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Background Lower respiratory infections are a leading cause of morbidity and mortality around the world. The Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2016, provides an up-to-date analysis of the burden of lower respiratory infections in 195 countries. This study assesses cases, deaths, and aetiologies spanning the past 26 years and shows how the burden of lower respiratory infection has changed in people of all ages. Antecedentes Las infecciones respiratorias bajas son una de las principales causas de morbilidad y mortalidad en todo el mundo. Lo global El estudio sobre la carga de enfermedades, lesiones y factores de riesgo (GBD) de 2016 proporciona un análisis actualizado de la carga de Infecciones respiratorias bajas en 195 países. Este estudio evalúa casos, muertes y etiologías que abarcan el pasado 26 años y muestra cómo la carga de la infección respiratoria inferior ha cambiado en personas de todas las edades.

A decrease in food intake during the acute phase of lower respiratory tract infections may affect the course of illness. To determine if enteral feeding improves the clinical course of lower respiratory infections (LRI) we studied 42 infants (2 to 12 months of age) with LRI which were given antibiotics and salbutamol therapy based on clinical and X-ray findings. On admission to the hospital patients were randomly allocated to group A (fed by nasogastric tube as intermittent bolus); group B (infants fed by continuous drip via nasogastric tube) and group C (subjects fed ad-libitum by the oral route). Feedings consisted of powdered whole cow's milk formula, reconstituted to 7.5% (W/V), with added sucrose 5% and maltodextrin 5% (77 kcal/dl). Energy intake in group A increased from 69 to 110 kcal.kg.day; in group B, from 68 to 114 kcal.kg.day, and in group C, from 55 to 109 kcal.kg.day (ANOVA, p < 0.005 for the first three days). Infants of groups A and B had shorter hospital stays than C (8.7 and 8.4 vs. 9.8 days, ANOVA, p < 0.02) and a faster improvement of respiratory failure index (4.1 and 3.8 vs. 5.5. days, p < 0.001). Groups A and B also showed greater decrease in their heart rates (mean 170 down to 134 beats/min) than group C patients (169 down to 142 beats/min), p < 0.01 at discharge from the hospital. No differences were noted in trends of respiratory rate, weight/length, albuminemia, C-reactive protein, erythro-sedimentation rate or glycemia. No adverse effects of nasogastric tube feeding were observed.(ABSTRACT TRUNCATED AT 250 WORDS)

As a contribution to knowledge about the etiology of lower respiratory tract infections (LRI) in infants, 235 patients aged one year or less admitted to a children's hospital at northern metropolitan area of Santiago, Chile along years 1987 throughout 1989 with radiologically confirmed diagnosis were studied. Infants were eligible only if their symptoms lasted for not more than five days and their hospital stay was less than two days. Controls consisted on 74 healthy infants. A search for presumptive etiology was done by means of usual bacteriological procedures (pharyngeal swabs and blood cultures), plus latex test for type b Haemophilus influenzae (Hib) and Streptococcus pneumoniae (SP) in concentrated urine specimens; indirect immunofluorescence (IF) for specific Chlamydia trachomatis (CT) IgM; serological tests, isolation and IF in pharyngeal aspirates for syncytial respiratory virus (SRV), influenza, parainfluenzae and adenoviruses were also used. Evidence of viral infection was detected from 135/235 (57.5%) of cases and 21/74 (28.3%) controls, SRV being the most common. From 18/119 and 2/119 studied patients Hib and SP antigens were respectively detected, but urinary antigens were also present in 6/24 controls, raising questions about this test's specificity. IF titers of 1:32 or higher for CT were found in 5/80 patients, all younger than 5 months. It was possible to perform the whole set of available methods in 80 patients, in 70% of which some evidence of a known etiologic agent was found. Serology alone gave etiological clues in only 30% of these cases and usual microbiological cultures of throat swabs and blood from none of them. No combinations of age, fever, respiratory rate, apnea, bronchial obstructive syndrome, white blood cell counts over 15,000 or of band forms over 500 per cu mm, erythrocyte sedimentation rates, reactive C protein and x-ray findings allowed differential diagnosis between presumptive bacterial or viral etiology, except in one case of an infant presenting with pleural effusion and positive antigenuria for Hib.