Do combined upper airway cultures identify lower airway infections in children with chronic cough?

2019 ◽  
Vol 54 (6) ◽  
pp. 907-913 ◽  
Author(s):  
Kim M. Hare ◽  
Anne B. Chang ◽  
Heidi C. Smith‐Vaughan ◽  
Paul A. Bauert ◽  
Brian Spain ◽  
...  
Keyword(s):  
Chronic Cough ◽  
Upper Airway ◽  
Lower Airway ◽  
Airway Infections

scholarly journals Changes in the Upper and Lower Pharyngeal Airway Spaces Associated with Rapid Maxillary Expansion

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Fitin Aloufi ◽  
Charles B. Preston ◽  
Khalid H. Zawawi
Keyword(s):  
Orthodontic Treatment ◽  
Upper Airway ◽  
Rapid Maxillary Expansion ◽  
Lower Airway ◽  
Control Group ◽  
Maxillary Expansion ◽  
Pharyngeal Airway ◽  
Significant Difference ◽  
And Gender ◽  
Maxillary Constriction

Objectives. The primary objectives of this retrospective study were first to compare the upper and lower pharyngeal airway spaces between orthodontic patients with and without maxillary constriction and second to evaluate the effect of rapid maxillary expansion (RME) on these airway spaces. A secondary objective was to compare the mode of breathing between groups. Materials and Methods. The experimental (RME) group consisted of 30 patients (mean age, years, 16 boys and 14 girls) with maxillary constriction who were treated with hyrax-type RME. The control group comprised the records of age- and gender matched patients (mean age, years, 16 boys and 14 girls) with no maxillary constriction but requiring nonextraction comprehensive orthodontic treatment. Cephalometric measurements in the sagittal dimension of upper and lower airway spaces for the initial and final records were recorded. Mode of breathing and length of treatment were also compared. Results. The sagittal dimension of the upper airway increased significantly in the RME group ( mm) compared to the control group ( mm), . However, there was no significant difference in the lower pharyngeal airway measurement between the RME group () and the control group (), . There was no significant difference with respect to mode of breathing between the two groups (). Conclusion. Rapid maxillary expansion (RME) during orthodontic treatment may have a positive effect on the upper pharyngeal airway, with no significant change on the lower pharyngeal airway.

Effects of pharyngeal lubrication on the opening of obstructed upper airway

1992 ◽  
Vol 72 (6) ◽  
pp. 2311-2316 ◽  
Author(s):  
H. Miki ◽  
W. Hida ◽  
Y. Kikuchi ◽  
T. Chonan ◽  
M. Satoh ◽  
...  
Keyword(s):  
Hypoglossal Nerve ◽  
Muscle Tone ◽  
Upper Airway ◽  
Intraluminal Pressure ◽  
Lower Airway ◽  
Before And After ◽  
Airway Opening ◽  
Cervical Trachea ◽  
Artificial Surfactant ◽  
Stimulation Of

We examined the effect of electrical stimulation of the hypoglossal nerve and pharyngeal lubrication with artificial surfactant (Surfactant T-A) on the opening of obstructed upper airway in nine anesthetized supine dogs. The upper airway was isolated from the lower airway by transecting the cervical trachea. Upper airway obstruction was induced by applying constant negative pressures (5, 10, 20, and 30 cmH2O) on the rostral cut end of the trachea. Peripheral cut ends of the hypoglossal nerves were electrically stimulated by square-wave pulses at various frequencies from 10 to 30 Hz (0.2-ms duration, 5–7 V), and the critical stimulating frequency necessary for opening the obstructed upper airway was measured at each driving pressure before and after pharyngeal lubrication with artificial surfactant. The critical stimulation frequency for upper airway opening significantly increased as upper airway pressure became more negative and significantly decreased with lubrication of the upper airway. These findings suggest that greater muscle tone of the genioglossus is needed to open the occluded upper airway with larger negative intraluminal pressure and that lubrication of the pharyngeal mucosa with artificial surfactant facilitates reopening of the upper airway.

Effect of intranasal steroids on chronic cough caused by upper airway cough syndrome

2014 ◽  
Vol 2 (5) ◽  
pp. 362
Author(s):  
Gun-Wung Na ◽  
Dong-Gyu Lee ◽  
Jun-Young Kim ◽  
Won-Il Park ◽  
Kyung-Been Lee ◽  
...  
Keyword(s):  
Chronic Cough ◽  
Upper Airway ◽  
Intranasal Steroids

scholarly journals Most Nosocomial Pneumonias are Not Due to Nosocomial Bacteria in Ventilated Patients. Evaluation of the Accuracy of the 48 h Time Cut-off Using Carriage as the Gold Standard

2002 ◽  
Vol 30 (3) ◽  
pp. 275-282 ◽  
Author(s):  
L. Silvestri ◽  
R. E. Sarginson ◽  
J. Hughes ◽  
M. Milanese ◽  
D. Gregori ◽  
...  
Keyword(s):  
Predictive Value ◽  
Adult Population ◽  
Paediatric Population ◽  
Carrier State ◽  
Lower Airway ◽  
Airway Infections ◽  
The Difference ◽  
Sensitivity Specificity ◽  
Micro Organisms ◽  
Ventilated Patients

A prospective observational cohort study was undertaken with two endpoints: (1) to compare the time cut-off of 48h and the carrier state criterion for classifying lower airway infections in adult and paediatric long-term ventilated patients, and (2) to evaluate the potential of optimized time cut-offs for characterizing imported and ICU-acquired lower airway infections. All patients admitted to the general and paediatric intensive care units and expected to require mechanical ventilation for a period 3 days were enrolled. Surveillance cultures of throat and rectum were obtained on admission and thereafter twice weekly to distinguish micro-organisms that were imported into the unit from those acquired during the stay on the unit. A total of 130 adults and 400 children were studied. In the adult population, 70% of lower airway infections were classified as ICU-acquired by the 48 h cut-off and 48% by the criterion of carriage; on the paediatric ICU the percentages were 65% and 20%, respectively. To separate imported from ICU-acquired infections, eight days was optimal in the adult population and 10 days in the paediatric population. Sensitivity, specificity, positive predictive value and negative predictive value for a time cut-off of eight days for adults were 86, 77, 80, 83%, respectively, and using 10 days for children were 87, 62, 90, 56%, respectively. The use of the 48 h cut-off rule classifies patients as having nosocomial pneumonia, when in fact the infections are commonly caused by microorganisms carried in by the patients. In contrast, using the carriage method, the proportion of lung infections due to nosocomial bacteria was relatively small and was a late phenomenon. Although in prolonging the time cut-off the difference between the two types of classification was shorter, time cut-offs were still found to be unreliable for distinguishing imported from unit-acquired lower airway infections.

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