WorldWideScience

Sample records for chronic respiratory diseases

  1. Chronic lower respiratory diseases among demolition and cement workers

    DEFF Research Database (Denmark)

    Mølgaard, Ellen Fischer; Hannerz, Harald; Tüchsen, Finn;

    2013-01-01

    To estimate standardised hospitalisation ratios (SHR) for chronic lower respiratory diseases among demolition and cement workers in Denmark, 1995-2009.......To estimate standardised hospitalisation ratios (SHR) for chronic lower respiratory diseases among demolition and cement workers in Denmark, 1995-2009....

  2. Chronic Respiratory Diseases of School-Age Children

    Science.gov (United States)

    McGovern, John P.

    1976-01-01

    The author examines the problems of chronic respiratory disease in school-age children from a medical viewpoint, including recognition and diagnosis, commonly encountered diseases, their effect on participation in physical exercise, emotional factors, medication, and emergency care. (MB)

  3. Chronic respiratory disease in premature infants caused by Chlamydia trachomatis.

    OpenAIRE

    Numazaki, K; Chiba, S.; Kogawa, K; Umetsu, M; Motoya, H; Nakao, T.

    1986-01-01

    The relation between chronic respiratory disease and infection with Chlamydia trachomatis in premature infants was investigated to ascertain the aetiological importance of intrauterine C trachomatis infection and chronic respiratory disease in premature infants. Serum IgM antibodies against C trachomatis were determined by enzyme linked fluorescence assay. Sections of lung tissues obtained by biopsy and at necropsy were also tested for the presence of antigens using fluorescein conjugated mon...

  4. [Gastro-esophageal reflux and chronic respiratory diseases].

    Science.gov (United States)

    Dirou, S; Germaud, P; Bruley des Varannes, S; Magnan, A; Blanc, F-X

    2015-12-01

    Gastroesophageal reflux disease (GERD) frequently occurs in association with chronic respiratory diseases although the casual link is not always clear. Several pathophysiological and experimental factors are considered to support a role for GERD in respiratory disease. Conversely, respiratory diseases and bronchodilator treatment can themselves exacerbate GERD. When cough or severe asthma is being investigated, GERD does not need to be systematically looked for and a therapeutic test with proton pump inhibitors is not always recommended. pH impedance monitoring is now the reference diagnostic tool to detect non acid reflux, a form of reflux for which proton pump inhibitor treatment is ineffective. Recent data have shown a potential role of GERD in idiopathic pulmonary fibrosis and bronchiolitis obliterans following lung transplantation, leading to discussions about the place of surgery in this context. However, studies using pH impedance monitoring are still needed to better understand and manage the association between GERD and chronic respiratory diseases.

  5. Importance of Social Relationships in Patients with Chronic Respiratory Diseases.

    Science.gov (United States)

    Kurpas, Donata; Szwamel, Katarzyna; Mroczek, Bozena

    2016-01-01

    The literature lacks reports on the role of the social relationships domain (SRD) of quality of life (QoL) in shaping care for patients with chronic respiratory diseases in primary care. In this study we examined a group of 582 patients with chronic respiratory diseases and chronic non-respiratory diseases recruited from 199 primary care centers. In the patients with chronic respiratory diseases, higher SRD correlated with more frequent patient visits due to medical issue, fewer district nurse interventions over the past 12 months, less frequent hospitalizations over the past 3 years, and fewer chronic diseases. In these patients, a high SRD was most effectively created by high QoL in the Psychological, Environmental, and Physical domains, and the satisfaction with QoL. Programs for preventing a decline in SRD should include patients with low scores in the Psychological, Environmental, and Physical domains, those who show no improvement in mental or somatic well-being in the past 12 months, those with a low level of positive mental attitudes, unhealthy eating habits, and with low levels of met needs. Such programs should include older widows and widowers without permanent relationships, with only primary education, living far from a primary care center, and those whose visits were not due to a medical issue.

  6. The Expert Patient and Chronic Respiratory Diseases

    Directory of Open Access Journals (Sweden)

    Louis-Philippe Boulet

    2016-01-01

    Full Text Available The concept of “expert patient” has been developed in the last two decades to define a patient who has a significant knowledge of his/her disease and treatment in addition to self-management skills. However, this concept has evolved over the last years, and these patients are now considered, not only to be more efficient in the management of their own condition and communicating effectively with health professionals, but to also act as educators for other patients and as resources for the last, provide feedback on care delivery, and be involved in the production and implementation of practice guidelines, as well as in the development and conduct of research initiatives. There are some barriers, however, to the integration of this new contributor to the health care team, and specific requirements need to be considered for an individual to be considered as an expert. This new player has, however, a potentially important role to improve current care, particularly in respiratory health.

  7. Update on the "Dutch hypothesis" for chronic respiratory disease

    DEFF Research Database (Denmark)

    Vestbo, J; Prescott, E

    1998-01-01

    BACKGROUND: Many patients with chronic obstructive lung disease show increased airways responsiveness to histamine. We investigated the hypothesis that increased airways responsiveness predicts the development and remission of chronic respiratory symptoms. METHODS: We used data from 24-year follow......-up (1965-90) of 2684 participants in a cohort study in Vlagtwedde and Vlaardingen, Netherlands. Increased airways responsiveness was defined as a PC10 value (concentration of histamine for which challenge led to a 10% fall in forced expiratory volume in 1 s) of less than 8 mg/ml. Information on respiratory...... of the odds ratio for the development of any of the six symptoms was 1.7 (1.2-2.3). Participants with increased airways responsiveness were less likely than those without this characteristic to show remission of these respiratory symptoms. The estimate of the odds ratio for the remission of any of the six...

  8. The global burden of chronic respiratory disease in adults.

    Science.gov (United States)

    Burney, P; Jarvis, D; Perez-Padilla, R

    2015-01-01

    With an aging global population, chronic respiratory diseases are becoming a more prominent cause of death and disability. Age-standardised death rates from chronic obstructive pulmonary disease (COPD) are highest in low-income regions of the world, particularly South Asia and sub-Saharan Africa, although airflow obstruction is relatively uncommon in these areas. Airflow obstruction is, by contrast, more common in regions with a high prevalence of cigarette smoking. COPD mortality is much more closely related to the prevalence of a low forced vital capacity which is, in turn, associated with poverty. Mortality from asthma is less common than mortality from COPD, but it is also relatively more common in poorer areas, particularly Oceania, South and South-East Asia, the Middle East and Africa. Again this contrasts with the asthma prevalence among adults, which is highest in high-income regions. In high-income areas, mortality due to asthma, which is predominantly an adult problem, has fallen substantially in recent decades with the spread of new guidelines for treatment that emphasise the use of inhaled steroids to control the disease. Although mortality rates have been falling, the prevalence of atopy has been increasing between generations in Western Europe. Changes in the prevalence of wheeze among adults has been more varied and may have been influenced by the reduction in smoking and the increase in the use of inhaled steroids. PMID:25519785

  9. How to adapt the pulmonary rehabilitation programme to patients with chronic respiratory disease other than COPD

    OpenAIRE

    Holland, Anne E.; Karin Wadell; Spruit, Martijn A

    2013-01-01

    Dyspnoea, fatigue, reduced exercise tolerance, peripheral muscle dysfunction and mood disorders are common features of many chronic respiratory disorders. Pulmonary rehabilitation successfully treats these manifestations in chronic obstructive pulmonary disease (COPD) and emerging evidence suggests that these benefits could be extended to other chronic respiratory conditions, although adaptations to the standard programme format may be required. Whilst the benefits of exercise training are we...

  10. Within-breath respiratory impedance and airway obstruction in patients with chronic obstructive pulmonary disease

    OpenAIRE

    Karla Kristine Dames da Silva; Alvaro Camilo Dias Faria; Agnaldo José Lopes; Pedro Lopes de Melo

    2015-01-01

    OBJECTIVE: Recent work has suggested that within-breath respiratory impedance measurements performed using the forced oscillation technique may help to noninvasively evaluate respiratory mechanics. We investigated the influence of airway obstruction on the within-breath forced oscillation technique in smokers and chronic obstructive pulmonary disease patients and evaluated the contribution of this analysis to the diagnosis of chronic obstructive pulmonary disease. METHODS: Twenty healthy indi...

  11. Within-breath respiratory impedance and airway obstruction in patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Karla Kristine Dames da Silva

    2015-07-01

    Full Text Available OBJECTIVE: Recent work has suggested that within-breath respiratory impedance measurements performed using the forced oscillation technique may help to noninvasively evaluate respiratory mechanics. We investigated the influence of airway obstruction on the within-breath forced oscillation technique in smokers and chronic obstructive pulmonary disease patients and evaluated the contribution of this analysis to the diagnosis of chronic obstructive pulmonary disease. METHODS: Twenty healthy individuals and 20 smokers were assessed. The study also included 74 patients with stable chronic obstructive pulmonary disease. We evaluated the mean respiratory impedance (Zm as well as values for the inspiration (Zi and expiration cycles (Ze at the beginning of inspiration (Zbi and expiration (Zbe, respectively. The peak-to-peak impedance (Zpp=Zbe-Zbi and the respiratory cycle dependence (ΔZrs=Ze-Zi were also analyzed. The diagnostic utility was evaluated by investigating the sensitivity, the specificity and the area under the receiver operating characteristic curve. ClinicalTrials.gov: NCT01888705. RESULTS: Airway obstruction increased the within-breath respiratory impedance parameters that were significantly correlated with the spirometric indices of airway obstruction (R=−0.65, p90%. CONCLUSIONS: We conclude the following: (1 chronic obstructive pulmonary disease introduces higher respiratory cycle dependence, (2 this increase is proportional to airway obstruction, and (3 the within-breath forced oscillation technique may provide novel parameters that facilitate the diagnosis of respiratory abnormalities in chronic obstructive pulmonary disease.

  12. Chronic diseases, chromosomal abnormalities, and congenital malformations as risk factors for respiratory syncytial virus hospitalization

    DEFF Research Database (Denmark)

    Kristensen, Kim; Hjuler, Thomas; Ravn, Henrik;

    2012-01-01

    Little is known about how chronic conditions other than prematurity, heart disease, and Down syndrome affect the risk and severity of hospitalization for respiratory syncytial virus (RSV). We assess the risk and severity of RSV hospitalization in children with chronic conditions in this register...

  13. Quality of Care for Patients with Chronic Respiratory Diseases: Data for Accreditation Plan in Primary Healthcare.

    Science.gov (United States)

    Kurpas, Donata; Szwamel, Katarzyna; Mroczek, Bożena

    2016-01-01

    There are scarce reports in the literature on factors affecting the assessment of the quality of care for patients with chronic respiratory diseases. Such information is relevant in the accreditation process on implementing the healthcare. The study group consisted of 133 adult patients with chronic respiratory diseases and 125 adult patients with chronic non-respiratory diseases. In the present study, the level of satisfaction from healthcare provided by the primary healthcare unit, disease acceptance, quality of life, health behaviors, and met needs were examined, as well as associations between variables with the use of correspondence analysis. The results are that in patients with chronic respiratory diseases an increase in satisfaction depends on the improvement of well-being in the mental sphere. The lack of problems with obtaining a referral to a specialist and a higher level of fulfilled needs also have a positive effect. Additionally, low levels of satisfaction should be expected in those patients with chronic respiratory diseases who wait for an appointment in front of the office for a long time, report problems with obtaining a referral to additional tests, present a low level of health behaviors, and have a low index of benefits.

  14. Canadian Practice Assessment in Chronic Obstructive Pulmonary Disease: Respiratory Specialist Physician Perception Versus Patient Reality

    Directory of Open Access Journals (Sweden)

    Paul Hernandez

    2013-01-01

    Full Text Available INTRODUCTION: Chronic obstructive pulmonary disease (COPD is a common respiratory condition and the fourth leading cause of death in Canada. Optimal COPD management requires patients to participate in their care and physician knowledge of patients’ perceptions of their disease.

  15. High rates of detection of respiratory viruses in tonsillar tissues from children with chronic adenotonsillar disease.

    Directory of Open Access Journals (Sweden)

    Jose Luiz Proenca-Modena

    Full Text Available Chronic tonsillar diseases are an important health problem, leading to large numbers of surgical procedures worldwide. Little is known about pathogenesis of these diseases. In order to investigate the role of respiratory viruses in chronic adenotonsillar diseases, we developed a cross-sectional study to determine the rates of viral detections of common respiratory viruses detected by TaqMan real time PCR (qPCR in nasopharyngeal secretions, tonsillar tissues and peripheral blood from 121 children with chronic tonsillar diseases, without symptoms of acute respiratory infections. At least one respiratory virus was detected in 97.5% of patients. The viral co-infection rate was 69.5%. The most frequently detected viruses were human adenovirus in 47.1%, human enterovirus in 40.5%, human rhinovirus in 38%, human bocavirus in 29.8%, human metapneumovirus in 17.4% and human respiratory syncytial virus in 15.7%. Results of qPCR varied widely between sample sites: human adenovirus, human bocavirus and human enterovirus were predominantly detected in tissues, while human rhinovirus was more frequently detected in secretions. Rates of virus detection were remarkably high in tonsil tissues: over 85% in adenoids and close to 70% in palatine tonsils. In addition, overall virus detection rates were higher in more hypertrophic than in smaller adenoids (p = 0.05, and in the particular case of human enteroviruses, they were detected more frequently (p = 0.05 in larger palatine tonsils than in smaller ones. While persistence/latency of DNA viruses in tonsillar tissues has been documented, such is not the case of RNA viruses. Respiratory viruses are highly prevalent in adenoids and palatine tonsils of patients with chronic tonsillar diseases, and persistence of these viruses in tonsils may stimulate chronic inflammation and play a role in the pathogenesis of these diseases.

  16. Pulmonary rehabilitation in chronic respiratory diseases--from goals to outcomes.

    Science.gov (United States)

    Pesut, Dragica; Ciobanu, Laura; Nagorni-Obradovic, Ljudmila

    2008-01-01

    This paper is a review of current approaches on pulmonary rehabilitation (PR) in chronic pulmonary diseases. Pulmonary rehabilitation is the most accepted method of non-pharmacological treatment in patients with chronic obstructive pulmonary disease (COPD), bronchial asthma, bronchiectasis, cystic fibrosis, interstitial lung disease, neuromuscular degenerative disease and post-tuberculosis lung sequelae. Throughout its components, especially oxygen therapy, it is the most important intervention in chronic respiratory failure in order to improve exercise tolerance, lung function and self-management. Enrolling patients in pulmonary rehabilitation programmes is a consistent help to a better control of their illness and a step forward to the international standards of treating COPD and non-COPD chronic respiratory diseases. It is evidence-based that PR is effective in reducing dyspnoea, improving health-related quality of life, reducing the number of hospital days and the utilisation of costly healthcare resources; there are also psychosocial benefits from comprehensive PR programmes in patients with COPD. PR is currently considered as effective in patients with COPD and in some patients with chronic respiratory diseases other than COPD. PMID:18822868

  17. Draft Genome Sequence of Legionella jamestowniensis Isolated from a Patient with Chronic Respiratory Disease

    Science.gov (United States)

    Prochazka, Birgit; Indra, Alexander; Hasenberger, Petra; Blaschitz, Marion; Wagner, Laura; Wewalka, Günther; Sorschag, Sieglinde; Schmid, Daniela

    2016-01-01

    Legionella jamestowniensis can be found in the environment in various water samples, in wet soil, and in compost facilities, but evidence of its human pathogenicity has not yet been demonstrated. Here, we report the first draft genome sequence of an L. jamestowniensis isolate, derived from a patient suffering from a chronic respiratory disease. PMID:27635013

  18. Draft Genome Sequence of Legionella jamestowniensis Isolated from a Patient with Chronic Respiratory Disease.

    Science.gov (United States)

    Prochazka, Birgit; Indra, Alexander; Hasenberger, Petra; Blaschitz, Marion; Wagner, Laura; Wewalka, Günther; Sorschag, Sieglinde; Schmid, Daniela; Ruppitsch, Werner

    2016-01-01

    Legionella jamestowniensis can be found in the environment in various water samples, in wet soil, and in compost facilities, but evidence of its human pathogenicity has not yet been demonstrated. Here, we report the first draft genome sequence of an L. jamestowniensis isolate, derived from a patient suffering from a chronic respiratory disease. PMID:27635013

  19. Biological mechanisms in respiratory and limb muscle dysfunction in chronic respiratory conditions : influence of disease severity and body composition

    OpenAIRE

    Puig Vilanova, Ester, 1987-

    2014-01-01

    Skeletal muscle dysfunction and wasting are major comorbidities of chronic obstructive pulmonary disease (COPD) and lung cancer (LC). Despite that the lower limb muscles are usually more severely affected, the respiratory muscles may also experience structural and functional abnormalities in COPD. Muscle dysfunction negatively impacts on the patients’ quality of life by impairing their exercise tolerance even of daily life activities. Several molecular mechanisms are involved in the etiology ...

  20. [Relevance of Outpatient, Equipment-based Exercise Training in Patients with Chronic Respiratory Diseases].

    Science.gov (United States)

    Glöckl, R; Göhl, O; Spielmanns, M; Taube, K; Bock, R; Schultz, K; Worth, H

    2016-07-01

    Exercise training is one of the most important components in disease management for patients with chronic respiratory diseases. The clinically relevant benefits of endurance and strength training on dyspnea, exercise capacity and quality of life have been evaluated very well. However, there are some legal limitations by the German Working Group for Rehabilitation (BAR) concerning outpatient exercise training programs (beyond pulmonary rehabilitation): only group-based callisthenic training programs receive funding from health care insurances while professional equipment-based training programs are excluded despite their outstanding effectiveness.This review provides an overview on the methodology and the benefits of outpatient exercise training programs for patients with chronic respiratory diseases, and it critically discusses the organizational structures of these programs in Germany. PMID:27218214

  1. How to adapt the pulmonary rehabilitation programme to patients with chronic respiratory disease other than COPD.

    Science.gov (United States)

    Holland, Anne E; Wadell, Karin; Spruit, Martijn A

    2013-12-01

    Dyspnoea, fatigue, reduced exercise tolerance, peripheral muscle dysfunction and mood disorders are common features of many chronic respiratory disorders. Pulmonary rehabilitation successfully treats these manifestations in chronic obstructive pulmonary disease (COPD) and emerging evidence suggests that these benefits could be extended to other chronic respiratory conditions, although adaptations to the standard programme format may be required. Whilst the benefits of exercise training are well established in asthma, pulmonary rehabilitation can also provide evidence-based interventions including breathing techniques and self-management training. In interstitial lung disease, a small number of trials show improved exercise capacity, symptoms and quality of life following pulmonary rehabilitation, which is a positive development for patients who may have few treatment options. In pulmonary arterial hypertension, exercise training is safe and effective if patients are stable on medical therapy and close supervision is provided. Pulmonary rehabilitation for bronchiectasis, including exercise training and airway clearance techniques, improves exercise capacity and quality of life. In nonsmall cell lung cancer, a comprehensive interdisciplinary approach is required to ensure the success of pulmonary rehabilitation following surgery. Pulmonary rehabilitation programmes provide important and underutilised opportunities to improve the integrated care of people with chronic respiratory disorders other than COPD. PMID:24293474

  2. How to adapt the pulmonary rehabilitation programme to patients with chronic respiratory disease other than COPD

    Directory of Open Access Journals (Sweden)

    Anne E. Holland

    2013-12-01

    Full Text Available Dyspnoea, fatigue, reduced exercise tolerance, peripheral muscle dysfunction and mood disorders are common features of many chronic respiratory disorders. Pulmonary rehabilitation successfully treats these manifestations in chronic obstructive pulmonary disease (COPD and emerging evidence suggests that these benefits could be extended to other chronic respiratory conditions, although adaptations to the standard programme format may be required. Whilst the benefits of exercise training are well established in asthma, pulmonary rehabilitation can also provide evidence-based interventions including breathing techniques and self-management training. In interstitial lung disease, a small number of trials show improved exercise capacity, symptoms and quality of life following pulmonary rehabilitation, which is a positive development for patients who may have few treatment options. In pulmonary arterial hypertension, exercise training is safe and effective if patients are stable on medical therapy and close supervision is provided. Pulmonary rehabilitation for bronchiectasis, including exercise training and airway clearance techniques, improves exercise capacity and quality of life. In nonsmall cell lung cancer, a comprehensive interdisciplinary approach is required to ensure the success of pulmonary rehabilitation following surgery. Pulmonary rehabilitation programmes provide important and underutilised opportunities to improve the integrated care of people with chronic respiratory disorders other than COPD.

  3. Temperature effects on outpatient visits of respiratory diseases, asthma, and chronic airway obstruction in Taiwan

    Science.gov (United States)

    Wang, Yu-Chun; Lin, Yu-Kai

    2015-07-01

    This study evaluated the risk of outpatient visits for respiratory diseases, asthma, and chronic airway obstruction not elsewhere classified (CAO) associated with ambient temperatures and extreme temperature events from 2000 to 2008 in Taiwan. Based on geographical and socioeconomics characteristics, this study divided the whole island into seven areas. A distributed lag non-linear model was used to estimate the area-disease-specific cumulative relative risk (RR), and random-effect meta-analysis was used to estimate the pooled RR of outpatient visits, from lag 0 to lag 7 days, associated with daily temperature, and added effects of prolonged extreme heat and cold for population of all ages, the elderly and younger than 65 years. Pooled analyses showed that younger population had higher outpatient visits for exposing to low temperature of 18 °C, with cumulative 8-day RRs of 1.36 (95 % confidence interval (CI) 1.31-1.42) for respiratory diseases, 1.10 (95 % CI 1.03-1.18) for asthma, and 1.12 (95 % CI 1.02-1.22) for CAO. The elderly was more vulnerable to high temperature of 30 °C with the cumulative 8-day RR of 1.08 (95 % CI 1.03-1.13) for CAO. Elevated outpatient visits for all respiratory diseases and asthma were associated with extreme heat lasting for 6 to 8 days. On the contrary, the extreme cold lasting more than 8 days had significant negative association with outpatient visits of all respiratory diseases. In summary, elderly patients of respiratory diseases and CAO are vulnerable to high temperature. Cold temperature is associated with all types of respiratory diseases for younger patients.

  4. August 2014 Phoenix pulmonary journal club: the use of macrolide antibiotics in chronic respiratory disease

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2014-08-01

    Full Text Available No abstract available. Article truncated after 150 words. This month's journal club reviewed the role of macrolide antibiotics in chronic respiratory disease. Macrolide usage was suggested from observational studies in Japan in diffuse panbroncholitis, a disorder associated with chronic respiratory infection, usually Pseudomonas aeruginosa (1. Clinical improvement was noted despite doses of antibiotics well below the minimal inhibitory concentration (MIC of the antibiotic. This suggested the antibiotic was likely working by an anti-inflammatory effect. These observations were extended to cystic fibrosis (CF where prophylactic macrolide therapy in CF patients infected with Pseudomonas has become standard therapy (2. More recently, low dose macrolide therapy has been applied to non-CF lung diseases such as chronic obstructive pulmonary disease (COPD, bronchiectasis and asthma. Time did not permit a review of all studies so a representative sample was discussed. In patients with COPD, the four randomized, placebo-controlled trials reviewed all suggested that chronic therapy with macrolide antibiotics reduced COPD exacerbations (3-5. This ...

  5. Time trend in hospitalised chronic lower respiratory diseases among Danish building and construction workers, 1981-2009

    DEFF Research Database (Denmark)

    Tüchsen, Finn; Hannerz, Harald; Mølgaard, Ellen Fisher;

    2012-01-01

    To show trends in age-standardised hospital admission ratios (SHR) for chronic lower respiratory diseases, estimated for Danish construction workers over three time periods (1981-1990, 1991-2000, 2001-2009).......To show trends in age-standardised hospital admission ratios (SHR) for chronic lower respiratory diseases, estimated for Danish construction workers over three time periods (1981-1990, 1991-2000, 2001-2009)....

  6. A review of Vitamin D effects on common respiratory diseases: Asthma, chronic obstructive pulmonary disease, and tuberculosis

    OpenAIRE

    Hejazi, Mohammad Esmaeil; Modarresi-Ghazani, Faezeh; Entezari-Maleki, Taher

    2016-01-01

    Despite the classic role of Vitamin D in skeletal health, new aspects of Vitamin D have been discovered in tissues and organs other than bones. Epidemiological and observational studies demonstrate a link between Vitamin D deficiency and risk of developing respiratory diseases including asthma, chronic obstructive pulmonary disease (COPD), and tuberculosis (TB). To review the literature, we searched the terms “Vitamin D” (using the set operator) and “asthma,” “COPD” and “TB” in electronic dat...

  7. Functional connectivity and information flow of the respiratory neural network in chronic obstructive pulmonary disease.

    Science.gov (United States)

    Yu, Lianchun; De Mazancourt, Marine; Hess, Agathe; Ashadi, Fakhrul R; Klein, Isabelle; Mal, Hervé; Courbage, Maurice; Mangin, Laurence

    2016-08-01

    Breathing involves a complex interplay between the brainstem automatic network and cortical voluntary command. How these brain regions communicate at rest or during inspiratory loading is unknown. This issue is crucial for several reasons: (i) increased respiratory loading is a major feature of several respiratory diseases, (ii) failure of the voluntary motor and cortical sensory processing drives is among the mechanisms that precede acute respiratory failure, (iii) several cerebral structures involved in responding to inspiratory loading participate in the perception of dyspnea, a distressing symptom in many disease. We studied functional connectivity and Granger causality of the respiratory network in controls and patients with chronic obstructive pulmonary disease (COPD), at rest and during inspiratory loading. Compared with those of controls, the motor cortex area of patients exhibited decreased connectivity with their contralateral counterparts and no connectivity with the brainstem. In the patients, the information flow was reversed at rest with the source of the network shifted from the medulla towards the motor cortex. During inspiratory loading, the system was overwhelmed and the motor cortex became the sink of the network. This major finding may help to understand why some patients with COPD are prone to acute respiratory failure. Network connectivity and causality were related to lung function and illness severity. We validated our connectivity and causality results with a mathematical model of neural network. Our findings suggest a new therapeutic strategy involving the modulation of brain activity to increase motor cortex functional connectivity and improve respiratory muscles performance in patients. Hum Brain Mapp 37:2736-2754, 2016. © 2016 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc.

  8. Chronic respiratory diseases and quality of life in elderly nursing home residents.

    Science.gov (United States)

    Carreiro-Martins, Pedro; Gomes-Belo, Joana; Papoila, Ana Luísa; Caires, Iolanda; Palmeiro, Teresa; Gaspar-Marques, João; Leiria-Pinto, Paula; Mendes, Ana Sofia; Paulo-Teixeira, João; Botelho, Maria Amália; Neuparth, Nuno

    2016-08-01

    Few studies have assessed the quality of life (QOL) related to chronic respiratory diseases in the elderly. In the framework of the geriatric study on the health effects of air quality in elderly care centers (GERIA) study, a questionnaire was completed by elderly subjects from 53 selected nursing homes. It included various sections in order to assess respiratory complaints, QOL (World Health Organization QOL (WHOQOL)-BREF), and the cognitive and depression status. The outcome variables were the presence of a score lower than 50 (current wheezing, asthma, and allergic rhinitis were considered as potential risk factors. The surveyed sample was (n = 887) 79% female, with a mean age of 84 years (SD: 7 years). In the multivariable analysis, a score of <50 in the physical domain was associated with wheezing in the previous 12 months (odds ratio (OR): 2.03, confidence interval (CI): 1.25-3.31) and asthma (OR: 1.95, CI: 1.12-3.38). The psychological domain was related with a frequent cough (OR: 1.43, CI: 0.95-2.91). A score of <50 in the environmental domain was associated with chronic bronchitis (OR: 2.89, CI: 1.34-6.23) and emphysema (OR: 3.89, CI: 1.27-11.88). In view of these findings, the presence of respiratory diseases seems to be an important risk factor for a low QOL among elderly nursing home residents. PMID:26965222

  9. The role of invasive ventilation in exacerbations of chronic obstructive pulmonary disease causing respiratory failure.

    Science.gov (United States)

    Kosky, Christopher; Turton, Charles

    2006-01-01

    Acute hypercapnic respiratory failure in chronic obstructive pulmonary disease can usually be managed initially with medical treatment and non- invasive ventilation. In circumstances where non- invasive ventilation cannot be used or has failed, intubation and invasive ventilation may be lifesaving. The outcome of patients with an exacerbation of COPD requiring invasive ventilation is better than often thought, with a hospital survival of 70-89%. Decisions regarding invasive ventilation made by physicians and patients with COPD are unpredictable and vary with the individual. This article reviews the role of invasive ventilation in exacerbations of COPD to assist decision making.

  10. Chronic respiratory failure in patients with neuromuscular diseases: diagnosis and treatment.

    Science.gov (United States)

    Paschoal, Ilma Aparecida; Villalba, Wander de Oliveira; Pereira, Mônica Corso

    2007-01-01

    Neuromuscular diseases affect alveolar air exchange and therefore cause chronic respiratory failure. The onset of respiratory failure can be acute, as in traumas, or progressive (slow or rapid), as in amyotrophic lateral sclerosis, muscular dystrophies, diseases of the myoneural junction, etc. Respiratory muscle impairment also affects cough efficiency and, according to the current knowledge regarding the type of treatment available in Brazil to these patients, it can be said that the high rates of morbidity and mortality in these individuals are more often related to the fact that they cough inefficiently rather than to the fact that they ventilate poorly. In this review, with the objective of presenting the options of devices available to support and substitute for natural ventilation in patients with neuromuscular diseases, we have compiled a brief history of the evolution of orthopedic braces and prostheses used to aid respiration since the end of the 19th century. In addition, we highlight the elements that are fundamental to the diagnosis of alveolar hypoventilation and of failure of the protective cough mechanism: taking of a clinical history; determination of peak cough flow; measurement of maximal inspiratory and expiratory pressures; spirometry in two positions (sitting and supine); pulse oximetry; capnography; and polysomnography. Furthermore, the threshold values available in the literature for the use of nocturnal ventilatory support and for the extension of this support through the daytime period are presented. Moreover, the maneuvers used to increase cough efficiency, as well as the proper timing of their introduction, are discussed.

  11. Scaling up strategies of the chronic respiratory disease programme of the European Innovation Partnership on Active and Healthy Ageing (Action Plan B3

    DEFF Research Database (Denmark)

    Bousquet, J; Farrell, J; Crooks, G;

    2016-01-01

    Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) focuses on the integrated care of chronic diseases. Area 5 (Care Pathways) was initiated using chronic respiratory diseases as a model. The chronic respiratory disease action plan includes (1) AIRWAYS ...... learnt, including emerging technologies for individualised and predictive medicine. This strategy has already been applied to the chronic respiratory disease action plan of the European Innovation Partnership on Active and Healthy Ageing.......Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) focuses on the integrated care of chronic diseases. Area 5 (Care Pathways) was initiated using chronic respiratory diseases as a model. The chronic respiratory disease action plan includes (1) AIRWAYS...

  12. Acute respiratory failure secondary to eosinophilic pneumonia following influenza vaccination in an elderly man with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Prapaporn Pornsuriyasak

    2014-09-01

    Full Text Available Acute respiratory failure with diffuse pulmonary opacities is an unusual manifestation following influenza vaccination. We report herein a patient with chronic obstructive pulmonary disease who developed fever with worsening of respiratory symptoms and severe hypoxemia requiring ventilatory support shortly after influenza vaccination. Bronchoalveolar lavage was compatible with acute eosinophilic pneumonia. Rapid clinical improvement was observed 2 weeks after systemic corticosteroid treatment, followed by radiographic improvement at 4 weeks. No disease recurrence was observed at the 6-month follow-up.

  13. Recommendations for Patients with Chronic Respiratory Disease Considering Air Travel: A Statement from the Canadian Thoracic Society

    Directory of Open Access Journals (Sweden)

    Dale Lien

    1998-01-01

    Full Text Available Patients with respiratory disease regularly seek the convenience of commercial airline travel. In addition to the stresses that all patients with chronic disease encounter, these patients are exposed to the affects of acute altitudinal hypoxemia. This in turn has the potential to produce significant symptoms and complications in-flight for patients with chronic respiratory disease. This article reviews the current literature, and seeks to help the practicing physician by providing recommendations on which patients should be assessed preflight, the type of assessment that should be carried out and recommendations for providing advice to these travelling patients.

  14. Non-invasive mechanical ventilation in acute respiratory failure due to chronic obstructive pulmonary disease: correlates for success.

    OpenAIRE

    Ambrosino, N; Foglio, K; Rubini, F.; Clini, E.; Nava, S.; M. Vitacca

    1995-01-01

    BACKGROUND--Non-invasive mechanical ventilation is increasingly used in the treatment of acute respiratory failure in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to identify simple parameters to predict the success of this technique. METHODS--Fifty nine episodes of acute respiratory failure in 47 patients with COPD treated with non-invasive mechanical ventilation were analysed, considering each one as successful (78%) or unsuccessful (22%) according t...

  15. Prothrombotic state in senile patients with acute exacerbations of chronic obstructive pulmonary disease combined with respiratory failure

    OpenAIRE

    SONG, YA-JUN; ZHOU, ZHE-HUI; LIU, YAO-KANG; RAO, SHI-MING; HUANG, YING-JUN

    2013-01-01

    The aim of this study was to study the clinical value of prethrombotic state and treatment with low molecular weight heparin (LMWH) in senile patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) combined with respiratory failure. Hemorheological markers (hematocrit, blood viscosity and plasma viscosity), fibrinogen (FIB), D-dimer and gas analysis were evaluated in 30 senile patients with AECOPD combined with respiratory failure and compared with those in 30 case...

  16. Differential serologic response to Mycoplasma ovipneumoniae and Mycoplasma arginini in lambs affected with chronic respiratory disease.

    Science.gov (United States)

    Niang, M; Rosenbusch, R F; Lopez-Virella, J; Kaeberle, M L

    1999-01-01

    An enzyme-linked immunoabsorbent assay (ELISA) was used to evaluate the levels of antibodies to Mycoplasma ovipneumoniae and M. arginini in lambs with chronic respiratory disease. Sera were obtained from lambs in several flocks at various stages of the clinical disease and tested with sodium dodecyl sulfate (SDS)-treated M. ovipneumoniae and M. arginini whole cells and a crude capsular extract of M. ovipneumoniae as the antigens. There were low levels of antibody to M. ovipneumoniae in flocks sampled at the early stages of infection, whereas increased levels of antibody were present in lambs from flocks that had apparently recovered from the clinical disease. Slowly rising titers of circulating antibodies to M. ovipneumoniae were confirmed by sequential bleeding of lambs during the course of the clinical disease. However, antibody levels of M. arginini were more likely to increase earlier in the disease process. There was significant cross-reactivity between the 2 SDS-treated antigens in both the ELISA test and western immunoblotting. In contrast, the crude capsular extract was specific for detecting antibodies to M. ovipneumoniae.

  17. A review of Vitamin D effects on common respiratory diseases: Asthma, chronic obstructive pulmonary disease, and tuberculosis.

    Science.gov (United States)

    Hejazi, Mohammad Esmaeil; Modarresi-Ghazani, Faezeh; Entezari-Maleki, Taher

    2016-01-01

    Despite the classic role of Vitamin D in skeletal health, new aspects of Vitamin D have been discovered in tissues and organs other than bones. Epidemiological and observational studies demonstrate a link between Vitamin D deficiency and risk of developing respiratory diseases including asthma, chronic obstructive pulmonary disease (COPD), and tuberculosis (TB). To review the literature, we searched the terms "Vitamin D" (using the set operator) and "asthma," "COPD" and "TB" in electronic databases, including PubMed/MEDLINE, Scopus, and Google Scholar until July 2015. Non-English articles or articles with unavailable full text were excluded. Both in vivo and in vitro studies were included. All the reviewed articles state that Vitamin D deficiency is very common among patients with respiratory diseases. The present data regarding Vitamin D and asthma is still controversial, but data about COPD and TB are more encouraging. The relevant studies have been conducted in different populations therefore it is not particularly possible to compare the data due to genetic variations. In order to point out a role for Vitamin D, large clinical trials with Vitamin D deficient subjects and sufficient Vitamin D supplementation are needed.

  18. Singing teaching as a therapy for chronic respiratory disease - a randomised controlled trial and qualitative evaluation

    Directory of Open Access Journals (Sweden)

    Kelly Julia L

    2010-08-01

    Full Text Available Abstract Background Despite optimal pharmacological therapy and pulmonary rehabilitation, patients with COPD continue to be breathless. There is a need to develop additional strategies to alleviate symptoms. Learning to sing requires control of breathing and posture and might have benefits that translate into daily life. Methods To test this hypothesis we performed a randomised controlled trial, comparing a six week course of twice weekly singing classes to usual care, in 28 COPD patients. The experience of singing was assessed in a qualitative fashion, through interviews with a psychologist. In addition, we surveyed patients with chronic respiratory conditions who participated in a series of open singing workshops. Results In the RCT, the physical component score of the SF36 improved in the singers (n = 15 compared to the controls (n = 13; +7.5(14.6 vs. -3.8(8.4 p = 0.02. Singers also had a significant fall in HAD anxiety score; -1.1(2.7 vs. +0.8(1.7 p = 0.03. Singing did not improve single breath counting, breath hold time or shuttle walk distance. In the qualitative element, 8 patients from the singing group were interviewed. Positive effects on physical sensation, general well-being, community/social support and achievement/efficacy emerged as common themes. 150 participants in open workshops completed a questionnaire. 96% rated the workshops as "very enjoyable" and 98% thought the workshop had taught them something about breathing in a different way. 81% of attendees felt a "marked physical difference" after the workshop. Conclusion Singing classes can improve quality of life measures and anxiety and are viewed as a very positive experience by patients with respiratory disease; no adverse consequences of participation were observed. Trial Registration Current Controlled Trials - ISRCTN17544114.

  19. The applicable value of respiratory impedance for the stage 0 of chronic obstructive pulmonary disease

    Institute of Scientific and Technical Information of China (English)

    LIU Yuan; XIE Wei; WEI Ping; YU Bao-ping; FANG Ping

    2005-01-01

    Objective:To evaluate the applicable value of respiratory impedance for the stage 0 of chronic obstructive pulmonary disease (COPD). Methods:Respiratory impedance was measured by impulse oscillometry (IOS) in 41 cases at stage 0 of COPD (NHLBI/WHO, 2001 Standard) and their conventional pulmonary function values were compared with 42 healthy subjects. Both groups had no significant deviation in age, stature and avoirdupois, etc. Master-Screen pulmonary function test system (Jaeger Co, Germany) were used to determine IOS parameters including viscous resistance of 5Hz, 20 Hz and 35Hz (R5, R20, R35), reactance of 5Hz, 35 Hz (X5, X35 ), resonant frequency (Fres) ,total respiratory impedance (Zrs) and routine pulmonary function values including forced expiratory volume in one second to predicted value (FEV1%), forced expiratory volume in one second to forced vital capacity ratio( FEV1/FVC%), maximal mid-expiratory flow (MMEF%),V25% and V50%. Results:Both groups had no significant deviation in FEV1%, FEV1/FVC% and X35 (P>0.05). It was increased significantly in viscous resistance of 5Hz, 20 Hz and 35Hz (R5, R20, R35) in COPD group than that in healthy group (P<0.01). So were Fres and Zrs (P<0.01). MMEF%,V25%,V50% and reactance of 5Hz (X5) in COPD group were marked lower than that in healthy group (P<0.01). The sensitivity of MMEF%, V25%,V50% was higher than others, but its specificity was lower. In parameters of IOS, Fres was the most sensitive index for diagnosis of the small airway function and its specificity was higher than that of MMEF%, V25%,V50%. Conclusion:In the risk case at the stage 0 of COPD, MMEF%, V25% and V50% could be decreased, but Fres, R5,R5-20 could be increased in spite of FEV1% and FEV1/FVC% in normal range.

  20. Overlap Syndrome in Respiratory Medicine: Asthma and Chronic Obstructive Pulmonary Disease

    OpenAIRE

    Alexandru Corlateanu; Valeria Pripa; Gloria Montanari; Victor Botnaru

    2014-01-01

    Asthma and chronic obstructive pulmonary disease (COPD) are highly prevalent chronic diseases in the general population. Both are characterized by similar mechanisms: airway inflammation, airway obstruction, and airway hyperresponsiveness. However, the distinction between the two obstructive diseases is not always clear. Multiple epidemiological studies demonstrate that in elderly people with obstructive airway disease, as many as half or more may have overlapping diagnoses of asthma and COPD...

  1. Obesity and respiratory diseases

    Directory of Open Access Journals (Sweden)

    Christopher Zammit

    2010-10-01

    Full Text Available Christopher Zammit, Helen Liddicoat, Ian Moonsie, Himender MakkerSleep and Ventilation Unit, Department of Respiratory Medicine, North Middlesex University Hospital, London, UKAbstract: The obesity epidemic is a global problem, which is set to increase over time. However, the effects of obesity on the respiratory system are often underappreciated. In this review, we will discuss the mechanical effects of obesity on lung physiology and the function of adipose tissue as an endocrine organ producing systemic inflammation and effecting central respiratory control. Obesity plays a key role in the development of obstructive sleep apnea and obesity hypoventilation syndrome. Asthma is more common and often harder to treat in the obese population, and in this study, we review the effects of obesity on airway inflammation and respiratory mechanics. We also discuss the compounding effects of obesity on chronic obstructive pulmonary disease (COPD and the paradoxical interaction of body mass index and COPD severity. Many practical challenges exist in caring for obese patients, and we highlight the complications faced by patients undergoing surgical procedures, especially given the increased use of bariatric surgery. Ultimately, a greater understanding of the effects of obesity on the respiratory disease and the provision of adequate health care resources is vital in order to care for this increasingly important patient population.Keywords: obesity, lung function, obstructive sleep apnea, obesity hypoventilation syndrome, anesthesia

  2. Access to essential medicines to treat chronic respiratory disease in low-income countries.

    Science.gov (United States)

    Bissell, K; Perrin, C; Beran, D

    2016-06-01

    Chronic respiratory diseases (CRDs) affect hundreds of millions of people. The United Nations 2011 meeting on non-communicable diseases (NCDs) marked a turning point in addressing this burden. The targets established following this meeting incorporated specific measures to address the availability and affordability of essential medicines. These are aligned with the sustainable development goals (SDGs) and the push for universal health coverage. However, essential medicines for CRDs remain unaffordable and unavailable to many. For asthma, the availability of medicines was respectively 30.1% and 43.1% in the public and private sectors. The maximum annual costs of treatment were US$102.10 for beclometasone, US$82.99 for salbutamol and US$1501.79 for budesonide, representing respectively 40%, 15% and 209% of per capita income in Malawi, Burkina Faso and Guinea. Multiple factors contribute to poor availability and affordability. Experience from human immunodeficiency virus/acquired immune-deficiency syndrome shows that medicines and care can be delivered in low-income countries and among the NCDs. A unique example of an effective mechanism for providing access to affordable essential CRD medicines is the Asthma Drug Facility. Working on the six health system building blocks proposed by the World Health Organization can help countries address not only problems regarding access to medicines, but also those hampering adequate care. Improving medicine supply systems, training, national guidelines, financing, research, data utilisation and models of care at the primary health care level will help. A CRD target (e.g., 50% reduction in asthma hospitalisations) as well as the use of asthma as a measure for health system effectiveness and CRDs as a tracer for SDGs would help focus global, national and local leadership. PMID:27155173

  3. Milk protein and Oil-red-O staining of alveolar macrophages in chronic respiratory disease of infancy.

    OpenAIRE

    De Baets, Frans; Aarts, Claudia; HAERYNCK, FILOMEEN; Van daele, Sabine; De Wachter, Elke; De Schutter, Iris; Malfroot, Anne; Schelstraete, Petra

    2010-01-01

    Abstract Aspiration is a suspected cause of chronic respiratory disease in infants. We assessed the probability of aspiration by immunocytochemical staining of alveolar macrophages for milk proteins (?-lactalbumin and ?-lactoglobulin) and compared these findings with the Oil-Red-0 staining score. Broncho-alveolar lavage (BAL), 24-hour esophageal pH-measurement and/or gastro-esophageal scintigraphy were performed in 111 children. Seventy nine patients were enrolled. Ten exclu...

  4. Chronic respiratory disease in adults treated for tuberculosis in Khartoum, Sudan

    Science.gov (United States)

    Mortimer, K.; Bjune, G.; El Sony, A. I.

    2016-01-01

    Background: Chronic respiratory disease (CRD) causes substantial morbidity and mortality. Although the global CRD epidemic collides with the tuberculosis (TB) epidemic in many low- and middle-income country settings, the risk of TB-associated CRD is not well described in countries with a high burden of TB. Methods: We recruited 136 patients with a history of sputum smear-positive pulmonary TB (PTB) from the TB clinic at Omdurman Teaching Hospital in Khartoum, Sudan, and 136 age- and sex-matched community controls, between 28 July 2013 and 30 December 2013. Data were collected using standardised questionnaires and spirometry was performed before and after bronchodilator. Results: The mean age of the subjects with previous PTB and controls was respectively 44.0 years (SD 8.5) and 44.5 years (SD 8.6), with 27.2% females in both groups. Chronic respiratory symptoms such as chronic cough (OR 6.67, 95%CI 2.98–14.90, P enfermedad pulmonar crónica (EPC) es una causa importante de morbilidad y mortalidad. Aunque la epidemia mundial de EPC rivaliza con la epidemia de tuberculosis (TB) en muchos entornos de países con bajos y medianos recursos, el riesgo de aparición de EPC asociado con la TB se ha descrito cabalmente en los países con una alta carga de morbilidad por TB. Métodos: Entre el 28 de julio y el 30 de diciembre del 2013, participaron en el estudio 136 pacientes con antecedente de tuberculosis pulmonar (TBP) y baciloscopia positiva del esputo que habían recibido tratamiento en el consultorio de neumología del Hospital Universitario Omdurman de Jartún, en Sudán, y 136 testigos sanos de la comunidad, emparejados en función de la edad y el sexo. Se recogieron datos mediante cuestionarios normalizados y se practicó una espirometría antes y despuès una prueba de broncodilatación. Resultados: El promedio de la edad en el grupo de los casos fue 44,0 (desviación estándar 8,5 años) y en el grupo de testigos fue 44,5 años (8,6 años); la proporción de

  5. Pulmonary infection control window as a switching point for consequential ventilation: an encouraging finding in treatment of acute respiratory failure of chronic obstructive pulmonary disease

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xi-long

    2005-01-01

    @@ I read with great interest the article by Collaborating Research Group for Noninvasive Mechanical Ventilation of Chinese Respiratory Society.1 Based on the concept mentioned in this paper, I have found that it is really an encouraging new finding in the field of clinical application of mechanical ventilation and treatment of acute respiratory failure (ARF) of chronic obstructive pulmonary disease (COPD).

  6. Cardiovascular and respiratory dysfunction in chronic obstructive pulmonary disease complicated by impaired peripheral oxygenation

    Directory of Open Access Journals (Sweden)

    Chuang ML

    2015-02-01

    Full Text Available Ming-Lung Chuang,1,2 Shih-Feng Huang,1 Chun-Hung Su2,3 1Division of Pulmonary Medicine and Department of Critical Care Medicine, 2School of Medicine, 3Division of Cardiology and Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan, Republic of China Background: Impaired peripheral oxygenation (IPO-related variables readily achieved with cardiopulmonary exercise testing (CPET represent cardiovascular dysfunction. These variables include peak oxygen uptake (VO2 <85% predicted, anaerobic threshold <40%  VO2max predicted, VO2-work rate slope <8.6 mL/watt, oxygen pulse <80% predicted, and ventilatory equivalents for O2 and CO2 at nadir of >31 and >34, respectively. Some of these six variables may be normal while the others are abnormal in patients with chronic obstructive pulmonary disease (COPD. This may result in confusion when using the interpretation algorithm for diagnostic purposes. We therefore hypothesized that patients found to have abnormal values for all six variables would have worse cardiovascular function than patients with abnormal values for none or some of these variables.Methods: In this cross-sectional comparative study, 58 COPD patients attending a university teaching hospital underwent symptom-limited CPET with multiple lactate measurements. Patients with abnormal values in all six IPO-related variables were assigned to an IPO group while those who did not meet the requirements for the IPO group were assigned to a non-IPO group. Cardiovascular function was measured by two-dimensional echocardiography and Δlactate/ΔVO2, and respiratory dynamics were compared between the two groups.Results: Fourteen IPO and 43 non-IPO patients were entered into the study. Both groups were similar with regard to left ventricular ejection fraction and right ventricular morphology (P>0.05 for both. At peak exercise, both groups reached a similar heart rate level and Δlactate/ΔVO2. The IPO patients had an

  7. An effect of the outpatient rehabilitation programme in patients with chronic respiratory diseases

    Directory of Open Access Journals (Sweden)

    Jakub Zatloukal

    2013-12-01

    Full Text Available BACKGROUND: Pulmonary rehabilitation is a common type of complex treatment especially in patients with chronic obstructive pulmonary disease (COPD. By contrast, only few rehabilitation centres in the Czech Republic provide pulmonary rehabilitation programme to non-COPD patients. OBJECTIVE: To find out if the rehabilitation programme has a similar effect in patient with obstructive and restrictive ventilatory disorder. METHODS: Twenty-eight patients with either COPD or pulmonary sarcoidosis (PS have been enrolled for the 6-week rehabilitation programme. Lung functions, maximal inspiratory (MIP and expiratory (MEP mouth pressures, chest expansion at the level of the 4th intercostal space (IC and at the level of the xiphoid process (XP, six-minute walk test, health-related quality of life using the St. George’s Questionnaire (SGRQ and fatigue occurrence using the Multidimensional Assessment of Fatigue scale (MAF were tested at the baseline and after 6 weeks. The rehabilitation programme consisted of exercise training, ventilatory muscle training, respiratory physiotherapy and soft-tissue techniques. RESULTS: Patients with COPD improved significantly (p < .05 in MIP by 17% (10.5 cm H2O, MEP by 18% (16.8 cm H2O, IC by 65% (1.7 cm, XP by 90% (1.9 cm, six-minute walk distance (6MWD by 15% (64.1 m and SGRQ by –28% (–12.3 points. Patients with PS improved significantly (p < .05 in MIP by 25% (20.1 cm H2O, IC by 29% (1.3 cm, XP by 29% (1.3 cm and 6MWD by 6% (31.6 m. The change in lung functions and MAF in both groups; MEP and SGRQ in PS group were insignificant after the 6-week rehabilitation programme. CONCLUSIONS: The 6-week rehabilitation programme produces similar responses in functional health status of patients with either obstructive or restrictive ventilatory disorder. However, patients with restrictive ventilatory disorder in particular should be encouraged to continue in the programme to enhance the health

  8. Chronic respiratory disease in adults treated for tuberculosis in Khartoum, Sudan

    Science.gov (United States)

    Mortimer, K.; Bjune, G.; El Sony, A. I.

    2016-01-01

    Background: Chronic respiratory disease (CRD) causes substantial morbidity and mortality. Although the global CRD epidemic collides with the tuberculosis (TB) epidemic in many low- and middle-income country settings, the risk of TB-associated CRD is not well described in countries with a high burden of TB. Methods: We recruited 136 patients with a history of sputum smear-positive pulmonary TB (PTB) from the TB clinic at Omdurman Teaching Hospital in Khartoum, Sudan, and 136 age- and sex-matched community controls, between 28 July 2013 and 30 December 2013. Data were collected using standardised questionnaires and spirometry was performed before and after bronchodilator. Results: The mean age of the subjects with previous PTB and controls was respectively 44.0 years (SD 8.5) and 44.5 years (SD 8.6), with 27.2% females in both groups. Chronic respiratory symptoms such as chronic cough (OR 6.67, 95%CI 2.98–14.90, P tuberculose (TB) dans de nombreux pays à revenu faible ou moyen, le risque de MRC associée à la TB n'est pas bien décrit dans les pays durement frappés par la TB. Méthodes : Nous avons recruté 136 patients ayant des antécédents de tuberculose pulmonaire (TBP) à frottis positif dans le service de pneumologie du Centre Hospitalier Universitaire Omdurman à Khartoum, Soudan, et 136 témoins de la communauté, appariés sur l'âge et le sexe, entre le 28 juillet 2013 et le 30 décembre 2013. Les données ont été recueillies grâce à des questionnaires standardisés ainsi qu'à une spirométrie avant et après bronchodilatateur. Résultats : L'âge moyen des cas et des témoins a été de 44,0 ans (DS 8,5) et 44,5 ans (DS 8,61), respectivement, avec 27,2% de femmes dans les deux groupes. Des symptômes respiratoires chroniques comme une toux chronique (OR 6,67 ; IC95% 2,98–14,90 ; P < 0,001) et la présence d'une obstruction chronique des voies aériennes (OR 12,39 ; IC%95 1,56–98,40 ; P = 0,02) ont été tous deux fortement associés à des

  9. Macrophage Heterogeneity in Respiratory Diseases

    OpenAIRE

    Boorsma, Carian E.; Christina Draijer; Barbro N. Melgert

    2013-01-01

    Macrophages are among the most abundant cells in the respiratory tract, and they can have strikingly different phenotypes within this environment. Our knowledge of the different phenotypes and their functions in the lung is sketchy at best, but they appear to be linked to the protection of gas exchange against microbial threats and excessive tissue responses. Phenotypical changes of macrophages within the lung are found in many respiratory diseases including asthma, chronic obstructive pulmon...

  10. An effect of the outpatient rehabilitation programme in patients with chronic respiratory diseases

    OpenAIRE

    2013-01-01

    BACKGROUND: Pulmonary rehabilitation is a common type of complex treatment especially in patients with chronic obstructive pulmonary disease (COPD). By contrast, only few rehabilitation centres in the Czech Republic provide pulmonary rehabilitation programme to non-COPD patients. OBJECTIVE: To find out if the rehabilitation programme has a similar effect in patient with obstructive and restrictive ventilatory disorder. METHODS: Twenty-eight patients with either COPD or pulmonary sarcoidosis (...

  11. Combined use of non-invasive techniques to predict pulmonary arterial pressure in chronic respiratory disease.

    OpenAIRE

    Bishop, J M; Csukas, M

    1989-01-01

    The value of non-invasive procedures for predicting pulmonary arterial pressure was investigated in 370 patients with chronic obstructive lung diseases and in 73 with fibrosing alveolitis in a combined study at nine centres in six European countries. Measurements included forced expiratory volume in one second, arterial blood gas tensions, standard electrocardiogram, radiographic dimensions of pulmonary artery, right ventricle dimensions by M mode echocardiography, and myocardial scintigraphy...

  12. Determinants of Noninvasive Ventilation Outcomes during an Episode of Acute Hypercapnic Respiratory Failure in Chronic Obstructive Pulmonary Disease: The Effects of Comorbidities and Causes of Respiratory Failure

    OpenAIRE

    2014-01-01

    Objectives. To investigate the effect of the cause of acute respiratory failure and the role of comorbidities both acute and chronic on the outcome of COPD patients admitted to Respiratory Intensive Care Unit (RICU) with acute respiratory failure and treated with NIV. Design. Observational prospective study. Patients and Methods. 176 COPD patients consecutively admitted to our RICU over a period of 3 years and treated with NIV were evaluated. In all patients demographic, clinical, and functio...

  13. Overlap Syndrome in Respiratory Medicine: Asthma and Chronic Obstructive Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Alexandru Corlateanu

    2014-02-01

    Full Text Available Asthma and chronic obstructive pulmonary disease (COPD are highly prevalent chronic diseases in the general population. Both are characterized by similar mechanisms: airway inflammation, airway obstruction, and airway hyperresponsiveness. However, the distinction between the two obstructive diseases is not always clear. Multiple epidemiological studies demonstrate that in elderly people with obstructive airway disease, as many as half or more may have overlapping diagnoses of asthma and COPD. A COPD-Asthma overlap syndrome is defined as an airflow obstruction that is not completely reversible, accompanied by symptoms and signs of increased obstruction reversibility. For the clinical identification of overlap syndrome COPD-Asthma Spanish guidelines proposed six diagnostic criteria. The major criteria include very positive bronchodilator test [increase in forced expiratory volume in one second (FEV1 ≥15% and ≥400 ml], eosinophilia in sputum, and personal history of asthma. The minor criteria include high total IgE, personal history of atopy and positive bronchodilator test (increase in FEV1 ≥12% and ≥200 ml on two or more occasions. The overlap syndrome COPD-Asthma is associated with enhanced response to inhaled corticosteroids due to the predominance of eosinophilic bronchial inflammation.The future clinical studies and multicenter clinical trials should lead to the investigation of disease mechanisms and simultaneous development of the novel treatment.

  14. Respiratory Consequences of Mild-to-Moderate Obesity: Impact on Exercise Performance in Health and in Chronic Obstructive Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Denis E. O'Donnell

    2012-01-01

    Full Text Available In many parts of the world, the prevalence of obesity is increasing at an alarming rate. The association between obesity, multiple comorbidities, and increased mortality is now firmly established in many epidemiological studies. However, the link between obesity and exercise intolerance is less well studied and is the focus of this paper. Although exercise limitation is likely to be multifactorial in obesity, it is widely believed that the respiratory mechanical constraints and the attendant dyspnea are important contributors. In this paper, we examined the evidence that critical ventilatory constraint is a proximate source of exercise limitation in individuals with mild-to-moderate obesity. We first reviewed existing information on exercise performance, including ventilatory and perceptual response patterns, in obese individuals who are otherwise healthy. We then considered the impact of obesity in patients with preexisting respiratory mechanical abnormalities due to chronic obstructive pulmonary disease (COPD, with particular reference to the effect on dyspnea and exercise performance. Our main conclusion, based on the existing and rather sparse literature on the subject, is that abnormalities of dynamic respiratory mechanics are not likely to be the dominant source of dyspnea and exercise intolerance in otherwise healthy individuals or in patients with COPD with mild-to-moderate obesity.

  15. Macrophage Heterogeneity in Respiratory Diseases

    Directory of Open Access Journals (Sweden)

    Carian E. Boorsma

    2013-01-01

    Full Text Available Macrophages are among the most abundant cells in the respiratory tract, and they can have strikingly different phenotypes within this environment. Our knowledge of the different phenotypes and their functions in the lung is sketchy at best, but they appear to be linked to the protection of gas exchange against microbial threats and excessive tissue responses. Phenotypical changes of macrophages within the lung are found in many respiratory diseases including asthma, chronic obstructive pulmonary disease (COPD, and pulmonary fibrosis. This paper will give an overview of what macrophage phenotypes have been described, what their known functions are, what is known about their presence in the different obstructive and restrictive respiratory diseases (asthma, COPD, pulmonary fibrosis, and how they are thought to contribute to the etiology and resolution of these diseases.

  16. Scaling up strategies of the chronic respiratory disease programme of the European Innovation Partnership on Active and Healthy Ageing (Action Plan B3: Area 5).

    Science.gov (United States)

    Bousquet, J; Farrell, J; Crooks, G; Hellings, P; Bel, E H; Bewick, M; Chavannes, N H; de Sousa, J Correia; Cruz, A A; Haahtela, T; Joos, G; Khaltaev, N; Malva, J; Muraro, A; Nogues, M; Palkonen, S; Pedersen, S; Robalo-Cordeiro, C; Samolinski, B; Strandberg, T; Valiulis, A; Yorgancioglu, A; Zuberbier, T; Bedbrook, A; Aberer, W; Adachi, M; Agusti, A; Akdis, C A; Akdis, M; Ankri, J; Alonso, A; Annesi-Maesano, I; Ansotegui, I J; Anto, J M; Arnavielhe, S; Arshad, H; Bai, C; Baiardini, I; Bachert, C; Baigenzhin, A K; Barbara, C; Bateman, E D; Beghé, B; Kheder, A Ben; Bennoor, K S; Benson, M; Bergmann, K C; Bieber, T; Bindslev-Jensen, C; Bjermer, L; Blain, H; Blasi, F; Boner, A L; Bonini, M; Bonini, S; Bosnic-Anticevitch, S; Boulet, L P; Bourret, R; Bousquet, P J; Braido, F; Briggs, A H; Brightling, C E; Brozek, J; Buhl, R; Burney, P G; Bush, A; Caballero-Fonseca, F; Caimmi, D; Calderon, M A; Calverley, P M; Camargos, P A M; Canonica, G W; Camuzat, T; Carlsen, K H; Carr, W; Carriazo, A; Casale, T; Cepeda Sarabia, A M; Chatzi, L; Chen, Y Z; Chiron, R; Chkhartishvili, E; Chuchalin, A G; Chung, K F; Ciprandi, G; Cirule, I; Cox, L; Costa, D J; Custovic, A; Dahl, R; Dahlen, S E; Darsow, U; De Carlo, G; De Blay, F; Dedeu, T; Deleanu, D; De Manuel Keenoy, E; Demoly, P; Denburg, J A; Devillier, P; Didier, A; Dinh-Xuan, A T; Djukanovic, R; Dokic, D; Douagui, H; Dray, G; Dubakiene, R; Durham, S R; Dykewicz, M S; El-Gamal, Y; Emuzyte, R; Fabbri, L M; Fletcher, M; Fiocchi, A; Fink Wagner, A; Fonseca, J; Fokkens, W J; Forastiere, F; Frith, P; Gaga, M; Gamkrelidze, A; Garces, J; Garcia-Aymerich, J; Gemicioğlu, B; Gereda, J E; González Diaz, S; Gotua, M; Grisle, I; Grouse, L; Gutter, Z; Guzmán, M A; Heaney, L G; Hellquist-Dahl, B; Henderson, D; Hendry, A; Heinrich, J; Heve, D; Horak, F; Hourihane, J O' B; Howarth, P; Humbert, M; Hyland, M E; Illario, M; Ivancevich, J C; Jardim, J R; Jares, E J; Jeandel, C; Jenkins, C; Johnston, S L; Jonquet, O; Julge, K; Jung, K S; Just, J; Kaidashev, I; Kaitov, M R; Kalayci, O; Kalyoncu, A F; Keil, T; Keith, P K; Klimek, L; Koffi N'Goran, B; Kolek, V; Koppelman, G H; Kowalski, M L; Kull, I; Kuna, P; Kvedariene, V; Lambrecht, B; Lau, S; Larenas-Linnemann, D; Laune, D; Le, L T T; Lieberman, P; Lipworth, B; Li, J; Lodrup Carlsen, K; Louis, R; MacNee, W; Magard, Y; Magnan, A; Mahboub, B; Mair, A; Majer, I; Makela, M J; Manning, P; Mara, S; Marshall, G D; Masjedi, M R; Matignon, P; Maurer, M; Mavale-Manuel, S; Melén, E; Melo-Gomes, E; Meltzer, E O; Menzies-Gow, A; Merk, H; Michel, J P; Miculinic, N; Mihaltan, F; Milenkovic, B; Mohammad, G M Y; Molimard, M; Momas, I; Montilla-Santana, A; Morais-Almeida, M; Morgan, M; Mösges, R; Mullol, J; Nafti, S; Namazova-Baranova, L; Naclerio, R; Neou, A; Neffen, H; Nekam, K; Niggemann, B; Ninot, G; Nyembue, T D; O'Hehir, R E; Ohta, K; Okamoto, Y; Okubo, K; Ouedraogo, S; Paggiaro, P; Pali-Schöll, I; Panzner, P; Papadopoulos, N; Papi, A; Park, H S; Passalacqua, G; Pavord, I; Pawankar, R; Pengelly, R; Pfaar, O; Picard, R; Pigearias, B; Pin, I; Plavec, D; Poethig, D; Pohl, W; Popov, T A; Portejoie, F; Potter, P; Postma, D; Price, D; Rabe, K F; Raciborski, F; Radier Pontal, F; Repka-Ramirez, S; Reitamo, S; Rennard, S; Rodenas, F; Roberts, J; Roca, J; Rodriguez Mañas, L; Rolland, C; Roman Rodriguez, M; Romano, A; Rosado-Pinto, J; Rosario, N; Rosenwasser, L; Rottem, M; Ryan, D; Sanchez-Borges, M; Scadding, G K; Schunemann, H J; Serrano, E; Schmid-Grendelmeier, P; Schulz, H; Sheikh, A; Shields, M; Siafakas, N; Sibille, Y; Similowski, T; Simons, F E R; Sisul, J C; Skrindo, I; Smit, H A; Solé, D; Sooronbaev, T; Spranger, O; Stelmach, R; Sterk, P J; Sunyer, J; Thijs, C; To, T; Todo-Bom, A; Triggiani, M; Valenta, R; Valero, A L; Valia, E; Valovirta, E; Van Ganse, E; van Hage, M; Vandenplas, O; Vasankari, T; Vellas, B; Vestbo, J; Vezzani, G; Vichyanond, P; Viegi, G; Vogelmeier, C; Vontetsianos, T; Wagenmann, M; Wallaert, B; Walker, S; Wang, D Y; Wahn, U; Wickman, M; Williams, D M; Williams, S; Wright, J; Yawn, B P; Yiallouros, P K; Yusuf, O M; Zaidi, A; Zar, H J; Zernotti, M E; Zhang, L; Zhong, N; Zidarn, M; Mercier, J

    2016-01-01

    Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) focuses on the integrated care of chronic diseases. Area 5 (Care Pathways) was initiated using chronic respiratory diseases as a model. The chronic respiratory disease action plan includes (1) AIRWAYS integrated care pathways (ICPs), (2) the joint initiative between the Reference site MACVIA-LR (Contre les MAladies Chroniques pour un VIeillissement Actif) and ARIA (Allergic Rhinitis and its Impact on Asthma), (3) Commitments for Action to the European Innovation Partnership on Active and Healthy Ageing and the AIRWAYS ICPs network. It is deployed in collaboration with the World Health Organization Global Alliance against Chronic Respiratory Diseases (GARD). The European Innovation Partnership on Active and Healthy Ageing has proposed a 5-step framework for developing an individual scaling up strategy: (1) what to scale up: (1-a) databases of good practices, (1-b) assessment of viability of the scaling up of good practices, (1-c) classification of good practices for local replication and (2) how to scale up: (2-a) facilitating partnerships for scaling up, (2-b) implementation of key success factors and lessons learnt, including emerging technologies for individualised and predictive medicine. This strategy has already been applied to the chronic respiratory disease action plan of the European Innovation Partnership on Active and Healthy Ageing.

  17. Scaling up strategies of the chronic respiratory disease programme of the European Innovation Partnership on Active and Healthy Ageing (Action Plan B3: Area 5).

    Science.gov (United States)

    Bousquet, J; Farrell, J; Crooks, G; Hellings, P; Bel, E H; Bewick, M; Chavannes, N H; de Sousa, J Correia; Cruz, A A; Haahtela, T; Joos, G; Khaltaev, N; Malva, J; Muraro, A; Nogues, M; Palkonen, S; Pedersen, S; Robalo-Cordeiro, C; Samolinski, B; Strandberg, T; Valiulis, A; Yorgancioglu, A; Zuberbier, T; Bedbrook, A; Aberer, W; Adachi, M; Agusti, A; Akdis, C A; Akdis, M; Ankri, J; Alonso, A; Annesi-Maesano, I; Ansotegui, I J; Anto, J M; Arnavielhe, S; Arshad, H; Bai, C; Baiardini, I; Bachert, C; Baigenzhin, A K; Barbara, C; Bateman, E D; Beghé, B; Kheder, A Ben; Bennoor, K S; Benson, M; Bergmann, K C; Bieber, T; Bindslev-Jensen, C; Bjermer, L; Blain, H; Blasi, F; Boner, A L; Bonini, M; Bonini, S; Bosnic-Anticevitch, S; Boulet, L P; Bourret, R; Bousquet, P J; Braido, F; Briggs, A H; Brightling, C E; Brozek, J; Buhl, R; Burney, P G; Bush, A; Caballero-Fonseca, F; Caimmi, D; Calderon, M A; Calverley, P M; Camargos, P A M; Canonica, G W; Camuzat, T; Carlsen, K H; Carr, W; Carriazo, A; Casale, T; Cepeda Sarabia, A M; Chatzi, L; Chen, Y Z; Chiron, R; Chkhartishvili, E; Chuchalin, A G; Chung, K F; Ciprandi, G; Cirule, I; Cox, L; Costa, D J; Custovic, A; Dahl, R; Dahlen, S E; Darsow, U; De Carlo, G; De Blay, F; Dedeu, T; Deleanu, D; De Manuel Keenoy, E; Demoly, P; Denburg, J A; Devillier, P; Didier, A; Dinh-Xuan, A T; Djukanovic, R; Dokic, D; Douagui, H; Dray, G; Dubakiene, R; Durham, S R; Dykewicz, M S; El-Gamal, Y; Emuzyte, R; Fabbri, L M; Fletcher, M; Fiocchi, A; Fink Wagner, A; Fonseca, J; Fokkens, W J; Forastiere, F; Frith, P; Gaga, M; Gamkrelidze, A; Garces, J; Garcia-Aymerich, J; Gemicioğlu, B; Gereda, J E; González Diaz, S; Gotua, M; Grisle, I; Grouse, L; Gutter, Z; Guzmán, M A; Heaney, L G; Hellquist-Dahl, B; Henderson, D; Hendry, A; Heinrich, J; Heve, D; Horak, F; Hourihane, J O' B; Howarth, P; Humbert, M; Hyland, M E; Illario, M; Ivancevich, J C; Jardim, J R; Jares, E J; Jeandel, C; Jenkins, C; Johnston, S L; Jonquet, O; Julge, K; Jung, K S; Just, J; Kaidashev, I; Kaitov, M R; Kalayci, O; Kalyoncu, A F; Keil, T; Keith, P K; Klimek, L; Koffi N'Goran, B; Kolek, V; Koppelman, G H; Kowalski, M L; Kull, I; Kuna, P; Kvedariene, V; Lambrecht, B; Lau, S; Larenas-Linnemann, D; Laune, D; Le, L T T; Lieberman, P; Lipworth, B; Li, J; Lodrup Carlsen, K; Louis, R; MacNee, W; Magard, Y; Magnan, A; Mahboub, B; Mair, A; Majer, I; Makela, M J; Manning, P; Mara, S; Marshall, G D; Masjedi, M R; Matignon, P; Maurer, M; Mavale-Manuel, S; Melén, E; Melo-Gomes, E; Meltzer, E O; Menzies-Gow, A; Merk, H; Michel, J P; Miculinic, N; Mihaltan, F; Milenkovic, B; Mohammad, G M Y; Molimard, M; Momas, I; Montilla-Santana, A; Morais-Almeida, M; Morgan, M; Mösges, R; Mullol, J; Nafti, S; Namazova-Baranova, L; Naclerio, R; Neou, A; Neffen, H; Nekam, K; Niggemann, B; Ninot, G; Nyembue, T D; O'Hehir, R E; Ohta, K; Okamoto, Y; Okubo, K; Ouedraogo, S; Paggiaro, P; Pali-Schöll, I; Panzner, P; Papadopoulos, N; Papi, A; Park, H S; Passalacqua, G; Pavord, I; Pawankar, R; Pengelly, R; Pfaar, O; Picard, R; Pigearias, B; Pin, I; Plavec, D; Poethig, D; Pohl, W; Popov, T A; Portejoie, F; Potter, P; Postma, D; Price, D; Rabe, K F; Raciborski, F; Radier Pontal, F; Repka-Ramirez, S; Reitamo, S; Rennard, S; Rodenas, F; Roberts, J; Roca, J; Rodriguez Mañas, L; Rolland, C; Roman Rodriguez, M; Romano, A; Rosado-Pinto, J; Rosario, N; Rosenwasser, L; Rottem, M; Ryan, D; Sanchez-Borges, M; Scadding, G K; Schunemann, H J; Serrano, E; Schmid-Grendelmeier, P; Schulz, H; Sheikh, A; Shields, M; Siafakas, N; Sibille, Y; Similowski, T; Simons, F E R; Sisul, J C; Skrindo, I; Smit, H A; Solé, D; Sooronbaev, T; Spranger, O; Stelmach, R; Sterk, P J; Sunyer, J; Thijs, C; To, T; Todo-Bom, A; Triggiani, M; Valenta, R; Valero, A L; Valia, E; Valovirta, E; Van Ganse, E; van Hage, M; Vandenplas, O; Vasankari, T; Vellas, B; Vestbo, J; Vezzani, G; Vichyanond, P; Viegi, G; Vogelmeier, C; Vontetsianos, T; Wagenmann, M; Wallaert, B; Walker, S; Wang, D Y; Wahn, U; Wickman, M; Williams, D M; Williams, S; Wright, J; Yawn, B P; Yiallouros, P K; Yusuf, O M; Zaidi, A; Zar, H J; Zernotti, M E; Zhang, L; Zhong, N; Zidarn, M; Mercier, J

    2016-01-01

    Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) focuses on the integrated care of chronic diseases. Area 5 (Care Pathways) was initiated using chronic respiratory diseases as a model. The chronic respiratory disease action plan includes (1) AIRWAYS integrated care pathways (ICPs), (2) the joint initiative between the Reference site MACVIA-LR (Contre les MAladies Chroniques pour un VIeillissement Actif) and ARIA (Allergic Rhinitis and its Impact on Asthma), (3) Commitments for Action to the European Innovation Partnership on Active and Healthy Ageing and the AIRWAYS ICPs network. It is deployed in collaboration with the World Health Organization Global Alliance against Chronic Respiratory Diseases (GARD). The European Innovation Partnership on Active and Healthy Ageing has proposed a 5-step framework for developing an individual scaling up strategy: (1) what to scale up: (1-a) databases of good practices, (1-b) assessment of viability of the scaling up of good practices, (1-c) classification of good practices for local replication and (2) how to scale up: (2-a) facilitating partnerships for scaling up, (2-b) implementation of key success factors and lessons learnt, including emerging technologies for individualised and predictive medicine. This strategy has already been applied to the chronic respiratory disease action plan of the European Innovation Partnership on Active and Healthy Ageing. PMID:27478588

  18. Chronic obstructive pulmonary disease

    OpenAIRE

    NR Anthonisen

    2007-01-01

    The global prevalence of physiologically defined chronic obstructive pulmonary disease (COPD) in adults aged >40 yr is approximately 9-10 per cent. Recently, the Indian Study on Epidemiology of Asthma, Respiratory Symptoms and Chronic Bronchitis in Adults had shown that the overall prevalence of chronic bronchitis in adults >35 yr is 3.49 per cent. The development of COPD is multifactorial and the risk factors of COPD include genetic and environmental factors. Pathological changes in COPD are...

  19. [The comparative analysis: the occurrence of acute respiratory system infections and chronic diseases among active smokers and non-smokers].

    Science.gov (United States)

    Kałucka, Sylwia

    2006-01-01

    Cigarette smoking is one of the factors causing a lot of health problems. Breathing the smoke makes the development of arteriosclerosis and ischemic heart disease faster and the risk of myocardial infarction much higher. Toxic substances contained in the smoke induce inflammatory processes in bronchial tree, which finally leads to the destruction of lungs. One of the way of preventing complications in the circulatory system and stopping the inflammatory process in lungs is to give up the habit of smoking. Within the period of three years the group of more than 1000 people (smokers and non-smokers) was examined and the analysis of occurrence of acute respiratory system infections and chronic diseases was conducted. In the studies the questionnaire prepared by the author of the paper, some specialistic studies and medical reports were used. The achieved results show that more and more women smoke as many cigarettes as men and for as many years as they do. Both men and women who graduated either a grammar school or a university smoke more often than with elementary level of education. People who smoke suffer more often from numerous acute respiratory tract infections and must more often pay a visit to general practitioner. Considering the sex there are no statistically significant differences in the occurrence of chronic pulmonary diseases and the cardiovascular system. The achieved results show the changes of the attitude to smoking in Polish society. The increase of the consumption of cigarettes among women with high education is very worrying. It is a serious challenge for the whole medical staff. PMID:17288171

  20. Nutritional Risk Screening 2002 as a Predictor of Outcome During General Ward-Based Noninvasive Ventilation in Chronic Obstructive Pulmonary Disease with Respiratory Failure

    OpenAIRE

    Cui, Jinbo; Wan, Qunfang; Wu, Xiaoling; Zeng, Yihua; Jiang, Li; Ao, Dongmei; Wang, Feng; Chen, Ting; Li, Yanli

    2015-01-01

    Background Noninvasive ventilation (NIV) may reduce the need for intubation and mortality associated with chronic obstructive pulmonary disease (COPD) with type II respiratory failure. Early and simple predictors of NIV outcome could improve clinical management. This study aimed to assess whether nutritional risk screening 2002 (NRS2002) is a useful outcome predictor in COPD patients with type II respiratory failure treated by noninvasive positive pressure ventilation (NIPPV). Material/Method...

  1. Evaluation of respiratory impedance in patients with chronic obstructive pulmonary disease by an impulse oscillation system.

    Science.gov (United States)

    Gong, Su-Gang; Yang, Wen-Lan; Zheng, Wei; Liu, Jin-Ming

    2014-11-01

    An impulse oscillometry system (IOS) assesses pulmonary resistance and reactance. The present study investigated which IOS measurement is correlated with airflow obstruction, airway conductance and lung volume in chronic obstructive pulmonary disease (COPD). A total of 180 patients with COPD were selected and 95 agreed to follow‑up 1 year after the initial tests. IOS measurements [R5, R20, X5 and resonant frequency (Fres)], body plethysmography [forced end‑expiratory flow (FEF)75, total lung capacity, residual volume (RV) and total inspiratory resistance (Rtot)] and spirometry [forced expiratory volume in 1 sec (FEV1)] were performed. Pearson's or Spearman's correlation tests were used to determine the correlation between the IOS and other measurements. R5, X5 and Fres were all significantly associated (Pcompliance caused by airflow obstruction. PMID:25189185

  2. Respiratory motor training and neuromuscular plasticity in patients with chronic obstructive pulmonary disease: A pilot study.

    Science.gov (United States)

    Ovechkin, Alexander V; Sayenko, Dimitry G; Ovechkina, Elena N; Aslan, Sevda C; Pitts, Teresa; Folz, Rodney J

    2016-07-15

    The objective of this study was to examine the feasibility of a full-scale investigation of the neurophysiological mechanisms of COPD-induced respiratory neuromuscular control deficits. Characterization of respiratory single- and multi-muscle activation patterns using surface electromyography (sEMG) were assessed along with functional measures at baseline and following 21±2 (mean±SD) sessions of respiratory motor training (RMT) performed during a one-month period in four patients with GOLD stage II or III COPD. Pre-training, the individuals with COPD showed significantly increased (prespiratory muscle activity and disorganized multi-muscle activation patterns in association with lowered spirometrical measures and decreased fast- and slow-twitch fiber activity as compared to healthy controls (N=4). Following RMT, functional and respiratory sEMG activation outcomes during quite breathing and forced expiratory efforts were improved suggesting that functional improvements, induced by task-specific RMT, are evidence respiratory neuromuscular networks re-organization.

  3. Relationship between the use of inhaled steroids for chronic respiratory diseases and early outcomes in community-acquired pneumonia.

    Directory of Open Access Journals (Sweden)

    Jordi Almirall

    Full Text Available BACKGROUND: The role of inhaled steroids in patients with chronic respiratory diseases is a matter of debate due to the potential effect on the development and prognosis of community-acquired pneumonia (CAP. We assessed whether treatment with inhaled steroids in patients with chronic bronchitis, COPD or asthma and CAP may affect early outcome of the acute pneumonic episode. METHODS: Over 1-year period, all population-based cases of CAP in patients with chronic bronchitis, COPD or asthma were registered. Use of inhaled steroids were registered and patients were followed up to 30 days after diagnosis to assess severity of CAP and clinical course (hospital admission, ICU admission and mortality. RESULTS: Of 473 patients who fulfilled the selection criteria, inhaled steroids were regularly used by 109 (23%. In the overall sample, inhaled steroids were associated with a higher risk of hospitalization (OR=1.96, p = 0.002 in the bivariate analysis, but this effect disappeared after adjusting by other severity-related factors (adjusted OR=1.08, p=0.787. This effect on hospitalization also disappeared when considering only patients with asthma (OR=1.38, p=0.542, with COPD alone (OR=4.68, p=0.194, but a protective effect was observed in CB patients (OR=0.15, p=0.027. Inhaled steroids showed no association with ICU admission, days to clinical recovery and mortality in the overall sample and in any disease subgroup. CONCLUSIONS: Treatment with inhaled steroids is not a prognostic factor in COPD and asthmatic patients with CAP, but could prevent hospitalization for CAP in patients with clinical criteria of chronic bronchitis.

  4. Stem cells and respiratory diseases

    Energy Technology Data Exchange (ETDEWEB)

    Abreu, Soraia Carvalho; Maron-Gutierrez, Tatiana; Garcia, Cristiane Sousa Nascimento Baez; Morales, Marcelo Marcos; Rocco, Patricia Rieken Macedo [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Inst. de Biofisica Carlos Chagas Filho. Lab. de Investigacao]. E-mail: prmrocco@biof.ufrj.br

    2008-12-15

    Stem cells have a multitude of clinical implications in the lung. This article is a critical review that includes clinical and experimental studies of MedLine and SciElo database in the last 10 years, where we highlight the effects of stem cell therapy in acute respiratory distress syndrome or more chronic disorders such as lung fibrosis and emphysema. Although, many studies have shown the beneficial effects of stem cells in lung development, repair and remodeling; some important questions need to be answered to better understand the mechanisms that control cell division and differentiation, therefore enabling the use of cell therapy in human respiratory diseases. (author)

  5. Respiratory motor training and neuromuscular plasticity in patients with chronic obstructive pulmonary disease: A pilot study.

    Science.gov (United States)

    Ovechkin, Alexander V; Sayenko, Dimitry G; Ovechkina, Elena N; Aslan, Sevda C; Pitts, Teresa; Folz, Rodney J

    2016-07-15

    The objective of this study was to examine the feasibility of a full-scale investigation of the neurophysiological mechanisms of COPD-induced respiratory neuromuscular control deficits. Characterization of respiratory single- and multi-muscle activation patterns using surface electromyography (sEMG) were assessed along with functional measures at baseline and following 21±2 (mean±SD) sessions of respiratory motor training (RMT) performed during a one-month period in four patients with GOLD stage II or III COPD. Pre-training, the individuals with COPD showed significantly increased (p<0.05) overall respiratory muscle activity and disorganized multi-muscle activation patterns in association with lowered spirometrical measures and decreased fast- and slow-twitch fiber activity as compared to healthy controls (N=4). Following RMT, functional and respiratory sEMG activation outcomes during quite breathing and forced expiratory efforts were improved suggesting that functional improvements, induced by task-specific RMT, are evidence respiratory neuromuscular networks re-organization. PMID:27137413

  6. Mortality rates for chronic lower respiratory diseases in Italy from 1979 to 2010: an age–period–cohort analysis

    Directory of Open Access Journals (Sweden)

    Giancarlo Pesce

    2016-03-01

    Full Text Available Chronic lower respiratory diseases (CLRDs are a major cause of morbidity and mortality worldwide. The objectives of this study were to estimate the trends in CLRD mortality in Italy, and the specific contributions of age, time period and birth cohort in driving these trends. Population and cause-of-death data in Italy between 1979 and 2010 were collected from the World Health Organization website. Age-specific mortality rates for CLRDs, and effects for age, time period and birth cohort on mortality trends were estimated using age–period–cohort models. Chronic obstructive pulmonary disease (COPD and chronic bronchitis represent nearly 98% of the deaths from CLRDs. Despite the overall number of deaths have been stable (in men or increasing (in women, the age-standardised rates have been steadily decreasing from 1979 to 2010, passing from 104.3 to 55.4 per 100 000 person-years in men and from 32.2 to 19.6 per 100 000 person-years in women. The average relative annual decrease was −3.6% in men and −2.7% in women. Since the end of the 1990s, the decreasing trend of CLRD mortality has started to level off, in particular in women. The decrease in CLRD mortality rates has been more accentuated in more recent cohorts and in younger age groups. Both birth cohort and time period significantly affected the CLRD mortality rates, suggesting that changes in the spread of risk factors (smoking habits, early-life and occupational exposures across different birth cohorts, as well as in advanced in healthcare and medical practice, may have played a major role in secular changes in COPD mortality rates in Italy.

  7. Respiratory Diseases of Poultry

    Science.gov (United States)

    A new Respiratory Diseases of Poultry CRIS will be established effective October 1, 2006. Initially, the disease agents to be studied will include Ornithobacterium rhinotracheale (ORT), Bordetella avium (BART) and Pasteurella multocida. The research will focus on development of more effective vacc...

  8. The AIMAR recommendations for early diagnosis of chronic obstructive respiratory disease based on the WHO/GARD model*

    OpenAIRE

    Nardini, Stefano; Annesi-Maesano, Isabella; Donno, Mario Del; Delucchi, Maurizio; Bettoncelli, Germano; Lamberti, Vincenzo; Patera, Carlo; Polverino, Mario; Russo, Antonio; Santoriello, Carlo; Soverina, Patrizio

    2014-01-01

    Respiratory diseases in Italy already now represent an emergency (they are the 3rd ranking cause of death in the world, and the 2nd if Lung cancer is included). In countries similar to our own, they result as the principal cause for a visit to the general practitioner (GP) and the second main cause after injury for recourse to Emergency Care. Their frequency is probably higher than estimated (given that respiratory diseases are currently underdiagnosed). The trend is towards a further increas...

  9. The AIMAR recommendations for early diagnosis of chronic obstructive respiratory disease based on the WHO/GARD model

    OpenAIRE

    Nardini, Stefano; Annesi-Maesano, Isabella; Del Donno, Mario; Delucchi, Maurizio; Bettoncelli, Germano; Lamberti, Vincenzo; Patera, Carlo; Polverino, Mario; Russo, Antonio; Santoriello, Carlo; Soverina, Patrizio

    2014-01-01

    International audience Respiratory diseases in Italy already now represent an emergency (they are the 3 rd ranking cause of death in the world, and the 2 nd if Lung cancer is included). In countries similar to our own, they result as the principal cause for a visit to the general practitioner (GP) and the second main cause after injury for recourse to Emergency Care. Their frequency is probably higher than estimated (given that respiratory diseases are currently underdiagnosed). The trend ...

  10. Gender and respiratory factors associated with dyspnea in chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Aguirre-Jaime Armando

    2007-03-01

    Full Text Available Abstract Rationale We had shown that COPD women expressed more dyspnea than men for the same degree of airway obstruction. Objectives Evaluate gender differences in respiratory factors associated with dyspnea in COPD patients. Methods In a FEV1 % matched population of 100 men and women with COPD we measured: age, MMRC, FEV1, FVC, TLC, IC/TLC, PaO2, PaCO2, DLCO, Pimax, P0.1, Ti/Ttot, BMI, ffmi, 6MWD and VAS scale before and after the test, the Charlson score and the SGRQ. We estimated the association between these parameters and MMRC scores. Multivariate analysis determined the independent strength of those associations. Results MMRC correlated with: BMI (men:-0.29, p = 0.04; women:-0.28, p = 0.05, ffmi (men:-0.39, p = 0.01, FEV1 % (men:-0.64, p 2 (men:-0.59, p 2 (men:0.27, p = 0.05, DLCO (men:-0.54, p 0.1/Pimax (men:0.46, p = 0.002; women:0.47, p = 0.005, dyspnea measured with the Visual Analog Scale before (men:0.37, p = 0.04; women:0.52, p = 0.004 and after 6MWD (men:0.52, p = 0.002; women:0.48, p = 0.004 and SGRQ total (men:0.50, p 0.1/Pimax in women (r2 = 0.30 and BMI, DLCO, PaO2 and P0.1/Pimax in men (r2 = 0.81 were the strongest predictors of MMRC scores. Conclusion In mild to severe COPD patients attending a pulmonary clinic, P0.1/Pimax was the unique predictor of MMRC scores only in women. Respiratory factors explain most of the variations of MMRC scores in men but not in women. Factors other than the respiratory ones should be included in the evaluation of dyspnea in women with COPD.

  11. The reliability of an arabic version of the self-administered standardized chronic respiratory disease questionnaire (CRQ-SAS

    Directory of Open Access Journals (Sweden)

    Tamim Hani M

    2011-04-01

    Full Text Available Abstract Background To produce a conceptually equivalent Arabic version to the original Self-Administered Chronic Respiratory Disease Questionnaire with standardized dyspnea domain (CRQ-SAS and to assess its reliability. Methods The study was carried out in two stages: stage I which was the translation of the CRQ-SAS questionnaire from the English to the Arabic language, and stage II which represented the test-retest reliability for patients receiving usual care for COPD who were not yet admitted to the pulmonary rehabilitation program. Results Forty five patients with stable COPD were enrolled in this study. Strong test-retest reliability was found for the four domains of the CRQ-SAS, with the intra-class correlation coefficient of 0.97 for each of the domains. The association between most parameters and the four domains of CRQ-SAS were not found to be statistically significant, as measured by Pearson correlation. The number of exacerbations was negatively correlated with the dyspnea domain (correlation = -0.36, p-value = 0.02. The disease duration was negatively correlated with the domain fatigue (correlation = -0.35, p-value = 0.02. The correlation between FEV1/FVC ratio and emotion domain was -0.30 (p-value = 0.05. The mastery domain was negatively correlated with FEV1/FVC ratio with a correlation of -0.27 with borderline statistical significance (p-value = 0.07. Conclusion The Arabic translation of the CRQ-SAS was found to be reliable to assess the quality of life among patients with COPD.

  12. Respiratory System Disease.

    Science.gov (United States)

    Goetz, Danielle M; Singh, Shipra

    2016-08-01

    Respiratory system involvement in cystic fibrosis is the leading cause of morbidity and mortality. Defects in the cystic fibrosis transmembrane regulator (CFTR) gene throughout the sinopulmonary tract result in recurrent infections with a variety of organisms including Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus, and nontuberculous mycobacteria. Lung disease occurs earlier in life than once thought and ideal methods of monitoring lung function, decline, or improvement with therapy are debated. Treatment of sinopulmonary disease may include physiotherapy, mucus-modifying and antiinflammatory agents, antimicrobials, and surgery. In the new era of personalized medicine, CFTR correctors and potentiators may change the course of disease. PMID:27469180

  13. Is Previous Respiratory Disease a Risk Factor for Lung Cancer?

    NARCIS (Netherlands)

    Denholm, Rachel; Schüz, Joachim; Straif, Kurt; Stücker, Isabelle; Jöckel, Karl-Heinz; Brenner, Darren R; De Matteis, Sara; Boffetta, Paolo; Guida, Florence; Brüske, Irene; Wichmann, Heinz-Erich; Landi, Maria Teresa; Caporaso, Neil; Siemiatycki, Jack; Ahrens, Wolfgang; Pohlabeln, Hermann; Zaridze, David; Field, John K; McLaughlin, John; Demers, Paul; Szeszenia-Dabrowska, Neonila; Lissowska, Jolanta; Rudnai, Peter; Fabianova, Eleonora; Dumitru, Rodica Stanescu; Bencko, Vladimir; Foretova, Lenka; Janout, Vladimir; Kendzia, Benjamin; Peters, Susan; Behrens, Thomas; Vermeulen, Roel; Brüning, Thomas; Kromhout, Hans; Olsson, Ann

    2014-01-01

    Rationale: Previous respiratory diseases have been associated with increased risk of lung cancer. Respiratory conditions often co-occur and few studies have investigated multiple conditions simultaneously. Objectives: Investigate lung cancer risk associated with chronic bronchitis, emphysema, tuberc

  14. Validity, reliability, and responsiveness of a new shortVisual Simplified Respiratory Questionnaire (VSRQ©) for health-related quality of life assessment in chronic obstructive pulmonary disease

    OpenAIRE

    Perez, T.; Arnould, B.; Grosbois, J-M; Bosch, V; Guillemin, I; Bravo, M-L; BRUN, M.; Tonnel, A-B; ,

    2009-01-01

    The Visual Simplified Respiratory Questionnaire (VSRQ) was designed to assess health-related quality of life (HRQoL) in patients with chronic obstructive pulmonary disease (COPD). It contains eight items: dyspnea, anxiety, depressed mood, sleep, energy, daily activities, social activities and sexual life. Psychometric properties were assessed during a clinical trial that evaluated the impact of tiotropium on HRQoL of COPD patients. These included the determination of structure, internal consi...

  15. ETIOLOGICAL STRUCTURE OF VIRAL RESPIRATORY DISEASES IN ADULT PATIENTS WITH BRONCHIAL ASTHMA EXACERBATION AND CHRONICAL BRONCHIOLITIS OBLITERANS

    Directory of Open Access Journals (Sweden)

    V. Z. Krivitskaya

    2015-01-01

    Full Text Available Exacerbation of bronchial asthma (BA and common deterioration of health during chronic bronchiolitis obliterans (ChBO are associated with viral infections in adults in 64 and 83% respectively. Mixed virus-viral associations were shown in 21–25% of cases. Respiratory syncytial infections were diagnosed with the highest frequency (50% in patients with BA. Influenza A(H1N1pdm09 and adenoviral infections dominated in persons with ChBO in 50 and 42% of cases, respectively. Response of virus-specific IgG in patients with BA and ChBO indicates the acute course of influenza A(H1N1pdm09 (63% of seroconversions. There were no reactions of IgG which is specific to respiratory syncytial virus in 75% of cases and to adenovirus in 83% of cases, that is the risk factor for occurrence of latent/persistent infection. Presence of structural components of respiratory syncytial virus in the upper respiratory tract had been revealed in three patients with asthma within at least 21–28 days. Respiratory syncytial viral infections and pandemic influenza A(H1N1 pdm09 in patients with BA and ChBO are characterized by the presence of an allergic component, which is indicated by the high levels of virus-specific IgE in blood. An adenoviral infection, in contrast, has no such peculiarity. 

  16. Cardiac and Respiratory Disease in Aged Horses.

    Science.gov (United States)

    Marr, Celia M

    2016-08-01

    Respiratory and cardiac diseases are common in older horses. Advancing age is a specific risk factor for cardiac murmurs and these are more likely in males and small horses. Airway inflammation is the most common respiratory diagnosis. Recurrent airway obstruction can lead to irreversible structural change and bronchiectasis; with chronic hypoxia, right heart dysfunction and failure can develop. Valvular heart disease most often affects the aortic and/or the mitral valve. Management of comorbidity is an essential element of the therapeutic approach to cardiac and respiratory disease in older equids.

  17. Respiratory diseases of global consequence

    Science.gov (United States)

    Respiratory diseases are one of the two major categories of poultry diseases that cause the most severe economic losses globally (the other being enteric disease). The economic impact of respiratory disease is both direct, from the production losses caused by primary disease and indirect from preve...

  18. Chronic Respiratory Apparatus Diseases by Dog-day Moxibustion%三伏灸治疗慢性呼吸道疾病的疗效观察

    Institute of Scientific and Technical Information of China (English)

    艾宙; 刘媛媛; 奚玉风; 张倩如; 邹婷; 陈瑞; 方焕奎

    2011-01-01

    目的:观察慢性呼吸道疾病如慢性咽炎、过敏性鼻炎、慢性单纯性鼻炎、慢性支气管炎(缓解期)、支气管哮喘(缓解期)应用三伏灸的疗效,探讨三伏灸疗法对多种常见慢性呼吸道疾病的优势病种.方法:在每年确定的三伏天时间内,将"天灸膏"药粉配适量蜂蜜和新鲜姜汁调和,制成软膏状,将药物敷贴固定在相关穴位.结果:慢性单纯性鼻炎疗程越长则疗效越好;过敏性鼻炎、慢性咽炎见效稍缓;慢性支气管炎和哮喘则起效较快、疗效相对稳定.%Objective: To observe the effects of natural moxibustion in dogdays on chronic respiratory apparatus disease, such as chronic pharyngitis, allergic rhnitis, chronic simple rhinitis, chronic bronchitis (in remission), bronchial asthma( in remssion).Find out the advantage effect of these chronic respiratory apparatus diseases.Methods: In the specified dog days each year, stick ointmeat of natural moxibustion which is mixed with suitable amount of honey and fresh ginger on the related points.Results:The effect on chronic simple rhinitis is connected with the time of natural moxibustion in dogdays.Conclusion :The effects on allergic coryza and chronic pharyngitis are slow.The effects on chronic bronchitis and Asthma are much more obvious than others.

  19. Chronic obstructive pulmonary disease

    Science.gov (United States)

    ... airways disease; Chronic obstructive lung disease; Chronic bronchitis; Emphysema; Bronchitis - chronic ... a protein called alpha-1 antitrypsin can develop emphysema. Other risk factors for COPD are: Exposure to ...

  20. Animal models for diseases of respiratory system

    Directory of Open Access Journals (Sweden)

    R. Adil

    2012-07-01

    Full Text Available Latest trends in understanding of respiratory diseases in human beings can be derived from thorough clinical studies of these diseases occurring in man, but conducting such studies in man is difficult in terms of experimental manipulation. In the last 2 decades, various types of experimental respiratory disease models has been developed and utilized by investigators, which have contributed a lot to the understanding of respiratory diseases in man, but only little investigation has been done on the naturally occurring pulmonary diseases of animals as potential models which could have added to our knowledge. There are certain selected examples of spontaneous pulmonary disease in animals that may serve as exploitable models for human chronic bronchitis, bronchiectasis, emphysema, interstitial lung disease, hypersensitivity pneumonitis, hyaline membrane disease, and bronchial asthma.

  1. Study of the usefulness of 133Xe pulmonary ventilation scintigraphy in infants having persistent respiratory distress syndrome (chronic lung disease)

    International Nuclear Information System (INIS)

    Twelve infants with chronic lung disease, 7 of bronchopulmonary dysplasia (BPD) and 5 of Wilson-Mikity syndrome, underwent 133Xe pulmonary ventilation scintigraphy. The examination was carried out in safety and diagnostic image was obtained in all cases. In BPD, 4 cases were demonstrated air trapping by ventilation scintigraphy but only 2 cases were demonstrated emphysema by chest X-ray film. In Wilson-Mikity syndrome, 4 cases were demonstrated emphysema by ventilation scintigraphy and chest X-ray film. In infants, chest X-ray film was difficult to confirm emphysema, so that 133Xe ventilation scintigraphy was valuable to estimate chronic lung disease. (author)

  2. [Respiratory preparation before surgery in patients with chronic respiratory failure].

    Science.gov (United States)

    Delay, Jean-Marc; Jaber, Samir

    2012-03-01

    Scheduled and/or thoracic, abdominal surgeries increase the risk of respiratory postoperative complications. In patients with chronic respiratory failure, preoperative evaluation should be performed to evaluate respiratory function in aim to optimize perioperative management. Preoperative gas exchange abnormalities (hypoxemia or hypercapnia) are associated with respiratory postoperative complications. Respiratory physiotherapy and prophylactic non-invasive ventilation should be integrated in a global rehabilitation management for cardiothoracic or abdominal surgery procedures, which are at high risk of postoperative respiratory dysfunction. Stopping tobacco consummation should be benefit, but decease risk of postoperative complications is relevant only after a period for 6 to 8 weeks of cessation. Bronchodilatator aerosol therapy (beta-agonists and atropinics) and inhaled corticotherapy allow a rapid preparation for 24 to 48 h. Systematic preoperative antibiotherapy should not be recommended. PMID:22004791

  3. Hematopoietic and mesenchymal stem cells for the treatment of chronic respiratory diseases: role of plasticity and heterogeneity.

    Science.gov (United States)

    Conese, Massimo; Piro, Donatella; Carbone, Annalucia; Castellani, Stefano; Di Gioia, Sante

    2014-01-01

    Chronic lung diseases, such as cystic fibrosis (CF), asthma, and chronic obstructive pulmonary disease (COPD) are incurable and represent a very high social burden. Stem cell-based treatment may represent a hope for the cure of these diseases. In this paper, we revise the overall knowledge about the plasticity and engraftment of exogenous marrow-derived stem cells into the lung, as well as their usefulness in lung repair and therapy of chronic lung diseases. The lung is easily accessible and the pathophysiology of these diseases is characterized by injury, inflammation, and eventually by remodeling of the airways. Bone marrow-derived stem cells, including hematopoietic stem/progenitor cells (HSPCs) and mesenchymal stromal (stem) cells (MSCs), encompass a wide array of cell subsets with different capacities of engraftment and injured tissue regenerating potential. Proof-of-principle that marrow cells administered locally may engraft and give rise to specialized epithelial cells has been given, but the efficiency of this conversion is too limited to give a therapeutic effect. Besides the identification of plasticity mechanisms, the characterization/isolation of the stem cell subpopulations represents a major challenge to improving the efficacy of transplantation protocols used in regenerative medicine for lung diseases. PMID:24563632

  4. Hematopoietic and Mesenchymal Stem Cells for the Treatment of Chronic Respiratory Diseases: Role of Plasticity and Heterogeneity

    Directory of Open Access Journals (Sweden)

    Massimo Conese

    2014-01-01

    Full Text Available Chronic lung diseases, such as cystic fibrosis (CF, asthma, and chronic obstructive pulmonary disease (COPD are incurable and represent a very high social burden. Stem cell-based treatment may represent a hope for the cure of these diseases. In this paper, we revise the overall knowledge about the plasticity and engraftment of exogenous marrow-derived stem cells into the lung, as well as their usefulness in lung repair and therapy of chronic lung diseases. The lung is easily accessible and the pathophysiology of these diseases is characterized by injury, inflammation, and eventually by remodeling of the airways. Bone marrow-derived stem cells, including hematopoietic stem/progenitor cells (HSPCs and mesenchymal stromal (stem cells (MSCs, encompass a wide array of cell subsets with different capacities of engraftment and injured tissue regenerating potential. Proof-of-principle that marrow cells administered locally may engraft and give rise to specialized epithelial cells has been given, but the efficiency of this conversion is too limited to give a therapeutic effect. Besides the identification of plasticity mechanisms, the characterization/isolation of the stem cell subpopulations represents a major challenge to improving the efficacy of transplantation protocols used in regenerative medicine for lung diseases.

  5. The safety of beta-blocker use in chronic obstructive pulmonary disease patients with respiratory failure in the intensive care unit

    OpenAIRE

    Kargin, Feyza; Takir, Huriye Berk; Salturk, Cuneyt; Goksenoglu, Nezihe Ciftaslan; Karabay, Can Yucel; Mocin, Ozlem Yazicioglu; Adiguzel, Nalan; Gungor, Gokay; Balci, Merih Kalamanoglu; Yalcinsoy, Murat; Kargin, Ramazan; Karakurt, Zuhal

    2014-01-01

    Background The safety of beta-blockers as a heart rate-limiting drug (HRLD) in patients with acute respiratory failure (ARF) due to chronic obstructive lung disease (COPD) has not been properly assessed in the intensive care unit (ICU) setting. This study aims to compare the use of beta-blocker drugs relative to non-beta-blocker ones in COPD patients with ARF due to heart rate-limiting with respect to length of ICU stay and mortality. Methods We performed a retrospective (January 2011-Decembe...

  6. "Chronic Lyme Disease"

    Science.gov (United States)

    ... Content Marketing Share this: Main Content Area "Chronic Lyme Disease" What is "chronic Lyme disease?" Lyme disease is an infection caused by ... J Med 357:1422-30, 2008). How is Lyme disease treated? For early Lyme disease, a short ...

  7. Small animal disease surveillance: respiratory disease

    OpenAIRE

    Sánchez-Vizcaíno, Fernando; Daly, Janet M.; Philip H Jones; Dawson, Susan; Gaskell, Rosalind; Menacere, Tarek; Heayns, Bethaney; Wardeh, Maya; Newman, Jenny; Everitt, Sally; Day, Michael J.; McConnell, Katie; Noble, Peter J.M.; Radford, Alan D

    2016-01-01

    This second Small Animal Disease Surveillance report focuses on syndromic surveillance of i) respiratory disease in veterinary practice and ii) feline calicivirus (FCV) based on laboratory diagnosis, in a large veterinary-visiting pet population of the UK between January 2014 and December 2015. Presentation for respiratory disease comprised 1.7%, 2.3% and 2.5% of canine, feline and rabbit consultations, respectively. In dogs, the most frequent respiratory sign reported was coughing (71.1% of ...

  8. The role of community pharmacists in screening and subsequent management of chronic respiratory diseases: a systematic review

    OpenAIRE

    Fathima, Mariam; Naik-Panvelkar, Pradnya; Saini, Bandana; Carol L. Armour

    2013-01-01

    Objective The purpose of this review was to evaluate the role of community pharmacists in provision of screening with/without subsequent management of undiagnosed chronic obstructive pulmonary disease (COPD) and uncontrolled asthma. Methods An extensive literature search using four databases (ie. Medline, PubMed, International Pharmaceutical Abstracts (IPA) and Scopus) with search terms pharmacy, screening, asthma or COPD was conducted. Searches were limited to the years 2003-2013, those in E...

  9. Chronic granulomatous disease

    Directory of Open Access Journals (Sweden)

    Nair Pradeep

    2005-01-01

    Full Text Available A 2½-year-old child presented with multiple discrete granulomatous lesions on the face and flexural regions since the age of 2 months along with lymphadenopathy. The patient also had recurrent bouts of pyodermas and respiratory tract infections. Biopsy of the lesion showed necrosis of tissue with suppuration and histiocytes but no evidence of tuberculosis, fungal infections or atypical mycobacteria. Lymph node biopsy also showed necrosis with suppuration but no infective organism. Nitroblue tetrazolium test was negative indicating that the neutrophils failed to oxidize the dye. We are reporting here a rare case of chronic granulomatous disease.

  10. Chronic granulomatous disease.

    Science.gov (United States)

    Nair, Pradeep S; Moorthy, Prasanna K; Suprakasan, S; Jayapalan, Sabeena; Preethi, K

    2005-01-01

    A 2(1/2)-year-old child presented with multiple discrete granulomatous lesions on the face and flexural regions since the age of 2 months along with lymphadenopathy. The patient also had recurrent bouts of pyodermas and respiratory tract infections. Biopsy of the lesion showed necrosis of tissue with suppuration and histiocytes but no evidence of tuberculosis, fungal infections or atypical mycobacteria. Lymph node biopsy also showed necrosis with suppuration but no infective organism. Nitroblue tetrazolium test was negative indicating that the neutrophils failed to oxidize the dye. We are reporting here a rare case of chronic granulomatous disease. PMID:16394414

  11. Chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    V K Vijayan

    2013-01-01

    Full Text Available The global prevalence of physiologically defined chronic obstructive pulmonary disease (COPD in adults aged >40 yr is approximately 9-10 per cent. Recently, the Indian Study on Epidemiology of Asthma, Respiratory Symptoms and Chronic Bronchitis in Adults had shown that the overall prevalence of chronic bronchitis in adults >35 yr is 3.49 per cent. The development of COPD is multifactorial and the risk factors of COPD include genetic and environmental factors. Pathological changes in COPD are observed in central airways, small airways and alveolar space. The proposed pathogenesis of COPD includes proteinase-antiproteinase hypothesis, immunological mechanisms, oxidant-antioxidant balance, systemic inflammation, apoptosis and ineffective repair. Airflow limitation in COPD is defined as a postbronchodilator FEV1 (forced expiratory volume in 1 sec to FVC (forced vital capacity ratio <0.70. COPD is characterized by an accelerated decline in FEV1. Co morbidities associated with COPD are cardiovascular disorders (coronary artery disease and chronic heart failure, hypertension, metabolic diseases (diabetes mellitus, metabolic syndrome and obesity, bone disease (osteoporosis and osteopenia, stroke, lung cancer, cachexia, skeletal muscle weakness, anaemia, depression and cognitive decline. The assessment of COPD is required to determine the severity of the disease, its impact on the health status and the risk of future events (e.g., exacerbations, hospital admissions or death and this is essential to guide therapy. COPD is treated with inhaled bronchodilators, inhaled corticosteroids, oral theophylline and oral phosphodiesterase-4 inhibitor. Non pharmacological treatment of COPD includes smoking cessation, pulmonary rehabilitation and nutritional support. Lung volume reduction surgery and lung transplantation are advised in selected severe patients. Global strategy for the diagnosis, management and prevention of Chronic Obstructive Pulmonary Disease

  12. Association between Psychological Flexibility and Health Beliefs in the Uptake of Influenza Vaccination among People with Chronic Respiratory Diseases in Hong Kong

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    Kin Wai Cheung

    2016-01-01

    Full Text Available It is common for elderly people and those with such chronic disorders as respiratory diseases to suffer severe complications from influenza, a viral infection. The voluntary uptake of vaccination is vital to the effectiveness of influenza prevention efforts. The Health Belief Model (HBM is the most commonly used framework in the field of vaccination behavior to explain the decision that people make to accept or refuse vaccination. In addition, psychological flexibility is considered helpful in causing people to be open to adopting new practices that are consistent with their values. This study examined the role of psychological flexibility and health beliefs in predicting the uptake of influenza vaccination among people in Hong Kong. Eligible participants were Hong Kong permanent residents aged 18 years or above with a history of chronic respiratory diseases (CRD. A convenience sample of 255 patients was recruited to participate in a cross-sectional survey in which HBM components and factors of psychological flexibility were assessed. The following variables were found to be significant predictors of vaccination: age, smoking status, comorbidity, previous hospitalization, perceived susceptibility, perceived severity, and psychological flexibility. Enhancing psychological flexibility might be a potential new direction for motivating people to accept influenza vaccination.

  13. Prevalence and diagnosis of chronic respiratory symptoms in adults.

    OpenAIRE

    Littlejohns, P; Ebrahim, S; Anderson, R

    1989-01-01

    OBJECTIVE--To investigate the prevalence and diagnosis of chronic respiratory disease in adults. DESIGN--Screening questionnaire was sent to all patients aged 40-70 on the register of a group general practice; those responding positively were sent a detailed questionnaire and invited for assessment of respiratory function by forced expiratory volume in one second, forced vital capacity, peak flow rate, and reversibility studies with a beta adrenergic inhaler. SETTING--Group general practice i...

  14. High-dose oral N-acetylcysteine fails to improve respiratory health status in patients with chronic obstructive pulmonary disease and chronic bronchitis: a randomized, placebo-controlled trial

    Directory of Open Access Journals (Sweden)

    Johnson K

    2016-04-01

    Full Text Available Kara Johnson,1,2 Charlene E McEvoy,3 Sakina Naqvi,1,4 Chris Wendt,1 Ronald A Reilkoff,4,5 Ken M Kunisaki,1 Erin E Wetherbee,1 David Nelson,6 Rabindra Tirouvanziam,7 Dennis E Niewoehner1 1Pulmonary Section, Minneapolis VA Health Care System, Minneapolis, MN, 2Sanford Health, Fargo, ND, 3Pulmonary Section, HealthPartners Research Foundation, St Paul, 4HealthEast Maplewood Clinic, Maplewood, 5Pulmonary Section, University of Minnesota Medical Center, 6Center for Chronic Disease Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, 7Center for Cystic Fibrosis and Airways Disease Research, Emory University School of Medicine, Atlanta, GA, USA Background: Clinical outcomes are worse in patients with COPD and chronic bronchitis. N-acetylcysteine (NAC is commonly prescribed for such patients but with uncertain clinical benefits. We postulated that oral NAC, at much larger doses than those ordinarily prescribed, would improve clinical outcomes in a subset of patients with COPD and chronic bronchitis. Objective: The aim of this study was to determine whether very high-dose NAC would improve respiratory health status in patients with COPD and chronic bronchitis. Methods: Patients with COPD and chronic bronchitis were enrolled in a randomized, controlled, double-blinded trial. Patients received oral NAC (1,800 mg or matching placebo twice daily for 8 weeks in addition to their usual respiratory medications. The primary outcome, respiratory health status, was assessed by changes in the St George’s Respiratory Questionnaire. The effects of NAC on lung function and circulating markers of oxidative stress and inflammation were also evaluated. Results: We terminated the study prematurely because new external information suggested the possibility of a safety issue. Of the planned 130 patients, 51 were randomized and 45 (22 in the placebo arm and 23 in the NAC arm completed the study. There was no statistically significant difference between

  15. Approaches to the control of respiratory virus diseases*

    OpenAIRE

    Tyrrell, D. A. J.

    1980-01-01

    Viruses of various biological types are known to cause a wide range of acute respiratory infections, ranging from mild colds and catarrh to severe bronchiolitis and pneumonia. Bacteria also cause respiratory diseases including serious conditions such as otitis media and pneumonia. The whole situation is complex and to understand the epidemiology we also need to consider nutrition, environment, climate, and chronic diseases. Acute respiratory viral diseases are very common in all areas of the ...

  16. Obesity and respiratory diseases

    OpenAIRE

    Christopher Zammit; Helen Liddicoat; Ian Moonsie; et al

    2010-01-01

    Christopher Zammit, Helen Liddicoat, Ian Moonsie, Himender MakkerSleep and Ventilation Unit, Department of Respiratory Medicine, North Middlesex University Hospital, London, UKAbstract: The obesity epidemic is a global problem, which is set to increase over time. However, the effects of obesity on the respiratory system are often underappreciated. In this review, we will discuss the mechanical effects of obesity on lung physiology and the function of adipose tissue as an endocrine organ produ...

  17. Pulmonary infection control window in treatment of severe respiratory failure of chronic obstructive pulmonary diseases: a prospective, randomized controlled, multi-centred study

    Institute of Scientific and Technical Information of China (English)

    Collaborating Research Group for Noninvasive Mecha

    2005-01-01

    Background Early withdraw from invasive mechanical ventilation (MV) followed by noninvasive MV is a new strategy for changing modes of treatment. This study was conducted to estimate the feasibility and the efficacy of early extubation and sequential noninvasive MV commenced at beginning of pulmonary infection control window in patients with exacerbated hypercapnic respiratory failure caused by chronic obstructive pulmonary diseases (COPD). Methods A prospective, randomized controlled study was conducted in eleven teaching hospitals' respiratory or medical intensive care units in China. Ninety intubated COPD patients with severe hypercapnic respiratory failure triggered by pulmonary infection (pneumonia or purulent bronchitis) were involved in the study. When the pulmonary infection had been controlled by antibiotics and comprehensive therapy, the "pulmonary infection control window (PIC window)" has been reached. Each case was randomly assigned to study group (extubation and noninvasive MV via facial mask immediately) or control group (invasive MV was received continuously after PIC window by using conventional weaning technique).Results Study group (n=47) and control group (n=43) had similar clinical characteristics initially and at the time of PIC window. Compared with control group, study group had shorter duration of invasive MV [(6.4±4.4) days vs (11.3±6.2) days, P=0.000], lower rate of ventilator associated pneumonia (VAP) (3/47 vs 12/43, P=0.014), fewer days in ICU [(12±8) days vs (16±11) days, P=0.047] and lower hospital mortality (1/47 vs 7/43, P=0.025).Conclusions In COPD patients requiring intubation and invasive MV for hypercapnic respiratory failure, which is exacerbated by pulmonary infection, early extubation followed by noninvasive MV initiated at the start of PIC window may decrease significantly the duration of invasive MV, the risk of VAP and hospital mortality.

  18. Occurrence of respiratory symptoms in persons with restrictive ventilatory impairment compared with persons with chronic obstructive pulmonary disease: The PLATINO study.

    Science.gov (United States)

    Nonato, Nívia L; Nascimento, Oliver A; Padilla, Rogelio P; de Oca, Maria M; Tálamo, Carlos; Valdivia, Gonzalo; Lisboa, Carmen; López, Maria V; Celli, Bartolomé; Menezes, Ana Maria B; Jardim, José R

    2015-08-01

    Patients with chronic obstructive pulmonary disease (COPD) usually complain of symptoms such as cough, sputum, wheezing, and dyspnea. Little is known about clinical symptoms in individuals with restrictive ventilatory impairment. The aim of this study was to compare the prevalence and type of respiratory symptoms in patients with COPD to those reported by individuals with restrictive ventilatory impairment in the Proyecto Latinoamericano de Investigacion en Obstruccion Pulmonar study. Between 2002 and 2004, individuals ≥40 years of age from five cities in Latin America performed pre and post-bronchodilator spirometry and had their respiratory symptoms recorded in a standardized questionnaire. Among the 5315 individuals evaluated, 260 (5.1%) had a restrictive spirometric diagnosis (forced vital capacity (FVC) normal (LLN) with forced expiratory volume in the first second to forced vital capacity ratio (FEV1/FVC) ≥ LLN; American Thoracic Society (ATS)/European Respiratory Society (ERS) 2005) and 610 (11.9%) were diagnosed with an obstructive pattern (FEV1/FVC < LLN; ATS/ERS 2005). Patients with mild restriction wheezed more ((30.8%) vs. (17.8%); p < 0.028). No difference was seen in dyspnea, cough, and sputum between the two groups after adjusting for severity stage. The health status scores for the short form 12 questionnaire were similar in restricted and obstructed patients for both physical (48.4 ± 9.4 vs. 48.3 ± 9.8) and mental (50.8 ± 10.6 vs. 50.0 ± 11.5) domains. Overall, respiratory symptoms are not frequently reported by patients with restricted and obstructed patterns as defined by spirometry. Wheezing was more frequent in patients with restricted pattern compared with those with obstructive ventilatory defect. However, the prevalence of cough, sputum production, and dyspnea are not different between the two groups when adjusted by the same severity stage. PMID:26041119

  19. Stem cells and respiratory diseases

    Directory of Open Access Journals (Sweden)

    Soraia Carvalho Abreu

    2008-12-01

    Full Text Available Stem cells have a multitude of clinical implications in the lung. This article is a critical review that includes clinical and experimental studies of MedLine and SciElo database in the last 10 years, where we highlight the effects of stem cell therapy in acute respiratory distress syndrome or more chronic disorders such as lung fibrosis and emphysema. Although, many studies have shown the beneficial effects of stem cells in lung development, repair and remodeling; some important questions need to be answered to better understand the mechanisms that control cell division and differentiation, therefore enabling the use of cell therapy in human respiratory diseases.As células-tronco têm uma infinidade de implicações clínicas no pulmão. Este artigo é uma revisão crítica que inclui estudos clínicos e experimentais advindos do banco de dados do MEDLINE e SciElo nos últimos 10 anos, onde foram destacados os efeitos da terapia celular na síndrome do desconforto respiratório agudo ou doenças mais crônicas, como fibrose pulmonar e enfisema. Apesar de muitos estudos demonstrarem os efeitos benéficos das células-tronco no desenvolvimento, reparo e remodelamento pulmonar; algumas questões ainda precisam ser respondidas para um melhor entendimento dos mecanismos que controlam a divisão celular e diferenciação, permitindo o uso da terapia celular nas doenças respiratórias.

  20. Effects of indacaterol versus tiotropium on respiratory mechanics assessed by the forced oscillation technique in patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Inui N

    2015-06-01

    Full Text Available Naoki Inui,1,2 Sayomi Matsushima,1 Shinpei Kato,1 Hideki Yasui,1 Masato Kohno,1 Tomoyuki Fujisawa,1 Noriyuki Enomoto,1 Yutaro Nakamura,1 Mikio Toyoshima,3 Takafumi Suda1 1Second Division, Department of Internal Medicine, 2Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine, Handayama, Hamamatsu, Japan; 3Department of Respiratory Medicine, Hamamatsu Rosai Hospital, Shougen-cho, Hamamatsu, JapanAbstract: The forced oscillation technique (FOT can measure respiratory mechanics and has attracted attention in chronic obstructive pulmonary disease (COPD. We aimed to evaluate the effects of only indacaterol and tiotropium monotherapies on airflow limitation and respiratory impedance. Pulmonary function tests, COPD assessment test (CAT, and multifrequency FOT with MostGraph-01 were performed at the beginning and after 8 weeks of treatment with indacaterol or tiotropium. The resistance index, resistance at 5 Hz (R5, resistance at 20 Hz (R20, reactance index, reactance at 5 Hz (X5, resonant frequency (Fres, and low-frequency reactance area (ALX were determined at whole-breath, inspiratory, and expiratory phases. Eighty-two patients (mean age: 73 years; mean forced expiratory volume in 1 second (FEV1: 61.6%±19.0% predicted were randomized to indacaterol or tiotropium treatment. Both bronchodilators improved airflow limitation, with mean trough improvements in FEV1 of 165 mL and 80 mL in the indacaterol and tiotropium groups, respectively. The CAT score decreased in the indacaterol group (P<0.001; 11.2±6.6 to 7.5±5.6. Compared with tiotropium, indacaterol significantly improved FEV1, percent predicted FEV1, and CAT score (P=0.042, P=0.008, and P=0.027, respectively. For respiratory impedance, indacaterol and tiotropium changed R5, X5, Fres, and ALX at whole-breath, inspiratory, and expiratory phases. In the indacaterol group, the changes in R5, R5–R20, X5, Fres, and ALX were significantly correlated

  1. ACUTE RESPIRATORY DISEASE AS THE DEBUT OF SYSTEMIC LUPUS ERYTHEMATOSUS

    Directory of Open Access Journals (Sweden)

    A. Yu. Ischenko

    2015-01-01

    Full Text Available Systemic lupus erythematosus — a chronic autoimmune disease that is often associated with infectious processes. The paper presents two clinical cases of systemic lupus erythematosus , debuted with acute respiratory infection.

  2. Bile signalling promotes chronic respiratory infections and antibiotic tolerance.

    Science.gov (United States)

    Reen, F Jerry; Flynn, Stephanie; Woods, David F; Dunphy, Niall; Chróinín, Muireann Ní; Mullane, David; Stick, Stephen; Adams, Claire; O'Gara, Fergal

    2016-01-01

    Despite aggressive antimicrobial therapy, many respiratory pathogens persist in the lung, underpinning the chronic inflammation and eventual lung decline that are characteristic of respiratory disease. Recently, bile acid aspiration has emerged as a major comorbidity associated with a range of lung diseases, shaping the lung microbiome and promoting colonisation by Pseudomonas aeruginosa in Cystic Fibrosis (CF) patients. In order to uncover the molecular mechanism through which bile modulates the respiratory microbiome, a combination of global transcriptomic and phenotypic analyses of the P. aeruginosa response to bile was undertaken. Bile responsive pathways responsible for virulence, adaptive metabolism, and redox control were identified, with macrolide and polymyxin antibiotic tolerance increased significantly in the presence of bile. Bile acids, and chenodeoxycholic acid (CDCA) in particular, elicited chronic biofilm behaviour in P. aeruginosa, while induction of the pro-inflammatory cytokine Interleukin-6 (IL-6) in lung epithelial cells by CDCA was Farnesoid X Receptor (FXR) dependent. Microbiome analysis of paediatric CF sputum samples demonstrated increased colonisation by P. aeruginosa and other Proteobacterial pathogens in bile aspirating compared to non-aspirating patients. Together, these data suggest that bile acid signalling is a leading trigger for the development of chronic phenotypes underlying the pathophysiology of chronic respiratory disease. PMID:27432520

  3. Chronic diseases in elderly men

    DEFF Research Database (Denmark)

    Nielsen, Morten Frost Munk; Wraae, Kristian; Gudex, Claire;

    2012-01-01

    OBJECTIVE: prevalence estimates for chronic diseases and associated risk factors are needed for priority setting and disease prevention strategies. The aim of this cross-sectional study was to estimate the self-reported and clinical prevalence of common chronic disorders in elderly men. STUDY......-reported data on risk factors and disease prevalence were compared with data from hospital medical records. RESULTS: physical inactivity, smoking and excessive alcohol intake were reported by 27, 22 and 17% of the study population, respectively. Except for diabetes, all the chronic diseases investigated......, including hypertension, musculoskeletal and respiratory diseases were underreported by study participants. Erectile dysfunction and hypogonadism were substantially underreported in the study population even though these diseases were found to affect 48 and 21% of the participants, respectively. CONCLUSIONS...

  4. Validity, reliability, and responsiveness of a new short Visual Simplified Respiratory Questionnaire (VSRQ© for health-related quality of life assessment in chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    T Perez

    2008-12-01

    Full Text Available T Perez1, B Arnould2, J-M Grosbois3, V Bosch2, I Guillemin2, M-L Bravo4, M Brun4, A-B Tonnel1 on behalf of TIPHON Study Group1Centre Hospitalier Régional Universitaire (CHRU, Lille, France; 2Mapi Values, Lyon, France; 3Service de Pneumologie, Centre Hospitalier de Béthune, Béthune, France; 4Boehringer Ingelheim France, Reims Cédex, FranceAbstract: The Visual Simplified Respiratory Questionnaire (VSRQ was designed to assess health-related quality of life (HRQoL in patients with chronic obstructive pulmonary disease (COPD. It contains eight items: dyspnea, anxiety, depressed mood, sleep, energy, daily activities, social activities and sexual life. Psychometric properties were assessed during a clinical trial that evaluated the impact of tiotropium on HRQoL of COPD patients. These included the determination of structure, internal consistency reliability, concurrent validity with the St George’s Respiratory Questionnaire (SGRQ, test – retest reliability, clinical validity and responsiveness to change over two weeks. Minimal important difference (MID was calculated; cumulative response curves (CRC were based on the dyspnea item. Psychometric analyses showed that VSRQ structure was unidimensional. The questionnaire demonstrated good internal consistency reliability (Cronbach’s alpha = 0.84, good concurrent validity with SGRQ (Spearman = −0.70 and clinical validity, good test-retest reproducibility (ICC = 0.77, and satisfactory responsiveness (standardized response mean = 0.57; Guyatt’s statistic = 0.63. MID was 3.4; CRC median value of the ‘minimally improved’ patients was 3.5. In conclusion, VSRQ brevity and satisfactory psychometric properties make it a good candidate for large studies to assess HRQoL in COPD patients. Further validation is needed to extend its use in clinical practice.Keywords: chronic obstructive pulmonary disease, VSRQ, SGRQ, health-related quality of life, minimal important difference

  5. Rehabilitation in Patients with Chronic Respiratory Disease Other than Chronic Obstructive Pulmonary Disease: Exercise and Physical Activity Interventions in Cystic Fibrosis and Non-Cystic Fibrosis Bronchiectasis

    OpenAIRE

    Burtin, Chris; Hebestreit, Helge

    2015-01-01

    A relevant proportion of children and adults with cystic fibrosis (CF) have a marked decrease in exercise tolerance, which can be partly related to impaired muscle function and decreased physical activity levels in daily life, in addition to lung disease. Preliminary findings suggest that patients with non-CF bronchiectasis face the same problems. These patients might be excellent candidates for exercise and physical activity interventions. This review elaborates on the rationale for exercise...

  6. Chronic kidney disease

    Science.gov (United States)

    Kidney failure - chronic; Renal failure - chronic; Chronic renal insufficiency; Chronic kidney failure; Chronic renal failure ... 2012_CKD_GL.pdf . McCullough PA. Interface between renal disease ... patients with kidney failure. N Engl J Med . 2010;362(14):1312- ...

  7. Validity, reliability, and responsiveness of a new short Visual Simplified Respiratory Questionnaire (VSRQ) for health-related quality of life assessment in chronic obstructive pulmonary disease.

    Science.gov (United States)

    Perez, T; Arnould, B; Grosbois, J-M; Bosch, V; Guillemin, I; Bravo, M-L; Brun, M; Tonnel, A-B

    2009-01-01

    The Visual Simplified Respiratory Questionnaire (VSRQ) was designed to assess health-related quality of life (HRQoL) in patients with chronic obstructive pulmonary disease (COPD). It contains eight items: dyspnea, anxiety, depressed mood, sleep, energy, daily activities, social activities and sexual life. Psychometric properties were assessed during a clinical trial that evaluated the impact of tiotropium on HRQoL of COPD patients. These included the determination of structure, internal consistency reliability, concurrent validity with the St George's Respiratory Questionnaire (SGRQ), test - retest reliability, clinical validity and responsiveness to change over two weeks. Minimal important difference (MID) was calculated; cumulative response curves (CRC) were based on the dyspnea item. Psychometric analyses showed that VSRQ structure was unidimensional. The questionnaire demonstrated good internal consistency reliability (Cronbach's alpha = 0.84), good concurrent validity with SGRQ (Spearman = -0.70) and clinical validity, good test-retest reproducibility (ICC = 0.77), and satisfactory responsiveness (standardized response mean = 0.57; Guyatt's statistic = 0.63). MID was 3.4; CRC median value of the 'minimally improved' patients was 3.5. In conclusion, VSRQ brevity and satisfactory psychometric properties make it a good candidate for large studies to assess HRQoL in COPD patients. Further validation is needed to extend its use in clinical practice. PMID:19436682

  8. They can't bury you while you're still moving: A review of the European Respiratory Society statement on physical activity in chronic obstructive pulmonary disease.

    Science.gov (United States)

    Nici, Linda; ZuWallack, Richard

    2015-01-01

    Physical activity (PA) and exercise are interrelated but separate concepts. PA refers to bodily movement produced by skeletal muscles that results in energy expenditure. Exercise is a subset of PA, in which generally higher levels of muscular activity are performed for a purpose, such as achieving physical fitness or winning a sporting contest. Higher exercise capacity is considered to be permissive of greater PA in the home and community settings. Individuals with chronic obstructive pulmonary disease (COPD) are physically inactive when compared with healthy age-matched control subjects. Furthermore, physical inactivity is independently associated with adverse outcome in patients with COPD, including more rapid disease progression, impaired health status, and increased health care utilization and mortality risk. While there are several methods to objectively measure PA, recent scientific studies have commonly utilized questionnaires and activity monitors. The latter include simple pedometers and complex accelerometers, which can measure and record movement in up to 3 planes. In COPD, multiple patient characteristics and disease severity markers are related to activity level, including pulmonary physiological abnormalities such as airway obstruction and hyperinflation; exercise capacity such as the 6-minute walking distance; exacerbations of respiratory disease; and comorbid conditions. Clinical trials of bronchodilators, supplemental oxygen therapy, exercise training or pulmonary rehabilitation, or PA counseling have provided inconsistent results in demonstrating increased PA from the interaction. This is probably because the phenomenon of physical inactivity is complex, resulting not only from physiological impairments, but symptoms, cultural, motivational, and environmental factors. PMID:26307102

  9. Respiratory disease surveillance in Hungary

    Energy Technology Data Exchange (ETDEWEB)

    Agocs, M.M.; Rudnai, P.; Etzel, R.A. (Division of Environmental Hazards and Health Effects, Centers for Disease Control, Budapest (Hungary))

    1992-08-28

    In October 1989, the Hungarian National Institute of Hygiene initiated the Children's Acute Respiratory Morbidity (CHARM) Surveillance System to assess the association between nine reportable respiratory diseases and air pollution. The weekly number of physician-diagnosed, reportable respiratory diseases among four age groups of children (less than 1, 1-2, 3-5, and 6-14 years) was tabulated for Sopron, a city with 60,000 residents. We calculated the proportion of diseases occurring during weeks with low, moderate, and high sulfur dioxide (SO2) and nitrogen dioxide (NO2) concentrations. The weekly averages of the 24-hour median SO2 concentrations were divided into thirds at less than or equal to 17.6, greater than 17.6 to less than or equal to 26.3, and greater than 26.3 micrograms/m3 (range: 0.9-79.6 micrograms/m3), and the NO2 concentrations at less than or equal to 29.8, greater than 29.8 to less than or equal to 44.1, and greater than 44.1 micrograms/m3 (range: 4.2-90.1 micrograms/m3). During 1990, 11,474 respiratory disease cases occurred among the 4,020 children less than 15 years of age living in Sopron and monitored by the CHARM system. The two most frequently reported disease categories were rhinitis/tonsillitis/pharyngitis (71.5%) and acute bronchitis (8.5%). Sixty-seven percent of pneumonia cases occurred when SO2 concentrations were highest. We found no association between levels of NO2 and respiratory diseases. The CHARM Surveillance System may characterize more fully which groups of children develop particular respiratory diseases following exposure to air pollution.

  10. Functional Image-Guided Radiotherapy Planning in Respiratory-Gated Intensity-Modulated Radiotherapy for Lung Cancer Patients With Chronic Obstructive Pulmonary Disease

    Energy Technology Data Exchange (ETDEWEB)

    Kimura, Tomoki, E-mail: tkkimura@hiroshima-u.ac.jp [Department of Radiation Oncology, Hiroshima University, Graduate School of Biomedical Sciences, Hiroshima City (Japan); Nishibuchi, Ikuno; Murakami, Yuji; Kenjo, Masahiro; Kaneyasu, Yuko; Nagata, Yasushi [Department of Radiation Oncology, Hiroshima University, Graduate School of Biomedical Sciences, Hiroshima City (Japan)

    2012-03-15

    Purpose: To investigate the incorporation of functional lung image-derived low attenuation area (LAA) based on four-dimensional computed tomography (4D-CT) into respiratory-gated intensity-modulated radiotherapy (IMRT) or volumetric modulated arc therapy (VMAT) in treatment planning for lung cancer patients with chronic obstructive pulmonary disease (COPD). Methods and Materials: Eight lung cancer patients with COPD were the subjects of this study. LAA was generated from 4D-CT data sets according to CT values of less than than -860 Hounsfield units (HU) as a threshold. The functional lung image was defined as the area where LAA was excluded from the image of the total lung. Two respiratory-gated radiotherapy plans (70 Gy/35 fractions) were designed and compared in each patient as follows: Plan A was an anatomical IMRT or VMAT plan based on the total lung; Plan F was a functional IMRT or VMAT plan based on the functional lung. Dosimetric parameters (percentage of total lung volume irradiated with {>=}20 Gy [V20], and mean dose of total lung [MLD]) of the two plans were compared. Results: V20 was lower in Plan F than in Plan A (mean 1.5%, p = 0.025 in IMRT, mean 1.6%, p = 0.044 in VMAT) achieved by a reduction in MLD (mean 0.23 Gy, p = 0.083 in IMRT, mean 0.5 Gy, p = 0.042 in VMAT). No differences were noted in target volume coverage and organ-at-risk doses. Conclusions: Functional IGRT planning based on LAA in respiratory-guided IMRT or VMAT appears to be effective in preserving a functional lung in lung cancer patients with COPD.

  11. Cost-effectiveness of noninvasive ventilation for chronic obstructive pulmonary disease-related respiratory failure in Indian hospitals without ICU facilities

    Directory of Open Access Journals (Sweden)

    Shraddha P Patel

    2015-01-01

    Full Text Available Introduction: The majority of Indian hospitals do not provide intensive care unit (ICU care or ward-based noninvasive positive pressure ventilation (NIV. Because no mechanical ventilation or NIV is available in these hospitals, the majority of patients suffering from respiratory failure die. Objective: To perform a cost-effective analysis of two strategies (ward-based NIV with concurrent standard treatment vs standard treatment alone in chronic obstructive pulmonary disease (COPD respiratory failure patients treated in Indian hospitals without ICU care. Materials and Methods: A decision-analytical model was created to compare the cost-effectiveness for the two strategies. Estimates from the literature were used for parameters in the model. Future costs were discounted at 3%. All costs were reported in USD (2012. One-way, two-way, and probabilistic sensitivity analysis were performed. The time horizon was lifetime and perspective was societal. Results: The NIV strategy resulted in 17.7% more survival and was slightly more costly (increased cost of $101 (USD 2012 but resulted in increased quality-adjusted life-years (QALYs (1.67 QALY. The cost-effectiveness (2012 USD/QALY in the standard and NIV groups was $78/QALY ($535.02/6.82 and $75/QALY ($636.33/8.49, respectively. Incremental cost-effectiveness ratio (ICER was only $61 USD/QALY. This was substantially lower than the gross domestic product (GDP per capita for India (1489 USD, suggesting the NIV strategy was very cost effective. Using a 5% discount rate resulted in only minimally different results. Probabilistic analysis suggests that NIV strategy was preferred 100% of the time when willingness to pay was >$250 2012 USD. Conclusion: Ward-based NIV treatment is cost-effective in India, and may increase survival of patients with COPD respiratory failure when ICU is not available.

  12. Functional Image-Guided Radiotherapy Planning in Respiratory-Gated Intensity-Modulated Radiotherapy for Lung Cancer Patients With Chronic Obstructive Pulmonary Disease

    International Nuclear Information System (INIS)

    Purpose: To investigate the incorporation of functional lung image-derived low attenuation area (LAA) based on four-dimensional computed tomography (4D-CT) into respiratory-gated intensity-modulated radiotherapy (IMRT) or volumetric modulated arc therapy (VMAT) in treatment planning for lung cancer patients with chronic obstructive pulmonary disease (COPD). Methods and Materials: Eight lung cancer patients with COPD were the subjects of this study. LAA was generated from 4D-CT data sets according to CT values of less than than −860 Hounsfield units (HU) as a threshold. The functional lung image was defined as the area where LAA was excluded from the image of the total lung. Two respiratory-gated radiotherapy plans (70 Gy/35 fractions) were designed and compared in each patient as follows: Plan A was an anatomical IMRT or VMAT plan based on the total lung; Plan F was a functional IMRT or VMAT plan based on the functional lung. Dosimetric parameters (percentage of total lung volume irradiated with ≥20 Gy [V20], and mean dose of total lung [MLD]) of the two plans were compared. Results: V20 was lower in Plan F than in Plan A (mean 1.5%, p = 0.025 in IMRT, mean 1.6%, p = 0.044 in VMAT) achieved by a reduction in MLD (mean 0.23 Gy, p = 0.083 in IMRT, mean 0.5 Gy, p = 0.042 in VMAT). No differences were noted in target volume coverage and organ-at-risk doses. Conclusions: Functional IGRT planning based on LAA in respiratory-guided IMRT or VMAT appears to be effective in preserving a functional lung in lung cancer patients with COPD.

  13. Short-term respiratory effects of 0. 12 ppm ozone exposure in volunteers with chronic obstructive pulmonary disease

    Energy Technology Data Exchange (ETDEWEB)

    Linn, W.S.; Fischer, D.A.; Medway, D.A.; Anzar, U.T.; Spier, C.E.; Valencia, L.M.; Venet, T.G.; Hackney, J.D.

    1982-06-01

    Twenty-five volunteers with chronic obstructive pulmonary disease of mild to moderately severe degree underwent 1-h exposures to 0.12 ppm ozone (O/sub 2/) in purified air with intermittent mild exercise. Their responses were assessed in terms of forced expiratory performance, ear oximetry, and reported symptoms. Control studied consisted of similar exposures to purified air alone. Control studies were separated from O/sub 2/ exposures by 1 month, and the order was randomized. All studies took place in a controlled-environment chamber, and were preceded by approximately 1 h of rest in a purified-air environment. No significant disturbances in forced expiratory performance or symptoms attributable to O/sub 2/ exposure were found. A slight but significant tendency to decreased arterial hemoglobin oxygen saturation (SaO/sub 2/) during exercise in O/sub 2/ was observed. The decrement in SaO/sub 2/ with O/sub 2/ relative to clean air (mean 1.3%) was near the limit of resolution of the ear oximeter test and was detected by signal averaging, thus its physiologic or clinical significance is uncertain.

  14. Stem cells and respiratory diseases

    OpenAIRE

    Soraia Carvalho Abreu; Tatiana Maron-Gutierrez; Cristiane Sousa Nascimento Baez Garcia; Marcelo Marcos Morales; Patricia Rieken Macedo Rocco

    2008-01-01

    Stem cells have a multitude of clinical implications in the lung. This article is a critical review that includes clinical and experimental studies of MedLine and SciElo database in the last 10 years, where we highlight the effects of stem cell therapy in acute respiratory distress syndrome or more chronic disorders such as lung fibrosis and emphysema. Although, many studies have shown the beneficial effects of stem cells in lung development, repair and remodeling; some important questions ne...

  15. 慢性阻塞性肺疾病的呼吸肌功能%Respiratory muscle function in chronic obstructive pulmonary disease

    Institute of Scientific and Technical Information of China (English)

    蒋雷服; 殷凯生; 黄茂

    2013-01-01

    The respiratory muscle strength and (or) muscle endurance often decrease in patients with chronic obstructive pulmonary disease (COPD).Respiratory muscle strength and (or) muscle endurance decrease contribute to dyspnea,limit exercise performance,reduce quality of life.Hypercapnic respiratory failure duc to respiratory muscle dysfunction is associated with morbidity in these patients,Respiratory muscle function measurement is useful tool for clinical diagnosis and prognosis of patients with COPD.Maximal inspiratory pressure and maximal expiratory pressure measurement is a simple way to assess inspiratory and expiratory muscle strength.Maximal inspiratory pressure is more sensitive than forced expiratory vohume in one second.Respiratory muscle dysfunction ascribed to intrinsic muscle alterations and hyperinflation-induced diaphragm shortening.Patients with respiratory muscle dysfunction should receive treatment such as anticholincrgic drugs,β2-adrenergic agonists,exercise (including inspiratory muscle training),nutritional support,anabolic steroids,psychosocial support,and education.The clinical potential for protcasome inhibitor,peroxisome proliferator-activated receptors,magnesium sulfate therapy in COPD deserves further investigation.%慢性阻塞性肺疾病患者常存在呼吸肌收缩力和(或)耐力下降,引起呼吸困难,限制患者活动能力,使患者的运动量减少,日常生活质量降低;如果病情得不到控制,可以导致高碳酸性呼吸衰竭,严重者造成患者死亡.呼吸肌功能评价在慢性阻塞性肺疾病患者临床病情评估和预后判断方面很有应用价值.最大吸气压和最大呼气压测定是临床最常用的、可信的、非创伤性的评价呼吸肌功能的指标.研究结果显示最大吸气压较一秒量敏感.呼吸肌本身的病理改变和肺过度充气导致膈肌的收缩初长度缩短等原因可以引起呼吸肌功能障碍.可以应用抗胆碱药物、β2-受体

  16. Anemia and performance status as prognostic markers in acute hypercapnic respiratory failure due to chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Haja Mydin H

    2013-03-01

    Full Text Available Helmy Haja Mydin, Stephen Murphy, Howell Clague, Kishore Sridharan, Ian K TaylorDepartment of Respiratory Medicine, Sunderland Royal Infirmary, Sunderland, United KingdomBackground: In patients with acute hypercapnic respiratory failure (AHRF during exacerbations of COPD, mortality can be high despite noninvasive ventilation (NIV. For some, AHRF is terminal and NIV is inappropriate. However there is no definitive method of identifying patients who are unlikely to survive. The aim of this study was to identify factors associated with inpatient mortality from AHRF with respiratory acidosis due to COPD.Methods: COPD patients presenting with AHRF and who were treated with NIV were studied prospectively. The forced expiratory volume in 1 second (FEV1, World Health Organization performance status (WHO-PS, clinical observations, a composite physiological score (Early Warning Score, routine hematology and biochemistry, and arterial blood gases prior to commencing NIV, were recorded.Results: In total, 65 patients were included for study, 29 males and 36 females, with a mean age of 71 ± 10.5 years. Inpatient mortality in the group was 33.8%. Mortality at 30 days and 12 months after admission were 38.5% and 58.5%, respectively. On univariate analysis, the variables associated with inpatient death were: WHO-PS ≥ 3, long-term oxygen therapy, anemia, diastolic blood pressure < 70 mmHg, Early Warning Score ≥ 3, severe acidosis (pH < 7.20, and serum albumin < 35 g/L. On multivariate analysis, only anemia and WHO-PS ≥ 3 were significant. The presence of both predicted 68% of inpatient deaths, with a specificity of 98%.Conclusion: WHO-PS ≥ 3 and anemia are prognostic factors in AHRF with respiratory acidosis due to COPD. A combination of the two provides a simple method of identifying patients unlikely to benefit from NIV.Keywords: acute exacerbations of COPD, noninvasive ventilation, emphysema, prognostic markers

  17. Diphenylhydantoin (phenytoin)-induced chronic pulmonary disease

    OpenAIRE

    Dixit Ramakant; Dixit Kalpana; Nuwal Paras; Banerjee Arunima; Sharma Sidharth; Dave Lokendra

    2009-01-01

    Drug-induced respiratory diseases are difficult to diagnose and therefore usually not identified, probably underestimated and under-reported. We report a case of diphenylhydantoin/phenytoin-induced chronic pulmonary disease in a 62-year-old male patient presenting with progressive dyspnea, eosinophilia, and pulmonary abnormalities. The importance of drug history in clinical history-taking and early diagnosis of drug-induced respiratory diseases is emphasized so as to prevent permanent pulmona...

  18. Personalized Medicine in Respiratory Disease: Role of Proteomics.

    Science.gov (United States)

    Priyadharshini, V S; Teran, Luis M

    2016-01-01

    Respiratory diseases affect humanity globally, with chronic lung diseases (e.g., asthma, chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis, among others) and lung cancer causing extensive morbidity and mortality. These conditions are highly heterogeneous and require an early diagnosis. However, initial symptoms are nonspecific, and the clinical diagnosis is made late frequently. Over the last few years, personalized medicine has emerged as a medical care approach that uses novel technology aiming to personalize treatments according to the particular patient's medical needs. This review highlights the contributions of proteomics toward the understanding of personalized medicine in respiratory disease and its potential applications in the clinic.

  19. [Respiratory diseases in metallurgy production workers].

    Science.gov (United States)

    Shliapnikov, D M; Vlasova, E M; Ponomareva, T A

    2012-01-01

    The authors identified features of respiratory diseases in workers of various metallurgy workshops. Cause-effect relationships are defined between occupational risk factors and respiratory diseases, with determining the affection level.

  20. Asthma and Respiratory Allergic Disease

    Science.gov (United States)

    The pathogenesis of non-communicable diseases such as allergy is complex and poorly understood. The causes of chronic allergic diseases including asthma involve to a large extent, immunomodulation of the adaptive and particularly the innate immune systems and are markedly influen...

  1. Relationships between respiratory and airway resistances and activity-related dyspnea in patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Plantier L

    2012-03-01

    Full Text Available Bruno Mahut1,2, Aurore Caumont-Prim3,4, Laurent Plantier1,5, Karine Gillet-Juvin1,6, Etienne Callens1, Olivier Sanchez5,6, Brigitte Chevalier-Bidaud3, Plamen Bokov1, Christophe Delclaux1,5,71Assistance Publique – Hôpitaux de Paris (AP-HP, Hôpital Européen Georges Pompidou, Service de Physiologie – Clinique de la Dyspnée, F-75015 Paris, France; 2Cabinet La Berma, 4 avenue de la Providence; F-92160 Antony, France; 3AP-HP, Hôpital Européen Georges Pompidou, Unité d'Épidémiologie et de Recherche Clinique, F-75015 Paris, France; 4INSERM, Centre d'Investigation Épidémiologique 4, F-75015 Paris, France; 5Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, F-75015 Paris, France; 6AP-HP, Hôpital Européen Georges Pompidou, Service de Pneumologie; F-75015 Paris, France; 7CIC 9201 Plurithématique, Hôpital Européen Georges Pompidou, F-75015 Paris, FranceBackground: The aims of the study were: (1 to compare numerical parameters of specific airway resistance (total, sRawtot, effective, sRaweff and at 0.5 L • s-1, sRaw0.5 and indices obtained from the forced oscillation technique (FOT: resistance extrapolated at 0 Hz [Rrs0 Hz], mean resistance [Rrsmean], and resistance/frequency slope [Rrsslope] and (2 to assess their relationships with dyspnea in chronic obstructive pulmonary disease (COPD.Methods: A specific statistical approach, principal component analysis that also allows graphic representation of all correlations between functional parameters was used. A total of 108 patients (mean ± SD age: 65 ± 9 years, 31 women; GOLD stages: I, 14; II, 47; III, 39 and IV, 8 underwent spirometry, body plethysmography, FOT, and Medical Research Council (MRC scale assessments.Results: Principal component analysis determined that the functional parameters were described by three independent dimensions (airway caliber, lung volumes and their combination, specific resistance and that resistance parameters of the two techniques

  2. Predictors of mortality of patients with acute respiratory failure secondary to chronic obstructive pulmonary disease admitted to an intensive care unit: A one year study

    Directory of Open Access Journals (Sweden)

    Banga Amit

    2004-11-01

    Full Text Available Abstract Background Patients with acute exacerbation of chronic obstructive pulmonary disease (COPD commonly require hospitalization and admission to intensive care unit (ICU. It is useful to identify patients at the time of admission who are likely to have poor outcome. This study was carried out to define the predictors of mortality in patients with acute exacerbation of COPD and to device a scoring system using the baseline physiological variables for prognosticating these patients. Methods Eighty-two patients with acute respiratory failure secondary to COPD admitted to medical ICU over a one-year period were included. Clinical and demographic profile at the time of admission to ICU including APACHE II score and Glasgow coma scale were recorded at the time of admission to ICU. In addition, acid base disorders, renal functions, liver functions and serum albumin, were recorded at the time of presentation. Primary outcome measure was hospital mortality. Results Invasive ventilation was required in 69 patients (84.1%. Fifty-two patients survived to hospital discharge (63.4%. APACHE II score at the time of admission to ICU {odds ratio (95 % CI: 1.32 (1.138–1.532; p Conclusion APACHE II score at admission and SA levels with in 24 hrs after admission are independent predictors of mortality for patients with COPD admitted to ICU. The equation derived from these two parameters is useful for predicting outcome of these patients.

  3. Small animal disease surveillance: respiratory disease.

    Science.gov (United States)

    Sánchez-Vizcaíno, Fernando; Daly, Janet M; Jones, Philip H; Dawson, Susan; Gaskell, Rosalind; Menacere, Tarek; Heayns, Bethaney; Wardeh, Maya; Newman, Jenny; Everitt, Sally; Day, Michael J; McConnell, Katie; Noble, Peter J M; Radford, Alan D

    2016-04-01

    Presentation for respiratory disease comprised 1.7 per cent, 2.3 per cent and 2.5 per cent of canine, feline and rabbit consultations, respectively, between January 2014 and December 2015Coughing was the most frequent respiratory sign reported in dogs (71.1 per cent of consultations); in cats it was sneezing (42.6 per cent)Mean percentage of samples testing positive for feline calicivirus (FCV) was 30.1 per cent in 2014 and 27.9 per cent in 2015January was the month with the highest percentage of FCV-positive samples in both 2014 and 2015. PMID:27056810

  4. Chronic diseases in adolescence

    Directory of Open Access Journals (Sweden)

    Rončević Nevenka

    2006-01-01

    Full Text Available Introduction. The prevalence of chronic diseases in adolescence is constantly increasing, especially in the last two decades. Adolescence is a period of important changes: body growth and development, sexual development, development of cognitive abilities, change in family relations and between peers, formation of personal identity and personal system of values, making decisions on future occupation etc. Chronic diseases in adolescence. Chronic disorders affect all development issues and represent an additional burden for adolescents. The interaction between chronic disorders and various development issues is complex and two-way: the disease may affect development, and development may affect the disease. Developmental, psychosocial and family factors are of great importance in the treatment of adolescents with chronic disorders. Chronic disorders affect all aspects of adolescent life, including relations with peers, school, nutrition, learning, traveling, entertainment, choice of occupation, plans for the future. Physicians should keep in mind that chronic diseases and their treatment represent only one aspect of person's life. Adolescents with chronic diseases have other needs as well, personal priorities, social roles and they expect these needs to be recognized and respected. Adolescent health care should be adjusted to the life style of adolescents.

  5. Significance of Aspergillus spp.isolation from lower respiratory tract samples for the diagnosis and prognosis of invasive pulmonary aspergillosis in chronic obstructive pulmonary disease

    Institute of Scientific and Technical Information of China (English)

    HE Hang-yong; CHANG Shuo; DING Lin; SUN Bing; LI Fang; ZHAN Qing-yuan

    2012-01-01

    Background Chronic obstructive pulmonary diseases (COPD) is an emerging population at risk for invasive infection of Aspergillus.Isolation of Aspergillus from lower respiratory tract (LRT) samples is important for the diagnosis of invasive pulmonary aspergillosis (IPA).The purpose of this study was to investigate the value of Aspergillus isolation from LRT samples for the diagnosis and prognosis of IPA in COPD population.Methods Clinical record with Aspergillus spp.isolation in COPD and immunocompromised patients was reviewed in a retrospective study.Patients were categorized and compared according to their severity of illness (admitted to general ward or ICU) and immunological function (COPD or immunocompromised).Results Multivariate statistical analysis showed that,combined with Aspergillus spp.isolation,APACHE Ⅱ scores >18,high cumulative doses of corticosteroids (>350 mg prednisone or equivalent dose) and more than four kinds of broad-spectrum antibiotics received in hospital may be predictors of IPA in COPD (OR=9.076,P=0.001; OR=4.073,P=-0.026; OR=4.448,P=0.021,respectively).The incidence of IPA,overall mortality,mortality of patients with IPA and mortality of patients with Aspergillus spp.colonization were higher in COPD patients in ICU than in general ward,but were similar between COPD and immunocompromised patients.Conclusions Aspergilltus spp.isolation from LRT in COPD may be of similar importance as in immunocompromised patients,and may indicate an increased diagnosis possibility of IPA and worse prognosis when these patients received corticosteroids,antibiotics,and need to admit to ICU.Aspergillus spp.isolation from LRT samples combined with certain risk factors may be useful in differentiating colonization from IPA and evaluating the prognosis of IPA in COPD patients.

  6. 8th International conference on management and rehabilitation of chronic respiratory failure: the long summaries – Part 3

    OpenAIRE

    Ambrosino, Nicolino; Casaburi, Richard; Chetta, Alfredo; Clini, Enrico; Donner, Claudio F; Dreher, Michael; Goldstein, Roger; Jubran, Amal; Nici, Linda; Owen, Caroline A; Rochester, Carolyn; Tobin, Martin J.; Vagheggini, Guido; Vitacca, Michele; ZuWallack, Richard

    2015-01-01

    This paper summarizes the Part 3 of the proceedings of the 8th International Conference on Management and Rehabilitation of Chronic Respiratory Failure, held in Pescara, Italy, on 7 and 8 May, 2015. It summarizes the contributions from numerous experts in the field of chronic respiratory disease and chronic respiratory failure. The outline follows the temporal sequence of presentations. This paper (Part 3) presents a section regarding Moving Across the Spectrum of Care for Long-Term Ventilati...

  7. Helicobacter pyloriinfection and respiratory diseases: a review

    Institute of Scientific and Technical Information of China (English)

    Anastasios Roussos; Nikiforos Philippou; Konstantinos I Gouraoulianis

    2003-01-01

    In the past few years, a variety of extradigestive disorders,including cardiovascular, skin, rheumatic and liver diseases,have been associated with Helicobacter pylori(H. pylori)infection. The activation of inflammatory mediators by H. pyloriseems to be the pathogenetic mechanism underlying theobserved associations. The present review summarizes thecurrent literature, including our own studies, concerning theassociation between H. pvloriinfection and respiratory diseases.A small number of epidemiological and serologic, case-control studies suggest that H. pyloriinfection may beassociated with the development of chronic bronchitis. Afrequent coexistence of pulmonary tuberculosis and H. pyloriinfection has also been found. Moreover, recent studies haveshown an increasedH. pyloriseroprevalence in patients withbronchiectasis and in those with lung cancer. On the otherhand, bronchial asthma seems not to be related withH. pyloriinfection.All associations between H. pyloriinfection and respiratorydiseases are primarily based on case-control studies,concerning relatively small numbers of patients. Moreover,there is a lack of studies focused on the pathogenetic linkbetween respiratory diseases and H. pylori infection.Therefore, we believe that larger studies should beundertaken to confirm the observed results and to clarifythe underlying pathogenetic mechanisms.

  8. Coal Mining-Related Respiratory Diseases

    Science.gov (United States)

    ... ray Surveillance Program (CWXSP) Frequently Asked Questions Coal Miner Health Surveillance Coal Mining-Related Respiratory Diseases CWHSP Data Query System CWHSP Public Data Digital Imaging Activity ...

  9. Sleep and Chronic Disease

    Science.gov (United States)

    ... message, please visit this page: About CDC.gov . Sleep About Us About Sleep Key Sleep Disorders Sleep ... Sheets Data & Statistics Projects and Partners Resources Events Sleep and Chronic Disease Recommend on Facebook Tweet Share ...

  10. Chronic Kidney Disease

    Science.gov (United States)

    You have two kidneys, each about the size of your fist. Their main job is to filter wastes and excess water out of ... help control blood pressure, and make hormones. Chronic kidney disease (CKD) means that your kidneys are damaged ...

  11. Depression in chronic respiratory disorders in a tertiary rural hospital of Central India

    Institute of Scientific and Technical Information of China (English)

    Sameer singhal; Pankaj Banode; Nitish Baisakhiya

    2009-01-01

    Objective: To determine prevalence of depression in chronic respiratory disorders in a tertiary rural hospital of Central India. Various studies done in past have shown that prevalence of depression in diabetes and hypertension is around 40%-57%. Few studies have been done to screen depression in chronic respiratory disorders. This study was conducted in a tertiary rural hospital of Central India to find out prevalence of depression in indoor patients suffering from chronic respiratory disorders. Methods: Total 68 patients were evaluated for depression. Patients suffering from chronic respiratory disorders (total duration of illness >3 months) were evaluated using Prime MD Questionnaire. Patients suffering from diabetes, heart diseases, stroke, having past history of psychiatric illness, drug abusers, having lack of social support and suffering from chronic upper respiratory tract infections were excluded from this study. Questionnaire was asked when treatment for acute phase of illness is over. Results: Out of 68 patients evaluated, 36 (53%) were found out to be suffering from depression. Female gender (80%) was more prone to depression, inspite of the fact that all alcoholics were male. 39% of all chronic obstructive pulmonary disease (COPD) patients were suffering from depression in comparison to 65% for pulmonary tuberculosis and 44% for other chronic respiratory illness. 54% of patients suffering from depression are 60 yrs of age, suggesting that age has no relation with depression. No association was seen between alcoholism and depression. Conclusion: Prevalence of depression in patients of chronic respiratory illness is very high, like in cases of diabetes and hypertension. Further community and hospital based studies are needed to find out exact prevalence of depression in chronic respiratory illnesses.

  12. CONSENSO CHILENO DE REHABILITACIÓN RESPIRATORIA EN EL PACIENTE CON EPOC: INTRODUCCIÓN Consensus of Respiratory Rehabilitation in Chronic Obstructive Pulmonary Disease Patients: Introduction

    Directory of Open Access Journals (Sweden)

    FRANCISCO ARANCIBIA H

    2011-06-01

    Full Text Available En Chile y el mundo, la enfermedad pulmonar obstructiva crónica (EPOC es un problema de salud pública, debido a su alta prevalencia, su condición progresiva, el deterioro de la calidad de vida y el gran impacto económico. La rehabilitación respiratoria (RR es un tratamiento multidisciplinario y en los pacientes con EPOC permite intervenir el círculo vicioso que limita la capacidad de ejercicio en estos pacientes. Los objetivos de la RR son: reducir los síntomas, mejorar la tolerancia al ejercicio físico y la calidad de vida. Presentamos el primer Consenso Chileno de Rehabilitación Respiratoria en pacientes con EPOC. Estas guías tienen por objetivo que la RR pueda aplicarse en todo el país, tanto en hospitales como en la atención primaria. Para la elaboración de este documento, un grupo de neumonólogos, kinesiólogos, enfermeras, nutricionistas y psicólogos realizó un análisis sistemático de la evidencia científica disponible hasta diciembre de 20l0. La evidencia fue analizada según el sistema GRADE (Grading of Recommendations Assessment, Development and Evaluation modificado. El consenso se dividió en capítulos los cuales analizan en profundidad cada uno de los tópicos de la RR. Estos incluyen fisiopatologia, evaluación y programas, entrenamiento muscular de: extremidades inferiores, superiores y musculatura inspiratoria, oxígenoterapia, ventilación no invasiva, educación, nutrición, aspectos psicológicos y costo-efectividad.In Chile and the world, the chronic obstructive pulmonary disease (COPD is a problem of public health, due to its high prevalence, its progressive condition, the deterioration of the quality of life and its great economic impact. The respiratory rehabilitation (RR is a multidisciplinary treatment and in COPD patients allows to control the vicious circle that limits the capacity of exercise in these patients. The aims of the RR are: to reduce the symptoms, to improve the tolerance to the physical

  13. RESPIRATORY STUDIES IN CHRONIC MOUNTAIN SICKNESS:THE PERUVIAN EXPERIENCE

    Institute of Scientific and Technical Information of China (English)

    Fabiola León-Velarde

    2005-01-01

    @@ Chronic Mountain Sickness (CMS) is a multifactorial disease caused by a limited capacity to achieve complete adaptation to life under chronic hypoxic conditions. It is accompanied by excessive erythrocitosis (levels of erythrocytes above the normal value set for each altitude), and in advances cases also by pulmonary hypertension. The hypoxemia, caused by central or peripheral respiratory disorders and/or associated to diverse risk factors, produces the excessive erythrocytosis. The most common symptoms are headaches, dizziness, breathlessness, sleep disturbances, tinnitus, physical and mental fatigue, anorexia, and bone and muscle pain. The most common signs are an intermittent or permanent cyanosis, hyperemia and venous dilatation in hands or feet (Monge-M et al., 1928; Winslow and Monge-C, 1987). Aging, respiratory diseases, sleep, menopause, and overweight has proved to be additional risk factors in the development of CMS (Kryger et al., 1978; León-Velarde et al., 1993; Sime et al., 1975; León-Velarde et al., 1997; León-Velarde et al., 2001; Monge-C et al., 1992; Normand et al., 1992)

  14. Lung Compliance and Chronic Obstructive Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    D. Papandrinopoulou

    2012-01-01

    Full Text Available Chronic obstructive pulmonary disease, namely, pulmonary emphysema and chronic bronchitis, is a chronic inflammatory response of the airways to noxious particles or gases, with resulting pathological and pathophysiological changes in the lung. The main pathophysiological aspects of the disease are airflow obstruction and hyperinflation. The mechanical properties of the respiratory system and its component parts are studied by determining the corresponding volume-pressure (P-V relationships. The consequences of the inflammatory response on the lung structure and function are depicted on the volume-pressure relationships.

  15. Chronic inflammatory systemic diseases

    OpenAIRE

    Straub, Rainer H.; Schradin, Carsten

    2016-01-01

    It has been recognized that during chronic inflammatory systemic diseases (CIDs) maladaptations of the immune, nervous, endocrine and reproductive system occur. Maladaptation leads to disease sequelae in CIDs. The ultimate reason of disease sequelae in CIDs remained unclear because clinicians do not consider bodily energy trade-offs and evolutionary medicine. We review the evolution of physiological supersystems, fitness consequences of genes involved in CIDs during different life-history sta...

  16. Measurement of the Validity and Reliability of the Persian Translation of the Saint George Respiratory Questionnaire for Patients with Chronic Obstructive Pulmonary Disease

    OpenAIRE

    Fallah Tafti, Saeid; Cheraghvandi, Ali; Marashian, Mehran; Emami, Habib; Mokri, Bahareh

    2009-01-01

    Background: One of the important tools in measuring the quality of life in patients having a chronic disease is using questionnaires in which the impact of disease and its different types of treatments on daily tasks and social activities are evaluated. Materials and Methods: At first, the questionnaire was translated into Persian and some of the concepts were changed by the researchers. Next, it was back translated by a person living in an English-speaking area who was unaware of the subject...

  17. Effects of Inhaled Fenoterol and Positive End-Expiratory Pressure on the Respiratory Mechanics of Patients with Chronic Obstructive Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Claude Guerin

    2005-01-01

    Full Text Available BACKGROUND: During acute ventilatory failure in patients with chronic obstructive pulmonary disease (COPD, applying external positive end-expiratory pressure (PEEPe will reopen small airways and, thus, may enhance peripheral deposition as well as the physiological effects of inhaled beta-2 agonists.

  18. FRESH AIR : an implementation research project funded through Horizon 2020 exploring the prevention, diagnosis and treatment of chronic respiratory diseases in low-resource settings

    NARCIS (Netherlands)

    Cragg, Liza; Williams, Siân; Chavannes, Niels H; Postma, Maarten

    2016-01-01

    This protocol describes FRESH AIR, an implementation science project exploring how to improve the prevention, diagnosis and treatment of chronic lung diseases in contexts with limited healthcare resources. It consists of inter-related studies that take place in four countries that are part of the In

  19. The development of the 'Quality-of-life for Respiratory Illness Questionnaire (QOL-RIQ)': a disease-specific quality-of-life questionnaire for patients with mild to moderate chronic non-specific lung disease.

    Science.gov (United States)

    Maillé, A R; Koning, C J; Zwinderman, A H; Willems, L N; Dijkman, J H; Kaptein, A A

    1997-05-01

    Chronic non-specific lung disease (CNSLD) encompasses asthma as well as chronic obstructive pulmonary disease (COPD). Recently in health care, there has been increasing awareness in the functional, psychological and social aspects of the health of patients; their quality of life (QOL). Quality-of-life research addressing CNSLD patients has been rather underdeveloped for a long period of time. Recently, however, the importance of QOL is being increasingly recognized, and several research groups have started to study QOL in CNSLD patients in more detail. This paper describes the construction of a disease-specific QOL instrument for patients with mild to moderately severe CNSLD. Items relating to several domains of QOL were listed, and 171 CNSLD patients in general practice were asked how much of a problem each item had been (assessed on a seven-point Likert scale). After applying an item-selection procedure, a uni-dimensional QOL questionnaire was constructed consisting of 55 items divided into seven domain subscales: breathing problems, physical problems, emotions, situations triggering or enhancing breathing problems, general activities, daily and domestic activities, and social activities, relationships and sexuality. Reliability estimates of the domain subscales of the constructed questionnaire varied from 0.68 to 0.89, and was 0.92 for the QOL for Respiratory Illness Questionnaire (QOL-RIQ) total scale. A first impression of the construct validity of the questionnaire was gained by investigation of the relationship between the QOL domain subscales and several indicators of illness severity, as well as the relative contribution of illness severity variables, background characteristics and symptoms to QOL, using regression analysis. Further research to validate the questionnaire to a greater extent (construct validity, test-retest reliability and responsiveness to change) is currently taking place. PMID:9176649

  20. Chronic obstructive pulmonary disease.

    Science.gov (United States)

    Barnes, Peter J; Burney, Peter G J; Silverman, Edwin K; Celli, Bartolome R; Vestbo, Jørgen; Wedzicha, Jadwiga A; Wouters, Emiel F M

    2015-01-01

    Chronic obstructive pulmonary disease (COPD) is a common disease with high global morbidity and mortality. COPD is characterized by poorly reversible airway obstruction, which is confirmed by spirometry, and includes obstruction of the small airways (chronic obstructive bronchiolitis) and emphysema, which lead to air trapping and shortness of breath in response to physical exertion. The most common risk factor for the development of COPD is cigarette smoking, but other environmental factors, such as exposure to indoor air pollutants - especially in developing countries - might influence COPD risk. Not all smokers develop COPD and the reasons for disease susceptibility in these individuals have not been fully elucidated. Although the mechanisms underlying COPD remain poorly understood, the disease is associated with chronic inflammation that is usually corticosteroid resistant. In addition, COPD involves accelerated ageing of the lungs and an abnormal repair mechanism that might be driven by oxidative stress. Acute exacerbations, which are mainly triggered by viral or bacterial infections, are important as they are linked to a poor prognosis. The mainstay of the management of stable disease is the use of inhaled long-acting bronchodilators, whereas corticosteroids are beneficial primarily in patients who have coexisting features of asthma, such as eosinophilic inflammation and more reversibility of airway obstruction. Apart from smoking cessation, no treatments reduce disease progression. More research is needed to better understand disease mechanisms and to develop new treatments that reduce disease activity and progression. PMID:27189863

  1. Respiratory Disease: Diagnostic Approaches in the Horse.

    Science.gov (United States)

    Hewson, Joanne; Arroyo, Luis G

    2015-08-01

    Evaluation of the upper and lower respiratory tract of horses requires strategic selection of possible diagnostic tests based on location of suspected pathologic lesions and purpose of testing and must also include consideration of patient status. This article discusses the various diagnostic modalities that may be applied to the respiratory system of horses under field conditions, indications for use, and aspects of sample collection, handling, and laboratory processing that can impact test results and ultimately a successful diagnosis in cases of respiratory disease.

  2. Fabry disease, respiratory symptoms, and airway limitation

    DEFF Research Database (Denmark)

    Svensson, Camilla Kara; Feldt-Rasmussen, Ulla; Backer, Vibeke

    2015-01-01

    . The remaining 27 articles were relevant for this review. RESULTS: The current literature concerning lung manifestations describes various respiratory symptoms such as dyspnoea or shortness of breath, wheezing, and dry cough. These symptoms are often related to cardiac involvement in Fabry disease as respiratory...

  3. Respiratory Conditions Update: Restrictive Lung Disease.

    Science.gov (United States)

    Robinson, H Coleman

    2016-09-01

    Restrictive lung diseases are a heterogeneous group of conditions characterized by a restrictive pattern on spirometry and confirmed by a reduction in total lung volume. Patients with more severe symptoms may have a reduced diffusing capacity of the lung for carbon monoxide. Etiologies can be intrinsic with lung parenchymal involvement, as in interstitial lung diseases, or extrinsic to the lung, as in obesity and neuromuscular disorders. Idiopathic pulmonary fibrosis is a chronic progressive interstitial pneumonia with fibrosis for which treatment is primarily supportive with oxygen therapy, pulmonary rehabilitation, and management of comorbid conditions. Newer drugs for idiopathic pulmonary fibrosis, such as pirfenidone and nintedanib, can slow disease progression. Referral for evaluation for lung transplantation is recommended for appropriate patients. Obstructive sleep apnea and obesity hypoventilation syndrome increasingly are common health issues, with symptoms that can include snoring, daytime somnolence, difficulty concentrating, fatigue, witnessed apneas, and morning headaches. Serum bicarbonate may serve as a biomarker in screening for subclinical obesity hypoventilation syndrome. Preoperative evaluations should assess pulmonary risk in addition to cardiac risk with a thorough history, laboratory tests, and functional capacity assessments. Optimization of management may include weight loss, pulmonary rehabilitation, oxygen therapy, and respiratory support. PMID:27576233

  4. Inhaled protein/peptide-based therapies for respiratory disease.

    Science.gov (United States)

    Fellner, Robert C; Terryah, Shawn T; Tarran, Robert

    2016-12-01

    Asthma, chronic obstructive pulmonary disease (COPD), and cystic fibrosis (CF) are all chronic pulmonary diseases, albeit with different etiologies, that are characterized by airflow limitation, chronic inflammation, and abnormal mucus production/rheology. Small synthetic molecule-based therapies are commonly prescribed for all three diseases. However, there has been increased interest in "biologicals" to treat these diseases. Biologicals typically constitute protein- or peptide-based therapies and are often more potent than small molecule-based drugs. In this review, we shall describe the pros and cons of several different biological-based therapies for respiratory disease, including dornase alfa, a recombinant DNAase that reduces mucus viscosity and short palate lung and nasal epithelial clone 1 (SPLUNC1)-derived peptides that treat Na(+) hyperabsorption and rebalance CF airway surface liquid homeostasis. PMID:27098663

  5. Ventilatory-perfusion relationships and respiratory drive in chronic obstructive pulmanory disease : With special reference to hypoxaemia, sleep quality and treatment with inhaled corticisteroid

    OpenAIRE

    Sandek, Karin

    2002-01-01

    By measuring retention in blood and excretion in exhaled air of six infused inert gases using multiple inert gas technique (MIGET), it is possible to obtain detailed assessment of the ventilation-perfusion (VA/Q) relationships in patients with chronic obstructive pulmonary disease. Stable, non-bronchitic COPD patients show a substantial perfusion of hyper-ventilated lung regions. For individuals with exclusively nocturnal hypoxaemia, when the nocturnal arterial oxygen satur...

  6. Perturbação respiratória durante o sono em doença pulmonar obstrutiva crônica Respiratory disturbance during sleep in chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Ana C. Krieger

    2005-04-01

    Full Text Available A doença pulmonar obstrutiva crônica é uma condição freqüente e é hoje a quarta principal causa de mortes nos Estados Unidos. A prevalência de perturbação respiratória durante o sono, ou síndrome de superposição, como anteriormente denominada, ainda não foi determinada devido à publicação de relatos conflitantes. Esta condição deve continuar sendo investigada devido aos efeitos adversos causados por transtornos respiratórios relacionados ao sono em pacientes com doença pulmonar de base. Neste relato, discutiremos brevemente os mecanismos envolvidos na origem da perturbação respiratória durante o sono em doença pulmonar obstrutiva crônica e auxiliaremos o leitor a distinguir àqueles pacientes que se beneficiariam de uma avaliação do padrão do sono mais detalhada, com a discussão de tópicos de gerenciamento e opções de tratamento.Chronic obstructive pulmonary disease is a prevalent condition and is currently the forth leading cause of mortality in the US. The prevalence of respiratory disturbance during sleep, or overlap syndrome as it was commonly known in the past, is still undetermined as conflicting reports have been published. Because of the adverse effects of sleep-related respiratory impairment in patients with underlying pulmonary disease, this condition deserves further investigation. In this report, we will briefly discuss the mechanisms involved in generating respiratory disturbance during sleep in Chronic Obstructive Pulmonary Disease and will guide the reader into distinguishing those patients who would benefit from a more detailed sleep evaluation, discussing management issues and treatment options.

  7. Exogenous Glutamine in Respiratory Diseases: Myth or Reality?

    Directory of Open Access Journals (Sweden)

    Gisele P. Oliveira

    2016-02-01

    Full Text Available Several respiratory diseases feature increased inflammatory response and catabolic activity, which are associated with glutamine depletion; thus, the benefits of exogenous glutamine administration have been evaluated in clinical trials and models of different respiratory diseases. Recent reviews and meta-analyses have focused on the effects and mechanisms of action of glutamine in a general population of critical care patients or in different models of injury. However, little information is available about the role of glutamine in respiratory diseases. The aim of the present review is to discuss the evidence of glutamine depletion in cystic fibrosis (CF, asthma, chronic obstructive pulmonary disease (COPD, acute respiratory distress syndrome (ARDS, and lung cancer, as well as the results of exogenous glutamine administration in experimental and clinical studies. Exogenous glutamine administration might be beneficial in ARDS, asthma, and during lung cancer treatment, thus representing a potential therapeutic tool in these conditions. Further experimental and large randomized clinical trials focusing on the development and progression of respiratory diseases are necessary to elucidate the effects and possible therapeutic role of glutamine in this setting.

  8. Exogenous Glutamine in Respiratory Diseases: Myth or Reality?

    Science.gov (United States)

    Oliveira, Gisele P; de Abreu, Marcelo Gama; Pelosi, Paolo; Rocco, Patricia R M

    2016-02-04

    Several respiratory diseases feature increased inflammatory response and catabolic activity, which are associated with glutamine depletion; thus, the benefits of exogenous glutamine administration have been evaluated in clinical trials and models of different respiratory diseases. Recent reviews and meta-analyses have focused on the effects and mechanisms of action of glutamine in a general population of critical care patients or in different models of injury. However, little information is available about the role of glutamine in respiratory diseases. The aim of the present review is to discuss the evidence of glutamine depletion in cystic fibrosis (CF), asthma, chronic obstructive pulmonary disease (COPD), acute respiratory distress syndrome (ARDS), and lung cancer, as well as the results of exogenous glutamine administration in experimental and clinical studies. Exogenous glutamine administration might be beneficial in ARDS, asthma, and during lung cancer treatment, thus representing a potential therapeutic tool in these conditions. Further experimental and large randomized clinical trials focusing on the development and progression of respiratory diseases are necessary to elucidate the effects and possible therapeutic role of glutamine in this setting.

  9. Screening for Chronic Kidney Disease

    Science.gov (United States)

    Understanding Task Force Recommendations Screening for Chronic Kidney Disease The U.S. Preventive Services Task Force (Task Force) has issued a final recommendation on Screening for Chronic Kidney Disease (CKD) . This recommendation ...

  10. Influenza vaccination in children at high risk of respiratory disease.

    Science.gov (United States)

    Patria, Maria Francesca; Tagliabue, Claudia; Longhi, Benedetta; Esposito, Susanna

    2013-05-01

    Chronic respiratory diseases (CRDs) are a heterogeneous group of diseases that can affect the pediatric population and health authorities throughout the world recommend influenza vaccination because of the significant risk of influenza-related complications. However, despite this recommendation, vaccine coverage is generally unsatisfactory. The aim of this review is to analyze the impact of influenza on children at high risk of respiratory disease, and the immunogenicity, safety and efficacy of influenza vaccination in such children. The results show that there is a significant risk of influenza-related complications in preterm neonates and infants, in whom influenza vaccines are immunogenic and safe (although their efficacy has not been specifically studied). There are conflicting data concerning the effect of influenza infection on asthma morbidity in children, and whether or not influenza vaccination helps to prevent asthma exacerbations. Recent data provide no evidence that influenza is more frequent in patients with cystic fibrosis than in healthy subjects, or that it is responsible for increased lower respiratory tract morbidity. The lack of any clear correlate of protection suggests that future studies should also consider the efficacy of the different influenza vaccines and not only evaluate them in terms of immunogenicity. Furthermore, there is a need for clinical studies to assess the effectiveness of the available vaccines in patients with other rare CRDs and other chronic underlying diseases with possibly severe respiratory involvement. It is also important to determine whether children with recurrent respiratory tract infections should be included in the list of those for whom influenza vaccination is recommended. In the meantime, given the increasing evidence of the burden of influenza on the population as a whole and the benefits associated with vaccination, annual influenza vaccinations should be recommended for all children at high risk of

  11. The Christmas Season as a Risk Factor for Chronic Obstructive Pulmonary Disease Exacerbations

    Directory of Open Access Journals (Sweden)

    Neil W Johnston

    2010-01-01

    Full Text Available BACKGROUND: Epidemics of hospitalization for chronic obstructive pulmonary disease (COPD occur annually during the Christmas holidays, and COPD exacerbations commonly coincide with respiratory viral infections.

  12. Firing Patterns of Muscle Vasoconstrictor Neurons in Respiratory Disease

    OpenAIRE

    Macefield, Vaughan G.

    2012-01-01

    Because the cardiovascular system and respiration are so intimately coupled, disturbances in respiratory control often lead to disturbances in cardiovascular control. Obstructive Sleep Apnea (OSA), Chronic Obstructive Pulmonary Disease (COPD), and Bronchiectasis (BE) are all associated with a greatly elevated muscle vasoconstrictor drive (muscle sympathetic nerve activity, MSNA). Indeed, the increase in MSNA is comparable to that seen in congestive heart failure (CHF), in which the increase i...

  13. Environmental Attributes to Respiratory Diseases of Small Ruminants

    Directory of Open Access Journals (Sweden)

    Anu Rahal

    2014-01-01

    Full Text Available Respiratory diseases are the major disease crisis in small ruminants. A number of pathogenic microorganisms have been implicated in the development of respiratory disease but the importance of environmental factors in the initiation and progress of disease can never be overemphasized. They irritate the respiratory tree producing stress in the microenvironment causing a decline in the immune status of the small ruminants and thereby assisting bacterial, viral, and parasitic infections to break down the tissue defense barriers. Environmental pollutants cause acute or chronic reactions as they deposit on the alveolar surface which are characterized by inflammation or fibrosis and the formation of transitory or persistent tissue manifestation. Some of the effects of exposures may be immediate, whereas others may not be evident for many decades. Although the disease development can be portrayed as three sets of two-way communications (pathogen-environment, host-environment, and host-pathogen, the interactions are highly variable. Moreover, the environmental scenario is never static; new compounds are introduced daily making a precise evaluation of the disease burden almost impossible. The present review presents a detailed overview of these interactions and the ultimate effect on the respiratory health of sheep and goat.

  14. Chronic granulomatous disease associated with chronic glomerulonephritis

    DEFF Research Database (Denmark)

    Frifelt, J J; Schønheyder, Henrik Carl; Valerius, Niels Henrik;

    1985-01-01

    A boy with chronic granulomatous disease (CGD) developed glomerulonephritis at the age of 12 years. The glomerulonephritis progressed to terminal uraemia at age 15 when maintenance haemodialysis was started. The clinical course was complicated by pulmonary aspergillosis and Pseudomonas septicaemia...

  15. Airway hyperresponsiveness in chronic obstructive pulmonary disease : A marker of asthma-chronic obstructive pulmonary disease overlap syndrome?

    NARCIS (Netherlands)

    Tkacova, Ruzena; Dai, Darlene L Y; Vonk, Judith M; Leung, Janice M; Hiemstra, Pieter S; van den Berge, Maarten; Kunz, Lisette; Hollander, Zsuzsanna; Tashkin, Donald; Wise, Robert; Connett, John; Ng, Raymond; McManus, Bruce; Paul Man, S F; Postma, Dirkje S; Sin, Don D

    2016-01-01

    BACKGROUND: The impact of airway hyperreactivity (AHR) on respiratory mortality and systemic inflammation among patients with chronic obstructive pulmonary disease (COPD) is largely unknown. We used data from 2 large studies to determine the relationship between AHR and FEV1 decline, respiratory mor

  16. Total inspiratory and expiratory impedance in patients with severe chronic obstructive pulmonary disease

    OpenAIRE

    Karla Kristine Dames Silva; Agnaldo José Lopes; José Manoel Jansen; Pedro Lopes de Melo

    2011-01-01

    OBJECTIVES: Several studies have confirmed the high potential of the forced oscillation technique for the assessment of respiratory modifications related to chronic obstructive pulmonary disease. However, most of these studies did not employ within-breath analyses of the respiratory system. The aim of this study is to analyze respiratory impedance alterations in different phases of the respiratory cycle of chronic obstructive pulmonary disease patients and to evaluate their clinical use. METH...

  17. Diaphragm Dysfunction in Chronic Obstructive Pulmonary Disease

    OpenAIRE

    Ottenheijm, Coen A. C.; Heunks, Leo M.A.; Sieck, Gary C.; Zhan, Wen-Zhi; Jansen, Suzanne M.; Degens, Hans; de Boo, Theo; Dekhuijzen, P.N Richard

    2005-01-01

    Rationale: Hypercapnic respiratory failure because of inspiratory muscle weakness is the most important cause of death in chronic obstructive pulmonary disease (COPD). However, the pathophysiology of failure of the diaphragm to generate force in COPD is in part unclear. Objectives: The present study investigated contractile function and myosin heavy chain content of diaphragm muscle single fibers from patients with COPD. Methods: Skinned muscle fibers were isolated from muscle biopsies from t...

  18. Late and chronic Lyme disease.

    Science.gov (United States)

    Donta, Sam T

    2002-03-01

    This article reviews the late and chronic manifestations of Lyme disease. Special attention is given to the chronic manifestations of the disease, detailing its pathogenesis, clinical spectrum, and laboratory criteria for the diagnosis. Based on experimental evidence and experience, approaches to the successful treatment of the late and chronic disease are outlined. Much additional work is needed to improve the understanding of the underlying pathophysiology of the disease, its diagnosis and treatment.

  19. Real-Time Surveillance for Respiratory Disease Outbreaks, Ontario, Canada

    OpenAIRE

    van Dijk, Adam; Aramini, Jeff; Edge, Graham; Moore, Kieran M.

    2009-01-01

    To validate the utility of a chief complaint–based emergency department surveillance system, we compared it with respiratory diagnostic data and calls to Telehealth Ontario about respiratory disease. This local syndromic surveillance system accurately monitored status of respiratory diseases in the community and contributed to early detection of respiratory disease outbreaks.

  20. Impaired cortical processing of inspiratory loads in children with chronic respiratory defects

    Directory of Open Access Journals (Sweden)

    Clément Annick

    2007-09-01

    Full Text Available Abstract Background Inspiratory occlusion evoked cortical potentials (the respiratory related-evoked potentials, RREPs bear witness of the processing of changes in respiratory mechanics by the brain. Their impairment in children having suffered near-fatal asthma supports the hypothesis that relates asthma severity with the ability of the patients to perceive respiratory changes. It is not known whether or not chronic respiratory defects are associated with an alteration in brain processing of inspiratory loads. The aim of the present study was to compare the presence, the latencies and the amplitudes of the P1, N1, P2, and N2 components of the RREPs in children with chronic lung or neuromuscular disease. Methods RREPs were recorded in patients with stable asthma (n = 21, cystic fibrosis (n = 32, and neuromuscular disease (n = 16 and in healthy controls (n = 11. Results The 4 RREP components were significantly less frequently observed in the 3 groups of patients than in the controls. Within the patient groups, the N1 and the P2 components were significantly less frequently observed in the patients with asthma (16/21 for both components and cystic fibrosis (20/32 and 14/32 than in the patients with neuromuscular disease (15/16 and 16/16. When present, the latencies and amplitudes of the 4 components were similar in the patients and controls. Conclusion Chronic ventilatory defects in children are associated with an impaired cortical processing of afferent respiratory signals.

  1. Clinical analysis of training of respiratory function in chronic obstructive pulmonary disease remission%慢性阻塞性肺疾病缓解期呼吸功能训练的临床分析

    Institute of Scientific and Technical Information of China (English)

    潘彩虹

    2011-01-01

    目的 观察呼吸肌训练对慢性阻塞性肺疾病(COPD)康复期患者的血气和肺功能的影响.方法 对120例COPD患者进行呼吸肌训练1年后观察锻炼前后患者的血气分析和肺功能检测指标变化情况.结果 有108例完成了1年呼吸肌训练,锻炼后患者的血气分析和肺功能检测指标均较锻炼前有明显改善.结论 经过呼吸肌训练后,患者肺功能和血气分析指标均较锻炼前有很大改善,延缓了病情的进展,提高了生活质量,减轻了经济负担,提高了社会效益.呼吸肌训练具有方法简单易学,无特殊要求,患者和家属都能接受,适合推广使用.%Objective To investigate respiratory muscle training in chronic obstructive pulmonary disease (COPD) rehabilitation of patients with blood gas and pulmonary function. Methods Totally 120 patients with respiratory muscle training in COPD patients was observed after 1 year before and after exercise in patients with blood gas analysis and pulmonary function changes in indicators. Results 108 patients completed 1 year of respiratory muscle training in patients with post - exercise blood gas analysis and pulmonary function parameters were significantly improved before exercise. Conclusions After training the respiratory muscles, pulmonary function and blood gas analysis has greatly improved compared with that before exercise, delayed disease progression and improve quality of life, reduce the economic burden, increase social benefits. Respiratory muscle training method is simple to learn, no special requirements, acceptable to all patients and their families.

  2. Hyperphosphatemia of Chronic Kidney Disease

    OpenAIRE

    Hruska, Keith A.; Mathew, Suresh; Lund, Richard; Qiu, Ping; Pratt, Raymond

    2008-01-01

    Observational studies have determined hyperphosphatemia to be a cardiovascular risk factor in chronic kidney disease. Mechanistic studies have elucidated that hyperphosphatemia is a direct stimulus to vascular calcification, which is one cause of morbid cardiovascular events contributing to the excess mortality of chronic kidney disease. This review describes the pathobiology of hyperphosphatemia that develops as a consequence of positive phosphate balance in chronic kidney disease and the me...

  3. [Pulmonary obstructive chronic disease and physical exercise].

    Science.gov (United States)

    António, Carla; Gonçalves, Ana Paula; Tavares, Alcina

    2010-01-01

    Chronic Obstructive Pulmonary Disease (COPD) is a disease that can be prevented and treated, with a pulmonary component and with significant systemic effects that contribute to the severity of clinical manifestations. COPD causes a number of changes, including those which lead to exercise tolerance limitation and to a progressive deterioration of life quality of the patients. Respiratory rehabilitation (RR) represents a key part of the treatment. The benefits of RR are independent of sex, age and disease severity. At the end of the program, the patient should have acquired a life style as independent and healthy as possible. With this article the authors intend to review the benefits of physical exercise in rehabilitation of patients with COPD and the different types of training used in the respiratory rehabilitation program established for each patient. PMID:20700562

  4. Chinese children's respiratory diseases in 60 years

    Institute of Scientific and Technical Information of China (English)

    QIN Qiang; SHEN Kun-ling

    2009-01-01

    @@ This year marks the 60th anniversary of the founding of the People's Republic of China. On this occasion, it is worthy to recall the past and look towards the future in order to do a better job in research and control of children's respiratory diseases.

  5. Treatment of congestion in upper respiratory diseases

    Directory of Open Access Journals (Sweden)

    Eli O Meltzer

    2010-02-01

    Full Text Available Eli O Meltzer1, Fernan Caballero2, Leonard M Fromer3, John H Krouse4, Glenis Scadding51Allergy and Asthma Medical Group and Research Center, San Diego, CA and Department of Pediatrics, University of California, San Diego, USA; 2Allergy and Clinical Immunology Service, Centro Medico-Docente La Trinidad, Caracas, Venezuela; 3David Geffen School of Medicine, University of California, Los Angeles, USA; 4Wayne State University School of Medicine, Detroit, Michigan, USA; 5Department of Allergy and Rhinology, Royal National TNE Hospital, London, UKAbstract: Congestion, as a symptom of upper respiratory tract diseases including seasonal and perennial allergic rhinitis, acute and chronic rhinosinusitis, and nasal polyposis, is principally caused by mucosal inflammation. Though effective pharmacotherapy options exist, no agent is universally efficacious; therapeutic decisions must account for individual patient preferences. Oral H1-antihistamines, though effective for the common symptoms of allergic rhinitis, have modest decongestant action, as do leukotriene receptor antagonists. Intranasal antihistamines appear to improve congestion better than oral forms. Topical decongestants reduce congestion associated with allergic rhinitis, but local adverse effects make them unsuitable for long-term use. Oral decongestants show some efficacy against congestion in allergic rhinitis and the common cold, and can be combined with oral antihistamines. Intranasal corticosteroids have broad anti-inflammatory activities, are the most potent long-term pharmacologic treatment of congestion associated with allergic rhinitis, and show some congestion relief in rhinosinusitis and nasal polyposis. Immunotherapy and surgery may be used in some cases refractory to pharmacotherapy. Steps in congestion management include (1 diagnosis of the cause(s, (2 patient education and monitoring, (3 avoidance of environmental triggers where possible, (4 pharmacotherapy, and (5 immunotherapy

  6. Update on respiratory disease from coal mine and silica dust

    Energy Technology Data Exchange (ETDEWEB)

    Cohen, R.; Velho, V. [Cooks City Hospital, Chicago, IL (USA)

    2002-12-01

    Excessive exposure to coal, coal mine, and silica dust causes a variety of pathological responses in susceptible hosts, including pulmonary fibrosis or pneumoconiosis and chronic obstructive pulmonary disease and their resultant restrictive, obstructive, or mixed pattern pulmonary function impairments. For many years, much of the discussion on the respiratory health effects of exposure to these dusts was restricted to the fibrosing pulmonary tissue reactions in response to retained dust. It excluded other reactions of the pulmonary parenchyma and airways to the dust, which are extremely important, and can result in significant impairment in sensitive individuals. This article discusses the broad spectrum of pulmonary toxicity to these inorganic dusts, clinical evaluation, and management of patients with respiratory disease from dust exposure, as well as the association between silica exposure and an increased risk of pulmonary malignancy.

  7. Understanding anemia of chronic disease.

    Science.gov (United States)

    Fraenkel, Paula G

    2015-01-01

    The anemia of chronic disease is an old disease concept, but contemporary research in the role of proinflammatory cytokines and iron biology has shed new light on the pathophysiology of the condition. Recent epidemiologic studies have connected the anemia of chronic disease with critical illness, obesity, aging, and kidney failure, as well as with the well-established associations of cancer, chronic infection, and autoimmune disease. Functional iron deficiency, mediated principally by the interaction of interleukin-6, the iron regulatory hormone hepcidin, and the iron exporter ferroportin, is a major contributor to the anemia of chronic disease. Although anemia is associated with adverse outcomes, experimental models suggest that iron sequestration is desirable in the setting of severe infection. Experimental therapeutic approaches targeting interleukin-6 or the ferroportin-hepcidin axis have shown efficacy in reversing anemia in either animal models or human patients, although these agents have not yet been approved for the treatment of the anemia of chronic disease.

  8. [Legislation on professional respiratory diseases].

    Science.gov (United States)

    Lezaun, M

    2005-01-01

    The legally protected occupational pathology consists of work accidents and occupational diseases. Diseases are considered to be occupational when there is a relationship of demonstrable causality between exposure to a determinate occupational risk and a specific disease. To facilitate recognition, different organisations (International Labour Organisation, European Community) draw up, update and recommend the use of lists that are voluntarily adopted by member states. In the case of the Spanish state, the system of the closed list has been adopted. The current list was published in 1978 and the system of notification and registration currently in use is in need of urgent reform, which has been started. It is frequently difficult to identify the work-related origin of occupational diseases and they are often treated in the public health care system without their relation to work being recognised. Knowledge of some basic aspects of the labour legislation by the health workers and the inclusion of a few questions during the anamnesis of patients would make their identification and adequate treatment possible.

  9. Occupational respiratory disease caused by acrylates.

    Science.gov (United States)

    Savonius, B; Keskinen, H; Tuppurainen, M; Kanerva, L

    1993-05-01

    Acrylates are compounds used in a variety of industrial fields and their use is increasing. They have many features which make them superior to formerly used chemicals, regarding both their industrial use and their possible health effects. Contact sensitization is, however, one of their well known adverse health effects but they may also cause respiratory symptoms. We report on 18 cases of respiratory disease, mainly asthma, caused by different acrylates, 10 cases caused by cyanoacrylates, four by methacrylates and two cases by other acrylates. PMID:8334539

  10. Chronic Kidney Disease and Medicines

    Science.gov (United States)

    ... from our online catalog. Alternate Language URL Español Chronic Kidney Disease and Medicines: What You Need to Know Page ... What you need to know Because you have chronic kidney disease, you should take steps to protect your kidneys. ...

  11. Controlled expiration in patients with chronic obstructive pulmonary disease on ventilatory support

    OpenAIRE

    Aerts, Joachim

    1996-01-01

    textabstractChronic respiratory failure develops over the years in many patients with chronic obstructive pulmonary disease (COPD). During exacerbations of COPD the gas-exchange is known to deteriorate in these patients. This acute-on-chronic respiratory failure may ultimately lead to hypercapnic coma. Mechanical ventilation has to be applied to maintain gas-exchange. As this treatment does not affect the pathophysiological mechanisms leading to the respiratory failure, mechanical ventilation...

  12. Clinical Scenarios in Chronic Kidney Disease: Chronic Tubulointerstitial Diseases.

    Science.gov (United States)

    Meola, Mario; Samoni, Sara; Petrucci, Ilaria

    2016-01-01

    Chronic tubulointerstitial diseases are a common final pathway toward chronic renal failure regardless the primary damage (glomerular, vascular or directly the tubulointerstitium). Chronic tubulointerstitial nephritis (CTN) is characterized by interstitial scarring, fibrosis and tubule atrophy, resulting in progressive chronic kidney disease. Most frequent causes of CTN are drugs, heavy metals, obstructive uropathy, nephrolithiasis, reflux disease, immunologic diseases, neoplasia, ischemia, metabolic diseases, genetics and miscellaneous. At ultrasound (US), kidneys' morphological aspect is similar in all forms of chronic interstitial nephropathy and only chronic pyelonephritis with or without reflux shows distinguishing characteristics. In interstitial nephropathy, kidneys' profiles are finely irregular and corticomedullary differentiation is altered because of a diffused hyperechogenicity. The only indirect sign of chronic interstitial damage can be derived from the value of intrarenal resistive indexes that hardly overcome 0.75. US is mandatory in clinical chronic pyelonephritis work-up because it provides information on kidney's diameter and on growth nomogram in children. Renal profiles can be more or less altered depending on the number of cortical scars and the presence of pseudonodular areas of segmental compensatory hypertrophy. In the early stages, US diagnosis of renal tuberculosis is difficult because parenchymal lesions are non-specific. US sensitivity in the diagnosis of hydronephrosis is very high, close to 100% and, finally, US is the first choice imaging technique in the diagnosis of urinary lithiasis. PMID:27169608

  13. Respiratory Diseases in Agate Grinding Workers in Iran

    Directory of Open Access Journals (Sweden)

    E Rafeemanesh

    2014-07-01

    Full Text Available Background: Agate is a hard silica stone with bands of various colors, which is used in jewelry. The agate grinding workers are exposed to silica dust.Objective: To determine the prevalence of respiratory diseases in agate grinding workers and the associated factors.Methods: In this cross-sectional study, 170 agate grinding workers from Mashhad, northeastern Iran, were examined. Medical and occupational history for respiratory illnesses was taken using respiratory questionnaire of the national program of silicosis control, lung examination, spirometry and chest radiography. Chest x-rays were interpreted according to the International Labor Office (ILO classification system, 2000.Results: The mean±SD of age and work duration of the participants were 31.2±10.1 and 13±8.2 years, respectively. The prevalence of silicosis among agate workers was 12.9% (95% CI: 7.9%–18.0%; 18 workers had simple and 4 had complicated silicosis. There was a significant (p<0.05 relationship between contracting silicosis and exposure duration. 20 (11.7% workers had symptoms consistent with chronic bronchitis and 8 (4.7% showed asthma and asthma-like symptoms. The most frequent disorder observed in spirometry was the restrictive pattern (n=43, 30%. In the agate grinders, clinical and spirometry findings did not match with radiological findings.Conclusion: Agate grinding workers are at increased risk for respiratory diseases, specifically for silicosis and chronic bronchitis. The disease is related to silica dust exposure, poor ventilation and inappropriate personal protection.

  14. Acute effects of urban air pollution on respiratory health of children with and without chronic respiratory symptoms

    NARCIS (Netherlands)

    van der Zee, S; Hoek, G; Boezen, H M; Schouten, J P; van Wijnen, J H; Brunekreef, B

    1999-01-01

    OBJECTIVES: To investigate to what extent different components of air pollution are associated with acute respiratory health effects in children with and without chronic respiratory symptoms. METHODS: During three consecutive winters starting in 1992-3, peak expiratory flow (PEF) and respiratory sym

  15. The Clinical Study on Hyponatremia as Complicated by Respiratory Failure due to Chronic Obstructive Disease%慢性阻塞性肺疾病呼吸衰竭并发低钠血症的临床研究

    Institute of Scientific and Technical Information of China (English)

    童长刚

    2013-01-01

    目的:探讨慢性阻塞性肺疾病合并呼吸衰竭患者并发低钠血症的影响因素,寻找最佳的防治措施。方法:回顾性分析2010-2013年本院收治的106例慢性阻塞性肺疾病呼吸衰竭并发低钠血症患者,通过分析临床资料,找出低钠血症发生的原因及有效的治疗方案。结果:106例患者除原发疾病外,有85例伴随不同程度的精神症状和体征,全部患者的血钠平均水平为(119.77±6.53)mmol/L,伴有代偿性呼吸性酸中毒的患者18例,伴有失代偿性呼吸性酸中毒的患者52例,呼吸性酸中毒合并代谢性碱中毒17例,呼吸性酸中毒合并代谢性酸中毒14例。在综合治疗的基础上补钠,纠正电解质紊乱,治疗后患者痊愈77例,好转26例,病情恶化死亡3例。死亡的3例患者中,2例死于多器官衰竭,1例死于重度低钠血症。结论:慢性阻塞性肺疾病呼吸衰竭的患者并发低钠血症的发生率较高,临床医生需要仔细观察患者表现,做到早期发现、明确诊断、有效干预。%Objective:To investigate the pathogenic causes of chronic obstructive pneumonic disease(COPD)with respiratory failure and hyponatremia,and formulate the best preventive measure. Method:To select clinical data of 106 management of COPD with respiratory failure and hyponatremia patients admitted in our hospital during 2010 to 2013 and retrospectively analyze. The pathogenic causes and effective treatments of hyponatremia were identified. Result:In 106 patients with primary disease,85 cases accompany with different degree of mental symptoms and signs. The serum sodium average of all patients was(119.77±6.53)mmol/L. 106 patients included compensatory respiratory acidosis(18 cases),decompensate respiratory acidosis(52 cases),respiratory acidosis and metabolic alkalosis(17 cases),and respiratory acidosis and metabolic acidosis(14 cases). On the basis of comprehensive therapy,patients were

  16. Effects of indacaterol versus tiotropium on respiratory mechanics assessed by the forced oscillation technique in patients with chronic obstructive pulmonary disease

    OpenAIRE

    Inui N; Matsushima S; Kato S; Yasui H; Kono M; Fujisawa T; Enomoto N; Nakamura Y; Toyoshima M; Suda T

    2015-01-01

    Naoki Inui,1,2 Sayomi Matsushima,1 Shinpei Kato,1 Hideki Yasui,1 Masato Kohno,1 Tomoyuki Fujisawa,1 Noriyuki Enomoto,1 Yutaro Nakamura,1 Mikio Toyoshima,3 Takafumi Suda1 1Second Division, Department of Internal Medicine, 2Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine, Handayama, Hamamatsu, Japan; 3Department of Respiratory Medicine, Hamamatsu Rosai Hospital, Shougen-cho, Hamamatsu, JapanAbstract: The forced oscillation technique (FOT) ...

  17. Droplets and modes of respiratory disease transmission

    Science.gov (United States)

    Bourouiba, Lydia

    2014-11-01

    Direct observation of violent expirations such as sneezes and coughs events reveal that such flows are multiphase turbulent buoyant clouds with suspended droplets of various sizes. The effects of ambient conditions indoors, such as moisture and temperature, coupled with the water content of such clouds are key in shaping the pathogen footprint emitted by potentially sick individuals. Such pathogen footprint can change the patterns of respiratory disease transmission. We discuss how the fluid dynamics of violent expirations can help inform how.

  18. Obstructive sleep apnea in chronic obstructive pulmonary disease patients.

    LENUS (Irish Health Repository)

    Lee, Ruth

    2011-03-01

    Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) represent two of the most prevalent chronic respiratory disorders and cardiovascular diseases are major co-morbidities in both. Co-existence of both disorders (overlap syndrome) occurs in 1% of adults and overlap patients have worse nocturnal hypoxemia and hypercapnia than COPD and OSA patients alone. The present review discusses recent data concerning the pathophysiological and clinical significance of the overlap syndrome.

  19. Osteoporosis Associated with Chronic Obstructive Pulmonary Disease.

    Science.gov (United States)

    Okazaki, Ryo; Watanabe, Reiko; Inoue, Daisuke

    2016-08-01

    Recent epidemiological studies have revealed that osteoporosis is closely associated with common chronic diseases including diabetes, hypertension, chronic kidney disorders, and chronic obstructive pulmonary disease (COPD). COPD is a chronic inflammatory airway disease but now well known to be associated with various systemic comorbidities including osteoporosis. Osteoporosis and osteoporotic fractures are extremely common in COPD patients, which have significant impacts on their quality of life (QOL), activities of daily life (ADL), respiratory function, and possibly their prognosis. COPD-associated osteoporosis is however extremely under-recognized, hence undertreated. Recent studies have suggested that both decreased bone mineral density (BMD) and impaired bone quality compromise bone strength causing fractures in COPD. In COPD patients, various general clinical risk factors for osteoporosis are present including smoking, older age, low body weight, and physical inactivity. In addition, disease-related risk factors such as decreased pulmonary function, inflammation, glucocorticoid use and vitamin D deficiency/insufficiency have been linked to the development of osteoporosis in COPD. Increased awareness of osteoporosis in COPD, especially that of high prevalence of vertebral fractures is called upon among general physicians as well as pulmonologists. Routine screening for osteoporosis and risk assessment of fractures will enable physicians to diagnose COPD patients with comorbid osteoporosis at an early stage. Timely prevention of developing osteoporosis together with appropriate treatment of established osteoporosis may improve QOL and ADL of the COPD patients, preserve their lung function and eventually result in better prognosis in these patients. PMID:27622174

  20. Osteoporosis Associated with Chronic Obstructive Pulmonary Disease

    Science.gov (United States)

    Watanabe, Reiko; Inoue, Daisuke

    2016-01-01

    Recent epidemiological studies have revealed that osteoporosis is closely associated with common chronic diseases including diabetes, hypertension, chronic kidney disorders, and chronic obstructive pulmonary disease (COPD). COPD is a chronic inflammatory airway disease but now well known to be associated with various systemic comorbidities including osteoporosis. Osteoporosis and osteoporotic fractures are extremely common in COPD patients, which have significant impacts on their quality of life (QOL), activities of daily life (ADL), respiratory function, and possibly their prognosis. COPD-associated osteoporosis is however extremely under-recognized, hence undertreated. Recent studies have suggested that both decreased bone mineral density (BMD) and impaired bone quality compromise bone strength causing fractures in COPD. In COPD patients, various general clinical risk factors for osteoporosis are present including smoking, older age, low body weight, and physical inactivity. In addition, disease-related risk factors such as decreased pulmonary function, inflammation, glucocorticoid use and vitamin D deficiency/insufficiency have been linked to the development of osteoporosis in COPD. Increased awareness of osteoporosis in COPD, especially that of high prevalence of vertebral fractures is called upon among general physicians as well as pulmonologists. Routine screening for osteoporosis and risk assessment of fractures will enable physicians to diagnose COPD patients with comorbid osteoporosis at an early stage. Timely prevention of developing osteoporosis together with appropriate treatment of established osteoporosis may improve QOL and ADL of the COPD patients, preserve their lung function and eventually result in better prognosis in these patients.

  1. [Respiratory diseases in sheep due to Mycoplasma ovipneumoniae].

    Science.gov (United States)

    Masalski, N; Ivanov, I; Dikova, Ts; Pavlov, N

    1982-01-01

    Mycoplasma ovipneumoniae was isolated from sheep and lambs affected with a respiratory disease. It was established that the pneumonic disease caused by this organism was a severe one, with high mortality rate in young lambs. Adult sheep and older lambs remained chronically affected. Susceptibility varied, depending on the breed of the animals, some imported animals running a more severe course of the disease than the local ones. The disease was artificially induced in lambs at the joint infection with M. ovipneumoniae and P. haemolytica. The morphologic changes in the lungs consisted in a prevailing proliferation of the septal cells and polynuclear cells in the alveoli, an interseptal histiocyte proliferation, and a serous leukocyte infiltration.

  2. [The curative action of Monticelli Term's water in upper respiratory tract diseases (author's transl)].

    Science.gov (United States)

    Turchi, R; Jemmi, G; Barani, B

    1976-01-01

    The Authors study the action of the sodio bromide-iodic water of Monticelli Terme in upper respiratory tract disease and particularly assert that is not to neglect the organic ground on which establishes mucosa's disease. Therman treatment gives the best therapeutic results in every patient presenting chronic inflammatory processes of the upper respiratory trach alternating periods of quiescency and of activity, and poor therapeutic action in patients presenting chronic inveterate diseases with great alterations in vascular and glandular components of the mucosa. PMID:1021139

  3. Air pollutants and incidence of respiratory disease

    Energy Technology Data Exchange (ETDEWEB)

    Dohan, F.C.

    1961-01-01

    The correlation of prolonged (> 7 days) respiratory disease incidence in women working in electronics plants was studied with various pollutant indices. A three-year study of plants in 7 cities was conducted. Mean incidence was significantly correlated with suspended particulate sulfate (r = 0.964, 5 cities). No similar trend was found for benzene-soluble organic matter (OM), acetone-soluble OM, nitrates, Cu, Ti, Bi, Cd, Fe, Pb, Sn, Cl, or Zn. Similar trends for Ni and V, however, were noted. Various factors (e.g., age, socio-economic class, children, weather) were not thought to affect this conclusion. Pollution may prolong illness due to viral disease.

  4. [Chronic non-communicable diseases in Brazil: priorities for disease management and research].

    Science.gov (United States)

    Duncan, Bruce Bartholow; Chor, Dóra; Aquino, Estela M L; Bensenor, Isabela M; Mill, José Geraldo; Schmidt, Maria Inês; Lotufo, Paulo Andrade; Vigo, Alvaro; Barreto, Sandhi Maria

    2012-12-01

    Chronic Non-Communicable Diseases are the main source of disease burden in Brazil. In 2011, the Brazilian Ministry of Health launched the Strategic Plan of Action for Management of Chronic Non-Communicable Diseases focusing on population-based interventions to manage cardiovascular diseases, diabetes, cancer, and chronic respiratory diseases mainly through fighting tobacco use, unhealthy diets, physical inactivity and the harmful use of alcohol. Although a significant number of scientific studies on chronic diseases and their risk factors have been undertaken in Brazil, few are of cohort design. In this context, the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a cohort study of 15,105 Brazilian public servants reflects the reality of high prevalences of diabetes, hypertension and the main chronic diseases risk factors. The diversity of information that the Study will produce can provide important input to better understand the causes of chronic diseases and to support public policies for fighting them.

  5. Validity, reliability, and responsiveness of a new short Visual Simplified Respiratory Questionnaire (VSRQ©) for health-related quality of life assessment in chronic obstructive pulmonary disease

    OpenAIRE

    Guillemin, Isabelle

    2008-01-01

    T Perez1, B Arnould2, J-M Grosbois3, V Bosch2, I Guillemin2, M-L Bravo4, M Brun4, A-B Tonnel1 on behalf of TIPHON Study Group1Centre Hospitalier Régional Universitaire (CHRU), Lille, France; 2Mapi Values, Lyon, France; 3Service de Pneumologie, Centre Hospitalier de Béthune, Béthune, France; 4Boehringer Ingelheim France, Reims Cédex, FranceAbstract: The Visual Simplified Respiratory Questionnaire (VSRQ) was designed to assess health-related quality o...

  6. Chronic diseases and mental disorder.

    NARCIS (Netherlands)

    Verhaak, P.F.M.; Heijmans, M.J.W.M.; Peters, L.; Rijken, M.

    2005-01-01

    The aim of this study was to achieve a better understanding of the relationship between chronic medical illness and mental distress. Therefore, the association between chronic medical illness and mental distress was analysed, taking into account the modifying effects of generic disease characteristi

  7. Managing multimorbidity in primary care in patients with chronic respiratory conditions.

    Science.gov (United States)

    Morrison, Deborah; Agur, Karolina; Mercer, Stewart; Eiras, Andreia; González-Montalvo, Juan I; Gruffydd-Jones, Kevin

    2016-01-01

    The term multimorbidity is usually defined as the coexistence of two or more chronic conditions within an individual, whereas the term comorbidity traditionally describes patients with an index condition and one or more additional conditions. Multimorbidity of chronic conditions markedly worsens outcomes in patients, increases treatment burden and increases health service costs. Although patients with chronic respiratory disease often have physical comorbidities, they also commonly experience psychological problems such as depression and anxiety. Multimorbidity is associated with increased health-care utilisation and specifically with an increased number of prescription drugs in individuals with multiple chronic conditions such as chronic obstructive pulmonary disease. This npj Primary Care Respiratory Medicine Education Section case study involves a patient in a primary care consultation presenting several common diseases prevalent in people of this age. The patient takes nine different drugs at this moment, one or more pills for each condition, which amounts to polypharmacy. The problems related with polypharmacy recommend that a routine medication review by primary care physicians be performed to reduce the risk of adverse effects of polypharmacy among those with multiple chronic conditions. The primary care physician has the challenging role of integrating all of the clinical problems affecting the patient and reviewing all medicaments (including over-the-counter medications) taken by the patient at any point in time, and has the has the key to prevent the unwanted consequences of polypharmacy. Multimorbid chronic disease management can be achieved with the use of care planning, unified disease templates, use of information technology with appointment reminders and with the help of the wider primary care and community teams. PMID:27629064

  8. Managing multimorbidity in primary care in patients with chronic respiratory conditions

    Science.gov (United States)

    Morrison, Deborah; Agur, Karolina; Mercer, Stewart; Eiras, Andreia; González-Montalvo, Juan I; Gruffydd-Jones, Kevin

    2016-01-01

    The term multimorbidity is usually defined as the coexistence of two or more chronic conditions within an individual, whereas the term comorbidity traditionally describes patients with an index condition and one or more additional conditions. Multimorbidity of chronic conditions markedly worsens outcomes in patients, increases treatment burden and increases health service costs. Although patients with chronic respiratory disease often have physical comorbidities, they also commonly experience psychological problems such as depression and anxiety. Multimorbidity is associated with increased health-care utilisation and specifically with an increased number of prescription drugs in individuals with multiple chronic conditions such as chronic obstructive pulmonary disease. This npj Primary Care Respiratory Medicine Education Section case study involves a patient in a primary care consultation presenting several common diseases prevalent in people of this age. The patient takes nine different drugs at this moment, one or more pills for each condition, which amounts to polypharmacy. The problems related with polypharmacy recommend that a routine medication review by primary care physicians be performed to reduce the risk of adverse effects of polypharmacy among those with multiple chronic conditions. The primary care physician has the challenging role of integrating all of the clinical problems affecting the patient and reviewing all medicaments (including over-the-counter medications) taken by the patient at any point in time, and has the has the key to prevent the unwanted consequences of polypharmacy. Multimorbid chronic disease management can be achieved with the use of care planning, unified disease templates, use of information technology with appointment reminders and with the help of the wider primary care and community teams. PMID:27629064

  9. Impact of bone marrow on respiratory disease.

    Science.gov (United States)

    Rankin, Sara M

    2008-06-01

    The bone marrow is not only a site of haematopoiesis but also serves as an important reservoir for mature granulocytes and stem cells, including haematopoietic stem cells, mesenchymal stem cells and fibrocytes. In respiratory diseases, such as asthma and idiopathic pulmonary fibrosis these cells are mobilised from the bone marrow in response to blood-borne mediators and subsequently recruited to the lungs. Although the granulocytes contribute to the inflammatory reaction, stem cells may promote tissue repair or remodelling. Understanding the factors and molecular mechanisms that regulate the mobilisation of granulocytes and stem cells from the bone marrow may lead to the identification of novel therapeutic targets for the treatment of a wide range of respiratory disorders. PMID:18372214

  10. Occupational chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Omland, Oyvind; Würtz, Else Toft; Aasen, Tor Brøvig;

    2014-01-01

    Occupational-attributable chronic obstructive pulmonary disease (COPD) presents a substantial health challenge. Focusing on spirometric criteria for airflow obstruction, this review of occupational COPD includes both population-wide and industry-specific exposures.......Occupational-attributable chronic obstructive pulmonary disease (COPD) presents a substantial health challenge. Focusing on spirometric criteria for airflow obstruction, this review of occupational COPD includes both population-wide and industry-specific exposures....

  11. Nutrition in Chronic Liver Disease

    OpenAIRE

    Marco Silva; Sara Gomes; Armando Peixoto; Paulo Torres-Ramalho; Hélder Cardoso; Rosa Azevedo; Carla Cunha; Guilherme Macedo

    2015-01-01

    Protein-calorie malnutrition is a transversal condition to all stages of chronic liver disease. Early recognition of micro or macronutrient deficiencies is essential, because the use of nutritional supplements reduces the risk of complications. The diet of patients with chronic liver disease is based on a standard diet with supplements addition as necessary. Restrictions may be harmful and should be individualized. Treatment management should aim to maintain an adequate protein and caloric...

  12. Carga del cuidado y calidad de vida en cuidadores familiares de personas con enfermedad respiratoria crónica / Burden load and quality of life in family caregivers of people with chronic respiratory disease

    Directory of Open Access Journals (Sweden)

    Edgar A. Pinzón

    2016-05-01

    Full Text Available Resumen Objetivo: establecer la relación entre la carga del cuidado y la calidad de vida en cuidadores familiares de personas con enfermedades respiratorias crónicas. Metodología: estudio de abordaje cuantitativo descriptivo, de correlación, y corte transversal. Participaron 55 cuidadores familiares que asisten a una institución de tercer nivel de atención en salud de la ciudad de Bucaramanga. Se utilizaron los instrumentos: encuesta de caracterización del cuidador familiar de persona con enfermedad crónica, calidad de vida versión familiar de persona con enfermedad crónica y Carga del cuidado de Zarit. El análisis se realizó mediante estadística descriptiva con medidas de tendencia central y de dispersión y la determinación del coeficiente de correlación de Spearman Resultados: los cuidadores familiares son en su mayoría mujeres, de estratos socioeconómicos bajos, ocupación hogar, una mediana de 18 horas día a la asistencia y cuidado; presentan una calidad de vida global percibida media. En cuanto a la carga del cuidado el 23,7% de los cuidadores presenta una sobrecarga severa, el 27,3% sobrecarga leve y el 49%, no presentan sobrecarga de acuerdo con la clasificación establecida por Zarit. El coeficiente de correlación de Spearman obtenido fue de -0,783 estadísticamente significativo (p=0,00 Conclusión: existe una correlación inversa entre la calidad de vida y la carga de cuidado de los cuidadores familiares de personas con enfermedad respiratoria crónica. / Abstract Objective: to establish the relationship between the care burden and quality of life of family caregivers of patients with chronic respiratory diseases. Methodology: a quantitative, descriptive, correlation, and cross sectional study performed with 55 family caregivers attending a tertiary health care institution in the city of Bucaramanga. The following instruments were used: characterization survey of the family caregivers of people with chronic

  13. 慢性阻塞性肺疾病院内下呼吸道肠球菌感染临床分析%Clinical analysis of nosocomial lower respiratory enterococcus infection in chronic obstructive pulmonary disease

    Institute of Scientific and Technical Information of China (English)

    邱勤; 李小惠

    2015-01-01

    目的:调查与分析老年慢性阻塞性肺疾病(COPD)住院患者院内下呼吸道肠球菌感染情况和耐药性。方法回顾性分析68例发生下呼吸道肠球菌属感染患者的临床资料和耐药情况。结果从患者痰标本中共分离出68株肠球菌,其中粪肠球菌30株,屎肠球菌38株。所有68株肠球菌均对利奈唑胺、替考拉宁以及万古霉素敏感,屎肠球菌对青霉素、氨苄西林、利福平、庆大霉素、环丙沙星、四环素的耐药性显著高于粪肠球菌(P14 d、合并肿瘤和基底节脑梗死、侵入性操作、合并非发酵菌和肠杆菌科感染是COPD院内感染肠球菌的高危因素。结论本院COPD院内下呼吸道肠球菌感染的现象时有发生,临床应依据药敏试验结果给予合适的抗菌药物治疗,以提高治疗效果。%ObjectiveTo research and analyze nosocomial lower respiratory enterococcus infection condition and drug resistance in hospitalized patients with chronic obstructive pulmonary disease (COPD). MethodsClinical data and drug resistance status of 68 patients with nosocomial lower respiratory enterococcus infection were retrospectively analyzed.ResultsA total of 68 enterococcus strains were separated from sputum samples. Among them, there were 30 enterococcus faecalis strains and 38 enterococcus faecium strains. All the 68 strains were sensitive to linezolid, teicoplanin, and vancomycin. Enterococcus faecium had much high resistance to penicillin, ampicillin, rifampicin, gentamicin, ciprofloxacin and tetracycline than enterococcus faecalis (P14 d, complicated tumor and basal ganglia cerebral infarction, invasive procedure, and complicated non-fermentative bacteria and enterobacteriaceae infection.ConclusionOccurrence of nosocomial lower respiratory enterococcus infection in COPD is occasional. Clinical application of suitable antibacterial agents therapy in accordance with drug sensitive test results can improve curative effect.

  14. Exhaled nitric oxide in diagnosis and management of respiratory diseases

    Directory of Open Access Journals (Sweden)

    Abba Abdullah

    2009-01-01

    Full Text Available The analysis of biomarkers in exhaled breath constituents has recently become of great interest in the diagnosis, treatment and monitoring of many respiratory conditions. Of particular interest is the measurement of fractional exhaled nitric oxide (FENO in breath. Its measurement is noninvasive, easy and reproducible. The technique has recently been standardized by both American Thoracic Society and European Respiratory Society. The availability of cheap, portable and reliable equipment has made the assay possible in clinics by general physicians and, in the near future, at home by patients. The concentration of exhaled nitric oxide is markedly elevated in bronchial asthma and is positively related to the degree of esinophilic inflammation. Its measurement can be used in the diagnosis of bronchial asthma and titration of dose of steroids as well as to identify steroid responsive patients in chronic obstructive pulmonary disease. In primary ciliary dyskinesia, nasal NO is diagnostically low and of considerable value in diagnosis. Among lung transplant recipients, FENO can be of great value in the early detection of infection, bronchioloitis obliterans syndrome and rejection. This review discusses the biology, factors affecting measurement, and clinical application of FENO in the diagnosis and management of respiratory diseases.

  15. STUDY ON PREVALENCE OF RESPIRATORY DISEASE IN URBAN POPULATION OF BHOPAL CITY

    Directory of Open Access Journals (Sweden)

    PAPIYA BIGONIYA*, ALOK SHUKLA, HUMA IRAM ,FARAH IRAM

    2013-09-01

    Full Text Available Chronic respiratory disease occurrence in urban population is creating burden on economic growth and challenges to public health management. This descriptive, prevalence study was designed to gather data on risk factor related association of respiratory diseases occurrence with information on sign, symptoms and treatment modalities. Questionnaire based personal interview was conducted on selected patients with well documented respiratory problem on demographic, biosocial, educational, occupational and economic background. Body weight, height, blood pressure, details of treatment modalities, sign and symptoms were recorded from hospital data. The prevalence rates were presented as percentage and 95% confidence interval estimated and analyzed by person’s chi-square test. Age, number of children more than three (p<0.0001, family members more than three (p<0.01, overcrowding (p<0.0001, low socioeconomic class (p<0.0001, unhygienic surrounding (p<0.001, education below secondary level (p<0.01, low to normal BMI (p<0.002 and chronic smoking habit (p<0.001 showed significant risk factor related association with occurrence of respiratory disease. Most frequently found sign and symptom are apnea, tiredness, nausea, coughing and nose tickling. Marital status, source of drinking water, cooking fuel, occupation, employment status, income, respiratory rate, sleep pattern and regular use of other medication does not show any co-relation with respiratory disease occurrence. The significant risk factor for respiratory disease occurrence is aging, unhygienic environment, low level education, overcrowding and smoking.

  16. Nanoparticle-based therapy for respiratory diseases

    Directory of Open Access Journals (Sweden)

    ADRIANA L. DA SILVA

    2013-03-01

    Full Text Available Nanotechnology is an emerging science with the potential to create new materials and strategies involving manipulation of matter at the nanometer scale (<100 nm. With size-dependent properties, nanoparticles have introduced a new paradigm in pharmacotherapy – the possibility of cell-targeted drug delivery with minimal systemic side effects and toxicity. The present review provides a summary of published findings, especially regarding to nanoparticle formulations for lung diseases. The available data have shown some benefits with nanoparticle-based therapy in the development of the disease and lung remodeling in respiratory diseases. However, there is a wide gap between the concepts of nanomedicine and the published experimental data and clinical reality. In addition, studies are still required to determine the potential of nanotherapy and the systemic toxicity of nanomaterials for future human use.

  17. Chronic respiratory symptoms, bronchial responsiveness and dietary sodium and potassium: a population-based study.

    Science.gov (United States)

    Zoia, M C; Fanfulla, F; Bruschi, C; Basso, O; De Marco, R; Casali, L; Cerveri, I

    1995-04-01

    A possible relationship between Na+ intake and increased prevalence and mortality from asthma and chronic obstructive pulmonary disease (COPD) has been suggested but not clearly proven for several reasons (difficulty in assessing Na+ and K+ both by 24 h excretion and dietary recall, too small an effect of these ions on the pathology, and the role of potential confounders). We wanted to determine the relationship of Na+ and K+ intake, assessed by means of a 7 day recall, with chronic respiratory symptoms and bronchial responsiveness in a sample of the general population. Two hundred and five subjects were studied, with complete dietary and respiratory questionnaires, and baseline respiratory function tests, together with a subsample of 146 subjects who underwent histamine challenge. The 7 day recall consisted of two parts: the first assessed discretionary Na+; and the second assessed Na+ and K+ contained in food. The whole sample was split into two groups based on the levels of consumption, and the statistical analysis was performed contrasting the three lower quartiles vs the highest. Smoking habit, social economic status, age and body mass index (BMI) were not confounders for Na+ and K+ intake. The prevalence of symptomatic subjects and baseline respiratory function values were not significantly different in the two groups of quartiles for Na+ and K+. Baseline respiratory values and dose-response slope of the subsample were also not significantly different. We did not prove a relationship between these dietary factors and either bronchial responsiveness or chronic respiratory symptoms. Although we consider that our questionnaire is more reliable than other methods for Na+ and K+ assessment, several potential biases still remain.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7613539

  18. Children, Sports, and Chronic Disease.

    Science.gov (United States)

    Goldberg, Barry

    1990-01-01

    Discusses four chronic diseases (cystic fibrosis, congenital heart disease, rheumatoid arthritis, and asthma) that affect American children. Many have their physical activities unnecessarily restricted, though sports and exercise can actually alleviate symptoms and improve their psychosocial development. Physicians are encouraged to prescribe…

  19. Nature and frequency of respiratory involvement in chronic progressive external ophthalmoplegia

    NARCIS (Netherlands)

    Smits, B.W.; Heijdra, Y.F.; Cuppen, F.; Engelen, B.G. van

    2011-01-01

    Chronic progressive external ophthalmoplegia (CPEO) is a relatively common mitochondrial disorder. Weakness of the extra-ocular, limb girdle and laryngeal muscles are established clinical features. Respiratory muscle involvement however has never been studied systematically, even though respiratory

  20. The role of hyaluronan in the pathobiology and treatment of respiratory disease.

    Science.gov (United States)

    Garantziotis, Stavros; Brezina, Martin; Castelnuovo, Paolo; Drago, Lorenzo

    2016-05-01

    Hyaluronan, a ubiquitous naturally occurring glycosaminoglycan, is a major component of the extracellular matrix, where it participates in biological processes that include water homeostasis, cell-matrix signaling, tissue healing, inflammation, angiogenesis, and cell proliferation and migration. There are emerging data that hyaluronan and its degradation products have an important role in the pathobiology of the respiratory tract. We review the role of hyaluronan in respiratory diseases and present evidence from published literature and from clinical practice supporting hyaluronan as a novel treatment for respiratory diseases. Preliminary data show that aerosolized exogenous hyaluronan has beneficial activity against airway inflammation, protects against bronchial hyperreactivity and remodeling, and disrupts the biofilm associated with chronic infection. This suggests a role in airway diseases with a predominant inflammatory component such as rhinosinusitis, asthma, chronic obstructive pulmonary disease, cystic fibrosis, and primary ciliary dyskinesia. The potential for hyaluronan to complement conventional therapy will become clearer when data are available from controlled trials in larger patient populations. PMID:26747781

  1. The role of hyaluronan in the pathobiology and treatment of respiratory disease.

    Science.gov (United States)

    Garantziotis, Stavros; Brezina, Martin; Castelnuovo, Paolo; Drago, Lorenzo

    2016-05-01

    Hyaluronan, a ubiquitous naturally occurring glycosaminoglycan, is a major component of the extracellular matrix, where it participates in biological processes that include water homeostasis, cell-matrix signaling, tissue healing, inflammation, angiogenesis, and cell proliferation and migration. There are emerging data that hyaluronan and its degradation products have an important role in the pathobiology of the respiratory tract. We review the role of hyaluronan in respiratory diseases and present evidence from published literature and from clinical practice supporting hyaluronan as a novel treatment for respiratory diseases. Preliminary data show that aerosolized exogenous hyaluronan has beneficial activity against airway inflammation, protects against bronchial hyperreactivity and remodeling, and disrupts the biofilm associated with chronic infection. This suggests a role in airway diseases with a predominant inflammatory component such as rhinosinusitis, asthma, chronic obstructive pulmonary disease, cystic fibrosis, and primary ciliary dyskinesia. The potential for hyaluronan to complement conventional therapy will become clearer when data are available from controlled trials in larger patient populations.

  2. Chronic Mountain Sickness (CMS,Monge's Disease) of the respiratory type:an open debate of scoring systems used for its diagnosis

    Institute of Scientific and Technical Information of China (English)

    Dante Penaloza,M.D.

    2004-01-01

    @@ Professor Monge M. was the first to describe the clinical picture of CMS (16). In the intervening seventy years, the symptoms and signs of the disease with some variants have been described in case reports and case series published in South America, Asia, and North America.

  3. Chronic diseases and mental disorder.

    OpenAIRE

    Verhaak, P.F.M.; Heijmans, M.J.W.M.; L. Peters; Rijken, M.

    2005-01-01

    The aim of this study was to achieve a better understanding of the relationship between chronic medical illness and mental distress. Therefore, the association between chronic medical illness and mental distress was analysed, taking into account the modifying effects of generic disease characteristics (concerning course, control and possible stressful consequences), physical quality of life indicators and social and relationship problems. Panel data from the Dutch national Panel of Patients w...

  4. Progression from respiratory dysfunction to failure in late-onset Pompe disease.

    Science.gov (United States)

    Berger, Kenneth I; Chan, Yinny; Rom, William N; Oppenheimer, Beno W; Goldring, Roberta M

    2016-08-01

    To identify determinants of respiratory disease progression in late-onset Pompe disease (LOPD), we studied relationships between pulmonary function, respiratory muscle strength, gas exchange, and respiratory control. Longitudinal evaluation of 22 LOPD patients (mean age 38 years) was performed at 6-month intervals for 6-24 months. Measurements included vital capacity (VC), maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), tidal volume (VT), dead space (VD), and ventilatory response to CO2. Although reduction in VC correlated with MIP and MEP (p respiratory failure, is tightly linked to the degree of respiratory muscle weakness and severity of pulmonary dysfunction in LOPD patients. Reductions in CO2 clearance efficiency and ventilatory responsiveness may contribute to the development of chronic daytime hypercapnia.

  5. An association between Helicobacter pylori and upper respiratory tract disease: fact or fiction?

    Science.gov (United States)

    Kariya, Shin; Okano, Mitsuhiro; Nishizaki, Kazunori

    2014-02-14

    Helicobacter pylori (H. pylori) is a major cause of chronic gastritis and gastric ulcers and considerable evidence supports the notion that infection with this bacterium is also associated with gastric malignancy in addition to various other conditions including pulmonary, vascular and autoimmune disorders. Gastric juice infected with H. pylori might play an important role in upper respiratory tract infection. Although direct and/or indirect mechanisms might be involved in the association between H. pylori and upper respiratory tract diseases, the etiological role of H. pylori in upper respiratory tract disorders has not yet been fully elucidated. Although various studies over the past two decades have suggested a relationship between H. pylori and upper respiratory tract diseases, the findings are inconsistent. The present overview describes the outcomes of recent investigations into the impact of H. pylori on upper respiratory tract and adjacent lesions.

  6. An open randomized controlled trial of noninvasive positive pressure ventilation in patients of acute on chronic hypercapnic respiratory failure in a general respiratory ward setting

    Directory of Open Access Journals (Sweden)

    Prasad R

    2007-01-01

    Full Text Available Objective : To compare the standard medical therapy (SMT and noninvasive posi-tive pressure ventilation (NPPV in acute on chronic hypercapnic respiratory fail-ure due to exacerbation of chronic obstructive pulmonary disease (COPD. Method : Between June 2002 and May 2003, 19 patients with acute on chronic hypercapnic respiratory failure were prospectively and randomly recruited to re-ceive either SMT (n=10 or NPPV plus SMT (n=9 in a general respiratory ward and followed up after 4 to 6 weeks after discharge. NPPV was given with a silicone cushioned nasal mask via a bilevel ventilator with initial pressure support of 5 cm of H 2 O. Results : At the time of randomization there was no significant difference in respiratory rate, PaO 2 , PaCO 2 , pH and HCO3 - , between the two groups. At 2 hours with SMT, there was significant improvement only in respiratory rate (p = 0.0000 and PaO 2 (p=0.0014. However with NPPV, respiratory rate (p=0.0000, PaO2 (p=0.0011, pH (0.0002, pulse rate (p=0.0329 and mean arterial pressure (p=0.0096 improved significantly at 2 hours while PaCO2 (p=0.0008 significantly improved at24 hours. Hospital stay was significantly shorter for NPPV group as compared to SMT group (9.63 + 1.4 days vs. 13.33 + 4.69 days, p < 0.05. There was 1 failure (12.5% in NPPV group as compared to 2 failures (20% in SMT group of which one was salvaged by NPPV. Conclusion : The study suggests that early application of NPPV in acute on chronic hypercapnic respiratory failure due to COPD facilitates improvement, favors early mobiliation and discharge from hospital.

  7. The Efficacy of Supervised Home-based Pulmonary Rehabilitation in Patients with Chronic Respiratory Disorders

    Directory of Open Access Journals (Sweden)

    İpek Candemir

    2015-12-01

    Full Text Available Objective: Pulmonary rehabilitation (PR programs can be carried out in hospital or home basis with a different organizational aspect and program content. This study aimed to evaluate the efficacy of a multidisciplinary supervised home-based PR program in patients with chronic respiratory disorders. Methods: Forty patients with chronic respiratory disorders who admitted to our center between September 2007 and May 2012 were enrolled. In all patients before and after PR, dyspnea was assessed with Medical Research Council (MRC dyspnea scale, exercise capacity with Incremental Shuttle Walk Test (ISWT and Endurance Shuttle Walk Test (ESWT, health related quality of life with St. Geoerge Respiratory Questionnaire (SGRQ, psychosocial evaluation with hospital anxiety and depression scale (HAD, the body composition with bioelectrical impedance method. Ten patients did not complete home-based PR for various reasons. Results: In patients with Chronic Obstructive Pulmonary Disease (COPD, dyspnea sensation (p=0.026, exercise capacity (p=0.001, quality of life (p=0.001, body composition (p=0.012, anxiety and depression score (p=0.001 improvements were statistically significant. In all patients with COPD and non-COPD perception of dyspnea, exercise capacity, quality of life, anxiety and depression score improvements were above minimal clinically important differences. Conclusion: In this study supervised home-based pulmonary rehabilitation has been shown as an effective and safe modality when applied by an experiencied and multidisciplinary team in selected severe COPD or non-COPD patients.

  8. Social position and mortality from respiratory diseases in males and females

    DEFF Research Database (Denmark)

    Prescott, E; Godtfredsen, N; Vestbo, J;

    2003-01-01

    Although social differences in respiratory diseases are considerable, few studies have focused on this disease entity using mortality as an outcome. Does mortality from respiratory disease, including chronic obstructive pulmonary disease (COPD) differ with social position measured by education......). Although smoking rates were inversely associated with the level of education, the social gradient was not affected by adjustment for smoking. In males, but not in females, there was an additional effect of other indicators of social position, i.e. employment grade (white collar versus blue collar...... disease, which is independent of smoking and is stronger in males. Social disadvantage is a potentially avoidable cause of death from respiratory disease and further research is needed to explain the excess risk in the socioeconomically disadvantaged....

  9. Total inspiratory and expiratory impedance in patients with severe chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Karla Kristine Dames Silva

    2011-01-01

    Full Text Available OBJECTIVES: Several studies have confirmed the high potential of the forced oscillation technique for the assessment of respiratory modifications related to chronic obstructive pulmonary disease. However, most of these studies did not employ within-breath analyses of the respiratory system. The aim of this study is to analyze respiratory impedance alterations in different phases of the respiratory cycle of chronic obstructive pulmonary disease patients and to evaluate their clinical use. METHODS: 39 individuals were evaluated, including 20 controls and 19 individuals with chronic obstructive pulmonary disease who experienced severe airway obstruction.Weevaluated the mean respiratory impedance (Zm as well as values for inspiration (Zi and expiration cycles (Ze, at the beginning of inspiration (Zbi and expiration (Zbe. The peak-to-peak impedance (Zpp, and the impedance change (DZrs were also analyzed. The clinical usefulness was evaluated by investigating the sensibility, specificity and the area under the receiver operating characteristic curve. RESULTS: The respiratory impedance increased in individuals with chronic obstructive pulmonary disease in all of the studied parameters (Zm, Zi, Ze, Zbi, Zbe, DZrs and Zpp. These changes were inversely associated with spirometric parameters. Higher impedanceswere observed in the expiratory phase of individualswith chronic obstructive pulmonary disease. All of the studied parameters, except for DZrs (area under the receiver operating characteristic ,0.8, exhibited high accuracy for clinical use (area under the receiver operating characteristic .0.90; Sensibility $ 0.85; Sp $ 0.85. CONCLUSIONS: The respiratory alterations in severe chronic obstructive pulmonary disease may be identified by the increase in respiratory system impedance, which is more evident in the expiratory phase. These results confirm the potential of within-breath analysis of respiratory impedance for the assessment of respiratory

  10. Chronic Venous Disease under pressure

    NARCIS (Netherlands)

    S.W.I. Reeder (Suzan)

    2013-01-01

    textabstractIn chapter 1 we provide a general introduction of this thesis. Chronic venous disease (CVD) is a common medical condition that affects 2-64% of the worldwide population and leads to leg ulcers in 1% of the Western population. Venous leg ulceration (VLU) has an unfavorable prognosis with

  11. Metformin in chronic kidney disease

    DEFF Research Database (Denmark)

    Heaf, James

    2014-01-01

    Metformin has traditionally been regarded as contraindicated in chronic kidney disease (CKD), though guidelines in recent years have been relaxed to permit therapy if the glomerular filtration rate (GFR) is > 30 mL/min. The main problem is the perceived risk of lactic acidosis (LA). Epidemiological...

  12. Gastroesophageal reflux and respiratory diseases in children

    International Nuclear Information System (INIS)

    The association of gastroesophageal reflux disease and its pulmonary manifestation is well known however the exact underlying mechanism is unclear. The medical literature is deluged with studies on relationship between Gear and its pulmonary manifestations. The aim of this study was to 1) determine prevalence of GER in children with rLRTI, wheezing and asthma. 2) determine prevalence of asymptomatic respiratory anomalies in children with clinical reflux 3) determine effectiveness of anti-reflux therapy in clinical control of asthma, wheezing and rLRTI. Children were included in the study if they presented either with rLRTI, wheezing, Bronchial asthma or Clinical suspicion of GER without any respiratory symptoms. The GER study comprised esophageal transit, gastroesophageal reflux and lung aspiration studies. Acquisition and processing were according to predetermined protocol. Segmental and global esophageal transit times, GER according to duration of episode and volume of refluxed liquid, Reflux severity, Gastric retention at 30 minutes, Gastric emptying time, Presence of lung aspiration were calculated for each study. All children underwent Barium studies on a separate day. Clinical follow-up was done every 3 months and GER study was repeated every 6 months up to one year. The patient's therapy was determined by local protocols at discretion of clinicians. GER scintigraphy was performed in 43 patients (age range 5 months -12 years). Gastroesophageal reflux of varying degrees was observed in 10 children (23.25%) in all groups. The severity of clinical symptoms was directly related to severity of GER. The direct correlation was found between GER and reflux index. The results of GER scintigraphy were compared with Barium studies and results were found to be superior in terms of sensitivity, specificity and accuracy in detecting disease. It was possible to objectively evaluate and monitor response to therapy after medical treatment in few cases with help of follow

  13. The effect of maternal nutrition on the developmental origins of respiratory disease

    OpenAIRE

    Davis, Shelley A.

    2011-01-01

    Environmental challenges during early life have been shown to result in greater risk of chronic diseases such as diabetes and coronary disease in later life. Factors such as unbalanced nutrition before birth result in metabolic and structural adaptations that lead to persistent modifications to offspring phenotype. There is evidence that respiratory disease is influenced by developmental environment. Reduced fetal growth is associated with impaired lung development, increasing risk of develop...

  14. Screening for Common Respiratory Diseases among Israeli Adolescents

    OpenAIRE

    Yaron Bar Dayan; Keren Elishkevits; Liav Goldstein; Avishay Goldberg; Michel Fichler; Nisim Ohana; Yehezkel Levi; Yosefa Bar Dayan

    2004-01-01

    BACKGROUND: Respiratory diseases are responsible for a significant proportion of serious morbidity among adolescents. There are few reports on the prevalence of common respiratory disorders in this population. The previous studies focused on specific diseases and screened relatively small samples.OBJECTIVE: To define the prevalence of different common respiratory disorders among 17-year-old Israeli conscripts.DESIGN: All 17-year-old Israeli nationals are obliged by law to appear at the Israel...

  15. Update on Recent Advances in the Management of Aspirin Exacerbated Respiratory Disease

    OpenAIRE

    Palikhe, Nami Shrestha; Kim, Joo-Hee; Park, Hae-Sim

    2009-01-01

    Aspirin intolerant asthma (AIA) is frequently characterized as an aspirin (ASA)-exacerbated respiratory disease (AERD). It is a clinical syndrome associated with chronic severe inflammation in the upper and lower airways resulting in chronic rhinitis, sinusitis, recurrent polyposis, and asthma. AERD generally develops secondary to abnormalities in inflammatory mediators and arachidonic acid biosynthesis expression. Upper and lower airway eosinophil infiltration is a key feature of AERD; howev...

  16. Sequential mechanical ventilation in chronic obstructive pulmonary disease with concomitant respiratory failure%序贯机械通气在慢性阻塞性肺疾病并呼吸衰竭中的应用

    Institute of Scientific and Technical Information of China (English)

    林卫涵; 吴卫锋; 陈颖丰; 罗书裕

    2013-01-01

    目的:探讨序贯机械通气在慢性阻塞性肺疾病(COPD)合并呼吸衰竭中的应用价值.方法:收集2011年4月至2013年2月广东省揭阳市人民医院收治的40例COPD合并呼吸衰竭的患者作为研究对象,随机分为序贯组(序贯机械通气)和传统组(有创机械通气),每组20例.比较两组生命体征、血气分析、呼吸机参数、呼吸机相关性肺炎发生率、死亡率、有创机械通气时间、住ICU时间、住院费用等指标.结果:两组患者生命体征、血气分析、呼吸机参数比较,差异无统计学意义(P>0.05).序贯组有创机械通气时间、ICU入住时间、住院费用、呼吸机相关性肺炎发生率、死亡率均少于传统组(P<0.05).结论:对于COPD合并严重呼吸衰竭,序贯机械通气可降低呼吸机相关性肺炎发生率和死亡率下降,缩短有创机械通气时间、ICU入住时间,减少住院费用,是较好的机械通气策略.%Objective:To investigate the value of sequential mechanical ventilation in patients with chronic obstructive pulmonary disease (COPD) and concomitant respiratory failure.Methods:A total of 40 patients with COPD and concomitant respiratory failure admitted to Guangdong Jieyang People' s Hospital between April 2011 and February 2013 were randomly assigned to receive sequential mechanical ventilation (sequential ventilation group,n =20) or invasive mechanical ventilation (conventional ventilation group,n =20).The vital signs,blood-gas analysis indices,parameters of respirator,incidence of respirator-associated pneumonia,mortality,duration of invasive mechanical ventilation,length of ICU stay and cost of hospital stay were compared.Results:The difference in vital signs,blood-gas analysis indices and parameters of respirator was unremarkable (all P >0.05).Sequential ventilation group was associated with reduced incidence of respirator-associated pneumonia,mortality,duration of invasive mechanical ventilation,length of ICU

  17. Determining the Role of Dynamic Hyperinflation in Patients with Severe Chronic Obstructive Pulmonary Disease

    NARCIS (Netherlands)

    Klooster, Karin; ten Hacken, Nick H. T.; Hartman, Jorine E.; Sciurba, Frank C.; Kerstjens, Huib A. M.; Slebos, Dirk-Jan

    2015-01-01

    Background: Dynamic hyperinflation due to increased respiratory frequency during exercise is associated with limitations in exercise capacity in patients with moderately severe chronic obstructive pulmonary disease (COPD). Objectives: The present study assessed whether the manually paced tachypnea (

  18. Regional chest wall volumes during exercise in chronic obstructive pulmonary disease

    OpenAIRE

    Aliverti, A; Stevenson, N.; Dellaca, R; Lo, M.; A. Pedotti; Calverley, P

    2004-01-01

    Background: Dynamic hyperinflation of the lungs impairs exercise performance in chronic obstructive pulmonary disease (COPD). However, it is unclear which patients are affected by dynamic hyperinflation and how the respiratory muscles respond to the change in lung volume.

  19. Respiratory Diseases in Children: studies in general practice

    NARCIS (Netherlands)

    J.H.J.M. Uijen (Hans)

    2011-01-01

    textabstractThe work presented in this thesis covers various aspects of the epidemiology, diagnosis and management of various respiratory symptoms and diseases in children frequently encountered in general practice. These respiratory tract symptoms and diseases can be categorized into symptoms and d

  20. Animal models of human respiratory syncytial virus disease

    NARCIS (Netherlands)

    R.A. Bem; J.B. Domachowske; H.F. Rosenberg

    2011-01-01

    Infection with the human pneumovirus pathogen, respiratory syncytial virus (hRSV), causes a wide spectrum of respiratory disease, notably among infants and the elderly. Laboratory animal studies permit detailed experimental modeling of hRSV disease and are therefore indispensable in the search for n

  1. Respiratory system impedance from 4 to 40 Hz in paralyzed intubated infants with respiratory disease.

    OpenAIRE

    Dorkin, H L; Stark, A. R.; Werthammer, J W; Strieder, D J; Fredberg, J.J.; Frantz, I D

    1983-01-01

    To describe the mechanical characteristics of the respiratory system in intubated neonates with respiratory disease, we measured impedance and resistance in six paralyzed intubated infants with respiratory distress syndrome, three of whom also had pulmonary interstitial emphysema. We subtracted the effects of the endotracheal tube after showing that such subtraction was valid. Oscillatory flow was generated from 4 to 40 Hz by a loudspeaker, airway pressure was measured, and flow was calculate...

  2. Chronic Lyme disease: a review.

    Science.gov (United States)

    Marques, Adriana

    2008-06-01

    Studies have shown that most patients diagnosed with chronic Lyme disease either have no objective evidence of previous or current infection with Borrelia burgdorferi or are patients who should be classified as having post-Lyme disease syndrome, which is defined as continuing or relapsing nonspecific symptoms (such as fatigue, musculoskeletal pain, and cognitive complaints) in a patient previously treated for Lyme disease. Despite extensive study, there is currently no clear evidence that post-Lyme disease syndrome is caused by persistent infection with B burgdorferi. Four randomized placebo-controlled studies have shown that antibiotic therapy offers no sustained benefit to patients who have post-Lyme disease syndrome. These studies also showed a substantial placebo effect and a significant risk of treatment-related adverse events. Further research to elucidate the mechanisms underlying persistent symptoms after Lyme disease and controlled trials of new approaches to the treatment and management of these patients are needed.

  3. Perspectives on "chronic Lyme disease".

    Science.gov (United States)

    Baker, Phillip J

    2008-07-01

    There is much controversy about the treatment of Lyme disease with respect to 2 poorly defined entities: "chronic Lyme disease" and "posttreatment Lyme disease syndrome." In the absence of direct evidence that these conditions are the result of a persistent infection, some mistakenly advocate extended antibiotic therapy (>/=6 months), which can do great harm and has resulted in at least 1 death. The purpose of this brief report is to review what is known from clinical research about these conditions to assist both practicing physicians and lawmakers in making sound and safe decisions with respect to treatment.

  4. [Mucolytics in acute and chronic respiratory tract disorders. II. Uses for treatment and antioxidant properties].

    Science.gov (United States)

    Kupczyk, Maciej; Kuna, Piotr

    2002-03-01

    In the first part of our editorial we reviewed the possible factors responsible for mucus hypersecretion in acute and chronic pulmonary diseases. The present paper presents the results of studies proving, that mucolytics are useful in adjunctive therapy of respiratory tract disorders. Mucolytic agents such as Ambroxol and N-acetylcysteine are able to alter the secretion of mucus and its physical properties which results in improvement of mucociliary clearance. Current evidence indicate, that these drugs are effective, especially in chronic obstructive pulmonary disease, asthma and acute bronchitis. They produce a modest improvement in symptom control and lung function. It has been demonstrated that there is a synergism between mucolytics and antibiotics in the treatment of exacerbation of chronic bronchitis. Moreover, they act as scavengers of reactive oxygen species. Ambroxol is able to inhibit mediator release involved in the pathogenesis of allergic inflammation. As mucolytics are cheap and well-tolerated they are beneficial in the therapy of patients suffering from respiratory tract disorders. PMID:12053601

  5. [Prognostic factors for COPD patients with chronic hypercapnic respiratory failure and home ventilation].

    Science.gov (United States)

    Budweiser, S; Jörres, R A; Heinemann, F; Pfeifer, M

    2009-09-01

    The prevalence of patients with severe COPD and chronic hypercapnic respiratory failure (CHRF) receiving non-invasive home ventilation has greatly increased. With regard to disease severity, a multidimensional assessment seems indicated. Base excess (BE), in particular, reflects the long-term metabolic response to chronic hypercapnia and thus constitutes a promising, easily accessible, integrative marker of CHRF. Infact, BE as well as nutritional status and lung hyperinflation have been identified as independent predictors of long-term survival. In addition and in a review with the literature, a broad panel of indices including frequent comorbidities are helpful for assessment and monitoring purposes of patients with CHRF. Accordingly, in view of the patients' individual risk profile, the decision about the initiation of NIV should probably not rely solely on symptoms and chronic persistent hypercapnia but include a spectrum of factors that specifically reflect disease severity. Owing to the physiologically positive effects of NIV and according to retrospective data, patients with COPD and recurrent hypercapnic respiratory decompensation and patients with prolonged mechanical ventilation and/or difficult weaning could also be considered for long-term non-invasive ventilation. This, however, has to be corroborated in future prospective trials. PMID:19750411

  6. Usefulness of targeting lymphocyte Kv1.3-channels in the treatment of respiratory diseases.

    Science.gov (United States)

    Kazama, Itsuro; Tamada, Tsutomu; Tachi, Masahiro

    2015-10-01

    T lymphocytes predominantly express delayed rectifier K(+)-channels (Kv1.3) in their plasma membranes. Patch-clamp studies revealed that the channels play crucial roles in facilitating the calcium influx necessary to trigger lymphocyte activation and proliferation. Using selective channel inhibitors in experimental animal models, in vivo studies further revealed the clinically relevant relationship between the channel expression and the development of chronic respiratory diseases, in which chronic inflammation or the overstimulation of cellular immunity in the airways is responsible for the pathogenesis. In chronic respiratory diseases, such as chronic obstructive pulmonary disease, asthma, diffuse panbronchiolitis and cystic fibrosis, in addition to the supportive management for the symptoms, the anti-inflammatory effects of macrolide antibiotics were shown to be effective against the over-activation or proliferation of T lymphocytes. Recently, we provided physiological and pharmacological evidence that macrolide antibiotics, together with calcium channel blockers, HMG-CoA reductase inhibitors, and nonsteroidal anti-inflammatory drugs, effectively suppress the Kv1.3-channel currents in lymphocytes, and thus exert anti-inflammatory or immunomodulatory effects. In this review article, based on the findings obtained from recent in vivo and in vitro studies, we address the novel therapeutic implications of targeting the lymphocyte Kv1.3-channels for the treatment of chronic or acute respiratory diseases.

  7. Shrinking the room for invasive mechanical ventilation in acute chronic hypercapnic respiratory failure: yes, but must be sure to have opened windows for noninvasive ventilation

    OpenAIRE

    Esquinas, Antonio M.

    2013-01-01

    Antonio M Esquinas Rodriguez,1 Rafaelle Scala,2 Nicolino Ambrosino31International Fellow AARC, Intensive Care Unit, Hospital Morales Meseguer, Murcia, Spain; 2Respiratory Ward and Respiratory Intensive Care Unit, S, Donato Hospital, Arezzo, Italy; 3Pulmonary and Respiratory Intensive Care Unit, Cardio-Thoracic Department, University Hospital Pisa, Pisa, ItalyIn the last decade, the treatment and prognosis of chronic obstructive pulmonary disease (COPD) patients have been improved by noninvasi...

  8. Risk Factors for Chronic Kidney Disease

    Science.gov (United States)

    ... Materials Webinars Tips & Stories Links & Resources Learn About Chronic Kidney Disease Kidney Glossary Ask Our Expert Toll-Free Helpline: ... Questions What You Can Do Download all the chronic kidney disease information presented here. Preview Our CKD Booklets Stage ...

  9. Respiratory plasticity in the behaving rat following chronic intermittent hypoxia.

    Science.gov (United States)

    Edge, Deirdre; Skelly, J Richard; Bradford, Aidan; O'Halloran, Ken D

    2010-01-01

    Chronic intermittent hypoxia (CIH), a feature of obstructive sleep apnoea (OSA) has been shown to have myriad effects on the respiratory control system. The effects on breathing are of great clinical significance for the sleep apnoea patient. We sought to determine the effect of CIH on normoxic ventilation. Both male and female adult Wistar rats were studied due to the evident sex difference in the prevalence of OSA. A role for oxidative stress in respiratory modifications was also explored. Adult male (n = 30) and female (n = 16) rats were exposed to alternating periods of N(2) and O(2) for 90 s each, bringing the ambient oxygen concentration to 5% at nadir (CIH) group. Sham groups were subject to cycles of air/air under identical experimental conditions. A subset of male rats (8 controls, 8 CIH) had free access to water containing 1 mM Tempol (SOD-mimetic) at all times. Treatments were carried out for 8 hours a day for 9 days. Following treatment, normoxic ventilation was assessed by whole body plethysmography in sleeping animals. Baseline normoxic ventilation was increased in both male and female treated rats but this did not achieve statistical significance. However, ventilatory drive (V(T)/Ti) was significantly increased in male rats. Chronic treatment with Tempol abolished this effect. Conversely, CIH had no significant effect on VT/Ti in female rats. Our results indicate subtle effects of intermittent hypoxia on breathing in conscious behaving rats. We speculate the increased ventilatory drive following CIH represents a form a neural plasticity - a ROS dependent phenomenon - with sexual dimorphism. PMID:20217363

  10. The pathology of chronic obstructive pulmonary disease.

    Science.gov (United States)

    Hogg, James C; Timens, Wim

    2009-01-01

    The pathogenesis of chronic obstructive pulmonary disease (COPD) is based on the innate and adaptive inflammatory immune response to the inhalation of toxic particles and gases. Although tobacco smoking is the primary cause of this inhalation injury, many other environmental and occupational exposures contribute to the pathology of COPD. The immune inflammatory changes associated with COPD are linked to a tissue-repair and -remodeling process that increases mucus production and causes emphysematous destruction of the gas-exchanging surface of the lung. The common form of emphysema observed in smokers begins in the respiratory bronchioles near the thickened and narrowed small bronchioles that become the major site of obstruction in COPD. The mechanism(s) that allow small airways to thicken in such close proximity to lung tissue undergoing emphysematous destruction remains a puzzle that needs to be solved. PMID:18954287

  11. Pericytes in chronic lung disease.

    Science.gov (United States)

    Rowley, Jessica E; Johnson, Jill R

    2014-01-01

    Pericytes are mesenchymal cells embedded within the abluminal surface of the endothelium of microvessels such as capillaries, pre-capillary arterioles, post-capillary and collecting venules, where they maintain microvascular homeostasis and participate in angiogenesis. In addition to their roles in supporting the vasculature and facilitating leukocyte extravasation, pericytes have been recently investigated as a subpopulation of mesenchymal stem cells (MSCs) due to their capacity to differentiate into numerous cell types including the classic MSC triad, i.e. osteocytes, chondrocytes and adipocytes. Other studies in models of fibrotic inflammatory disease of the lung have demonstrated a vital role of pericytes in myofibroblast activation, collagen deposition and microvascular remodelling, which are hallmark features of chronic lung diseases such as asthma, chronic obstructive pulmonary disorder, pulmonary fibrosis and pulmonary hypertension. Further studies into the mechanisms of the pericyte-to-myofibroblast transition and migration to fibrotic foci will hopefully clarify the role of these cells in chronic lung disease and confirm the importance of pericytes in human fibrotic pulmonary disease. PMID:25034005

  12. Recurrent Respiratory Papillomatosis Causing Chronic Stridor and Delayed Speech in an 18-Month-Old Boy

    Directory of Open Access Journals (Sweden)

    Adel Alharbi

    2006-01-01

    Full Text Available Recurrent respiratory papillomatosis is a relatively uncommon disease that presents clinically with symptoms ranging from hoarseness to severe dyspnea. Human papilloma virus types 6 and 11 are important in the etiology of papillomas and are most probably transmitted from mother to child during birth. Although spontaneous remission is frequent, pulmonary spread and/or malignant transformation resulting in death has been reported. CO2 laser evaporation of papillomas and adjuvant drug therapy using lymphoblastoid interferon-alpha are the most common treatments. However, several other treatments have been tried, with varying success. In the present report, a case of laryngeal papillomatosis presenting with chronic stridor and delayed speech is described.

  13. [Mucolytics in acute and chronic respiratory tract disorders. I. Pathophysiology and mechanisms of action].

    Science.gov (United States)

    Kupczyk, Maciej; Kuna, Piotr

    2002-03-01

    Mucus hypersecretion is a cardinal sign of both acute and chronic pulmonary diseases. Normally, mucus protects respiratory tract, but its overproduction leads to airway obstruction and promotes bacterial colonization. In the first part of our review we outlined the possible factors responsible for mucus hypersecretion and clinical consequences of this process. Mucolytic agents such as Ambroxol and N-acetylcysteine are able to alter the secretion of mucus and its physical properties which results in improvement of mucociliary clearance. Mechanisms of action and indications for use of mucolytics are presented. Mucolytics have been shown to have a role in improving lung functions and patients' quality of life. Undoubtedly they are useful as an adjunctive therapy of respiratory tract disorders. PMID:12053600

  14. Respiratory diseases and the impact of cough in Taiwan: Results from the APBORD observational study.

    Science.gov (United States)

    Lin, Horng-Chyuan; Cho, Sang-Heon; Ghoshal, Aloke Gopal; Muttalif, Abdul Razak Bin Abdul; Thanaviratananich, Sanguansak; Bagga, Shalini; Faruqi, Rab; Sajjan, Shiva; Cahill, Camilla L; Hamrosi, Kim K; Wang, De Yun

    2016-07-01

    Chronic respiratory diseases such as asthma, allergic rhinitis (AR), chronic obstructive pulmonary disease (COPD), and rhinosinusitis are becoming increasingly prevalent in the Asia-Pacific region. The Asia-Pacific Burden of Respiratory Diseases (APBORD) study was a cross-sectional, observational study which examined the disease and economic burden of AR, asthma, COPD, and rhinosinusitis across Asia-Pacific using 1 standard protocol. Here we report symptoms, healthcare resource use (HCRU), work impairment, and associated cost in Taiwan.Consecutive participants aged ≥ 18 years presenting to a physician with symptoms meeting the diagnostic criteria for a primary diagnosis of asthma, AR, COPD, or rhinosinusitis were enrolled. Participants and their treating physician completed surveys detailing respiratory symptoms, HCRU, work productivity, and activity impairment. Costs including direct medical costs and indirect costs associated with lost work productivity were calculated.The study enrolled 1001 patients. AR was the most frequent primary diagnosis (31.2%). A quarter of patients presented with a combination of respiratory diseases, with AR and asthma being the most frequent combination (14.1%). Cough or coughing up phlegm was the primary reason for the medical visit for patients with asthma and COPD, whereas nasal symptoms (watery runny nose, blocked nose, and congestion) were the primary reasons for AR and rhinosinusitis. Specialists were the most frequently used healthcare resource by patients with AR (26.1%), asthma (26.4%), COPD (26.6%), and rhinosinusitis (47.3%). The mean annual cost per patient with a respiratory disease was US$4511 (SD 5395). The cost was almost double for employed patients (US$8047, SD 6175), with the majority attributable to lost productivity.Respiratory diseases have a significant impact on disease burden in Taiwan. Treatment strategies that prevent lost work productivity could greatly reduce the economic burden of these diseases. PMID

  15. Respiratory diseases and the impact of cough in Taiwan: Results from the APBORD observational study.

    Science.gov (United States)

    Lin, Horng-Chyuan; Cho, Sang-Heon; Ghoshal, Aloke Gopal; Muttalif, Abdul Razak Bin Abdul; Thanaviratananich, Sanguansak; Bagga, Shalini; Faruqi, Rab; Sajjan, Shiva; Cahill, Camilla L; Hamrosi, Kim K; Wang, De Yun

    2016-07-01

    Chronic respiratory diseases such as asthma, allergic rhinitis (AR), chronic obstructive pulmonary disease (COPD), and rhinosinusitis are becoming increasingly prevalent in the Asia-Pacific region. The Asia-Pacific Burden of Respiratory Diseases (APBORD) study was a cross-sectional, observational study which examined the disease and economic burden of AR, asthma, COPD, and rhinosinusitis across Asia-Pacific using 1 standard protocol. Here we report symptoms, healthcare resource use (HCRU), work impairment, and associated cost in Taiwan.Consecutive participants aged ≥ 18 years presenting to a physician with symptoms meeting the diagnostic criteria for a primary diagnosis of asthma, AR, COPD, or rhinosinusitis were enrolled. Participants and their treating physician completed surveys detailing respiratory symptoms, HCRU, work productivity, and activity impairment. Costs including direct medical costs and indirect costs associated with lost work productivity were calculated.The study enrolled 1001 patients. AR was the most frequent primary diagnosis (31.2%). A quarter of patients presented with a combination of respiratory diseases, with AR and asthma being the most frequent combination (14.1%). Cough or coughing up phlegm was the primary reason for the medical visit for patients with asthma and COPD, whereas nasal symptoms (watery runny nose, blocked nose, and congestion) were the primary reasons for AR and rhinosinusitis. Specialists were the most frequently used healthcare resource by patients with AR (26.1%), asthma (26.4%), COPD (26.6%), and rhinosinusitis (47.3%). The mean annual cost per patient with a respiratory disease was US$4511 (SD 5395). The cost was almost double for employed patients (US$8047, SD 6175), with the majority attributable to lost productivity.Respiratory diseases have a significant impact on disease burden in Taiwan. Treatment strategies that prevent lost work productivity could greatly reduce the economic burden of these diseases.

  16. Chronic mucus hypersecretion

    DEFF Research Database (Denmark)

    Harmsen, L; Thomsen, S F; Sylvan Ingebrigtsen, Truls;

    2010-01-01

    Chronic mucus hypersecretion (CMH) is a common condition in patients with chronic respiratory diseases. Little is known about the incidence, prevalence and determinants of CMH in younger individuals....

  17. Vouchers for chronic disease care.

    Science.gov (United States)

    Watts, Jennifer J; Segal, Leonie

    2008-08-01

    This paper explores the economic implications of vouchers for chronic disease management with respect to achieving objectives of equity and efficiency. Vouchers as a payment policy instrument for health care services have a set of properties that suggest they may address both demand-side and supply-side issues, and contribute to equity and efficiency. They provide a means whereby health care services can be targeted at selected groups, enabling consumer choice of provider, and encouraging competition in the supply of health services. This analysis suggests that, when structured appropriately, vouchers can support consumers to choose services that will meet their health care needs and encourage competition among providers. Although they may not be appropriate across the entire health care system, there are features of vouchers that make them a potentially attractive option, especially for the management of chronic disease.

  18. Endothelins in chronic liver disease

    DEFF Research Database (Denmark)

    Møller, S; Henriksen, Jens Henrik Sahl

    1996-01-01

    This review describes recent progress in the accumulation of knowledge about the endothelins (ETs), a family of vasoactive 21-amino acid polypeptides, in chronic liver disease. Particular prominence is given to the dynamics of ET-1 and ET-3 and their possible relation to the disturbed circulation...... renal failure. Studies on liver biopsies have revealed synthesis of ET-1 in hepatic endothelial and other cells, and recent investigations have identified the hepatosplanchnic system as a major source of ET-1 and ET-3 spillover into the circulation, with a direct relation to portal venous hypertension....... In addition, marked associations with disturbance of systemic haemodynamics and with abnormal distribution of blood volume have been reported. Although the pathophysiological importance of the ET system in chronic liver disease is not completely understood, similarities to other vasopressive...

  19. Tackling Africa's chronic disease burden: from the local to the global

    OpenAIRE

    Campbell Catherine; Allotey Pascale; Agyemang Charles; Unwin Nigel; de-Graft Aikins Ama; Arhinful Daniel

    2010-01-01

    Abstract Africa faces a double burden of infectious and chronic diseases. While infectious diseases still account for at least 69% of deaths on the continent, age specific mortality rates from chronic diseases as a whole are actually higher in sub Saharan Africa than in virtually all other regions of the world, in both men and women. Over the next ten years the continent is projected to experience the largest increase in death rates from cardiovascular disease, cancer, respiratory disease and...

  20. Firing patterns of muscle vasoconstrictor neurones in respiratory disease

    Directory of Open Access Journals (Sweden)

    Vaughan G Macefield

    2012-05-01

    Full Text Available Because the cardiovascular system and respiration are so intimately coupled, disturbances in respiratory control often lead to disturbances in cardiovascular control. Obstructive Sleep Apnoea (OSA, Chronic Obstructive Pulmonary Disease (COPD and Bronchiectasis (BE are all associated with a greatly elevated muscle vasoconstrictor drive (muscle sympathetic nerve activity; MSNA. Indeed, the increase in MSNA is comparable to that seen in congestive heart failure (CHF, in which the increase in MSNA compensates for the reduced cardiac output and thereby assists in maintaining blood pressure. However, in OSA – but not COPD or BE – the increase in MSNA can lead to hypertension. Here, the features of the sympathoexcitation in OSA, COPD and BE are reviewed in terms of the firing properties of post-ganglionic muscle vasoconstrictor neurones. Compared to healthy subjects with low levels of resting MSNA, single-unit recordings revealed that the augmented MSNA seen in OSA, BE, COPD and CHF were each associated with an increase in firing probability and mean firing rates of individual neurones. However, unlike patients with heart failure, all patients with respiratory disease exhibited an increase in multiple within-burst firing which, it is argued, reflects an increase in central sympathetic drive. Similar patterns to those seen in OSA, COPD and BE were seen in healthy subjects during an acute increase in muscle vasoconstrictor drive. These observations emphasise the differences by which the sympathetic nervous system grades its output in health and disease, with an increase in firing probability of active neurones and recruitment of additional neurones being the dominant mechanisms.

  1. Firing patterns of muscle vasoconstrictor neurons in respiratory disease.

    Science.gov (United States)

    Macefield, Vaughan G

    2012-01-01

    Because the cardiovascular system and respiration are so intimately coupled, disturbances in respiratory control often lead to disturbances in cardiovascular control. Obstructive Sleep Apnea (OSA), Chronic Obstructive Pulmonary Disease (COPD), and Bronchiectasis (BE) are all associated with a greatly elevated muscle vasoconstrictor drive (muscle sympathetic nerve activity, MSNA). Indeed, the increase in MSNA is comparable to that seen in congestive heart failure (CHF), in which the increase in MSNA compensates for the reduced cardiac output and thereby assists in maintaining blood pressure. However, in OSA - but not COPD or BE - the increase in MSNA can lead to hypertension. Here, the features of the sympathoexcitation in OSA, COPD, and BE are reviewed in terms of the firing properties of post-ganglionic muscle vasoconstrictor neurons. Compared to healthy subjects with low levels of resting MSNA, single-unit recordings revealed that the augmented MSNA seen in OSA, BE, COPD, and CHF were each associated with an increase in firing probability and mean firing rates of individual neurons. However, unlike patients with heart failure, all patients with respiratory disease exhibited an increase in multiple within-burst firing which, it is argued, reflects an increase in central sympathetic drive. Similar patterns to those seen in OSA, COPD, and BE were seen in healthy subjects during an acute increase in muscle vasoconstrictor drive. These observations emphasize the differences by which the sympathetic nervous system grades its output in health and disease, with an increase in firing probability of active neurons and recruitment of additional neurons being the dominant mechanisms. PMID:22654767

  2. Chronic Obstructive Pulmonary Disease Biomarkers

    Directory of Open Access Journals (Sweden)

    Tatsiana Beiko

    2016-04-01

    Full Text Available Despite significant decreases in morbidity and mortality of cardiovascular diseases (CVD and cancers, morbidity and cost associated with chronic obstructive pulmonary disease (COPD continue to be increasing. Failure to improve disease outcomes has been related to the paucity of interventions improving survival. Insidious onset and slow progression halter research successes in developing disease-modifying therapies. In part, the difficulty in finding new therapies is because of the extreme heterogeneity within recognized COPD phenotypes. Novel biomarkers are necessary to help understand the natural history and pathogenesis of the different COPD subtypes. A more accurate phenotyping and the ability to assess the therapeutic response to new interventions and pharmaceutical agents may improve the statistical power of longitudinal clinical studies. In this study, we will review known candidate biomarkers for COPD, proposed pathways of pathogenesis, and future directions in the field.

  3. Insuficiência respiratória crônica nas doenças neuromusculares: diagnóstico e tratamento Chronic respiratory failure in patients with neuromuscular diseases: diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Ilma Aparecida Paschoal

    2007-02-01

    Full Text Available As doenças neuromusculares prejudicam a renovação do ar alveolar e, por esta razão, produzem insuficiência respiratória crônica. A instalação da insuficiência respiratória pode acontecer de modo agudo, como nos traumas, ou ser lenta ou rapidamente progressiva, como na esclerose lateral amiotrófica, distrofias musculares, doença da placa mioneural, etc. O comprometimento da musculatura respiratória prejudica também a eficiência da tosse e, no estado atual da terapêutica disponível no Brasil para estes doentes, pode-se dizer que a morbimortalidade nestes indivíduos está mais associada ao fato de que eles tossem mal do que de que ventilam mal. Nesta revisão, uma breve compilação histórica procura mostrar a evolução das órteses e próteses respiratórias, desde o final do século XIX até agora, com o objetivo de apresentar as opções de máquinas disponíveis para o suporte e substituição da ventilação nas doenças neuromusculares. Além disso, são enfatizados os elementos fundamentais para o diagnóstico da hipoventilação alveolar e da falência do mecanismo protetor da tosse: história clínica, determinação do pico de fluxo da tosse, medida da pressão expiratória máxima e da pressão inspiratória máxima, espirometria em dois decúbitos (sentado e supino, oximetria de pulso, capnografia e polissonografia. São apresentados os valores limites disponíveis na literatura tanto para a indicação do suporte noturno da ventilação como para a extensão do suporte para o período diurno. As manobras para incremento da eficiência da tosse são aqui também discutidas, assim como o momento adequado para sua introdução.Neuromuscular diseases affect alveolar air exchange and therefore cause chronic respiratory failure. The onset of respiratory failure can be acute, as in traumas, or progressive (slow or rapid, as in amyotrophic lateral sclerosis, muscular dystrophies, diseases of the myoneural junction, etc

  4. Respiratory disease and the role of oral bacteria

    OpenAIRE

    Isaac S. Gomes-Filho; Passos, Johelle S.; Seixas da Cruz, Simone

    2010-01-01

    The relationship between oral health and systemic conditions, including the association between poor oral hygiene, periodontal disease, and respiratory disease, has been increasingly debated over recent decades. A considerable number of hypotheses have sought to explain the possible role of oral bacteria in the pathogenesis of respiratory diseases, and some clinical and epidemiological studies have found results favoring such an association. This review discusses the effect of oral bacteria o...

  5. [Influence of ecologic factors on respiratory diseases in urban residents of Kazakhstan Republic].

    Science.gov (United States)

    Ibrayeva, L K; Amanbekova, A U; Turgunova, L G; Lariushina, E M

    2015-01-01

    The authors studied influence of ecologic factors on respiratory diseases development in urban residents of Kazakhstan Republic. Multivariate (correlation and regression) analysis demonstrates that chronic obstructive lung disease development is contributed by high concentration of nitrogen oxide in ambient air (r = -0.75; p = 0.005) in Temirtau, Kamenogorsk and Aktau cities, high lead content of sedimented dust (r = 0.64; p = 0.02) in Temirtau, Ust'-Kamenogorsk and Ekibastuz cities.

  6. Lung VITAL: Rationale, design, and baseline characteristics of an ancillary study evaluating the effects of vitamin D and/or marine omega-3 fatty acid supplements on acute exacerbations of chronic respiratory disease, asthma control, pneumonia and lung function in adults.

    Science.gov (United States)

    Gold, Diane R; Litonjua, Augusto A; Carey, Vincent J; Manson, JoAnn E; Buring, Julie E; Lee, I-Min; Gordon, David; Walter, Joseph; Friedenberg, Georgina; Hankinson, John L; Copeland, Trisha; Luttmann-Gibson, Heike

    2016-03-01

    Laboratory and observational research studies suggest that vitamin D and marine omega-3 fatty acids may reduce risk for pneumonia, acute exacerbations of respiratory diseases including chronic obstructive lung disease (COPD) or asthma, and decline of lung function, but prevention trials with adequate dosing, adequate power, and adequate time to follow-up are lacking. The ongoing Lung VITAL study is taking advantage of a large clinical trial-the VITamin D and OmegA-3 TriaL (VITAL)--to conduct the first major evaluation of the influences of vitamin D and marine omega-3 fatty acid supplementation on pneumonia risk, respiratory exacerbation episodes, asthma control and lung function in adults. VITAL is a 5-year U.S.-wide randomized, double-blind, placebo-controlled, 2 × 2 factorial trial of supplementation with vitamin D3 ([cholecalciferol], 2000 IU/day) and marine omega-3 FA (Omacor® fish oil, eicosapentaenoic acid [EPA]+docosahexaenoic acid [DHA], 1g/day) for primary prevention of CVD and cancer among men and women, at baseline aged ≥50 and ≥55, respectively, with 5107 African Americans. In a subset of 1973 participants from 11 urban U.S. centers, lung function is measured before and two years after randomization. Yearly follow-up questionnaires assess incident pneumonia in the entire randomized population, and exacerbations of respiratory disease, asthma control and dyspnea in a subpopulation of 4314 randomized participants enriched, as shown in presentation of baseline characteristics, for respiratory disease, respiratory symptoms, and history of cigarette smoking. Self-reported pneumonia hospitalization will be confirmed by medical record review, and exacerbations will be confirmed by Center for Medicare and Medicaid Services data review.

  7. Respiratory viral infection predisposing for bacterial disease : a concise review

    NARCIS (Netherlands)

    Hament, JM; Kimpen, JLL; Fleer, A; Wolfs, TFW

    1999-01-01

    Although bacterial superinfection in viral respiratory disease is a clinically well documented phenomenon, the pathogenic mechanisms are still poorly understood. Recent studies have revealed some of the mechanisms involved. Physical damage to respiratory cells as a result of viral infection may lead

  8. Pasteurella multocida involved in respiratory disease of wild chimpanzees.

    Directory of Open Access Journals (Sweden)

    Sophie Köndgen

    Full Text Available Pasteurella multocida can cause a variety of diseases in various species of mammals and birds throughout the world but nothing is known about its importance for wild great apes. In this study we isolated P. multocida from wild living, habituated chimpanzees from Taï National Park, Côte d'Ivoire. Isolates originated from two chimpanzees that died during a respiratory disease outbreak in 2004 as well as from one individual that developed chronic air-sacculitis following this outbreak. Four isolates were subjected to a full phenotypic and molecular characterisation. Two different clones were identified using pulsed field gel electrophoresis. Multi Locus Sequence Typing (MLST enabled the identification of previous unknown alleles and two new sequence types, ST68 and ST69, were assigned. Phylogenetic analysis of the superoxide dismutase (sodA gene and concatenated sequences from seven MLST-housekeeping genes showed close clustering within known P. multocida isolated from various hosts and geographic locations. Due to the clinical relevance of the strains described here, these results make an important contribution to our knowledge of pathogens involved in lethal disease outbreaks among endangered great apes.

  9. Placental Origins of Chronic Disease.

    Science.gov (United States)

    Burton, Graham J; Fowden, Abigail L; Thornburg, Kent L

    2016-10-01

    Epidemiological evidence links an individual's susceptibility to chronic disease in adult life to events during their intrauterine phase of development. Biologically this should not be unexpected, for organ systems are at their most plastic when progenitor cells are proliferating and differentiating. Influences operating at this time can permanently affect their structure and functional capacity, and the activity of enzyme systems and endocrine axes. It is now appreciated that such effects lay the foundations for a diverse array of diseases that become manifest many years later, often in response to secondary environmental stressors. Fetal development is underpinned by the placenta, the organ that forms the interface between the fetus and its mother. All nutrients and oxygen reaching the fetus must pass through this organ. The placenta also has major endocrine functions, orchestrating maternal adaptations to pregnancy and mobilizing resources for fetal use. In addition, it acts as a selective barrier, creating a protective milieu by minimizing exposure of the fetus to maternal hormones, such as glucocorticoids, xenobiotics, pathogens, and parasites. The placenta shows a remarkable capacity to adapt to adverse environmental cues and lessen their impact on the fetus. However, if placental function is impaired, or its capacity to adapt is exceeded, then fetal development may be compromised. Here, we explore the complex relationships between the placental phenotype and developmental programming of chronic disease in the offspring. Ensuring optimal placentation offers a new approach to the prevention of disorders such as cardiovascular disease, diabetes, and obesity, which are reaching epidemic proportions. PMID:27604528

  10. [Respiratory bronchiolitis-associated interstitial lung disease (RB-ILD)].

    Science.gov (United States)

    Goeckenjan, G

    2003-05-01

    Respiratory bronchiolitis-associated interstitial lung disease (RB-ILD) designates interstitial lung changes in smokers, characterized histologically by bronchiolocentric accumulation of pigmented alveolar macrophages and fibrotic or cellular inflammatory changes of pulmonary interstitium. The definition is nearly identical to that of condensate pneumopathy, smoker's pneumopathy or smoker's lung, defined by accumulation of pigmented alveolar macrophages with bland alveoloseptal or peribronchial fibrosis and cellular inflammation of the bronchial wall. In addition to respiratory bronchiolitis, which is found in nearly all smokers, RB-ILD comprises a broad spectrum of varying degrees of the interstitial reaction to the exogenous injury of inhalation smoking with gradual transition to desquamative interstitial pneumonia (DIP). In most cases RB-ILD manifestations are subclinical and detected coincidentally. Radiographic features are reticulonodular and ground glass opacities of the lung. The high resolution computed tomography reveals centrilobular nodules, ground glass opacities, thickening of bronchial walls, and in some cases a reticular pattern. Mild emphysema is frequent. Lung function analysis reveals only minor restrictive or obstructive defects in most cases, often combined with hyperinflation. CO diffusing capacity is slightly to moderately impaired. Pronounced interstitial lung diseases with serious restrictive defects and arterial hypoxemia have been reported infrequently. In differential diagnosis smoking related interstitial lung diseases (DIP, Langerhans cell histiocytosis, idiopathic pulmonary fibrosis) and other interstitial lung diseases have to be excluded. In most cases diagnosis can be achieved by bronchoalveolar lavage and transbronchial lung biopsy. In cases of pronounced interstitial lung disease or assumption of an additional interstitial lung disease besides RB-ILD a thoracoscopic or open lung biopsy can be necessary. RB-ILD has a favourable

  11. Ghrelin in Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Wai W. Cheung

    2010-01-01

    Full Text Available Patients with chronic kidney disease (CKD often exhibit symptoms of anorexia and cachexia, which are associated with decreased quality of life and increased mortality. Chronic inflammation may be an important mechanism for the development of anorexia, cachexia, renal osteodystrophy, and increased cardiovascular risk in CKD. Ghrelin is a gastric hormone. The biological effects of ghrelin are mediated through the growth hormone secretagogue receptor (GHSR. The salutary effects of ghrelin on food intake and meal appreciation suggest that ghrelin could be an effective treatment for anorexic CKD patients. In addition to its appetite-stimulating effects, ghrelin has been shown to possess anti-inflammatory properties. The known metabolic effects of ghrelin and the potential implications in CKD will be discussed in this review. The strength, shortcomings, and unanswered questions related to ghrelin treatment in CKD will be addressed.

  12. Airway Reflux, Cough and Respiratory Disease

    OpenAIRE

    Molyneux, Ian D.; Morice, Alyn H.

    2011-01-01

    It is increasingly accepted that the effects of gastro-oesophageal reflux are not limited to the gastrointestinal tract. The adjacent respiratory structures are also at risk from material ejected from the proximal oesophagus as a result of the failure of anatomical and physiological barriers. There is evidence of the influence of reflux on several respiratory and otorhinological conditions and although in many cases the precise mechanism has yet to be elucidated, the association alone opens p...

  13. Neuropsychological functioning in chronic Lyme disease.

    Science.gov (United States)

    Westervelt, Holly James; McCaffrey, Robert J

    2002-09-01

    Lyme disease is currently the most common vector-borne illness in the United States. The disease is multisystemic, and chronic disease, in particular, may be associated with neuropsychological deficits. However, to date, only a few empirical studies exist, which examine the neuropsychological sequelae associated with chronic Lyme disease. A review of the literature shows that the deficits observed in adults with chronic Lyme disease are generally consistent with the deficits that can be seen in processes with primarily frontal systems involvement. These observations are generally consistent with neuroradiologic findings. The clinical presentation in chronic Lyme disease and the nature of the neuropsychological deficits are discussed, as are several central issues in understanding neuropsychological functioning in chronic Lyme disease, such as the impact of chronic illness, response to treatment, and the relationship between neuropsychological performance and depression, fatigue, and neurological indicators of disease.

  14. Optimism's Explicative Role for Chronic Diseases.

    Science.gov (United States)

    Avvenuti, Giulia; Baiardini, Ilaria; Giardini, Anna

    2016-01-01

    The increasing interest about dispositional optimism's role in health status and its positive modulating effect on health outcomes has led to a remarkable scientific production in the last decade. To date lot is known for which diseases optimism is relevant, instead much less is known about how optimism interacts with other factors, both biological and psychological, in determining health status. The aim of this mini review is to explore the literature derived from clinical and experimental research assessing the associations between dispositional optimism and health status. Dispositional optimism can be considered as facet of personality that is cognitive in nature which holds the global expectation that the future will be plenty of good events. Optimists view desired goals as obtainable, so they often confront adversities in active manners resulting in perseverance and increased goal attainment. Only studies that explicitly included optimism and health outcomes, as measurable variables, and that reported a clear association between them have been reviewed. Cancer, cardiovascular disease, respiratory failure, and aging with multimorbidity were considered. Among the possible explicative hypotheses, two seem to best describe results: optimism may have a direct effect on the neuroendocrine system and on immune responses, and it may have an indirect effect on health outcomes by promoting protective health behaviors, adaptive coping strategies and enhancing positive mood. The research on optimism and health status has already shed light on important mechanisms regarding chronic diseases' management, however, further studies are needed to deepen the knowledge. PMID:26973582

  15. Chronic Disease and Childhood Development: Kidney Disease and Transplantation.

    Science.gov (United States)

    Klein, Susan D.; Simmons, Roberta G.

    As part of a larger study of transplantation and chronic disease and the family, 124 children (10-18 years old) who were chronically ill with kidney disease (n=72) or were a year or more post-transplant (n=52) were included in a study focusing on the effects of chronic kidney disease and transplantation on children's psychosocial development. Ss…

  16. Clinical features of invasive pulmonary aspergillosis in critically ill patients with chronic respiratory diseases%重症慢性呼吸道疾病合并侵袭性肺曲霉病的临床特点

    Institute of Scientific and Technical Information of China (English)

    詹庆元; 贺航咏; 童朝晖; 栗芳; 孙兵; 王辰

    2008-01-01

    目的 总结重症慢性呼吸道疾病(CRD)合并侵袭性肺曲霉病(IPA)的临床特点,为早期诊断和治疗提供依据.方法 分析2004年10月至2007年2月在北京朝阳医院呼吸科重症监护室(RICU)住院的149例痰或BALF分离出曲霉的CRD患者资料.以SPSS 10.0统计软件进行数据处理,所有计量资料以均数±标准差表示,计数资料以例数表示.计量资料采用t检验,计数资料采用X2检验.结果 149例CRD患者中共收集16例IPA病例(COPD 11例,COPD合并支气管哮喘4例,支气管扩张症1例),其中3例确诊,10例临床诊断,3例拟诊.12例在人RICU前使用过大量糖皮质激素,15例使用广谱抗生素.15例临床表现为严重气道痉挛,9例行无创通气失败,14例因严重呼吸衰竭而需有创机械通气.12例X线胸片可见明显渗出影.外周血白细胞及中性粒细胞比例在疾病后期迅速增高;早期气管镜检查可见气道黏膜充血、水肿、糜烂,气道痉挛,痰液黏稠,后期气道黏膜可出现伪膜;早期真菌病原学检查阳性率低(2/12),后期阳性率高(10/12);早期治疗的患者存活率高(4/4),晚期治疗效果差(11/12),由呼吸衰竭迅速进展为多脏器衰竭是最主要的死亡原因.结论 CRD合并IPA并不少见,预后差.根据临床特点进行早期诊断及经验性治疗可改善患者的预后.%Objective To describe the clinical features of invasive pulmonary aspergillosis(IPA) in critically ill patients with chronic respiratory diseases(CRD)and to estimate its value for early diagnosis and treatment. Methods Retrospective study of critically ill CRD patients with Dositive Aspergillus from sputum or bronchial alveolar lavage fluid in a respiratory ICU of a teaching hospital.Results There were 149 CRD patients admitted between October 2004 and February 2007. Among these patients,16 cases of IPA(11 COPD,4 COPD with asthma,1 bronchiectasis)were collected.Three cases fulfilled the criteria of proven IPA,10 of probable

  17. HIV and chronic kidney disease.

    Science.gov (United States)

    Naicker, Saraladevi; Rahmanian, Sadaf; Kopp, Jeffrey B

    2015-01-01

    Chronic kidney disease (CKD) is a frequent complication of HIV infection, occurring in 3.5 - 48.5%, and occurs as a complication of HIV infection, other co-morbid disease and infections and as a consequence of therapy of HIV infection and its complications. The classic involvement of the kidney by HIV infection is HIV-associated nephropathy (HIVAN), occurring typically in young adults of African ancestry with advanced HIV disease in association with APOL1 high-risk variants. HIV-immune complex disease is the second most common diagnosis obtained from biopsies of patients with HIV-CKD. CKD is mediated by factors related to the virus, host genetic predisposition and environmental factors. The host response to HIV infection may influence disease phenotype through activation of cytokine pathways. With the introduction of antiretroviral therapy (ART), there has been a decline in the incidence of HIVAN, with an increasing prevalence of focal segmental glomerulosclerosis. Several studies have demonstrated the overall improvement in kidney function when initiating ART for HIV CKD. Progression to end stage kidney disease has been reported to be more likely when high grade proteinuria, severely reduced eGFR, hepatitis B and/C co-infection, diabetes mellitus, extensive glomerulosclerosis, and chronic interstitial fibrosis are present. Improved renal survival is associated with use of renin angiotensin system blockers and viral suppression. Many antiretroviral medications are partially or completely eliminated by the kidney and require dose adjustment in CKD. Certain drug classes, such as the protease inhibitors and the non-nucleoside reverse transcriptase inhibitors, are metabolized by the liver and do not require dose adjustment. HIV-infected patients requiring either hemo- or peritoneal dialysis, who are stable on ART, are achieving survival rates comparable to those of dialysis patients without HIV infection. Kidney transplantation has been performed successfully in HIV

  18. Pesticides and human chronic diseases: Evidences, mechanisms, and perspectives

    International Nuclear Information System (INIS)

    Along with the wide use of pesticides in the world, the concerns over their health impacts are rapidly growing. There is a huge body of evidence on the relation between exposure to pesticides and elevated rate of chronic diseases such as different types of cancers, diabetes, neurodegenerative disorders like Parkinson, Alzheimer, and amyotrophic lateral sclerosis (ALS), birth defects, and reproductive disorders. There is also circumstantial evidence on the association of exposure to pesticides with some other chronic diseases like respiratory problems, particularly asthma and chronic obstructive pulmonary disease (COPD), cardiovascular disease such as atherosclerosis and coronary artery disease, chronic nephropathies, autoimmune diseases like systemic lupus erythematous and rheumatoid arthritis, chronic fatigue syndrome, and aging. The common feature of chronic disorders is a disturbance in cellular homeostasis, which can be induced via pesticides' primary action like perturbation of ion channels, enzymes, receptors, etc., or can as well be mediated via pathways other than the main mechanism. In this review, we present the highlighted evidence on the association of pesticide's exposure with the incidence of chronic diseases and introduce genetic damages, epigenetic modifications, endocrine disruption, mitochondrial dysfunction, oxidative stress, endoplasmic reticulum stress and unfolded protein response (UPR), impairment of ubiquitin proteasome system, and defective autophagy as the effective mechanisms of action. - Highlights: ► There is a link between exposure to pesticides and incidence of chronic diseases. ► Genotoxicity and proteotoxicity are two main involved mechanisms. ► Epigenetic knowledge may help diagnose the relationships. ► Efficient policies on safe use of pesticides should be set up

  19. Pesticides and human chronic diseases: Evidences, mechanisms, and perspectives

    Energy Technology Data Exchange (ETDEWEB)

    Mostafalou, Sara; Abdollahi, Mohammad, E-mail: Mohammad.Abdollahi@UToronto.Ca

    2013-04-15

    Along with the wide use of pesticides in the world, the concerns over their health impacts are rapidly growing. There is a huge body of evidence on the relation between exposure to pesticides and elevated rate of chronic diseases such as different types of cancers, diabetes, neurodegenerative disorders like Parkinson, Alzheimer, and amyotrophic lateral sclerosis (ALS), birth defects, and reproductive disorders. There is also circumstantial evidence on the association of exposure to pesticides with some other chronic diseases like respiratory problems, particularly asthma and chronic obstructive pulmonary disease (COPD), cardiovascular disease such as atherosclerosis and coronary artery disease, chronic nephropathies, autoimmune diseases like systemic lupus erythematous and rheumatoid arthritis, chronic fatigue syndrome, and aging. The common feature of chronic disorders is a disturbance in cellular homeostasis, which can be induced via pesticides' primary action like perturbation of ion channels, enzymes, receptors, etc., or can as well be mediated via pathways other than the main mechanism. In this review, we present the highlighted evidence on the association of pesticide's exposure with the incidence of chronic diseases and introduce genetic damages, epigenetic modifications, endocrine disruption, mitochondrial dysfunction, oxidative stress, endoplasmic reticulum stress and unfolded protein response (UPR), impairment of ubiquitin proteasome system, and defective autophagy as the effective mechanisms of action. - Highlights: ► There is a link between exposure to pesticides and incidence of chronic diseases. ► Genotoxicity and proteotoxicity are two main involved mechanisms. ► Epigenetic knowledge may help diagnose the relationships. ► Efficient policies on safe use of pesticides should be set up.

  20. 76 FR 28789 - Draft Alert Entitled “Preventing Occupational Respiratory Disease From Dampness in Office...

    Science.gov (United States)

    2011-05-18

    ... Respiratory Disease From Dampness in Office Buildings, Schools, and Other Nonindustrial Buildings'' AGENCY... Occupational Respiratory Disease from Dampness in Office Buildings, Schools, and other Nonindustrial Buildings... is to provide workers and employers with information necessary for prevention of respiratory...

  1. Clinical analysis of the relationship between 56 cases of chronic obstructive pulmonary disease with re-spiratory failure and hyponatremia%56例慢性阻塞性肺疾病合并呼吸衰竭与低钠血症关系的临床分析

    Institute of Scientific and Technical Information of China (English)

    石屏屏

    2016-01-01

    目的:探讨慢性阻塞性肺疾病合并呼吸衰竭的发生与低钠血症的关系。方法:选取56例患者,分为A、B、C三组,观察其血钠情况,并分析其中关系。结果:三组血钠相比,差异有显著统计学意义( P﹤0.01),B、C两组相比,差异有显著统计学意义( P﹤0.05)。慢性阻塞性肺疾病合并呼吸衰竭患者发生低血钠与下列因素有关,且Ⅱ型呼吸衰竭引起低血钠的原因较I型呼吸衰竭明显,差异有统计学意义( P﹤0.05)。低钠血症患者往往伴随酸碱失衡,特别是碱中毒,慢性阻塞性肺疾病合并呼吸衰竭患者呼酸并代碱及代碱发生率较高,差异有统计学意义( P﹤0.05)。结论:慢性阻塞性肺疾病合并呼吸衰竭与低钠血症关系密切,且其发病原因复杂,与疾病的发展程度及医源性因素有关,需要定期对其血电解质进行检测并给予及时处理,使患者的死亡率降低。%Objective To investigate the relationship between chronic obstructive pulmonary disease with respiratory failure and hyponatremia. Method 56 cases of patients were divided into A group,B group,C group,to observe the serum sodium,and analyzes the relationship between them. Results The three groups were compared,the difference was significant( P ﹤0. 01 ), compared to B,C two groups,there was significant difference(P﹤0. 05). Hyponatremia was related to the following factors in pa-tients with chronic obstructive pulmonary disease complicated with respiratory failure,and type Ⅱ respiratory failure caused by hyponatremia with typeⅠ respiratory failure significantly,the difference was statistically significant( P﹤0. 05 ). Hyponatremia often accompanied by acid-base imbalance,especially alkali poisoning,chronic obstructive pulmonary disease with respiratory failure in patients with respiratory acidosis and metabolic alkalosis and metabolic alkalosis were higher,the difference was

  2. Chronic kidney disease in children.

    Science.gov (United States)

    Becherucci, Francesca; Roperto, Rosa Maria; Materassi, Marco; Romagnani, Paola

    2016-08-01

    Chronic kidney disease (CKD) is a major health problem worldwide. Although relatively uncommon in children, it can be a devastating illness with many long-term consequences. CKD presents unique features in childhood and may be considered, at least in part, as a stand-alone nosologic entity. Moreover, some typical features of paediatric CKD, such as the disease aetiology or cardiovascular complications, will not only influence the child's health, but also have long-term impact on the life of the adult that they will become. In this review we will focus on the unique issues of paediatric CKD, in terms of aetiology, clinical features and treatment. In addition, we will discuss factors related to CKD that start during childhood and require appropriate treatments in order to optimize health outcomes and transition to nephrologist management in adult life. PMID:27478602

  3. Anemia of Chronic Liver Diseases

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Hyun Chung; Lee, Jhung Sang; Koh, Chang Soon; Lee, Mun Ho [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1971-09-15

    The pathogenetic mechanisms of anemia in patients with chronic liver disease were observed. Seventeen patients with moderate to advanced hepatic diseases were studied by various methods. Only patients without previous blood loss were included : 14 had cirrhosis, 2 had active chronic hepatitis, and one had inferior vena cava obstruction with associated liver cirrhosis. The followings were the results: 1. The anemia based on red blood cell count, Hb., and Ht. was found in 76.5-78.6% of the patients. 2. Red cell indices indicated that normo-macrocytic and normochromic anemia was present is the majority of the patients. 3. No evidence of megaloblastic anemia was found on the basis of the morphological examinations. 4. Serum iron, TIBC, % saturation and iron content in the bone marrow indicated that iron deficiency anemia was present in about half of the patients. 5. In the view of the erythrocyte dynamics, primary increase in the red cell destruction was ascribed to the cause of the anemia. 6. Decrease in the red cell survival time was not correlated with MCV, % saturation and S.L. ratio. Also, hemoglobin level was not correlated with MCV, % saturation and T{sub 50} Cr. Therefore, multiple causes may be involved in the pathogenesis of the anemia. 7. Anemia as determined by the red cell volume was found in only 60% of the patients. It may be possible that hemodilutional anemia is present.

  4. Unmet needs in severe chronic upper airway disease (SCUAD).

    Science.gov (United States)

    Bousquet, Jean; Bachert, Claus; Canonica, Giorgio W; Casale, Thomas B; Cruz, Alvaro A; Lockey, Richard J; Zuberbier, Torsten

    2009-09-01

    Although the majority of patients with chronic upper airway diseases have controlled symptoms during treatment, many patients have severe chronic upper airway diseases (SCUADs). SCUAD defines those patients whose symptoms are inadequately controlled despite adequate (ie, effective, safe, and acceptable) pharmacologic treatment based on guidelines. These patients have impaired quality of life, social functioning, sleep, and school/work performance. Severe uncontrolled allergic rhinitis, nonallergic rhinitis, chronic rhinosinusitis, aspirin-exacerbated respiratory diseases, or occupational airway diseases are defined as SCUADs. Pediatric SCUADs are still unclear. In developing countries SCUADs exist, but risk factors can differ from those seen in developed countries. Comorbidities are common in patients with SCUADs and might increase their severity. The present document is the position of a group of experts considering that SCUADs should be considered differently from mild chronic upper airway diseases. It reviews the state of the art, highlighting gaps in our knowledge, and proposes several areas for a better understanding, prevention, and management of SCUADs. This document can also serve to optimize the pharmacoeconomic evaluation of SCUADs by means of comparison with mild chronic upper airway diseases. PMID:19660803

  5. Burden of respiratory disease in Thailand: Results from the APBORD observational study.

    Science.gov (United States)

    Thanaviratananich, Sanguansak; Cho, Sang-Heon; Ghoshal, Aloke Gopal; Muttalif, Abdul Razak Bin Abdul; Lin, Horng-Chyuan; Pothirat, Chaicharn; Chuaychoo, Benjamas; Aeumjaturapat, Songklot; Bagga, Shalini; Faruqi, Rab; Sajjan, Shiva; Baidya, Santwona; Wang, De Yun

    2016-07-01

    Asia-Pacific Burden of Respiratory Diseases (APBORD) was a cross-sectional, observational study examining the burden of respiratory disease in adults across 6 Asia-Pacific countries.This article reports symptoms, healthcare resource utilization (HCRU), work impairment and cost burden associated with allergic rhinitis (AR), asthma, chronic obstructive pulmonary disease (COPD), and rhinosinusitis in Thailand.Consecutive participants aged ≥18 years with a primary diagnosis of AR, asthma, COPD, or rhinosinusitis were enrolled at 4 hospitals in Thailand during October 2012 and October 2013. Participants completed a survey detailing respiratory symptoms, HCRU, work productivity, and activity impairment. Locally sourced unit costs were used in the calculation of total costs.The study enrolled 1000 patients. The most frequent primary diagnosis was AR (44.2%), followed by rhinosinusitis (24.1%), asthma (23.7%), and COPD (8.0%). Overall, 316 (31.6%) of patients were diagnosed with some combination of the 4 diseases. Blocked nose or congestion (17%) and cough or coughing up phlegm (16%) were the main reasons for the current medical visit. The mean annual cost for patients with a respiratory disease was US$1495 (SD 3133) per patient. Costs associated with work productivity loss were the principal contributor for AR and rhinosinusitis patients while medication costs were the highest contributor for asthma and COPD patients.The study findings highlight the burden associated with 4 prevalent respiratory diseases in Thailand. Thorough investigation of concomitant conditions and improved disease management may help to reduce the burden of these respiratory diseases.

  6. Chronic non-communicable diseases.

    Science.gov (United States)

    Unwin, N; Alberti, K G M M

    2006-01-01

    Chronic non-communicable diseases (NCD) account for almost 60% of global mortality, and 80% of deaths from NCD occur in low- and middle-income countries. One quarter of these deaths--almost 9 million in 2005--are in men and women aged globalisation of the food, tobacco and alcohol industries. Because NCD have a major impact on men and women of working age and their elderly dependents, they result in lost income, lost opportunities for investment, and overall lower levels of economic development. Reductions in the incidences of many NCD and their complications are, however, already possible. Up to 80% of all cases of cardiovascular disease or type-2 diabetes and 40% of all cases of cancer, for example, are probably preventable based on current knowledge. In addition, highly cost-effective measures exist for the prevention of some of the complications of established cardiovascular disease and diabetes. Achieving these gains will require a broad range of integrated, population-based interventions as well as measures focused on the individuals at high risk. At present, the international-assistance community provides scant resources for the control of NCD in poor countries, partly, at least, because NCD continue to be wrongly perceived as predominantly diseases of the better off. As urbanization continues apace and populations age, investment in the prevention and control of NCD in low-and middle-income countries can no longer be ignored. PMID:16899148

  7. Hypertrophic osteoarthropathy of chronic inflammatory bowel disease

    Energy Technology Data Exchange (ETDEWEB)

    Oppenheimer, D.A.; Jones, H.H.

    1982-12-01

    The case of a 14-year old girl with painful periostitis and ulcerative colitis is reported. The association of chronic inflammatory bowel disease with osteoarthropathy is rare and has previously been reported in eight patients. The periosteal reaction found in association with inflammatory bowel disease is apparently related to a chronic disease course and may cause extreme localized pain.

  8. Optimism's explicative role for chronic diseases

    Directory of Open Access Journals (Sweden)

    Giulia eAvvenuti

    2016-03-01

    Full Text Available The increasing interest about dispositional optimism's role in health status and its positive modulating effect on health outcomes has led to a remarkable scientific production in the last decade. To date lot is known about which fields of medicine are affected by optimism, instead much less is known about how optimism interacts with other factors, both biological and psychological, in determining health status. The aim of this mini review is to explore the literature derived from clinical and experimental research assessing the associations between dispositional optimism and health status. Dispositional optimism can be considered as facet of personality that is cognitive in nature which holds the global expectation that the future will be plenty of good events. Optimists view desired goals as obtainable, so they often confront adversities in active manners resulting in perseverance and increased goal attainment. Only studies that explicitly included optimism and health outcomes, as measurable variables, and that reported a clear association between them have been reviewed. Cancer, cardiovascular disease, respiratory failure and ageing with multimorbidity were considered. Among the possible explicative hypotheses, two seem to best describe results: optimism may have a direct effect on the neuroendocrine system and on immune responses, and it may have an indirect effect on health outcomes by promoting protective health behaviors, adaptive coping strategies and enhancing positive mood. The research on optimism and health status has already shed light on important mechanisms regarding chronic diseases' management, however further studies are needed to deepen the knowledge.

  9. Non-invasive positive pressure ventilation (NIPPV) in stable patients with chronic obstructive pulmonary disease (COPD)

    NARCIS (Netherlands)

    Wijkstra, PJ

    2003-01-01

    While non-invasive positive pressure ventilation (NIPPV) has become an accepted management approach for patients with acute hypercapnia, it remains unclear whether it can also be beneficial in stable chronic obstructive pulmonary disease (COPD) patients with chronic respiratory failure. Randomised c

  10. Chronic Obstructive Pulmonary Disease Subtypes. Transitions over Time

    Science.gov (United States)

    Esteban, Cristóbal; Arostegui, Inmaculada; Aburto, Myriam; Moraza, Javier; Quintana, José M.; García-Loizaga, Amaia; Basualdo, Luis V.; Aramburu, Amaia; Aizpiri, Susana; Uranga, Ane; Capelastegui, Alberto

    2016-01-01

    Background Although subtypes of chronic obstructive pulmonary disease are recognized, it is unknown what happens to these subtypes over time. Our objectives were to assess the stability of cluster-based subtypes in patients with stable disease and explore changes in clusters over 1 year. Methods Multiple correspondence and cluster analysis were used to evaluate data collected from 543 stable patients included consecutively from 5 respiratory outpatient clinics. Results Four subtypes were identified. Three of them, A, B, and C, had marked respiratory profiles with a continuum in severity of several variables, while the fourth, subtype D, had a more systemic profile with intermediate respiratory disease severity. Subtype A was associated with less dyspnea, better health-related quality of life and lower Charlson comorbidity scores, and subtype C with the most severe dyspnea, and poorer pulmonary function and quality of life, while subtype B was between subtypes A and C. Subtype D had higher rates of hospitalization the previous year, and comorbidities. After 1 year, all clusters remained stable. Generally, patients continued in the same subtype but 28% migrated to another cluster. Together with movement across clusters, patients showed changes in certain characteristics (especially exercise capacity, some variables of pulmonary function and physical activity) and changes in outcomes (quality of life, hospitalization and mortality) depending on the new cluster they belonged to. Conclusions Chronic obstructive pulmonary disease clusters remained stable over 1 year. Most patients stayed in their initial subtype cluster, but some moved to another subtype and accordingly had different outcomes. PMID:27611911

  11. Right Ventricular Dysfunction in Chronic Lung Disease

    OpenAIRE

    Kolb, Todd M.; Hassoun, Paul M.

    2012-01-01

    Right ventricular dysfunction arises in chronic lung disease when chronic hypoxemia and disruption of pulmonary vascular beds contribute to increase ventricular afterload, and is generally defined by hypertrophy with preserved myocardial contractility and cardiac output. Although the exact prevalence is unknown, right ventricular hypertrophy appears to be a common complication of chronic lung disease, and more frequently complicates advanced lung disease. Right ventricular failure is rare, ex...

  12. Molecular survey of avian respiratory pathogens in commercial broiler chicken flocks with respiratory diseases in Jordan.

    Science.gov (United States)

    Roussan, D A; Haddad, R; Khawaldeh, G

    2008-03-01

    Acute respiratory tract infections are of paramount importance in the poultry industry. Avian influenza virus (AIV), infectious bronchitis virus (IBV), Newcastle disease virus (NDV), avian pneumovirus (APV), and Mycoplasma gallisepticum (MG) have been recognized as the most important pathogens in poultry. In this study, trachea swabs from 115 commercial broiler chicken flocks that suffered from respiratory disease were tested for AIV subtype H9N2, IBV, NDV, and APV by using reverse transcription PCR and for MG by using PCR. The PCR and reverse transcription PCR results showed that 13 and 14.8% of these flocks were infected with NDV and IBV, respectively, whereas 5.2, 6.0, 9.6, 10.4, 11.3, and 15.7% of these flocks were infected with both NDV and MG; MG and APV; IBV and NDV; IBV and MG; NDV and AIV; and IBV and AIV, respectively. Furthermore, 2.6% of these flocks were infected with IBV, NDV, and APV at the same time. On the other hand, 11.3% of these flocks were negative for the above-mentioned respiratory diseases. Our data showed that the above-mentioned respiratory pathogens were the most important causes of respiratory disease in broiler chickens in Jordan. Further studies are necessary to assess circulating strains, economic losses caused by infections and coinfections of these pathogens, and the costs and benefits of countermeasures. Furthermore, farmers need to be educated about the signs and importance of these pathogens.

  13. [Modern threats and burden of respiratory system diseases in Poland].

    Science.gov (United States)

    Płusa, Tadeusz

    2013-11-01

    Polish population according to the National Census of Population and Housing, which was conducted in 2011, was 38 511.8 thousand. The average life expectancy in Poland is 71.0 years for men and 79.7 years for women. The reason for hospitalization in Poland are primarily cardiovascular disease (18%), tumors (11.4%), digestive diseases (10.6%), respiratory (9.3%), trauma (9.1%), infectious diseases (2.3%) and others (39%). Mortality rates determined on the basis of the analyzes and simulations in different disease groups indicates that the predominant causes of death of Polish citizens are strongly cardiovascular disease and cancer. Respiratory diseases occupy fourth place. World analyses clearly show that the number of deaths in 2030 due to lung diseases will be the fourth (COPD), fifth (pneumonia) and sixth (lung cancer) cause of death. As it turns out, the existence of various pathologies affecting the country's economic status. Respiratory allergies are observed more often, including in approximately 20% of Europeans are symptoms of allergic rhinitis (15-20% severe) and in 5-11% are diagnosed with asthma. Malignant tumors are the second most common causes of death in the group with the highest risk of life for the residents of Polish, particularly for men, is lung cancer, because of which in 2001, 20 570 people died. Incurred costs of the social security system are mainly caused by inflammatory diseases of the respiratory system, which corresponds to the number of days of sick leave, especially in the age group 19-28 years, with a decrease in the age group above 59 years of age. Numbers hospitalized for respiratory diseases according to data from the National Health Fund also clearly indicate the cause of inflammation and cancer, and in the population aged 41-60 years, the need for hospital treatment is multiplied. The data indicate the constant threat of respiratory diseases.

  14. Patient-Specific Airway Wall Remodeling in Chronic Lung Disease.

    Science.gov (United States)

    Eskandari, Mona; Kuschner, Ware G; Kuhl, Ellen

    2015-10-01

    Chronic lung disease affects more than a quarter of the adult population; yet, the mechanics of the airways are poorly understood. The pathophysiology of chronic lung disease is commonly characterized by mucosal growth and smooth muscle contraction of the airways, which initiate an inward folding of the mucosal layer and progressive airflow obstruction. Since the degree of obstruction is closely correlated with the number of folds, mucosal folding has been extensively studied in idealized circular cross sections. However, airflow obstruction has never been studied in real airway geometries; the behavior of imperfect, non-cylindrical, continuously branching airways remains unknown. Here we model the effects of chronic lung disease using the nonlinear field theories of mechanics supplemented by the theory of finite growth. We perform finite element analysis of patient-specific Y-branch segments created from magnetic resonance images. We demonstrate that the mucosal folding pattern is insensitive to the specific airway geometry, but that it critically depends on the mucosal and submucosal stiffness, thickness, and loading mechanism. Our results suggests that patient-specific airway models with inherent geometric imperfections are more sensitive to obstruction than idealized circular models. Our models help to explain the pathophysiology of airway obstruction in chronic lung disease and hold promise to improve the diagnostics and treatment of asthma, bronchitis, chronic obstructive pulmonary disease, and respiratory failure. PMID:25821112

  15. Subclinical respiratory dysfunction in chronic cervical cord compression: a pulmonary function test correlation.

    Science.gov (United States)

    Bhagavatula, Indira Devi; Bhat, Dhananjaya I; Sasidharan, Gopalakrishnan M; Mishra, Rakesh Kumar; Maste, Praful Suresh; Vilanilam, George C; Sathyaprabha, Talakkad N

    2016-06-01

    OBJECTIVE Respiratory abnormalities are well documented in acute spinal cord injury; however, the literature available for respiratory dysfunction in chronic compressive myelopathy (CCM) is limited. Respiratory dysfunction in CCM is often subtle and subclinical. The authors studied the pattern of respiratory dysfunction in patients with chronic cord compression by using spirometry, and the clinical and surgical implications of this dysfunction. In this study they also attempted to address the postoperative respiratory function in these patients. METHODS A prospective study was done in 30 patients in whom cervical CCM due to either cervical spondylosis or ossification of the posterior longitudinal ligament (OPLL) was diagnosed. Thirty age-matched healthy volunteers were recruited as controls. None of the patients included in the study had any symptoms or signs of respiratory dysfunction. After clinical and radiological diagnosis, all patients underwent pulmonary function tests (PFTs) performed using a standardized Spirometry Kit Micro before and after surgery. The data were analyzed using Statistical Software SPSS version 13.0. Comparison between the 2 groups was done using the Student t-test. The Pearson correlation coefficient was used for PFT results and Nurick classification scores. A p value disc) was the predominant cause of compression (n = 21, 70%) followed by OPLL (n = 9, 30%). The average patient age was 45.06 years. Degenerative cervical spine disease has a relatively younger onset in the Indian population. The majority of the patients (n = 28, 93.3%) had compression at or above the C-5 level. Ten patients (33.3%) underwent an anterior approach and discectomy, 11 patients (36.7%) underwent decompressive laminectomy, and the remaining 9 underwent either corpectomy with fusion or laminoplasty. The mean preoperative forced vital capacity (FVC) (65%) of the patients was significantly lower than that of the controls (88%) (p < 0.001). The mean postoperative

  16. Kidneys in chronic liver diseases

    Institute of Scientific and Technical Information of China (English)

    Marek Hartleb; Krzysztof Gutkowski

    2012-01-01

    Acute kidney injury (AKI),defined as an abrupt increase in the serum creatinine level by at least 0.3 mg/dL,occurs in about 20% of patients hospitalized for decompensating liver cirrhosis.Patients with cirrhosis are susceptible to developing AKI because of the progressive vasodilatory state,reduced effective blood volume and stimulation of vasoconstrictor hormones.The most common causes of AKI in cirrhosis are pre-renal azotemia,hepatorenal syndrome and acute tubular necrosis.Differential diagnosis is based on analysis of circumstances of AKI development,natriuresis,urine osmolality,response to withdrawal of diuretics and volume repletion,and rarely on renal biopsy.Chronic glomeruIonephritis and obstructive uropathy are rare causes of azotemia in cirrhotic patients.AKI is one of the last events in the natural history of chronic liver disease,therefore,such patients should have an expedited referral for liver transplantation.Hepatorenal syndrome (HRS) is initiated by progressive portal hypertension,and may be prematurely triggered by bacterial infections,nonbacterial systemic inflammatory reactions,excessive diuresis,gastrointestinal hemorrhage,diarrhea or nephrotoxic agents.Each type of renal disease has a specific treatment approach ranging from repletion of the vascular system to renal replacement therapy.The treatment of choice in type 1 hepatorenal syndrome is a combination of vasoconstrictor with albumin infusion,which is effective in about 50% of patients.The second-line treatment of HRS involves a transjugular intrahepatic portosystemic shunt,renal vasoprotection or systems of artificial liver support.

  17. Difference between functional residual capacity and elastic equilibrium volume in patients with chronic obstructive pulmonary disease.

    OpenAIRE

    Morris, M. J.; Madgwick, R. G.; Lane, D. J.

    1996-01-01

    BACKGROUND: A study was performed to determine the elastic equilibrium volume (Vr) of the respiratory system in patients with chronic obstructive pulmonary disease (COPD). METHODS: Voluntary relaxed expiration from total lung capacity (TLC) was studied in three groups of subjects: seven patients with severe chronic airways obstruction (COPD), 10 normal subjects, and 15 subjects with restrictive disease. RESULTS: In the normal subjects and the patients with restrictive disease voluntary relaxe...

  18. Genetic Testing for Respiratory Disease: Are We There Yet?

    Directory of Open Access Journals (Sweden)

    Peter D Paré

    2012-01-01

    Full Text Available The human genome project promised a revolution in health care – the development of ‘personalized medicine’, where knowledge of an individual’s genetic code enables the prediction of risk for specific diseases and the potential to alter that risk based on preventive measures and lifestyle modification. The present brief review provides a report card on the progress toward that goal with respect to respiratory disease. Should generalized population screening for genetic risk factors for respiratory disease be instituted? Or not?

  19. Base excess, a marker of chronic hypercapnic respiratory failure and predictor of survival in COPD

    Directory of Open Access Journals (Sweden)

    Stephan Budweiser

    2006-12-01

    Full Text Available We studied the role of base excess (BE as marker of chronic hypercapnia and survival in patients with chronic obstructive pulmonary disease (COPD and chronic hypercapnic respiratory failure (CHRF. Moreover, it was investigated whether the effects of non-invasive positive pressure ventilation (NPPV on CHRF were reflected in BE and survival. In 240 (160 without exacerbation patients with COPD (mean±SD FEV1 30.7±9.7 %pred; PaCO2 56.9±9.9 mmHg body-mass index (BMI, lung function, respiratory muscle function, blood gases and 6-minute walking distance (6-MWD were assessed prior to initiation of NPPV. In addition, the changes of risk factors 6.3±2.9 months after initiation of NPPV were evaluated. Overall mortality during the follow-up time (26.0±24.5 months was 34.6%. Deaths resulted predominantly from respiratory causes (65.1%; among those, respiratory failure was most frequent (85.2%. Univariate analysis revealed BMI, FEV1, maximal inspiratory pressure (PImax, inspiratory load (P0.1, haemoglobin, 6-MWD, hyperinflation (IC/TLC, RV/TLC, blood gases and BE to be associated (p<0.05 each with prognosis. In multivariate analyses, however, only BMI, RV/TLC and BE turned out to be independent cross-sectional predictors (p<0.05. Kaplan-Meier analyses showed that BE had predictive value particularly in patients with BMI25 kg·m–2, RV/TLC70 % and PaCO257 mmHg. Furthermore, changes of BMI, RV/TLC and BE (p<0.01 were associated with improved prognosis in severe hypercapnic COPD. In patients with COPD and CHRF, BE was a prognostic marker for mortality, that was independent from other factors, particularly PaCO2. In addition, reversal of CHRF was reflected in BE and appeared to have an impact on prognosis.

  20. Respiratory muscle strength and muscle endurance are not affected by acute metabolic acidemia.

    NARCIS (Netherlands)

    Nizet, T.; Heijdra, Y.F.; Elshout, F.J.J. van den; Ven, M.J.T. van de; Bosch, F.H.; Mulder, P.H.M. de; Folgering, H.T.M.

    2009-01-01

    Respiratory muscle fatigue in asthma and chronic obstructive lung disease (COPD) contributes to respiratory failure with hypercapnia, and subsequent respiratory acidosis. Therapeutic induction of acute metabolic acidosis further increases the respiratory drive and, therefore, may diminish ventilator

  1. Oxygen therapy in acute exacerbations of chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Brill SE

    2014-11-01

    Full Text Available Simon E Brill, Jadwiga A Wedzicha Airway Disease Section, National Heart and Lung Institute, Imperial College, London, UK Abstract: Acute exacerbations of chronic obstructive pulmonary disease (COPD are important events in the history of this debilitating lung condition. Associated health care utilization and morbidity are high, and many patients require supplemental oxygen or ventilatory support. The last 2 decades have seen a substantial increase in our understanding of the best way to manage the respiratory failure suffered by many patients during this high-risk period. This review article examines the evidence underlying supplemental oxygen therapy during exacerbations of COPD. We first discuss the epidemiology and pathophysiology of respiratory failure in COPD during exacerbations. The rationale and evidence underlying oxygen therapy, including the risks when administered inappropriately, are then discussed, along with further strategies for ventilatory support. We also review current recommendations for best practice, including methods for improving oxygen provision in the future. Keywords: chronic obstructive pulmonary disease (COPD, exacerbation, oxygen therapy, respiratory failure, hypercapnia

  2. Chronic Obstructive Pulmonary Disease (COPD) Includes: Chronic Bronchitis and Emphysema

    Science.gov (United States)

    ... Obstructive Pulmonary Disease (COPD) Includes: Chronic Bronchitis and Emphysema Recommend on Facebook Tweet Share Compartir Data are ... of adults who have ever been diagnosed with emphysema: 3.4 million Percent of adults who have ...

  3. Helicobacter Infection and Chronic Liver Diseases

    Institute of Scientific and Technical Information of China (English)

    Zhao-chun Chi; Xin-juan Yu; Quan-jiang Dong

    2014-01-01

    This paper reviews the recentHelicobacter infection associated with chronic liver disease. The bacteriology, prevalence, pathogenesis and diagnosis were reviewed. Future work should be conducted on the pathogenesis and treatment of this disease.

  4. Anemia of Inflammation and Chronic Disease

    Science.gov (United States)

    ... Disease Organizations (PDF, 270 KB). Alternate Language URL Anemia of Inflammation and Chronic Disease Page Content On ... Nutrition Points to Remember Clinical Trials What is anemia? Anemia is a condition in which a person ...

  5. Clinical and fiberoptic endoscopic assessment of swallowing in patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Macri, Marina Rodrigues Bueno

    2014-01-01

    Full Text Available Introduction: Chronic obstructive pulmonary disease is characterized by progressive and partially reversible obstruction of pulmonary airflow. Aim: To characterize swallowing in patients with chronic obstructive pulmonary disease and correlate the findings with the degree chronic obstructive pulmonary disease, heart and respiratory rate, oxygen saturation, and smoking. Method: We conducted a prospective cohort study of 19 patients (12 men and 7 women; age range, 50–85 years with confirmed medical diagnosis of chronic obstructive pulmonary disease. This study was performed in 2 stages (clinical evaluation and functional assessment using nasolaryngofibroscopy on the same day. During both stages, vital signs were checked by medical personnel. Results: Clinical evaluation of swallowing in all patients showed the clinical signs of cough. The findings of nasolaryngofibroscopy highlighted subsequent intraoral escape in 5 patients (26.5%. No patient had tracheal aspiration. There was no association of subsequent intraoral escape with degree of chronic obstructive pulmonary disease, heart and respiratory rate, oxygen saturation, or smoking. Conclusion: In patients with chronic obstructive pulmonary disease, there was a prevalence of oral dysphagia upon swallowing and nasolaryngofibroscopy highlighted the finding of subsequent intraoral escape. There was no correlation between intraoral escape and the degree of chronic obstructive pulmonary disease, heart and respiratory rate, oxygen saturation, or smoking.

  6. Controversies in Chronic Kidney Disease Staging

    OpenAIRE

    Polkinghorne, Kevan R

    2011-01-01

    In 2002, a new chronic kidney disease staging system was developed by the US National Kidney Foundation. The classification system represented a new conceptual framework for the diagnosis of chronic kidney disease (moving to a schema based on disease severity defined by the glomerular filtration rate). While the introduction of the staging system stimulated significant clinical and research interest in kidney disease, there has been vigorous debate on its merits. This mini-review aims to summ...

  7. Is acute recurrent pancreatitis a chronic disease?

    OpenAIRE

    Mariani, Alberto; Testoni, Pier Alberto

    2008-01-01

    Whether acute recurrent pancreatitis is a chronic disease is still debated and a consensus is not still reached as demonstrated by differences in the classification of acute recurrent pancreatitis. There is major evidence for considering alcoholic pancreatitis as a chronic disease ab initio while chronic pancreatitis lesions detectable in biliary acute recurrent pancreatitis (ARP) seem a casual association. Cystic fibrosis transmembrane conductance regulator (CFTR) gene mutation, hereditary a...

  8. Chronic diseases among older cancer patients.

    NARCIS (Netherlands)

    Deckx, L.D.; Akker, M.A. van der; Metsemakers, J.M.; Knottnerus, A.K.; Schellevis, F.G.; Buntinx, F.B.

    2011-01-01

    Introduction: With the growing number of older cancer patients, the burden of chronic diseases among older cancer patients will become increasingly important. Chronic diseases often interfere with treatment decisions and prognosis for cancer patients. However, little is known about the occurrence of

  9. Osteoporosis in chronic obstructive pulmonary disease patients

    DEFF Research Database (Denmark)

    Jørgensen, Niklas Rye; Schwarz, Peter

    2008-01-01

    The purpose of this review is to examine the state of knowledge and clinical practice in the association of chronic obstructive pulmonary disease to osteoporosis and fracture incidence.......The purpose of this review is to examine the state of knowledge and clinical practice in the association of chronic obstructive pulmonary disease to osteoporosis and fracture incidence....

  10. Nanocarriers as pulmonary drug delivery systems to treat and to diagnose respiratory and non respiratory diseases

    Directory of Open Access Journals (Sweden)

    Malgorzata Smola

    2008-03-01

    Full Text Available Malgorzata Smola1,2, Thierry Vandamme1, Adam Sokolowski21Université Louis Pasteur, Faculté de Pharmacie, Département de Chimie Bioorganique, Illkirch Graffenstaden, France; 2Wroclaw University of Technology, Faculty of Chemical Engineering, Wroclaw, PolandAbstract: The purpose of this review is to discuss the impact of nanocarriers administered by pulmonary route to treat and to diagnose respiratory and non respiratory diseases. Indeed, during the past 10 years, the removal of chlorofluorocarbon propellants from industrial and household products intended for the pulmonary route has lead to the developments of new alternative products. Amongst these ones, on one hand, a lot of attention has been focused to improve the bioavailability of marketed drugs intended for respiratory diseases and to develop new concepts for pulmonary administration of drugs and, on the other hand, to use the pulmonary route to administer drugs for systemic diseases. This has led to some marketed products through the last decade. Although the introduction of nanotechnology permitted to step over numerous problems and to improve the bioavailability of drugs, there are, however, unresolved delivery problems to be still addressed. These scientific and industrial innovations and challenges are discussed along this review together with an analysis of the current situation concerning the industrial developments.Keywords: nanotechnology, nanocarriers, nanoparticle, liposome, lung, pulmonary drug delivery, drug targeting, respiratory disease, microemulsion, bioavailability, micelle

  11. Exercise training modalities and strategies to improve exercise performance in patients with respiratory disease.

    Science.gov (United States)

    Almeida, P; Rodrigues, F

    2014-01-01

    Pulmonary rehabilitation is an evidence-based, multidisciplinary, comprehensive intervention for patients with chronic respiratory diseases who are symptomatic and whose daily living activities are often restricted. Pulmonary rehabilitation programs are designed to improve the physical and emotional condition of people with chronic respiratory disease and to promote long-term adherence to health-enhancing behavior. Exercise training is at the core of pulmonary rehabilitation (PR) programs. The benefits of exercise training include decreased dyspnea, improved health-related quality of life, fewer days of hospitalization, and decreased health-care utilization. To gain PR benefits, patients should be able to complete an exercise training program, preferably with high intensity exercise, and it is likely that these benefits will translate into a change from a pattern of a sedentary lifestyle to a physically active lifestyle. Chronic respiratory patients, namely COPD patients, have a low exercise tolerance due to multiple factors, such as dynamic hyperinflation and peripheral muscle dysfunction. In this article, the authors describe a variety of modalities and strategies to overcome exercise limitations and improve the effects of exercise training. PMID:24290562

  12. First data on Pneumocystis jirovecii colonization in patients with respiratory diseases in North Lebanon

    Directory of Open Access Journals (Sweden)

    S. Khalife

    2015-07-01

    Full Text Available Pneumocystis colonization may play a role in transmission and local inflammatory response. It was explored in patients with respiratory diseases in North Lebanon. Overall prevalence reached only 5.2% (95% CI 2.13–10.47 but it was higher (17.3% in the subpopulation of patients with chronic obstructive pulmonary disease (COPD. COPD was the only factor associated with a significantly increased risk of colonization. mtLSU genotyping revealed predominance of genotype 2, identified in five patients (71.4%, including one patient who had co-infection with genotype 3. These first data in North Lebanon confirm Pneumocystis circulation among patients with respiratory diseases and the potential for transmission to immunocompromised patients.

  13. How air pollution influences clinical management of respiratory diseases. A case-crossover study in Milan

    Directory of Open Access Journals (Sweden)

    Santus Pierachille

    2012-10-01

    Full Text Available Abstract Background Environmental pollution is a known risk factor for multiple diseases and furthermore increases rate of hospitalisations. We investigated the correlation between emergency room admissions (ERAs of the general population for respiratory diseases and the environmental pollutant levels in Milan, a metropolis in northern Italy. Methods We collected data from 45770 ERAs for respiratory diseases. A time-stratified case-crossover design was used to investigate the association between air pollution levels and ERAs for acute respiratory conditions. The effects of air pollutants were investigated at lag 0 to lag 5, lag 0–2 and lag 3–5 in both single and multi-pollutant models, adjusted for daily weather variables. Results An increase in ozone (O3 levels at lag 3–5 was associated with a 78% increase in the number of ERAs for asthma, especially during the warm season. Exposure to carbon monoxide (CO proved to be a risk factor for pneumonia at lag 0–2 and in the warm season increased the risk of ERA by 66%. A significant association was found between ERAs for COPD exacerbation and levels of sulphur dioxide (SO2, CO, nitrate dioxide (NO2, and particulate matter (PM10 and PM2.5. The multipollutant model that includes all pollutants showed a significant association between CO (26% and ERA for upper respiratory tract diseases at lag 0–2. For chronic obstructive pulmonary disease (COPD exacerbations, only CO (OR 1.19 showed a significant association. Conclusions Exposure to environmental pollution, even at typical low levels, can increase the risk of ERA for acute respiratory diseases and exacerbation of obstructive lung diseases in the general population.

  14. Etiologies of chronic liver disease in children

    Directory of Open Access Journals (Sweden)

    Farahmand F

    2001-11-01

    Full Text Available Chronic Liver diseases in children is the result of many different diseases including: metabolic, genetic, infectious, toxic and idiopathic causes. This was a case series study on 133 infants and children with age range 6 month to 12 years old, who presented clinically with manifestation of chronic liver disease and were admitted to Children Hospital Medical Center from year 1999 to 2000. In this study, 32 (24.5 percent patients had autoimmune chronic hepatitis, 15 (11.3 percent Glycogen storage diseases, 12 (9 percent extrahepatic biliary atresia, 11 (8.2 percent willson disease, 10 (7.5 percent cryptogenic cirrhosis, 6 (4.5 percent chronic hepatitis C, 5 (3.8 percen chronic hepatitic B, 5 (3.8 percent galactosemia 3 (2.25 percent congenital hepatic fibrosis, 3 (3.8 percent histiocytosis X, 3 (2.25 percent sclerosing cholangitis, 2 (1.5 percent byler’s disease 2 (1.5 percent primary tuberculosis, 1 (0.75 percent choledocalcyst, 1 (0.75 percent Alagyle syndrome. According to our data, chronic liver disease should be considered in infants and children. In our study, the most common causes are found to be: metabolic and genetic diseases (37.5 percent, chronic autoimmune hepatitis (24 percent and biliary disorders (14 percent, that encompass 86 percent of the patients.

  15. Imaging in Chronic Kidney Disease.

    Science.gov (United States)

    Meola, Mario; Samoni, Sara; Petrucci, Ilaria

    2016-01-01

    Chronic kidney disease (CKD) diagnosis and staging are based on estimated or calculated glomerular filtration rate (GFR), urinalysis and kidney structure at renal imaging techniques. Ultrasound (US) has a key role in evaluating both morphological changes (by means of B-Mode) and patterns of vascularization (by means of color-Doppler and contrast-enhanced US), thus contributing to CKD diagnosis and to the follow-up of its progression. In CKD, conventional US allows measuring longitudinal diameter and cortical thickness and evaluating renal echogenicity and urinary tract status. Maximum renal length is usually considered a morphological marker of CKD, as it decreases contemporarily to GFR, and should be systematically recorded in US reports. More recently, it has been found to be a significant correlation of both renal longitudinal diameter and cortical thickness with renal function. Conventional US should be integrated by color Doppler, which shows parenchymal perfusion and patency of veins and arteries, and by spectral Doppler, which is crucial for the diagnosis of renal artery stenosis and provides important information about intrarenal microcirculation. Different values of renal resistive indexes (RIs) have been associated with different primary diseases, as they reflect vascular compliance. Since RIs significantly correlate with renal function, they have been proposed to be independent risk factors for CKD progression, besides proteinuria, low GFR and arterial hypertension. Despite several new applications, US and color Doppler contribute to a definite diagnosis in <50% of cases of CKD, because of the lack of specific US patterns, especially in cases of advanced CKD. However, US is useful to evaluate CKD progression and to screen patients at risk for CKD. The indications and the recommended frequency of color Doppler US could differ in each case and the follow-up should be tailored. PMID:27170301

  16. Targeting MicroRNA Function in Respiratory Diseases: Mini-Review.

    Science.gov (United States)

    Maltby, Steven; Plank, Maximilian; Tay, Hock L; Collison, Adam; Foster, Paul S

    2016-01-01

    MicroRNAs (miRNAs) are small non-coding RNA molecules that modulate expression of the majority of genes by inhibiting protein translation. Growing literature has identified functional roles for miRNAs across a broad range of biological processes. As such, miRNAs are recognized as potential disease biomarkers and novel targets for therapies. While several miRNA-targeted therapies are currently in clinical trials (e.g., for the treatment of hepatitis C virus infection and cancer), no therapies have targeted miRNAs in respiratory diseases in the clinic. In this mini-review, we review the current knowledge on miRNA expression and function in respiratory diseases, intervention strategies to target miRNA function, and considerations specific to respiratory diseases. Altered miRNA expression profiles have been reported in a number of respiratory diseases, including asthma, chronic obstructive pulmonary disease, cystic fibrosis, and idiopathic pulmonary fibrosis. These include alterations in isolated lung tissue, as well as sputum, bronchoalveolar lavage fluids and peripheral blood or serum. The observed alterations in easily accessible body fluids (e.g., serum) have been proposed as new biomarkers that may inform disease diagnosis and patient management. In a subset of studies, miRNA-targeted interventions also improved disease outcomes, indicating functional roles for altered miRNA expression in disease pathogenesis. In fact, direct administration of miRNA-targeting molecules to the lung has yielded promising results in a number of animal models. The ability to directly administer compounds to the lung holds considerable promise and may limit potential off-target effects and side effects caused by the systemic administration required to treat other diseases.

  17. Caregiver Burden in Chronic Diseases

    Directory of Open Access Journals (Sweden)

    Murat Ilhan Atagun

    2011-09-01

    Full Text Available Duration of human life has been substantially increased in the last fifty years. Survivals of diseases have been prolonged through the advances in medicine. Together with these gratifying consequences, there appeared novel difficulties to cope with. Furthermore developments including globalization, industrialization and transition from rural to urban life occurred during the last century; so family units became smaller and numbers of members on employment in family units increased. As a result numbers of family members to undertake the responsibility of care decreased. As a concept, caregiver burden expresses physical, psychosocial and financial reactions during the course of care providing. Distinct factors including structures of social, cultural and family units and health care systems may affect conditions of care. Caregiver’s age, gender, ethnicity, education, relationship with the patient, attitude towards providing care, financial situation, coping abilities, her own health, beliefs, social support and cultural pattern are the personal factors that are related to perception of caregiver burden. Burden of care giving is geared to differential aspects of care needs. For instance care needs of physically disabled and medical care requiring patients with spinal cord injuries may differ from care needs of chronic psychiatric disorders, demented patients in advanced age of their lives or cancer patients in terminal periods. Strain due to care giving may differ as a result of properties of care demands. It is aimed to review the burden of caregivers in different medical and psychiatric care requiring conditions and to introduce differential aspects of caregiver burden in these different conditions.

  18. Development of a Barthel Index based on dyspnea for patients with respiratory diseases

    Directory of Open Access Journals (Sweden)

    Vitacca M

    2016-06-01

    Full Text Available Michele Vitacca,1 Mara Paneroni,1 Paola Baiardi,2 Vito De Carolis,3 Elisabetta Zampogna,4 Stefano Belli,5 Mauro Carone,3 Antonio Spanevello,4,6 Bruno Balbi,5 Giorgio Bertolotti7 1Respiratory Rehabilitation Division, Salvatore Maugeri Foundation, IRCCS, Institute of Lumezzane, Brescia, 2Scientific Direction, Salvatore Maugeri Foundation, IRCCS, Institute of Pavia, Pavia, 3Respiratory Division, Salvatore Maugeri Foundation, IRCCS, Institute of Cassano delle Murge, Bari, 4Respiratory Division, Salvatore Maugeri Foundation, IRCCS, Institute of Tradate, Varese, 5Respiratory Division, Salvatore Maugeri Foundation, IRCCS, Institute of Veruno, Novara, 6Respiratory Diseases Unit, University of Insubria, Varese, 7Psychology Unit, Salvatore Maugeri Foundation, IRCCS, Institute of Tradate, Varese, Italy Background: As Barthel Index (BI quantifies motor impairment but not breathlessness, the use of only this index could underestimate disability in chronic respiratory disease (CRD. To our knowledge, no study evaluates both motor and respiratory disability in CRD during activities of daily living (ADLs simultaneously and with a unique tool. The objective of this study was to propose for patients with CRD an additional tool for dyspnea assessment during ADLs based on BI items named Barthel Index dyspnea.Methods: Comprehensibility, reliability, internal consistency, validity, responsiveness, and ability to differentiate between disease groups were assessed on 219 subjects through an observational study performed in an in-hospital rehabilitation setting.Results: Good comprehensibility, high reliability (interrater intraclass correlation coefficient was 0.93 [95% confidence interval 0.892–0.964] and test–retest intraclass correlation coefficient was 0.99 [95% confidence interval 0.983–0.994], good internal consistency (Cronbach’s alpha 0.89, strong concurrent validity with 6 minute walking distance (Pearson r=–0.538, P<0.001 and Medical Research Council

  19. The Gut-Lung Axis in Respiratory Disease.

    Science.gov (United States)

    Marsland, Benjamin J; Trompette, Aurélien; Gollwitzer, Eva S

    2015-11-01

    Host-microorganism interactions shape local cell functionality, immune responses, and can influence disease development. Evidence indicates that the impact of host-microbe interactions reaches far beyond the local environment, thus influencing responses in peripheral tissues. There is a vital cross-talk between the mucosal tissues of our body, as exemplified by intestinal complications during respiratory disease and vice versa. Although, mechanistically, this phenomenon remains poorly defined, the existence of the gut-lung axis and its implications in both health and disease could be profoundly important for both disease etiology and treatment. In this review, we highlight how changes in the intestinal microenvironment, with a particular focus on the intestinal microbiota, impact upon respiratory disease.

  20. Bronchial asthma and chronic obstructive pulmonary disease: research activity in Arab countries

    OpenAIRE

    Sweileh, Waleed M; Al-Jabi, Samah W.; Zyoud, Sa’ed H; Ansam F Sawalha

    2014-01-01

    Background Chronic respiratory diseases, like bronchial asthma and chronic obstructive pulmonary disease (COPD), are a worldwide health problem. Quantitative and qualitative assessment of asthma and COPD-related research from Arab countries has not been explored and there are few internationally published reports on such field. The main objectives of this study were to analyze research output originating from Arab countries in the field of bronchial asthma and COPD. Methods Original scientifi...

  1. End-of-life decision making in respiratory failure. The therapeutic choices in chronic respiratory failure in a 7-item questionnaire

    Directory of Open Access Journals (Sweden)

    Dagmar Elfriede Rinnenburger

    2012-01-01

    Full Text Available INTRODUCTION: The transition from paternalistic medicine to a healthcare culture centred on the patient's decision making autonomy presents problems of communication and understanding. Chronic respiratory failure challenges patients, their families and caregivers with important choices, such as invasive and non-invasive mechanical ventilation and tracheostomy, which, especially in the case of neuromuscular diseases, can significantly postpone the end of life. MATERIAL AND METHODS: A 7-item questionnaire was administered to 100 patients with advanced COPD, neuromuscular diseases and pulmonary fibrosis, all of them on oxygen therapy and receiving day-hospital treatment for respiratory failure. The objective was to find out whether or not patients, if faced with a deterioration of their health condition, would want to take part in the decision making process and, if so, how and with whom. RESULTS. Results showed that: 90% of patients wanted to be interviewed, 10% preferred not to be interviewed, 82% wanted to be regularly updated on their clinical situation, 75% wanted to be intubated, if necessary, and 56% would also agree to have a tracheostomy. These choices have been confirmed one year later, with 93% of respondents accepting the questionnaire and considering it useful. CONCLUSIONS: It is possible to conclude that a simple questionnaire can be a useful tool contributing to therapeutic decision making in respiratory failure.

  2. Dust exposure and chronic respiratory symptoms among coffee curing workers in Kilimanjaro: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Sakwari Gloria

    2011-11-01

    Full Text Available Abstract Background Coffee processing causes organic dust exposure which may lead to development of respiratory symptoms. Previous studies have mainly focused on workers involved in roasting coffee in importing countries. This study was carried out to determine total dust exposure and respiratory health of workers in Tanzanian primary coffee-processing factories. Methods A cross sectional study was conducted among 79 workers in two coffee factories, and among 73 control workers in a beverage factory. Personal samples of total dust (n = 45 from the coffee factories and n = 19 from the control factory were collected throughout the working shift from the breathing zone of the workers. A questionnaire with modified questions from the American Thoracic Society questionnaire was used to assess chronic respiratory symptoms. Differences between groups were tested by using independent t-tests and Chi square tests. Poisson Regression Model was used to estimate prevalence ratio, adjusting for age, smoking, presence of previous lung diseases and years worked in dusty factories. Results All participants were male. The coffee workers had a mean age of 40 years and were older than the controls (31 years. Personal total dust exposure in the coffee factories were significantly higher than in the control factory (geometric mean (GM 1.23 mg/m3, geometric standard deviation (GSD (0.8 vs. 0.21(2.4 mg/m3. Coffee workers had significantly higher prevalence than controls for cough with sputum (23% vs. 10%; Prevalence ratio (PR; 2.5, 95% CI 1.0 - 5.9 and chest tightness (27% vs. 13%; PR; 2.4, 95% CI 1.1 - 5.2. The prevalence of morning cough, cough with and without sputum for 4 days or more in a week was also higher among coffee workers than among controls. However, these differences were not statistically significant. Conclusion Workers exposed to coffee dust reported more respiratory symptoms than did the controls. This might relate to their exposure to coffee dust

  3. HIV/AIDS, chronic diseases and globalisation

    OpenAIRE

    Colvin Christopher J

    2011-01-01

    Abstract HIV/AIDS has always been one of the most thoroughly global of diseases. In the era of widely available anti-retroviral therapy (ART), it is also commonly recognised as a chronic disease that can be successfully managed on a long-term basis. This article examines the chronic character of the HIV/AIDS pandemic and highlights some of the changes we might expect to see at the global level as HIV is increasingly normalised as "just another chronic disease". The article also addresses the ...

  4. Medicines used in respiratory diseases only seen in children

    NARCIS (Netherlands)

    Lenney, W.; Boner, A. L.; Bont, L.; Bush, A.; Carlsen, K-H.; Eber, E.; Fauroux, B.; Goetz, M.; Greenough, A.; Grigg, J.; Hull, J.; Kimpen, J.; Sanchez Luna, M.; de Benedictis, F. M.

    2009-01-01

    Detailed literature searches were carried out in seven respiratory disease areas. Therapeutic evidence for efficacy of medicinal products was assessed using the Grades of Recommendation, Assessment and Evaluation (GRADE) methodology, as well as an assessment of safety and side-effects. Systemic cort

  5. Air pollution and respiratory disease: a preliminary report

    Energy Technology Data Exchange (ETDEWEB)

    Dohan, F.C.; Taylor, E.W.

    1960-01-01

    Incidence of respiratory disease in females working in electronics plants in 5 cities was positively correlated (r = 0.964) with suspended sulfates. No or poor correlation with particulates, benzene- or acetone-soluble organic matter, chlorides, nitrates, or radioactivity was noted.

  6. Has the airway microbiome been overlooked in respiratory disease?

    OpenAIRE

    Salami, Olawale; Marsland, Benjamin J

    2015-01-01

    Editorial summary The respiratory disease field is changing because of recent advances in our understanding of the airway microbiome. Central to this is dysbiosis, an imbalance of microbial communities that can lead to and flag inflammation in the airways. The increasing momentum of research in this area holds promise for novel treatment strategies.

  7. Low hospital admission rates for respiratory diseases in children.

    NARCIS (Netherlands)

    Uijen, J.H.J.M.; Schellevis, F.G.; Bindels, P.J.E.; Willemsen, S.P.; Wouden, J.C. van der

    2010-01-01

    BACKGROUND: Population-based data on hospital admissions for children aged 0-17 years concerning all respiratory diseases are scarce. This study examined hospital admissions in relation to the preceding consultations in general practice in this age group. METHODS: Data on children aged 0-17 years wi

  8. 28 CFR 79.46 - Proof of nonmalignant respiratory disease.

    Science.gov (United States)

    2010-07-01

    ... Program will treat as equivalent to a diagnosis of pulmonary fibrosis any diagnosis of “restrictive lung... claimant contracted a nonmalignant respiratory disease, including pulmonary fibrosis, fibrosis of the lung, cor pulmonale related to fibrosis of the lung, silicosis, and pneumoconiosis: (i) Pathology report...

  9. 28 CFR 79.65 - Proof of nonmalignant respiratory disease.

    Science.gov (United States)

    2010-07-01

    ... Program will treat as equivalent to a diagnosis of pulmonary fibrosis any diagnosis of “restrictive lung... that the claimant contracted a nonmalignant respiratory disease, including pulmonary fibrosis, fibrosis of the lung, cor pulmonale related to fibrosis of the lung, silicosis and pneumoconiosis:...

  10. 28 CFR 79.55 - Proof of nonmalignant respiratory disease.

    Science.gov (United States)

    2010-07-01

    ... Program will treat as equivalent to a diagnosis of pulmonary fibrosis any diagnosis of “restrictive lung... that the claimant contracted a nonmalignant respiratory disease, including pulmonary fibrosis, fibrosis of the lung, cor pulmonale related to fibrosis of the lung, silicosis, and pneumoconiosis:...

  11. Chronic heart failure modifies respiratory mechanics in rats: a randomized controlled trial

    OpenAIRE

    Deise M. Pacheco; Viviane D. Silveira; Alex Thomaz; Ramiro B Nunes; Viviane R. Elsner; Pedro Dal Lago

    2016-01-01

    ABSTRACT Objective To analyze respiratory mechanics and hemodynamic alterations in an experimental model of chronic heart failure (CHF) following myocardial infarction. Method Twenty-seven male adult Wistar rats were randomized to CHF group (n=12) or Sham group (n=15). Ten weeks after coronary ligation or sham surgery, the animals were anesthetized and submitted to respiratory mechanics and hemodynamic measurements. Pulmonary edema as well as cardiac remodeling were measured. Results The C...

  12. Is acute recurrent pancreatitis a chronic disease?

    Institute of Scientific and Technical Information of China (English)

    Alberto Mariani; Pier Alberto Testoni

    2008-01-01

    Whether acute recurrent pancreaUtis is a chronic disease is still debated and a consensus is not still reached as demonstrated by differences in the classification of acute recurrent pancreatitis.There is major evidence for considering alcoholic pancreatitis as a chronic disease ab initio while chronic pancreatitis lesions detectable in biliary acute recurrent pancreatitis (ARP) seem a casual association.Cystic fibrosis transmembrane con ductance regulator (CFTR) gene mutation,hereditary and obstructive pancreatitis seem an acute disease that progress to chronic pancreatitis,likely as a consequence of the activation and proliferation of pancreatic stellate cells that produce and activate collagen and therefore fibrosis.From the diagnostic point of view,in patients with acute recurrent pancreatitis Endoscopic ultrasound (EUS) seems the more reliable technique for an accurate evaluation and follow-up of some ductal and parenchymal abnormalities suspected for early chronic pancreatitis.

  13. [Chronic diseases. Definition and basic concept].

    Science.gov (United States)

    Raspe, H

    2011-01-01

    The baroque deity Chronos symbolizes much of what we intuitively connect with "chronic", but it must not obscure our view of the diversity of chronic diseases. Common to all forms is a prognostic implication: a chronic disease and all associated burden will accompany the patient for the rest of his/her life. Chronic diseases are in general multifocal disorders simultaneously affecting biological, psychic, and social equilibria. This requires systematic problem-screening and -assessment, including possible comorbidities. Comorbidity in a strict sense should be distinguished from risk factors, implications, complications, and consequences of the index disorder of interest. The assessment is usually followed by the shared identification of therapeutic goals and indications. In chronic disorders, a wide spectrum of diagnostic and therapeutic approaches, methods, and professions becomes relevant. PMID:21246322

  14. HIV/AIDS, chronic diseases and globalisation.

    Science.gov (United States)

    Colvin, Christopher J

    2011-08-26

    HIV/AIDS has always been one of the most thoroughly global of diseases. In the era of widely available anti-retroviral therapy (ART), it is also commonly recognised as a chronic disease that can be successfully managed on a long-term basis. This article examines the chronic character of the HIV/AIDS pandemic and highlights some of the changes we might expect to see at the global level as HIV is increasingly normalised as "just another chronic disease". The article also addresses the use of this language of chronicity to interpret the HIV/AIDS pandemic and calls into question some of the consequences of an uncritical acceptance of concepts of chronicity.

  15. HIV/AIDS, chronic diseases and globalisation

    Directory of Open Access Journals (Sweden)

    Colvin Christopher J

    2011-08-01

    Full Text Available Abstract HIV/AIDS has always been one of the most thoroughly global of diseases. In the era of widely available anti-retroviral therapy (ART, it is also commonly recognised as a chronic disease that can be successfully managed on a long-term basis. This article examines the chronic character of the HIV/AIDS pandemic and highlights some of the changes we might expect to see at the global level as HIV is increasingly normalised as "just another chronic disease". The article also addresses the use of this language of chronicity to interpret the HIV/AIDS pandemic and calls into question some of the consequences of an uncritical acceptance of concepts of chronicity.

  16. HIV/AIDS, chronic diseases and globalisation.

    Science.gov (United States)

    Colvin, Christopher J

    2011-01-01

    HIV/AIDS has always been one of the most thoroughly global of diseases. In the era of widely available anti-retroviral therapy (ART), it is also commonly recognised as a chronic disease that can be successfully managed on a long-term basis. This article examines the chronic character of the HIV/AIDS pandemic and highlights some of the changes we might expect to see at the global level as HIV is increasingly normalised as "just another chronic disease". The article also addresses the use of this language of chronicity to interpret the HIV/AIDS pandemic and calls into question some of the consequences of an uncritical acceptance of concepts of chronicity. PMID:21871074

  17. [Chronic inflammatory bowel diseases in cats].

    Science.gov (United States)

    Ghermai, A K

    1989-01-01

    The aetiology of chronic idiopathic intestinal inflammation is unknown. It is characterized by a diffuse infiltration with inflammatory cells into the intestinal mucosa and sometimes submucosa. Cats with chronic intermittent vomiting and diarrhoea, later on accompanied by anorexia and weight loss, are presented. Definitive diagnosis can be obtained by intestinal biopsy only. An immune pathogenesis is suspected, which is supported by the fact, that chronic inflammatory bowel disease responds to steroid therapy.

  18. Helicobacter pylori infection and respiratory diseases: a review

    OpenAIRE

    Roussos, Anastasios; Philippou, Nikiforos; Gourgoulianis, Konstantinos I

    2003-01-01

    In the past few years, a variety of extradigestive disorders, including cardiovascular, skin, rheumatic and liver diseases, have been associated with Helicobacter pylori (H. pylori) infection. The activation of inflammatory mediators by H. pylori seems to be the pathogenetic mechanism underlying the observed associations. The present review summarizes the current literature, including our own studies, concerning the association between H. pylori infection and respiratory diseases.

  19. A Review of Pediatric Chronic Kidney Disease.

    Science.gov (United States)

    Kaspar, C D W; Bholah, R; Bunchman, T E

    2016-01-01

    Chronic kidney disease is complex in both adults and children, but the disease is far from the same between these populations. Here we review the marked differences in etiology, comorbidities, impact of disease on growth and quality of life, issues unique to adolescents and transitions to adult care, and special considerations of congenital kidney and urinary tract anomalies for transplantation. PMID:26766175

  20. Sleep effects on breathing and respiratory diseases

    Directory of Open Access Journals (Sweden)

    Choudhary Sumer

    2009-01-01

    Full Text Available To understand normal sleep pattern and physiological changes during sleep, sleep and breathing interaction, nomenclature and scales used in sleep study, discuss the effect of rapid eye movements and non-rapid eye movements while sleep and to review the effects of obstructive and restrictive lung disease on gas exchange during sleep and sleep architecture.

  1. Sleep effects on breathing and respiratory diseases

    OpenAIRE

    Choudhary Sumer; Choudhary Sanjiw

    2009-01-01

    To understand normal sleep pattern and physiological changes during sleep, sleep and breathing interaction, nomenclature and scales used in sleep study, discuss the effect of rapid eye movements and non-rapid eye movements while sleep and to review the effects of obstructive and restrictive lung disease on gas exchange during sleep and sleep architecture.

  2. Hedgehogs and sugar gliders: respiratory anatomy, physiology, and disease.

    Science.gov (United States)

    Johnson, Dan H

    2011-05-01

    This article discusses the respiratory anatomy, physiology, and disease of African pygmy hedgehogs (Atelerix albiventris) and sugar gliders (Petaurus breviceps), two species commonly seen in exotic animal practice. Where appropriate, information from closely related species is mentioned because cross-susceptibility is likely and because these additional species may also be encountered in practice. Other body systems and processes are discussed insofar as they relate to or affect respiratory function. Although some topics, such as special senses, hibernation, or vocalization, may seem out of place, in each case the information relates back to respiration in some important way. PMID:21601815

  3. Hedgehogs and sugar gliders: respiratory anatomy, physiology, and disease.

    Science.gov (United States)

    Johnson, Dan H

    2011-05-01

    This article discusses the respiratory anatomy, physiology, and disease of African pygmy hedgehogs (Atelerix albiventris) and sugar gliders (Petaurus breviceps), two species commonly seen in exotic animal practice. Where appropriate, information from closely related species is mentioned because cross-susceptibility is likely and because these additional species may also be encountered in practice. Other body systems and processes are discussed insofar as they relate to or affect respiratory function. Although some topics, such as special senses, hibernation, or vocalization, may seem out of place, in each case the information relates back to respiration in some important way.

  4. Chronic obstructive pulmonary disease and risk of infection

    DEFF Research Database (Denmark)

    Lange, Peter

    2009-01-01

    bacteria causing acute exacerbations. Also lung infections like pneumonia, lung abscess and empyema are more often seen in patients with COPD than in healthy subjects. With regard to extrapulmonary infections, it seems that COPD patients are not at higher risk of infection compared with subjects without......This review article focuses on the risk of infections in patients with chronic obstructive pulmonary disease (COPD). Throughout the years there have been a number of studies describing the risk of pulmonary infections in patients with COPD, whereas only few studies have focused on the risk of...... infection outside the lungs. With increasing severity of COPD the risk of respiratory tract infection also increases. The impairment of the innate immune system is most likely responsible for both the colonization of respiratory tract with bacteria and for an increased risk of infection with new strains of...

  5. Chronic obstructive pulmonary disease and risk of infection

    DEFF Research Database (Denmark)

    Lange, Peter

    2009-01-01

    This review article focuses on the risk of infections in patients with chronic obstructive pulmonary disease (COPD). Throughout the years there have been a number of studies describing the risk of pulmonary infections in patients with COPD, whereas only few studies have focused on the risk...... of infection outside the lungs. With increasing severity of COPD the risk of respiratory tract infection also increases. The impairment of the innate immune system is most likely responsible for both the colonization of respiratory tract with bacteria and for an increased risk of infection with new strains...... of bacteria causing acute exacerbations. Also lung infections like pneumonia, lung abscess and empyema are more often seen in patients with COPD than in healthy subjects. With regard to extrapulmonary infections, it seems that COPD patients are not at higher risk of infection compared with subjects without...

  6. 慢性阻塞性肺疾病患者呼吸肌适应性的重构与受损后的功能%Adaptive reconstitution and damaged function of respiratory muscles in patients with chronic obstructive pulmonary disease

    Institute of Scientific and Technical Information of China (English)

    秦茵茵; 罗远明

    2008-01-01

    慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)是一类危害人民健康的呼吸系统疾病,近年病死率不断增高.随着病程的进展,肌纤维在细胞及亚细胞水平有不同程度的受损,同时产生适应性改变.通过一些肌力及耐力试验及时认识呼吸肌受损后的功能.为临床上制定具体治疗策略如呼吸肌锻炼等提供重要参考资料,可望为临床防治提供新的途径.本文就有关COPD患者呼吸肌适应性的重构和功能下降的检测方法等新观点作一综述.%Chronic obstructive puimonary disease(COPD)is harmful for health and its case fatality is increasing in recent years.Following the progress of course,muscle fibres show different degrees of impairment in cellular and subcellular structures and express adaptive changes at the same time.Assessment of respiratory muscle damaged function through specific tests evaluating the strength and endurance could offer valuable information,which could have important implications for the application of specific strategies,such as respiratory muscle training.The present review aims at high lighting some detecting tests and relevant recent findings regarding adaptive reconstitution and damaged function of respiratory muscles in patients with COPD.

  7. Chronic disease self-management and exercise in COPD as pulmonary rehabilitation: a randomized controlled trial

    OpenAIRE

    Cameron-Tucker HL; Wood-Baker R; Owen C; Joseph L; Walters EH

    2014-01-01

    Helen L Cameron-Tucker,1 Richard Wood-Baker,1 Christine Owen,2 Lyn Joseph,3 E Haydn Walters11Centre of Research Excellence for Chronic Respiratory Disease and Lung Aging, School of Medicine, University of Tasmania, Hobart, TAS, Australia; 2Faculty of Education, University of Tasmania, Hobart, TAS, Australia; 3Department of Respiratory Medicine, Royal Hobart Hospital, Hobart, TAS, AustraliaPurpose: Both exercise and self-management are advocated in pulmonary rehabilitation for people with chro...

  8. Chronic respiratory aeroallergen exposure in mice induces epithelial-mesenchymal transition in the large airways.

    Directory of Open Access Journals (Sweden)

    Jill R Johnson

    Full Text Available Chronic allergic asthma is characterized by Th2-polarized inflammation and leads to airway remodeling and fibrosis but the mechanisms involved are not clear. To determine whether epithelial-mesenchymal transition contributes to airway remodeling in asthma, we induced allergic airway inflammation in mice by intranasal administration of house dust mite (HDM extract for up to 15 consecutive weeks. We report that respiratory exposure to HDM led to significant airway inflammation and thickening of the smooth muscle layer in the wall of the large airways. Transforming growth factor beta-1 (TGF-β1 levels increased in mouse airways while epithelial cells lost expression of E-cadherin and occludin and gained expression of the mesenchymal proteins vimentin, alpha-smooth muscle actin (α-SMA and pro-collagen I. We also observed increased expression and nuclear translocation of Snail1, a transcriptional repressor of E-cadherin and a potent inducer of EMT, in the airway epithelial cells of HDM-exposed mice. Furthermore, fate-mapping studies revealed migration of airway epithelial cells into the sub-epithelial regions of the airway wall. These results show the contribution of EMT to airway remodeling in chronic asthma-like inflammation and suggest that Th2-polarized airway inflammation can trigger invasion of epithelial cells into the subepithelial regions of the airway wall where they contribute to fibrosis, demonstrating a previously unknown plasticity of the airway epithelium in allergic airway disease.

  9. Exertional dyspnoea in chronic heart failure: the role of the lung and respiratory mechanical factors.

    Science.gov (United States)

    Dubé, Bruno-Pierre; Agostoni, Piergiuseppe; Laveneziana, Pierantonio

    2016-09-01

    Exertional dyspnoea is among the dominant symptoms in patients with chronic heart failure and progresses relentlessly as the disease advances, leading to reduced ability to function and engage in activities of daily living. Effective management of this disabling symptom awaits a better understanding of its underlying physiology.Cardiovascular factors are believed to play a major role in dyspnoea in heart failure patients. However, despite pharmacological interventions, such as vasodilators or inotropes that improve central haemodynamics, patients with heart failure still complain of exertional dyspnoea. Clearly, dyspnoea is not determined by cardiac factors alone, but likely depends on complex, integrated cardio-pulmonary interactions.A growing body of evidence suggests that excessively increased ventilatory demand and abnormal "restrictive" constraints on tidal volume expansion with development of critical mechanical limitation of ventilation, contribute to exertional dyspnoea in heart failure. This article will offer new insights into the pathophysiological mechanisms of exertional dyspnoea in patients with chronic heart failure by exploring the potential role of the various constituents of the physiological response to exercise and particularly the role of abnormal ventilatory and respiratory mechanics responses to exercise in the perception of dyspnoea in patients with heart failure. PMID:27581831

  10. Genetic influences on Chronic Obstructive Pulmonary Disease

    DEFF Research Database (Denmark)

    Ingebrigtsen, Truls; Thomsen, Simon F; Vestbo, Jørgen;

    2010-01-01

    Genes that contribute to the risk of developing Chronic Obstructive Pulmonary Disease (COPD) have been identified, but an attempt to accurately quantify the total genetic contribution to COPD has to our knowledge never been conducted....

  11. Chronic Obstructive Pulmonary Disease in Women

    Directory of Open Access Journals (Sweden)

    Louis Laviolette

    2007-01-01

    Full Text Available BACKGROUND: Little is known about the comparative impact of chronic obstructive pulmonary disease (COPD between women and men and about women’s response to pulmonary rehabilitation.

  12. Percutaneous Nephrolithotomy and Chronic Kidney Disease

    DEFF Research Database (Denmark)

    Sairam, Krish; Scoffone, Cesare M; Alken, Peter;

    2012-01-01

    by glomerular filtration rate, including chronic kidney disease stages 0/I/II-greater than 60, stage III-30 to 59 and stages IV/V-less than 30 ml/minute/1.73 m(2). Patient characteristics, operative characteristics, outcomes and morbidity were assessed. RESULTS: Estimated glomerular filtration rate data were...... available on 5,644 patients, including 4,436 with chronic kidney disease stages 0/I/II, 994 with stage III and 214 with stages IV/V. A clinically significant minority of patients with nephrolithiasis presented with severe chronic kidney disease. A greater number of patients with stages IV/V previously...... underwent percutaneous nephrolithotomy, ureteroscopy or nephrostomy and had positive urine cultures than less severely affected patients, consistent with the higher incidence of staghorn stones in these patients. Patients with chronic kidney disease stages IV/V had statistically significantly worse...

  13. COPD (Chronic Obstructive Pulmonary Disease)

    Science.gov (United States)

    ... page from the NHLBI on Twitter. What Is COPD? Español COPD, or chronic obstructive pulmonary (PULL-mun- ... can clog them. Normal Lungs and Lungs With COPD Figure A shows the location of the lungs ...

  14. Dispelling the chronic Lyme disease myth.

    Science.gov (United States)

    Kemperman, Melissa M; Bakken, Johan S; Kravitz, Gary R

    2008-07-01

    Lyme disease is a tick-borne illness endemic to Minnesota that can have potentially severe complications. As the incidence of Lyme disease continues to increase, it is important for physicians in Minnesota to become familiar with its clinical aspects, including the concept of "chronic Lyme disease." Chronic Lyme disease is a misnomer that is often applied to patients with nonspecific presentations who may or may not have a history of infection with Borrelia burgdorferi, the agent that causes Lyme disease. When a patient does present with persistent nonspecific symptoms attributed to chronic Lyme disease, clinicians should ascertain the presence of objective manifestations, obtain laboratory results, and get a history of tick exposure. If active infection with B. burgdorferi is unlikely, they should avoid prescribing empiric antibiotic therapy and instead thoroughly evaluate the patient for other possible causes of the complaints and recommend appropriate care.

  15. Chronic obstructive pulmonary disease : a proteomics approach

    OpenAIRE

    Alexandre, Bruno Miguel Coelho, 1980-

    2011-01-01

    Tese de doutoramento, Biologia (Biologia Molecular), Universidade de Lisboa, Faculdade de Ciências, 2012 Chronic obstructive pulmonary disease (COPD) is characterized by chronic airflow limitation that is not fully reversible even under bronchodilators effect, caused by a mixture of small airway disease – obstructive bronchiolitis – and parenchymal destruction – emphysema. At the present time, COPD is the fourth leading cause of death and its prevalence and mortality are expected to contin...

  16. Obesity and chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Čekerevac Ivan

    2011-01-01

    Full Text Available Introduction. Nutritional abnormalities have one of the most important systematic effects on chronic obstructive pulmonary disease (COPD. A relationship between COPD and obesity has been observed and recognized. In COPD patients, beside changes in the total body weight, changes in body composition are also possible with the loss of fat-free mass (FFM. Objective. This study was undertaken to evaluate the impact of obesity and the change of body composition on the pulmonary function, dyspnoea level and the quality of life in COPD patients. Methods. Seventy-nine patients in the stable state of COPD were evaluated. Pulmonary function and arterial blood gas analysis were assessed. Nutritional status was analyzed according to Body Mass Index (BMI. Body composition was evaluated by using anthropometric measurement by fat free mass index (FFMI. Quality of life was assessed using the St. George Respiratory Questionnaire (SGRQ. The Visual Analogue Scale (VAS was used to evaluate dyspnoea. Results. The highest prevalence of obesity (50.0% was found in patients with mild COPD, while the lowest prevalence was detected in very severe COPD patients (10.0%. The loss of FFM occurred in 22.2% patients with normal body weight and in 9.0% of overweight COPD patients. The quality of life was lower in obese patients compared to other COPD patients. A higher dyspnoea level was also present in obese patients. The lowest airflow obstruction was in obese patients (p=0.023. We found a significant positive correlation between forced expiratory volume in the first second (FEV1% and BMI (r=0.326, p=0.003, FEV1% and FFMI (r=0.321, p=0.004. Conclusion. The highest prevalence of obesity was in patients with mild COPD. Obese patients with COPD had the lowest level of airflow obstruction, higher dyspnoea level and lower quality of life in comparison to other COPD patients.

  17. Health-related quality of life and long-term prognosis in chronic hypercapnic respiratory failure: a prospective survival analysis

    Directory of Open Access Journals (Sweden)

    Schmidbauer Kathrin

    2007-12-01

    Full Text Available Abstract Background Health-related quality of life (HRQL is considered as an important outcome parameter in patients with chronic diseases. This study aimed to assess the role of disease-specific HRQL for long-term survival in patients of different diagnoses with chronic hypercapnic respiratory failure (CHRF. Methods In a cohort of 231 stable patients (chronic obstructive pulmonary disease (COPD, n = 98; non-COPD (obesity-hypoventilation syndrome, restrictive disorders, neuromuscular disorders, n = 133 with CHRF and current home mechanical ventilation (HMV, HRQL was assessed by the disease-specific Severe Respiratory Insufficiency (SRI questionnaire and its prognostic value was prospectively evaluated during a follow-up of 2–4 years, using univariate and multivariate regression analysis. Results HRQL was more impaired in COPD (mean ± SD SRI-summary score (SRI-SS 52.5 ± 15.6 than non-COPD patients (67.6 ± 16.4; p 1 turned out to be independent predictors (p Conclusion In patients with CHRF and HMV, the disease-specific SRI was an overall predictor of long-term survival in addition to established risk factors. However, the SRI predominantly beared information regarding long-term survival in non-COPD patients, while in COPD patients objective measures of the disease state were superior. This on one hand highlights the significance of HRQL in the long-term course of patients with CHRF, on the other hand it suggests that the predictive value of HRQL depends on the underlying disease.

  18. Asthma and chronic obstructive pulmonary disease overlap: asthmatic chronic obstructive pulmonary disease or chronic obstructive asthma?

    Science.gov (United States)

    Slats, Annelies; Taube, Christian

    2016-02-01

    Asthma and chronic obstructive pulmonary disease (COPD) are different disease entities. They are both clinical diagnoses, with diagnostic tools to discriminate between one another. However, especially in older patients (>55 years) it seems more difficult to differentiate between asthma and COPD. This has led to the definition of a new phenotype called asthma COPD overlap syndrome (ACOS). However, our understanding of ACOS is at a very preliminary stage, as most research has involved subjects with existing diagnoses of asthma or COPD from studies with different definitions for ACOS. This has led to different and sometimes opposing results between studies on several features of ACOS, also depending on the comparison with COPD alone, asthma alone or both, which are summarized in this review.We suggest not using the term ACOS for a patient with features of both asthma and COPD, but to describe a patient with chronic obstructive airway disease as completely as possible, with regard to characteristics that determine treatment response (e.g. eosinophilic inflammation) and prognosis (such as smoking status, exacerbation rate, fixed airflow limitation, hyperresponsiveness, comorbidities). This will provide a far more clinically relevant diagnosis, and would aid in research on treatment in more homogenous groups of patients with chronic airways obstruction. More research is certainly needed to develop more evidence-based definitions for this patient group and to evaluate biomarkers, which will help to further classify these patients, treat them more adequately and unravel the underlying pathophysiological mechanism. PMID:26596632

  19. Respiratory protection and emerging infectious diseases: lessons from severe acute respiratory syndrome

    Institute of Scientific and Technical Information of China (English)

    John H. Lange

    2005-01-01

    @@ The severe acute respiratory syndrome (SARS) that emerged 2002-2003 and apparently again 2004 (reported by the news media on December 27, 2003) as the first confirmed case by the World Health Organization (WHO)1,2 raised awareness of emerging infectious diseases.3 Every year there are both new and old infectious diseases emerging as potential pandemic agents.4-6 However, few of these diseases receive the public attention and concern expressed as occurred during the emergence of SARS. Much of this concern was a result of the rapid spread of the novel coronavirus (CoV) to different regions of the world and its high infectivity, especially for health care workers (HCW).3 In many ways, the high percent of HCW infected is a warning of the potential hazards of old and emerging infectious diseases.6 However, SARS was not the only disease (e.g. Monkeypox) that emerged in 2003,3 rather it received the greatest attention.

  20. Event-related evoked potentials in chronic respiratory encephalopathy

    OpenAIRE

    Zaidan, Radwan

    2010-01-01

    A R Al Tahan1, R Zaidan1, S Jones2, A Husain3, A Mobeireek1, A Bahammam11Department of Medicine, 3Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 2Department of Neurophysiology, Institute of Neurology, London, UKBackground: Cognitive event-related potential (P300) is an index of cognitive processing time. It was found to be prolonged in dementia, renal, and hepatic encephalopathies, but was not extensively assessed in respiratory failure.Objective: T...

  1. 呼吸科慢性病患者对健康相关类手机软件的使用情况及需求调查%Investigation of application and needs' survey of mobile App health software in the patients with respiratory chronic disease

    Institute of Scientific and Technical Information of China (English)

    孙爱华; 陈燕; 韩春燕; 赵树娟; 李杰红

    2016-01-01

    Objective To investigate the application and needs' survey of mobile App health software in the patients with respiratory chronic disease. To make mobile App health software development more targeted and practical in the near future. To provide the foundation for continuous nursing service. Methods A survey research method was adopted in which self-designed questionnaires were administered to 163 patients with respiratory chronic disease from respiratory ward and outpatient clinic. Results Totally 119(73.0%) patients used smartphone, the mean score of experience in using mobile phones was (32.4 ± 14.1), which was in the medium range. There were 80 patients had ever installed and used this kind of App. The frequency of use of mobile App health software was Breathing Exercises App, Healthy Exercise App, Healthy Diet App and Medicine Remind App. The major reason for using of these App was disease prevention, self health care, disease and health monitoring and rehabilitation exercises. There were 120 patients would like to install App health software specific to respiratory chronic disease. They hope the characters of these App were simple operated, practical and without product placement. These App health software should include following function:timely feedback and guidance, providing practical method and help to register. Conclusion Most patients with respiratory chronic disease had the hardware basis and experience basis of using mobile App health software. More targeted and practical mobile App health software for the patients with respiratory chronic diseases should be developed to provide the foundation for continuous nursing service and patient′s self-management.%目的:了解呼吸科慢性病患者健康类手机软件(App)使用情况,以及患者在此方面的期待和需求,将来开发具有针对性和实用性的呼吸科疾病相关健康软件,为实现延续性护理服务提供基础。方法采用自行设计的调查问卷对中

  2. Assessment and Management of Patients with Chronic Cough by Certified Respiratory Educators: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Stephen K Field

    2009-01-01

    Full Text Available BACKGROUND: The value of other health care professionals is increasingly being recognized to compensate for the shortage of physicians in Canada. Chronic cough is one of the most common reasons for consultation with a respirologist. In the present study, a prospective, randomized, controlled study was undertaken to determine whether Certified Respiratory Educators (CREs could manage screened patients with chronic cough as effectively as respirologists.

  3. Chronic Kidney Disease and Its Complications

    OpenAIRE

    Thomas, Robert; Kanso, Abbas; Sedor, John R

    2008-01-01

    Chronic kidney disease (CKD) is a complex disease impacting more than twenty million individuals in the United States. Progression of CKD is associated with a number of serious complications, including increased incidence of cardiovascular disease, hyperlipidemia, anemia and metabolic bone disease. CKD patients should be assessed for the presence of these complications and receive optimal treatment to reduce their morbidity and mortality. A multidisciplinary approach is required to accomplish...

  4. [Respiratory disease caused by MMVF fibers and yarn].

    Science.gov (United States)

    Riboldi, L; Rivolta, G; Barducci, M; Errigo, G; Picchi, O

    1999-01-01

    The non-carcinogenic effects of vitreous fibres on the human respiratory apparatus have been the subjects of numerous studies on large exposed populations. No evidence seems to have been produced of the existence of a fibrogenic effect. However, no definite and agreed opinion has yet been expressed by the main Agencies and Institutions working in the field of prevention. As a contribution to the discussion, the paper presents the experience of the Clinica del Lavoro of Milano involving 1000 subjects who underwent broncho-alveolar lavage during assessment and checking for suspected occupational respiratory disease. A group of 23 cases was selected who were exposed to vitreous fibres without other significant exposures to factors considered hazardous for the respiratory apparatus, especially asbestos. We observed 7 cases of alveolitis; 6 cases with pleural thickening; 2 cases of interstitial disease. On the basis of the nature of exposure (duration, latency from beginning and from the end of hazardous occupation), of the data obtained from the examination of the bronchial lavage liquid (presence of vitreous fibres, siderocytes, cellularity), and of the clinical and laboratory data (X-ray, PFR), the view expressed is tendentially reassuring concerning the possible effects of vitreous fibres on the respiratory apparatus. Although the existence of an irritative type of lesion that manifests in the form of alveolitis and localised pleural thickening seems possible, albeit in a limited number of cases, it does however appear much more difficult to admit the existence of a fibrogenic effect. PMID:10339954

  5. Evidence-based risk assessment and recommendations for physical activity clearance: respiratory disease.

    Science.gov (United States)

    Eves, Neil D; Davidson, Warren J

    2011-07-01

    The 2 most common respiratory diseases are chronic obstructive pulmonary disease (COPD) and asthma. Growing evidence supports the benefits of exercise for all patients with these diseases. Due to the etiology of COPD and the pathophysiology of asthma, there may be some additional risks of exercise for these patients, and hence accurate risk assessment and clearance is needed before patients start exercising. The purpose of this review was to evaluate the available literature regarding the risks of exercise for patients with respiratory disease and provide evidence-based recommendations to guide the screening process. A systematic review of 4 databases was performed. The literature was searched to identify adverse events specific to exercise. For COPD, 102 randomized controlled trials that involved an exercise intervention were included (n = 6938). No study directly assessed the risk of exercise, and only 15 commented on exercise-related adverse events. For asthma, 30 studies of mixed methodologies were included (n = 1278). One study directly assessed the risk of exercise, and 15 commented on exercise-related adverse events. No exercise-related fatalities were reported. The majority of adverse events in COPD patients were musculoskeletal or cardiovascular in nature. In asthma patients, exercise-induced bronchoconstriction and (or) asthma symptoms were the primary adverse events. There is no direct evidence regarding the risk of exercise for patients with COPD or asthma. However, based on the available literature, it would appear that with adequate screening and optimal medical therapy, the risk of exercise for these respiratory patients is low. PMID:21800949

  6. Use of Spirometry and Respiratory Drugs in Manitobans Over 35 Years of Age with Obstructive Lung Diseases

    OpenAIRE

    NR Anthonisen; K Woodlrage; J Manfreda

    2005-01-01

    BACKGROUND: Previous data indicated that spirometry was underused in people with obstructive disease, especially those with chronic obstructive pulmonary disease (COPD).OBJECTIVE: To examine the use of respiratory drugs in patients with COPD and asthma, and to relate drug use to spirometry.METHODS: Manitoba Health maintains a database of physician services remunerated by fees that includes spirometry. The database contains the diagnosis and patient identifiers, as well as sex, date of birth a...

  7. Effect of Bi-level positive airway pressure combined with vibration spu-tum elimination in the treatment of chronic obstructive pulmonary disease with acute exacerbation complicated with respiratory failure%BiPAP联合振动排痰治疗AECOPD合并呼吸衰竭的效果评价

    Institute of Scientific and Technical Information of China (English)

    李海泉; 赵杰; 王海清; 徐俊马; 杜永亮; 李慧婷

    2014-01-01

    目的:探讨无创双水平气道正压通气联合振动排痰治疗慢性阻塞性肺疾病合并呼吸衰竭的临床效果。方法将40例患者随机分为A组与B组各20例。 A组患者采用无创双水平正压通气联合振动排痰进行治疗,B组患者仅使用无创双水平正压通气治疗,观察两组的治疗效果。结果 A组患者的PaCO2较B组下降快(P<0.05),呼吸支持时间及住院时间亦明显缩短(P<0.05),气管插管率较B组低(P<0.05)。结论无创正压通气联合振动排痰对治疗慢性阻塞性肺疾病合并呼衰的患者具有明显优势,值得临床推广。%Objective To evaluate the efficacy of Bi-level positive airway pressure (BiPAP) combined with vibration sputum elimination in the treatment of chronic obstructive pulmonary disease with acute exacerbation (AECOPD) com-plicated with respiratory failure. Methods 40 cases of patients with respiratory failure were randomly divided into group A (20 cases) and group B (20 cases).The patients in group A were received noninvasive BiPAP ventilation and vibration sputum elimination.The patients in group B were treated with BiPAP ventilation only.Clinical effect in two groups were observed. Results After treatment,PaCO2 changed more significantly in group A than that in group B .The patients in group A had a significantly shorter duration of respiratory support than group B (P<0.05).The respiratory support time and hospital stay of group A was shorter than that of group B (P<0.05).The rate of endotracheal intubation of group A was lower than that of group B (P<0.05). Conclusion BiPAP combined with vibration sputum elimination in treatment of AECOPD complicated with respiratory failure has good curative effect and it is worth promoting.

  8. The chronic gastrointestinal manifestations of Chagas disease

    Directory of Open Access Journals (Sweden)

    Nilce Mitiko Matsuda

    2009-01-01

    Full Text Available Chagas disease is an infectious disease caused by the protozoan Trypanosoma cruzi. The disease mainly affects the nervous system, digestive system and heart. The objective of this review is to revise the literature and summarize the main chronic gastrointestinal manifestations of Chagas disease. The chronic gastrointestinal manifestations of Chagas disease are mainly a result of enteric nervous system impairment caused by T. cruzi infection. The anatomical locations most commonly described to be affected by Chagas disease are salivary glands, esophagus, lower esophageal sphincter, stomach, small intestine, colon, gallbladder and biliary tree. Chagas disease has also been studied in association with Helicobacter pylori infection, interstitial cells of Cajal and the incidence of gastrointestinal cancer.

  9. Nutritional supplementation in patients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Hsieh, Meng-Jer; Yang, Tsung-Ming; Tsai, Ying-Huang

    2016-08-01

    Malnutrition in patients with chronic obstructive pulmonary disease (COPD) is associated with cachexia, sarcopenia, and weight loss, and may result in poorer pulmonary function, decreased exercise capacity, and increased risk of exacerbations. Providing nutritional supplementation is an important therapeutic intervention, particularly for severely ill COPD patients with malnutrition. Higher calorie intake through nutritional supplementation significantly increases body weight and muscle strength, and improves quality of life in malnourished COPD patients. Difficulties may be experienced by these COPD patients, who are struggling to breathe and eliminate CO2 from the lungs, resulting in dyspnea, hypercapnia, hypoxia, and respiratory acidosis, which exacerbates muscle loss through oxidative stress and inflammatory responses. To overcome these problems, nutritional supplements should aim to reduce metabolic CO2 production, lower respiratory quotient, and improve lung function. Several studies have shown that high-fat supplements produce less CO2 and have lower respiratory quotient value than high-carbohydrate supplements. In addition, high-fat supplements may be the most efficient means of providing a low-volume, calorie-dense supplement to COPD patients, and may be most beneficial to patients with prolonged mechanical ventilation where hypercapnia and malnutrition are most pronounced. Further studies are required to investigate the optimal nutritional supplements for COPD patients according to their disease severity. PMID:26822811

  10. Respiratory Diseases in Iron Ore Miners and Millers

    OpenAIRE

    Edstrom, Harry W.

    1989-01-01

    Workers in iron mines are at risk of developing interstitial lung disease if the dust levels are above the threshold limit value. However, they more commonly develop the usual diseases that affect all workers. Some illnesses, such as chronic bronchitis, bronchial asthma, and the collagen vascular diseases that affect the lung, may be more severe because of the inhalation of dust. The most difficult problem is to differentiate asymptomatic sarcoidosis from pneumoconiosis. The family doctor who...

  11. Acute and chronic respiratory effects of occupational exposure to ammonia.

    Science.gov (United States)

    Holness, D L; Purdham, J T; Nethercott, J R

    1989-12-01

    In a soda ash plant, 58 workers exposed to mean airborne ammonia levels of 9.2 +/- 1.4 ppm were compared with 31 control workers with a mean exposure of 0.3 +/- 0.1 ppm. There were no differences between the groups in the reporting of respiratory or cutaneous symptoms, sense of smell, baseline lung function, or change in lung function over a work shift at the beginning and end of a workweek. No relationships between level or length of ammonia exposure and lung function results were demonstrated. PMID:2596404

  12. 无创机械通气治疗慢性阻塞性肺病合并呼吸衰竭疗效观察%Non-invasive mechanical ventilation in the treatment of chronic obstructive pulmonary disease with respiratory failure Efficacy

    Institute of Scientific and Technical Information of China (English)

    李玉

    2010-01-01

    Objective To explore the bi-level positive airway pressure non-invasive ventilation (BI-PAP) for chronic obstructive pulmonary disease (COPD)with respiratory failure,the value of the cure.Methods COPD patients with type Ⅱ respiratory failure 47 regular bi-level positive airway pressure non-invasive ventilation(BIPAP) ,recorded the change before treatment,on the plane two hours after one day,three days PH,PaO2 ,PaCO2,SPO2 change.Results All patients through the bi-level positive airway pressure non-invasive ventilation,the clinical symptoms significantly improved after treatment,blood gas analysis The PH,PaO2,PaCO2 ,SPO2 a significant improvement compared with before treatment (P < 0.05).Conclusion The bi-level positive airway pressure non-invasive ventilation (BIPAP) for chronic obstructive pulmonary disease (COPD) with respiratory failure has a significant effect.%目的 探讨双水平气道正压无创通气(BIPAP)对慢性阻塞性肺病(COPD)合并呼吸衰竭的冶疗价值.方法 对COPD合并Ⅱ型呼吸衰竭患者47例行双水平气道正压无创通气(BIPAP),记录治疗前,上机后2 h、1 d、3 d的pH、PaO2、PaCO2、SPO2变化.结果 所有患者经过双水平气道正压无创通气后,临床症状有明显好转,治疗后血气分析中的pH、PaO2、PaCO2、SPO2较治疗前有明显改善(P<0.05).结论 双水平气道正压无创通气(BIPAP)对慢性阻塞性肺病(COPD)合并呼吸衰竭患者疗效显著.

  13. Circulating Adipocytokines and Chronic Kidney Disease

    OpenAIRE

    Mills, Katherine T.; L Lee Hamm; A Brent Alper; Chad Miller; Alhakam Hudaihed; Saravanan Balamuthusamy; Chung-Shiuan Chen; Yanxi Liu; Joseph Tarsia; Nader Rifai; Myra Kleinpeter; Jiang He; Jing Chen

    2013-01-01

    BACKGROUND: Adipokines have been associated with atherosclerotic heart disease, which shares many common risk factors with chronic kidney disease (CKD), but their relationship with CKD has not been well characterized. METHODS: We investigated the association of plasma leptin, resistin and adiponectin with CKD in 201 patients with CKD and 201 controls without. CKD was defined as estimated glomerular filtration rate (eGFR)

  14. The Western Diet and Chronic Kidney Disease.

    Science.gov (United States)

    Hariharan, Divya; Vellanki, Kavitha; Kramer, Holly

    2015-03-01

    Characteristics of the Western diet that fueled the obesity epidemic may also impact kidney disease incidence and progression. Enlarging portion sizes over the past half century has been accompanied by increased intake of protein, sodium, and processed foods while consumption of fruits and vegetables has declined. Overall dietary patterns play a strong role for chronic disease risk including chronic kidney disease. While dietary patterns high in fresh fruits and vegetables and low in red meats, such as the Mediterranean diet, decrease the risk of chronic diseases, the Western diet, characterized by high intake of red meat, animal fat, sweets, and desserts and low intake of fresh fruits and vegetables and low-fat dairy products, increases risk of chronic diseases. In this article, we review the potential mechanisms whereby several key characteristics of the typical Western diet may impact kidney disease incidence and progression. We also discuss a public health policy initiative to improve dietary choices. Reducing protein intake to the recommended daily allowance of 0.8 g/kg/day and increasing intake of fruit and vegetables and fiber may mitigate kidney disease progression and reduce risk of cardiovascular disease and mortality. PMID:25754321

  15. Chronic Wasting Disease Agents in Nonhuman Primates

    OpenAIRE

    Race, Brent; Meade-White, Kimberly D.; Phillips, Katie; Striebel, James; Race, Richard; Chesebro, Bruce

    2014-01-01

    Chronic wasting disease is a prion disease of cervids. Assessment of its zoonotic potential is critical. To evaluate primate susceptibility, we tested monkeys from 2 genera. We found that 100% of intracerebrally inoculated and 92% of orally inoculated squirrel monkeys were susceptible, but cynomolgus macaques were not, suggesting possible low risk for humans.

  16. Update: Non-Invasive Positive Pressure Ventilation in Chronic Respiratory Failure Due to COPD.

    Science.gov (United States)

    Altintas, Nejat

    2016-01-01

    Long-term non-invasive positive pressure ventilation (NPPV) has widely been accepted to treat chronic hypercapnic respiratory failure arising from different etiologies. Although the survival benefits provided by long-term NPPV in individuals with restrictive thoracic disorders or stable, slowly-progressing neuromuscular disorders are overwhelming, the benefits provided by long-term NPPV in patients with chronic obstructive pulmonary disease (COPD) remain under question, due to a lack of convincing evidence in the literature. In addition, long-term NPPV reportedly failed in the classic trials to improve important physiological parameters such as arterial blood gases, which might serve as an explanation as to why long-term NPPV has not been shown to substantially impact on survival. However, high intensity NPPV (HI-NPPV) using controlled NPPV with the highest possible inspiratory pressures tolerated by the patient has recently been described as a new and promising approach that is well-tolerated and is also capable of improving important physiological parameters such as arterial blood gases and lung function. This clearly contrasts with the conventional approach of low-intensity NPPV (LI-NPPV) that uses considerably lower inspiratory pressures with assisted forms of NPPV. Importantly, HI-NPPV was very recently shown to be superior to LI-NPPV in terms of improved overnight blood gases, and was also better tolerated than LI-NPPV. Furthermore, HI-NPPV, but not LI-NPPV, improved dyspnea, lung function and disease-specific aspects of health-related quality of life. A recent study showed that long-term treatment with NPPV with increased ventilatory pressures that reduced hypercapnia was associated with significant and sustained improvements in overall mortality. Thus, long-term NPPV seems to offer important benefits in this patient group, but the treatment success might be dependent on effective ventilatory strategies. PMID:26418151

  17. Chronic kidney disease - pediatric risk factors.

    Science.gov (United States)

    Tasic, Velibor; Janchevska, Aleksandra; Emini, Nora; Sahpazova, Emilija; Gucev, Zoran; Polenakovic, Momir

    2016-01-01

    The knowledge about the progression of chronic kidney disease is an important issue for every pediatric nephrologist and pediatrician in order to implement appropriate measures to prevent wasting of renal function and the final consequence - end stage renal disease with the need for the dialysis and transplantation. Therefore it is important to know, treat or ameliorate the standard risk factors such as hypertension, proteinuria, anemia, hyperparathyroidism etc. In this review devoted to the World Kidney Day 2016 we will pay attention to the low birth parameters, obesity, hyperuricemia and smoking which emerged as particularly important risk factors for children and adolescent with chronic kidney disease. PMID:27442412

  18. Trace elements and chronic liver diseases

    Energy Technology Data Exchange (ETDEWEB)

    Loguercio, C.; De Girolamo, V.; Federico A., A.; Del Vecchio Blanco, C. [Seconda Universita di Napoli, Naples (Italy). Cattedra di Gastroenterologia; Feng, S.L.; Gialanella, G. [Naples Univ. (Italy). Dipt. di Scienze Fisiche; Cataldi, V. [Naples Univ. (Italy). Prima Medicina Ospedale Ascalesi

    1997-12-31

    The relationships between chronic liver diseases and trace element (TE) contents are debated. Particularly, no defined data are available about the TE levels in viral liver disease patients with or without malnutrition. In this study we evaluated blood and plasma levels of various trace elements in patients with HCV-related chronic liver disease, at different stages of liver damage (8 patients with chronic hepatitis and 32 with liver cirrhosis) with or without malnutrition. We also studied 10 healthy volunteers as control group. We found that cirrhotic subjects had a significant decrease of blood levels of Zn and Se, independently on the nutritional status, whereas plasma levels of Fe were significantly reduced only in malnourished cirrhotic patients. Our data indicate that liver impairment is the main cause of the blood decrease of Se and Zn levels in patients with non alcoholic liver disease, whereas the malnutrition affects Fe levels only. (orig.)

  19. Air pollution and respiratory allergic diseases in schoolchildren

    OpenAIRE

    Nicolussi, Francine Heloisa; dos Santos, Ana Paula Milla; André, Sílvia Carla da Silva; Veiga, Tatiane Bonametti; Takayanagui, Angela Maria Magosso

    2014-01-01

    Study on the prevalence of allergic respiratory diseases in schoolchildren between six and seven years old, associated with indicators of air pollution. A questionnaire based on the International Study of Asthma and Allergies in Childhood was administered to parents of students from public schools, located in urban areas with differing vehicle flows. There was a positive correlation between monthly frequency of rhinitis and concentration of pollutants, and negative with relative air humidity....

  20. Cuirass respirator treatment of chronic respiratory failure in scoliotic patients.

    Science.gov (United States)

    Wiers, P W; Le Coultre, R; Dallinga, O T; van Dijl, W; Meinesz, A F; Sluiter, H J

    1977-04-01

    The results are reported of domiciliary cuirass respirator treatment, using tailor-made shells, in four patients with severe thoracic scoliosis. Three of the patients had suffered from poliomyelitis. All complained of increasing dyspnoea on exertion, ultimately interfering with almost every activity of daily life; three patients had severe acute respiratory failure necessitating urgent admission to the Respiratory Care Unit. Right heart failure was present in two. Two patients required mechanical treatment via an endotracheal tube. All the patients were discharged home with a cuirass respirator. Standard type shells were used initially with low efficiency due to the poor fit of the cuirass shell to the deformed thoracic cage. Tailor-made shells were constructed from polyester reinforced with glass fibre, modelled on plaster casts of the thoracic cage. Subjectively the patients improved greatly and were able to resume and increase many activities. One patient committed suicide for reasons unconnected with treatment but the other three patients have been doing well from the time the cuirass respirator treatment was started, respectively, 3, 6, and 10 years ago. This treatment seems particularly effective in younger patients with severe paralytic scoliosis and cardiorespiratory failure, although the possibility of using it in older patients suffering from scoliosis of other aetiology should certainly be explored.

  1. Prevalence of respiratory diseases in hospitalized patients in Saudi Arabia: A 5 years study 1996-2000

    Directory of Open Access Journals (Sweden)

    Alamoudi Omer

    2006-01-01

    Full Text Available OBJECTIVES: 1 To determine the prevalence of respiratory diseases and the length of stay among hospitalized patients with respiratory disorders 2 To detect the medical disorders commonly associated with respiratory diseases. MATERIALS AND METHODS: A retrospective review was done for 810 patients hospitalized with respiratory diseases in King Abdulaziz University Hospital, Jeddah, Saudi Arabia, over 5 years (January 1996 to December 2000. A special form was used to collect information from patient medical records including demographic data (such as age, sex and nationality, discharge diagnosis with other associated diseases and length of stay during hospitalization. RESULTS: Fifty-five percent of patients were males and 56.3% were Saudis. The mostly affected age group was 46-65 years (41.8%. Asthma (38.6%, chronic obstructive pulmonary disease (COPD (17.2%, pneumonia (11.5%, lung cancer (8.4% and tuberculosis (TB (7.2% had the highest prevalence among hospitalized patients. Asthma was higher among females (63.3% than males (36.7%. In contrast, lung cancer, COPD and TB were higher among males (88.2, 66.9 and 74.1% than females (11.8, 33.1 and 25.9% respectively ( P P CONCLUSION: Asthma, COPD and pneumonia were the leading causes of hospitalization among patients with respiratory disorders, while diabetes and hypertension were the most commonly associated diseases.

  2. Studying human respiratory disease in animals--role of induced and naturally occurring models.

    Science.gov (United States)

    Williams, Kurt; Roman, Jesse

    2016-01-01

    Respiratory disorders like asthma, emphysema, and pulmonary fibrosis affect millions of Americans and many more worldwide. Despite advancements in medical research that have led to improved understanding of the pathophysiology of these conditions and sometimes to new therapeutic interventions, these disorders are for the most part chronic and progressive; current interventions are not curative and do not halt disease progression. A major obstacle to further advancements relates to the absence of animal models that exactly resemble the human condition, which delays the elucidation of relevant mechanisms of action, the unveiling of biomarkers of disease progression, and identification of new targets for intervention in patients. There are currently many induced animal models of human respiratory disease available for study, and even though they mimic features of human disease, discoveries in these models have not always translated into safe and effective treatments in humans. A major obstacle relates to the genetic, anatomical, and functional variations amongst species, which represents the major challenge to overcome when searching for appropriate models of respiratory disease. Nevertheless, rodents, in particular mice, have become the most common species used for experimentation, due to their relatively low cost, size, and adequate understanding of murine genetics, among other advantages. Less well known is the fact that domestic animals also suffer from respiratory illnesses similar to those found in humans. Asthma, bronchitis, pneumonia, and pulmonary fibrosis are among the many disorders occurring naturally in dogs, cats, and horses, among other species. These models might better resemble the human condition and are emphasized here, but further investigations are needed to determine their relevance.

  3. Studying human respiratory disease in animals--role of induced and naturally occurring models.

    Science.gov (United States)

    Williams, Kurt; Roman, Jesse

    2016-01-01

    Respiratory disorders like asthma, emphysema, and pulmonary fibrosis affect millions of Americans and many more worldwide. Despite advancements in medical research that have led to improved understanding of the pathophysiology of these conditions and sometimes to new therapeutic interventions, these disorders are for the most part chronic and progressive; current interventions are not curative and do not halt disease progression. A major obstacle to further advancements relates to the absence of animal models that exactly resemble the human condition, which delays the elucidation of relevant mechanisms of action, the unveiling of biomarkers of disease progression, and identification of new targets for intervention in patients. There are currently many induced animal models of human respiratory disease available for study, and even though they mimic features of human disease, discoveries in these models have not always translated into safe and effective treatments in humans. A major obstacle relates to the genetic, anatomical, and functional variations amongst species, which represents the major challenge to overcome when searching for appropriate models of respiratory disease. Nevertheless, rodents, in particular mice, have become the most common species used for experimentation, due to their relatively low cost, size, and adequate understanding of murine genetics, among other advantages. Less well known is the fact that domestic animals also suffer from respiratory illnesses similar to those found in humans. Asthma, bronchitis, pneumonia, and pulmonary fibrosis are among the many disorders occurring naturally in dogs, cats, and horses, among other species. These models might better resemble the human condition and are emphasized here, but further investigations are needed to determine their relevance. PMID:26467890

  4. RESPONSES OF SUBJECTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE AFTER EXPOSURES TO 0.3 PPM OZONE

    Science.gov (United States)

    The authors previously reported (1982) that the respiratory mechanics of intermittently exercising persons with chronic obstructive pulmonary disease (COPD) were unaffected by a 2-h exposure to 0.2 ppm ozone. Employing a single-blind cross-over design protocol, 13 white men with ...

  5. Differential diagnosis of infections in a patient with Chronic Obstructive Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Paolo Ghiringhelli

    2008-12-01

    Full Text Available We describe a case of a 65-years-old patient with Chronic Obstructive Pulmonary Disease (COPD, receiving oxygen therapy and resistant to antibiotic therapy. He was admitted with high fever, productive cough, marked leukocytosis, and chest X-ray findings of infiltration and fluid levels within lung cysts. A differential diagnosis was essential to start an adequate treatment and avoid the rapid worsening of patients respiratory status. In patients with chronic pulmonary diseases under immunotherapy, micotic infections should be considered. Aspergillus fumigatus was cultured from bronchial washing fluid and we diagnosed chronic necrotizing pulmonary aspergillosis (CNPA. Oral itraconazole was started and his symptoms and laboratory data markedly improved.

  6. Challenges and opportunities for managing respiratory disease in dairy calves.

    Science.gov (United States)

    Stanton, Amy

    2009-12-01

    Bovine respiratory disease (BRD) is important for the Ontario dairy industry due to the large economic and welfare costs of this disease. Practical science-based management techniques are needed to control and reduce the risk of this disease. Currently, the emphasis on BRD is focused on early detection of disease and prevention. These areas are important but it is not practical to assume this disease will be eliminated in the near future. It is necessary to determine the best practices for caring for sick animals, monitoring their recovery and making changes to their management to facilitate health and recovery. If management changes can be made for animals that are failing to thrive in a current situation, a more complete recovery may be possible and the welfare and economic costs of BRD may be minimized. PMID:20003645

  7. Exploring metabolic dysfunction in chronic kidney disease

    OpenAIRE

    Slee Adrian D

    2012-01-01

    Abstract Impaired kidney function and chronic kidney disease (CKD) leading to kidney failure and end-stage renal disease (ESRD) is a serious medical condition associated with increased morbidity, mortality, and in particular cardiovascular disease (CVD) risk. CKD is associated with multiple physiological and metabolic disturbances, including hypertension, dyslipidemia and the anorexia-cachexia syndrome which are linked to poor outcomes. Specific hormonal, inflammatory, and nutritional-metabol...

  8. Relationship between acute and chronic disease epidemiology.

    OpenAIRE

    Kuller, L.H. (Lewis H.)

    1987-01-01

    Epidemiology is the study of epidemics. The primary goal of epidemiological studies should be the identification of the determinants of disease in order to decrease morbidity and mortality. Epidemiological studies evolve through descriptive, analytical, and experimental approaches. The traditional infectious disease epidemiology studies were primarily concerned with identification of an agent, incubation period, mode of transmission, population at risk, and methods of disease control. Chronic...

  9. Cardiovascular disease in patients with chronic kidney disease

    OpenAIRE

    Julian Wright; Alastair Hutchison

    2009-01-01

    Julian Wright, Alastair HutchisonManchester Institute of Nephrology and Transplantation, Manchester Royal Infirmary, Manchester, UKAbstract: Patients with chronic kidney disease have a high burden of cardiovascular morbidity and mortality. The vast majority of patients with chronic kidney disease do not progress to end stage renal failure, but do have a significantly higher incidence of all cardiovascular co-morbidities. Traditional cardiovascular risk factors only partially account for this ...

  10. Dynamic Adaptive Remote Health Monitoring for Patients with Chronic Disease

    OpenAIRE

    Suh, Myung-kyung

    2012-01-01

    Chronic diseases are the leading causes of death and disability in the United States. More than 70% of deaths among Americans are caused by chronic diseases and more than 133 million Americans have at least one chronic disease. Due to the prevalence of chronic disease-related issues, it is prudent to seek out methodologies that would facilitate the prevention, monitoring, and feedback for patients with chronic diseases.This dissertation describes WANDA (Weight and Activity with Other Vital Si...

  11. 无创通气在慢性阻塞性肺疾病合并呼吸衰竭中的疗效观察%Efficacy of Non-invasive Ventilation in Patients with Chronic Obstructive Pulmonary Disease with Respiratory Failure

    Institute of Scientific and Technical Information of China (English)

    曹玉海; 先锋

    2013-01-01

    Non-invasive ventilation in chronic obstructive pulmonary disease (COPD) combined type II respiratory failure clinical ef icacy. 50 patients with COPD with type II respiratory failure, age 46 to 80 years were randomly divided into treatment and control groups. Control group for the conventional treatment group, including (oxygen, aminophyl ine, respiratory stimulants); experimental group, while in the conventional therapy, application of bilevel non-invasive pass (BiPAP) ventilator-assisted treatment, observation and treatment before and after treatment 4h, 24h and 72h in patients with arterial oxygen tension (PaO2), arterial carbon dioxide pressure (PaCO2 was), oxygen saturation (SaO2), pH and respiratory frequency (RR), heart rate (HR) changes. The results show that the BiPAP ventilator noninvasive ventilation for COPD patients with type 2 respiratory failure is feasible, ef ective and safe, as soon as possible applications to prevent disease progression, reversal of the disease, can be used as the conventional treatment of COPD patients with respiratory failure.%慢性阻塞性肺疾病是一种以气流受限为特征的小气道疾病,与肺部对有害气体或有害颗粒的异常炎症反应有关,重症呼吸衰竭患者常需气管插管或气管切开机械通气来改善症状。机械通气是抢救临床危重患者重要的措施,无创辅助通气治疗COPD合并轻、中度Ⅱ型呼吸衰竭,可以改善患者的氧合功能和通气功能,纠正缺O2和CO2潴留,及时纠正呼吸衰竭,减少有创通气的应用[2]。无创通气被作为有创通气的变通用来治疗拒绝气管插管的患者,部分患者可存活出院。本文对50例COPD合并Ⅱ型呼吸衰竭患者分为两组,实验组使用双水平正压无创通气(BiPAP)呼吸机进行通气治疗,对照组应用常规药物治疗,无创呼吸机组取得了满意的疗效。无创通气治疗组COPD合并Ⅱ型呼吸衰竭后2~6 h PaO2和SaO2升高,PaCO2

  12. Framing international trade and chronic disease

    Directory of Open Access Journals (Sweden)

    Mohindra Katia S

    2011-07-01

    Full Text Available Abstract There is an emerging evidence base that global trade is linked with the rise of chronic disease in many low and middle-income countries (LMICs. This linkage is associated, in part, with the global diffusion of unhealthy lifestyles and health damaging products posing a particular challenge to countries still facing high burdens of communicable disease. We developed a generic framework which depicts the determinants and pathways connecting global trade with chronic disease. We then applied this framework to three key risk factors for chronic disease: unhealthy diets, alcohol, and tobacco. This led to specific 'product pathways', which can be further refined and used by health policy-makers to engage with their country's trade policy-makers around health impacts of ongoing trade treaty negotiations, and by researchers to continue refining an evidence base on how global trade is affecting patterns of chronic disease. The prevention and treatment of chronic diseases is now rising on global policy agendas, highlighted by the UN Summit on Noncommunicable Diseases (September 2011. Briefs and declarations leading up to this Summit reference the role of globalization and trade in the spread of risk factors for these diseases, but emphasis is placed on interventions to change health behaviours and on voluntary corporate responsibility. The findings summarized in this article imply the need for a more concerted approach to regulate trade-related risk factors and thus more engagement between health and trade policy sectors within and between nations. An explicit recognition of the role of trade policies in the spread of noncommunicable disease risk factors should be a minimum outcome of the September 2011 Summit, with a commitment to ensure that future trade treaties do not increase such risks.

  13. Obstructive sleep apnea in chronic obstructive pulmonary disease patients.

    LENUS (Irish Health Repository)

    Lee, Ruth

    2012-02-01

    PURPOSE OF REVIEW: Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) represent two of the most prevalent chronic respiratory disorders and cardiovascular diseases are major co-morbidities in both. Co-existence of both disorders (overlap syndrome) occurs in 1% of adults and overlap patients have worse nocturnal hypoxemia and hypercapnia than COPD and OSA patients alone. The present review discusses recent data concerning the pathophysiological and clinical significance of the overlap syndrome. RECENT FINDINGS: The severity of obstructive ventilatory impairment and hyperinflation, especially the inspiratory capacity to total lung capacity (TLC) ratio, correlates with the severity of sleep-related breathing disturbances. Early treatment with continuous positive airway pressure (CPAP) improves survival, reduces hospitalization and pulmonary hypertension, and also reduces hypoxemia. Evidence of systemic inflammation and oxidative stress in COPD and sleep apnea provides insight into potential interactions between both disorders that may predispose to cardiovascular disease. Long-term outcome studies of overlap patients currently underway should provide further evidence of the clinical significance of the overlap syndrome. SUMMARY: Studies of overlap syndrome patients at a clinical, physiological and molecular level should provide insight into disease mechanisms and consequences of COPD and sleep apnea, in addition to identifying potential relationships with cardiovascular disease.

  14. 低糖高脂肪营养支持治疗慢性阻塞性肺病并发呼吸衰竭患者的临床疗效观察%Observing clinical curative effects of low carborhydrate and high fat enteral nutrition in chronic obstructive pulmonary disease (COPD) patients complicated by respiratory failure

    Institute of Scientific and Technical Information of China (English)

    夏艳; 王宏星; 邵少英

    2011-01-01

    目的:评价低糖高脂肪营养支持治疗慢性阻塞性肺病(Chronic obstructive pulmonary disease,COPD)并发呼吸衰竭患者的临床疗效.方法:将60例COPD并发呼吸衰竭患者随机分成2组:研究组30例,对照组30例.2组均予抗感染、吸氧、解痉平喘、化痰、纠正酸碱失衡及电解质紊乱等治疗.研究组予低糖高脂肪营养支持,对照组予传统营养支持,疗程10 d.在研究前1d、研究后10 d分别对2组患者进行血气分析指标、呼吸功能状况测定.结果:研究组在血气分析指标、呼吸功能状况方面改善情况均较对照组有显著性差异(P<0.05).结论:低糖高脂肪营养支持治疗可明显改善COPD并发呼吸衰竭患者的症状和体征,明显改善人体血气分析和肺功能,对纠正呼吸衰竭有良好疗效.%Objective:to evaluate clinical curative effects of low carborhydrate and high fat enteral nutrition in chronic obstructive pulmonary disease(COPD) patients complicated by respiratory failure. Methods:60 patients with COPD patients complicated by res piratory failure were randomly divided into two groups(people in the treatment group and the control group are all 30). Anti-infection, oxyen inhalation, spasmolysis and anti-asthma, eliminating phlegm, correcting acid- base inbalance and electrolyte disorder and so on were used in both groups.The treatment group were given low carborhydrate and high fat enteral nutrition support, while the control group were given traditional nutritional support for 10 days.When one day before and 10 days after the study,blood gas analysis index, respiratory function condition were determined in the two groups of patients. Results:The levels of blood gas analysis index,respiratory function condition in the treatment group were increased significantly as compared with the control group(P<0.05).Conclusion: Low carborhydrate and high fat enteral nutrition support can evidently improve the signs and symptoms of the COPD

  15. Transcending chronic liver disease: a qualitative study.

    Science.gov (United States)

    Wainwright, S P

    1997-01-01

    This study explores and describes experiences of chronic liver disease from the patient's perspective. No qualitative research studies appear to have examined the experiences of these patients. In-depth focused interviews and grounded theory data collection and data analysis methods were used. A two-stage theoretical framework (becoming ill, and not living) of the experience of transcending chronic liver disease is presented. Sociological and psychological literature on common sense models of health and illness are briefly reviewed. Several suggestions for further research are made. The way in which this qualitative research study is leading to a quantitative and qualitative appraisal of the psychological adjustment in end-stage chronic liver disease patients is outlined.

  16. Management of Pruritus in Chronic Liver Disease

    Directory of Open Access Journals (Sweden)

    Angeline Bhalerao

    2015-01-01

    Full Text Available Background. There continues to be uncertainty on the ideal treatment of pruritus in chronic liver disease. The aim of this study was to gather the latest information on the evidence-based management of pruritus in chronic liver disease. Methodology. A literature search for pruritus in chronic liver disease was conducted using Pubmed and Embase database systems using the MeSH terms “pruritus,” “chronic liver disease,” “cholestatic liver disease,” and “treatment.” Results. The current understanding of the pathophysiology of pruritus is described in addition to detailing research into contemporary treatment options of the condition. These medical treatments range from bile salts, rifampicin, and opioid receptor antagonists to antihistamines. Conclusion. The burden of pruritus in liver disease patients persists and, although it is a common symptom, it can be difficult to manage. In recent years there has been greater study into the etiology and treatment of the condition. Nonetheless, pruritus remains poorly understood and many patients continue to suffer, reiterating the need for further research to improve our understanding of the etiology and treatment for the condition.

  17. Chronic Disease Cost not Transferable: Colombian Reality

    Directory of Open Access Journals (Sweden)

    Karina Gallardo Solarte

    2016-01-01

    Full Text Available Objective: The aim is to reflect on the social and economic costs of chronic non-communicable disease (NCD in Colombia to display a charging indicator of these pathologies. Material and methods: In a review of 50 studies, 27 were selected since these met the inclusion criteria, like chronical disease, studies conducted between 2002 and 2011 related to costs, chronic disease, and being Colombian. Results: This is a review study of chronic diseases vs. their costs, being here cardiovascular diseases part of the group of high cost and higher incidence diseases, thus repre­senting a great risk to the financial stability of healthcare companies. There are few studies that address the costs generated by the treatment of ncds patients that show the economic impact experienced by public and private institutions providing and promoting health services. Most of them forget the economic, family and social costs the affected population must suffer. Conclu­sions: ncds represent a burden to the health service system for their very high costs, untimely intervention and reduced significant benefit for this population and their families.

  18. Advances in mechanical ventilation onrespiratoryfailure as a result of chronic obstructive pulmonary disease and bronchial asthma

    Directory of Open Access Journals (Sweden)

    Zhuang MA

    2011-08-01

    Full Text Available Over years,great strides have been made in theories and practices of mechanical ventilation.The indications of non-invasive ventilation have been increasing,while invasive ventilation has been playing a vital role in patients who are critically ill with inadequate drainage of sputum and fail to benefit from non-invasive ventilation.Chronic diseases,including chronic obstructive pulmonary disease(COPD,one of the most common chronic diseases,and bronchial asthma,the incidence of which is ascending recent years,are main causes for respiratory failure.Accordingly,we focus in the present paper on discussion and elaboration of respiratory failure as a result of COPD and bronchial asthma.Type II respiratory failure is the major type of respiratory failure induced by COPD,both in acute exacerbation and stable stage,and mechanical ventilation is one of the most common treatments.Severe acute bronchial asthma complicated with respiratory failure is an emergency.In this situation,primary goal of mechanical ventilation is to make an efficient oxygenation and ventilation of patients,and to avoid hyperinflation to the utmost.For patients who are able to cooperate,non-invasive ventilation in early stage may be beneficial,avoiding tracheal intubation and application of invasive ventilation.But in those who can not achieve remission in a short term,an artificial airway should be established for invasive ventilation as soon as possible.

  19. Allergy to house dust mites in primary health care subjects with chronic or recurrent inflammatory states of respiratory system.

    Science.gov (United States)

    Paszkowski, Jacek; Łopatyński, Jerzy

    2002-01-01

    Chronic and recurrent respiratory tract disorders are a frequent problem in general practice. The purpose of the study was to investigate the role of hypersensitivity to house dust mites in respiratory tract diseases in general practice patients. We tried to assess the influence of determined risk factors exposure on development of respiratory tract allergy. Patients from family practitioners surgeries with chronic or recurrent respiratory tract symptoms who had no diagnosis of allergy were recruited to the study (n = 89). All patients responded to a questionnaire focused on history of symptoms, atopic conditions in family and exposure to determined environmental factors like dwelling conditions, obstetrician history, diet in the first year of life. All patients underwent skin prick test with common inhalant allergens. Families of the patients were asked to participate in the study. Families who agreed to take part also responded to the questionnaire and underwent skin tests. In patients and their families blood samples were taken to determine total IgE and specific IgE antibodies to mites allergens. Dust samples were collected by vacuuming of patients' bedroom carpets and mattresses to determine house dust mites allergens concentration. Data on 30 complete patients family sets of their brotherhood, mother and father were collected. Total and specific serum IgE antibodies were determined by disc enzyme-immunoassay (Analco). Mites allergens concentration in dust was measured by simple Acarex strip test (Nexter). The results of the assays (positive skin tests and/or elevated levels of specific IgE) showed allergy to house dust mites in 24 of 89 study patients from general practitioners surgeries (27%). The prevalence of chronic rhinitis, recurrent bronchitis, chronic or recurrent cough, wheezing, dyspnoea was higher in allergic than in nonallergic subjects. Patients with the diagnosis of allergy to house dust mites had usually worse dwelling conditions. Especially

  20. Chronic Obstructive Pulmonary Disease (COPD)

    Science.gov (United States)

    ... learn about your disease, receive counseling, and create exercise and eating plans tailored to your needs. Surgery: Rarely, patients who have very serious COPD may benefit from surgery. They might have a lung reduction ...

  1. Quality of life in chronic disease patients

    Directory of Open Access Journals (Sweden)

    Kalliopi Megari

    2013-09-01

    Full Text Available During the past decades there was an increasing predominance of chronic disorders, with a large number of people living with chronic diseases that can adversely affect their quality of life. The aim of the present paper is to study quality of life and especially Health-related quality of life (HRQoL in chronic diseases. HRQOL is a multidimensional construct that consists of at least three broad domains − physical, psychological, and social functioning − that are affected by one’s disease and/or treatment. HRQoL is usually measured in chronic conditions and is frequently impaired to a great extent. In addition, factors that are associated with good and poor HRQoL, as well as HRQoL assessment will be discussed. The estimation of the relative impact of chronic diseases on HRQoL is necessary in order to better plan and distribute health care resources aiming at a better HRQoL.[«All the people perceive the concept of living good or being well, that is the same as being happy». (Aristotle. 384-322 BC. Ethica Nichomachea

  2. Autoimmune thyroid disease and chronic urticaria.

    Science.gov (United States)

    Monge, Cecilia; Demarco, Paul; Burman, Kenneth D; Wartofsky, Leonard

    2007-09-01

    We report six cases of autoimmune thyroid disease associated with chronic urticaria and briefly review the literature, including the histopathological nature of such lesions, and their aetiology and pathogenesis. In view of the prevalence of thyroid disease in patients with chronic urticaria, screening measurements of thyrotropin and anti-thyroperoxidase antibodies are recommended, although negative antibodies do not exclude a relationship between urticaria and thyroid autoimmunity. After failure of conventional therapy for urticaria, patients who are apparently clinically euthyroid may be considered for a trial with levothyroxine. Improvement of urticaria was seen with levothyroxine treatment in three of four patients with only marginal abnormalities in thyroid function.

  3. Hot topics in the prevention of respiratory syncytial virus disease.

    Science.gov (United States)

    Habibi, Maximillian S; Patel, Sanjay; Openshaw, Peter

    2011-03-01

    The 7th International Respiratory Syncytial Virus Symposium took place in Hotel Blijdorp, Rotterdam, The Netherlands. The series has been running since 1996; this meeting took place after a 3-year gap, and was attended by approximately 200 clinicians, scientists and industry representatives from all over the world. The conference covered all aspects of respiratory syncytial virus disease, including virology, cell biology, pathogenesis, clinical presentation, diagnosis, immunology, vaccines, antivirals and other therapeutic approaches. Reviews by invited keynote speakers were accompanied by oral and poster presentations, with ample opportunity for discussion of unpublished work. This article summarizes a small selection of hot topics from the meeting, focused on pathogenesis, therapeutics and vaccine development. PMID:21434796

  4. Exosomes and Exosomal miRNA in Respiratory Diseases

    Science.gov (United States)

    Alipoor, Shamila D.; Garssen, Johan; Movassaghi, Masoud

    2016-01-01

    Exosomes are nanosized vesicles released from every cell in the body including those in the respiratory tract and lungs. They are found in most body fluids and contain a number of different biomolecules including proteins, lipids, and both mRNA and noncoding RNAs. Since they can release their contents, particularly miRNAs, to both neighboring and distal cells, they are considered important in cell-cell communication. Recent evidence has shown their possible importance in the pathogenesis of several pulmonary diseases. The differential expression of exosomes and of exosomal miRNAs in disease has driven their promise as biomarkers of disease enabling noninvasive clinical diagnosis in addition to their use as therapeutic tools. In this review, we summarize recent advances in this area as applicable to pulmonary diseases.

  5. Exosomes and Exosomal miRNA in Respiratory Diseases

    Directory of Open Access Journals (Sweden)

    Shamila D. Alipoor

    2016-01-01

    Full Text Available Exosomes are nanosized vesicles released from every cell in the body including those in the respiratory tract and lungs. They are found in most body fluids and contain a number of different biomolecules including proteins, lipids, and both mRNA and noncoding RNAs. Since they can release their contents, particularly miRNAs, to both neighboring and distal cells, they are considered important in cell-cell communication. Recent evidence has shown their possible importance in the pathogenesis of several pulmonary diseases. The differential expression of exosomes and of exosomal miRNAs in disease has driven their promise as biomarkers of disease enabling noninvasive clinical diagnosis in addition to their use as therapeutic tools. In this review, we summarize recent advances in this area as applicable to pulmonary diseases.

  6. Fibulin-1 regulates the pathogenesis of tissue remodeling in respiratory diseases

    Science.gov (United States)

    Liu, Gang; Cooley, Marion A.; Jarnicki, Andrew G.; Hsu, Alan C-Y.; Nair, Prema M.; Haw, Tatt Jhong; Fricker, Michael; Gellatly, Shaan L.; Kim, Richard Y.; Inman, Mark D.; Tjin, Gavin; Wark, Peter A.B.; Walker, Marjorie M.; Horvat, Jay C.; Oliver, Brian G.; Argraves, W. Scott; Knight, Darryl A.; Burgess, Janette K.; Hansbro, Philip M.

    2016-01-01

    Airway and/or lung remodeling, involving exaggerated extracellular matrix (ECM) protein deposition, is a critical feature common to pulmonary diseases including chronic obstructive pulmonary disease (COPD), asthma, and idiopathic pulmonary fibrosis (IPF). Fibulin-1 (Fbln1), an important ECM protein involved in matrix organization, may be involved in the pathogenesis of these diseases. We found that Fbln1 was increased in COPD patients and in cigarette smoke–induced (CS-induced) experimental COPD in mice. Genetic or therapeutic inhibition of Fbln1c protected against CS-induced airway fibrosis and emphysema-like alveolar enlargement. In experimental COPD, this occurred through disrupted collagen organization and interactions with fibronectin, periostin, and tenascin-c. Genetic inhibition of Fbln1c also reduced levels of pulmonary inflammatory cells and proinflammatory cytokines/chemokines (TNF-α, IL-33, and CXCL1) in experimental COPD. Fbln1c–/– mice also had reduced airway remodeling in experimental chronic asthma and pulmonary fibrosis. Our data show that Fbln1c may be a therapeutic target in chronic respiratory diseases. PMID:27398409

  7. TREM-2 promotes macrophage survival and lung disease after respiratory viral infection

    Science.gov (United States)

    Wu, Kangyun; Byers, Derek E.; Jin, Xiaohua; Agapov, Eugene; Alexander-Brett, Jennifer; Patel, Anand C.; Cella, Marina; Gilfilan, Susan; Colonna, Marco; Kober, Daniel L.; Brett, Tom J.

    2015-01-01

    Viral infections and type 2 immune responses are thought to be critical for the development of chronic respiratory disease, but the link between these events needs to be better defined. Here, we study a mouse model in which infection with a mouse parainfluenza virus known as Sendai virus (SeV) leads to long-term activation of innate immune cells that drive IL-13–dependent lung disease. We find that chronic postviral disease (signified by formation of excess airway mucus and accumulation of M2-differentiating lung macrophages) requires macrophage expression of triggering receptor expressed on myeloid cells-2 (TREM-2). Analysis of mechanism shows that viral replication increases lung macrophage levels of intracellular and cell surface TREM-2, and this action prevents macrophage apoptosis that would otherwise occur during the acute illness (5–12 d after inoculation). However, the largest increases in TREM-2 levels are found as the soluble form (sTREM-2) long after clearance of infection (49 d after inoculation). At this time, IL-13 and the adapter protein DAP12 promote TREM-2 cleavage to sTREM-2 that is unexpectedly active in preventing macrophage apoptosis. The results thereby define an unprecedented mechanism for a feed-forward expansion of lung macrophages (with IL-13 production and consequent M2 differentiation) that further explains how acute infection leads to chronic inflammatory disease. PMID:25897174

  8. [Cerebral hemodynamic disorders in patients with chronic decompensated respiratory insufficiency. Physiopathogenetic considerations].

    Science.gov (United States)

    Ionescu, M

    1978-01-01

    The present paper reports on 12 patients (8 males, 4 females) suffering from chronic decompensated respiratory failure, who presented concomitant transient haemodynamic disturbances in the carotid and vertebrobasilary systems, manifested by hemisphere or brain stem symptoms. Owing to the adaptive capacity of these patients there exists a certain tolerance threshold to hypercapnic hypoxemia, but following accentuated or rapid aggravation of acid-base hypercapnic hypoxemia, the biological balance is abruptly perturbed leading to cerebral haemodynamic disturbances. The pathophysiological mechanism of production appears to be the accumulation of acid ions caused by pH acidification of the cerebrospinal fluid. Increase in the cerebral arterial output with decrease in the rate of circulation and vascular resistance take place especially in the vessels with atheromatous or hyaline lesions. Under conditions of severe acidosic hypercapnic hypoxemia this, nevertheless, insures a minimum of 10--20% oxygen required by the metabolism of the nerve cell, sufficient for maintaining the structure of the cell (vita minima). These vasculometabolic mechanisms explain why with improvement of haematosis, following remission of the decompensated disease and fall in acidotic hypercapnic hypoxemia values, the cerebral haemodynamic disturbances also show a more or less evident remission because the nerve cells having maintained their structure are able to take up their function again.

  9. Chronic granulomatous disease: the European experience

    DEFF Research Database (Denmark)

    van den Berg, J Merlijn; van Koppen, Elsbeth; Ahlin, Anders;

    2009-01-01

    CGD is an immunodeficiency caused by deletions or mutations in genes that encode subunits of the leukocyte NADPH oxidase complex. Normally, assembly of the NADPH oxidase complex in phagosomes of certain phagocytic cells leads to a "respiratory burst", essential for the clearance of phagocytosed.......6 years) than in XL CGD (37.8 years), suggesting a milder disease course in AR patients. The disease manifested itself most frequently in the lungs (66% of patients), skin (53%), lymph nodes (50%), gastrointestinal tract (48%) and liver (32%). The most frequently cultured micro-organisms per episode were...... Staphylococcus aureus (30%), Aspergillus spp. (26%), and Salmonella spp. (16%). Surprisingly, Pseudomonas spp. (2%) and Burkholderia cepacia (

  10. What have transgenic and knockout animals taught us about respiratory disease?

    Directory of Open Access Journals (Sweden)

    Spina Domenico

    2000-08-01

    Full Text Available Abstract Over the past decade there has been a significant shift to the use of murine models for investigations into the molecular basis of respiratory diseases, including asthma and chronic obstructive pulmonary disease. These models offer the exciting prospect of dissecting the complex interaction between cytokines, chemokines and growth related peptides in disease pathogenesis. Furthermore, the receptors and the intracellular signalling pathways that are subsequently activated are amenable for study because of the availability of monoclonal antibodies and techniques for targeted gene disruption and gene incorporation for individual mediators, receptors and proteins. However, it is clear that extrapolation from these models to the human condition is not straightforward, as reflected by some recent clinical disappointments. This is not necessarily a problem with the use of mice itself, but results from our continued ignorance of the disease process and how to improve the modelling of complex interactions between different inflammatory mediators that underlie clinical pathology. This review highlights some of the strengths and weaknesses of murine models of respiratory disease.

  11. Mitochondrial respiratory chain disease presenting as progressive bulbar paralysis of childhood.

    NARCIS (Netherlands)

    Roeleveld-Versteegh, A.B.; Braun, K.P.; Smeitink, J.A.M.; Dorland, L.; Koning, T.J.

    2004-01-01

    We report two siblings with a mitochondrial respiratory chain defect who presented with progressive bulbar paralysis of childhood (Fazio-Londe disease). Mitochondrial respiratory chain defects should be considered in differential diagnosis of this rare clinical entity.

  12. Mitochondrial respiratory chain disease presenting as progressive bulbar paralysis of childhood

    NARCIS (Netherlands)

    Roeleveld-Versteegh, ABC; Braun, KPJ; Smeitink, JAM; Dorland, L; de Koning, TJ

    2004-01-01

    We report two siblings with a mitochondrial respiratory chain defect who presented with progressive bulbar paralysis of childhood ( Fazio-Londe disease). Mitochondrial respiratory chain defects should be considered in the differential diagnosis of this rare clinical entity.

  13. Motor function and respiratory capacity in patients with late-onset pompe disease

    DEFF Research Database (Denmark)

    Illes, Zsolt; Mike, Andrea; Trauninger, Anita;

    2014-01-01

    Introduction: The relationship between skeletal muscle strength and respiratory dysfunction in Pompe disease has not been examined by quantitative methods. We investigated correlations among lower extremity proximal muscle strength, respiratory function, and motor performance. Methods: Concentric...

  14. Chronic respiratory symptoms in children following in utero and early life exposure to arsenic in drinking water in Bangladesh

    Science.gov (United States)

    Smith, Allan H; Yunus, Mohammad; Khan, Al Fazal; Ercumen, Ayse; Yuan, Yan; Smith, Meera Hira; Liaw, Jane; Balmes, John; von Ehrenstein, Ondine; Raqib, Rubhana; Kalman, David; Alam, Dewan S; Streatfield, Peter K; Steinmaus, Craig

    2013-01-01

    Background Arsenic exposure via drinking water increases the risk of chronic respiratory disease in adults. However, information on pulmonary health effects in children after early life exposure is limited. Methods This population-based cohort study set in rural Matlab, Bangladesh, assessed lung function and respiratory symptoms of 650 children aged 7–17 years. Children with in utero and early life arsenic exposure were compared with children exposed to less than 10 µg/l in utero and throughout childhood. Because most children drank the same water as their mother had drunk during pregnancy, we could not assess only in utero or only childhood exposure. Results Children exposed in utero to more than 500 µg/l of arsenic were more than eight times more likely to report wheezing when not having a cold [odds ratio (OR) = 8.41, 95% confidence interval (CI): 1.66–42.6, P < 0.01] and more than three times more likely to report shortness of breath when walking on level ground (OR = 3.86, 95% CI: 1.09–13.7, P = 0.02) and when walking fast or climbing (OR = 3.19, 95% CI: 1.22–8.32, P < 0.01]. However, there was little evidence of reduced lung function in either exposure category. Conclusions Children with high in utero and early life arsenic exposure had marked increases in several chronic respiratory symptoms, which could be due to in utero exposure or to early life exposure, or to both. Our findings suggest that arsenic in water has early pulmonary effects and that respiratory symptoms are a better marker of early life arsenic toxicity than changes in lung function measured by spirometry. PMID:24062297

  15. Gene-environment interactions in chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Nestor A Molfino

    2008-09-01

    Full Text Available Nestor A Molfino, Anthony J CoyleMedImmune, Gaithersburg, MD, USAAbstract: Chronic obstructive pulmonary disease (COPD is one of the leading causes of death throughout the world and is largely associated with cigarette smoking. Despite the appreciation of the central role of smoking in the development of COPD, only a relatively small number of smokers (15%–20% develop COPD. Recent studies depicting familial aggregation suggest that some subjects may have a genetic predisposition to developing COPD. In this respect, a number of single nucleotide polymorphisms have been reported in association with different COPD features (subphenotypes, although much of this data remains controversial. Classical genetic studies (including twin and family studies assume an “equal-environment” scenario, but as gene-environment interactions occur in COPD, this assumption needs revision. Thus, new integrated models are needed to examine the major environmental factors associated with COPD which include smoking as well as air pollution, and respiratory infections, and not only genetic predisposition. Revisiting this area, may help answer the question of what has more bearing in the pathogenesis of COPD—the environment or the genomic sequence of the affected subjects. It is anticipated that an improved understanding of this interaction will both enable improved identification of individuals susceptible to developing this disease, as well as improved future treatments for this disease.Keywords: chronic obstructive pulmonary disease, environment, genomics, pathogenesis

  16. Pneumocystis jirovecii colonization in Chronic Obstructive Pulmonary Disease (COPD

    Directory of Open Access Journals (Sweden)

    Sadegh Khodavaisy

    2015-01-01

    Full Text Available Chronic obstructive pulmonary disease (COPD is associated with a chronic inflammatory response in airways and lung parenchyma that results in significant morbidity and mortality worldwide. Cigarette smoking considered as an important risk factor plays a role in pathogenesis of disease. Pneumocystis jirovecii is an atypical opportunistic fungus that causes pneumonia in immunosuppressed host, although the low levels of its DNA in patients without signs and symptoms of pneumonia, which likely represents colonization. The increased prevalence of P. jirovecii colonization in COPD patients has led to an interest in understanding its role in the disease. P. jirovecii colonization in these patients could represent a problem for public health since colonized patients could act as a major reservoir and source of infection for susceptible subjects. Using sensitive molecular techniques, low levels of P. jirovecii DNA have been detected in the respiratory tract of certain individuals. It is necessary to elucidate the role of P. jirovecii colonization in the natural history of COPD patients in order to improve the clinical management of this disease. In the current review paper, we discuss P. jirovecii colonization in COPD patients.

  17. Respiratory syncytial virus prevention in children with congenital heart disease: who and how?

    Directory of Open Access Journals (Sweden)

    Nam Kyun Kim

    2011-05-01

    Full Text Available Respiratory syncytial virus (RSV is a major cause of respiratory infection in children. Most of the pediatric population have RSV infection before the age of 2, and recurrent infections are common even within one season. Chronic lung disease, prematurity, along with congenital heart disease (CHD are major risk factors in severe lower respiratory infection. In hemo-dynamically significant CHD patients with RSV infection, hospitalization is usually needed and the possibility of treatment in intensive care unit and the use of mechanical ventilator support are known to increase. Therefore the prevention of RSV infection in CHD patients is mandatory. The current standard for RSV prevention is immunoprophylaxis by palivizumab. Immunoprophylaxis is recommended monthly in hemodynamically significant CHD patients, up to 5 months. Motabizumab, a second generation drug and newly developing RSV vaccines are also expected to play a key role in RSV prevention in the future. The prophylaxis of RSV infection in CHD patients is cost-effective in both the medical aspect of the patients as well as the socio-economic aspect. Therefore an effort to promote prevention should be made by not only the family of the patients but also by the government.

  18. Anemia in Chronic Kidney Disease

    Science.gov (United States)

    ... Disease Organizations​​ . (PDF, 345 KB)​​​​​ Alternate Language URL Anemia in CKD Page Content On this page: What ... Nutrition Points to Remember Clinical Trials What is anemia? Anemia is a condition in which the body ...

  19. 新型黏痰溶解剂对比氨溴索治疗慢性呼吸道疾病的祛痰效果的系统评价%Effects of New Mucolytic Agent vs. Ambroxol on Eliminating Phlegm for Chronic Respiratory Disease: a Systematic Review

    Institute of Scientific and Technical Information of China (English)

    章云峰; 陈辉; 姚晓梅

    2012-01-01

    OBJECTIVE: To evaluate the therapeutic efficacy and safety of new mucolytic agent vs. ambroxol on eliminating phlegm for chronic respiratory disease. METHODS: Random controlled trails of new mucolytic agent vs. ambroxol on eliminating phlegm for chronic respiratory disease were gathered from Cochrane library, PubMed, EMbase, ISI, CBM, CNKI, VIP, Wanfang database; Methodology quality evaluation and Meta-analysis of included studies were conducted. RESULTS: 5 RCT with a total of 537 patients were included.Meta-analysis showed that the control of phlegm properties [RR=1.00, 95%CI(0.74, 1.34), P=0.98], sputum quantity [RR=1.07, 95%CI(0.91, 1.25), P=0.42], cough frequency [RR=0.88, 95%CI(0.60, 1.29), P=0.52] total effective rate [RR=1.02, 95%CI(0.93, 1.12), P=0.69] of new mucolytic agent group was better than that of ambroxol group,while the degree of sputum [RR=0.93, 95%CI(0.69, 1.24), P=0.61] was lower than that of ambroxol group, but there was no statistical significance in 2 groups; there was no statistical significance in the difference of ADR. CONCLUSION: New mucolytic agent could relieve difficult coughing due to chronic respiratory disease with sound clinical efficacy and slight adverse drug reaction.%目的:系统评价新型黏痰溶解剂对比氨溴索治疗慢性呼吸道疾病的祛痰效果的疗效.方法:计算机检索Cochrane图书馆、PubMed、EMbase、ISI、中国生物医学文献数据库(CBM)、中国期刊全文数据库(CNKI)、维普数据库(VIP)、万方数据库,纳入新型黏痰溶解剂对比氨溴索治疗慢性呼吸道疾病的祛痰效果的随机对照试验(RCT),对纳入的RCT进行方法学质量评价和Meta分析.结果:共纳入5项RCT,合计537例患者.Meta分析结果显示,对照组痰性状控制[RR=1.00,95%CI(0.74,1.34),P=0.98]、痰量控制[RR=1.07,95%CI(0.91,1.25),P=0.42]、咳嗽频度[RR=0.88,95%CI(0.60,1.29),P=0.52]、综合有效率[RR=1.02,95%CI(0.93,1.12),P=0.69]优于试验组,咳痰容易度[RR=0

  20. Adult stem cells for chronic lung diseases.

    Science.gov (United States)

    Mora, Ana L; Rojas, Mauricio

    2013-10-01

    Idiopathic pulmonary fibrosis (IPF) and chronic obstructive pulmonary disease (COPD) are chronic, progressive and lethal lung diseases. The incidence of IPF and COPD increases with age, independent of exposure to common environmental risk factors. At present, there is limited understanding of the relationship between ageing and the development of chronic lung diseases. One hypothesis is that chronic injury drives to exhaustion the local and systemic repair responses in the lung. These changes are accentuated during ageing where there is a progressive accumulation of senescent cells. Recently, stem cells have emerged as a critical reparative mechanism for lung injury. In this review, we discuss the repair response of bone marrow-derived mesenchymal stem cells (B-MSC) after lung injury and how their function is affected by ageing. Our own work has demonstrated a protective role of B-MSC in several animal models of acute and chronic lung injury. We recently demonstrated the association, using animal models, between age and an increase in the susceptibility to develop severe injury and fibrosis. At the same time, we have identified functional differences between B-MSC isolated from young and old animals. Further studies are required to understand the functional impairment of ageing B-MSC, ultimately leading to a rapid stem cell depletion or fatigue, interfering with their ability to play a protective role in lung injury. The elucidation of these events will help in the development of rational and new therapeutic strategies for COPD and IPF. PMID:23648014

  1. Increasing Prevalence of Chronic Lung Disease in Veterans of the Wars in Iraq and Afghanistan.

    Science.gov (United States)

    Pugh, Mary Jo; Jaramillo, Carlos A; Leung, Kar-Wei; Faverio, Paola; Fleming, Nicholas; Mortensen, Eric; Amuan, Megan E; Wang, Chen-Pin; Eapen, Blessen; Restrepo, Marcos; Morris, Michael J

    2016-05-01

    Research from the wars in Afghanistan and Iraq have focused on traumatic brain injury (TBI) and mental health conditions; however, it is becoming clear that other health concerns, such as respiratory illnesses, warrant further scientific inquiry. Early reports from theater and postdeployment health assessments suggested an association with deployment-related exposures (e.g., sand, burn pits, chemical, etc.) and new-onset respiratory symptoms. We used data from Veterans Affairs medical encounters between fiscal years 2003 and 2011 to identify trends in chronic obstructive pulmonary disease, asthma, and interstitial lung disease in veterans. We used data from Veterans Affairs and Department of Defense sources to identify sociodemographic (age, sex, race), military (e.g., service branch, multiple deployments) and clinical characteristics (TBI, smoking) of individuals with and without chronic lung diseases. Generalized estimating equations found significant increases over time for chronic obstructive pulmonary disease and asthma in both unadjusted and adjusted analyses. Trends for interstitial lung disease were significant only in adjusted analyses. Age, smoking, and TBI were also significantly associated with chronic lung diseases; however, multiple deployments were not associated. Research is needed to identify which characteristics of deployment-related exposures are linked with chronic lung disease. PMID:27136656

  2. Cytokines in the pathogenesis of chronic obstructive pulmonary disease.

    Science.gov (United States)

    Reid, P T; Sallenave, J-M

    2003-01-01

    Chronic obstructive pulmonary disease (COPD) is a common cause of morbidity and mortality. The term is heterogenous and encompasses a number of distinct but often overlapping phenotypes including chronic bronchitis, small airways obstruction, emphysema and in some individuals, a systemic component. Although there have been significant advances in understanding the pathophysiology of COPD, understanding of the role of the inflammation in the pathogenesis of the condition remains in its infancy. Indeed, cytokines that are known to orchestrate the inflammatory response in asthma and other inflammatory diseases are only beginning to be reported in COPD. In this review, we highlight the potential role of cytokines in the development of mucus hypersecretion observed in chronic bronchitis and the morphological changes observed in the small airways and airspaces contributing to the development of airflow limitation and respiratory failure respectively. We report evidence that exacerbations are linked to increased expression of pro-inflammatory cytokines and that the wasting and skeletal muscle dysfunction observed in some patients is most probably related to the presence of a systemic inflammatory response. In addition transgenic and gene therapy technology has been used to explore the temporal and co-ordinated role of cytokines in the development of COPD animal models. Enhanced understanding of the events involved in the pathogenesis of COPD will lead to the development of therapy with potential to modify the observed progressive decline in lung function and impact on the development of the illness. PMID:12570672

  3. Study of respiratory disorders in endoscopically negative and positive gastroesophageal reflux disease

    Directory of Open Access Journals (Sweden)

    Maher Maha

    2010-01-01

    Full Text Available Background/Aim : The relation between respiratory disorders and reflux symptoms has been debated since the beginning of the last century and the interest in this question has increased during the last few decades. This study aims to investigate the relation between specified respiratory disorders and reflux symptoms and examine the correlations between respiratory disorders and endoscopic findings in patients with gastroesophageal reflux disease. Patients and Methods: This study included 515 patients evaluated for gastroesophageal reflux disease (GERD by patient self-report symptom questionnaire; modified four grade Likert scale and endoscopic assessment using endoscopic Los Angeles Classification. All participants were asked about various respiratory symptoms experienced during the past six months and exposed to measuring body mass index (BMI, medical history, pulmonary physical examination, chest X-ray, respiratory function tests and available sleep studies. Results : A total number of 515 patients were categorized according to endoscopic findings into two groups; (group1 subjects with normal endoscopic studies (NERD 118 (22.9% patients and (group2 subjects with abnormal endoscopic studies (ERD 397 (77.1%. The proportion of females was significantly higher in ERD group (80.1% as compared with NERD group (62.7% ( P < 0.02. Duration of reflux symptoms found to be significantly prolonged in ERD group ( P < 0.03. The cases of ERD group were more likely to be overweight (BMI>25 P < 0.02. History of pulmonary symptoms preceding GERD symptoms was found in 15% of patients. There were 294 patients (57.1% with different pulmonary manifestations. These manifestations were significantly higher among female group ( P < 0.01 and among obese, above 40 years old ( P < 0.001, 0.05 respectively. Among all patients with respiratory manifestations the commonest disorders diagnosed were chronic pharyngitis (50.3%, chronic bronchitis (15.8%, bronchial asthma (12

  4. An Investigation of the Pathology and Pathogens Associated with Porcine Respiratory Disease Complex in Denmark

    DEFF Research Database (Denmark)

    Hansen, Mette Sif; Pors, S. E.; Jensen, H. E.;

    2010-01-01

    Respiratory infections are among the most important diseases of growing pigs. In order to elucidate the multifactorial aetiology of porcine respiratory disease complex (PRDC) in Denmark, lungs from 148 finishing pigs with cranioventral bronchopneumonia (case group) and 60 pigs without lung lesions......), porcine reproductive and respiratory syndrome virus (both European and US type), porcine circovirus type 2 (PCV2), porcine respiratory coronavirus, porcine cytomegalovirus, Mycoplasma hyopneumoniae and Mycoplasma hyorhinis. All cases had cranioventral lobular bronchopneumonia consistent with PRDC...

  5. An Update on Coronary Artery Disease and Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Baris Afsar

    2014-01-01

    Full Text Available Despite the improvements in diagnostic tools and medical applications, cardiovascular diseases (CVD, especially coronary artery disease (CAD, remain the most common cause of morbidity and mortality in patients with chronic kidney disease (CKD. The main factors for the heightened risk in this population, beside advanced age and a high proportion of diabetes and hypertension, are malnutrition, chronic inflammation, accelerated atherosclerosis, endothelial dysfunction, coronary artery calcification, left ventricular structural and functional abnormalities, and bone mineral disorders. Chronic kidney disease is now recognized as an independent risk factor for CAD. In community-based studies, decreased glomerular filtration rate (GFR and proteinuria were both found to be independently associated with CAD. This paper will discuss classical and recent epidemiologic, pathophysiologic, and clinical aspects of CAD in CKD patients.

  6. A Customizable Model for Chronic Disease Coordination: Lessons Learned From the Coordinated Chronic Disease Program.

    Science.gov (United States)

    Voetsch, Karen; Sequeira, Sonia; Chavez, Amy Holmes

    2016-01-01

    In 2012, the Centers for Disease Control and Prevention provided funding and technical assistance to all states and territories to implement the Coordinated Chronic Disease Program, marking the first time that all state health departments had federal resources to coordinate chronic disease prevention and control programs. This article describes lessons learned from this initiative and identifies key elements of a coordinated approach. We analyzed 80 programmatic documents from 21 states and conducted semistructured interviews with 7 chronic disease directors. Six overarching themes emerged: 1) focused agenda, 2) identification of functions, 3) comprehensive planning, 4) collaborative leadership and expertise, 5) managed resources, and 6) relationship building. These elements supported 4 essential activities: 1) evidence-based interventions, 2) strategic use of staff, 3) consistent communication, and 4) strong program infrastructure. On the basis of these elements and activities, we propose a conceptual model that frames overarching concepts, skills, and strategies needed to coordinate state chronic disease prevention and control programs. PMID:27032986

  7. Severe chronic allergic (and related) diseases

    DEFF Research Database (Denmark)

    Bousquet, J; Anto, J M; Demoly, P;

    2012-01-01

    and associated factors such as comorbidities and risk factors. This uniform definition will allow a better definition of the phenotypes of severe allergic (and related) diseases for clinical practice, research (including epidemiology), public health purposes, education and the discovery of novel therapies.......-up. Control is the degree to which therapy goals are currently met. These concepts have evolved over time for asthma in guidelines, task forces or consensus meetings. The aim of this paper is to generalize the approach of the uniform definition of severe asthma presented to WHO for chronic allergic...... and associated diseases (rhinitis, chronic rhinosinusitis, chronic urticaria and atopic dermatitis) in order to have a uniform definition of severity, control and risk, usable in most situations. It is based on the appropriate diagnosis, availability and accessibility of treatments, treatment responsiveness...

  8. Multiple Bowen's disease in chronic arsenicosis

    Directory of Open Access Journals (Sweden)

    Joydeep Singha

    2014-04-01

    Full Text Available Bowen’s disease is a carcinoma in-situ of skin. It was fi rst described by John T. Bowen. It usually present as a solitary lesion in elderly person over sun-exposed area. A case of multiple Bowen’s disease involving non-sun exposed areas of a person with clinical sign of chronic arsenicosis has been found.Read more....

  9. Multiple Bowen's disease in chronic arsenicosis

    OpenAIRE

    Joydeep Singha

    2014-01-01

    Bowen’s disease is a carcinoma in-situ of skin. It was fi rst described by John T. Bowen. It usually present as a solitary lesion in elderly person over sun-exposed area. A case of multiple Bowen’s disease involving non-sun exposed areas of a person with clinical sign of chronic arsenicosis has been found.Read more....

  10. Exacerbations of Chronic Obstructive Pulmonary Disease

    OpenAIRE

    Garvey, Christine; Ortiz, Gabriel

    2012-01-01

    Epidemiologic data indicate that chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality. Patients with poorly managed COPD are likely to experience exacerbations that require emergency department visits or hospitalization—two important drivers contributing to escalating healthcare resource use and costs associated with the disease. Exacerbations also contribute to worsening lung function and negative outcomes in COPD. The aim of this review is to present th...

  11. Hypertension and chronic kidney disease in Turkey

    OpenAIRE

    Sengul, Sule; Erdem, Yunus; Batuman, Vecihi; Erturk, Sehsuvar

    2013-01-01

    Worldwide, both hypertension and chronic kidney disease are major public health problems, due to their epidemic proportions and their association with high cardiovascular mortality. In 2003, the first Prevalence, awareness, treatment, and control of hypertension in Turkey (the PatenT) study was conducted in a nationally representative population (n=4910) by the Turkish Society of Hypertension and Renal Diseases, and showed that overall age- and sex-adjusted prevalence of hypertension in Turke...

  12. Interleukin-10 and chronic liver disease

    OpenAIRE

    ZHANG, LI-JUAN; Wang, Xiao-Zhong

    2006-01-01

    Interleukin (IL)-10 is an important immunoregulatory cytokine produced by many cell populations. Numerous investigations suggest that IL-10 plays a major role in chronic liver diseases. IL-10 gene polymorphisms are possibly associated with liver disease susceptibility or severity. Recombinant human IL-10 has been produced and is currently tested in clinical trials. These trials may give new insights into the immunobiology of IL-10 and suggest that the IL-10/IL-10 receptor system may become a ...

  13. Interleukin-10 and chronic liver disease

    Institute of Scientific and Technical Information of China (English)

    Li-Juan Zhang; Xiao-Zhong Wang

    2006-01-01

    Interleukin (IL)-10 is an important immunoregulatory cytokine produced by many cell populations. Numerous investigations suggest that IL-10 plays a major role in chronic liver diseases. IL-10 gene polymorphisms are possibly associated with liver disease susceptibility or severity. Recombinant human IL-10 has been produced and is currently tested in clinical trials. These trials may give new insights into the immunobiology of IL-10 and suggest that the IL-10/IL-10 receptor system may become a new therapeutic target.

  14. Asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS): current literature review

    Science.gov (United States)

    Papaiwannou, Antonis; Porpodis, Konstantinos; Spyratos, Dionysios; Kioumis, Ioannis; Pitsiou, Georgia; Pataka, Athanasia; Tsakiridis, Kosmas; Arikas, Stamatis; Mpakas, Andreas; Tsiouda, Theodora; Katsikogiannis, Nikolaos; Kougioumtzi, Ioanna; Machairiotis, Nikolaos; Siminelakis, Stavros; Kolettas, Alexander; Kessis, George; Beleveslis, Thomas; Zarogoulidis, Konstantinos

    2014-01-01

    Asthma and chronic obstructive pulmonary disease (COPD) are chronic diseases, very common in general population. These obstructive airway illnesses are manifested with chronic inflammation affecting the whole respiratory tract. Obstruction is usually intermittent and reversible in asthma, but is progressive and irreversible in COPD. Asthma and COPD may overlap and converge, especially in older people [overlap syndrome—asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS)]. Although ACOS accounts approximately 15-25% of the obstructive airway diseases, is not well recognised because of the structure of clinical trials. COPD studies exclude asthma patients and asthma studies exclude COPD patients, respectively. It is crucial to define asthma, COPD and overlap syndrome (ACOS), as notable clinical entities, which they share common pathologic and functional features, but they are characterized from differences in lung function, acute exacerbations, quality of life, hospital impact and mortality. PMID:24672688

  15. Chronic obstructive pulmonary disease and cancer risk

    DEFF Research Database (Denmark)

    Kornum, Jette Brommann; Sværke, Claus; Thomsen, Reimar Wernich;

    2012-01-01

    Little is known about the risk of cancer in patients with chronic obstructive pulmonary disease (COPD), including which cancer sites are most affected. We examined the short- and long-term risk of lung and extrapulmonary cancer in a nationwide cohort of COPD patients....

  16. Anemia of Inflammation and Chronic Disease

    Science.gov (United States)

    ... 699–710. 4 Anemia of Inflammation and Chronic Disease Eating, Diet, and Nutrition People with anemia caused by ... Phone: 202–776–0544 Fax: 202–776–0545 Internet: www. hematology. org Iron Disorders Institute P.O. Box 675 Taylors, SC 29687 ...

  17. Screening of Elderly for Chronic Kidney Disease

    NARCIS (Netherlands)

    Lezaic, Visnja; Bajcetic, Sanja; Perunicic-Pekovic, Gordana; Bukvic, Danica; Dimkovic, Nada; Djukanovic, Ljubica

    2012-01-01

    Background and Aims: The frequency of chronic kidney disease (CKD) markers was assessed in two groups of patients over 60 years - one without and the other with hypertension. Methods: The cross-sectional study involved 585 asymptomatic elderly patients (227 males), 93 without and 492 with hypertensi

  18. Living With Chronic Lower Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Charlotte Pooler

    2014-09-01

    Full Text Available In this article, I present a phenomenological study of individuals’ experiences of living with moderate to very severe chronic lower pulmonary disease (chronic obstructive pulmonary disease, asthma, or both. Phenomenology is a philosophy, distinct from descriptive or thematic research, which is useful as a foundation for scientific inquiry. In this study, I used the lens of Merleau-Ponty to understand and interpret participants’ experiences of living with pulmonary disease, and the approach of van Manen for analysis. I conclude that in chronic pulmonary disease, awareness of breathing and the body is experienced in the sounds, sensations, and signals of breathing and the body, and in the experiences of the body-in-the-world. Central themes of being-in-the-world from the study describe the disruption of the embodied phenomenological self: Participants experienced slowing down, doing less, and having to stop due to shortness of breath. Both chronic and acute dyspnea were prevalent and the taken-for-granted aspects of daily activities were disrupted. Findings of this study have implications for public and patient education, and opportunities for integration of experiential aspects within nursing education and practice.

  19. Pompe Disease: Cyanosed Hypotonic Infant with Normal Respiratory Rate.

    Science.gov (United States)

    Koirala, S; Poudel, A; Basnet, R; Subedi, K

    2015-01-01

    Infantile hypotonia or floppy infant is a diagnostic challenge when it presents with other presenting complaints such as fever, cough or diarrhea. Many times the hypotonia goes unnoticed when other symptom covers the hypotonia and child continues to receive the treatment for other symptoms. We report a rare case from Nepal of infantile Pompe disease who presented with the history of fever and cough in the recent earthquake disaster camp at remote part of Sindhupalchowk, Nepal. He was being treated as a case of pneumonia. Pompe disease can be diagnosed clinically by taking detailed history and correlating the clinical findings during the presentation with other symptoms. In our case the normal respiratory rate, reduced Spo2 and presence of crackles dominated the hypotonia and was mistreated as pneumonia. High index of suspicion is necessary in diagnosing Pompe disease. PMID:26643838

  20. Endothelial Dysfunction in Chronic Inflammatory Diseases

    Directory of Open Access Journals (Sweden)

    Curtis M. Steyers

    2014-06-01

    Full Text Available Chronic inflammatory diseases are associated with accelerated atherosclerosis and increased risk of cardiovascular diseases (CVD. As the pathogenesis of atherosclerosis is increasingly recognized as an inflammatory process, similarities between atherosclerosis and systemic inflammatory diseases such as rheumatoid arthritis, inflammatory bowel diseases, lupus, psoriasis, spondyloarthritis and others have become a topic of interest. Endothelial dysfunction represents a key step in the initiation and maintenance of atherosclerosis and may serve as a marker for future risk of cardiovascular events. Patients with chronic inflammatory diseases manifest endothelial dysfunction, often early in the course of the disease. Therefore, mechanisms linking systemic inflammatory diseases and atherosclerosis may be best understood at the level of the endothelium. Multiple factors, including circulating inflammatory cytokines, TNF-α (tumor necrosis factor-α, reactive oxygen species, oxidized LDL (low density lipoprotein, autoantibodies and traditional risk factors directly and indirectly activate endothelial cells, leading to impaired vascular relaxation, increased leukocyte adhesion, increased endothelial permeability and generation of a pro-thrombotic state. Pharmacologic agents directed against TNF-α-mediated inflammation may decrease the risk of endothelial dysfunction and cardiovascular disease in these patients. Understanding the precise mechanisms driving endothelial dysfunction in patients with systemic inflammatory diseases may help elucidate the pathogenesis of atherosclerosis in the general population.

  1. Toll-Like Receptor 7-Targeted Therapy in Respiratory Disease.

    Science.gov (United States)

    Lebold, Katie M; Jacoby, David B; Drake, Matthew G

    2016-03-01

    Allergic asthma and allergic rhinitis are inflammatory diseases of the respiratory tract characterized by an excessive type-2 T helper cell (Th2) immune response. Toll-like receptor 7 (TLR7) is a single-stranded viral RNA receptor expressed in the airway that initiates a Th1 immune response and has garnered interest as a novel therapeutic target for treatment of allergic airway diseases. In animal models, synthetic TLR7 agonists reduce airway hyperreactivity, eosinophilic inflammation, and airway remodeling while decreasing Th2-associated cytokines. Furthermore, activation of TLR7 rapidly relaxes airway smooth muscle via production of nitric oxide. Thus, TLR7 has dual bronchodilator and anti-inflammatory effects. Two TLR7 ligands with promising pharmacologic profiles have entered clinical trials for the treatment of allergic rhinitis. Moreover, TLR7 agonists are potential antiviral therapies against respiratory viruses. TLR7 agonists enhance influenza vaccine efficacy and also reduce viral titers when given during an active airway infection. In this review, we examine the current data supporting TLR7 as a therapeutic target in allergic airway diseases. PMID:27226793

  2. Calculating the respiratory flow velocity fluctuations in pericardial diseases.

    Science.gov (United States)

    Siniorakis, Eftychios; Arvanitakis, Spyridon; Zarreas, Elias; Barlagiannis, Dimitris; Skandalakis, Nikos; Karidis, Constantinos

    2010-11-01

    An excessive respiratory fluctuation (RTFV) in transmitral early diastolic velocity E is a pivotal Doppler echocardiographic sign of haemodynamic compromise, in constrictive pericardial diseases. RTFV is expressed as a percentage and 25% is considered a threshold value. Unfortunately there is no unanimity in calculating RTFV. Sometimes it is expressed as a percentage of expiratory E velocity, while others of inspiratory E velocity. This disparity has led to gross misinterpretations in medical literature. Here we emphasize the importance of a rational procedure calculating RTFV and we propose the appropriate mathematical model.

  3. Differential Effects of Temperature Extremes on Hospital Admission Rates for Respiratory Disease between Indigenous and Non-Indigenous Australians in the Northern Territory.

    Science.gov (United States)

    Green, Donna; Bambrick, Hilary; Tait, Peter; Goldie, James; Schultz, Rosalie; Webb, Leanne; Alexander, Lisa; Pitman, Andrew

    2015-12-03

    The health gap between Indigenous and non-Indigenous Australians may be exacerbated by climate change if temperature extremes have disproportionate adverse effects on Indigenous people. To explore this issue, we analysed the effect of temperature extremes on hospital admissions for respiratory diseases, stratified by age, Indigenous status and sex, for people living in two different climates zones in the Northern Territory during the period 1993-2011. We examined admissions for both acute and chronic respiratory diagnoses, controlling for day of the week and seasonality variables. Our analysis showed that: (1) overall, Indigenous hospital admission rates far exceeded non-Indigenous admission rates for acute and chronic diagnoses, and Top End climate zone admission rates exceeded Central Australia climate zone admission rates; (2) extreme cold and hot temperatures were associated with inconsistent changes in admission rates for acute respiratory disease in Indigenous and non-Indigenous children and older adults; and (3) no response to cold or hot temperature extremes was found for chronic respiratory diagnoses. These findings support our two hypotheses, that extreme hot and cold temperatures have a different effect on hospitalisations for respiratory disease between Indigenous and non-Indigenous people, and that these health risks vary between the different climate zones. We did not, however, find that there were differing responses to temperature extremes in the two populations, suggesting that any increased vulnerability to climate change in the Indigenous population of the Northern Territory arises from an increased underlying risk to respiratory disease and an already greater existing health burden.

  4. Neural dysfunction following respiratory viral infection as a cause of chronic cough hypersensitivity

    Science.gov (United States)

    Zaccone, Eric

    2015-01-01

    Respiratory viral infections are a common cause of acute coughing, an irritating symptom for the patient and an important mechanism of transmission for the virus. Although poorly described, the inflammatory consequences of infection likely induce coughing by chemical (inflammatory mediator) or mechanical (mucous) activation of the cough-evoking sensory nerves that innervate the airway wall. For some individuals, acute cough can evolve into a chronic condition, in which cough and aberrant airway sensations long outlast the initial viral infection. This suggests that some viruses have the capacity to induce persistent plasticity in the neural pathways mediating cough. In this brief review we present the clinical evidence of acute and chronic neural dysfunction following viral respiratory tract infections and explore possible mechanisms by which the nervous system may undergo activation, sensitization and plasticity. PMID:26141017

  5. 28 CFR 79.67 - Proof of chronic renal disease.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Proof of chronic renal disease. 79.67... renal disease. (a) In determining whether a claimant developed chronic renal disease following pertinent... claimant. A conclusion that a claimant developed chronic renal disease must be supported by...

  6. Myocardial Ischemia Assessment in Chronic Kidney Disease: Challenges and Pitfalls

    OpenAIRE

    Susie Fei Cen Parnham; Gleadle, Jonathan M.; De Pasquale, Carmine G; Selvanayagam, Joseph B

    2014-01-01

    Coronary artery disease is the leading cause of mortality and morbidity in the chronic kidney disease population and often presents with atypical symptoms. Current diagnostic investigations of myocardial ischemia in chronic kidney disease lack sensitivity and specificity or may have adverse effects. We present a case vignette and explore the challenges of diagnostic myocardial stress investigation in patients with chronic kidney disease.

  7. Pregnancy in chronic kidney disease.

    Science.gov (United States)

    Vellanki, Kavitha

    2013-05-01

    Despite vast improvements in fetal outcomes, pregnancy in women with CKD is fraught with hazards; worsening of renal function and complications like preeclampsia and premature delivery are common. To date, there is no accurate formula to calculate glomerular filtration rate (GFR). Also, whether the current CKD classification is better than the older classification at predicting outcomes in pregnant women with CKD is unknown. Women with an estimated GFR ≥1.4 mg/dL are at increased risk of progressive worsening of renal function regardless of the cause of the underlying kidney disease. Preeclampsia is difficult to diagnose in pregnant women with underlying CKD, and serum markers such as soluble fms-like tyrosine kinase 1 (sFlt1) and placental growth factor (PIGF) may lead the way for definitive diagnosis. New-onset lupus or lupus flare is an indication for kidney biopsy during pregnancy; cyclosporine is safe and is the most effective agent that can be used during pregnancy. Women with adult polycystic kidney disease are at increased risk of hypertension and preeclampsia during pregnancy, as well as hepatic cysts later in life, the latter occurring with multiple pregnancies. Strict blood pressure control is important in pregnant women with diabetic nephropathy. A multidisciplinary team that includes nephrologists and obstetricians who deal with high-risk pregnancies should be involved in the care of pregnant women with CKD for successful pregnancy outcomes. PMID:23928386

  8. Residential characteristics and household risk factors and respiratory diseases in Chinese women: The Seven Northeast Cities (SNEC) Study

    Energy Technology Data Exchange (ETDEWEB)

    Dong, Guang-Hui [Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, Liaoning Province 110001 (China); Department of Occupational and Environmental Health, School of Public Health, China Medical University, Shenyang, Liaoning Province 110001 (China); Qian, Zhengmin, E-mail: zqian2@slu.edu [Department of Epidemiology, School of Public Health, Saint Louis University, Saint Louis, MO 63104 (United States); Wang, Jing [Department of Biostatistics, School of Public Health, Saint Louis University, Saint Louis, MO 63104 (United States); Trevathan, Edwin [Department of Epidemiology, School of Public Health, Saint Louis University, Saint Louis, MO 63104 (United States); Ma, Wenjun [Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong Province 510300 (China); Chen, Weiqing [Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080 (China); Xaverius, Pamela K.; Buckner-Petty, Skye; Ray, Asheesh [Department of Epidemiology, School of Public Health, Saint Louis University, Saint Louis, MO 63104 (United States); Liu, Miao-Miao; Wang, Da [Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, Liaoning Province 110001 (China); Ren, Wan-Hui [Department of Ambient Air Pollution Monitor, Shenyang Environmental Monitoring Center, Shenyang, Liaoning Province 110014 (China); Emo, Brett [Department of Environmental and Occupational Health School of Public Health, Saint Louis University, Saint Louis, MO 63104 (United States); Chang, Jen-Jen [Department of Epidemiology, School of Public Health, Saint Louis University, Saint Louis, MO 63104 (United States)

    2013-10-01

    Background: Few studies have assessed the impact of residential home characteristics and home environmental risk factors on respiratory diseases in Chinese women. Therefore, this study sought to determine the association between residential home features, domestic pets, home renovation and other indoor environmental risk factors with respiratory health outcomes of Chinese women. Methods: This cross-sectional study included a study sample of 30,780 Chinese women aged 23 to 49 from 25 districts of seven cities in Liaoning Province, Northeast China. Information on respiratory health, residential characteristics, and indoor air pollution sources was obtained by a standard questionnaire from the American Thoracic Society. Multivariable logistic regression was used to estimate prevalence odds ratios (POR) and 95% confidence interval (95%CI). Results: The odds of respiratory diseases were higher for those who lived near the main road, or near ambient air pollution sources. Pet-keeping was associated with increased odds of chronic bronchitis (POR = 1.40; 95%CI: 1.09–1.81) and doctor-diagnosed asthma (POR = 2.07; 95%CI: 1.18–3.64). Additionally, humidifier use was associated with increased odds of chronic bronchitis (POR = 1.44; 95%CI: 1.07–1.94). Home renovation in recent 2 years was associated with increased likelihood of allergic rhinitis (POR = 1.39; 95%CI 1.17–1.64). Conclusion: Home renovation and residential home environmental risk factors were associated with an increased likelihood of respiratory morbidity among Chinese women. - Highlights: • Relatively few significant associations were observed. • Pet ownership was associated with increased odds of asthma and chronic bronchitis. • Home renovation was associated with increased odds of allergic rhinitis in women. • Humidifier use was associated with increased odds of chronic bronchitis in women.

  9. Renal imaging in children with chronic kidney disease

    OpenAIRE

    Wiwit Rahmawati; Heru Muryawan; Farah Prabowo

    2013-01-01

    Background Chronic kidney failure is a cause of death in children. Diagnosing chronic kidney disease is often made by clinical manifestations, laboratory findings and ultrasonography or other imaging tests. Early detection of chronic kidney disease is needed for education and management of the disease. Objective To describe renal imaging findings and mortality in children with chronic kidney disease. Methods This was a cross-sectional study on children with kidney diseases who were in...

  10. 无创正压机械通气治疗慢性阻塞性肺疾病急性加重期合并Ⅱ型呼吸衰竭的研究%Clinical study of noninvasive positive pressure ventilation in the treatment of acute exacerbation of chronic ob-structive pulmonary disease combined with type Ⅱ respiratory failure

    Institute of Scientific and Technical Information of China (English)

    林飞克; 陈丰

    2015-01-01

    Objective To investigate the curative effect of noninvasive positive pressure ventilation (NIPPV) on treating patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) combined with type Ⅱ respiratory failure. Methods A total of 86 cases of AECOPD combined with type Ⅱ respiratory failure were randomly divided into the NIPPV group and the control group according to whether accept NIPPV therapy or not. The curative effect,the parame-ters of PaO2, PaCO2 and RR and HR before and after treatment were compared between the two groups. The average length of stay,expenses for medicine, examination fee and the total of hospitalization costs were also compared between the two groups. Results The total effective rate of NIPPV group was significantly higher than that of the control group (χ2=5.94, P0.05). The average length of stay of NIPPV groups was shorter than that of control group(t=5.23,P0.05). NIPPV组平均住院天数短与对照组,药费、检查费及住院总费用低于对照组,差异均有统计学意义(t分别=5.23、16.42、2.64、11.36,P均<0.05). 结论 NIPPV在治疗AECOPD合并呼吸衰竭患者有十分明显的治疗效果,并且可以减低患者住院天数、药费、检查费及总住院费用.

  11. Asymptomatic patients of chronic obstructive pulmonary disease in China

    Institute of Scientific and Technical Information of China (English)

    LU Ming; WANG Chang-zheng; NI Dian-tao; WANG Xiao-ping; WANG Da-li; LIU Sheng-ming; L(U) Jia-chun; SHEN Ning; DING Yan-ling; RAN Pi-xin; YAO Wan-zhen; ZHONG Nan-shan; ZHOU Yu-min; WANG Chen; CHEN Ping; KANG Jian; HUANG Shao-guang; CHEN Bao-yuan

    2010-01-01

    Background Chronic obstructive pulmonary disease (COPD) has a variable natural history and not all individuals follow the same course. This study aimed to identify the prevalence and characteristics of asymptomatic COPD patients from a population-based survey in China.Methods A multistage cluster sampling strategy was used in a population from seven different provinces/cities. All residents (over 40 years old) were interviewed with a standardized questionnaire and spirometry.Post-bronchodilator forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) of less than 70% was defined as the diagnostic criterion of COPD. All COPD patients screened were divided into symptomatic group and asymptomatic group according to the presence or absence of chronic respiratory symptoms. Socio-demographic,personal and exposure variables were collected and analyzed.Results Among the 1668 patients who were diagnosed with COPD from the 25 627 sampling subjects, 589 (35.3%)were asymptomatic. The age, sex, body mass index (BMI),rural and urban distributions, smoking habit and education levels were similar in the two groups. A total of 64.7% of the asymptomatic patients had no comorbidities. Cardiovascular diseases and lung cancer were more common among symptomatic COPD patients than asymptomatic group.Asymptomatic COPD group were less likely to present with poor ventilation in the kitchen, a family history of respiratory disease and recurrent childhood cough. Asymptomatic COPD patients had significantly higher FEV1 (73.1% vs. 61.0%), FVC (91.9% vs. 82.0%), and a higher ratio of FEV1/FVC (62.9% vs.58.7%) (all P <0.001) than symptomatic group. More asymptomatic patients were underdiagnosed (91.9% vs.54.3%, P<0.001) than symptomatic patients.Conclusions This large population-based survey confirmed a high prevalence of asymptomatic COPD patients in China. More use of spirometry screening test may be important to the early detection of COPD.

  12. Oral and pharyngeal bolus transit in patients with chronic obstructive pulmonary disease

    OpenAIRE

    Cassiani RA; Santos CM; Baddini-Martinez J; Dantas RO

    2015-01-01

    Rachel Aguiar Cassiani, Carla Manfredi Santos, José Baddini-Martinez, Roberto Oliveira Dantas Department of Medicine, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil Background: Patients with respiratory diseases, such as chronic obstructive pulmonary disease (COPD), may have swallowing dysfunction. Objective: The aim of this investigation was to evaluate the oral and pharyngeal phases of swa...

  13. Long-term trends in cardiovascular disease mortality and association with respiratory disease.

    Science.gov (United States)

    Mercer, A J

    2016-03-01

    The recent decline in cardiovascular disease mortality in Western countries has been linked with changes in life style and treatment. This study considers periods of decline before effective medical interventions or knowledge about risk factors. Trends in annual age-standardized death rates from cerebrovascular disease, heart disease and circulatory disease, and all cardiovascular disease are reviewed for three phases, 1881-1916, 1920-1939, and 1940-2000. There was a consistent decline in the cerebrovascular disease death rate between 1891 and 2000, apart from brief increases after the two world wars. The heart disease and circulatory disease death rate was declining between 1891 and 1910 before cigarette smoking became prevalent. The early peak in cardiovascular mortality in 1891 coincided with an influenza pandemic and a peak in the death rate from bronchitis, pneumonia and influenza. There is also correspondence between short-term fluctuations in the death rates from these respiratory diseases and cardiovascular disease. This evidence of ecological association is consistent with the findings of many studies that seasonal influenza can trigger acute myocardial infarction and episodes of respiratory infection are followed by increased risk of cardiovascular events. Vaccination studies could provide more definitive evidence of the role in cardiovascular disease and mortality of influenza, other viruses, and common bacterial agents of respiratory infection. PMID:26243537

  14. Long-term trends in cardiovascular disease mortality and association with respiratory disease.

    Science.gov (United States)

    Mercer, A J

    2016-03-01

    The recent decline in cardiovascular disease mortality in Western countries has been linked with changes in life style and treatment. This study considers periods of decline before effective medical interventions or knowledge about risk factors. Trends in annual age-standardized death rates from cerebrovascular disease, heart disease and circulatory disease, and all cardiovascular disease are reviewed for three phases, 1881-1916, 1920-1939, and 1940-2000. There was a consistent decline in the cerebrovascular disease death rate between 1891 and 2000, apart from brief increases after the two world wars. The heart disease and circulatory disease death rate was declining between 1891 and 1910 before cigarette smoking became prevalent. The early peak in cardiovascular mortality in 1891 coincided with an influenza pandemic and a peak in the death rate from bronchitis, pneumonia and influenza. There is also correspondence between short-term fluctuations in the death rates from these respiratory diseases and cardiovascular disease. This evidence of ecological association is consistent with the findings of many studies that seasonal influenza can trigger acute myocardial infarction and episodes of respiratory infection are followed by increased risk of cardiovascular events. Vaccination studies could provide more definitive evidence of the role in cardiovascular disease and mortality of influenza, other viruses, and common bacterial agents of respiratory infection.

  15. Psychosocial interventions for patients with chronic disease

    Directory of Open Access Journals (Sweden)

    Deter Hans-Christian

    2012-01-01

    Full Text Available Abstract Treatment of patients with chronic diseases will be one of the main challenges of medicine in the future. This paper presents an overview of different origins, mechanism, and symptoms necessary for understanding new and different interventions that include a psychosomatic view. In a psychosomatic therapeutic intervention there are very different targets, such as psychological symptoms, personality traits, attitudes toward disease and life, risk behaviour, and social isolation and as biological targets the change of autonomic imbalance and of the effects of the psycho-endocrinological or psycho-immunological stress responses. And there are also different psychosomatic measures that influence the individual biological, psychological and sociological targets. There is a need to give different answer to different questions in the field of psychosomatic and behavioral medicine. Comparative effectiveness research is an important strategy for solving some methodological issues. What is the target of treatment for different diseases: Symptom reduction, healing, or limiting progression to the worst case - the death of patients. We know that, the patient-physician relationship is important for every medical/therapeutic action for patients with chronic diseases. This volume of BioPsychoSocial Medicine will present four different psychosomatic treatment studies from the clinical field in the sense of phase 2 studies: Reports of patients with obesity, anorexia nervosa, chronic somatoform pain and coronary artery disease were presented

  16. Alcoholic Beverage Consumption and Chronic Diseases.

    Science.gov (United States)

    Zhou, Yue; Zheng, Jie; Li, Sha; Zhou, Tong; Zhang, Pei; Li, Hua-Bin

    2016-01-01

    Epidemiological and experimental studies have consistently linked alcoholic beverage consumption with the development of several chronic disorders, such as cancer, cardiovascular diseases, diabetes mellitus and obesity. The impact of drinking is usually dose-dependent, and light to moderate drinking tends to lower risks of certain diseases, while heavy drinking tends to increase the risks. Besides, other factors such as drinking frequency, genetic susceptibility, smoking, diet, and hormone status can modify the association. The amount of ethanol in alcoholic beverages is the determining factor in most cases, and beverage types could also make an influence. This review summarizes recent studies on alcoholic beverage consumption and several chronic diseases, trying to assess the effects of different drinking patterns, beverage types, interaction with other risk factors, and provide mechanistic explanations. PMID:27231920

  17. Alcoholic Beverage Consumption and Chronic Diseases

    Directory of Open Access Journals (Sweden)

    Yue Zhou

    2016-05-01

    Full Text Available Epidemiological and experimental studies have consistently linked alcoholic beverage consumption with the development of several chronic disorders, such as cancer, cardiovascular diseases, diabetes mellitus and obesity. The impact of drinking is usually dose-dependent, and light to moderate drinking tends to lower risks of certain diseases, while heavy drinking tends to increase the risks. Besides, other factors such as drinking frequency, genetic susceptibility, smoking, diet, and hormone status can modify the association. The amount of ethanol in alcoholic beverages is the determining factor in most cases, and beverage types could also make an influence. This review summarizes recent studies on alcoholic beverage consumption and several chronic diseases, trying to assess the effects of different drinking patterns, beverage types, interaction with other risk factors, and provide mechanistic explanations.

  18. Arterial hypertension and chronic liver disease

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik Sahl; Møller, S

    2005-01-01

    , calcitonin gene-related peptide, nitric oxide, and other vasodilators, and is most pronounced in the splanchnic area. This provides an effective (although relative) counterbalance to raised arterial blood pressure. Subjects with arterial hypertension (essential, secondary) may become normotensive during......This review looks at the alterations in the systemic haemodynamics of patients with chronic liver disease (cirrhosis) in relation to essential hypertension and arterial hypertension of renal origin. Characteristic findings in patients with cirrhosis are vasodilatation with low overall systemic...... the development of chronic liver disease, and arterial hypertension is rarely manifested in patients with cirrhosis, even in those with renovascular disease and high circulating renin activity. There is much dispute as to the understanding of homoeostatic regulation in cirrhotic patients with manifest arterial...

  19. Alcoholic Beverage Consumption and Chronic Diseases

    Science.gov (United States)

    Zhou, Yue; Zheng, Jie; Li, Sha; Zhou, Tong; Zhang, Pei; Li, Hua-Bin

    2016-01-01

    Epidemiological and experimental studies have consistently linked alcoholic beverage consumption with the development of several chronic disorders, such as cancer, cardiovascular diseases, diabetes mellitus and obesity. The impact of drinking is usually dose-dependent, and light to moderate drinking tends to lower risks of certain diseases, while heavy drinking tends to increase the risks. Besides, other factors such as drinking frequency, genetic susceptibility, smoking, diet, and hormone status can modify the association. The amount of ethanol in alcoholic beverages is the determining factor in most cases, and beverage types could also make an influence. This review summarizes recent studies on alcoholic beverage consumption and several chronic diseases, trying to assess the effects of different drinking patterns, beverage types, interaction with other risk factors, and provide mechanistic explanations. PMID:27231920

  20. Neurohumoral fluid regulation in chronic liver disease

    DEFF Research Database (Denmark)

    Møller, Søren; Henriksen, Jens Henrik

    1998-01-01

    Impaired homeostasis of the blood volume, with increased fluid and sodium retention, is a prevailing element in the deranged systemic and splanchnic haemodynamics in patients with liver disease. In this review, some basic elements of the circulatory changes that take place and of neurohumoral fluid...... regulation are outlined in order to provide an update of recent investigations on the neuroendocrine compensation of circulatory and volume dysfunction in chronic liver disease. The underlying pathophysiology is a systemic vasodilatation in which newly described potent vasoactive substances such as nitric...... and lungs. It is still an enigma why patients with chronic liver disease are at the same time overloaded and functional hypovolaemic with a hyperdynamic, hyporeactive circulation. Further research is needed to find the solution to this apparent haemodynamic conflict concerning the abnormal neurohumoral...

  1. Health Status Measurement Instruments in Chronic Obstructive Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Yves Lacasse

    1997-01-01

    Full Text Available Chronic obstructive pulmonary disease (COPD is associated with primary respiratory impairment, disability and handicap, as well as with secondary impairments not necessarily confined to the respiratory system. Because the primary goals of managing patients with COPD include relief of dyspnea and the improvement of health-related quality of life (HRQL, a direct measurement of HRQL is important. Fourteen disease-specific and nine generic questionnaires (four health profiles and five utility measures most commonly used to measure health status in patients with COPD were reviewed. The measures were classified according to their domain of interest, and their measurement properties - specifications, validity, reliability, responsiveness and interpretability - were described. This review suggests several findings. Currently used health status instruments usually refer to the patients’ perception of performance in three major domains of HRQL - somatic sensation, physical and occupational function, and psychological state. The choice of a questionnaire must be related to its purpose, with a clear distinction being made between its evaluative and discriminative function. In their evaluative function, only a few instruments fulfilled the criteria of responsiveness, and the interpretability of most questionnaires is limited. Generic questionnaires should not be used alone in clinical trials as evaluative instruments because of their inability to detect change over time. Further validation and improved interpretability of existing instruments would be of greater benefit to clinicians and scientists than the development of new questionnaires.

  2. Arterial Stiffness and Chronic Kidney Disease

    OpenAIRE

    Garnier, Anne-Sophie; Briet, Marie

    2016-01-01

    Chronic kidney disease (CKD) is a major public health concern due to the high prevalence of associated cardiovascular (CV) disease. CV mortality is 10-30 times higher in end-stage renal disease patients than in the age-adjusted general population. The last 20 years have been marked by a huge effort in the characterization of the vascular remodeling process associated with CKD and its consequences on the renal, CV and general prognosis. By comparison with patients with normal renal function, w...

  3. Risk factors for asthma prevalence and chronic respiratory illnesses among residents of different neighbourhoods in Buffalo, New York

    OpenAIRE

    Lwebuga-Mukasa, J.; Oyana, T.; Wydro, P.

    2004-01-01

    Study objective: The aim of this study is to identify risk factors for asthma prevalence and chronic respiratory illnesses in Buffalo's neighbourhoods after previous studies reported increased levels of asthma among residents on Buffalo's west side.

  4. Interstitial lung disease - adults - discharge

    Science.gov (United States)

    Diffuse parenchymal lung disease - discharge; Alveolitis - discharge; Idiopathic pulmonary pneumonitis - discharge; IPP - discharge; Chronic interstitial lung - discharge; Chronic respiratory interstitial lung - ...

  5. Chronic intermittent hypoxia creates the perfect storm with calamitous consequences for respiratory control.

    Science.gov (United States)

    O'Halloran, Ken D

    2016-06-01

    Obstructive sleep apnoea syndrome (OSAS) is a common respiratory disorder with devastating consequences for integrative body systems. A picture is emerging to illustrate wide-ranging deleterious consequences of disordered breathing during sleep for major homeostatic control systems, with considerable interest in cardiorespiratory and autonomic morbidity underpinning the development of hypertension. The vista is bleak when one also considers the link between OSAS and a host of other maladies. Exposure to chronic intermittent hypoxia (CIH), resulting from repeated obstructions of the pharyngeal airway, is a hallmark feature of OSAS that appears, in animal models, to drive the development and maintenance of several key morbidities. A growing body of evidence now points to aberrant respiratory plasticity at multiple levels following exposure to CIH. Herein, we review the experimental data revealing that CIH causes: respiratory muscle weakness and fatigue; impaired motor control of the upper airway; and, discordant respiratory rhythm and pattern generation. This multifaceted conspiracy creates the perfect storm with the potential to exacerbate OSAS-serving to establish an inescapable cycle of respiratory morbidity. Several pharmacological interventions in animal models appear wholly effective in preventing the calamitous consequences of CIH and may have application as adjunctive therapies in the treatment of OSAS. PMID:26528897

  6. Mediterranean dietary pattern and chronic diseases.

    Science.gov (United States)

    Panico, Salvatore; Mattiello, Amalia; Panico, Camilla; Chiodini, Paolo

    2014-01-01

    The study of the relationship between the Mediterranean way of eating and the occurrence of diseases typical of the economically developed countries has been considered the starting point of nutritional epidemiology. From the Seven Countries Study in the 1950s to the recent European EPIC collaboration, the evaluation of the components of diet-affecting chronic diseases such as cardiovascular disease and cancer has been crucially based on the analysis of foods and nutrients characterizing the Mediterranean dietary habits. This long research history has been marked by a consistency of data over time when either single nutrients/food groups or more complex dietary patterns have been analyzed: The Mediterranean way of eating is a protective tool from cardiovascular diseases and many cancers. Italy has been a natural point of observation, starting from cardiovascular disease in the mid-1950s and continuing with major cancers. In spite of unfavorable lifestyle changes in the Italian population mostly due to globalization of unhealthy habits (richer diet and lower levels of physical activity), those individuals still close to the Mediterranean style are significantly protected. The very recent Italian data derived from the observation of about 50,000 individuals, participating in the Italian cohorts of the EPIC study, confirm these findings and are consistent with results from other European populations and in some cases also from North American populations. Moreover, several dietary trials suggest that such a way of eating improves both the metabolic risk condition for chronic disease and the occurrence of those diseases. In conclusion, a way of eating inspired by a Mediterranean dietary pattern is not only based on evidence but is also a palatable style that has contributed to protection from the epidemic of chronic diseases. PMID:24114475

  7. Bone marrow-derived stem cells and respiratory disease.

    Science.gov (United States)

    Jones, Carla P; Rankin, Sara M

    2011-07-01

    Adult bone marrow contains a number of discrete populations of progenitor cells, including endothelial, mesenchymal, and epithelial progenitor cells and fibrocytes. In the context of a range of diseases, endothelial progenitor cells have been reported to promote angiogenesis, mesenchymal stem cells are potent immunosuppressors but can also contribute directly to tissue regeneration, and fibrocytes have been shown to induce tissue fibrosis. This article provides an overview of the basic biology of these different subsets of progenitor cells, reporting their distinct phenotypes and functional activities. The differences in their secretomes are highlighted, and the relative role of cellular differentiation vs paracrine effects of progenitor cells is considered. The article reviews the literature examining the contribution of progenitor cells to the pathogenesis of respiratory disease, and discusses recent studies using bone marrow progenitor cells as stem cell therapies in the context of pulmonary hypertension, COPD, and asthma. PMID:21729891

  8. Toxicological aspects and applications of nanoparticles in paediatric respiratory disease

    Energy Technology Data Exchange (ETDEWEB)

    J. Dobson [Keele University, Stoke-on-Trent (United Kingdom)

    2007-03-15

    Most research in the area of micro- and nano-particles as applied to respiratory disease has been on potential toxic effects. Particulate emissions from industrial processes, coal burning and diesel exhaust have been shown to cause a variety of adverse effects both in vitro and in vivo. However, the vast majority of these studies has focused on larger, micron-sized particles. It is only within the last few years that the emphasis has shifted to nanoparticles as nanotechnology research and its applications have increased. Investigations have also begun into how nanoparticles may be used for therapeutic and imaging purposes in pulmonary diseases such as tuberculosis and cystic fibrosis. Some of these applications, along with recent studies on the toxic effects of nanoparticulate emissions will be reviewed in this article.

  9. The prevalence of osteoporosis in patients with chronic obstructive pulmonary disease: a cross sectional study

    DEFF Research Database (Denmark)

    Jørgensen, N R; Schwarz, Peter; Holme, I;

    2007-01-01

    Chronic obstructive pulmonary disease (COPD) is a complex disease, where the initial symptoms are often cough as a result of excessive mucus production and dyspnea. With disease progression several other symptoms may develop, and patients with moderate to severe COPD have often multiorganic disease...... with severely impaired respiratory dysfunction, decreased physical activity, right ventricular failure of the heart, and a decreased quality of life. In addition osteoporosis might develop possibly due to a number of factors related to the disease. We wanted to investigate the prevalence of osteoporosis...

  10. Clinical research of noninvasive mechanical ventilation in patients with conscious disturbance due to acute exacerbation of chronic obstructive pulmonary disease complicated with respiratory failure%无创机械通气治疗伴意识障碍AECOPD呼吸衰竭患者的临床研究

    Institute of Scientific and Technical Information of China (English)

    徐丽娜; 孙开宇; 曹洁; 陈宝元

    2013-01-01

    目的 探讨无创机械通气救治伴有意识障碍慢性阻塞性肺疾病急性加重期(AECOPD)呼吸衰竭患者成功的相关因素.方法 AECOPD伴有意识障碍的重症呼吸衰竭患者54例,接受BiPAP呼吸机治疗.按照治疗效果分为成功组和失败组,比较两组患者各项指标及变化,进行Logistic回归分析,寻找无创通气成功的相关因素.结果 NIPPV失败组患者稳定期FEV1%pred较高,PaCO2值较低,治疗后GCS评分较低,pH值较低,PaCO2较高,均较NIPPV成功组明显.Logistic回归分析提示,治疗后GCS评分NIPPV后期失败有显著影响.结论 治疗后GCS评分是NIPPV治疗伴有意识障碍AECOPD呼吸衰竭患者成功的相关因素.%Objective To investigate the factors related to the success of noninvasive ventilation in the treatment of conscious disturbance due to acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with respiratory failure.Methods Fifty-four patients with conscious disturbance due to AECOPD complicated with respiratory failure were selected in the study,that treated by BiPAP ventilation.They were divided into effective group and failure group according to the curative effect,clinical and physiological parameters were analyzed comparatively between two groups,multi-variable logistic regression analysis was used to find the predictive factors of the success in noninvasive ventilation.Results In stable phase,FEV1 % predicted was higher,PaCO2 values was lower significantly in patients in NIPPV failure group who also had a lower GCS compared with NIPPV success group.Multi-variable logistic analysis suggests statistical significance in GCS after 2 h ventilation.Conclusions The failure of NIPPV in patients with conscious disturbance due to AECOPD complicated with respiratory failure was influenced by GCS after 2 h ventilation.

  11. Respiratory Disease Related Mortality and Morbidity on an Island of Greece Exposed to Perlite and Bentonite Mining Dust

    Directory of Open Access Journals (Sweden)

    Melina Stoltidis

    2013-10-01

    Full Text Available A morbidity and mortality study took place, focused on Milos Island, where perlite and bentonite mining sites are located. Official data concerning number and cause of deaths, regarding specific respiratory diseases and the total of respiratory diseases, for both Milos Island and the Cyclades Prefecture were used. Standardized Mortality Ratios (SMRs were computed, adjusted specifically for age, gender and calendar year. Tests of linear trend were performed. By means of a predefined questionnaire, the morbidity rates of specific respiratory diseases in Milos, were compared to those of the municipality of Oinofita, an industrial region. Chi-square analysis was used and the confounding factors of age, gender and smoking were taken into account, by estimating binary logistic regression models. The SMRs for Pneumonia and Chronic Obstructive Pulmonary Disease (COPD were found elevated for both genders, although they did not reach statistical significance. For the total of respiratory diseases, a statistically significant SMR was identified regarding the decade 1989–1998. The morbidity study revealed elevated and statistically significant Odds Ratios (ORs, associated with allergic rhinitis, pneumonia, COPD and bronchiectasis. An elevated OR was also identified for asthma. After controlling for age, gender and smoking, the ORs were statistically significant and towards the same direction.

  12. Respiratory disease related mortality and morbidity on an island of Greece exposed to perlite and bentonite mining dust.

    Science.gov (United States)

    Sampatakakis, Stefanos; Linos, Athena; Papadimitriou, Eleni; Petralias, Athanasios; Dalma, Archontoula; Papasaranti, Eirini Saranti; Christoforidou, Eleni; Stoltidis, Melina

    2013-10-14

    A morbidity and mortality study took place, focused on Milos Island, where perlite and bentonite mining sites are located. Official data concerning number and cause of deaths, regarding specific respiratory diseases and the total of respiratory diseases, for both Milos Island and the Cyclades Prefecture were used. Standardized Mortality Ratios (SMRs) were computed, adjusted specifically for age, gender and calendar year. Tests of linear trend were performed. By means of a predefined questionnaire, the morbidity rates of specific respiratory diseases in Milos, were compared to those of the municipality of Oinofita, an industrial region. Chi-square analysis was used and the confounding factors of age, gender and smoking were taken into account, by estimating binary logistic regression models. The SMRs for Pneumonia and Chronic Obstructive Pulmonary Disease (COPD) were found elevated for both genders, although they did not reach statistical significance. For the total of respiratory diseases, a statistically significant SMR was identified regarding the decade 1989-1998. The morbidity study revealed elevated and statistically significant Odds Ratios (ORs), associated with allergic rhinitis, pneumonia, COPD and bronchiectasis. An elevated OR was also identified for asthma. After controlling for age, gender and smoking, the ORs were statistically significant and towards the same direction.

  13. Chronic Liver Disease and American Indians/Alaska Natives

    Science.gov (United States)

    ... Native > Chronic Liver Disease Chronic Liver Disease and American Indians/Alaska Natives Among American Indians and Alaska Natives, ... 54. 1 At a glance – Cancer Rates for American Indian/Alaska Natives (2008-2012) Cancer Incidence Rates per ...

  14. Chronic obstructive pulmonary disease exacerbation frequency and severity

    Directory of Open Access Journals (Sweden)

    Stafyla E

    2013-11-01

    Full Text Available Eirini Stafyla, Theodora Kerenidi, Konstantinos I Gourgoulianis Respiratory Medicine Department, University of Thessaly Medical School, University Hospital of Larissa, Larissa, GreeceWe read with great interest the original work by Motegi et al1 comparing three multidimensional assessment systems – BODE (body mass index, obstruction, dyspnea, and exercise capacity index, DOSE (dyspnea, obstruction, smoking, exacerbations index and ADO (age, dyspnea, obstruction index – for predicting COPD (chronic obstructive pulmonary disease exacerbations. In this study, exacerbation rates for the first and second year were 0.57 and 0.48 per patient-year respectively, while previous exacerbations, DOSE index, FEV1% (% forced expiratory volume in 1 second predicted and long-term oxygen therapy (LTOT use were shown to be predictors of COPD exacerbations. However, this study seems to have quite different results from our own study that focused on exacerbation frequency and severity.View original paper by Motegi and colleagues.

  15. Invasive pneumococcal and meningococcal disease : association with influenza virus and respiratory syncytial virus activity?

    NARCIS (Netherlands)

    Jansen, A G S C; Sanders, E A M; VAN DER Ende, A; VAN Loon, A M; Hoes, A W; Hak, E

    2008-01-01

    Few studies have examined the relationship between viral activity and bacterial invasive disease, considering both influenza virus and respiratory syncytial virus (RSV). This study aimed to assess the potential relationship between invasive pneumococcal disease (IPD), meningococcal disease (MD), and

  16. Daily activities are sufficient to induce dynamic pulmonary hyperinflation and dyspnea in chronic obstructive pulmonary disease patients

    OpenAIRE

    Antonio A.M. Castro; Claudia Kümpel; Rosana Chaves Rangueri; Maurício Dalcin Oliveira; Rodrigo Alves Dornelles; Emerson Roberto Brito; Tânia Maria Seki; Porto, Elias F

    2012-01-01

    OBJECTIVE: The aim of this study was to measure dynamic lung hyperinflation and its influence on dyspnea perception in moderate and severe chronic obstructive pulmonary disease patients after performing activities of daily living. METHODS: We measured inspiratory capacity, sensation of dyspnea, peripheral oxygen saturation, heart rate and respiratory rate in 19 chronic obstructive pulmonary disease patients. These measurements were taken at rest and after performing activities of daily living...

  17. Azithromycin does not improve disease course in hospitalized infants with respiratory syncytial virus (RSV) lower respiratory tract disease : A randomized equivalence trial

    NARCIS (Netherlands)

    Kneyber, Martin C. J.; van Woensel, Job B. M.; Uijtendaal, Esther; Uiterwaal, Cuno S. P. M.; Kimpen, Jan L. L.

    2008-01-01

    Background: Nearly halt of all hospitalized infants with respiratory syncytial virus (RSV) lower respiratory tract disease (LRTD) are treated with (parenteral) antibiotics. The present study was designed to test our hypothesis that the use of antibiotics would not lead to a reduced duration of hospi

  18. Sleep disorders and chronic kidney disease.

    Science.gov (United States)

    Maung, Stephanie C; El Sara, Ammar; Chapman, Cherylle; Cohen, Danielle; Cukor, Daniel

    2016-05-01

    Sleep disorders have a profound and well-documented impact on overall health and quality of life in the general population. In patients with chronic disease, sleep disorders are more prevalent, with an additional morbidity and mortality burden. The complex and dynamic relationship between sleep disorders and chronic kidney disease (CKD) remain relatively little investigated. This article presents an overview of sleep disorders in patients with CKD, with emphasis on relevant pathophysiologic underpinnings and clinical presentations. Evidence-based interventions will be discussed, in the context of individual sleep disorders, namely sleep apnea, insomnia, restless leg syndrome and excessive daytime sleepiness. Limitations of the current knowledge as well as future research directions will be highlighted, with a final discussion of different conceptual frameworks of the relationship between sleep disorders and CKD. PMID:27152260

  19. Lactate metabolism in chronic liver disease

    DEFF Research Database (Denmark)

    Jeppesen, Johanne B; Mortensen, Christian; Bendtsen, Flemming;

    2013-01-01

    Background. In the healthy liver there is a splanchnic net-uptake of lactate caused by gluconeogenesis. It has previously been shown that patients with acute liver failure in contrast have a splanchnic release of lactate caused by a combination of accelerated glycolysis in the splanchnic region...... and a reduction in hepatic gluconeogenesis. Aims. The aims of the present study were to investigate lactate metabolism and kinetics in patients with chronic liver disease compared with a control group with normal liver function. Methods. A total of 142 patients with chronic liver disease and 14 healthy controls...... underwent a liver vein catheterization. Blood samples from the femoral artery and the hepatic and renal veins were simultaneously collected before and after stimulation with galactose. Results. The fasting lactate levels, both in the hepatic vein and in the femoral artery, were higher in the patients than...

  20. Direct renin inhibition in chronic kidney disease

    DEFF Research Database (Denmark)

    Persson, Frederik; Rossing, Peter; Parving, Hans-Henrik

    2013-01-01

    that renin inhibition could hold potential for improved treatment in patients with chronic kidney disease, with diabetic nephropathy as an obvious group of patients to investigate, as the activity of the renin-angiotensin-aldosterone system is enhanced in these patients and as there is an unmet need....... In addition, combination treatment seemed safe and effective also in patients with impaired kidney function. These initial findings formed the basis for the design of a large morbidity and mortality trial investigating aliskiren as add-on to standard treatment. The study has just concluded, but was terminated...... early as a beneficial effect was unlikely and there was an increased frequency of side effects. Also in non-diabetic kidney disease a few intervention studies have been carried out, but there is no ongoing hard outcome study. In this review we provide the current evidence for renin inhibition in chronic...

  1. [Assessment of chronic glucose metabolism disorders coexisting with respiratory failure in non-critical ill patients hospitalized with lower respiratory tract infections].

    Science.gov (United States)

    Sobocińska, Magdalena Barbara; Loba, Jerzy

    2015-01-01

    Lungs are the target organ in chronic hyperglycemia, but its large reserves causes a subclinical course of these changes. Given the results of other researchers indicating reduced active surface of gas exchange and pulmonary capillary damage, it can be assumed that diabetes and other hyperglycemic states diminish these reserves and impair effectiveness of respiratory gas exchange during pneumonia. So it is plausible to observe coexistence of glucose metabolism disorders and respiratory failure in patients hospitalized with lower respiratory tract infection. An observational study was conducted on 130 patients hospitalized with bacteriologically confirmed pneumonia. 63 patients suffering from chronic glucose metabolism disorders (A) and 67 randomly selected patients in control group (B) were observed on laboratory and clinical findings. There was no significant difference in prevalence of acute respiratory failure, although in the study group a slightly greater number of patients diagnosed with acute respiratory failure was observed. There was a significantly greater number of patients with previously confirmed chronic respiratory failure using long-term oxygen theraphy in A group (p = 0.029). The B patients with average blood glucose level > 108 mg/dl had significantly lower partial pressure of oxygen (PaO2)(gIc ≤ 108: 58.6 +/- 9.8; glc > 108: 51.7 +/- 11.1; p = 0.042). There was a statistically significant negative correlation of the average blood glucose level and PaO2 in the control group (p = 0.0152) and a significant inverse association between the average blood glucose level and the partial pressure of oxygen in patients without COPD belonging to the control group (p = 0.049). Respiratory failure is frequent in patients hospitalized with pneumonia. In patients without chronic glucose metabolism disorders with blood glucose level rising the oxygen tension decreases The association is stronger in patients without COPD.

  2. 28 CFR 79.57 - Proof of chronic renal disease.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Proof of chronic renal disease. 79.57... EXPOSURE COMPENSATION ACT Eligibility Criteria for Claims by Uranium Millers § 79.57 Proof of chronic renal disease. (a) In determining whether a claimant developed chronic renal disease following...

  3. Netherlands : employment opportunities for people with chronic diseases

    NARCIS (Netherlands)

    Hooftman, W.; Houtman, I.L.D.

    2014-01-01

    There is no clear national definition of a chronic disease in a work situation in the Netherlands. Questionnaire data shows that between 25% and 30% of all workers are affected by a chronic disease. Worker with a chronic disease have slightly different working conditions as compared to workers witho

  4. Chronic Kidney Disease: What Does It Mean for Me?

    Science.gov (United States)

    ... our online catalog. Alternate Language URL Españ​ol Chronic Kidney Disease (CKD) Basics Page Content Chronic Kidney Disease: The ... and My Lifestyle CKD: Tracking My Test Results Chronic Kidney Disease: The Basics You've been told that you ...

  5. Socioeconomic Status and Chronic Obstructive Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Zafer Kartaloglu

    2013-02-01

    Full Text Available Socioeconomic status (SES measured by educational and income levels has long been known to be associated with mortality from some diseases. Many studies from developed countries suggested that SES is associated with lung function and COPD exacerbation, prevalence and mortality. Socioeconomic disadvantage is an independent risk factor for COPD. The impact of low SES on respiratory disease in general has been attributed to poorer housing, more hazardous occupational exposure, poorer diet, a higher prevalence of smoking and respiratory infections in childhood. It was found that there was a significant negative correlation between lung function and SES. Childhood SES may influence pulmonary function in adulthood. Pulmonary functions decline earlier and faster for individual with lower childhood SES. It was reported that hospital admission rates for COPD in low SES group were higher than in the high SES group. There was not adequate data about relationship between SES and COPD in our country. [TAF Prev Med Bull 2013; 12(1.000: 87-96

  6. Observation on therapeutic effect of BiPAP respirator in treatment of cases of acute exacerbation of chronic obstructive pulmonary disease with type Ⅱ respiratory failure.%BiPAP呼吸机治疗AECOPD合并II型呼吸衰竭的疗效观察

    Institute of Scientific and Technical Information of China (English)

    马继扬; 高健; 梁民勇

    2011-01-01

    Objective To explore the clinical efficacy of bilevel positive airway pressure ( BIPAP ) respirator assisted ventilation in treatment of cases of acute exacerbation of chronic obstructive pulmonary disease ( AECOPD ) with type Ⅱ respiratory failure.Methods A total of 62 patients of acute exacerbation of chronic obstructive pulmonary disease with type Ⅱ respiratory failure were randomly allocated into two groups: trial group ( 32 cases ) and control group ( 30 cases ).The routine treatment including anti - infectious medication, cleaning airway and continuous inhalation of low concentration oxygen, and pneumatic analeptics was only given to patients of control group, but both BIPAP assisted ventilation and routine treatment were given to patients of trial group.Patients in these two groups were monitored for arterial blood gas parameters and changes of basic vital signs.Results Findings of heart rate, respiration rate, blood pH, PaO2 and PaCO2 in patients of two groups before treatment were compared with those after treatment, these parameters were obviously improved, their difference was significant ( P < 0.05 ).There was significant difference ( P < 0.05 ) in these findings between patients in trial group after treatment in comparison with those of patients in control group after treatment.Conclusion BIPAP assisted ventilation is certainly an effective measure for treatment of patients with AECOPD with type Ⅱ respiratory failure.%目的 探讨双水平气道正压无创通气(BIPAP)呼吸机在慢性阻塞性肺疾病急性加重期(AECOPD)并发Ⅱ型呼吸衰竭的临床应用.方法 62例AECOPD并发Ⅱ型呼吸衰竭患者随机分为治疗组(32例)和对照组(30例),治疗组除常规治疗外加用BiPAP呼吸机辅助通气治疗,对照组则予抗感染、通畅气道、持续低流量吸氧及应用呼吸兴奋剂等治疗,监测两组治疗前后血气参数和生命体征变化.结果 两组与治疗前相比心率、呼吸频率、pH、氧

  7. Application of Bi-level Positive Airway Pressure Ventilation in Elderly Do-not-intubate Patients with Acute Exacerbation Chronic Obstructive Pulmonary Disease and Respiratory Failure%双水平正压通气在拒绝插管的老年慢性阻塞性肺病急性加重呼吸衰竭病人的应用

    Institute of Scientific and Technical Information of China (English)

    王长捷

    2012-01-01

    Objective To determine the effect of bi- level positive airway pressure ventilation (Bi- PAP) in elderly do- not- intubate patients with acute exacerbation chronic obstructive pulmonary disease (AECOPD) and respiratory failure. Methods 65 elderly patients who were admitted to intensive care unit from September 2006 to December 2010 with acute exacerbation chronic obstructive pulmonary disease (AECOPD) and respiratory failure were randomly divided into 2 groups standard group (re =32) and Bi-PAP group (re =33) . The changes of consciousness, physiological parameters, hospital mortality and adverse events in patients were compared between the two groups. Results The baseline characters of patients were similar in both the Bi- PAP and standard therapy groups. After 2 hour of treatment, GCS scores of patients in Bi-PAP group (P<0.01) and median (5th-95th percentile) PaO2/FIO2 ratios were significantly higher [182 (77-384) vs 165 (70-358), P<0.0l] , and PaCO2 was lower than standard group [55 (31~86) mmHg vs 82 (47 - 107) mmHg, P<0.0l]. Treatment with Bi-PAP successfully reduced the hospital mortality [11 (33%) vs 24 (75%), P< 0.01]. It looked similar with adverse events occurred both Bi-PAP and standard treatment. Conclusion For elderly do-not-intubate patients with AECOPD and respiratory failure, treatment with Bi- PAP not only can improve the patient's physiological parameters, but also improve the patient's outcomes.%目的 观察双水平正压通气(Bi-PAP)在拒绝插管(Do-not-intubate)的老年慢件阻塞性肺病急性加重(AECOPD)呼吸衰竭病人的疗效.方法 2006年9月至2010年12月65名入住重症监护病房的老年慢性阻塞性肺病急性加重呼吸衰竭病人纳入研究.将病人随机分为普通治疗组(n=32)和Bi-PAP(n=33)组.比较2组病人研究期间的意识变化、生理学参数的变化、院内死亡率及不良事件发生率.结果 老年慢性阻塞性肺病急性加重呼吸衰竭无创通气组与普通治疗

  8. 无创正压通气治疗慢性阻塞性肺疾病合并呼吸衰竭的临床疗效%Effect of noninvasive positive pressure ventilation in the treatment of chronic obstructive pulmonary disease with respiratory failure

    Institute of Scientific and Technical Information of China (English)

    傅万颖; 陈菱菱

    2014-01-01

    目的:探讨无创正压通气治疗慢性阻塞性肺疾病合并呼吸衰竭的临床效果。方法将我院2010~2013年112例慢性阻塞性肺疾病合并呼吸衰竭患者随机分为对照组和实验组,每组各56例,其中对照组采用常规治疗,而实验组采用无创正压通气治疗。比较两组患者的住院时间、插管率、病死率以及治疗前后血气分析的指标(氧分压、二氧化碳分压、pH)。结果对照组住院时间、插管率和病死率均明显高于实验组,差异有统计学意义(P<0.05)。两组患者在治疗前氧分压、二氧化碳分压、pH间比较差异无统计学意义(P>0.05),但治疗后对照组氧分压低于实验组,二氧化碳分压高于实验组,差异有统计学意义(P<0.05)。对照组中插管率为15.00%,而实验组插管率为3.57%,差异有统计学意义(P<0.05)。结论无创正压通气治疗慢性阻塞性肺疾病合并呼吸衰竭效果较好,改善预后,降低并发症发生率,值得临床推广。%Objective To explore the effect of noninvasive positive pressure ventilation on chronic obstructive pulmonary disease complicated with respiratory failure. Methods A total of 112 chronic obstructive pulmonary disease patients with complication of respiratory failure admitted from 2010 to 2013 were selected, and randomly divided into control group and experimental group by half in which the control group using conventional treatment, while the experimental group using noninvasive positive pressure ventilation treatment. Then comparing hospitalization, intubation rate, mortality and indicators of blood gas analysis before and after treatment (for example partial pressure of oxygen, carbon dioxide partial pressure, pH). Results Hospitalization, intubation and mortality rates were compared between two groups, the indicators for control group were significantly higher than the experimental group, the difference was

  9. AECOPD呼吸衰竭患者无创正压通气治疗效果的相关因素分析%Analysis on relevant factors of the result of noninvasive positive pressure ventilation in patients with acute exacerbations of chronic obstructive pulmonary disease and respiratory failure

    Institute of Scientific and Technical Information of China (English)

    徐丽娜; 曹洁; 陈宝元

    2010-01-01

    Objective To investigate the factors related to the failure of noninvasive positive pressure ventilation(NIPPV) in the treatment of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and typeⅡ respiratory failure. Methods One hundred and seventy six AECOPD patients with hypercapnia respiratory failure treated by BiPAP ventilation were enrolled and were divided into effective group and failure group according to the curative effect ,clinical and physiological parameters were analyzed comparatively between two groups, multi-variable logistic regression analysis was used to find the predictive factors of the failure in noninvasive ventilation. Results In stable phase, FEV1%predicted was higher,PaCO2 values was lower significantly in patients in NIPPV failure group who also had a lower GCS, lower albumin and BMI, higher APACHE Ⅱ on admission compared with NIPPV success group. Multi-variable logistic analysis suggests statistical significance in GCS and APACHE Ⅱ on admission. Conclusions The failure of NIPPV in patients with AECOPD and type Ⅱ respiratory faliure was influenced by GCS and APACHEⅡ on admission.%目的 探讨应用无创正压通气(noninvasive positive pressure ventilation,NIPPV)救治慢性阻塞性肺疾病急性加重(acute exacerbations of chronic obstructive pulmonary disease,AECOPD)并Ⅱ型呼吸衰竭失败的相关因素.方法 选取176例AECOPD并Ⅱ型呼吸衰竭的患者接受无创双水平气道内正压呼吸机治疗.按照治疗效果分为成功组和失败组,比较两组患者各项指标及变化,进行Logistic回归分析,寻找无创通气失败的相关因素.结果 NIPPV失败组患者稳定期FEV1%预计值较高,PaCO2值较低,治疗之前GCS评分较低,白蛋白及体质量指数较低,急性生理学和慢性健康状况评分Ⅱ(APACHEⅡ)较高,与NIPPV成功组比较差异有显著性意义.Logistic回归分析提示,治疗前格拉斯哥昏迷评分(GCS)及APACHE Ⅱ评分对NIPPV后期

  10. Cytokines and chemokines in respiratory secretion and severity of disease in infants with respiratory syncytial virus (RSV) infection

    DEFF Research Database (Denmark)

    Hornsleth, Allan; Loland, Lotte; Larsen, Lars B.

    2001-01-01

    Background: little is known about inflammatory mediators (IM); like cytokines, chemokines and receptors; in respiratory secretion as possible indicators of the severity of respiratory syncytial virus (RSV) disease. Nor have systematic studies been published on the ratios between IM...... as such indicators. Objective: to define the role of IM ratios as possible indicators of the severity of RSV disease. Study design: about 46 infants aged 0-9 months with acute RSV infections were studied. Prematurity (PM) and/or underlying disease (UD) were present in 11 of them. The concentrations of seven...... from 0 to 3 according to the severity of disease. Results: when 25 patients with severe disease (CS 2-3) and 21 patients with mild disease (CS 0-1) were compared with respect to different IM ratios, three ratios were related to severity of disease: IL-1/RANTES, IL-8/RANTES and TNF-R1/RANTES. When 12...

  11. Clinical Scenarios in Chronic Kidney Disease: Cystic Renal Diseases.

    Science.gov (United States)

    Meola, Mario; Samoni, Sara; Petrucci, Ilaria

    2016-01-01

    Cysts are frequently found in chronic kidney disease (CKD) and they have a different prognostic significance depending on the clinical context. Simple solitary parenchymal cysts and peripelvic cysts are very common and they have no clinical significance. At US, simple cyst appears as a round anechoic pouch with regular and thin profiles. On the other hand, hereditary polycystic disease is a frequent cause of CKD in children and adults. Autosomal dominant polycystic kidney disease (ADPKD) and autosomal recessive polycystic kidney disease (ARPKD) are the best known cystic hereditary diseases. ADPKD and ARPKD show a diffused cystic degeneration with cysts of different diameters derived from tubular epithelium. Medullary cystic disease may be associated with tubular defects, acidosis and lithiasis and can lead to CKD. Acquired cystic kidney disease, finally, is secondary to progressive structural end-stage kidney remodelling and may be associated with renal cell carcinoma. PMID:27169740

  12. Skeletal muscle dysfunction in patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Ho Cheol Kim

    2009-01-01

    Full Text Available Ho Cheol Kim1, Mahroo Mofarrahi2, Sabah NA Hussain21Department of Internal Medicine, College of Medicine, Gyeongsang National University, Gyeongsang University Hospital, Jinju, Korea; 2Critical Care and Respiratory Divisions, Royal Victoria Hospital, McGill University Health Centre, Montreal, Quebec, CanadaAbstract: Chronic obstructive pulmonary disease (COPD is a debilitating disease characterized by inflammation-induced airflow limitation and parenchymal destruction. In addition to pulmonary manifestations, patients with COPD develop systemic problems, including skeletal muscle and other organ-specific dysfunctions, nutritional abnormalities, weight loss, and adverse psychological responses. Patients with COPD often complain of dyspnea on exertion, reduced exercise capacity, and develop a progressive decline in lung function with increasing age. These symptoms have been attributed to increases in the work of breathing and in impairments in gas exchange that result from airflow limitation and dynamic hyperinflation. However, there is mounting evidence to suggest that skeletal muscle dysfunction, independent of lung function, contributes significantly to reduced exercise capacity and poor quality of life in these patients. Limb and ventilatory skeletal muscle dysfunction in COPD patients has been attributed to a myriad of factors, including the presence of low grade systemic inflammatory processes, nutritional depletion, corticosteroid medications, chronic inactivity, age, hypoxemia, smoking, oxidative and nitrosative stresses, protein degradation and changes in vascular density. This review briefly summarizes the contribution of these factors to overall skeletal muscle dysfunction in patients with COPD, with particular attention paid to the latest advances in the field.Keywords: skeletal muscles, chronic obstructive pulmonary disease, diaphragm, quadriceps, fatigue, disuse, atrophy, smoking, exercise

  13. Chronic Diseases among Older Cancer Survivors

    Directory of Open Access Journals (Sweden)

    Laura Deckx

    2012-01-01

    Full Text Available Objective. To compare the occurrence of pre-existing and subsequent comorbidity among older cancer patients (≥60 years with older non-cancer patients. Material and Methods. Each cancer patient (n=3835, mean age 72 was matched with four non-cancer patients in terms of age, sex, and practice. The occurrence of chronic diseases was assessed cross-sectionally (lifetime prevalence at time of diagnosis and longitudinally (incidence after diagnosis for all cancer patients and for breast, prostate, and colorectal cancer patients separately. Cancer and non-cancer patients were compared using logistic and Cox regression analysis. Results. The occurrence of the most common pre-existing and incident chronic diseases was largely similar in cancer and non-cancer patients, except for pre-existing COPD (OR 1.21, 95% CI 1.06–1.37 and subsequent venous thrombosis in the first two years after cancer diagnosis (HR 4.20, 95% CI 2.74–6.44, which were significantly more frequent (P<0.01 among older cancer compared to non-cancer patients. Conclusion. The frequency of multimorbidity in older cancer patients is high. However, apart from COPD and venous thrombosis, the incidence of chronic diseases in older cancer patients is similar compared to non-cancer patients of the same age, sex, and practice.

  14. Chronic obstructive pulmonary disease and genetics

    DEFF Research Database (Denmark)

    Ingebrigtsen, T.; Thomsen, S.F.; Vestbo, J.;

    2008-01-01

    Chronic obstructive pulmonary disease (COPD) is characterised by airflow limitation and is associated with an inflammatory response of the lungs primarily caused by cigarette smoking. Cigarette smoking is by far the most important environmental risk factor for COPD, but less than half of all heavy...... smokers develop COPD. This indicates a genetic contribution to the individual disease susceptibility. Although many genes have been examined, the puzzle of COPD genetics seems still largely unsolved. It is therefore important to measure phenotypes and to perform genome-wide scans of COPD patients in order...

  15. Ivabradine, heart failure and chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Luca Di Lullo

    2015-12-01

    Full Text Available The incidence and prevalence of congestive heart failure are actually increasing worldwide, especially in Western countries. In Europe and the United States, congestive heart failure represents a disabling clinical disease, accountable for increased hospitalization and health care costs. European guidelines have underlined the importance of pharmacological treatment to improve both patients’ outcomes and quality of life. The latest clinical trials to evaluate ivabradine’s efficacy have underlined its usefulness as a stand-alone medication and in combination with conventional congestive heart failure therapy, including in chronic kidney disease patients.

  16. Biomarkers in chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Sin, Don D; Vestbo, Jørgen

    2009-01-01

    Currently, with exception of lung function tests, there are no well validated biomarkers or surrogate endpoints that can be used to establish efficacy of novel drugs for chronic obstructive pulmonary disease (COPD). However, the lung function test is not an ideal surrogate for short-term drug...... trials because it (1) does not provide information regarding disease activity or the underlying pathologic process, (2) cannot separate the various phenotypes of COPD, (3) is not specific for COPD, and (4) is relatively unresponsive to known therapies that prolong survival. Accordingly, there are large...

  17. A Valuable Option for the Treatment of Respiratory Diseases: Review on the Clinical Evidence of the Ivy Leaves Dry Extract EA 575®.

    Science.gov (United States)

    Lang, Christopher; Röttger-Lüer, Patricia; Staiger, Christiane

    2015-08-01

    Preparations from ivy leaves (Hederae helicis folium, Hedera helix) dry extracts are well established in the treatment of different respiratory diseases. Until today, the efficacy and safety of ivy leaf preparations has been demonstrated in a variety of controlled clinical studies and non-interventional studies. These results were nearly exclusively obtained using the commercial ivy leaves dry extract EA 575®. This paper will provide information on the clinical data obtained with this special extract, showing the importance of those preparations as a valuable therapeutic option for the treatment of acute and chronic respiratory diseases. Overall, 18 publications covering clinical trials and non-interventional studies of, in total, 65 383 patients suffering from acute as well as chronic respiratory diseases were included. PMID:25875509

  18. Increased respiratory disease mortality at a microwave popcorn production facility with worker risk of bronchiolitis obliterans.

    Directory of Open Access Journals (Sweden)

    Cara N Halldin

    Full Text Available BACKGROUND: Bronchiolitis obliterans, an irreversible lung disease, was first associated with inhalation of butter flavorings (diacetyl in workers at a microwave popcorn company. Excess rates of lung-function abnormalities were related to cumulative diacetyl exposure. Because information on potential excess mortality would support development of permissible exposure limits for diacetyl, we investigated respiratory-associated mortality during 2000-2011 among current and former workers at this company who had exposure to flavorings and participated in cross-sectional surveys conducted between 2000-2003. METHODS: We ascertained workers' vital status through a Social Security Administration search. Causes of death were abstracted from death certificates. Because bronchiolitis obliterans is not coded in the International Classification of Disease 10(th revision (ICD-10, we identified respiratory mortality decedents with ICD-10 codes J40-J44 which encompass bronchitis (J40, simple and mucopurulent chronic bronchitis (J41, unspecified chronic bronchitis (J42, emphysema (J43, and other chronic obstructive pulmonary disease (COPD (J44. We calculated expected number of deaths and standardized mortality ratios (SMRs with 95% confidence intervals (CI to determine if workers exposed to diacetyl experienced greater respiratory mortality than expected. RESULTS: We identified 15 deaths among 511 workers. Based on U.S. population estimates, 17.39 deaths were expected among these workers (SMR = 0.86; CI:0.48-1.42. Causes of death were available for 14 decedents. Four deaths among production and flavor mixing workers were documented to have a multiple cause of 'other COPD' (J44, while 0.98 'other COPD'-associated deaths were expected (SMR = 4.10; CI:1.12-10.49. Three of the 4 'other COPD'-associated deaths occurred among former workers and workers employed before the company implemented interventions reducing diacetyl exposure in 2001. CONCLUSION: Workers

  19. THE COMPARISON OF INFLUENZA VACCINE EFFICACY ON RESPIRATORY DISEASE AMONG IRANIAN PILGRIMS IN THE 2003 AND 2004 SEASONS

    Directory of Open Access Journals (Sweden)

    M. Razavi

    2005-07-01

    Full Text Available Prolonged cough occurs in a large proportion of the 2 million pilgrims who participate in the annual Hajj in Saudi Arabia. There is no unique cause for pilgrims’ respiratory involvement, but several studies suggest a high incidence of influenza as a cause of the disease. To determine influenza vaccine efficacy against respiratory disease in pilgrims, we conducted two similar cohort studies on 51100 Iranian pilgrims who had participated in the annual Hajj in the years 2003 and 2004. We calculated vaccine efficacy in these two years with the use of “1- odd’s ratio” formula and compared the results. The vaccine efficacy for prevention of influenza like illness in the year 2003 was 51% but the vaccine was not efficient in the year 2004. It was concluded that etiologic agents other than influenza virus should be considered as the cause of respiratory disease in Hajj. Bacterial infections superimposed on chronic respiratory diseases, and allergic or toxic conditions are suggested caourses for more investigation.

  20. Chronic liver disease in Aboriginal North Americans

    Institute of Scientific and Technical Information of China (English)

    John D Scott; Naomi Garland

    2008-01-01

    A structured literature review was performed to detail the frequency and etiology of chronic liver disease (CLD) in Aboriginal North Americans. CLD affects Aboriginal North Americans disproportionately and is now one of the most common causes of death.Alcoholic liver disease is the leading etiology of CLD,but viral hepatitis, particularly hepatitis C, is an important and growing cause of CLD. High rates of autoimmune hepatitis and primary biliary cirrhosis (PBC) are reported in regions of coastal British Columbia and southeastern Alaska. Non-alcoholic liver disease is a common, but understudied, cause of CLD.Future research should monitor the incidence and etiology of CLD and should be geographically inclusive.In addition, more research is needed on the treatment of hepatitis C virus (HCV) infection and non-alcoholicfatty liver disease (NAFLD) in this population.

  1. The upper respiratory tract microbiome and its potential role in bovine respiratory disease and otitis media

    Science.gov (United States)

    Lima, Svetlana F.; Teixeira, Andre Gustavo V.; Higgins, Catherine H.; Lima, Fabio S.; Bicalho, Rodrigo C.

    2016-01-01

    The upper respiratory tract (URT) hosts a complex microbial community of commensal microorganisms and potential pathogens. Analyzing the composition and nature of the healthy URT microbiota and how it changes over time will contribute to a better understanding of the pathogenesis of pneumonia and otitis. A longitudinal study was conducted including 174 Holstein calves that were divided in four groups: healthy calves, calves diagnosed with pneumonia, otitis or both diseases. Deep pharyngeal swabs were collected on days 3, 14, 28, and 35 of life, and next-generation sequencing of the 16S rRNA gene as well as quantitative PCR was performed. The URT of Holstein dairy calves aged 3 to 35 days revealed to host a highly diverse bacterial community. The relative abundances of the bacterial genera Mannheimia, Moraxella, and Mycoplasma were significantly higher in diseased versus healthy animals, and the total bacterial load of newborn calves at day 3 was higher for animals that developed pneumonia than for healthy animals. Our results corroborate the existing knowledge that species of Mannheimia and Mycoplasma are important pathogens in pneumonia and otitis. Furthermore, they suggest that species of Moraxella can potentially cause the same disorders (pneumonia and otitis), and that high neonatal bacterial load is a key contributor to the development of pneumonia. PMID:27363739

  2. A Clinical Analysis of Non-Invasive Positive Pressure Ventilation in Treating Chronic Obstructive Pulmonary Diseases with Respiratory Failure%无创正压通气治疗COPD伴呼吸衰竭疗效的临床分析

    Institute of Scientific and Technical Information of China (English)

    杨建民; 贺明

    2006-01-01

    近几年,慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)病例逐年增多,且多为老年性伴呼吸衰竭的患者,经鼻或口鼻无创正压通气(non-invasive positive pressure ventilation,NIPPV)治疗慢性阻塞性肺气肿伴呼吸衰竭具有良好效果。现将近4年来我科收治的COPD合并呼吸衰竭患者行NIPPV治疗26例分析如下。

  3. Relationship Between Helicobacter Pylori Infection and Chronic Obstructive Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Mohammad-Ali Seif-Rabiei

    2011-11-01

    Full Text Available There is some evidence indicating the role of Helicobacter pylori infection in pathogenesis of extragastrointestinal diseases including skin, vascular, and autoimmune disorders, as well as some respiratory diseases. The aim of this study was to investigate the association between H. pylori and chronic obstructive pulmonary disease (COPD. In a case-control study, 90 patients with COPD and 90 age- and sex- matched control subjects were included. Serum samples were tested for anti-H. pylori and anti-CagA IgG by ELISA. A physician completed a questionnaire including demographic characteristics, habitual history, and spirometric findings for each patient. Of 90 patients with COPD 66 (51% had mild, 31 (34.4% moderate, and 13 (14.4% sever disease. There was no significant association between H. pylori IgG seropositivity and COPD. Serum levels of anti-CagA IgG were significantly higher in patients with COPD than in the control subjects (P < 0.001. No association was observed between H. pylori infection and severity of COPD. The results suggest that there is an association between CagA-positive H. pylori infections and COPD. Further studies should be planned to investigate the potential pathogenic mechanisms that might underlie these associations.

  4. Clinical approach to chronic beryllium disease and other nonpneumoconiotic interstitial lung diseases.

    Science.gov (United States)

    Maier, Lisa A

    2002-10-01

    Exposures in the workplace result in a diverse set of diseases ranging from the pneumoconiosis to other interstitial lung diseases to acute lung injury. Physician awareness of the potential disease manifestations associated with specific exposures is important in defining these diseases and in preventing additional disease. Most occupational diseases mimic other forms of lung disease, including pulmonary fibrosis, sarcoidosis, adult respiratory distress syndrome (ARDS), and bronchiolitis. A "sarcoidosis"-like syndrome, usually limited to the lungs, may result from exposure to bioaerosols and a number of metals. Exposure to beryllium in the workplace produces a granulomatous lung disease clinically indistinguishable from sarcoidosis, chronic beryllium disease (CBD). Beryllium's ability to produce a beryllium-specific immune response is used in the beryllium lymphocyte proliferation tests to confirm a diagnosis of CBD and exclude sarcoidosis. Exposure to other metals must also be considered in the differential diagnosis of sarcoidosis. When an individual presents acutely with ARDS or acute lung injury, an acute inhalational exposure must be considered. Exposure to a number of irritant substances at high levels may cause a "chemical pneumonitis" or acute lung injury, depending on the solubility and physicochemical properties of the substance. Some of the most notable agents include nitrogen and sulfur oxides, phosgene, and smoke breakdown products. Ingestion of paraquat may also result in an ARDS syndrome, with pulmonary fibrosis eventually resulting. Bronchiolitis is a rare manifestation of inhalational exposures but must also be considered in the clinical evaluation of inhalational exposure. PMID:12362066

  5. The usage of Strelnikova's breathing exercises a chronic disease of the sinus paranasalis

    Directory of Open Access Journals (Sweden)

    Dikiy B.V.

    2012-03-01

    Full Text Available It is analysed that using in treatment of the chronic diseases sinus paranasalis of the procedure of the washing to nose cavity on system Yoga brings about defogging from viscous, thick, rack slime, liquidations of the stagnant phenomena's in nose cavity. Using the respiratory athletics Strelinikovoy does simple not traumatic drainage of the sinus paranasalis that brings about natural defogging nose cavity to account of the evacuations secret of the sinus paranasalis. Thereby, using in physical rehabilitation and recovery of the procedure of the washing to nose cavity for system Yoga with respiratory athletics Strelinikovoy enables significantly improves the condition of children in a dispensary condition.

  6. Health status of grandchildren of subjects occupationally exposed to chronic radiation. Communication 3. Disease incidence

    International Nuclear Information System (INIS)

    The morbidity of 1557 grandchildren of subjects occupationally exposed to chronic radiation were analyzed. Three groups were singled out. Group 1 consisted of children whose grandfathers were exposed, group 2 of children grandmothers were exposed and group 3 of children whose both grandparent were exposed. Total morbidity level and morbidity structure for 13 classes of diseases and 60 nosological entities was assessed. The study showed that disease incidence in general, structure by disease and individual nosological entities, the share of frequently falling ill children, and health index in the test group corresponded to those in controls. Reliable differences were observed only for respiratory diseases, at the expense of acute respiratory diseases, which were frequent during the second-third years of life in children whose both grandparents were occupationally exposed to radiation

  7. [Evaluation of the treatment with levodropropizine of respiratory diseases in children].

    Science.gov (United States)

    Fiocchi, A; Zuccotti, G V; Vignati, B; Pogliani, L; Sala, M; Riva, E

    1989-01-01

    Sometimes, antitussives can be a valid adjuvant to respiratory tract infections treatment. Although not always needed, this therapeutic support can be extremely useful in selected cases, and when patient is resident and monitored. In this line, the efficacy of a new peripheral antitussive, levodropropizine (Dompé farmaceutici, Milan), has been evaluated in 70 children inpatients of the Pediatric Department at san Paolo Hospital - Milan University - from September 1987 to May 1988. Thirty one male and 29 female children, aged 4 years and 6 months +/- 3 years and 5 months, suffering from various respiratory tract diseases were included in the study. Underlying diseases were represented by 21 acute bronchitis, 20 asthmatic attacks, 18 bronchopneumonia, 11 tracheitis, 6 acute episodes of chronic bronchitis, 2 hypoglottis laryngitis, 1 pertussis, 1 spontaneous pneumothorax. All parents gave their oral informed consent. The basic treatments were antibiotics in 44 patients associated or not with beta 2 agonists (31), theophylline (15), corticosteroids via aerosol (9) or parenterally (3), immunomodulators (2). Treatment with levodropropizine in the oral drops formulation at 2 mg pro kg a day was continued for 5 days and withdrawn according to the clinical evolution. Cough was registered by means of appropriate record forms given to the parents as well as with 120' tape recording whenever possible, i.e. 60 minutes before and 60 minutes after drug administration, on day one and 2. At treatment end, parents and investigator gave an antitussive efficacy judgement. Tolerability was evaluated as per clinical evolution and laboratory parameters.

  8. [Evaluation of the treatment with levodropropizine of respiratory diseases in children].

    Science.gov (United States)

    Fiocchi, A; Zuccotti, G V; Vignati, B; Pogliani, L; Sala, M; Riva, E

    1989-01-01

    Sometimes, antitussives can be a valid adjuvant to respiratory tract infections treatment. Although not always needed, this therapeutic support can be extremely useful in selected cases, and when patient is resident and monitored. In this line, the efficacy of a new peripheral antitussive, levodropropizine (Dompé farmaceutici, Milan), has been evaluated in 70 children inpatients of the Pediatric Department at san Paolo Hospital - Milan University - from September 1987 to May 1988. Thirty one male and 29 female children, aged 4 years and 6 months +/- 3 years and 5 months, suffering from various respiratory tract diseases were included in the study. Underlying diseases were represented by 21 acute bronchitis, 20 asthmatic attacks, 18 bronchopneumonia, 11 tracheitis, 6 acute episodes of chronic bronchitis, 2 hypoglottis laryngitis, 1 pertussis, 1 spontaneous pneumothorax. All parents gave their oral informed consent. The basic treatments were antibiotics in 44 patients associated or not with beta 2 agonists (31), theophylline (15), corticosteroids via aerosol (9) or parenterally (3), immunomodulators (2). Treatment with levodropropizine in the oral drops formulation at 2 mg pro kg a day was continued for 5 days and withdrawn according to the clinical evolution. Cough was registered by means of appropriate record forms given to the parents as well as with 120' tape recording whenever possible, i.e. 60 minutes before and 60 minutes after drug administration, on day one and 2. At treatment end, parents and investigator gave an antitussive efficacy judgement. Tolerability was evaluated as per clinical evolution and laboratory parameters. PMID:2631057

  9. Emergency department visits and hospitalizations for respiratory disease on the island of Hawaii, 1981 to 1991.

    Science.gov (United States)

    Mannino, D M; Ruben, S; Holschuh, F C; Holschuh, T C; Wilson, M D; Holschuh, T

    1996-03-01

    This study examined trends in and patterns of emergency department visits and hospitalizations for respiratory disease on the island of Hawaii from 1981 to 1991. We found that emergency department visit rates and hospitalization rates for both asthma and COPD for 1987 to 1991 increased in all regions of the island in comparison with such rates for 1981 to 1986. Rates of emergency department visits and hospitalizations for chronic obstructive pulmonary disease or COPD, but not asthma, were significantly higher in the high-exposure Kona side of the island than in the intermittent-exposure Hilo side of the island during 1983 and 1988 to 1990. We also found that during the weeks that winds were from the west, blowing volcanic air pollution toward Hilo, emergency department visits for asthma increased 15%. Some of the results of our study support the hypothesis that volcanic air pollution affects respiratory health on the island of Hawaii, while other results do not. Any future studies should include measurements of air pollutant levels. PMID:8882554

  10. Vitamin D deficiency in chronic liver disease

    Institute of Scientific and Technical Information of China (English)

    Paula; Iruzubieta; lvaro; Terán; Javier; Crespo; Emilio; Fábrega

    2014-01-01

    Vitamin D is an important secosteroid hormone with known effect on calcium homeostasis,but recently there is increasing recognition that vitamin D also is involved in cell proliferation and differentiation,has immunomodulatory and anti-inflammatory properties.Vitamin D deficiency has been frequently reported in many causes of chronic liver disease and has been associated with the development and evolution of non-alcoholic fatty liver disease(NAFLD)and chronic hepatitis C(CHC)virus infection.The role of vitamin D in the pathogenesis of NAFLD and CHC is not completely known,but it seems that the involvement of vitamin D in the activation and regulation of both innate and adaptive immune systems and its antiproliferative effect may explain its importance in these liver diseases.Published studies provide evidence for routine screening for hypovitaminosis D in patients with liver disease.Further prospectives studies demonstrating the impact of vitamin D replacement in NAFLD and CHC are required.

  11. Role of cannabinoids in chronic liver diseases

    Institute of Scientific and Technical Information of China (English)

    Anna Parfieniuk; Robert Flisiak

    2008-01-01

    Cannabinoids are a group of compounds acting primarily via CB1 and CB2 receptors. The expression of cannabinoid receptors in normal liver is low or absent. However, many reports have proven up-regulation of the expression of CB1 and CB2 receptors in hepatic myofibroblasts and vascular endothelial cells, as well as increased concentration of endocannabinoids in liver in the course of chronic progressive liver diseases. It has been shown that CB1 receptor signalling exerts profibrogenic and proinflammatory effects in liver tissue, primarily due to the stimulation of hepatic stellate cells, whereas the activation of CB2 receptors inhibits or even reverses liver fibrogenesis. Similarly, CB1 receptor stimulation contributes to progression of liver steatosis. In end-stage liver disease, the endocannabi-noid system has been shown to contribute to hepatic encephalopathy and vascular effects, such as portal hypertension, splanchnic vasodilatation, relative pe-ripheral hypotension and probably cirrhotic cardiomy-opathy. So far, available evidence is based on cellular cultures or animal models. Clinical data on the effects of cannabinoids in chronic liver diseases are limited. However, recent studies have shown the contribution of cannabis smoking to the progression of liver fibrosis and steatosis. Moreover, controlling CB1 or CB2 signal-ling appears to be an attractive target in managing liver diseases.

  12. Association of Bovine Viral Diarrhea Virus with Multiple Viral Infections in Bovine Respiratory Disease Outbreaks

    OpenAIRE

    Richer, Lisette; Marois, Paul; Lamontagne, Lucie

    1988-01-01

    We investigated eleven outbreaks of naturally occurring bovine respiratory diseases in calves and adult animals in the St-Hyacinthe area of Quebec. Specific antibodies to bovine herpesvirus-1, bovine viral diarrhea virus, respiratory syncytial virus, parainfluenza type 3 virus, reovirus type 3, and serotypes 1 to 7 of bovine adenovirus were found in paired sera from diseased animals. Several bovine viruses with respiratory tropism were involved concomitantly in herds during an outbreak of bov...

  13. Curcumin, Inflammation, and Chronic Diseases: How Are They Linked?

    Directory of Open Access Journals (Sweden)

    Yan He

    2015-05-01

    Full Text Available It is extensively verified that continued oxidative stress and oxidative damage may lead to chronic inflammation, which in turn can mediate most chronic diseases including cancer, diabetes, cardiovascular, neurological, inflammatory bowel disease and pulmonary diseases. Curcumin, a yellow coloring agent extracted from turmeric, shows strong anti-oxidative and anti-inflammatory activities when used as a remedy for the prevention and treatment of chronic diseases. How oxidative stress activates inflammatory pathways leading to the progression of chronic diseases is the focus of this review. Thus, research to date suggests that chronic inflammation, oxidative stress, and most chronic diseases are closely linked, and the antioxidant properties of curcumin can play a key role in the prevention and treatment of chronic inflammation diseases.

  14. Tackling Africa's chronic disease burden: from the local to the global

    Directory of Open Access Journals (Sweden)

    Campbell Catherine

    2010-04-01

    Full Text Available Abstract Africa faces a double burden of infectious and chronic diseases. While infectious diseases still account for at least 69% of deaths on the continent, age specific mortality rates from chronic diseases as a whole are actually higher in sub Saharan Africa than in virtually all other regions of the world, in both men and women. Over the next ten years the continent is projected to experience the largest increase in death rates from cardiovascular disease, cancer, respiratory disease and diabetes. African health systems are weak and national investments in healthcare training and service delivery continue to prioritise infectious and parasitic diseases. There is a strong consensus that Africa faces significant challenges in chronic disease research, practice and policy. This editorial reviews eight original papers submitted to a Globalization and Health special issue themed: "Africa's chronic disease burden: local and global perspectives". The papers offer new empirical evidence and comprehensive reviews on diabetes in Tanzania, sickle cell disease in Nigeria, chronic mental illness in rural Ghana, HIV/AIDS care-giving among children in Kenya and chronic disease interventions in Ghana and Cameroon. Regional and international reviews are offered on cardiovascular risk in Africa, comorbidity between infectious and chronic diseases and cardiovascular disease, diabetes and established risk factors among populations of sub-Saharan African descent in Europe. We discuss insights from these papers within the contexts of medical, psychological, community and policy dimensions of chronic disease. There is an urgent need for primary and secondary interventions and for African health policymakers and governments to prioritise the development and implementation of chronic disease policies. Two gaps need critical attention. The first gap concerns the need for multidisciplinary models of research to properly inform the design of interventions. The second

  15. Tackling Africa's chronic disease burden: from the local to the global.

    Science.gov (United States)

    de-Graft Aikins, Ama; Unwin, Nigel; Agyemang, Charles; Allotey, Pascale; Campbell, Catherine; Arhinful, Daniel

    2010-01-01

    Africa faces a double burden of infectious and chronic diseases. While infectious diseases still account for at least 69% of deaths on the continent, age specific mortality rates from chronic diseases as a whole are actually higher in sub Saharan Africa than in virtually all other regions of the world, in both men and women. Over the next ten years the continent is projected to experience the largest increase in death rates from cardiovascular disease, cancer, respiratory disease and diabetes. African health systems are weak and national investments in healthcare training and service delivery continue to prioritise infectious and parasitic diseases. There is a strong consensus that Africa faces significant challenges in chronic disease research, practice and policy. This editorial reviews eight original papers submitted to a Globalization and Health special issue themed: "Africa's chronic disease burden: local and global perspectives". The papers offer new empirical evidence and comprehensive reviews on diabetes in Tanzania, sickle cell disease in Nigeria, chronic mental illness in rural Ghana, HIV/AIDS care-giving among children in Kenya and chronic disease interventions in Ghana and Cameroon. Regional and international reviews are offered on cardiovascular risk in Africa, comorbidity between infectious and chronic diseases and cardiovascular disease, diabetes and established risk factors among populations of sub-Saharan African descent in Europe. We discuss insights from these papers within the contexts of medical, psychological, community and policy dimensions of chronic disease. There is an urgent need for primary and secondary interventions and for African health policymakers and governments to prioritise the development and implementation of chronic disease policies. Two gaps need critical attention. The first gap concerns the need for multidisciplinary models of research to properly inform the design of interventions. The second gap concerns understanding

  16. CARDIOVASCULAR RISK FACTORS IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

    Directory of Open Access Journals (Sweden)

    Ye. D. Bazdyrev

    2014-11-01

    Full Text Available Objective: to detect previously undiagnosed arterial hypertension in patients with chronic obstructive pulmonary disease (COPD as a risk factor for cardiovascular mortality.Materials and methods. 43 patients with stage I–II of COPD and the absence of clinical signs of cardiovascular diseases were examined. Spirometry, body plethysmography and diffusing lung capacity (DLCO were included in the respiratory system assessment. The cardiovascular system was assessed with echocardiography and ambulatory blood pressure monitoring (ABPM.Results. Despite the absence of obvious signs of cardiovascular lesions (an increase of office blood pressure, intracardiac hemodynamic changes, the following cardiovascular risk factors were identified: age (58.2 ± 2.0 years, male gender, smoking, hypercholesterolemia and dyslipidemia (total cholesterol 5.9 ± 0.9 mmol / l, low density lipoproteins 3.8 ± 0.5 mmol / l, triglycerides 1.8 ± 0.2 mmol / l. Correlation analysis has revealed the relation between several respiratory parameters and the severity of dyspnea and quality of life in patients with COPD, as well as its relation with lipid levels.Conclusion. The patients with COPD have a large number of risk factors for CVD. According to ABPM data, arterial hypertension was verified in 18 (41.9 % of 43 patients with COPD at normal level of office blood pressure; moreover, 51.2 % of patients demonstrated low reduction of blood pressure during the night-time that nowadays, is considered to be a predictor of cardiovascular disease and sudden death.

  17. Can GOLD Stage 0 provide information of prognostic value in chronic obstructive pulmonary disease?

    DEFF Research Database (Denmark)

    Vestbo, Jørgen; Lange, Peter

    2002-01-01

    In the recently published guidelines of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) for chronic obstructive pulmonary disease (COPD), the staging system included a Stage 0 for subjects without airways obstruction but with respiratory symptoms, denoting these subjects "at risk......" for COPD. Our aim was to validate this staging approach using data from three surveys in The Copenhagen City Heart Study, in which a sample of the general population was examined at baseline and in which, after 5 and 15 years, spirometry was performed at all surveys. Criteria for GOLD Stage 0 was fulfilled...... by 5.8% of the total adult population and 7.2% of smokers. After 5 and 15 years, 13.2 and 20.5%, respectively, of smokers with GOLD Stage 0 had developed COPD fulfilling criteria for GOLD Stage 1 or worse. This was the case for 11.6 and 18.5%, respectively, of smokers without respiratory symptoms...

  18. Methylotroph Infections and Chronic Granulomatous Disease.

    Science.gov (United States)

    Falcone, E Liana; Petts, Jennifer R; Fasano, Mary Beth; Ford, Bradley; Nauseef, William M; Neves, João Farela; Simões, Maria João; Tierce, Millard L; de la Morena, M Teresa; Greenberg, David E; Zerbe, Christa S; Zelazny, Adrian M; Holland, Steven M

    2016-03-01

    Chronic granulomatous disease (CGD) is a primary immunodeficiency caused by a defect in production of phagocyte-derived reactive oxygen species, which leads to recurrent infections with a characteristic group of pathogens not previously known to include methylotrophs. Methylotrophs are versatile environmental bacteria that can use single-carbon organic compounds as their sole source of energy; they rarely cause disease in immunocompetent persons. We have identified 12 infections with methylotrophs (5 reported here, 7 previously reported) in patients with CGD. Methylotrophs identified were Granulibacter bethesdensis (9 cases), Acidomonas methanolica (2 cases), and Methylobacterium lusitanum (1 case). Two patients in Europe died; the other 10, from North and Central America, recovered after prolonged courses of antimicrobial drug therapy and, for some, surgery. Methylotrophs are emerging as disease-causing organisms in patients with CGD. For all patients, sequencing of the 16S rRNA gene was required for correct diagnosis. Geographic origin of the methylotroph strain may affect clinical management and prognosis.

  19. Chronic kidney disease: considerations for nutrition interventions.

    Science.gov (United States)

    Steiber, Alison L

    2014-05-01

    Chronic kidney disease (CKD) is highly prevalent and has major health consequences for patients. Caring for patients with CKD requires knowledge of the food supply, renal pathophysiology, and nutrition-related medications used to work synergistically with diet to control the signs and symptoms of the disease. The nutrition care process and International Dietetic and Nutrition Terminology allow for systematic, holistic, quality care of patients with this complex, progressive disease. Nutrition interventions must be designed with the individual patients needs in mind while prioritizing factors with the largest negative impact on health outcomes and mortality risk. New areas of nutrition treatment are emerging that involve a greater focus on micronutrient needs, the microbiome, and vegetarian-style diets. These interventions may improve outcomes by decreasing inflammation, improving energy and protein delivery, and lowering phosphorus, electrolytes, and fluid retention.

  20. Therapeutic Efficacy of Tanreqing Injection as Adjuvant Therapy in Treatment of Chronic Obstructive Pulmonary Disease with Respiratory Failure: A Report of 42 Cases%痰热清佐治慢性阻塞性肺疾病并发呼吸衰竭42例

    Institute of Scientific and Technical Information of China (English)

    曹英俊; 查贵智; 纪小平

    2012-01-01

    To observe the therapeutic efficacy of Tanreqing Injection as an adjuvant therapy in the treatment of chronic obstructive pulmonary disease (COPD) with respiratory failure .Methods Eighty-two COPD patients were randomly divided into treatment group (re=42) and control group (re?0). The control group received respirator therapy and conventional treatment , while the treatment group was given Tanreqing Injection by intravenous drip in addition to respirator therapy and conventional treatment . The two groups were compared for response rate , symptom score , blood gas parameters , and mechanical ventilation duration after treatment .Results Compared with the control group , the treatment group showed a significantly higher overall response rate (90 .47% vs 70 .00% , P<0 .01), as well as lower symptom score , shorter duration of mechanical ventilation , and better blood gas parameters (P<0 .01) . Conclusion Tanreqing Injection combined with conventional Western medicine treatment can improve such symptoms as cough , expectoration , and dyspnea, increase arterial partial pressure of oxygen and oxygenation index , and shorten the duration of mechanical ventilation in COPD patients .Q%目的 观察痰热清注射液辅助治疗慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)并发呼吸衰竭的疗效.方法 将82例COPD患者随机分为两组,治疗组42例,对照组40例,对照组仅予呼吸机及常规方案治疗,治疗组加用痰热清注射液静脉滴注,治疗后比较两组临床疗效、症状体征评分、血气分析指标及机械通气时间.结果 治疗组总有效率显著高于对照组(90.47% vs 70.00%,P<0.01);治疗组在降低症状体征评分、使用呼吸机时间及改善血气分析指标方面优于对照组(P<0.01).结论 痰热清联合西医常规治疗在改善COPD患者咳嗽、咳痰、喘息症状,提高动脉氧分压,提高氧合指数,缩短上机时间方面具有较好疗效.