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PubMed1995

The effects of rhinovirus infections on allergic airway responses.

Although it has long been recognized that the common cold is a potent trigger for symptoms of asthma, the mechanisms underlying the association between upper respiratory infection and increased lower airway obstruction remain obscure. The use of experimental infection of volunteers with or without respiratory allergies has enabled direct comparisons of common cold symptoms in these two groups. Furthermore, techniques such as bronchoalveolar lavage and segmental antigen challenge have been used to directly sample lower airway fluids and tissues during acute viral infection. This review summarizes the findings of studies examining the separate and combined effects of rhinovirus infection and allergen exposure on airway physiology and inflammation.

Asthma↗

PubMed1983

Nasal reactivity in rhinitis.

The purpose of this review is to present data on nasal reactivity to methacholine, histamine and allergen in normal subjects, patients with common colds, perennial rhinitis and hay-fever. Nasal challenge is performed by spraying the agent into the nose and counting the sneezes, measuring the resulting secretion and the increase in nasal airway resistance during a 15 minute period. We found that there was a small increase in reactivity during a common cold, but a considerable increase during the hay-fever season and associated with perennial rhinitis. We conclude that a nasal challenge test may be a valuable tool as an objective parameter for the diagnosis and for the estimation of the severity of rhinitis. It may also be helpful in the evaluation of new drugs and give information regarding pathogenetic mechanisms as well as the mode of action of specific drugs.

Allergens↗

PubMed2003

Common infections and the role of burnout in a Dutch working population.

OBJECTIVE: To determine if burnout is a risk factor for common cold, flu-like illness and gastroenteritis. METHODS: We conducted a prospective cohort study among 12,140 employees at baseline, using three consecutive self-administered questionnaires. The Maslach Burnout Inventory-General Survey (MBI-GS) was used to define employees with burnout complaints (Level 1) and clinical burnout (Level 2). The cross-sectional relationship between burnout and the occurrence of common infections was assessed at baseline, using logistic regression analysis. Survival analysis with Cox regression was performed to study the longitudinal relationship between burnout and the subscales of the MBI-GS as risk factors for common infections. RESULTS: For both levels of burnout, an increased incidence of common infections was found at baseline. The largest effect was found for the relationship between burnout and gastroenteritis (OR: 1.86, CI: 1.57-2.21 for Level 1 and OR: 3.59, CI: 2.09-6.17 for Level 2). The longitudinal analyses showed comparable results, although less pronounced. The largest effect was again found for gastroenteritis (RR: 1.55, CI: 1.28-1.86 for Level 1 and RR: 2.09, CI: 1.09-3.98 for Level 2). For flu-like illness and common cold, we found smaller but significant effects at Level 1, but not at Level 2. The subscale "Exhaustion" was found to be the strongest predictor for infections at both levels of burnout. CONCLUSIONS: This study provides evidence for burnout as a risk factor for common infections in a large heterogeneous population. Taking into account that burnout or its subscales are not primary etiological agents for these common infections, the observed effects are large.

Adult↗

PubMed2005

Self-medication among Finnish young men in the beginning of common military service.

PURPOSE: Little is known about self-medication in adolescent and young adult males, particularly in ones exposed to increased stress. The objective of this article is to analyze self-medication and its predictors in young Finnish men at entry into common military service. METHODS: The responding men (n = 857) from nine brigades anonymously completed a self-administered questionnaire during the first conscription days before active military training in July 1999. The effect of pre-disposing, need and health behavior variables on self-medication was assessed using Andersen et al. theoretical health care utilization model. RESULTS: In the 2 weeks preceding the survey, 65% of the men reported self-medication. Self-medication for pain or common cold symptoms was reported by 54% while 8% had taken caffeine tablets or other stimulants. Multivariate analysis on overall self-medication showed an association with brigade and using health services before the conscription. Along with pre-disposing variables, need variables were associated with self-medication for pain or common cold symptoms and self-medication with stimulants. Stimulant use was also associated with health behaviors such as trial with illegal drugs during lifetime. CONCLUSIONS: Young men frequently self-medicate at the initial stage of conscription that may pose them at an increased risk for adverse effects of medicines or other medical problems. The military and civilian primary health care providers should discuss the proper use of self-medication with young men.

Adult↗

PubMed2005

Virucidal hand treatments for prevention of rhinovirus infection.

Rhinovirus infections are associated with substantial morbidity and economic cost. The available common cold remedies are of limited utility and specific antiviral approaches have been unsuccessful. Viral contamination of the hands appears to play an important role in the transmission of rhinovirus from person-to-person. Interruption of this step in transmission presents a potential target for intervention. Initial studies demonstrated that the common cold could be prevented by treatment of hands with iodine. Inactivation of the rhinoviruses by acid is well known and a survey of organic acids considered safe for consumer use revealed that salicylic acid and pyroglutamic acid have potent virucidal activity for the rhinoviruses that persists for several hours after application to the hands. A subsequent evaluation in human volunteers confirmed the prevention of rhinovirus infections by these acids and suggested that these agents have promise as cosmetically acceptable virucidal agents for interruption of the transmission of these infections.

Antiviral Agents↗

PubMedDate not supplied

Effects of adenoidectomy: a controlled two-year follow-up.

A prospective controlled study was made on the effect of adenoidectomy performed on 105 children. For various reasons, mainly severe long-standing nasal obstruction, 29 children were omitted from the study. The remaining 76 children were randomly divided into two groups, one adenoidectomy, and one control. Both groups were slightly reduced in number due to drop out. Thus 36 adenoidectomized children were followed during one year and 35 children during two years. The corresponding numbers for the children in the control group were 37 and 33. The incidence of common cold, purulent and serous otitis media and moderate nasal obstruction was compared in the two groups. A considerable reduction in the incidence of these variables was observed in both groups. The occurrence of moderate nasal obstruction was reduced more among the operated than among the unoperated children. The difference was only slightly significant during the first and not at all during the second year. Regarding the other variables, the differences were not significant, implying that adenoidectomy seems to have no effect on the incidence of common cold, serous and purulent otitis media.

Adenoidectomy↗

PubMedDate not supplied

Analysis of medication use patterns:apparent overuse of antibiotics and underuse of prescription drugs for asthma, depression, and CHF.

OBJECTIVE: To assess the appropriateness of prescription medication use based upon widely accepted treatment guidelines. METHODS: We analyzed administrative claims for the period October 1, 1998, through September 20, 1999, supplied by 3 California health plans to determine medication use patterns for outpatient prescriptions. We compared these patterns to those expected in the presence of adherence to treatment guidelines. RESULTS: During the study period, only 27.5% of antidepressant users received the recommended 6 months of continuous therapy, only 49.0% of diagnosed asthma patients received at least one inhaled corticosteroid prescription (compared to 67.1% who received at least one inhaled beta-agonist prescription), and only 54.5% of patients diagnosed with congestive heart failure (CHF) received an angiotensin-converting enzyme (ACE) inhibitor. Of patients who had a diagnosis of common cold or upper respiratory tract infection, 35.7% received antibiotics. CONCLUSION: There is a remarkable degree of apparent overuse and underuse of prescription medications despite the existence of clinical guidelines to support appropriate use in the conditions studied. Effective medications appear to be underused for patients with asthma, CHF, and depression. Antibiotics appear to be overused for the common cold and upper respiratory infections. More effective efforts must be made to address appropriate use of medications. Without these efforts, improved quality of care and decreased total health system costs are unlikely to be realized.

Adolescent↗

PubMed1997

Evidence-based management of upper respiratory infection in a family practice teaching clinic.

BACKGROUND AND OBJECTIVES: Management of upper respiratory infection (URI) was examined in a family practice clinic to determine evidence-based practices, specifically for medication choice. Scientific evidence supports the use of decongestants and perhaps decongestant/antihistamine combinations in adolescents and adults and antipyretics in all age groups. The use of cold preparations for children younger than age 5 is not evidence based. METHODS: Data on demographics, medications prescribed, and over-the-counter medications recommended were collected from patient charts for 293 URI visits over a 6-month period. The cost of evidence-based URI treatment was compared with the cost of nonevidence-based treatment. RESULTS: Thirty-three percent of patients younger than age 5 were given a prescription; 96% of the prescription cost in this age group was nonevidence based. Twenty-six percent of all patients seen were given unnecessary and potentially harmful medication. These unnecessary medications accounted for almost 60% of the total prescription cost. Various combinations of antihistamines, decongestants, and antitussives were most commonly prescribed. CONCLUSIONS: Few medications have been shown to effectively alleviate the symptoms of the generally self-limited, benign common cold. Medications are often overprescribed, escalating health care costs and, in some cases, exposing the patient to dangerous side effects. Family physicians and educators are encouraged to reexamine their treatment and teaching practices for the common cold.

Adolescent↗

PubMed1983

Changes of mucociliary function during colds.

We have investigated, using chicken and Newcastle disease virus, the relationship between the mucociliary function and acute upper respiratory infection. Average nasal transit time of the dye was 53 sec at the age of two to four weeks in controls. The average transit times were significantly longer than those of controls at day 6 and 12 postinoculation. A histopathological study has revealed that repair of the mucosal injury is usually completed within 13 days after virus challenge. This was confirmed with 3H-thymidine autoradiography. However, there were patches where cilia almost disappear as seen in the scanning electron microscope. The mucous blanket was tethered to the mucosal surface by strands of mucus from the acini of the nose after 7 days of infection. More extensive tethers were observed on the 14th day. This phenomenon is one of the factors which may affect mucociliary transport in vivo only. Nasal secretion from patients with a common cold was transported more slowly than that of controls on a frog palate from which mucus had been removed. The reduction in mucociliary transport rate in the nose during a common cold could be due to a combination of damage to the ciliated system, a change in the biorheological property of nasal secretion and in vivo factors, or other causes.

Animals↗

PubMed1991

Daycare attendance and risk of first infectious disease.

The health hazards of daycare attendance for the development of upper and lower respiratory tract infections have been well documented; however the importance and the mechanism of this association have not been well defined. In order to ascertain the risk associated with the beginning of daycare (DC) attendance we conducted a survey on 1263 children aged from 3 months to 3 years; the analysis focused on the risk of developing an initial episode of common cold with fever, a first otitis and a first wheezy bronchitis (WB) within the 2 month period following admission to DC. For each 2 month period, the risk of a first infectious event was much higher in children who had just begun attending DC than in children who remained at home; the risk ratio varied from 1.7 to 2.4 for common cold, from 1.5 to 1.9 for otitis and from 1.8 to 3.2 for WB. Because age at onset of the first infectious event may be related to a higher risk of repeated events we consider that admission to DC under 12 months of age should be questioned.

Age Factors↗

PubMed1998

Appropriate use of antibiotics for URIs in children: Part I. Otitis media and acute sinusitis. The Pediatric URI Consensus Team.

Five conditions--otitis media, acute sinusitis, cough, pharyngitis and the common cold--account for most of the outpatient use of antibiotics in the United States. The first part of this two-part article presents guidelines that encourage physicians to make an appropriate distinction between acute otitis media and otitis media with effusion, to use shorter courses of antibiotic therapy in uncomplicated cases of otitis media and to limit prophylaxis to recurrence as defined strictly by number of episodes. Sinusitis in younger children is difficult to distinguish from the common cold, and the criterion for use of antibiotics should be duration of symptoms.

Acute Disease↗

PubMed2006

Modulation of the immune system by human rhinoviruses.

Human rhinoviruses (HRV) are the major cause of the common cold, one of the most frequent infectious diseases in humans. Though HRV infections of the upper respiratory tract are usually rather harmless, there is increasing evidence that HRV sets the stage for more dangerous pathogens, elicits asthmatic exacerbations, severe diseases in the lower respiratory tract and even autoimmunity. The pathogenic mechanisms of HRV infections leading to such complications are still poorly understood. It is a common strategy of pathogens to manipulate our immune system in order to evade an efficient immune response. A major characteristic of HRV is a high degree of species specificity. Thus, analyzing the potential immune evasion mechanisms used by HRV will be helpful for a better understanding of the pathogenesis of the common cold and may contribute to a better understanding of the human immune system as well. In this review we want to illuminate what is known about potential immune escape mechanisms used by HRV and discuss how such disturbances might lead to a suppressed and dysregulated immune competence in man.

Antibodies, Viral↗

PubMed1989

[Primary ciliary dyskinesia; a questionnaire study of the clinical aspects].

With the aid of a questionnaire form we have gathered information about the clinical picture of patients suffering from primary ciliary dyskinesia. The study group numbered 34 persons, whose diagnosis was confirmed by electron microscopy. Chronic cough and common cold symptoms are present from shortly after birth. Twenty-three respondents reported respiratory tract problems in the neonatal period. The dysfunctional cilia result in chronic respiratory tract infections (chronic bronchitis; bronchiectasis; pneumonia; chronic sinusitis, rhinitis or otitis media). These lead to the following complaints: frequent blowing of the nose (in 32 pat.; 94%), chronic productive cough (in 28 pat.; 82%), chronic common cold (in 26 pat.; 77%), hearing problems (in 24 pat.; 71%), shortness of breath (in 23 pat.; 68%), frequent headache (in 13 pat.; 38%) and sore throat (in 9 pat.; 27%). In order to prevent the invalidating consequences of this disorder appropriate steps should be taken as soon as possible. These should include physiotherapy and adequate antibiotic therapy.

Adolescent↗

PubMed2002

Physicians' antibiotic prescribing habits for upper respiratory tract infections in Turkey.

The aim of this study was to evaluate the antibiotic prescription rates for upper respiratory tract infections (uRTIs) by primary care physicians in Samsun, Turkey. Data were obtained from the records of 2,083 visits to 8 primary care areas. Trained research students were stationed on site at each of the 8 primary care areas during the study period. Clinical features of patients were documented on a standardized form. Patients who had acute pharyngitis, acute sinusitis, acute otitis media (AOM) and common cold were included in the study. This survey was conducted between June 1, 1999 and July 1, 1999. A total of 2,083 office visits were recorded and 502 (24.1%) of the patients had uRTIs. Physicians approached these conditions empirically, with only 2.9% of patients having a diagnostic test at initial examination. Antibiotics were prescribed for 461 patients (91.8%) with uRTIs (common cold: 41.9%, acute pharyngitis: 94.7%, acute sinusitis: 94.1% and AOM: 100%). 11.5% of the antibiotic prescriptions were inconsistent with current recommendations derived from the literature. Inadequate antibiotic prescribing was documented in 29.7% of antibiotic prescriptions. Errors were frequent in relation to dosage, dosage interval and duration of therapy. Overuse of antibiotics is widespread in our geographic area. Both administrative and educational intervention should be implemented to improve antibotic prescribing habits at the primary health care level to reduce the unnecessary use of antimicrobial agents.

Adult↗

PubMed1993

A comparative analysis of nasal secretions from subjects with and without acute rhinitis and its application to forensic medicine.

Proteins in nasal secretions obtained from healthy subjects and subjects with acute rhinitis were analyzed by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE). The bands of 79 kilodalton (kD), 67 kD, 58 kD, 52 kD, 43 kD, 38 kD, 28 kD, 26 kD and below 26 kD were the proteins shared by most specimens. The state of the common cold was identified by determining the ratios of these proteins to the total proteins. 58 kD protein (IgA alpha-chain), contained mainly in glandular secretions, was found in abundance on average. However, the ratio of 67 kD protein (albumin) filtrated from the vascular system varied considerably. The highest ratio of 67 kD protein (albumin) was found in the nasal secretions obtained only from subjects with rhinitis. In nasal secretions from healthy subjects, the highest ratios of the major proteins were those of 58 kD protein (IgA alpha-chain) or proteins below 26 kD. These observations may be useful in discriminating rhinitis subjects with a common cold from healthy subjects in the forensic medical analysis of nasal smears.

Acute Disease↗

PubMed2004

A daily nasal spray with saline prevents symptoms of rhinitis.

OBJECTIVE: To ascertain whether a daily nasal spray with physiological saline could prevent symptoms of common cold in a population of otherwise healthy adults. MATERIAL AND METHODS: This was study involving 10 weeks of daily use of a nasal saline spray and 10 weeks of only recording symptoms. Young adults eligible for military service at an army barrack in Boden, Sweden were invited to participate in the study and 108 healthy conscripts aged approximately 20 years agreed to do so. Data were recorded by the participants in a diary at home. In the diary the participants noted symptoms such as rhinitis, blocked nose, cough, fever and sore throat (pharyngeal pain). They also recorded inability to perform their duties due to the symptoms, and any medication or antibiotics necessitated by upper respiratory tract infection. RESULTS: A total of 69 subjects completed the 20-week diary period. For 60 of them, compliance during the spray period exceeded 60% and their data were used in the statistical calculations. During the spray period the number of days with nasal secretion and/or blocked nose (mean 6.4 days) was significantly (p=0.027) lower than that during the observation period (mean 11 days). Furthermore, the participants had a mean of 0.7 episodes of upper respiratory tract infection during the spray period, compared with 1.0 episodes during the observation period (p=0.05). CONCLUSION: A daily nasal spray with saline can prevent nasal symptoms of common cold in a population of otherwise healthy adults.

Adult↗

PubMed1995

Effect of rhinovirus 39 (RV-39) infection on immune and inflammatory parameters in allergic and non-allergic subjects.

The economic impact and medical complication rate of the common cold are well documented, but many of the physiological, inflammatory, and immune responses to common cold viruses have only recently been investigated. The purpose of this study was to compare selected systemic immune and inflammatory responses to experimental rhinovirus (RV)-39 challenge in seronegative allergic rhinitis and non-allergic rhinitis subjects. Peripheral blood was obtained before (baseline), during (acute), and 23 days after (convalescent) RV-39 intranasal challenge and assayed for leucocyte histamine release, serum immunoglobulins, allergen-specific IgE antibodies, plasma histamine, and platelet aggregation. All subjects were infected, as manifested by viral shedding in nasal secretions or seroconversion. RV-39 infection induced significant acute increases in serum IgE, leucocyte histamine release, and platelet aggregation, but caused no changes in serum IgG, serum IgA, serum IgM, and plasma histamine. The first change was confined to the allergic rhinitis subjects. There was no evidence that the acute rise in total serum IgE was due to an elevation of a pre-existing, pollen-specific serum IgE antibody. The results show that intranasal challenge with RV-39 induced changes in systemic immune and inflammatory parameters with a unique response pattern in allergic rhinitis subjects.

Adolescent↗

PubMed2006

Traditional management of ear, nose and throat (ENT) diseases in Central Kenya.

Diseases of ear, nose and throat (ENT) often have serious consequences including hearing impairment, and emotional strain that lower the quality of life of patients. In Kenya, upper respiratory infections are among the most common infections encountered in outpatient facilities. Some of these infections are becoming difficult to control because some of the causing microorganisms have acquired antibiotic resistance and hence the need to develop new drugs with higher efficacy. Ethnobotanical studies have now been found to be instrumental in improving chances of discovering plants with antimicrobial activity in new drug development. In Kenya the majority of local people are turning to herbal remedies for primary health care needs. In most cases the sources of these remedies are undocumented and the knowledge about them passed orally form generation to generation, hence under threat of disappearing with current rates of modernisation. This study explored the traditional remedies used in managing various ENT diseases in seven districts of the Central Province of Kenya. The most common ENT conditions managed using traditional therapies include: common cold, cough, tonsillitis, otitis-media, chest pains and asthma. The results indicate that 67 species belonging to 36 plant families were utilized in this region. These plants were of varying habits; herbs (37.3%), shrubs (34.4%), trees (25.4%) as well as some grasses and sedges (3%). The traditional preparations were found to be made mainly from leaves (49%), roots (20.5%) and barks (12.5%). For each of the ENT conditions multiple species are utilized mainly as individual preparations but occasionally as polyherbal concoctions. In the case of common cold for example, 30 different species are used. Plants reported in this survey are important candidates for antimicrobial tests against ENT disease causing micro-organisms, especially those with antibiotic resistance.

Asthma↗