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At least 811 records · Page 45Linked to original sources
PubMed2000

IgE-mediated sensitization to mould allergens among patients with allergic respiratory diseases in a desert environment.

BACKGROUND: The importance of fungal allergens in the development of allergic diseases in a desert environment is uncertain. This study evaluated the prevalence of IgE sensitization to moulds among patients with allergic respiratory diseases in Kuwait - a desert country. METHODS: A total of 810 patients (male:female ratio 1.4) with a mean age of 32.3 years (range 2-76 years) with extrinsic asthma or allergic rhinitis were studied. Sera from the patients were tested by the CAP-RAST method for specific IgE to 6 fungi (Penicillium, Cladosporium, Aspergillus, Candida, Alternaria and Helminthosporium). For comparison house dust mite and Bermuda grass were also assessed. RESULTS: The overall positivity to at least one mould was 20.9%. Among 120 matched control subjects, the value was 5. 8%. The value was much higher among patients with asthma alone (45. 8%) or both asthma and rhinitis (28.3%) than those with rhinitis alone (11.8%; p < 0.001). Asthmatic children had the highest sensitization rate (66.0% in the 7- to 12-year age group), which declined sharply with age. Among asthmatics, Candida and Aspergillus had the highest sensitization rates (23.1 and 21.3%, respectively), followed by Helminthosporium (18.8%), Cladosporium (15.9%), Alternaria (14.6%) and Penicillium (13.9%). The values for mite and Bermuda grass were 41.2 and 54.6%, respectively. Among asthmatic children, severe asthma was significantly more frequent among mould-positive (51.6%) than mould-negative patients (17.5%; p < 0. 0001). CONCLUSIONS: Even in this desert environment, sensitization to moulds is quite common among patients with allergic respiratory diseases, with a striking preponderance among children with asthma. Mould allergy could also be an important factor determining asthma severity in this environment.

Adolescent↗
PubMed1987

The efficacy of sulbactam-ampicillin in the therapy of respiratory disease associated with ampicillin resistant Pasteurella species in housed calves.

Sulbactam-ampicillin is a combination of sulbactam, a beta-lactamase inhibitor, and ampicillin, a broad spectrum beta-lactam antibiotic. The efficacy of sulbactam-ampicillin was evaluated in the treatment of calf respiratory disease associated with ampicillin-sensitive and ampicillin-resistant strains of Pasteurella haemolytica and Pasteurella multocida. Treatment with sulbactam-ampicillin was compared with treatment with ampicillin alone in 123 Friesian calves, between three and five weeks old, exhibiting clinical signs of respiratory disease. Seven of the 59 calves treated with ampicillin died whereas only one death occurred in the 64 calves treated with sulbactam-ampicillin. In the calves which survived, treatment with sulbactam-ampicillin resulted in a significantly better clinical response, as measured by the reduction in severity of clinical signs. The results of bacteriological examinations indicated that there was a marked increase in the proportion of ampicillin-resistant isolates of P haemolytica subsequent to treatment with ampicillin, whereas the proportion of ampicillin-resistant isolates of P. haemolytica recovered from calves treated with sulbactam-ampicillin had declined. The superior efficacy of sulbactam-ampicillin observed in this study is explained by the inhibitory effect of sulbactam on beta-lactamases produced by resistant bacteria, thus rendering them susceptible to the ampicillin.

Ampicillin↗
PubMed1985

Clinical and biological evaluation of semi-rush and ordinary immunotherapy schemes in type I allergic respiratory diseases.

Forty-three patients with type I allergic respiratory diseases received aqueous grass pollen immunotherapy in a prospective study designed to compare the clinical and biological effects of a semi-rush hyposensitization (20 patients) with ordinary hyposensitization (23 patients). Before the start of the therapy (end of previous grass pollen season, t1) and before (t2) and after the next grass pollen season (t3), total serum IgE (tIgE), grass pollen-specific IgE (GPsIgE), grass pollen-specific IgG (GPsIgG) and complement factors C3 and C4 were determined. GPsIgE and GPsIgG levels increased significantly more during immunotherapy in patients receiving the semi-rush scheme as compared with the ordinary scheme. There were no significant changes between the two schemes at any times for tIgE, C3 and C4. GPsIgG was already higher in allergic patients before the start of therapy as compared with non-allergic patients and controls. Clinical improvement was the same in patients treated with the semi-rush scheme as in the ordinary group. The number of side effects was not statistically different between the two groups. In neither group was there a correlation between the change in biological parameters and change in clinical symptoms. As the semi-rush scheme gives the same results immunologically as well as clinically, it could be used in a number of patients since it reduces the time course of the initial therapy by about 2 months.

Adult↗
PubMed1999

New mechanistic model for organic diisocyanate-induced respiratory disease.

The pathophysiological mechanisms of organic diisocyanate-induced respiratory disease remain largely unknown. Some 20% of patients have specific antibodies towards diisocyanate monomers whereas even in this circumstance their presence does not correlate very well with results in clinical provocation tests. The formation of diisocyanate haptens is the trigger for the immunological reactions. However, it is known that the reactions with protein and other macromolecules may be slow and hydrolysis of the isocyanate moities to corresponding amines as catalyzed by bicarbonate is more rapid. The liberated amines, or their intermediates, probably have an important role in the activation of tissue thromboplastin activator, loss of serum antitrypsin activity, and, finally, in neurogenic inflammation. Hypothetically, susceptible individuals probably include those which are slow acetylators of exogenous amines and carries of heterozygous antitrypsin phenotypes.

Humans↗
PubMedDate not supplied

[The virological study of a certified focus of acute respiratory diseases in a half-closed community].

An acute respiratory disease outbreak appeared during February and March 1988 in a half-closed community. Virologic investigations were conducted and an influenza virus type B strain was isolated, antigenically like B/Victoria 2/87. Administration of the anti-influenza vaccine in the fifth day of the outbreak evolution led to considerable reduction of the new cases and to outbreak extinction after 48 hours.

Acute Disease↗
PubMed1982

Distribution of immunoglobulin-containing cells in the bronchial mucosa of patients with chronic respiratory disease.

Bronchi biopsy specimens of 42 patients with chronic respiratory diseases were studied for immunoglobulin-containing cells, using an indirect immunoperoxidase technique. The number of immunocytes was expressed per unit tissue section surface. The cells were located directly under the epithelium. In most biopsy specimens IgA-, IgG- and IgM-containing cells were demonstrable, with IgA- and IgG-containing cells in the majority. IgE-containing cells were found only in small numbers in biopsy specimens of a few patients. The presence of IgE-containing cells was nearly always accompanied by a high amount of mast cell-bound IgE in the bronchial mucosa. No correlation could be found between the number and class of immunocytes and clinical data.

Adolescent↗
PubMed1996

[Is the bronchial provocation test justified in occupational respiratory disease?].

Specific bronchial provocation tests can confirm the diagnosis of occupational respiratory disease and also identify the causal agent of occupational asthma. The changes in French regulations established in 1993 which allow other agents to be recognized as causal in compensation for occupational diseases has increased interest in these tests. The different diagnostic methods used for occupational asthma are discussed here with special emphasis on limitations in each case: history taking, immunological investigations, respiratory function tests, measurement of peak flow during occupational activity and holidays, sequential measurements of non-specific bronchial hyperreactivity. The difficulty in standardizing specific provocation tests used for occupational asthma is related to the wide variety of causal agents which can be inhaled as gas, aerosols or powders. Because of the required precautions, these tests must be performed by specialized personnel in hospital units. There are also limitations to specific provocation tests. False positives require placebo tests and false negatives may result from insufficient identification of the causal agent. Exposure time may be too short or concentrations too low, and may depend on how long the causal agent has been evicted. Specific provocation tests may be avoided when the clinical history reveals a typical situation due to an agent known to cause occupational asthma and repeated peak flow measurements at the working site and/or immunological sensitisation tests provide objective evidence. But in a certain number of cases, specific investigations are required to obtain the precise etiological diagnosis required to evict the allergen rapidly and avoid chronic asthma.

Asthma↗
PubMed1994

[Volume pulse wave and respiratory diseases].

We always record the volume pulse wave and oxygen saturation by using a pulse oximeter. The volume pulse wave fluctuation was induced by respiration; we have used this phenomenon to diagnose or assess respiratory diseases. First, differential diagnosis of sleep disorders, that is, central apnea, obstructive apnea, and respiration in upper airway resistance, by using only a pulse oximeter. Second, we used this phenomenon to evaluate dyspnea. When a big volume pulse wave fluctuation exists, most patients feel dyspnea, if they are awake and alert. Then, we monitored coughs by recording the volume pulse wave. Due to the pleural pressure change induced by the cough, the volume pulse wave reveals a characteristic form. This form changes with the intensity of the cough. Then we can evaluate the frequency and intensity of the cough. For recording the volume pulse wave, the pulse oximeter will be widely applicable in respiratory diseases.

Asthma↗
PubMed1996

Respiratory disease as a result of talc inhalation.

Three cases of respiratory disease in workers with occupational exposure to talc containing asbestos fibers are reported. Standard chest roentgenographs, high-resolution computed tomography, respiratory function tests, morphologic study of bronchoalveolar lavage fluid (BAL), light microscopic examination, and mineralogical analysis by transmission electron microscopy (TEM) of BAL was performed. All subjects showed bilateral pleural plaques, and in two subjects the study of BAL revealed lymphocytic alveolitis with an increased T4/T8 ratio. Mineralogical analysis of BAL detected asbestos-fiber concentrations of 510, 2039, and 3392 fibers/mL and many asbestos bodies. In one patient, mineralogical analysis of lung tissue was also performed; a concentration of 3,659,000 fibers/g dry tissue was found. Simultaneously, we performed a mineralogical study of 12 commercial talc samples, including those used by the patients during the last phase of their working lives. TEM revealed asbestos fibers in five samples. Two subjects used two of these talc powders. The study presented here confirms the need to perform all relevant clinical tests together with the study of BAL and mineralogical analysis of the materials to which the patients are or were exposed to determine occupational exposure to fibers, including those associated with talc, which are often misidentified.

Air Pollutants, Occupational↗
PubMed1993

Preliminary characterization of a pleomorphic gram-negative rod associated with avian respiratory disease.

An unidentified, pleomorphic, gram-negative rod (PGNR) bacterium has been isolated from domestic fowl with respiratory disease. The PGNR was isolated in 5% of turkey accessions and 3% of chicken accessions, primarily from the respiratory tract. Preliminary characterization of this organism included reviewing accession records, conducting cultural and biochemical tests, and analyzing cellular fatty acids. The PGNR was also compared with other bacteria capable of inhabiting the avian respiratory system. Biochemical and cellular fatty acid analysis failed to identify the organism, however all 14 isolates were similar.

Animals↗
PubMedDate not supplied

Muscle fibre types in costal and crural diaphragm in normal men and in patients with moderate chronic respiratory disease.

Histochemical muscle fibre composition of human costal and crural diaphragm was determined in biopsies sampled during surgical procedures. Two groups were studied: 10 subjects with normal lung function and 8 patients with chronic obstructive respiratory disease. Muscle fibres were classified as type I (slow twitch) or type II (fast twitch) on the basis of their myofibrillar ATPase pH lability. There was no significant difference in fibre proportions between costal diaphragm (COD) and crural diaphragm (CRD) for both groups of subjects. Yet, in the normal group, the diameters of both types of fibres were larger in COD than in CRD. The diameters of both types of fibres of the obstructive patients were significantly decreased in COD as compared to the normals. Moreover, linear correlations between type I and II fibre diameters and VC, FEV1, FEV1/VC, and body weight were found in COD and not in CRD. The differences found in muscle fibre size support the idea that the mechanical respiratory load is different for COD and CRD, COD being the more important force generator. Chronic obstructive respiratory disease causes a significant decrease in COD fibre size but does not affect CRD.

Adult↗
PubMed1992

NIH conference. Respiratory disease in the immunosuppressed patient.

Pulmonary complications, both infectious and noninfectious, are an important cause of morbidity in patients with various types of immunosuppression. The appropriate response to these clinical problems requires an understanding of pulmonary host defense and of the various types of systemic immunosuppression. Infectious and noninfectious pulmonary complications may vary according to the type of immunosuppression as well as to the degree and duration of immunosuppression. Appropriate clinical management also requires an understanding of the clinical problems commonly seen in specific groups of immunosuppressed patients and an understanding of the sensitivity, specificity, and potential complications associated with the available diagnostic approaches to those patients. Because respiratory disease in these patient groups may progress rapidly to respiratory failure, an expeditious evaluation based on the knowledge of likely causes of respiratory disease and prompt specific or empiric therapy are indicated. Specific sets of algorithms for the evaluation of both focal and diffuse pulmonary disease may facilitate such an evaluation. In addition, an aggressive approach to the prevention of pulmonary disease including immunization, prophylaxis, and immunomodulation (for example, colony stimulating factors) may be warranted in specific subgroups at risk.

Algorithms↗
PubMed1986

Clinical, microbiological and pharmacokinetic studies on ofloxacin in acute purulent exacerbations of chronic respiratory disease.

Thirty hospital patients with acute purulent exacerbations of chronic respiratory disease were treated with 400 mg ofloxacin by mouth either once or twice daily for ten days. Studies on concomitantly administered theophylline showed no significant accumulation. Most sputum cultures no longer yielded pathogens at the end-of-treatment, but some Pseudomonas aeruginosa strains persisted. Clinical results were usually excellent at the end of treatment (26/30 patients) and excellent or good a week later (24/30), although they were better in the patients receiving once daily dosage. One patient developed a maculopapular drug rash which disappeared when ofloxacin was discontinued.

Adult↗
PubMed1996

In corticosteroid-treated respiratory diseases, monofluorophosphate increases lumbar bone density: a double-masked randomized study.

The efficacy of a monofluorophosphate-calcium combination (MFP-Ca) in increasing lumbar bone mineral density (BMD) was assessed in a prospective double-masked study. Patients (n = 35), who had been treated for 1 year or more with prednisone-equivalent doses > or = 7 mg/day for asthma or other respiratory diseases, were randomly assigned to receive twice a day, for 2 years, either one MFP-Ca tablet [100 mg sodium monofluorophosphate (13.2 mg F-) + 500.5 mg Ca2+] or one Ca tablet (500.5 mg Ca2+). BMD was measured from L2 to L4 using a dual photon absorptiometer. The eligible patients (7 premenopausal women, 21 men), who had no previous vertebral fractures and were aged 46.5 (21-65) years, had received 18 (7.5-60) mg prednisone-equivalent/day and had a mean lumbar BMD of 0.917 +/- 0.141 g/cm2 at baseline (MO); in these 28 patients, the mean increase in lumbar BMD at final assessment was significantly greater in the MFP-Ca group (p = 0.05; Mann-Whitney). There was also a significant difference after 2 years between the two groups (p = 0.05, ANOVA) in favour of MFP-Ca, with an increase in lumbar BMD of 11% (MFP-Ca) compared with 1% (Ca); thus, with MFP-Ca, lumbar BMD increased by an average of approximately 5.5%/year. There was no statistically significant difference between the two groups in doses of corticosteroids used during the 2 study years, rate of vertebral fractures, or frequency of side-effects (which were all minor). No bone fissure was observed. Thus, the daily dose of 200 mg monofluorophosphate (26.4 mg F-) combined with 1 g Ca2+ in patients with long-term corticosteroid-treated respiratory diseases appears to be a safe and efficient way of increasing lumbar BMD, suggesting that its use should be further studied in corticosteroid-induced osteoporosis.

Absorptiometry, Photon↗
PubMedDate not supplied

Clinical efficacy of meloxicam (Metacam) and flunixin (Finadyne) as adjuncts to antibacterial treatment of respiratory disease in fattening cattle.

The clinical efficacy of two non-steroidal anti-inflammatory drugs (NSAIDs), meloxicam (Metacam 20 mg/ml) and flunixin meglumine (Finadyne), as adjuncts to antibacterial therapy in the treatment of acute febrile respiratory disease in cattle was compared. The randomised blind, positive controlled study was conducted under feedlot conditions in Mexico. Overall, 201 female cattle (weighing 220-250 kg) diagnosed with bronchopneumonia at the feedlot were recruited into the study. On Day 0 all animals were treated with 20 mg oxytetracycline/kg body-weight (Bivatop 200) by subcutaneous injection, in conjunction with either meloxicam (0.5 mg/kg subcutaneously, Metacam 20 mg/ml, n = 100), or flunixin meglumine (2.2 mg/kg intravenously, Finadyne, n = 101). According to label instructions, meloxicam was administered as a single dose, whereas flunixin meglumine could be administered daily for up to 3 consecutive days depending on the rectal temperature (with re-administration, if rectal temperature > or = 40.0 degrees C). Rectal temperature, respiratory rate, appetite, dyspnoea, coughing, nasal discharge and general condition were recorded on Days 0 (prior to treatment), 1, 2, 3 and 7 using a weighted numerical score. Scores were summed to generate a 'Clinical Sum Score' (CSS, range 7 to 24 points). Individual animal body weights were measured on Days 0 and 7. Nasal swabs were collected from 10 animals per treatment group on Day 0 for microbiological culture. Clinical parameters and the mean CSS showed no significant differences between treatment groups with mean CSS on Days 0 and 7 of 16.18 and 10.55 in the meloxicam group and 16.41 and 10.88 in the flunixin meglumine group. However, a significantly lower mean rectal temperature was measured in the meloxicam group on Day 2 (p < or = 0.01). No significant differences in mean body weights were found between groups. Repeated administration of flunixin meglumine was performed in 45% of the animals. No suspected adverse drug events related to treatments were reported. It is concluded that a single subcutaneous dose of meloxicam was as clinically effective as up to 3 consecutive daily intravenous doses of flunixin meglumine when used as an adjunctive therapy to antibacterial therapy in the treatment of acute febrile respiratory disease in feedlot cattle.

Animals↗