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Investigation of the effects and aftereffects of naturally occurring upper respiratory tract illnesses on mood and performance.

This study examined the effects and aftereffects of naturally occurring upper respiratory tract illnesses on mood and performance. Twenty-six subjects (12 males, 14 females, mean age 23 years 10 months, age range 18-39 years) were tested once a week for a period of a month. Fifteen subjects were suffering from a common cold on the first week and the other 11 subjects were matched healthy controls. Subjects attended for an initial 3-h testing period that consisted of a set of practice trials and two test sessions involving mood rating and performance of a battery of tests measuring psychomotor functions, attention, and memory. Sessions 3, 4, and 5 took place 1, 2, and 3 weeks later, respectively. In addition to measuring mood and mental performance, symptom severity was rated on a subjective checklist. The results showed that subjects with a cold reported an increase in negative mood and that this was only significant in the first week. Impairments of psychomotor function (simple reaction time and tracking) were also observed at this time. Performance of sustained and selective attention tasks was also impaired in subjects with colds but this effect was only significant in the second week. Other functions such as working and semantic memory were unimpaired in subjects with colds at any point in the experiment. Overall, the present results confirm many of the earlier results obtained in studies of experimentally induced upper respiratory tract illnesses. Indeed, these results are both of great practical importance and theoretical interest and further studies must now elucidate the mechanisms underlying these effects.

Adolescent↗

Prevalence of long-term upper aerodigestive symptoms after uncomplicated bilateral thyroidectomy.

BACKGROUND: Subjective nonspecific upper aerodigestive symptoms (UADS) are not uncommon after thyroidectomy. Their type, duration, and prevalence, however, have not been investigated in a controlled design. The objective of this study was to investigate the prevalence of UADS after thyroidectomy. METHODS: A consecutive cohort of 60 patients who had undergone uncomplicated total (n = 38) or near total (n = 22) thyroidectomy were investigated retrospectively at a mean of 4 years after surgery. An independent unblinded researcher interviewed each patient and asked for the presence or frequency of voice changes, cough, dysphagia, neck strangling, and annual incidence of common colds, before and after thyroidectomy. Sixty patients, matched for age, sex, and smoking habits, who had undergone laparoscopic cholecystectomy during the same years served as control subjects. RESULTS: The prevalence of UADS was similar before thyroidectomy (13%) and cholecystectomy (15%). After operation, UADS had a higher prevalence among thyroidectomized patients: nonspecific voice changes (28% vs 3%), neck strangling (22% vs 0%), and impaired swallowing (15% vs 3%) (P < or = .02 in each). Neck strangling was associated with voice changes and dysphagia (P < or = .03 each). CONCLUSIONS: Subjective UADS are common long after thyroidectomy. These symptoms may be related to injury to the extrinsic perithyroidal neural plexus innervating the pharyngeal and laryngeal structures.

Adult↗

Risk factors for sudden deafness: a case-control study.

In order to investigate risk factors for idiopathic sudden sensorineural hearing loss (sudden deafness), a case-control study was done in 109 patients with sudden deafness who visited our hospital between 1992 and 1994, with 109 controls matched to each patient by gender and age. Odds ratio (OR) and 95% confidence interval (CI) for smoking habits, drinking habits, dietary habits, environmental noise, past history of disease, sleeping hours, appetite, fatigue, incidence of common cold were obtained. Fatigue (OR: 3.28; 95% CI: 1.36-7.90) and loss of appetite (OR: 8:00; 95% CI: 1.00-64.0) elevated the risk for sudden deafness. Those who ate many fresh vegetables were at a decreased risk (OR: 0.48; 95% CI: 0.24-0.96 for light-colored vegetables, OR: 0.55; 95% CI: 0.30-1.02 for green-yellow vegetables). Personal histories of hypertension and thyroid disease, and susceptibility to colds appeared to be positively associated with the risk (0.05 < P < 0.10). Smoking habits, drinking habits and environmental noise had no significant association with sudden deafness. These results suggested that environmental factors, including diet, may be importantly involved in the genesis of sudden deafness.

Adolescent↗

New considerations in the treatment and prevention of rhinovirus infections.

Rhinoviruses are a very common cause of infections in children. Although these infections are most closely associated with the common cold, recent studies have established the rhinoviruses as important causes of other upper and lower respiratory illnesses as well. Treatment of these infections is limited to symptomatic therapy. There is no clear evidence that treatment with zinc or echinacea have any role in these infections. Interruption of transmission by handwashing remains the only method for prevention of rhinovirus infections.

Adult↗

[Influenza and other viral respiratory infections].

Since the discovery of influenza virus in 1933, many viruses have been reported as the causative agents of acute respiratory infections. On the other hand, disease entities such as influenza, common cold, pharyngitis and atypical pneumonia etc. are recognized and established clinically. Recent development and popularization of rapid diagnostic kit of influenza and anti-influenzal drugs(amantadine and neuraminidase inhibitor) in Japan made the concern of influenza more concretly. The discrepancy between clinically diagnosed influenza and virologically confirmed influenza is discussed for treatment and prevention of influenza in practice.

Amantadine↗

Chemical speciation applied to bio-inorganic chemistry.

The processes of converting new chemistry into new healthcare, environment-friendly, products are considerably facilitated when chemical speciation data are available. These identify causal links between speciation and biological responses based upon specific chemical species rather than total concentrations. The effective roles of bismuth for ulcer treatment, of Ca, Zn, Sn and F in dentifrices, and of zinc species and common cold symptoms are described. A new readily biodegradable ligand for minimising the environmental impact of washing powders, Al and Alzheimer's disease (and the absence of a causal link), and an audit of Cu and Zn flow from wound dressing through wound fluid to healing tissue, are all discussed in detail.

Aluminum↗

Zinc-induced suppression of inflammation in the respiratory tract, caused by infection with human rhinovirus and other irritants.

Free ionic zinc (Zn2+) in saliva shortens duration and severity of common cold (CC) symptoms. It is proposed that Zn2+ complexes with proteins of critical nerve endings and surface proteins of human rhinovirus (HRV) (a) interrupt nerve impulses and (b) block docking of HRV on intercellular adhesion molecule-1 (ICAM-1) on somatic cells, thereby interrupting HRV infection. Since leukocyte function associated antigen-1 (LFA-1) binds leukocytes to cells through ICAM-1, initiating inflammation, Zn2+ is expected to block LFA-1/ICAM-1 binding and thereby suppress inflammation. This could explain reduction of inflammation experienced by persons taking zinc gluconate/glycine (ZGG) lozenges for CC. Allergic rhinitis (AR) and CC share many common symptoms, and ZGG also mitigates AR symptoms. Focal irritation, increased ICAM-1 expression, and recruitment of leukocytes to epithelial foci are the common elements. Zinc ions may be an important anti-inflammatory factor because they can block docking of both HRV and LFA-1 with ICAM-1.

Anti-Inflammatory Agents↗

Rhinovirus infection induces expression of type 2 nitric oxide synthase in human respiratory epithelial cells in vitro and in vivo.

BACKGROUND: Human rhinovirus (HRV) infections are the predominant cause of the common cold and are associated with exacerbations of asthma. Nitric oxide (NO) may play an important role in host defense by means of its potent antiviral properties. OBJECTIVE: We sought to determine whether epithelial expression of type 2 nitric oxide synthase (NOS 2), which produces NO, is induced on rhinovirus infection in vitro and in vivo. METHODS: Primary cultures of human airway epithelial cells were infected with HRV-16, and NOS 2 mRNA expression was assessed by conventional and real-time RT-PCR and NOS 2 protein by using Western blot analysis. Human subjects were also infected with HRV-16 in vivo, and mRNA for NOS 2 was assessed in nasal epithelial scrapings obtained before and after infection. RESULTS: NOS 2 mRNA levels increased within 8 hours after HRV-16 infection of cultured cells and remained elevated up to 48 hours after infection. NOS 2 protein was elevated at 24 hours. Induction of NOS 2 did not occur with UV-inactivated HRV-16 but could be reproduced by using double-stranded RNA, indicating that induction was dependent on viral replication. Increased NOS 2 expression was also observed in nasal epithelial scrapings during symptomatic colds. CONCLUSION: Increased epithelial expression of NOS 2 mRNA occurs as part of the host response to HRV infection in vitro and in vivo. Given the antiviral effects of NO, we speculate that increased host production of NO may play an important role in host defense during HRV infections.

Bronchi↗

Detection of human herpesvirus 6 DNA in throat swabs by polymerase chain reaction.

The detection of human herpesvirus 6 (HHV-6) DNA was carried out in throat swabs of adults and children by the polymerase chain reaction, and isolation of virus was also attempted from peripheral mononuclear cells. Although virus was isolated only from peripheral blood mononuclear cells of infants with exanthem subitum, HHV-6 DNA was detected in one of 30 healthy adults (3%), two of nine adults (22%) with common cold, two of 10 infants (20%) with exanthem subitum, four of 39 febrile children (10%) with antibody to HHV-6 (including three of 10 infants aged under 1 year old, and one of 29 children aged over 1 year old). However, HHV-6 DNA was not detected in samples from healthy neonates.

Adult↗

Thrombophlebitis and upper respiratory tract virus infection.

During an episode of thrombophlebitis, the 72-year-old correspondent came down with a common cold presumably, but not provenly, due to infection by one of the rhinoviruses. During the 96 hr period of coryza, all symptoms of thrombophlebitis vanished completely. There is experimental evidence that rhinovirus infections elicit cytokine production [Stöckl et al. (1999): J Clin Invest 104: 957-965], and that IL-10 can assuage thrombosis in rats [Downing et al. (1998): J Immunol 161: 1471-1476].

Aged↗

Effects of upper respiratory tract illnesses on mood and performance over the working day.

The present study examined whether volunteers with common colds showed impairments in objective and subjective indicators of alertness over the course of the working day. All the volunteers (n = 21) were tested when healthy to provide baseline data for simple and choice reaction time tasks, visual search tasks and ratings of mood. These measures were taken before work (08.30 hours), at lunchtime (13.00) and after work (17.30). When participants developed a cold (n = 6) they repeated the procedure. Volunteers (n = 15) who remained healthy were recalled as controls and also repeated the procedures. The results showed that those with colds had significantly slower simple and choice reaction times, and felt less alert, more tense and less sociable. The effects of having a cold on simple reaction time, alertness and anxiety increased over the day. This extends earlier research and shows that some of the effects of upper respiratory tract illnesses on mood and performance will depend on when assessments are made. These results also imply that performance and well-being at work will be impaired by upper respiratory tract illnesses.

Adult↗

Rhinovirus viremia in children with respiratory infections.

RATIONALE: Viremia has been implicated in many viral infections; however, viremia due to rhinovirus (RV; rhinoviremia) has been considered not to occur in normal individuals. OBJECTIVE: To evaluate whether RV enters the bloodstream and identify the possible risk factors. METHODS: Nasopharyngeal washes (NPWs) of 221 children with respiratory infections were examined for the presence of RV by reverse transcription-polymerase chain reaction. Blood from 88 children, whose NPW was RV-positive, and 31 of RV-negative control subjects was subsequently examined for the presence of RV in the blood by semi-nested reverse transcription-polymerase chain reaction. Rhinoviremia was then correlated with clinical characteristics of the disease. RESULTS: RV was detected in the blood of 10 out of 88 NPW RV-positive cases (11.4%): 7 of 28 children with asthma exacerbations (25.0%), 2 of 26 with common cold (7.7%), 1 of 25 with bronchiolitis (4.0%), and 0 of 9 with pneumonia (0%). All NPW RV-negative cases were negative in the blood. The proportion of rhinoviremia in children with asthma exacerbation was significantly higher compared with children suffering from the other diseases (25 vs. 5%, p = 0.01). Significant risk factors were: sampling <or= 24 hours from symptom initiation, personal history of asthma, and male sex. Age, fever, family, and personal history of atopy did not affect the presence of RV in the blood. CONCLUSIONS: Viremia may occur during RV respiratory infections in normal children and is rather common in the early course of acute asthma exacerbations, suggesting that rhinoviremia may be involved in asthma exacerbation pathogenesis.

Acute Disease↗

[Clinical aspects of viral respiratory infections].

The Authors deal with some clinical aspect of the commonest types of respiratory tract viral infections. After a description of the characteristics of the most important diseases (common cold, ARD, influenza, viral pneumonia) they deal with some particular problem difficult in resolution, both from a pathogenetic and clinical viewpoint and quite constant bacterial over infection, the cardiac complications, th possible evolution to fibrosis and the relationship between viral infections and asthma. The nowadays problem of immunological and chemotherapeutic prevention of viral infections, particularly of type A influenza, is also discussed.

Adenoviridae Infections↗

Secretory leukocyte protease inhibitor in normal, allergic and virus induced nasal secretions.

Secretory leukocyte protease inhibitor (SLPI) and alpha-1-proteinase inhibitor (alpha-1-PI), both inhibitors of granulocyte elastase, were studied in nasal secretions from healthy persons and from patients with allergic rhinitis and common cold. SLPI and granulocyte elastase were found in all samples, while alpha-1-PI was lacking in several. In all three groups SLPI was found in an active form and in excess of granulocyte elastase, which thus was completely inhibited. The results indicate that SLPI is the main inhibitor in nasal secretions and that alpha-1-PI plays a minor role.

Common Cold↗

A note on Harold S. Diehl, randomization, and clinical trials.

Harold S. Diehl and coworkers published results from a remarkable trial on the efficacy of vaccines for the common cold in 1938. The original report states that patients were assigned to treatment and control groups "at random." Diehl's study has been referred to as one of the first instances of a randomized, double-blind, placebo-controlled trial. No description of a formal randomization scheme is given in the 1938 report and an unpublished paper of Diehl's suggests the use of alternate assignment in the study.

Common Cold↗

Vitamin therapy in the absence of obvious deficiency. What is the evidence?

Vitamins are a group of organic compounds occurring naturally in food and are necessary for good health. Lack of a vitamin may lead to a specific deficiency syndrome, which may be primary (due to inadequate diet) or secondary (due to malabsorption or to increased metabolic need), and it is rational to use high-dose vitamin supplementation in situations where these clinical conditions exist. However, pharmacological doses of vitamins are claimed to be of value in a wide variety of conditions which have no, or only a superficial, resemblance to the classic vitamin deficiency syndromes. The enormous literature on which these claims are based consists mainly of uncontrolled clinical trials or anecdotal reports. Only a few studies have made use of the techniques of randomisation and double-blinding. Evidence from such studies reveals a beneficial therapeutic effect of vitamin E in intermittent claudication and fibrocystic breast disease and of vitamin C in pressure sores, but the use of vitamin A in acne vulgaris, vitamin E in angina pectoris, hyperlipidaemia and enhancement of athletic capacity, of vitamin C in advanced cancer, and niacin in schizophrenia has been rejected. Evidence is conflicting or inconclusive as to the use of vitamin C in the common cold, asthma and enhancement of athletic capacity, of pantothenic acid in osteoarthritis, and folic acid (folacin) in neural tube defects. Most of the vitamins have been reported to cause adverse effects when ingested in excessive doses. It is therefore worthwhile to consider the risk-benefit ratio before embarking upon the use of high-dose vitamin supplementation for disorders were proof of efficacy is lacking.

Acne Vulgaris↗

[Evanescent toxic thyroid adenoma. Possible role of phenylpropanolamine].

A patient with a toxic adenoma, already reduced in size by TSH, presented on the third day after treatment of a common cold by phenylpropanolomine, a severe pain in the thyroid gland. 4 weeks later, the nodule, which measured 3 x 4 cm. had clinically disappeared and the scan returned to normal. The disappearance 5 months later of the antithyroid antibodies confirmed the cure. Catecholamines, stimulating the production of thyroid hormone and producing temporary ischemia of the gland, phenylpropanolamine, a sympathomimetic drug, may have caused hemorrhagic necrosis of the adenoma and its disappearance.

Adenoma↗

Leukocyte count and bronchial hyperresponsiveness.

The relationship of total and differential blood leukocyte counts with bronchial methacholine response was studied in a population-based sample of 324 men. Geometric mean total leukocyte counts were significantly higher in reactors (6567 cells/mm3) than in nonreactors (5732 cells/mm3; p = 0.003). After adjusting for smoking habits, a factor contributing to both an elevation in peripheral leukocyte count and an increased level of airway responsiveness, reactor status remained significantly associated with leukocyte count. This association also persisted after controlling, with a logistic model, for atopy and common cold (marker of infection) and after excluding men with a history of asthma, chronic bronchitis, or low FEV1. Study of the differential leukocyte counts has shown that an increase was present for almost every type of leukocyte, and particularly evident for neutrophils. Whether these findings reflect an association between bronchial hyperresponsiveness and cellular inflammation needs more investigation.

Adult↗