SUMMARYThis study investigated the morbidity associated with respiratory virus infections in patients with well-documented chest disease, and the risk of transmission between close contacts. Patients informed the study team if they were exposed to a family member or colleague with a cold. Patients and symptomatic index cases recorded respiratory symptoms during the study period. Acute nasopharyngeal swabs and paired sera were obtained for viral diagnosis.Twenty-five (43 %) of 58 recorded exposures resulted in a symptomatic illness and 16 (28%) patients developed lower respiratory tract symptoms. Sixteen (64%) of the 25 symptomatic patients contacted their general practitioner, 14 (56 %) received antibiotics and 4 (16 %) were hospitalized. Mean duration of illness was 106 days in symptomatic patients and 5-7 days in their corresponding index cases (P < 0005). Mean symptom scores were 100X6 in symptomatic patients and 62-2 in index cases (P < 0 01). Respiratory viruses were identified in 19 (33%) episodes. Rhinovirus, coronavirus and respiratory syncytial virus infections were all associated with lower respiratory tract exacerbations.
Background As respiratory virus infections often lead to exacerbations of chronic bronchitis and asthma an effective antiviral drug may be helpful in such patients. Alpha2 interferon has been shown to give protection against rhinovirus infections in field studies. Methods Patients with chronic respiratory disease exposed to close contacts with symptoms of upper respiratory tract infection were randomly allocated to receive nasal sprays of recombinant OC2 interferon (3 x 106 IU) or placebo twice daily for five days. Of the 123 patients recruited into the study, 69 took 117 courses of medication; 11 courses were excluded from analysis. Results No important side effects were recorded and the incidence of possible adverse effects was similar in the two groups. Interferon treatment did not reduce the number or severity of symptomatic episodes; 11 of 48 patients given interferon and 16 of 58 given placebo developed lower respiratory symptoms. There were no differences in mean symptom scores (51 interferon and 52 placebo), number of symptomatic days (3 3 interferon and 5 0 placebo), peak flow values, number of general practitioner consultations, or use of antibiotics. Conclusion Alpha2 interferon 3 x 10'IU taken twice daily for five days does not protect patients with chronic respiratory disease from exacerbations after they have been in contact with an upper respiratory tract infection.
SUMMARY Mucosal loperamide caused a dose dependent reduction in the absorption of actively transported hexoses and amino acids, together with the associated rise in short circuit current. Na+ and fluid movement were also inhibited. Serosal application of the drug was without effect on these processes. The passive movement of fructose across the gut was not affected by loperamide which is therefore unlikely to act by reducing tissue permeability. In low Na+ conditions the inhibitory actions of loperamide on glycine absorption were reduced. Loperamide reduced basal Na+ transport although it did not affect the stimulation of Na+ absorption caused by mannose. Loperamide had no effect on the total ATPase activity nor on the Na+, K+-ATPase activity of mucosal homogenates. The effects of loperamide were not mimicked by morphine nor were they antagonised by naloxone and hence do not seem to involve an opiate receptor. It is concluded that loperamide exerts its inhibitory effects by an interaction with the Na+ sites of the nutrient carriers.Loperamide (Imodium, Janssen) is an opiate agonist which is used as an antidiarrhoeal agent.' Its therapeutic efficacy appears to arise not only from an action on the motor functions of the intestine, which results in slowed intestinal transit and increased gut capacitance,2 but also from its ability to inhibit intestinal secretion.3 6The antisecretory actions of loperamide are observed in response to serosal application of the drug. Loperamide is, however, administered orally and will therefore come into contact with the luminal surface of the intestinal epithelium, which is the site of absorptive processes in the intestine. The present investigation indicates that loperamide causes an inhibition of hexose and amino acid absorption and the associated movement of Na+ and fluid in everted sacs of rat small intestine. Methods RATSExperiments were carried out on male albino rats weighing between 230 and 250 g. These were allowed free access to food (diet 86, Oxoid, London) and water. They were anaesthetised with sodium pentobarbitone (60 mg/kg ip).
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