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

The relationship between certain host-related variables and the short-term outcome of hospitalization for severe acute lower respiratory infections was studied prospectively in a cohort of 103 pre-school Nigerian children. The respective mean ages of those with bronchiolitis and croup were 3.2 months and 18.9 months while the corresponding M:F ratios were 2.5:1 and 1:1. It was highly significant that all the eight children that died were malnourished (P less than 0.01). Furthermore, malnourished subjects with pleural effusion, in whom bacteraemia was common, stayed longest in hospital while subjects with bronchiolitis and croup, in whom malnutrition was distinctly uncommon, had the shortest duration of admission. Multiple microbial identifications and bacteraemia were common in malnourished subjects with ALRI. Mortality was significantly higher in older children (P less than 0.05), but sex, immunization/breast-feeding status and co-existing measles or pertussis, were individually neither related to the admission outcome nor the duration. It is concluded that malnutrition is a strong predictor of ALRI-related death in the pre-school child. The significance of bacteraemia and multiple microbial identifications in malnourished children, and the ARI-control implications of the study are discussed.
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PMID:Host factors and acute lower respiratory infections in pre-school children. 150 9

We studied clinical effects of meropenem (MEPM, SM-7338), a newly developed parenteral carbapenem beta-lactam drug, and following results were obtained. The patients were administered with 16-20 mg/kg of MEPM every 8 hours using 1 hour drip infusion. 1. Clinical effects of MEPM were studied in 10 children with various infectious diseases: 1 with acute bronchitis, and 2 each with acute tonsillitis, acute bronchopneumonia, acute pneumonia, acute urinary infection, and 1 with pertussis pneumonia. The case of pertussis pneumonia later developed bronchiolitis obliterans, hence a steroid and gamma-globulin were used. This case was excluded from the clinical evaluation. The efficacy rate was 100% (9/9), and the bacteriological eradication rate was 100% (6/6). 2. No side effects were noted. Clinical laboratory test values were investigated in 10 patients. There was a case of abnormal laboratory test findings with mild elevations of liver functions such as GOT, GPT, and gamma-GTP. These abnormalities disappeared in 1 week after the end of therapy.
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PMID:[Clinical study on meropenem in pediatric field]. 152 76

Acute respiratory infections cause four and a half million deaths among children every year, the overwhelming majority occurring in developing countries. Pneumonia unassociated with measles causes 70% of these deaths; post-measles pneumonia, 15%; pertussis, 10%; and bronchiolitis and croup syndromes, 5%. Both bacterial and viral pathogens are responsible for these deaths. The most important bacterial agents are Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus. The data on bacterial etiology of pneumonia during the first 3 months of life are limited, and almost no information on the role of chlamydia and pertussis in this age period is available. The distribution of viral pathogens in developing countries can be summarized as follows: respiratory syncytial virus, 15%-20%; parainfluenza viruses, 7%-10%; and influenza A and B viruses and adenovirus, 2%-4%. Mixed viral and bacterial infections occur frequently. Risk factors that increase the incidence and severity of lower respiratory infection in developing countries include large family size, lateness in the birth order, crowding, low birth weight, malnutrition, vitamin A deficiency, lack of breast feeding, pollution, and young age. Effective interventions for prevention and medical case management are urgently needed to save the lives of many children predisposed to severe disease.
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PMID:Epidemiology of acute respiratory infections in children of developing countries. 186 76

During a 3-year survey of 805 children with acute lower respiratory tract infection (ALRI) who were admitted to three hospitals in Buenos Aires, 31 fatal cases were recorded--a fatality rate of 3.8%. Of the 31 children who died, 77% were less than 1 year of age, 48% were boys, 58% were malnourished, 29% had previous respiratory disease, and 22% had previous congenital disease. All children who died had clinical diagnoses of pneumonia (71%) or bronchiolitis (29%). Autopsies were performed in 14 of the cases. Viral etiology was determined by both cell culture and indirect immunofluorescence (IIF) assay of either nasopharyngeal aspirates (NPA) or lung tissue and bacterial etiology was determined by isolation of organisms from blood, lung tissue, and/or pleural fluid. NPA was examined for Bordetella pertussis by IIF. Pathogens were identified in 65% of fatal cases. Seven cases were bacterial; seven cases were viral; and six cases resulted from mixed infections. Lung tissue yielded positive etiologic results in 10 of 13 cases. Histopathologic examination performed on specimens from the 14 autopsied children revealed necrotizing bronchiolitis with intranuclear inclusions (n = 5) and multifocal pneumonia (n = 9).
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PMID:Etiologic, clinical, and pathologic analysis of 31 fatal cases of acute respiratory tract infection in Argentinian children under 5 years of age. 227 Apr 6

This paper summarizes the first study on clinical, etiologic, and epidemiologic features of acute lower respiratory tract infection (ALRI) in children in Argentina. A total of 1,003 children less than 5 years of age (805 inpatients and 198 outpatients) presenting with ALRI were studied during a 40-month period. Nasopharyngeal aspirate (NPA), blood, urine, and throat-swab samples were collected when each child was first seen for care. Virologic studies were performed on the NPA by means of indirect immunofluorescence and isolation of virus in cell culture. Bacteriologic studies primarily were done by means of culture of blood or pleural fluid (when available); Bordetella pertussis and Mycoplasma pneumoniae, however, were searched for by the use of immunofluorescence and complement-fixation testing, respectively, in paired sera. Respiratory syncytial virus was the most commonly isolated virus, followed by adenovirus, parainfluenza virus, and influenza virus. Streptococcus pneumoniae was the most frequently isolated bacterium, followed by B. pertussis and Haemophilus influenzae type b. Overall, the patient fatality rate was 3.8% among inpatients with pneumonia or bronchiolitis.
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PMID:Etiologic and clinical evaluation of acute lower respiratory tract infections in young Argentinian children: an overview. 227 Apr 11

Patients with asthma who have incomplete control of their symptoms or require regular systemic steroidal therapy are said to have recalcitrant asthma. A systematic approach may significantly improve quality of life. Factors that should be evaluated include living with an antigen, occupational exposure, use of beta-adrenoreceptor blockers, use of nonsteroidal anti-inflammatory agents, sensitivity to dietary chemicals, endocrinopathies, gastroesophageal reflux, sinusitis, bronchopulmonary aspergillosis, and noncompliance. Other diseases may mimic asthma or exacerbate nonspecific bronchial hyperreactivity. These include congestive heart failure, chronic infectious bronchitis resulting from cystic fibrosis, ciliary dysfunction syndrome, and immunodeficiency syndromes, upper airway obstruction, pertussis syndrome, psychogenic coughs, bronchiolitis obliterans, chronic eosinophilic pneumonia, and vasculitides. A systematic approach to the evaluation of coexisting factors and potential exacerbating diseases is presented.
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PMID:Recalcitrant asthma: an allergist's approach. 229 75

Whooping cough is endemic throughout the world. It becomes epidemic every 4-5 years (Yugoslavia 3-4 yrs). In Europe its incidence ranges from 0.4 (Hungary) to even 59/100.000 inhabitants (Rumania; Yugoslavia 28), with a general letality of 0.1% (infants: 1%; 75% children who die are younger than one yr). Only 5-10% cases are supposed to be registered. A low socioeconomic status is more and more emphasized as the principal risk factor. Its transmission rate is high (home contacts: 80-100%); infectivity lasts five weeks, disease from the beginning of incubation to the sanation lasts 50-60 days. Female children are more frequently affected. The term "Pertussis syndrome" is more end more used because a similar disease can be caused by various agents (B. pertussis; B. parapertussis: 5%-20%-30% cases; B. bronchiseptica rarely; adenoviruses, RS virus, parainfluenza virus, influenza A and B virus, HSV, CMV, EBV, entero-, adeno-, corona-, rota-viruses; chlamydiae and mycoplasmae). Prior to introducing vaccination, 95% of population have had a typical or atypical form of pertussis. Its differential diagnosis includes pneumonias of various etiology, bronchitis, bronchiolitis during an acute respiratory infection, bronchial asthma, cystic fibrosis, tuberculosis and lymphadenopathy. Morbidity in USA was reduced by vaccination from 157 to 0,5-1,5/100,000 inhabitants; in SR Croatia it was six times reduced in period 1959-1970. According to the official sources 81% of children in Croatia and Yugoslavia get primovaccinated; the 80% level is generally accepted as a rational goal. Immunization schedules differ from country to country. Local and general reactions after combined vaccines are mostly caused by pertussis component.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Review of the present status of prevention, prophylaxis and therapy of pertussis and parapertussis]. 229 2

A review was conducted of all patients seen at Upstate Medical Center, Syracuse, NY, from June 1975, to June 1983, whose nasopharyngeal specimens were positive by specific Bordetella pertussis-fluorescent antibody stain. Sixty-one patients were identified; 46 were hospitalized and 15 were outpatients. The age and immunization status of the two groups were compared. Admission diagnosis, indices of illness severity, and clinical course were assessed for the hospitalized patients. Review of the house officers' initial differential diagnoses disclosed that pertussis was considered in the diagnosis in only 45% of the cases. Bronchiolitis was the next most commonly listed diagnosis. Frequent vomiting and severe coughing were the most helpful clinical findings leading to an accurate diagnosis. Abnormal chest roentgenograms and elevated white blood cell counts were present in a minority of our patients, whether the initial diagnosis was correct or not. Younger and less-immunized patients had more severe and prolonged clinical courses. This study demonstrates that the diagnosis of pertussis is often missed or delayed because clinical findings are similar to those of other respiratory infections in infancy. Suspicion of the diagnosis in children with nonspecific respiratory illness is required for early diagnosis, treatment, and prevention of spread to susceptible individuals.
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PMID:Inaccurate diagnosis in infants with pertussis. An eight-year experience. 401 97

Air compressors for inhalation devices were equipped with counters which were activated whenever the inhalation was started. They recorded the time of the activated inhaler. The counters were invisible for the parent and the doctor. 40 outpatients, all children, were randomly given such a device for treatment at home under surveillance of their parents. The duration, dose and frequency of inhalation was explained, and the parents were instructed that if the child should not be well, the inhalation frequency could be doubled. 21 children (age: 3.8 +/- 3.7 years from two months to 14 years), five girls, 16 boys, were on the inhalation devices equipped with the counter; ten had asthma, four acute bronchitis, four mild bronchiolitis, one had pertussis, one cystic fibrosis and one pneumonia. The prescribed inhalation treatment extended over 21 +/- 14 days (3 to 50), the inhalation frequency per day was one to three times. The measured inhalation unit (recorded inhalation time times frequency) amounted to 4.87 +/- 5.01 vs. 4.31 +/- 3.58 (n.s.) for the expected unit (expected inhalation units according to the prescription). The maximum and the minimum differences for the measured vs. the expected unit were significantly different (p < 0.001). Ten children inhaled 80 to 120% of the prescribed inhalation units, six children inhaled more than 140%, and five children less than 70% of the prescribed units. This resulted in an overall inhalation compliance of 47.6%. This is the first double-blind study carried out so far studying inhalation compliance in children with respiratory diseases.
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PMID:[Compliance with inhalation therapy in children with respiratory diseases]. 790 18

The association between breast feeding and acute lower respiratory infection (ALRI) was studied in a case-control study in southern Italy. Two groups of children were studied: the first group comprised 73 infants, aged 0-6 months, whose diagnosis was pneumonia or bronchiolitis; the second group included 88 infants less than 12 months of age with a diagnosis of pertussis-like illness. Control infants were two groups of infants admitted to the same ward. Compared with controls, infants in the first group were less likely to have been breast fed (odds ratio 0.42, 95% CI 0.19-0.90). The protection conferred by breast feeding was stronger among infants who were receiving human milk at the time of admission (odds ratio 0.22, 95% CI 0.09-0.55) and was absent among those infants who had stopped breast feeding for two or more weeks before admission. Among infants who were severely ill, breast feeding was less likely than among those with milder illnesses. There was evidence in the stratified analysis of effect modification by the presence of other children in the family. Among the infants with pertussis-like illness, the incidence and duration of breast feeding were not different compared with controls. The results suggest that breast feeding has a strong protective effect against ALRI in industrialized countries also. No protection seems to be conferred by human milk against pertussis-like illness.
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PMID:Breast feeding and acute lower respiratory infection. 794


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