Fatigue of the respiratory muscle and respiratory insufficiency

Recent results on respiratory muscle function are reviewed, with special regard to the muscle fatigue theory of respiratory failure. In this respect diagnostic measures and clinical symptoms are reported. Therapy is directed to reduce the work of respiratory muscles and temporarily rest them. Within this special role is given to the treatment with respirator and positive pressure breathing.     

Nosocomial respiratory infections

Nosocomial respiratory infections, including influenza, parainfluenza, adenovirus disease, respiratory syncytial virus, psittacosis, tuberculosis, bacterial pneumonia, and fungal disease, have been widely reported in the medical literature. To estimate the relative risk of acquiring them and to determine their characteristics, data from 117 U. S. hospitals participating in the National Nosocomial Infections Study of the Center for Disease Control were analyzed for the calendar years 1970–1973. These data showed the following: (1) The over-all nosocomial infection rate for discharged patients was approximately 5%, and the over-all nosocomial respiratory infection rate was approximately 0.6%, or 17% of total nosocomial infections. (2) The majority of respiratory infections were in patients on surgical services. (3) A total of 27,409 organisms were isolated from patients with these respiratory infections, with gram-negative organisms accounting for two to three times more disease than gram-positive organisms. (4) The seasonal variation in disease was minor, with greatest incidence occurring in late winter and lowest in midsummer. Recommendations for controlling these infections effectively begin with the establishment of an ongoing surveillance program to define the problem. Then, direct control measures should be applied to assist the host in developing or maintaining resistance to infection, to control reservoirs of infection, and to interrupt the routes of transmission.     

Continuous respiratory therapy of newborn and premature infants with respiratory disorders

2216 newborns and prematures with respiratory distress of different underlying diseases were treated with long term respiratory therapy from 1. Jan. 1975 to 31. Dec. 1985. One part of the patients were born in our hospital, the other part of them were transported from outside. The rate of prematures was 81.2%. The respiratory therapy was applied in 1813 cases because of pulmonary diseases (group 1.), while in 403 cases the respiratory troubles were extrapulmonary in origin (group 2.). The diseases in the first group were as follows: hyaline membrane disease in 482 cases (27.30%), intrauterine pneumonia in 634 cases (34.64%), postnatal pneumonia in 291 cases (15.90%), meconium aspiration syndrome in 110 cases (6.01%), severe RDS-II in 158 cases (8.63%), pulmonary immaturity in 116 cases (6.35%), persistent fetal circulation in 21 cases (1.15%) and pulmonary aplasia on the left in 1 case (0.021%). In the second group the greatest part of the cases were treated for neurological disturbances. We discuss the indications of different types of respiratory therapy and the complications as well. The survival rate was in the first group 59.3%, while in the second only 16.9%. Therefore the respiratory therapy seems to be more effective in the pulmonary diseases of the newborns. The mortality rate and the rate of severe complications were lower among inborn babies because of the early application of the respiratory therapy.     

社会获得性呼吸道感染社会获得性呼吸道感染病原学变迁

1　社会获得性呼吸道感染 (CAP)病原的变迁我在 1 95 0年任住院医生时 ,新入院的呼吸道感染病人的 2 5 %为典型肺炎 ,即胸片示大叶性肺炎 ,当时基本上均为肺炎双球菌肺炎 (即目前的肺炎链球菌肺炎 ) ,约 1 5 %为化脓性肺炎或肺脓肿 ,大多为金黄色葡萄球菌 (金葡菌 )引起 ,约 3 5 %为各类型的肺结核 ,约 1 5 %为非典型肺炎即胸片示肺内未构成叶、段实变的小片阴影 ,多由病毒、支原体、衣原体等引起 ,还有约 1 0 %为寄生虫引起 ,包括阿米巴肝脓肿并胸腔感染、肺脓肿 ,胸片示肺多发性结节状病变 ,有疫水接触史的血吸虫 ,咳果酱痰 ,有到过疫区…     

Clinical and epidemiological aspects of respiratory syncytial virus lower respiratory tract infections

This paper has analyzed respiratory syncytial virus lower respiratory tract infections in 201 hospitalized children. In children with wheezing, erythrocyte sedimentation rate (ESR) was significantly higher in those with pneumonia than with syndroma pertussis, while the white blood cell (WBC) count was significantly lower in patients with bronchitis than in those with bronchiolitis and syndroma pertussis. Bronchodilatators were applied in 75.6% and corticosteroids in 20% of patients. Ten patients were ventilated. Fatal disease outcome was observed in one infant. Twelve consecutive-year study of respiratory syncytial virus (RSV) infections showed that 27.3% of these diseases were bronchiolitis and pneumonia.     

婴儿呼吸道合胞病毒急性下呼吸道感染的相关因素分析

目的：探究影响婴儿呼吸道合胞病毒急性下呼吸道感染的相关因素。方法选取2013年7月至2014年7月于浙江省金华市浦江县人民医院住院的急性下呼吸道感染（ ALRI）患儿1540例，根据浙江省金华市浦江县人民医院呼吸道合胞病毒（RSV）检测结果，将患儿分为RSV阳性组（n＝816）和RSV阴性组（n＝724）两组，对比两组患者的性别、年龄、出生体重、胎龄、发病季节、合并基础疾病、合并先心病、居住人口、家庭月收入、母乳喂养、家庭吸烟、妊娠合并糖尿病、妊娠合并高血压、孕母特应性疾病等。结果多因素分析发现，秋冬季节发病（OR＝1．579，95％CI＝1．172～2．127）、合并先心病（OR＝1．317，95％CI＝1．028～1．685）、孕母特应性疾病（OR＝1．802，95％CI＝1．235～2．631）是婴儿RSV相关ALRI的危险因素，而家庭月收入≥10千元（OR＝0．679，95％CI＝0．499～0．924）是其保护因素。结论秋冬季节发病、合并先心病、孕母特应性疾病的婴儿RSV相关ALRI发病率高，而家庭月收入≥10千元的家庭RSV相关ALRI发病率低。     

Parent-collected respiratory specimens--a novel method for respiratory virus and vaccine efficacy research

Population-based respiratory research and vaccine efficacy studies have previously required clinic or home visits when a subject had an acute respiratory illness. This method may mean parents are unwilling to enroll their child or report an illness of interest. We conducted a community-based cohort study into respiratory illnesses in 234 pre-school aged children using parent-collected specimens. Between January 2003 and January 2004 there were 563 specimens collected from 730 identified illnesses and these were tested using a panel of respiratory virus polymerase chain reaction (PCR) assays; 409 (73%) were positive for any virus. Specimens were not more likely to be positive when collected by a healthcare worker parent, when they included a throat swab, or when a very good collection technique was reported. A delay from illness onset to specimen collection of up to 5 days did not appear to impact on sensitivity of virus identification, but a delay of six or more days with minor delays in testing saw positivity fall. Combined with daily symptom diary completion and PCR testing, parent-collected specimens are an efficient and acceptable method for the conduct of future vaccine efficacy studies and other community-based respiratory virus research.