Upper Respiratory Tract Infections Ebook
At the first sign Can effectively shorten the duration of a Vitamin C 250-500 mg to protect against colds. 1 g to Can help reduce severity and shorten the treatacold duration of a cold12,13 Fig. 5.18 Zinc supplements and the common cold. 100 adults with acute onset of cold symptoms were given lozenges containing 13.3 mg zinc and told to dissolve a lozenge in their mouth every 2 hours while awake. Treatment with zinc significantly accelerated healing and resolution of symptoms. Median time to resolution of all symptoms was 4.4 days in the zinc group compared with 7.6 days with placebo. (Adapted from Mossad S, etal. Ann Intern Med. 1996 125 81) Viruses that cause colds and influenza can survive for several hours on the skin and other surfaces (such as clothes, towels, and dishes). The virus is usually picked up on the hands and then transferred to the nose, mouth, or eyes where it causes the infection. To help prevent colds, wash the hands thoroughly...
So where does our discussion leave Jake Will he ever find the best way to prevent a cold or reduce its effects In the United States over one billion cases of the common cold are reported per year, costing billions of dollars in medical visits, treatment, and lost work days. Consequently, there is an enormous effort to find effective protection from the different viruses that cause colds. Despite all of the research and the emergence of some promising possibilities, the best prevention method is still the old standby keep your hands clean. Numerous studies have indicated that rates of common-cold infection are 20-30 lower in populations who employ effective hand-washing procedures. Cold viruses can survive on surfaces for many hours if you pick them up from a surface on your hands and transfer them to your mouth, eyes, or nose, you may inoculate yourself with a seven-day sniffle. Of course, not everyone gets sick when exposed to a cold virus. The reason Jake has more colds than his lab...
The statements made by Jake's friends and family about what actions will help him remain healthy (for example, his mother's advice to wear a hat) are in some part based on the advice-giver's understanding of how our bodies resist colds. Ideas about how things work are called hypotheses. Or, more formally, a hypothesis is a proposed explanation for one or more observations. All of us generate hypotheses about the causes of some phenomenon based on our understanding of the world (Figure 1.1). When Jake's mom tells him to dress warmly in order to avoid colds, she is basing her advice on her belief in the following hypothesis Becoming chilled makes an individual more susceptible to becoming ill. The hallmark of science is that hypotheses are subject to rigorous testing. Therefore, scientific hypotheses must be testable it must be possible to evaluate the hypothesis through observations of the measurable universe. Not all hypotheses are testable. For instance, the statement that colds are...
Rituximab is a chimeric anti-CD20 mAb (Figure 33.1), containing the mouse variable domains of the mAb 2B8 grafted to the human IgG1 constant domains. Rituximab kills CD20+ cells by several mechanisms, including (1) complement-dependent cellular cytotox-icity, (2) antibody-dependent cellular cytotoxicity, and (3) induction of apoptosis.32 Both early phase II testing and phase II pivotal testing of rituximab at 375 mg m2 per week X 4 in relapsed low-grade NHL demonstrated overall response rates of up to 48 (6 CR). The majority of toxic events were infusion related (hypotension, bronchospasm, rhinitis, pruritis, rash, urticaria, and tumor pain) and decreased with repeated dosing. Human antimouse antibodies (HAMA) were not observed. This led to Food and Drug Administration's approval of rituximab for indolent NHL. Its effect against indolent NHL was greatly enhanced by combining the drug with chemotherapy, with 95 overall response rates and 55 CR in patients receiving CHOP...
The EPA report officially categorized ETS as a known human carcinogen, placing ETS in the Class A (most dangerous) category reserved for only a few toxic substances, including radon, benzene, and asbestos (Carlson, 1997). The report also identified ETS as a cause of serious respiratory illness in children,
Cruel and unusual punishment in violation of the Eighth Amendment to imprison someone based on the status of being addicted. The Court held that to do so would be akin to making it a crime for a person to be mentally ill, a leper, or afflicted with a venereal disease (Robinson v. California 1962, 666).24 To be sure, wrote the Court, imprisonment for ninety days is not, in the abstract, a punishment which is either cruel or unusual. But the question cannot be considered in the abstract. Even one day in prison would be a cruel and unusual punishment for the 'crime' of having a common cold. While diseases in the Old Testament were often seen as punishment for sin (Robinson v. California 1962, 669, Douglas, J., concurring), the Court was unwilling to punish for disease (Robinson v. California 1962, 674, Douglas, J., concurring).25
Larization (opposite of saxitoxin and tetrodo-toxin TTX ). Vectors Clams oysters. Incubation 15 minutes to 3 hours. Symptoms Mild ciguatera-like symptoms with perioral paresthesias and temperature reversal rarely nausea and diarrhea unique conjunctivitis, rhinitis, and or asthmatic bronchitis from aerosolized brevetoxins in breaking surf. Diagnosis By history, TLC or HPLC. Treatment Supportive only. Prognosis Full recovery in 48 hours. Prevention Monitor shellfish bed dinoflagel-late counts adhere to shellfish consumption advisories.
The bioavailability of intranasal cocaine is about 60 . Peak plasma levels occur over a range of 30-120 minutes (Barnett, Hawks, & Resnick, 1981). Cocaine is a topical anesthetic and causes numbness of the nose during snorting. Nasal congestion, with stuffiness and sneezing, may occur after snorting cocaine due to both vasoconstrictive properties and contaminants in the preparation. Users may flush out the inside of the nose with a saltwater mixture after a round of snorting, and they commonly employ decongestants and antihista-mines to relieve symptoms.
Allergic rhinitis, also called hay fever, is perhaps the most common allergic disease and is a consequence of immediate hypersensitivity reactions to common allergens such as plant pollen or house dust mites localized to the upper respiratory tract by inhalation. The pathologic and clinical manifestations include mucosal edema, leukocyte infiltration with abundant eosinophils, mucus secretion, coughing, sneezing, and difficulty in breathing. Allergic conjunctivitis with itchy eyes is commonly associated with the rhinitis. Focal protrusions of the nasal mucosa, called nasal polyps, filled with edema fluid and eosinophils may develop in patients who suffer frequent repetitive bouts of allergic rhinitis. Antihistamines are the most common drugs used to treat allergic rhinitis.
Symptoms follow an upper respiratory tract infection and, although nearly always bilateral, one eye might be infected before the other. The affected eye becomes red and discharges characteristically, the eyelids become thickened and the upper lid can droop. The ophthalmologist's finger should feel for the tell-tale tender enlarged preauricular lymph node. In some cases, the cornea becomes involved and subep-ithelial corneal opacities can appear and persist for several months (Figure 6.4). If such opacities are situated in the line of sight, the vision can be impaired. There is no known effective treatment but it is usual to treat with an antibiotic drop to prevent secondary infection.
Vitamin C, at doses of 1 g or more, increases body temperature slightly (enhancing white blood cell function), and is beneficial in lowering blood histamine. High levels of body histamine are associated with decreased immune response and increased nasal and bronchial congestion in colds and flu.8 Vitamin C stimulates acti-vitity of white blood cells9 and enhances their ability to destroy bacteria and viruses. Allergic disorders. Because of its ability to lower body and blood histamine levels, vitamin C may be beneficial in bronchial asthma, exercise-induced asthma, food allergy, allergic rhinitis (hay fever), and other allergies.12
Much of the research on common cold prevention and treatment is performed by scientists employed or funded by drug companies. Often these companies do not allow scientists to publish the results of their research for fear that competitors at other drug companies will use this research to develop a new drug before they do. Should our society
Cutaneous Black eschar, dramatic local edema, regional lymphadenopathy. Gastrointestinal (GI) Nausea and vomiting, malaise, bloody diarrhea, abdominal pain, sepsis, case fatality rate (CFR) 50+ Inhalation Upper respiratory illness (URI) prodrome, pneumonia, adult respiratory distress syndrome (ARDS), sepsis, hemorrhagic mediastinitis case fatality rate (CFR) was 70 , now
RC is a 43-yr-old man who presented without complaints for routine care. His past medical history is notable for seasonal allergic rhinitis and erectile dysfunction but is otherwise unremarkable. He has never smoked and eats a typical Western diet. He has a sedentary job but recently started exercising several days a week. He is concerned that his father died suddenly from an MI at the age of 60 his mother survived a stroke at the age of 68. His medications include fexofenadine as needed for allergies, and sildenafil as needed. He wants to know if he should start taking an aspirin every day.
Cause the common cold in humans and induce sarcomas in newborn hamsters and rats and (4) such herpesviruses as Herpes saimiri, which is indigenous in the New World squirrel monkey and may induce lymphosarcomas and leukemias when inoculated into certain species of monkeys. Table 2-4 lists some of the different types of RNA and DNA oncogenic viruses.
A well-known study of the placebo effect was reported in 1955 by Dr. Harry Beecher (1). He described the placebo effect in a variety of conditions, including the common cold, pain after surgery, headache, and seasickness. Overall, symptoms were improved in 35 percent of the people who were given the placebo. Subsequent studies of a variety of medical conditions found placebo effects that were frequently in the range of 30 to 40 percent. In some studies, placebos have been 70 percent effective.
The natural history of antigen exposure is an important determinant of the amount of specific IgE antibodies produced. Repeat exposure to a particular antigen is necessary for development of an allergic reaction to that antigen because switching to the IgE isotype and sensiti-zation of mast cells with IgE must happen before a hyper-sensitivity reaction to an antigen can occur. Individuals with allergic rhinitis or asthma often benefit from a geographic change of residence with a change in indigenous plant pollens, although environmental antigens in the new residence may trigger an eventual return of the symptoms. A dramatic example of the importance of repeated exposure to antigen in allergic disease is seen in cases of bee stings. The proteins in the insect venoms are not usually of concern on the first encounter because an atopic individual has no preexisting specific IgE antibodies. However, an IgE response may occur after a single encounter with antigen, and a second sting by an...
Respiratory tract infections are common, usually mild, and self-limiting, although they may require symptomatic treatment with paracetamol or a nonsteroidal antiinflammatory. These include the common cold (80 rhi-noviruses and 20 coronaviruses), adenoviruses, influenza, parainfluenza, and, during the summer and early autumn, enteroviruses. Special attention should be given to detainees with asthma or the who are immunocompromised, because infection in these people may be more serious particularly if the lower respiratory tract is involved.
Sinusitis is well recognised as a common cause of headache and the patient with headache should be questioned about recent upper respiratory tract infections or a previous history of sinus disease. Tenderness over the affected sinus is an important sign. The headache tends to begin after rising in the morning and reaches a
The clinical presentation of CLL patients is diverse, with variability in presenting symptoms, physical examination findings, and laboratory test results. As noted above, patients often present without any symptoms, and the diagnosis is made on the basis of an elevated absolute lymphocyte count found on routine complete blood count (CBC). Less commonly, patients present with nontender lymphadenopathy, and are noted to have an elevated blood lymphocyte count on further evaluation. Some patients present with concomitant illnesses such as infection or chronic rhinitis, or less commonly, autoimmune phenomena such as autoimmune hemolytic anemia (AIHA) or immune thrombocytopenia purpura (ITP).
Prior to the availability of effective therapeutic regimens, most infections were attributed to deficiencies in immunoglobulin production associated with the disease process. There are few data regarding the frequency, sites, and causes of infection prior to the advent of chemotherapy. In early reports, about 15-25 of patients were infected at the time of diagnosis (40). An early study of 102 patients treated with radiation reported infection in 30 of patients, and 10 died of infection (41). Most of the infections were pneumonias, upper respiratory tract infections, and septicemias. These infections were caused predominantly by encapsulated bacteria, especially S. pneumoniae and H. influenzae. S. aureus was also a frequent pathogen in some series. Urinary tract infections were common in some series, often associated with ureteral obstruction owing to enlarged abdominal lymph nodes.
Hospital visitors should not be permitted to visit if they have any fever or respiratory illness. Visitors should wash their hands before and after leaving the patient's room. In outbreak settings such as respiratory viruses in the community, it may be prudent to restrict visitation to immediate family members.
Thus, extracting key concepts from free text is a critical task. Words or word stems are commonly used for indexing, and these indexing techniques do not require any knowledge source. However, synonyms and some morphological differences between the texts in the target documents and the search words used often hamper the search results and are beyond the technological spectrum of word stem indexing and matching techniques. This issue is particularly problematic in health care, wherein the biomedical language is packed with many interchangeable terms, such as common cold'' and coryza,'' mass'' and lump,'' fever'' and pyrexia,'' weakness'' and paresis,'' etc. Therefore, we developed indexing systems based on standard descriptors or dictionaries, such as the UMLS.
HEENT Severe mucosal irritation and edema keratoconjunctivitis can lead to corneal epithelial ulcers ( gas eye ) rhinitis. Cardiovascular Bradycardia, angina. Pulmonary Dyspnea, cyanosis, bronchitis, cough, hemoptysis, pulmonary edema. Gastrointestinal Nonspecific nausea and vomiting.
Mast cell degranulation is a central component of all allergic diseases, and the clinical and pathologic manifestations of the diseases depend on the tissues in which the mast cell mediators have effects as well as the chronicity of the resulting inflammatory process. Atopic individuals may have one or more manifestations of allergic disease. The most common forms of these diseases are allergic rhinitis (hay fever), bronchial asthma, atopic dermatitis (eczema), and food allergies. The clinical and pathologic features of allergic reactions vary with the anatomic site of the reaction, for several reasons. The point of contact with the allergen determines the organs or tissues that are involved. For example, inhaled antigens cause rhinitis or asthma, ingested antigens often cause vomiting and diarrhea, and injected antigens cause systemic effects on the circulation. The concentration of mast cells in various target organs influences the severity of responses. Mast cells are particularly...
Biosafety levels are needed because some bacteria and viruses are more infectious and deadly than others. Common colds are infectious that is, the viruses that cause them are easy to get but they are not deadly to most people. Ebola virus, however, is not only infectious but deadly. It and other deadly viruses must be studied in Biosafety Level 4 labs. Less dangerous diseases could also be studied in Biosafety Level 4 labs, but it would cost too much. Biosafety levels are meant to make it less likely that a dangerous agent will infect a person working in the lab or escape to the outside world.
1.3 Is There a Cure for the Common Cold Jake's brand of science may eventually give him an answer to his question about how to prevent colds. But he won't know if it is the best answer unless he tries out all the potential treatments. We already know that Jake does not have time for that. Luckily for him, and for all of us, legions of professional scientists spend their time trying to answer questions like Jake's. Scientists use the same basic process of testing ideas about how the world works and discarding (or modifying) ideas that are inadequate. There are, however, some key differences between the ways scientists approach questions and the daily scientific investigations illustrated by Jake's quest for relief. This chapter will introduce you to the process of science as it is practiced in the research setting, and will help you understand how to evaluate scientific claims by following Jake's quest for relief from the common cold.
Which of the following is a prediction of the hypothesis Eating chicken noodle soup is an effective treatment for colds a. People who eat chicken noodle soup have shorter colds than people who do not eat chicken noodle soup. b. People who do not eat chicken noodle soup experience unusually long and severe colds. 10. A relationship between two factors, for instance between outside temperature and number of people with active colds in a population, is known as a(n)_.
Many scientific and clinical studies have evaluated echinacea. Some, but not all, studies indicate that echinacea limits the duration and severity of infections, especially the common cold. What about other measures to prevent or treat the common cold or other minor infections Goldenseal and garlic (see subsequent sections) have not been shown to have definite effects on infections, and the scientific basis for their use is unclear. Also, vitamin C and zinc, which are discussed in detail elsewhere in this book, sometimes are used for infections. However, both of these compounds also have unclear effects on infections and may activate the immune system. People with MS may take several safe measures to prevent and treat viral infections such as the flu and common cold. First, the flu vaccine is readily available, appears to be safe for people with MS, and helps prevent the flu. Recently developed prescription medications (oseltamivir Tamiflu , zanamivir Relenza ) also decrease the...
It is sometimes claimed that vitamin C prevents or decreases the severity of the common cold. This is potentially important to people with MS, because viral infections may trigger MS attacks. However, the effects of vitamin C on the common cold are unclear. Also, because vitamin C stimulates the immune system, high doses of vitamin C supplements are theoretically risky for people with MS. Because of its unclear effects on treating the common cold, and its theoretical risks for worsening MS, it is reasonable for people with MS to be cautious about vitamin C use. If vitamin C is used, orange juice (50 milligrams of vitamin C per half cup of orange juice) or supplements in low doses (90 to 120 milligrams or less daily) may be reasonable.
Goldenseal has been used medicinally for at least 200 years. This herb is taken alone or in combination with echinacea for a variety of infections, including the common cold. Unlike echinacea, which has been investigated extensively, little recent information is available about the biological effects or possible clinical benefits of goldenseal or its chemical constituents, berberine and hydrastine. Because of the limited information about goldenseal, it is difficult to make any definite conclusions about this herb. The clinical studies to date do not support its use for infections. Notably, goldenseal may produce sedation. Therefore, it may worsen MS fatigue or increase the sedating effects of alcohol and some prescription medications.
Over the past 25 years, more than 1,000 studies have evaluated the possible therapeutic effects of garlic. Suggestive, but not conclusive, results have been obtained in studies of the effectiveness of garlic in treating high cholesterol levels, high blood pressure, and cancer. On the basis of limited scientific studies, garlic sometimes is recommended as a treatment for the common cold.
It was an example of the kind of achievement that makes supporters of medical biotechnology so enthusiastic. Interferon is now used not only to combat viral infection in transplant patients but also to fight other viral diseases (including the common cold), and as an anticancer drug.
That alternative hypotheses could explain the results by randomly assigning subjects to treatment groups, using an effective placebo, and blinding both the data collectors and the subjects. Given such a well-designed experiment, this statistically significant result allows researchers to strongly infer that consuming zinc lozenges reduces the duration of colds. There is one final caveat however. A statistically significant result is defined as one that has a 5 probability or less of being due to chance alone. If all scientific research uses this same standard, as many as one in every 20 statistically significant results (that is, 5 of the total) is actually reporting an effect that is not real. An experiment with a statistically significant result will still be considered to support the hypothesis. However, the small but important probability that the results are due to chance explains why one supportive experiment is usually not enough to convince all scientists that a hypothesis is...
In psoriasis clinical trial experience, etanercept has been well tolerated. The most common adverse event in patients receiving placebo or any dose of etanercept was injection site reaction, where rates in the previously mentioned two phase 3 trials ranged from 6 to 18 . These reactions typically occur 2-3 weeks into treatment and consist of erythema, pain, itching, and or swelling, and typically resolve in 3-5 days. In addition, upper respiratory tract infections (5-11 ) and headache (3-12 ) were also seen. In the study by Leo-nardi and colleagues, serious infectious adverse events were infrequent and were not more frequent in the high dose etanercept groups when compared to the placebo-crossover group of lower dose groups. In placebo-controlled trials for all uses of etanercept, the most common type of adverse event was an upper respiratory tract infection, which occurred in between 12 and 20 of patients, but not at an increased frequency when compared with placebo groups.
Despite some claims, no magic CAM cure is available for colds and flu. No CAM therapy for the flu has been shown to be as effective as the medications currently available. As a result, people with MS who have flu symptoms should first consider these medications before CAM therapy.
Bronchitis is an inflammation of the airways resulting in excessive mucus production in the bronchial tree. Bronchitis occurs when the inner walls of the bronchi become inflamed. It often follows a cold or other respiratory infection and happens in virtually all people, just as the common cold. When the bronchitis does not go away quickly but persists, then it is termed chronic bronchitis.