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Voice Disorders and Laryngitis
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Laryngitis is a descriptive term indicating a degree of erythema, oedema, epithelial change that may include ulceration, leukoplakia, and/or stiffness of the mucosa of the vocal fold. Often there is an increased amount of thick mucus present. Most acute laryngitis is associated with upper respiratory tract infections. Chronic laryngitis has close links with smoking, alcohol, reflux, occupational exposures, social activities, allergies, and vocal/throat hygiene. The voice is usually hoarse (rough, strained, breathy, or whispery), which may be due to vocal fold stiffness from the inflammatory process and/or secondary to muscle tension imbalance. The majority of acute infections are self-limiting. Treatment of chronic laryngitis consists of voice hygiene (VH) with reduced use/abuse and rest.
Assessing and responding to sudden deterioration in the adult
Published in Nicola Neale, Joanne Sale, Developing Practical Nursing Skills, 2022
The production of mucus by the respiratory tract acts as a moisturiser and helps protect the vital organs from drying out. Adults normally produce about 1–1.5 L per day of mucus in the respiratory tract, but it goes unnoticed as it is usually swallowed (Fahy and Dickey 2010). Mucus can trap particles of dust, allergens and smoke to further protect the body from harm. In those with cystic fibrosis, excess mucus is seen in the airways and a respiratory infection will exacerbate mucous production. The mucus clogs the airway and makes breathing out problematic for the person (see What Is Cystic Fibrosis. Available from: https://www.cff.org/What-is-CF/About-Cystic-Fibrosis/, Accessed on 9 June 2021). Smoking can also stimulate excessive mucus production. The mucus expectorated from the lungs is termed ‘sputum’. Sputum consists of lower respiratory tract secretions, nasopharyngeal and oropharyngeal material (including saliva), microorganisms and cells (Rubin 2009). Clearance of secretions is very important to maintain a clear airway and reduce the risk of infection (Rubin 2009). However, individuals may deny the existence of sputum due to social stigma or lack of awareness, for example, in cases such as cystic fibrosis or those who smoke excessively. Some, particularly women, feel embarrassed to expectorate, and they are more likely to swallow their sputum.
Physiotherapy and airway clearance
Published in Claudio F. Donner, Nicolino Ambrosino, Roger S. Goldstein, Pulmonary Rehabilitation, 2020
Miguel R. Gonçalves, Amanda J. Piper
Treatment methods that improve mucus clearance are considered essential in optimizing respiratory status and reducing the progression of lung disease in these patient populations. The goal is to reduce disease progression by augmenting the normal mucociliary clearance mechanism of the lungs and facilitating expectoration (9).
Emerging strategies in nanotechnology to treat respiratory tract infections: realizing current trends for future clinical perspectives
Published in Drug Delivery, 2022
Minhua Chen, Zhangxuan Shou, Xue Jin, Yingjun Chen
A heterogeneous lung lining fluid is distributed continuously throughout the respiratory tract. The trachea, bronchi, and bronchioles (conducting parts) are lined with a mucus gel, while the pulmonary surfactants and alveolar sub-phase fluid line the alveoli (A. W. Ng et al., 2004). Mucus is composed of water, globular proteins, lipids, DNA, mucins, salts, and cellular debris. It acts as a protective layer and helps in lubrication Mucus blocks the passage of pathogens and foreign substances to the underlying epithelium. Mucins are glycoproteins that contribute to the viscoelasticity of the mucus membrane (Zanin et al., 2016). In pathological conditions, the microenvironment of the respiratory tract is affected. The chronic bacterial infections in Cystic fibrosis change the pH of the respiratory tract from almost neutral to acidic. This altered pH induces conformational changes in the structure of mucin protein which can impact the interaction of nanoparticles and mucus (Poschet et al., 2002; F. Wan et al., 2020). Furthermore, respiratory tract diseases lead to excessive production and dehydration of mucus that also disrupt the interactivity of mucus and therapeutics. The production of extremely viscous mucus in a certain pathological environment may lead to embolism in the trachea, bronchi, and bronchioles, thus further obstructing the passage of drugs from the respiratory tract. The low clearance rate and higher accumulation of mucus create room for microbial growth and thus cause infection.
Investigation of drug regimens and treatment outcome in patients with Mycobacterium Simiae: a systematic review
Published in Expert Review of Anti-infective Therapy, 2022
Shirin Dashtbin, Shiva Mirkalantari, Masoud Dadashi, Davood Darban-Sarokhalil
Typical symptoms include mild to chronic coughs with mucus production [52]. In this review, mild to severe coughs with sputum production were the main symptoms among the patients with M. simiae pulmonary infections. Lotfi et al. [48] surveyed the clinical features, risk factors, diagnosis, and management of M. simiae infection among 20 patients and found that, similar to the present study, the most common symptoms among the patients were coughing, sputum production, and hemoptysis. However, Jabbour et al. [2] revealed in their study that patients typically present nonspecific symptoms, including mild to severe coughs, hemoptysis, dyspnea, fever, night sweats, malaise, and weight loss. Also, in addition to the symptoms mentioned above, Heap et al. [53] reported intra-abdominal pain among patients with M. simiae infection. In some studies, patients with M. simiae infection have also Cytomegalovirus (CMV), Herpes zoster, and aspergillosis co-infections [54–56].
The effect of COVID-19 on nasal mucociliary clearance
Published in Acta Oto-Laryngologica, 2022
Ebru Ozer Ozturk, Mehmet Aslan, Tuba Bayındır
The respiratory epithelium has a critical role in infection protection. While the goblet cells in the respiratory epithelium release mucus, the ciliated cells that account for more than half of the epithelial cells move the overlying mucus layer towards the oropharynx [4]. Mucus protects the respiratory tract against harmful chemical, microbiological, and physical influences. Microorganisms are captured by the mucus layer in the respiratory system and kept away from the respiratory epithelial cell surface, and the ciliated cells remove them from the microenvironment. This innate defense system is called mucociliary clearance (MCC) [5]. Nasal mucus is transported to the oropharynx by efficient and coordinated nasociliary activity, adhering to inhaled particles or microorganisms [6]. Nasal MCC is the respiratory system's principal defense mechanism [7]. Impairment of nasociliary activity can cause acute or chronic infections of the upper and lower respiratory system.