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PubMed1976

Measurements of the prevalence of viral infections.

Viral diseases exert their major impact through morbidity, impairment of personal health, loss of time at work and school, and cost of medical care. Relatively few of the known viruses cause a significant number of deaths; influenza, childhood viral pneumonia, and hepatitis are the only viral diseases causing more than 1,000 deaths per year. Data based on the National Health Interview Survey of the National Center for Health Statistics show that the common cold annually causes 35.6 acute illnesses per 100 persons. The data reported by the National Therapeutic Disease Index (on the basis of visits by patients to a sample of 1,500 private physicians) show that influenza and other acute respiratory conditions account for about one-third of all visits to physicians. Nearly all viruses first infect humans in infancy and childhood, with a relatively low fatality rate but with frequent episodes of illness.

Adenoviridae↗
PubMed2003

Rhinoviruses in the pathogenesis of asthma.

Using sensitive diagnostic methodologies, epidemiologic studies during the past decade have allowed the identification of human rhinoviruses (RVs), generally recognized as "common cold viruses," as major asthma precipitants. This association was further established by evaluating the impact of RV infection in airway obstruction and inflammation during naturally acquired or experimentally induced RV colds. There is now strong evidence that RVs can infect and propagate not only in the upper but also in the lower airways. Bronchial and pulmonary epithelia infected by RVs are rich sources of inflammatory mediators, which may initiate or augment airway inflammation and obstruction. Furthermore, in an atopic environment, responses to the virus are skewed by and toward an "atopic," Th2-like balance, which may further enhance inflammation and exacerbate asthma.

Asthma↗
PubMed1997

Tropical illness profiles: the psychology of illness perception in Malawi.

Psychological and social investigations of tropical diseases can make a significant contribution to understanding and managing many illnesses. One-hundred and seventy-five Malawian university students rated peopled who suffered from AIDS, malaria, schistosomiasis and the 'common cold', on 11 psycho-social dimensions related to illness. Analysis of variance and factor analysis was used to distinguish distinctive illness profiles reflecting perceptions of (people with) these illnesses. Results suggested that infirmity was associated with AIDS and that the seriousness of malaria was minimized. Within a context of many threats to health the importance of distinguishing between serious illnesses is emphasized for effective health promotion interventions.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Mechanisms of the placebo effect of sweet cough syrups.

The review discusses the large placebo effect associated with cough medicines and speculates on the observation that most cough medicines are formulated as sweet syrups rather than capsules or tablets. The review proposes that the major benefit of cough medicines for treatment of cough associated with common cold is related to the placebo effect rather than the pharmacological effect of an active ingredient. The placebo effect is discussed in terms of physiological effects of cough syrups associated with the taste of the medicine and true placebo effects associated with belief in the therapy. The idea is developed that a sweet taste may modulate cough at the level of the nucleus tractus solitarius, possibly by influencing the production of endogenous opioids.

Animals↗
PubMed2004

Role of viruses in exacerbations of chronic obstructive pulmonary disease.

Exacerbations of chronic obstructive pulmonary disease (COPD) are a major cause of morbidity and mortality and hospital admission. Respiratory viral infections, especially rhinoviruses, are a major cause of COPD exacerbations, with upper respiratory tract infections being associated with over 50% of COPD exacerbations. The presence of an upper respiratory tract infection leads to a more severe exacerbation and a longer symptom recovery time at exacerbation. Respiratory viral infections occurring during COPD exacerbations are more likely to lead to hospitalization. Sputum inflammatory markers were found to be higher in those patients with symptoms of a common cold or where rhinovirus was detected at exacerbation, thus suggesting that viral infections lead to greater airway inflammation and thus more severe exacerbations. COPD exacerbations are associated also with systemic inflammatory effects with increases in markers such as plasma fibrinogen and interleukin-6. Respiratory viruses have also been detected when the patients are stable, and this suggests that chronic viral infection may occur. Strategies to prevent viral infection will have a significant effect on the morbidity of COPD and will improve quality of life.

Common Cold↗
PubMed2000

A case of toxic epidermal necrolysis-type drug eruption induced by oral lysozyme chloride.

We report a case of toxic epidermal necrolysis-type drug eruption. A 23-year-old man took an oral over-the-counter preparation for the common cold. A few days later, generalized erythema developed with systemic malaise and pain. A multiple blister formation followed, and Nikolsky's sign was noted on each blister. A lymphocyte stimulation test (LST) with the patient's peripheral lymphocytes strongly suggested that the eruption was attributable to lysozyme chloride which was included in the preparation taken. Following an intravenous drip of betamethasone for two weeks, the eruptions improved favorably.

Acetaminophen↗
PubMed2000

Experimental rhinovirus 16 infection increases intercellular adhesion molecule-1 expression in bronchial epithelium of asthmatics regardless of inhaled steroid treatment.

BACKGROUND: Rhinovirus infections in airway epithelial cells in vitro have been shown to upregulate intercellular adhesion molecule-1 (ICAM-1) expression. Epithelial ICAM-1, in its dual role as the major rhinovirus receptor and as adhesion molecule for inflammatory cells may be involved in the pathogenesis of rhinovirus-induced exacerbations of asthma. OBJECTIVE: We aimed to investigate the effect of experimental rhinovirus 16 (RV16) infection on ICAM-1 expression in bronchial mucosal biopsies in asthma. In addition, the effect of 2 weeks pretreatment with inhaled budesonide (800 microg b.d.) on RV16-associated changes in ICAM-1 expression was studied. METHODS: The study had a parallel, placebo-controlled design in 25 steroid-naive nonsmoking atopic asthmatic subjects. After 2 weeks budesonide (BUD) or placebo (PLAC) pretreatment bronchoscopy was performed 2 days before (day -2) and 6 days after (day 6) RV16 inoculation (on days 0 and 1). Immunohistochemical staining for ICAM-1 was performed on snap-frozen bronchial biopsies. ICAM-1 staining intensity on the basal epithelial cells was scored semiquantitatively from 1 (weak) to 3 (intense). Similarly, epithelial intactness was noted (1 = basal cells only, 2 = basal and parabasal cells, 3 = intact epithelium). RESULTS: ICAM-1 scores were not significantly different between the groups at day -2 (P > or = 0.08). Subsequent RV16 infection was associated with a trend towards an increase in ICAM-1 expression in the BUD-group (P = 0.07), whereas the increase was significant in the PLAC-group (P = 0.03). However, the increase was not significantly different between the groups (P = 0.74). Epithelial intactness score was not different between the groups before RV16 infection (P > or = 0.07), and no significant changes were observed in either group (P > or = 0.59). Moreover, ICAM-1 score did not correlate significantly with epithelium score in either group, at any time-point (P > or = 0.27). CONCLUSION: We conclude that an RV16 common cold in atopic asthmatic subjects is associated with increased ICAM-1 expression in the bronchial epithelium, which is not related to epithelial intactness. Glucocorticoid treatment does not appear to prevent the RV16-associated increased ICAM-1 expression. This suggests that other treatment modalities are required to protect against the spreading of infection during rhinovirus-induced exacerbations in asthma.

Administration, Inhalation↗
PubMed1994

Rapid culture-amplified immunofluorescent test for the detection of human rhinoviruses in clinical samples: evidence of a common epitope in culture.

Ohio HeLa cells in multichamber slides were inoculated with nasal samples from patients presenting with common cold symptoms and incubated at 33 degrees C with gentle shaking for 48 hours. The cultures were fixed with cold acetone, and viral antigens were detected by immunofluorescence using an antirhinovirus type 2 (HRV-2) polyclonal serum. Of 158 samples, 58 (36.7%) and 57 (36%) were positive for HRV by virus isolation (confirmed by acid lability test) and by culture-amplified immunofluorescent (CAIF) test, respectively. The correlation between the two tests was highly significant (P = 0.0001). Nasal washings or nasal/throat swabs were equally suitable for detecting virus by isolation but not by CAIF. On the other hand, nasal washings were better than nasal/throat swabs for detecting HRV by CAIF. In an ELISA system, the polyclonal anti-HRV-2 serum recognized a rhinovirus antigen expressed in situ within 48 hr postinfection by all the 11 HRV serotypes investigated. However, 60 hr postinfection, the anti-HRV-2 serum recognized only homologous and closely related HRV antigens. These results suggest that a rhinovirus "common" antigen may be expressed some 48 hr after infection of Ohio HeLa cells with rhinoviruses. The CAIF test provides a sensitive, rapid and reliable procedure to detect wild-type rhinovirus infection as well as a clear alternative to detection by isolation.

Antigens, Viral↗
PubMed2003

Mechanisms of virus-induced asthma.

In children and adults with asthma, infections with common cold viruses such as respiratory syncytial virus and rhinovirus frequently cause exacerbations of asthma. Recent studies suggest that these and other respiratory viruses infect the lower airways, and that the infected epithelial cells help to initiate immune responses to the virus. These immune responses have antiviral effects, but also enhance airway inflammation and may add to cold symptoms and airway obstruction. Moreover, there are data to suggest that there may be specific interactions between allergic and virus-induced inflammatory responses that contribute to lower airway dysfunction in asthma. Finally, impaired T-helper type 1-like lymphocyte responses during viral infections may be a risk factor for more severe viral illnesses in patients with allergies and asthma. It is hoped that these advances in our understanding of the relationship between viral infections and exacerbations of asthma will translate into new therapeutic targets for virus-induced exacerbations of asthma.

Asthma↗
PubMed2003

Inappropriate antibiotic prescription to children with acute respiratory infection in Brazil.

OBJECTIVE: To determine the rate of inappropriate antibiotic prescription and to describe the types of antibiotics prescribed by health workers to children with acute respiratory infection (ARI). DESIGN: Cross-sectional survey conducted in 6 state capitals of Brazil. METHODS: A representative sample of facilities was selected in each state using a cluster sampling method based on the mean number of visits of children less than 5 years of age. In each facility, consultations were observed and children were reassessed following standard guidelines. Health worker s diagnosis and treatment were compared with a gold standard and inappropriate antibiotic prescriptions noted. RESULTS: 1565 children with ARI from 156 health facilities (73% health centers) were included in study. Most children had a common cold (77.5%). Antibiotics were inappropriately prescribed in 9.2% (95% CI: 7.8, 10.7) of ARI cases (range: 2.8% to 25%). Most frequently prescribed antibiotics were those recommended by the ARI Program. Seventy-six percent of health workers explained to guardians how to use antibiotics at home and 3.9% demonstrated the first dose. Antibiotics were available in 84% of health facilities. CONCLUSION: Inappropriate prescription of antibiotics varied geographically in Brazil. More training and supervision is needed to decrease it.

Acute Disease↗
PubMed1995

Product characteristics and pharmacokinetics of intranasal ipratropium bromide.

The in vivo absorption potential of ipratropium bromide nasal spray was evaluated in studies involving healthy volunteers (0.03%, 0.06%, and 0.12% dosage strengths) and patients with perennial rhinitis (0.03% and 0.06%) and the common cold (0.06%). The dose used was two sprays per nostril, corresponding to a total dose of 84 micrograms, 168 micrograms, and 336 micrograms for the three dosage strengths. These studies indicate that 10% or less of active drug is absorbed systemically after nasal administration based on the amount of unchanged drug excreted in urine in a 24-hour interval. In most instances, the plasma drug concentrations were undetectable. In none of these studies did plasma ipratropium concentrations reach a level where systemic anticholinergic effects are known to occur.

Absorption↗
PubMed1989

[Therapeutic value of flavonoids in Rhinovirus infections].

The clinic evaluation of the canadian pharmacologic agent "propolis" verified its value known from the literature in common cold infections. 50 persons were treated in ENT Clinic of Marcinkowski's Medical Academy in Poznań during the 1987 year. The observed therapeutic effects were shortening of the disease duration. The regression of symptoms occurred in the first day of the therapy and the complete recovery followed in 1 day in 5 patients, in 2 day in 16, and in 3 day in 3. The placebo group has his full recovery in mean 4.80 days. In the therapeutic group the symptoms lasted 2.5 time shorter than in placebo one.

Adolescent↗
PubMed1983

Nose-, sinus- and ear-symptoms in 27 patients with primary ciliary dyskinesia.

Nose-, sinus- and ear-symptoms, signs and tests were studied in 27 patients with primary ciliary dyskinesia. All subjects had had daily nasal discharge since birth or early childhood. X-ray examination showed sinusitis, and most patients had frequent episodes of sinusitis symptoms. The frequency of common colds was apparently not increased. As a general rule, the patients had chronic secretory otitis media, but few episodes of acute otitis media. Repeated suctions, punctures, and insertion of tubes had been disappointing, but more radical surgery of the nose and sinuses had helped some of the patients. It is concluded that knowledge of the very characteristic ENT symptoms is important in respect of an early diagnosis and starting preventive treatment in order to inhibit the development of lung damage. The ENT symptoms, on the other hand, are more often overtreated than the reverse.

Adolescent↗
PubMed2001

A model of viral wheeze in nonasthmatic adults: symptoms and physiology.

Episodic wheezing associated with viral infections of the upper respiratory tract (URT) is a common problem in young children but also occurs in adults. It is hypothesized that an experimental infection with human coronavirus (HCoV), the second most prevalent common cold virus, would cause lower respiratory tract (LRT) changes in adults with a history of viral wheeze. Twenty-four viral wheezers (15 atopic) and 19 controls (seven atopic) were inoculated with HCoV 229E and monitored for the development of symptoms, changes in airway physiology and provocative concentration of methacholine causing a 20% fall in forced expiratory volume in one second (FEV1) (PC20). At baseline, viral wheezers were similar to controls in PC20 (mean+/-SD log2PC20: 5.1+/-1.9 and 5.8+/-1.4 g x L(-1), respectively) but had a lower FEV1 than controls (mean+/-SD 85.8+/-11.4 and 95.6+/-13.2% predicted, respectively p < 0.05). Nineteen viral wheezers and 11 controls developed colds. Viral wheezers with colds reported significantly more URT symptoms than controls (median scores (interquartile range): 24 (10-37) and 6 (4-15), respectively p = 0.014). Sixteen viral wheezers and no controls reported LRT symptoms (wheeze, chest tightness and shortness of breath). The viral wheezers with colds had small (3-4%) reductions in FEV1 and peak expiratory flow on days with LRT symptoms (days 3-6), but a progressive reduction in PC20 from baseline on days 2, 4 and 17 after inoculation (by 0.82, 1.35 and 1.82 doubling concentrations, respectively). The fall in PC20 affected both atopic and nonatopic subjects equally. There were no changes in FEV1 or PC20 in controls. An adult model of viral wheeze that is independent of atopy and therefore, of classical atopic asthma was established.

Adult↗
PubMed1999

Risk factors for IgA nephropathy: a case-control study in Japan.

To disclose the risk factors for immunoglobulin A nephropathy (IgAN), we conducted a case-control study in the Tokai area of central Japan. The subjects were 94 patients, aged 20 years or older at diagnosis, who had histologically confirmed IgAN. Two sex-, age-, and residence-matched controls were randomly selected for each case from the general population. Information on medical history and lifestyle was collected using a self-administered questionnaire. The strength of association between IgAN and a potential risk factor was assessed by calculating an odds ratio. A family history of chronic nephritis, susceptibility to the common cold, preference for salty foods, frequent consumption of raw eggs, and a high intake of carbohydrates, including rice, were significantly associated with an increased risk for IgAN. Alcohol consumption, use of antioxidant vitamin supplements, and a high intake of protein, fat, monounsaturated fatty acids, and all/n-3 polyunsaturated fatty acids were somewhat protective against IgAN. Episodes of tonsillitis and exposure to organic solvents were found not to be associated with the risk in the present study. Our findings may provide some clues to the cause of IgAN.

Adult↗
PubMed1989

A new analysis of natural killing activity and the role of monocytes in normal subjects.

A new analysis of natural killing activity in peripheral blood is proposed. In this new analysis, we did not use a fixed E/T ratio, which is practised in the conventional analysis. We employed the individual effector/target cell ratio (E/T ratio) according to the number of effector cells in the peripheral blood: the individual E/T ratio of the person was set precisely at the point when the effectors in 1 ml of the person's peripheral blood encountered 2 x 10(4) of target cells. Asymptomatic healthy persons were divided into high activity and low activity groups. Comparison between mononuclear and non-adherent cells in terms of natural killing activity indicated that monocytes possessed a suppressive effect on the activity. In the asymptomatic low activity group, monocytes were more strongly suppressive as the natural killing activity of non-adherent cells became higher. The degree of this suppression was controlled by the change in the ratio of monocytes over large granular lymphocytes (Mo/LGL ratio). The asymptomatic high activity group showed the same suppressive pattern as patients with common cold syndrome, who were found to be in an activated state of natural killing activity. In an activated state, the monocyte suppression was to a lesser degree although the natural killing activity was higher than that in a non-activated state. Also in an activated state, the degree of the suppression was controlled by the Mo/LGL ratio. In addition, the degree of monocyte suppressive function as determined by one Mo/LGL ratio was almost identical both in an activated state and in a non-activated state of natural killing activity.(ABSTRACT TRUNCATED AT 250 WORDS)

Common Cold↗
PubMed2006

Evaluation of a national programme to reduce inappropriate use of antibiotics for upper respiratory tract infections: effects on consumer awareness, beliefs, attitudes and behaviour in Australia.

The over-use of antibiotics, in particular, inappropriate use to treat upper respiratory tract infections (URTIs), is a global public health concern. In an attempt to reduce inappropriate use of antibiotics for URTIs, and, in particular, to modify patient misconceptions about the effectiveness of antibiotics for URTIs, Australia's National Prescribing Service Ltd (NPS) has undertaken a comprehensive, multistrategic programme for health professionals and the community. Targeted strategies for the community, via the NPS common colds community campaign, commenced in 2000 and have been repeated annually during the winter months. Community strategies were closely integrated, using the same tagline, key messages and visual images, and were delivered in numerous settings including general practice, community pharmacy, child-care centres and community groups. Strategies included written information via newsletters and brochures, mass media activity using billboards, television, radio and magazines and small grants to promote local community education. The evaluation used multiple methods and data sources to measure process, impact and outcomes. Consistent with intervention messages, the integrated nationwide prescriber and consumer programme is associated with modest but consistent positive changes in consumer awareness, beliefs, attitudes and behaviour to the appropriate use of antibiotics for URTIs. These positive changes among the community are corroborated by a national decline in total antibiotic prescriptions dispensed in the community (from 23.08 million prescriptions in 1998-99 to 21.44 million in 2001-02) and, specifically, by a decline among the nine antibiotics commonly used for URTI such that by 2003 nationally 216,000 fewer prescriptions for URTI are written each year by general practitioners.

Anti-Bacterial Agents↗
PubMed1992

Use of symptoms and signs to diagnose maxillary sinusitis in general practice: comparison with ultrasonography.

OBJECTIVE: To establish the incidence of maxillary sinusitis in general practice and the predictive value of symptoms and signs. DESIGN: Population based study. SETTING: 9 general practices with 15,220 patients aged 15 years and older on the list. PATIENTS: 400 patients with 441 episodes in whom practitioners intended to confirm or to exclude sinusitis. MAIN OUTCOME MEASURES: Results of ultrasonography and signs and symptoms associated with positive results. RESULTS: 212 of the 441 episodes were confirmed by ultrasonography. 15.7 episodes occurred per 1000 adults per year. The five symptoms beginning with common cold (beta coefficient = 1.035), purulent rhinorrhoea (0.996), pain at bending (0.950), unilateral maxillary pain (0.640), and pain in teeth (0.606) were associated with positive results on ultrasonography. General practitioners' clinical diagnoses were correct in 177 episodes, false positive in 88, false negative in 22, and uncertain in 154. With an algorithm using the five weighted symptoms 243 of the diagnoses would have been correct, but 110 would remain uncertain and 44 cases would have been missed. CONCLUSION: The five symptoms algorithm would improve diagnostic accuracy of general practitioners, but incorrect and uncertain diagnoses cannot be avoided.

Adolescent↗