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Query: UMLS:C0006271 (bronchiolitis)
 5,174 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In 50 of 94 patients with bronchiolitis obliterans we found no apparent cause or associated disease, and the bronchiolitis obliterans occurred with patchy organizing pneumonia. Histologic characteristics included polypoid masses of granulation tissue in lumens of small airways, alveolar ducts, and some alveoli. The fibrosis was uniform in age, suggesting that all repair had begun at the same time. The distribution was patchy, with preservation of background architecture. Clinically, there was cough or flu-like illness for 4 to 10 weeks, and crackles were heard in the lungs of 68 per cent of the patients. Radiographs showed an unusual pattern of patchy densities with a "ground glass" appearance in 81 per cent. Physiologically, there was restriction in 72 per cent of the patients, and 86 per cent had impaired diffusing capacity. Obstruction was limited to smokers. The mean follow-up period was four years. With corticosteroids, there was complete clinical and physiologic recovery in 65 per cent of the subjects; two died from progressive disease. This disorder differs from bronchiolitis obliterans with irreversible obstruction. It was confused most often with idiopathic pulmonary fibrosis. In view of the benign course and therapeutic response, a histologic distinction is important.
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PMID:Bronchiolitis obliterans organizing pneumonia. 396 33

This paper is a report on the first (serological) phase of a study organized by WHO in collaboration with the WHO International Reference Centre for Respiratory Virus Diseases other than Influenza in Bethesda, Md., USA, to define the viral etiology of severe respiratory infections in children, particularly in tropical areas. Paired sera from 528 children up to 5 years old admitted to hospital with severe respiratory illness of probable viral etiology were collected in 10 countries and sent frozen to the International Reference Centre, where standard complement-fixation tests were made for the following agents: parainfluenza virus types 1, 2 and 3, influenza virus types A and B, adenoviruses, respiratory syncytial virus, Mycoplasma pneumoniae, Coxiella burneti and psittacosis-ornithosis.Some 41% of paired sera showed rising antibody titres for one or more of these agents, multiple infections being observed in 8%. In most of the countries the pattern of infection was similar. RS virus was the most important respiratory tract pathogen of early life, particularly in the first year of life and in cases of bronchiolitis and pneumonia; the parainfluenza viruses were next in importance, particularly in cases of croup, but, in contra-distinction to RS virus infections, they were commoner in older children. Influenza, adenoviruses, and M. pneumoniae were of moderate importance, and C. burneti and the psittacosis-ornithosis agents were relatively rare. This pattern is similar to that which has been observed in temperate climates.
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PMID:WHO respiratory disease survey in children: a serological study. 530 80

Numerous epidemiological studies have shown that there is excess respiratory disease morbidity in areas of high atmospheric pollution, implying an interactive effect on the clinical illness associated with these common infections. The principal etiologic agents of human respiratory infections are respiratory syncytial virus (RSV), influenza viruses (IV), parainfluenza virus types 1 and 3 (P1, P3), adenoviruses (AD), rhinoviruses (RV) and Mycoplasma pneumoniae (Mpn). Understanding the pathogenesis of the excess morbidity related to pollutants would facilitate detection of undesirable human health effects and provide a basis for intervention strategies. Through use of experimental model systems the mechanism of toxic effects could be defined (whether microbiological, immunological, pathological or physiological) to provide direction for appropriate studies in the human host. Small animal models of IV and Mpn infections have been available for many years; recently, experimental models of several more common viral diseases have been developed. A parallel to human RSV infections is provided by the ferret: virus replicates in the lungs of infant animals, but only in the noses of adults. The common cotton rat infected with RSV develops small airways lesions which may mimic the pathophysiologic changes of bronchiolitis. Both guinea pigs and Syrian hamsters are susceptible to human P3 virus, developing peribronchiolar and interstitial lesions. Practical small animal models for human AD and RV infections are not available because of the high host-specificity of these agents. Both the RSV and P3 model infections are nonlethal which enables study for long-term sequelae. Recent reports of pulmonary function abnormalities among children suffering bronchiolitis in infancy underscores the importance of defining toxic influences which could play a role by making the initial infections more severe.
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PMID:Experimental models for study of common respiratory viruses. 625 Aug 7

A retrospective study of the laboratory results on respiratory specimens received from children under 12 years of age between January 1977 and December 1979 was carried out. These children were either hospital patients, usually with lower respiratory infections, or outpatients on the Influenza Surveillance Programme. The overall virus isolation rate was 26.8%, and the isolation rate among hospital patients, 38.5%. Epidemics or outbreaks were associated with infections due to the influenza viruses, respiratory syncytial virus (RSV), the parainfluenza viruses and the enteroviruses. RSV, parainfluenza virus types 1 and 3, and the adenoviruses caused infection mainly in young children under 3 years of age, while the influenza viruses and Mycoplasma pneumoniae caused infection more frequently in older, school-aged children. There was a strong clinical association of bronchiolitis with RSV and the rhinoviruses, of laryngitis or laryngotracheobronchitis with parainfluenza virus types 1 and 2, of pneumonia with Mycoplasma pneumoniae, and of upper respiratory infection or "flu" with the influenza viruses. The significance of some of these findings is discussed.
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PMID:Acute non-bacterial infections of the respiratory tract in Singapore children: an analysis of three years' laboratory findings. 626 79

The etiology and epidemiology of croup were studied in a pediatric group practice over an 11-year period, 1964 to 1975. Croup was diagnosed in 951 instances in 6,165 cases of lower respiratory tract infection (LRI) studied. As census figures of the practice clientele were available, attack rates were calculated. The incidence of total LRI was highest in the first year of life. In contrast, the attack rate for croup was highest in the second year of life; the rate declined gradually after that age. Croup was not diagnosed in the first month of life. Boys were 1.43 times more likely to develop croup than were girls. Three hundred sixty agents were isolated from the 951 croup cases. The parainfluenza viruses accounted for 74.2% of all isolates; 65% of the parainfluenza isolates were classified as parainfluenza virus type 1. Respiratory syncytial virus, influenza viruses A and B, and Mycoplasma pneumoniae were the only other agents isolated in appreciable numbers. The propensity of various agents to produce croup symptoms in children with LRI due to specific microorganisms was 58% for parainfluenzae type 1,60% for parainfluenzae type 2, and 29% for parainfluenzae type 3; similar figures for the other agents varied from 5% to 16%. The role of the various agents in the etiology of croup varied with patient age and depended on the propensity of the agent to produce the croup syndrome and the frequency of isolation of the agent at that age. The parainfluenza viruses were the most important croup agents at all ages; respiratory syncytial virus caused croup in children less than 5 years of age whereas the influenza viruses and M pneumoniae were significant causes of croup only in children more than 5 to 6 years old. Croup occurred predominately in late fall and early winter, times when the parainfluenza viruses, especially type 1, occurred most frequently. The epidemiology of croup differs from that of bronchiolitis, pneumonia, and tracheobronchitis; knowledge of this should be helpful to the clinician caring for children with LRI.
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PMID:Croup: an 11-year study in a pediatric practice. 630 11

A diagnosis of 979 respiratory viral infections was made in hospitalized children. Respiratory syncytial virus greatly out-numbered the other viruses: it caused 58% of the total virus infections and occurred in winter epidemics. Influenza A and B virus occurred during late winter and spring, rhinovirus had a seasonal distribution towards spring and autumn, whereas adenovirus types 1, 2 and 5 had no distinct seasonal distribution. Whereas respiratory syncytial virus were mainly associated with bronchiolitis and adenovirus type 7 with pneumonia, rhinovirus infections were most often found in children with episodes of acute bronchial asthma. The influenza A and B and adenovirus types 1, 2 and 5 infections often occurred with extrarespiratory symptoms, especially febrile convulsions.
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PMID:Viral infections of the respiratory tract in hospitalized children. A study from Oslo during a 90 months' period. 630 6

A survey of the virological and epidemiological features of acute respiratory diseases in children admitted to hospital in Naples has been carried out; the results of three years of research are reported.Between April 1979 and March 1982, 787 nasopharyngeal swabs were examined. There were 287 (36.5%) positive samples, with the highest isolation rate being found in children with bronchiolitis (39.5%).Among the different viruses isolated, adenovirus was the most common (161 positive samples, 56%); this agent appeared regularly in the different age and disease groups, with a marked increase in prevalence during the winter of 1980. Isolations of herpesvirus, respiratory syncytial virus and enterovirus were less frequent; however, echovirus 3 caused an epidemic in the summer of 1980. Influenza and parainfluenza viruses were seen fairly infrequently; two cases of Reye's syndrome yielded strains of influenza B.
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PMID:Viruses associated with acute respiratory infections in children admitted to hospital in Naples, 1979-82. 632 32

Nasal secretions from 349 Austrian children under six years of age who were hospitalized for respiratory illnesses were screened for the presence of respiratory syncytial virus (RSV), parainfluenza virus 1 and 3, adenovirus and influenza A virus over a period of four years by the immunofluorescence technique. 35% of the specimens were found to be positive for one of the five viruses investigated. RSV was detected in 31% of the nasal secretions and was thus the most frequently encountered causative agent of respiratory infections in the age group investigated. RSV infections occurred almost exclusively in the winter months and were mainly associated with bronchiolitis and pneumonia. Only sporadic infections were found with one of the other viruses investigated.
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PMID:Respiratory virus infection in hospitalized children in Austria 1979-1982. Diagnosis by immunofluorescence. 638 15

Respiratory infection, most prominently bronchiolitis, contracted in infancy is frequently associated with recurrent wheezing episodes and asthma in later life. Atopic individuals and those with a family history of allergy or asthma in first-degree relatives are especially susceptible to the development of chronic airway dysfunction and should be identified early. It is also noteworthy that parenteral cigarette smoking may serve as an additional marker of the high-risk patient. Respiratory infection affecting older children and adults is more commonly due to rhinovirus and influenza A and may cause a transient hyperreactivity to bronchoconstrictor agonists, but does not cause persistent dysfunction. The mechanism(s) by which antecedent respiratory infection is related to recurrent wheezing and asthma remain speculative, and at present a direct causal relationship cannot be established with certainty. Infectious respiratory disorders are also a cause of exacerbations of asthma in adults but more commonly in children, and these also are primarily viral in origin. Consequently, in the absence of clear evidence of bacterial infection, routine antibiotic use in this setting is unwarranted.
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PMID:The role of infection in asthma: implications for antibiotic therapy. 671 12

Epidemiologic characteristics of childhood tracheobronchitis occurring over a 104-month period in Chapel Hill, NC, were ascertained and compared to those of other pediatric lower respiratory illness (LRI) syndromes. Tracheobronchitis accounted for 40% of all LRI seen at the community's only pediatric practice. Tracheobronchitis incidence was highest during the first two years of life, through the ratio of tracheobronchitis incidence to total LRI incidence increased with age. A viral pathogen or Mycoplasma pneumoniae was isolated from 23% of tracheobronchitis cases; the agents most commonly isolated were parainfluenza viruses, influenza viruses, respiratory syncytial virus, and M. pneumoniae. Influenza virus, particularly type B, was isolated more commonly in tracheobronchitis than in other LRI syndromes. Over all age groups, peak incidence of tracheobronchitis, like that of pneumonia and bronchiolitis, occurred during the winter months. In school-age children, however, tracheobronchitis incidence was more likely than that of other syndromes to be elevated in late winter or early spring, when several influenza B outbreaks occurred in Chapel Hill. Available evidence suggests that risk of chronic respiratory disease is related inversely to age at which acute respiratory infection first occurs, and that a component of wheezing may not be required to confer such risk. These considerations, coupled with the high incidence of tracheobronchitis early in life, warrant further description of this syndrome and assessment of its implications.
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PMID:The epidemiology of tracheobronchitis in pediatric practice. 679 94


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