 años de vida. En Bogotá, Colombia nuestro grupo hizo en al año 2017 la descripción y seguimiento de 21 casos de esta patología. La presente publicación tiene como objetivo describir la evolución de 38 niños con BOPI que viven en la ciudad de Bogotá a 2640 m sobre el nivel del mar, con un segumiento de 6.5 años en promedio. Se calcula que la prevalencia de la enfermedad en el grupo poblacional de donde se refieren estos casos, es de al menos 1 caso por 10.526 menores de 15 años. Se destacan la mayor frecuencia de oxigeno dependencia e hipertensión pulmonar en este grupo de niños que viven a gran altura.


Assuntos
Humanos , Masculino , Feminino , Criança , Bronquiolite Obliterante/diagnóstico , Bronquiolite Obliterante/fisiopatologia , Bronquiolite Obliterante/epidemiologia , Testes de Função Respiratória , Infecções Respiratórias/complicações , Volume Expiratório Forçado , Prevalência , Seguimentos , Colômbia/epidemiologia , Altitude , Hipertensão Pulmonar
19.
Neumol. pediátr. (En línea) ; 14(1): 29-33, abr. 2019. ilus, graf
Artigo em Espanhol | LILACS | ID: biblio-995724

RESUMO

Bronchiolitis obliterans is a rare and severe chronic lung disease resulting from a lower respiratory tract injury. It may occur after a bone marrow or lung transplantation, infectious diseases, or less frequently after inhaling toxic substances or connective tissue diseases. Pathogenesis and molecular biology, as well as the best treatment of bronchiolitis obliterans, remain the subject of ongoing research. This review discusses our current knowledge of lung function of post-infectious bronchiolitis obliterans.


La bronquiolitis obliterante es una enfermedad pulmonar crónica rara y grave que resulta de una lesión del tracto respiratorio inferior. Puede ocurrir después de un trasplante de médula ósea o pulmón, enfermedades infecciosas, o menos frecuentemente después de inhalar sustancias tóxicas o después de enfermedades del tejido conectivo. La patogénesis y la biología molecular, así como el mejor tratamiento de la bronquiolitis obliterante, siguen siendo objeto de investigación. Esta revisión analiza nuestro conocimiento actual sobre la función pulmonar de los pacientes con bronquiolitis obliterante secundaria a infecciones.


Assuntos
Humanos , Lactente , Pré-Escolar , Criança , Adolescente , Infecções Respiratórias/complicações , Bronquiolite Obliterante/fisiopatologia , Prognóstico , Testes de Função Respiratória , Bronquiolite Obliterante/diagnóstico , Pulmão/fisiopatologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA