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Concept: Respiratory tract


Many respiratory tract infections are treated with macrolide antibiotics. Regulatory agencies warn that these antibiotics increase the risk of ventricular arrhythmia. We examined the 30-day risk of ventricular arrhythmia and all-cause mortality associated with macrolide antibiotics relative to nonmacrolide antibiotics.

Concepts: Respiratory system, Upper respiratory tract infection, Erythromycin, Macrolide, Antibiotics, Respiratory tract


Primary ciliary dyskinesia (PCD) is a rare autosomal recessive disease, caused by specific primary structural and/or functional abnormalities of the motile cilia, in contrast with the transitory abnormalities seen in secondary ciliary dyskinesia. Disease-causing mutations in at least 16 genes have already been identified. The true incidence of PCD may be higher than currently reported, because the diagnosis is challenging and often missed. For the confirmation of PCD, both ciliary motility as well as ciliary ultrastructure must be evaluated. An early and adequate diagnosis and therapy can theoretically prevent bronchiectasis. Measurement of nasal nitric oxide has some value as a screening test but cannot be performed in young children. In the respiratory tract epithelium, impaired mucociliary clearance leads to chronic and/or recurrent upper and lower respiratory tract infections. In up to 75 % of the patients, respiratory manifestations start in the newborn period, although the diagnosis is often missed at that time. During embryogenesis, nodal cilia, which are motile cilia, determine the correct lateralization of the organs. Dysfunction of these cilia leads to random lateralization and thus situs inversus in approximately 50 % of the patients with PCD. The tail of a spermatozoon has a structure similar to that of a motile cilium. Consequently, male infertility due to immotile spermatozoa is often part of the characteristics of PCD. Given the heterogeneity and the rarity of the disorder, therapy is not evidence-based. Many treatment schedules are proposed in analogy with the treatment for cystic fibrosis. CONCLUSION: Respiratory infections, situs inversus and male infertility are typical manifestations of PCD, a rare autosomal recessive disorder.

Concepts: Sperm, Cystic fibrosis, Respiratory system, Upper respiratory tract, Cilium, Situs inversus, Respiratory tract, Primary ciliary dyskinesia


The incidence of acute upper respiratory tract viral infections (URTI) is directly correlated to air temperature with most URTI occurring seasonally in cold weather. This review looks at four types of cold exposure and examines the evidence and possible mechanisms for any relationship to URTI. The effects of cold are discussed as: 1) Chilling of the nose and upper respiratory tract by breathing cold air, 2) Chilling of the mouth and upper digestive tract by ingestion of cold drinks and food, 3) Acute chilling of the body surface, and, 4) Chilling of the body as a whole with a fall in body temperature, hypothermia. Some studies were found to support a relationship between breathing cold air and chilling the body surface with the development of URTI, although this area is controversial. No evidence was found in the literature to support any relationship between ingestion of cold drinks and food and URTI, and similarly no evidence was found to link hypothermia and URTI.

Concepts: Infection, Temperature, Respiratory system, Upper respiratory tract, Upper respiratory tract infection, Lower respiratory tract, Cold, Respiratory tract


Bronchipret TE® exhibits multidirectional anti-inflammatory effects as demonstrated in vitro and in vivo studies. It has been disclosed that the drug has the ability to activate the bronchial cleaning mechanism, inhibit the respiratory tract remodeling process by reducing the number of goblet cells, inhibiting enzyme activity and proinflammatory mediators. These mechanisms cause the administration of medication to cause acute bronchitis patients to shorten and alleviate the course of the disease with rapid cough elimination. Use of Bronchipret TE® is in accordance with the recommendations of the European Guideline Committee’s and the German Respiratory Society.

Concepts: Inflammation, Enzyme, In vivo, Anti-inflammatory, In vitro, Mucus, Goblet cell, Respiratory tract


Reducing inappropriate antibiotic prescribing for acute upper respiratory tract infections (AURIs) requires a better understanding of the factors associated with this practice.

Concepts: Respiratory system, Upper respiratory tract, Upper respiratory tract infection, Lower respiratory tract, Respiratory tract


To describe the role patient expectations play in general practitioners (GPs) antibiotic prescribing for upper respiratory tract infections (URTI).

Concepts: Bacteria, Respiratory system, Upper respiratory tract, Upper respiratory tract infection, Lower respiratory tract, Respiratory tract



The purpose of this study was to understand clinicians' and parents' perceptions of communication within consultations for respiratory tract infections (RTI) in children and what influence clinician communication had on parents' understanding of antibiotic treatment.

Concepts: Understanding, Cognition, Perception, Respiratory system, Antibiotic, Upper respiratory tract infection, Clinic, Respiratory tract


There are increasing numbers of emergency medical paediatric admissions. Our hypothesis was that characteristics of children and details of their emergency admissions are also changing over time. Details of emergency admissions in Scotland 2000-2013 were analysed. There were 574,403 emergency admissions, median age 2.3 years. The age distribution, proportion of boys and socioeconomic status of children admitted were essentially unchanged. Emergency admissions rose by 49% from 36/1000 children per annum to 54/1000 between 2000 and 2013. Emergency admissions that were discharged on the same day rose by 186% from 8.6/1000 to 24.6/1000. The mean duration of emergency admission fell from 1.7 to 1.0 days. The odds for an emergency admission with upper respiratory infection, “viral infection”, tonsillitis, bronchiolitis and lower respiratory tract infection all rose. In contrast the odds for an emergency admission with asthma and gastroenteritis fell.

Concepts: Asthma, Population, Respiratory system, Arithmetic mean, Upper respiratory tract, Upper respiratory tract infection, Lower respiratory tract, Respiratory tract


Procalcitonin algorithms may reduce antibiotic use for acute respiratory tract infections (ARIs). We undertook an individual patient data meta-analysis to assess safety of this approach in different ARI diagnoses and different clinical settings.

Concepts: Medical terms, Evaluation methods, Educational psychology, Respiratory system, Antibiotic, Upper respiratory tract infection, Respiratory tract