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PubMed1999

[Environment and serum IgE].

Immunobiological diagnosis of allergy by measurement of total and specific IgE (by the technique of the CAP System on UNICAP) remains very valuable, especially if it is possible to repeat the measurements to follow the development of the patient. Concerning an observation of one patient who presented a rhinotracheitis that developed over 10 years and was linked clinically to guinea pig hair, the measurement of total and specific IgE confirmed the diagnosis and favourable clinical development was corroborated by the significant parallel diminution of total and specific IgE.

Adult↗
PubMedDate not supplied

Effect of route of vaccination on the prevention of infectious laryngotracheitis in commercial egg-laying chickens.

Commercial egg-laying chickens were vaccinated for infectious laryngotracheitis (ILT) with one of five commercially available vaccines (designated A, B, C, D, and E) on five separate farms by either eyedrop (e), spray (s), or double dose in the water (w) method. Groups were identified by the vaccine designation and the method of vaccination. Birds from the test groups were transferred to an isolation facility and challenged intratracheally 3 wk after vaccination. The remaining birds were given a second vaccination with the original chicken embryo origin vaccine by spray or a chicken embryo origin vaccine if the first vaccine was of tissue culture origin. After challenge, birds were monitored for clinical signs. Those surviving were euthanatized on day 6 postchallenge, and tissues and blood were collected for histopathology, virus isolation, and serology. On the basis of histopathology and enzyme-linked immunosorbent assay (ELISA) results, after one vaccination, all chickens given vaccines by eyedrop were provided better protection than nonvaccinated controls (CTLs). Birds in groups Bs and Ds had lower microscopic lesion scores whereas only birds given Bs had higher ELISA titers than CTLs. Birds in groups As and Cs and groups Bw birds taken from the rear of the barn (r) had microscopic lesion scores that were no different from those of CTLs. These same birds in addition to vaccine Ds had ELISA titers no different from those of CTLs. Of all vaccines, only A given by eyedrop or spray produced higher virus isolation titers than those of CTLs. The remainder of the vaccines produced virus isolation titers that were no different from those of CTLs. After two vaccinations, all groups had lower microscopic lesion scores than CTLs. Only Bw birds from the middle of the barn Bs, EeDs, and AsAs had virus isolation results that were higher than those of CTLs. Only groups BwrBs, CsCs, and DsDs had ELISA titers no different from those of controls. These results suggest that a priming vaccination followed by a booster dose offers better protection against ILT than a single vaccination alone. Vaccine application by eyedrop provides more uniform protection if only one vaccination is given, whereas spray vaccination may serve as an alternative method of vaccination for birds receiving two doses of vaccine.

Animal Husbandry↗
PubMed1975

Nasal infection of Alcaligenes bronchisepticus (Bordetella bronchiseptica) and lesions in newborn rabbits.

The mode of experimental infection with Alcaligenes bronchisepticus (Bordetella bronchiseptica) of pig and rabbit origin, and lesions in the respiratory organs were examined in three groups, A, B and C, of newborn rabbits. Groups A and C were free from the organism and agglutinating antibody and inoculated with the organisms of pig and rabbit origin, respectively. Group B had maternal antibody and was inoculated with the organism of pig origin. Establishment and persistence of infection with the organism were certified in the nasal cavities, trachea, or lungs of groups A and C 3 days after inoculation or later. Late establishment of infection occurred in trachea and lungs of group B. Agglutinating antibody was detected in groups A and B mostly 14 days after inoculation or later. Ventral turbinate atrophy occurred in groups A and B mostly 10 days after inoculation or later. Histologically, it was hypo-osteogenesis caused by degeneration of osteoblasts and proliferation of fibroblast-like cells in the osseous tissue. Catarrhal inflammation in the nasal and tracheal mucous membranes, and bronchopneumonia with peribronchiolitis developed commonly in all the groups. The fluorescent antibody technique revealed antigen of the organism of pig origin on the nasal mucosa, mostly of the dorsal and ventral meatus, and on the tracheal and bronchiolar mucosa in groups A and B.

Agglutination Tests↗
PubMed1975

Progressive pulmonary insufficiency and other pulmonary complications of thermal injury.

Progressive pulmonary insufficiency appears to be a universal response to the lung to a variety of injuries which damage the pulmonary-capillary emdothelium. Persistent hyperventilation, unresponsive to the administration of oxygen, is the earliest clinical sign of this complication of trauma and should prompt close monitoring of pulmonary function (measurement of arterial blood gas and pH levels, Vd/Vt A-aDo2, minute ventilation, vital capacity and inspiratory force) to assess the severity of the disease, the need for mechanical ventilatory support and the effectiveness of treatment. Other pulmonary complications of burn injury range from carbon monoxide poisoning and narcotics overdosage in the immediate postburn period through marked hyperventilation directly related to burn size occurring in the absence of significant parenchymal change to later occurring hematogenous and airborne pneumonia. Inhalation injury, a chemical tracheobronchitis which significantly increases the mortality of a given-sized burn, may be present immediately postburn but clinically inapparent for 48-72 hours. 133Xenon lung scans permit early diagnosis of this pulmonary injury and the timely institution of a graduated therapeutic response keyed to the severity of pulmonary disability. Knowledge of the pathogenesis of each of these complications is requisite for the physician caring for burn patients and permits the employment of rational preventive and therapeutic measures.

Burns↗
PubMed2000

[Aspergillosis in pulmonary transplantation].

BACKGROUND: Fungal infections are a frequent cause of morbidity an mortality in transplant recipients. Aspergillus spp. is an ubiquitous fungus capable of producing diverse clinical entities with varying severity. OBJECTIVE: To study the incidence and severity of Aspergillus spp. infections in lung transplantation, analysing the different clinical presentations and response to antifungal drugs. METHODS: A review was made of the clinical histories of all patients undergoing lung transplantation who developed positive Aspergillus spp. cultures in our centre between June 1991 and December 1996. RESULTS: Eleven of 49 transplanted patients (22%) developed Aspergillus spp. infections. Four patients presented invasive aspergillosis forms and 7 tracheobronchitis. In spite of antifungal treatment 3 patients (30%) died of invasive aspergillosis as a direct consequence of the infection. Of the 7 patients with tracheobronchitis, 2 were ulcerative and 1 pseudomembranous, all responded to antifungal treatment. Three patients (10.3%) developed Aspergillus spp. infections despite prophylaxis with itraconazole. CONCLUSION: Invasive aspergillosis in the immediate posttransplant period was mortal despite treatment. As opposed, aspergillar tracheobronchitis have been overcome using combined treatments of liposomal or lipidic amphotericin, itraconazole and nebulised amphotericin.

Adolescent↗
PubMed2000

Pseudomembranous tracheobronchitis caused by Aspergillus in a patient after peripheral blood stem cell transplantation.

INTRODUCTION: We report a case of pseudomembranous tracheobronchitis caused by Aspergillus fumigatus 2 years after matched unrelated stem cell transplant. CLINICAL PICTURE: The patient presented with dyspnoea and obstructive airway disease coinciding with the onset of chronic graft-versus-host disease (GVHD). Following treatment with higher immunosuppressive therapy for presumptive diagnosis of bronchiolitis obliterans, he subsequently developed recurrent spontaneous pneumomediastinum and progressive respiratory failure. TREATMENT AND OUTCOME: Tracheobronchial biopsy and culture of bronchoalveolar lavage (BAL) fluid revealed Aspergillus tracheobronchitis. Despite mechanical ventilation and antifungal therapy, he succumbed to progressive respiratory failure. CONCLUSIONS AND CLINICAL IMPLICATIONS: Aspergillus tracheobronchitis should be suspected in heavily immunosuppressed stem cell transplant recipients presenting with recurrent pneumomediastinum and progressive respiratory failure.

Adult↗
PubMed1975

Experimentally induced feline calicivirus infection: clinical signs and lesions.

Sixty-six specific-pathogen-free cats were allotted to 10 groups and exposed by aerosol to 10 feline calicivirus (FCV) isolates. Viruses of different virulence were identified. The more virulent FCV caused pyrexia, depression, dyspnea, pneumonia, vesicles, or ulcers of the tongue and ulceration of the hard palate and nostrils. The FCV of low virulence caused similar lesions of the tongue, palate, and nostrils but little or no malaise, pyrexia, or pneumonia. Lesions produced by FCV usually were confined to the oral mucosa, tonsils, and lungs. Lesions in the nasal or trachea were associated with 2 of the 10 FCV tested.

Aerosols↗
PubMed1975

[The treatment of the pseudocroup syndrome (author's transl)].

The results of the implementation of Myoscain E/Holzinger in the treatment of the "pseudocroup syndrome" (laryngitis catarrhalis) are reported. The generally prompt action of the drug is stressed. It is pointed out that non-response to the compound suggests a more serious form of the disease necessitating close observation. A list of diseases involved in the differential diagnosis is added.

Child↗
PubMed1975

[Acute obstructive laryngitis in children (author's transl)].

Three types of acute obstructive laryngitis in children are distinguished: 1. Acute supraglottic laryngitis (Epiglottitis acuta): The usual causative organism is Hemophilus influenzae, type B. Characteristic findings include a swollen red epiglottis. Treatment is based on Ampicillin, Solucortef (hydrocortisone-sodium succinate) i.m., air humidification, intravenous infusions and airway protection (tracheotomy or intubation). From 1958-1967, 68 children were treated, of whom boys were twice as commonly affected as girls. In about 80% of cases, tracheotomy was still found necessary. 2. Acute subglottic laryngitis: Mucosal swelling in the subglottic space causes a clinical picture which initially is common to several groups of deseases. In allergic subglottic edema, a pale "pillow-shaped" swelling occurs which responds favorably to antiallergenics and cortisone. In contrast, infectious swelling is partially caused by the infiltration of inflammatory cells. Parainfluenzae virus was isolated in 60% of these cases at our hospital. During the period studied, 2,741 cases were treated, of whom boys were 3.3 times more frequently affected than girls. The use of Solu-cortef i.m. has decreased the tracheotomy rate from 12% to 0. 3. Acute laryngotracheobronchitis: In this disease process, the initial infection is attributed to a virus, with the infected mucosa secondarily invaded by bacteria. The clinical course is prolonged when compared to subglottic laryngitis, and the general condition seriously affected. Both expiratory and inspiratory stridors occur. Tracheotomy is usually required, with viscous crusts removed by bronchoscopy. Respirator treatment is also often required. Fourteen children have been treated, of whom two have died.

Acute Disease↗
PubMed2002

[The Fantoni translaryngeal tracheostomy: perioperative complications In a series of 220 consecutive patients].

BACKGROUND: To evaluate problems arisen du-ring Fantoni translaryngeal tracheostomy (TLT). METHODS SETTING: intensive care unit. PATIENTS: 220 patients (aged from 18 to 87). EXCLUSION CRITERIA: coagulopathy, difficult intubation, local infections, previous neck surgery, suspected cervical spine lesion, severe hypoxemia, hemodynamic instability, patients close to be discharged from ICU. Operation: TLT was performed in general anesthesia, using the technique described by Fantoni in 206 cases; in the other 14 cases changes were made. RESULTS: Perioperative clinical complications were separated from instrumental problems. Clinical complications were 28 (12.7% of TLT): 20 (9.1% of total TLT, 71.4% of total complications) were considered minor and ascribed to medical staff training; among these the complete drawing of the cannula and the difficulty in pushing it in trachea. Eight complications (3.6% of TLT, 28.6% of total complications) were considered major; they were: the impossibility to place the cannula in trachea, the displacement of the prothesis in the peritracheal tissue, the rupture of tracheal ring, the bleeding and the infection of tracheostomy, the dental uprooting. Among instrumental problems, the faulty closure of the ring nut, the overdimension of rigid tracheoscope, and the difficult change of the cannula were observed. CONCLUSIONS: With expert medical staff, this technique is effective and safe, with a low rate of complications. Major complications were rare, and occurred in spite of patients selection, often needing changing of TLT in surgical tracheostomy.

Adolescent↗
PubMedDate not supplied

Endoscopic survey of post-extubation stridor in children.

Endotracheal intubation is an important airway procedure in the management of neonates and infants. Prolonged intubation may result in severe laryngeal injury which may lead to chronic laryngeal disability. The nature and causes of post-extubation airway obstruction were evaluated with videoendoscopy. From June 1998 to September 2000, detailed videoendoscopic examination of pediatric airway was performed in 30 children who had persistent stridor after endotracheal extubation or failure of elective extubation. Common locations of post-extubation lesion are the posterior glottis and subglottis. Retrospective analysis of the causes of stridor included: (1) isolated intubation laryngotracheitis (n = 19); (2) intubation laryngotracheitis with neuromuscular dysfunction which resulted in tongue drop, laryngotracheal incoordination, saliva pooling over the larynx or poor cough reflex(n = 5); and (3) specific airway problems such as laryngomalacia, subglottic stenosis or vocal paralysis(n = 6). We favored the term of "intubation laryngotracheitis" instead of "intubation injury" or 'intubation trauma". Although most cases of intubation laryngotracheitis heal, leaving a normal or near-normal larynx, some of them still suffer from airway obstruction after endotracheal extubation. Specific airway problems such as severe laryngomalacia or vocal cords paralysis and neurogenic defects should also be taken into consideration.

Adolescent↗
PubMed2001

Smoke inhalation-induced alveolar lung injury is inhibited by hyperbaric oxygen.

Smoke-induced lung injury in rats was assessed in terms of histopathology, gross mortality, neutrophil accumulation and as capillary leak. Administration of hyperbaric oxygen (HBO2), 2.8 atm abs for 45 min, inhibited adhesion of circulating neutrophils subsequent to smoke inhalation. HBO2 reduced pulmonary neutrophil accumulation whether used in a prophylactic manner, 24 h before smoke inhalation, or as treatment immediately after the smoke insult Emphasis was placed on prophylactic administration of HBO2 to avoid the possibility that beneficial effects may be related to hastened removal of carbon monoxide. Based on all parameters tested, smoke inhalation injury was reduced by prophylactic aadministration of HBO2. The beneficial effect appears related to inhibition of neutroophil adhesion to the vasculature.

Animals↗
PubMed1975

[Results in the surgical management of tracheal stenoses (author's transl)].

After a review of the methods for treating tracheal stenosis, own results of 20 cases are reported, concerning 6 with subglottic stenosis, 7 localized in the cervical and 4 in the thoracic region, in 3 other cases the cervical and thoracic region was involved. The stenosis was the sequela of tracheotomy in 12 cases, of extended inflammations in 3 cases, of benign subglottic tumors in 3 cases and 2 following intubation. 3 dilatations, 7 tracheopexies and 7 tracheoplastics were performed. In 1 patient the stenosed portion was resected followed by end-to-end-anastomosis. Complete unrestricted respiration was achieved in 11 patients, adequate breathing at rest in 4 patients, and 3 patients had to continue wearing a tube. 3 patients died, 2 of them from other causes and 1 from inadequate postoperative care. The treatment procedures must be individualized to each patient, according to the different causes, sites, types of the tracheal stenosis, to improve diagnostics, and the preoperative and postoperative care. Great patience from the side of the patient as well as the physician is necessary to relieve the patient suffering from his severe dyspnea.

Humans↗