scholarly journals Conurbation, Urban, and Rural Living as Determinants of Allergies and Infectious Diseases: Royal College of General Practitioners Research and Surveillance Centre Annual Report 2016-2017 (Preprint)

2018 ◽  
Author(s):  
Simon de Lusignan ◽  
Christopher McGee ◽  
Rebecca Webb ◽  
Mark Joy ◽  
Rachel Byford ◽  
...  

BACKGROUND Living in a conurbation, urban, or rural environment is an important determinant of health. For example, conurbation and rural living is associated with increased respiratory and allergic conditions, whereas a farm or rural upbringing has been shown to be a protective factor against this. OBJECTIVE The objective of the study was to assess differences in general practice presentations of allergic and infectious disease in those exposed to conurbation or urban living compared with rural environments. METHODS The population was a nationally representative sample of 175 English general practices covering a population of over 1.6 million patients registered with sentinel network general practices. General practice presentation rates per 100,000 population were reported for allergic rhinitis, asthma, and infectious conditions grouped into upper and lower respiratory tract infections, urinary tract infection, and acute gastroenteritis by the UK Office for National Statistics urban-rural category. We used multivariate logistic regression adjusting for age, sex, ethnicity, deprivation, comorbidities, and smoking status, reporting odds ratios (ORs) with 95% CIs. RESULTS For allergic rhinitis, the OR was 1.13 (95% CI 1.04-1.23; P=.003) for urban and 1.29 (95% CI 1.19-1.41; P<.001) for conurbation compared with rural dwellers. Conurbation living was associated with a lower OR for both asthma (OR 0.70, 95% CI 0.67-0.73; P<.001) and lower respiratory tract infections (OR 0.94, 95% CI 0.90-0.98; P=.005). Compared with rural dwellers, the OR for upper respiratory tract infection was greater in urban (OR 1.06, 95% CI 1.03-1.08; P<.001) but no different in conurbation dwellers (OR 1.00, 95% CI 0.97-1.03; P=.93). Acute gastroenteritis followed the same pattern: the OR was 1.13 (95% CI 1.01-1.25; P=.03) for urban dwellers and 1.04 (95% CI 0.93-1.17; P=.46) for conurbation dwellers. The OR for urinary tract infection was lower for urban dwellers (OR 0.94, 95% CI 0.89-0.99; P=.02) but higher in conurbation dwellers (OR 1.06, 95% CI 1.00-1.13; P=.04). CONCLUSIONS Those living in conurbations or urban areas were more likely to consult a general practice for allergic rhinitis and upper respiratory tract infection. Both conurbation and rural living were associated with an increased risk of urinary tract infection. Living in rural areas was associated with an increased risk of asthma and lower respiratory tract infections. The data suggest that living environment may affect rates of consultations for certain conditions. Longitudinal analyses of these data would be useful in providing insights into important determinants.

2018 ◽  
Vol 1 (1) ◽  
pp. 5-8
Author(s):  
Henish Shakya ◽  
Saurav Singh ◽  
Ashish Lakhey

Introduction: Lower respiratory tract infection is a major cause of death in children in a developing country and anemia is found to be one of the commonest associated cofactors. This study was aimed to determine association of anemia in children with lower respiratory tract infections.Materials and Methods: The retrospective study was done over a one-year period for children under 5 years of age, admitted in Pediatric Ward of a tertiary Hospital in Lalitpur. The study included 100 diagnosed cases of lower respiratory tract infections as per WHO criteria and 100 age and sex matched patients who did not have respiratory complaints as controls, excluding prematurity, chronic diseases, malnutrition and severe systemic illness. Appropriate clinical history, examination routine investigations like hemoglobin, peripheral smear, and Chest X-ray were included.Results: The age distribution maximum children were in the age group of 3 months to 23 months with significant association with prevalence of both pneumonia (p value 0.005) and anemia (p value 0.002). Anemia was found to be a significant risk factor for LRTI (p value < 0.001) with odds ratio of 2.68 and 95% CI (1.51 – 4.75).Conclusions: Anemia was significantly found to be associated with lower respiratory tract infections and these children were found to be 2.68 times more susceptible to lower respiratory tract infections. Early diagnosis and prevention of anemia is thus important to reduce the incidence of lower respiratory tract infections in children.Nepalese Medical Journal. vol.1, No. 1, 2018, page: 5-8


2020 ◽  
Vol 10 (5) ◽  
pp. 756-761
Author(s):  
Xiaofei Li ◽  
Lina Sheng ◽  
Juncai Tu ◽  
Lianqing Lou

This study evaluated the clinical efficacy and safety of piperacillin sulbactam in the treatment of lower respiratory tract infections, as well as the efficacy of silver nanoparticle-based disinfectant in equipment disinfection to reduce exogenous infection. From May 2018 to November 2018, 100 patients that had been diagnosed with a lower respiratory tract infection and hospitalized were divided into an experimental group and a control group. The experimental group was given piperacillin/sulbactam, and the control group was given mezlocillin/sulbactam, where 5.0 g was added to 100 mL of normal saline and administered via intravenous drip twice a day over a treatment course of 14 days. The cure rate of the experimental and control groups were 65.22% and 56.52% respectively. The efficacy rate was 91.30% and 91.30% respectively, with no significant difference between the two groups (P > 0.05). The results indicated that piperacillin/sulbactam is a safe, effective treatment for lower respiratory tract infections in elderly patients, the equipment was sterilized with silver nanoparticle-based disinfectant to reduce the incidence of adverse reactions and exogenous infections.


2020 ◽  
Vol 16 (4) ◽  
pp. 382-388
Author(s):  
Aneta Rzepka ◽  
◽  
Anna Mania ◽  

Aim: The aim of this study was to analyse the clinical picture of respiratory tract infections among adult patients visiting their general practitioners. Materials and methods: The analysis included 301 adult patients who reported to their general practitioners due to respiratory tract infection. W assessed clinical symptoms, age, final diagnosis, probable aetiology, additional tests, including Actim® Influenza A&B rapid test to confirm influenza infection, radiographic and laboratory findings, as well as comorbidities, treatment used, vaccinations against influenza, and smoking habits. Results: Upper respiratory tract infections accounted for the vast majority of cases (74%), and these primarily included viral infections (62%), some of which required a change of therapy (23%) due to suspected secondary bacterial infection; lower respiratory tract infections accounted for 26% of cases. The main symptoms reported by the patients included cough, pharyngeal pain, fever, rhinitis, general malaise, nasal obstruction, headache, muscle pain and dysphonia. Acute pharyngitis was the dominant diagnosis (27%), followed by acute upper respiratory tract infection of multiple sites (13.6%), acute nasopharyngitis (known as common cold) (10%), purulent tonsillitis (11.6%), acute bronchitis (11%) and influenza (11%). Antibiotic therapy was used in 60% of patients with upper respiratory tract infection and 68% of patients with lower respiratory tract infection. Conclusions: The majority of patients were diagnosed with viral infections. The highest incidence of respiratory tract infections was observed in elderly individuals and patients with chronic cardiovascular diseases, lung diseases, diabetes mellitus and cancer. Smokers are more likely to develop lower respiratory tract infections (confirmed by additional tests) compared to other groups of patients. Individuals vaccinated against influenza account for a small proportion of patients.


2009 ◽  
Vol 59 (567) ◽  
pp. 761-764 ◽  
Author(s):  
Jochen WL Cals ◽  
Kerenza Hood ◽  
Nienke Aaftink ◽  
Rogier M Hopstaken ◽  
Nick A Francis ◽  
...  

1983 ◽  
Vol 11 (6) ◽  
pp. 370-374 ◽  
Author(s):  
D G Moran

Seven-day courses of either pivampicillin (Pondocillin) 500 mg twice daily or amoxycillin (Amoxil) 250 mg three times daily were compared in a multicentre general practice study in 463 patients with symptoms of upper or lower respiratory tract infections. Patients were stratified into four diagnostic groups: sinusitis, otitis media, throat infections, and acute bronchitis, and randomly allocated to treatment within these groups. There was an over-all response of 93% in the 227 patients receiving 12-hourly pivampicillin compared with 90% for the 236 patients receiving 8-hourly amoxycillin. Patients suffering from acute bronchitis responded significantly better to pivampicillin (Pondocillin) than to amoxycillin. Side-effects were reported by 15·6% of patients in the amoxycillin group and 14·0% in the pivampicillin group.


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