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R.j. White - One of the best experts on this subject based on the ideXlab platform.
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The effect of nebulized salbutamol therapy on the incidence of postoperative Chest Infection in high risk patients
Respiratory medicine, 1994Co-Authors: J.p. Dilworth, A.r.h. Warley, C. Dawe, R.j. WhiteAbstract:Patients who smoke heavily and those with pre-existing airflow obstruction are at particular risk of postoperative respiratory Infection following upper abdominal surgery. This invariably prolongs hospital stay and increases morbidity. In order to determine whether high dose bronchodilator therapy in the perioperative period reduced the risk of Infection, all patients undergoing elective upper abdominal surgery were assessed for risk of developing postoperative Infection. Fifty-three patients were identified as high risk according to previously published criteria and were randomly allocated to receive nebulized salbutamol (5 mg) or saline placebo 6 hourly for 48 h beginning 1 h preoperatively. There was no difference in rates of postoperative Chest Infection in the two groups and this study, therefore, provides no support for the routine preoperative use of bronchodilators in these patients.
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Microbial flora of the trachea during intubation of patients undergoing upper abdominal surgery.
Thorax, 1992Co-Authors: J.p. Dilworth, R.j. White, E M BrownAbstract:BACKGROUND: The presence of Haemophilus influenzae in the oropharynx is correlated with the subsequent development of Chest Infection. The importance of colonisation of the trachea by bacteria at the time of surgery is uncertain. This study investigated the tracheal flora at the time of intubation in 24 patients undergoing elective upper abdominal surgery. METHODS: The bacterial flora of the trachea was sampled in all 24 patients immediately after intubation and immediately before extubation. Patients were assessed postoperatively for the development of Chest Infection. RESULTS: Bacteria, including H influenzae in five cases, were isolated from the post-intubation brushings of the trachea of 15 patients. The pre-extubation brushings from only four patients yielded growth. Three of five patients developing a Chest Infection were colonised by H influenzae according to the postintubation brush, compared with two of 19 without Chest Infections. Before extubation two of five developing Chest Infections had H influenzae in the trachea but none of 19 without Infection. All but one of the patients from whom H influenzae was isolated were smokers. CONCLUSIONS: These results suggest that the increased risk of postoperative Chest Infection in cigarette smokers may be due in part to colonisation of the trachea by H influenzae at the time of operation.
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Postoperative Chest Infection after upper abdominal surgery: an important problem for smokers
Respiratory medicine, 1992Co-Authors: J.p. Dilworth, R.j. WhiteAbstract:The incidence and risk factors for postoperative Chest Infection have been studied in 127 patients undergoing elective upper abdominal surgery. The overall incidence of postoperative Chest Infection was 20.5%. Mean length of postoperative stay was extended from 7.8 to 10.7 days in those developing Infection ( P Smoking and its sequelae are the principal risk factors for postoperative Chest Infection. This study showsthat the high risk patient can readily be identified by enquiry into respiratory symptoms, smoking history and by spirometry. This is the group in whom prophylactic measures are especially important, and they require close supervision to enable early identification and therapy of Infection.
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Oropharyngeal flora and Chest Infection after upper abdominal surgery.
Thorax, 1991Co-Authors: J.p. Dilworth, R.j. White, E M BrownAbstract:The oropharyngeal flora was determined before and after operation in 127 patients undergoing upper abdominal surgery. Swabs of the oropharynx were obtained on the day before operation and on the first, third, and fifth postoperative days. Isolation of Haemophilus influenzae, Streptococcus pneumoniae, and coliforms was noted. In the 108 patients with the full series of throat swabs the incidence of oropharyngeal colonisation by H influenzae was 16% and was unchanged after operation. S pneumoniae was present in only 5.6 (six patients) before operation and the incidence fell to 1.9% (two patients). There was a transient rise in coliform colonisation postoperatively. Twenty four patients developed a Chest Infection. In eight a bacterial cause was established, in six H influenzae and in two S pneumoniae. There was a significant relation between the carriage of H influenzae before operation and development of a Chest Infection. H influenzae was also found more often in cigarette smokers. The presence of S pneumoniae or coliform organisms before surgery was not related to the development of Infection. The high incidence of postoperative Chest Infection in cigarette smokers appears to be due in part to preoperative colonisation of the oropharynx by H influenzae.
J.p. Dilworth - One of the best experts on this subject based on the ideXlab platform.
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The effect of nebulized salbutamol therapy on the incidence of postoperative Chest Infection in high risk patients
Respiratory medicine, 1994Co-Authors: J.p. Dilworth, A.r.h. Warley, C. Dawe, R.j. WhiteAbstract:Patients who smoke heavily and those with pre-existing airflow obstruction are at particular risk of postoperative respiratory Infection following upper abdominal surgery. This invariably prolongs hospital stay and increases morbidity. In order to determine whether high dose bronchodilator therapy in the perioperative period reduced the risk of Infection, all patients undergoing elective upper abdominal surgery were assessed for risk of developing postoperative Infection. Fifty-three patients were identified as high risk according to previously published criteria and were randomly allocated to receive nebulized salbutamol (5 mg) or saline placebo 6 hourly for 48 h beginning 1 h preoperatively. There was no difference in rates of postoperative Chest Infection in the two groups and this study, therefore, provides no support for the routine preoperative use of bronchodilators in these patients.
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Microbial flora of the trachea during intubation of patients undergoing upper abdominal surgery.
Thorax, 1992Co-Authors: J.p. Dilworth, R.j. White, E M BrownAbstract:BACKGROUND: The presence of Haemophilus influenzae in the oropharynx is correlated with the subsequent development of Chest Infection. The importance of colonisation of the trachea by bacteria at the time of surgery is uncertain. This study investigated the tracheal flora at the time of intubation in 24 patients undergoing elective upper abdominal surgery. METHODS: The bacterial flora of the trachea was sampled in all 24 patients immediately after intubation and immediately before extubation. Patients were assessed postoperatively for the development of Chest Infection. RESULTS: Bacteria, including H influenzae in five cases, were isolated from the post-intubation brushings of the trachea of 15 patients. The pre-extubation brushings from only four patients yielded growth. Three of five patients developing a Chest Infection were colonised by H influenzae according to the postintubation brush, compared with two of 19 without Chest Infections. Before extubation two of five developing Chest Infections had H influenzae in the trachea but none of 19 without Infection. All but one of the patients from whom H influenzae was isolated were smokers. CONCLUSIONS: These results suggest that the increased risk of postoperative Chest Infection in cigarette smokers may be due in part to colonisation of the trachea by H influenzae at the time of operation.
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Postoperative Chest Infection after upper abdominal surgery: an important problem for smokers
Respiratory medicine, 1992Co-Authors: J.p. Dilworth, R.j. WhiteAbstract:The incidence and risk factors for postoperative Chest Infection have been studied in 127 patients undergoing elective upper abdominal surgery. The overall incidence of postoperative Chest Infection was 20.5%. Mean length of postoperative stay was extended from 7.8 to 10.7 days in those developing Infection ( P Smoking and its sequelae are the principal risk factors for postoperative Chest Infection. This study showsthat the high risk patient can readily be identified by enquiry into respiratory symptoms, smoking history and by spirometry. This is the group in whom prophylactic measures are especially important, and they require close supervision to enable early identification and therapy of Infection.
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Oropharyngeal flora and Chest Infection after upper abdominal surgery.
Thorax, 1991Co-Authors: J.p. Dilworth, R.j. White, E M BrownAbstract:The oropharyngeal flora was determined before and after operation in 127 patients undergoing upper abdominal surgery. Swabs of the oropharynx were obtained on the day before operation and on the first, third, and fifth postoperative days. Isolation of Haemophilus influenzae, Streptococcus pneumoniae, and coliforms was noted. In the 108 patients with the full series of throat swabs the incidence of oropharyngeal colonisation by H influenzae was 16% and was unchanged after operation. S pneumoniae was present in only 5.6 (six patients) before operation and the incidence fell to 1.9% (two patients). There was a transient rise in coliform colonisation postoperatively. Twenty four patients developed a Chest Infection. In eight a bacterial cause was established, in six H influenzae and in two S pneumoniae. There was a significant relation between the carriage of H influenzae before operation and development of a Chest Infection. H influenzae was also found more often in cigarette smokers. The presence of S pneumoniae or coliform organisms before surgery was not related to the development of Infection. The high incidence of postoperative Chest Infection in cigarette smokers appears to be due in part to preoperative colonisation of the oropharynx by H influenzae.
E M Brown - One of the best experts on this subject based on the ideXlab platform.
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Microbial flora of the trachea during intubation of patients undergoing upper abdominal surgery.
Thorax, 1992Co-Authors: J.p. Dilworth, R.j. White, E M BrownAbstract:BACKGROUND: The presence of Haemophilus influenzae in the oropharynx is correlated with the subsequent development of Chest Infection. The importance of colonisation of the trachea by bacteria at the time of surgery is uncertain. This study investigated the tracheal flora at the time of intubation in 24 patients undergoing elective upper abdominal surgery. METHODS: The bacterial flora of the trachea was sampled in all 24 patients immediately after intubation and immediately before extubation. Patients were assessed postoperatively for the development of Chest Infection. RESULTS: Bacteria, including H influenzae in five cases, were isolated from the post-intubation brushings of the trachea of 15 patients. The pre-extubation brushings from only four patients yielded growth. Three of five patients developing a Chest Infection were colonised by H influenzae according to the postintubation brush, compared with two of 19 without Chest Infections. Before extubation two of five developing Chest Infections had H influenzae in the trachea but none of 19 without Infection. All but one of the patients from whom H influenzae was isolated were smokers. CONCLUSIONS: These results suggest that the increased risk of postoperative Chest Infection in cigarette smokers may be due in part to colonisation of the trachea by H influenzae at the time of operation.
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Oropharyngeal flora and Chest Infection after upper abdominal surgery.
Thorax, 1991Co-Authors: J.p. Dilworth, R.j. White, E M BrownAbstract:The oropharyngeal flora was determined before and after operation in 127 patients undergoing upper abdominal surgery. Swabs of the oropharynx were obtained on the day before operation and on the first, third, and fifth postoperative days. Isolation of Haemophilus influenzae, Streptococcus pneumoniae, and coliforms was noted. In the 108 patients with the full series of throat swabs the incidence of oropharyngeal colonisation by H influenzae was 16% and was unchanged after operation. S pneumoniae was present in only 5.6 (six patients) before operation and the incidence fell to 1.9% (two patients). There was a transient rise in coliform colonisation postoperatively. Twenty four patients developed a Chest Infection. In eight a bacterial cause was established, in six H influenzae and in two S pneumoniae. There was a significant relation between the carriage of H influenzae before operation and development of a Chest Infection. H influenzae was also found more often in cigarette smokers. The presence of S pneumoniae or coliform organisms before surgery was not related to the development of Infection. The high incidence of postoperative Chest Infection in cigarette smokers appears to be due in part to preoperative colonisation of the oropharynx by H influenzae.
P S Hooi - One of the best experts on this subject based on the ideXlab platform.
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seasonal variation in respiratory syncytial virus Chest Infection in the tropics
Pediatric Pulmonology, 2002Co-Authors: P W K Chan, Fook Tim Chew, T N Tan, K B Chua, P S HooiAbstract:Respiratory syncytial virus (RSV) is the most important cause of lower respiratory tract Infection (LRTI) in young children. We determined if there was a seasonal variation in Malaysia in the incidence of RSV Infection in young children admitted with LRTI, and possible associations of RSV Infection with local meteorological parameters. A total of 5,691 children, aged less than 24 months and hospitalized with LRTI (i.e., bronchiolitis and pneumonia) between 1982–1997, were included in this study. Nasopharyngeal samples were collected and examined for RSV by immunofluorescence, viral culture, or both. Seasonal variations were determined by analyzing the monthly RSV-positive isolation rate via time series analysis. Possible correlations with local meteorological parameters were also evaluated. RSV was isolated in 1,047 (18.4%) children. Seasonal variations in RSV Infection rate were evident and peaked during the months of November, December, and January (test statistics [T] = 53.7, P < 0.001). This seasonal variation was evident for both bronchiolitis and pneumonia categories (T = 42.8 and 56.9, respectively, P < 0.001). The rate of RSV Infection appeared to correlate with the monthly number of rain days (r = 0.26, P < 0.01), and inversely with the monthly mean temperature (r = −0.38, P < 0.001). In the tropics, seasonal variations in the incidence of RSV Infection are evident, with an annual peak in November, December, and January. This information provides a guide for healthcare provisions and implementation of RSV prevention. Pediatr Pulmonol. 2002; 34:47–51. © 2002 Wiley-Liss, Inc.
P W K Chan - One of the best experts on this subject based on the ideXlab platform.
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cost of hospitalization for respiratory syncytial virus Chest Infection and implications for passive immunization strategies in a developing nation
Acta Paediatrica, 2007Co-Authors: P W K Chan, Mohamed E AbdellatifAbstract:UNLABELLED: Respiratory syncytial virus (RSV) Chest Infection is a common cause of hospitalization in the very young child. The aim of this study was to determine the direct cost of resource utilization in the treatment of children hospitalized with RSV Chest Infection and the potential cost-savings with passive immunization for high-risk infants. An audit of the hospital resource consumption and its costs was performed for 216 children aged < 24 mo admitted with RSV Chest Infection between 1995 and 1997. The cost-saving potential of passive immunization using monoclonal RSV antibodies during the RSV season was determined by assuming an 0.55 efficacy in hospitalization reduction when administered to "high-risk" infants according to the guidelines outlined by the American Academy of Pediatrics (AAP). The hospital treatment cost of 1064 bed-days amounted to USD 64 277.70. Each child occupied a median of 4.0 bed-days at a median cost of USD 169.99 (IQ1 128.08, IQ3 248.47). Children, who were ex-premature or with an underlying illness were more likely to have a longer hospital stay, higher treatment costs and need for intensive care. Ten (42%) of 24 ex-premature infants fulfilled the recommended criteria for passive immunization. Its use resulted in an incremental cost of USD 31.39 to a potential cost saving of USD 0.91 per infant for each hospital day saved. CONCLUSION: Ex-prematurity and the presence of an underlying illness results in escalation of the direct treatment cost of RSV Chest Infection. Current guidelines for use of passive RSV immunization do not appear to be cost-effective if adopted for Malaysian infants.
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seasonal variation in respiratory syncytial virus Chest Infection in the tropics
Pediatric Pulmonology, 2002Co-Authors: P W K Chan, Fook Tim Chew, T N Tan, K B Chua, P S HooiAbstract:Respiratory syncytial virus (RSV) is the most important cause of lower respiratory tract Infection (LRTI) in young children. We determined if there was a seasonal variation in Malaysia in the incidence of RSV Infection in young children admitted with LRTI, and possible associations of RSV Infection with local meteorological parameters. A total of 5,691 children, aged less than 24 months and hospitalized with LRTI (i.e., bronchiolitis and pneumonia) between 1982–1997, were included in this study. Nasopharyngeal samples were collected and examined for RSV by immunofluorescence, viral culture, or both. Seasonal variations were determined by analyzing the monthly RSV-positive isolation rate via time series analysis. Possible correlations with local meteorological parameters were also evaluated. RSV was isolated in 1,047 (18.4%) children. Seasonal variations in RSV Infection rate were evident and peaked during the months of November, December, and January (test statistics [T] = 53.7, P < 0.001). This seasonal variation was evident for both bronchiolitis and pneumonia categories (T = 42.8 and 56.9, respectively, P < 0.001). The rate of RSV Infection appeared to correlate with the monthly number of rain days (r = 0.26, P < 0.01), and inversely with the monthly mean temperature (r = −0.38, P < 0.001). In the tropics, seasonal variations in the incidence of RSV Infection are evident, with an annual peak in November, December, and January. This information provides a guide for healthcare provisions and implementation of RSV prevention. Pediatr Pulmonol. 2002; 34:47–51. © 2002 Wiley-Liss, Inc.