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PubMed2002

Rhinovirus infection in nonasthmatic subjects: effects on intrapulmonary airways.

The common cold is a highly prevalent, uncomplicated upper airway disease. However, rhinovirus (RV) infection can lead to exacerbation of asthma, with worsening in airway hyperresponsiveness and bronchial inflammation. The current authors questioned whether such involvement of the intrapulmonary airways is disease specific. Twelve nonatopic, healthy subjects (forced expiratory volume in one second (FEV1) >80% predicted, provocation concentration causing a 20% fall in FEV1 (PC20) >8 mg x mL(-1)) were experimentally infected with RV16. Next to PC20 and the maximal response to methacholine (MFEV1 and MV'40p), the numbers of mucosal inflammatory cells and epithelial intercellular adhesion molecule (ICAM)-1 expression in bronchial biopsies were assessed before and 6 days after RV16 inoculation. RV16 infection induced a small but consistent increase in maximal airway narrowing, without a change in PC20. There was a significant increase in bronchial epithelial ICAM-1 expression after RV16, whereas inflammatory cell counts did not change. Nevertheless, the change in the number of submucosal CD3+ cells was correlated with the change in MV'40p. In conclusion, rhinovirus infection in normal subjects induces a limited, but significant increase in maximal airway narrowing, which is associated with changes in bronchial T-cell numbers. Together with the upregulation of bronchial epithelial intercellular adhesion molecule-1, these findings indicate that, even in healthy subjects, rhinovirus infection affects the intrapulmonary airways.

Adult↗
PubMed2004

An optical thin film assay incorporating rhinovirus protease inhibitors as detector reagents.

Human rhinoviruses (HRV) are the main cause of the common cold. Viral replication utilizes the activity of the HRV3C protease (3CP) enzyme [Antimicrob. Agents Chemother. 43 (1999) 2444; Antimicrob. Agents Chemother. 44 (2000) 1236]. Therefore, 3CP is an attractive target for antiviral drug development, and a new class of orally bioavailable irreversible 3CP inhibitors has been designed [J. Med. Chem. 45 (2002) 1607]. We have used related inhibitors to develop a rapid test for rhinovirus. The optical immuno assay (OIA) thin film detection technology utilizes an optically coated silicon surface to convert specific molecular binding events into visual color changes by altering the reflective properties of light through molecular thin films. The purpose of this study was to develop a rapid assay for the determination of 3CP combining the Thermo Electron Bio Star OIA technology and the newly designed inhibitor compounds. The advantage of this assay was in its approach, in which therapeutic and diagnostic targets are the same thus allowing patients with detected rhinoviruses to receive optimal treatment. Three different biotinylated inhibitor compounds were synthesized. The length of the spacer between the inhibitor and biotin core was 5, 10, and 15 atoms. These compounds were incorporated into the OIA format for the HRV assay development. A rapid (20 min) OIA test was developed using a 15 atom spacer biotinylated inhibitor (4). Forty different HRV serotypes were studied and thirty three serotypes of these 40 were detected (80%).

3C Viral Proteases↗
PubMed1999

Nasal flow limitation in children.

Nasal congestion due to the common cold may be exacerbated in small children because of their small nasal passages. Our aims were 1) to test the hypothesis that smaller children have relatively larger nasal airways compared to the intrathoracic airways, and 2) to examine the effect of stenting and a decongestant on nasal patency and nasal flow. During oral forced vital capacity (FVC) maneuvers, expiratory flow is limited by intrathoracic airways. During nasal FVC, flow at high volumes is limited by the nose. The point where the nasal flow-volume curve becomes superimposable on the oral curve (%Sup) depends on the relative resistance of nasal and intrathoracic airways. Fifty-four healthy children (28 male), median age 9.5 years (range 5.9-16.0), performed full forced respiratory maneuvers through: 1) the mouth, 2) the nose, 3) the nose after application of an external stent (Breathe Right (BR) strip), and 4) the nose following instillation of xylometazoline. Peak inspiratory and expiratory flow (PIF and PEF), and mid-inspiratory and expiratory flow (MIF50 and MEF50) all showed a significant decrease from the oral to the nasal baseline maneuver. Mean (SD) %Sup of the nasal baseline was 35.6 (13.7)% and was unrelated to height. PIF and MIF50 increased with the BR strip (P < 0.05). Xylometazoline also caused a significant increase in all measured flows (P < 0.05). Mean (SD) %Sup of the nasal maneuver after application of xylometazoline increased to 53.3 (14.0)%. We conclude that there is no evidence that relative resistance of nasal and intrathoracic airways change with height. The %Sup is easy to obtain and may prove a useful index of nasal patency.

Administration, Intranasal↗
PubMed2003

Interleukin-1beta and interleukin-1ra levels in nasal lavages during experimental rhinovirus infection in asthmatic and non-asthmatic subjects.

BACKGROUND: Exacerbations of asthma are often associated with rhinovirus (RV)-induced common colds. During experimental RV-infection in healthy subjects, increased levels of the pro-inflammatory mediator IL-1beta and the anti-inflammatory IL-1 receptor antagonist (IL-1ra) have been found in nasal lavage. OBJECTIVE: We postulated that the balance between nasal pro- and anti-inflammatory mediator expression is disturbed in asthma, resulting in more extensive inflammation following RV-exposure in asthma. METHODS: We determined IL-1ra, IL-1beta, and IL-8 in nasal lavages (days -2, 3, and 6) of non-asthmatics and asthmatics (with and without pre-treatment with the inhaled steroid budesonide) before and after experimental RV16-infection (days 0 and 1). RESULTS: Following RV16-infection, a significant increase in IL-8 was observed in the placebo- and budesonide-treated asthmatics (P=0.033 and 0.037, respectively), whereas IL-1beta only increased in the two asthma groups combined (P=0.035). A small, but significant, increase in IL-1ra was only observed in the budesonide-treated asthmatics (P=0.047). At baseline, IL-1ra levels were significantly higher in the non-asthmatics than in the placebo-treated asthmatics (P=0.017). CONCLUSION: These results demonstrate differences between non-asthmatic and asthmatic subjects in the basal levels of nasal cytokines and their inhibitors, and in the effect of experimental RV-infection on these levels. The results indicate that RV may enhance inflammation more markedly in asthmatics, and suggest that this may in part be explained by lower IL-1ra levels. In addition, the observation that budesonide-treatment may result in higher nasal IL-1ra levels supports the hypothesis that steroids act in part by increasing the endogenous anti-inflammatory screen.

Asthma↗
PubMedDate not supplied

[Efficacy and distribution pattern of the medical device Prima Difesa on rhinosinusal area].

AIM: Common cold is the commonest form of acute rhinitis and the first pathology of the upper airways. Viruses, the main responsible of this pathology, carry out their cytopathic effect on the ciliated cells of the airways mucosa. Mucociliary transport shows their dangerous effect. The aim of our study is to evaluate the effect of the medical device Prima Difesa on the functioning of the mechanism thanks to its composition and its distribution modality in the nasal cavities. MATERIALS AND METHODS: The present study has been performed on three groups of subjects with their informed consent: Group A (30 healthy subjects: 19 M, 11 F; 18-36 yrs, mean age: 29.1 yrs), Gruppo B (30 patients affected by rhinosinusal pathology: 7 M, 13 F; 19-38 yrs, mean age 30.7 yrs) and Group C (20 healthy subjects: 12 M, 8 F; 20-40 yrs, mean age: 32.2 yrs). The protocol of administration for the Group A and B, in order to evaluate the efficacy of Prima Difesa, consisted of 2 puff per nostril of Prima Difesa 4 times a day over 15 days. The follow-up of patients belonging to Grup A and Group B was articulated in three consecutive visits, each consisting of: anterior rhinoscopy, active anterior rhinomanometry, measurement of mucociliary transport (TMCt). The C patients underwent only one administration of the device to the extent of evaluating through endoscopy its distribution modality in the nasal cavities. RESULTS: The results show that clinical effects, evaluated in term of improvement of MCTt and in term of decreasing of nasal resistance, are particularly clear in patients with alterations of these parameters caused by rhinosinusal pathologies. The device can reach the "key" areas of rhinosinusal pathologies that are: middle turbinate and osteomeatal complex. Beside, the percentage of diffusion, about 30% of the middle turbinate head, justifies its clinical effect. CONCLUSIONS: The medical device Prima Difesa has resulted to be able in interfering with the correct maintenance and performance of the Mucociliary Transport mechanism, that represents an important aspecific machinery for the local defence of nasal mucosa by microbial injuries.

Acute Disease↗
PubMed2001

Toxicity of over-the-counter cough and cold medications.

Over-the-counter (OTC) cough and cold medications are marketed widely for relief of common cold symptoms, and yet studies have failed to demonstrate a benefit of these medications for young children. In addition, OTC medications can be associated with significant morbidity and even mortality in both acute overdoses and when administered in correct doses for chronic periods of time. Physicians often do not inquire about OTC medication use, and parents (or other caregivers) often do not perceive OTCs as medications. We present 3 cases of adverse outcomes over a 13-month period-including 1 death-as a result of OTC cough and cold medication use. We explore the toxicities of OTC cough and cold medications, discuss mechanisms of dosing errors, and suggest why physicians should be more vigilant in specifically inquiring about OTCs when evaluating an ill child.

Acetaminophen↗
PubMed2004

[Cardiovascular diseases, medical apocalypse of the 21st century?].

The aim of this article is to bring forward and realise the size of cardiovascular diseases and the burden of its numbers that concern practising doctors in Lower Silesia, in Poland, Europe and the world. Every fourth patient knocking at the GP's door comes with a problem with the circulatory system. These diseases are the reason for every second in hospitalization or referral to a specialist. The most common diagnosis is not the common cold but arterial hypertension. Three of the most common diseases in patients over 65 years old are: hypertension, ischaemic heart disease, and atherosclerosis of the brain arteries. Poland belongs to the group of developed countries with an emerging economy, where degenerative diseases dominate, and cardiovascular diseases account for the biggest problems within the Health System. Nearly half of male deaths (46%) and over half of female deaths (56%) are the consequence of cardiovascular diseases. 80% of people around the world live in developing economies, where cardiovascular diseases cause 23% of all deaths. Every fifth person lives in a developed country and has a 50% chance of dying because of cardiovascular diseases. Will these diseases become "the number one killer" of the 21st century? 27% lost healthy life years are due to arterial hypertension, ischeamic heart disease, and congestive heart failure so their epidemiology is being regarded in this article.

Adult↗
PubMed1989

A study of prescribing in rural Sri Lanka.

A total of 2,344 prescriptions written for 800 outpatients attending eight peripheral health institutions in Sri Lanka were studied to establish the prescribing trends of Assistant Medical Practitioners (AMPs) and Registered Medical Practitioners (RMPS) who are the chief providers of health care in rural Sri Lanka. Bacterial infections accounted for 30.7% of the morbidity, with viral fever, influenza or the common cold for another 22.6%. Analgesics were the most commonly prescribed class of drugs with antimicrobials second (20% and 15.2% of all prescriptions respectively). Antimicrobials were prescribed for 42.4% of patients. Of all prescriptions 80.4% were judged appropriate (rational), and 98.6% were prescribed in correct dosage. Those considered unnecessary included mixtures, vitamins and antimicrobials. The therapeutic management of three cases of acute emergencies was satisfactory.

Allied Health Personnel↗
PubMed1995

[Risk factors for Guillain-Barre syndrome in northern China: a case-control study].

We conducted a case-control study in northern China to estimate possible risk factors for Guillain-Barre Syndrome (GBS). Forty patients were consecutively seen at the PUMC hospital and the Second Hospital of Hebei Medical College between July and September 1991. The diagnosis was established following the NINCDS criteria for GBS. Among 36 patients with measurements of motor evoked potentials, 34 had evidences of demyelination. Eighty controls chosen from spouses or siblings, and neighbors or work/school mates, were matched by sex and age (+/- 3 years). Using the Mantel-Haenszel estimate of the odds ratio, cold rain, overloaded activities, a history of diarrhea, common cold, and exposure to organophosphorus one month before onset, significantly increased, at least six-fold, the risk for development of GBS. Cases and controls did not differ in the number of previous vaccinations. We suggest that a single antigent is less likely of etiological importance in GBS.

Adolescent↗
PubMed2000

ICAM-1 receptors and cold viruses.

Human rhinoviruses (HRVs), the single most important etiologic agent of common colds, are small viruses composed of an icosahedral protein shell that encapsidates a single, positive RNA strand. Multiplication of HRVs occurs in the cytoplasm of the host cell. To produce infection, HRVs must first attach to specific cellular receptors embedded in the plasma membrane. Ninety percent of HRVs immunogenic variants use as receptor intercellular adhesion molecule-1 (ICAM-1), a cell surface glycoprotein that promotes intercellular signaling in processes derived from inflammation response. As HRV receptor, ICAM-1 positions the virus to within striking distance of the membrane, and then triggers a conformational change in the virus that ultimately results in delivery of the viral RNA genome into the cytoplasm, across a lipid bilayer. The interaction between ICAM-1 and HRVs has been analyzed by the combination of crystal structures of HRVs and ICAM-1 fragments with electron microscopy reconstructions of the complexes. The resulting molecular models are useful to address questions about receptor recognition, binding specificity, and mechanisms by which ICAM-1 induces virus uncoating.

Animals↗
PubMed1990

A soluble form of intercellular adhesion molecule-1 inhibits rhinovirus infection.

Rhinoviruses belong to the picornavirus family and cause about 50% of common colds. Most rhinoviruses and some coxsackie viruses share a common receptor on human cells. The glycoprotein intercellular adhesion molecule-1 (ICAM-1) has recently been identified as the cellular receptor for the subgroup of rhinoviruses known as the major groups. ICAM-1 is a member of the immunoglobulin supergene family and is a ligand for lymphocyte function-associated antigen-1 (LFA-1); these ICAM-1/LFA-1 interactions are critical to many cell adhesion processes involved in the immunological response. Because anti-ICAM-1 antibodies can block binding of major-group rhinoviruses to cells, we considered that antagonism of virus-receptor interaction might be a way of preventing rhinovirus infection. We have constructed and purified a soluble form of the ICAM-1 molecule, which is normally membrane-bound, and demonstrated that it is a potent and specific inhibitor of rhinovirus infection.

Amino Acid Sequence↗
PubMed1988

Cold panniculitis in children (Haxthausen's disease).

This report describes the rarely recognized, but probably quite common, cold panniculitis, which occurs predominantly in infants, as red indurated plaques or nodules on the face, following exposure to severe cold.

Cold Temperature↗
PubMedDate not supplied

Ammonia exposure: a common cause for sinusitis. A case report and review of the literature.

Sinuses are a part of the upper respiratory system and sinusitis has been well-defined as an inflammation of the mucous membrane. Sinusitis occurs commonly as a result of allergies, polyps, common cold and environmental pollution. Reports of sinusitis secondary to ammonia exposure, while common clinically from a reporting point of view, have not been described extensively in the literature. We describe here a patient who was exposed to ammonia gas and developed chronic relapsing sinusitis. The mechanism of injury and review of the world literature indicate that although common clinically, chronic sinusitis as a result of ammonia exposure has not been described extensively.

Ammonia↗
PubMed1996

Acute sensorineural hearing loss caused by Mycoplasma pneumoniae.

Four cases with acute sensorineural hearing loss on one side and one case with bilateral ear fullness associated with Mycoplasma pneumoniae (MP) were described. These cases were characterized by highly elevated MP complement fixation titer, and cold hemagglutinin titer. All patients experienced cochlear symptoms in an early stage following common cold. In all cases, clarythromycin (CAM) had been administered for 10 days, and adenosine triphosphate (ATP), vitamin B1, B12, and prednisolone were concurrently administered for 14 days. Two cases with acute hearing loss and one case with ear fullness returned to normal hearing after treatment. The other cases were remarkably improved in hearing level. MP is a common causative agent for protein respiratory disease. The true incidence of hearing loss in this disease may be higher than has been reported so far. Prompt diagnosis possibly facilitates the administration of specific treatment and leads to good prognosis.

Adult↗
PubMed2006

Olfactory disorders following upper respiratory tract infections.

Postviral olfactory disorders usually occur after an upper respiratory tract infection (URTI) associated with a common cold or influenza. With a prevalence between 11 and 40% they are among the common causes of olfactory disorders. Women are more often affected than men and post-URTI disorders usually occur between the fourth and eighth decade of life. The exact location of the damage in post-URTI is not yet known even though from biopsies a direct damage of the olfactory receptor cells is very likely. Nevertheless, central mechanisms cannot completely be ruled out. The diagnosis is made according to the history, clinical examination and olfactory testing. Affected patients usually recall the acute URTI and a close temporal connection should be present to establish the diagnosis. Spontaneous recovery might occur within 2 years. So far, no effective therapy exists even though specific olfactory training might be promising.

Humans↗
PubMed1996

Health care of villagers in northeast Thailand--a health diary study.

A one-month health diary was used as a research instrument for measuring health care in the northeastern rural area of Thailand during the month of November, 1992. Three hundred forty-five respondents, which represents 22.2% of the total households in 12 villages from 2 districts in the Khon Kaen province of northeast Thailand, completed the health diaries. Self-medication was most practiced for health care (37.5% of ill persons) followed by health service utilization at local health center (19.4%), at community hospital (11.4%), at private clinic (11.4%), and by "wait and see" (9.0%). Analgesics were the most frequently used drugs for relief of fever, headache, common cold and abdominal pain. The use of a combination of drug (eg. a cocktail) was common as self-medication for relief of back and leg pain. Traditional or herbal drugs were a frequently chosen alternative for self-medication, both in adult and children. The authors suggest that the villagers should be educated concerning drug hazards in order to increase their background knowledge on drug use.

Adolescent↗
PubMed2005

Combating the diabetes epidemic.

What would happen if one could develop diabetes as quickly as catching the common cold? Well of course this is not the case, but diabetes is becoming more and more common in the United States. From the period 1980 through 2002, the number of Americans diagnosed with diabetes mellitus more than doubled (from 5.8 million people to 13 million people). New evidence reveals that one in three Americans born in 2000 will develop diabetes sometime during their lifetime. Diabetes has the greatest impact on older adults, women, and particular racial and ethnic groups. One in five adults over the age of 65 has diabetes. African Americans, Hispanics, Native American Indians and Alaska Native adults are two to three times more likely than Caucasian adults to have diabetes. In addition to these statistics, an estimated 41 million United States adults aged 40-74 have prediabetes. Prediabetes is defined as blood glucose elevated more than normal, but not increased enough to be classified as that of diabetes mellitus. Fasting blood glucose levels greater than 100 mg/dl but less than 126 mg/dl is characteristic of prediabetes. These people are at great risk for developing diabetes.

Adult↗